Study Guide: Final Exam
170 Cards in this Set
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Pathogen
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Any disease-producing organism (opportunistic)
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Pathogenicity
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The ability to produce harmful pathologic changes or disease
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Virulence
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Quantitativ measure of pathogenicity
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Infection
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Growth of microbes inside the host tissues; the host may or may not be harmed
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Disease
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Damage or injury to the host in which host function is impaired
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Normal Flora
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Mixture of microbes normally found at any anatomical site in a human
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Human microbiome
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The sum total of all the microbial cells in and on us
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Gnotobiotic
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Known flora; gnotobiotic animals are raised in germ free environments; allow investigation of interactions with specific micro organisms introduced to animals
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Propionibacterium acnes
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Normal inhabitants but associated with the disease acnes vulagris; organism thrives in sebum produced by oil glands; growth of bacteria triggers inflammation
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Bacterial Interference
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competition antagonism; lactobacilli in female genital tract; coryne bacteria on the skin
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Resident Flora
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Flora consistently found on skin (normally found)
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Transient Flora
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Flora don't colonize/persist
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Immunocompromised
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A host with a weakened immune system
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Virulence factor
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A pathogen produced substanace that promotes the establishment and maintenance of disease; encoded by virulence genes
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Adherence Proteins
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Bind bacteria to specific host receptors (glycoproteins, polysaccharides)
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Hyaluronidase
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Type of virulence factor, aids invasion of the host, breaks down hyaluronic acid in connective tissue
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Collagenase
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Breaks down collagen in connective tissue
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Streptokinase
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destroys fibrin of blood clots
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Coagulase
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Works by causing blood to clot; prevents access by host immune cells
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Elastase
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Breaks down host cell membranes
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Leukocidins
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Active against white blood cells thus decreasing the hosts immunity; exotoxin that is cytotoxic to host cell
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Hemolysins
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Originally discovered because of lysis of red blood cells, but also work on other cell types; distinctive clear zones around colonies on blood agar plate
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Endogenous Pyrogens
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Endotoxins release these to regulate temperature
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Limulus ameobocyte assay (LAL)
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Amoebacytes from blood; extremely sensitive to endotoxins; measure lysis in clinical test
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Exotoxins
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Bacterially produced toxins that are usually small proteins that are released into the cell surroundings
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A-B Toxin
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COnsist of 2 subunits: B binds to host surface, A crosses into cell; type of exotoxin
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Enterotoxin
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Exotoxins that affect the small intestine
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LD 50
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Endotoxin in mouse= 200-400 (less toxic) botulinum toxin= .000025 (highly toxic)
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Prevalence
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Fraction or percent of a given population that has a disease
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Incidence
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Number of cases of a disease within a population
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Common source epidemic
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Transmitted from a single source
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Outbreak
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Sudden increase in cases of disease in population
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Endemic
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Present at fairly constant low levels
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Epidemic
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Disease incidence is far from above normal levels
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Pandemic
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Disease spread to continents (influenze)
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Mortality
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(Deaths due to disease)/(total population of individuals)
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Carrier
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Carry a disease (sub-clinical) carry pathogen and can give to others; individual with asymptomatic or subclinical infections (usually chronic) that can expose others to infectious diseases
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Reservoir
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Place or population where infectious disease is maintained between outbreaks; can be inanimate or living organism; ex: soil (botulism, tetanus, anthrax); humans; animals
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Zoonosis
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disease occurs primarily in animals but can be transmitted to humans
ex: leptospirosis, rabies, E. coli 0157:H7, influenza
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Vectors
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Type of indirect transmission; live agents
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Fomites
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Indirect transmission; inanimate, contaminated objects (toys, bedding)
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Vehicles
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Nonliving source of pathogens that infect many individuals (food or water)
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Nosocomial Infection
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Acquired in a health care setting
Major infection sites: urinary tract, surgical site, pneumonia, bacteremia
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DPT Vaccine
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Diptheria, pertussis, tetanus vaccine
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Sequelae
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A pathological conditions resulting from a disease
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Pneumonia
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An inflammatory condition of the lung, especially affecting the alveoli
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Bacteremia
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Presence of bacteria in blood
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Abscess
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Enclosed formation of puss
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Protein A
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Virulence produced by S. aureus; cell wall component that binds antibodies and interferes with immune response
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Otidis Media
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Inner ear, where Staphylocccus infections can occur
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Pyogenic
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Cause formation of puss
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Opportunistic pathogens
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Pneumonia: pnemocystis jiroveci (fungal; most common)
Candidiasis: candida albicans (fungal; systemic)
Toxoplasmosis: toxoplasma gondii (protozoan; brain)
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Accidental host
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one that harbors an organism which usually does not infect it
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Cirrhosis
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Scarring of the liver, final phase of chronic liver disease, cause from Hep B and Hep C
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Polymicrobial Disease
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infections of animals or humans that are induced by multiple bacteria, viruses, fungal or parasitic organisms
Can be induced by weakened immune system, initial infection causing secondary infection, pathogens can share properties that when working together favor infections more readily t…
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Negri Bodies
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Occur in brain from rabies in animals
Virus has bullet shape
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Aflatoxins
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Toxin produced by fungal mycoses; toxic and many are carcinogens
Produced by aspergillis flavus
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Zoonoses
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Disease primarily in animals but transmissible to humans
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GRAS
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Generally Recognized As Safe by FDA; talking about the chemical preservatives used in food preservation
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Enterotoxins
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Found in S. aureus (food poisoning); Salmonellis produce these; Cholera disease releases cholera enterotoxins
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Verotoxin
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Shiga toxin producing E. coli produces verotoxin
Results in intestinal hemorrhaging and kidney failure
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Psychrotolerant
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Microbes can grow at refrigerator temps
ex: listeria can grow at 1 degrees C
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3 Types of host-microbe interactions
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1) loose association
2)Adhesion
3)Invasion
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Lactoperoxidase
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Enzyme found in saliva that protects against microbial infections
Natural antibiotic enzyme
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Lysozyme
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Cleaves peptidoglycan and kills bacteria; protects against microbial infections in saliva
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Dental Caries
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Disease of oral cavity
Colonization of crevices by microorganisms followed by demineralization of tooth surface
Streptococcus sobrinus-affinity for salivary glycoproteins, significant role in tooth decay; biofilm formation
Streptococcus mutans- aids in biofilm formation adheres to toot…
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Gingivitis
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Infection of the gingival crevice resulting in tissue and underlying bone loss
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Helicobacter pylori
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survives in low pH of stomach by living in the mucosal lining of the stomach
associated with 80% of gastric ulcers; 50% of asymptomatic adults in developing countries
takes urea and uses urease to produce NH4 which makes it a neutral environment
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Facultative bacteria
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Makes the large intestine an anaerobic environment; like E. coli that consume an oxygen present
Mostly bacteroides, clostridium, entercoccus, some live attached to intestinal wall in a biofilm
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Lactobacillus acidophilus
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Ferments the available glycogen to produce lactic acid, lowers pH and makes unfavorable conditions for microbes (in vagina)
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Adherence
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Aided by adherence factors that are specific to epithelial cells of certain tissues
Glycocalyx, adherence proteins, fimbrae, pili
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Types of Pathogens
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Opportunistic: immuncompromised host
Accidental: accidentally introduced (wound)
Obligate: can only replicate within host cell
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Invasion
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Entry of pathogen through epithelium
Not required to cause some diseases
Usually occurs through breaks or lesions of the mucosa or skin
Virulence factors involved: Hyaluronidase, collagenase, streptokinase, coagulase, elastase (all aid in invasion of host cell)
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Colonization/Growth
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Multiplication and growth of microbes after entry into host tissues that have a suitable environment with proper nutrients, pH, trace minerals, temperature
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Systemic locations
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Spread through out body to blood
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A-B Toxin
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One of the common exotoxins
consist of 2 subunits: A and B
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Superantigens
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Hyperstimulate immune cells- tissue inflammation and damage
One of the common exotoxins
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A-B Toxins
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Block neurotransmitter function
Usually a localized infection but toxin spreads throughout body
Produced by the spore forming obligate anaerobe Clostridium
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Botulism
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-Clostridium botulinum (anaerobe)
-7 types are known, most toxic substances known
-Usually the result of improper food preservation
-Toxin binds to presynaptic membranes of motor neurons resulting in paralysis by blocking release of the neurotransmitter acetylcholine
-Death results fo…
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Tetanus
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Clostridium tetani
organism infects deep wounds
toxin binds to neuron lipids, mainly in spinal cord
results in blockage of glycine inhibition of motor neurons leading to spastic paralysis
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Cholera
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affects small intestine
vibrio cholerae
A-B toxin; B binds to intestinal epithelium; A activates the enzyme adenyl cyclase (ATP to cAMP)
increased cAMP results in excretion of sodium and bicarbonate ions; this is accompanied by large fluid losses from the host
large fluid loss because…
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Shiga Toxin
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Shigella dyseneriae, also some E. coli
A-B toxin; A fragment cuts rRNA in host cells
works mainly in small intestine but also kidneys
Spastic paralysis: blockage of glycine inhibition
Flaccid paralysis: toxin binds to presynaptic of motor neurons
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Diptheria Toxin
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Only one toxin molecule kills one host cell
2 fragments of protein linked together
B fragment binds to host cell receptors; after binding, a protease cleaves between the A and B
A fragment then enters cell and blocks tRNA from entering the ribosome by enzymatic modification
ADP ribose…
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Endotoxins
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Found in gram (-) bacteria
Cell-bound lipopolysaccharides that are usually released upon lysis of the bacterial cell
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Infection
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First stage of disease
initial exposure and entry
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Incubation
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Time between infection and onset of symptoms; can be days or years
Second stage of disease
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Acute Stage
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Third stage of disease
Fever and other symptoms at their worst
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Decline
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Symptoms subside, reduced fever
Last stage of disease
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Morbidity
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(Incidence of a disease fatal and nonfatal)/total population
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Herd Immunity
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Interference in transmission
A group can be resistant to infection if most of the membres are immune to the disease
If a high fraction of the population is immune, all of the population members are protected
The fraction of the population that is immune will vary depending on how infe…
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Host-to-host Epidemic
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Transmission from one host to another
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1854 Cholera Epidemic
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Humans were found to be the reservoirs
John Snow mapped the locations of homes with infections as well as pumping stations (discovered contaminated water was causing the disease)
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Reservoir Control
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Monitoring domestic/wild animals for diseases, immunizations for rabies
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Transmission Control
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Mosquito control, elimination of H2O or food contamination
Constant monitoring of food and water supply
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Immunizations
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Small pox has been eliminated from Earth by immunizations
Diptheria, tetanus, pertussis, measles, rubella, polio, all prevented
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Quarantine
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Restricting movement of infected individual
Required for smallpox, cholera, plague, yellow fever, typhoid, and relapsing fevers
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Surveillance
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Monitoring of diseases by center for disease control (world health organization)
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Reportable Disease
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Infections that must be reported to local, state, and the CDC
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HA-MRSA
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Health care associated MRSA
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CA-MRSA
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Community associated MRSA (acquired by people with no hospital contact)
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Invasive MRSA
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Progress into deeper underlying tissue
Concern because 19,000 died during hospital stay
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Clostridium Difficile
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Spore forming gram (+) anaerobic rod
Produces 2 toxins A and B
Symptoms: watery diarrhea, fever, nausea, ab pain
Prevented by wearing gloves/maintain sterile field around infected patients
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MDR-TB
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Multi-drug resistant tuberculosis-resistant to several antibiotics that are used routinely to treat TB infections
About 4% of TB cases are MDR-TB
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XDR-TB
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Rare type of MDR
Resistant to almost all antibiotics used for treatment of TB
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Factors responsible for emerging disease
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1. Ecological changes- agriculture, dams, deforestration
2. Human demographics- pop growth, migration, wars, drugs
3. Increased international travel
4. technology and industry
5. Microbial adaptation- mutations, genetic changes
6. Short comings of public health measures
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Streptococcus pyogenes
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Responsible for about half of all severe sore throat cases
Scarlet fever: carry lysogenic bacteriaphage
Rheumatic fever: immune system attacks normal tissue
Invasive infections: exotoxins and M-protein act as superantigen
necrotizing fascitis: flesh-eating bacteria
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Group A Strep
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Most common group
Many asymptomatic carriers
Strep throat, necrotizing fascitits, impetigo
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Group B Strep
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Newborn babies, pregnant women, elderly
Usually Streptococcus agalactiae
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Corynebacterium diptheriae
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Gram (+) rod
Infects upper respiratory tract (tonsils and throat)
Inflammatory response to infections results in lesion called pseudomembrane (can block airway)
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Bordetella pertussis
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Pertussis (whooping cough)
Attaches to upper respiratory tract cells
Filamentous hemagglutinin, on surface
Pertussis exotoxin produced; induces cAMP synthesis in host cells that eventually leads to tissue damage
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Mycobacterium tuberculosis
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Obligate anaerobes
Intracellular parasites: live inside macrophage cells of the immune system
The immunity that develops can be tested for with TB skin test
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Streptococcus pneumoniae
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Form of meningitis
Causes pneumonia and bacteremia
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N. meningitidis
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Found in narpharynx
About 30% are carriers, vaccine available
Group B streptococci and Listeria monocytogenes also cause bacterial meningitis
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Legionnaires disease
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Legionellosis
First outbreak at American Legion convention in Philly 1976
Aerobic gram (-) rod
Waterborne but inhaled in droplets
Lives inside macrophages, multiplies and eventually cause localized
Also causes Pontiac fever (flu-like symptoms)
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Influenza
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ssRNA enveloped virus can undergo antigenic shift to elude host immune system
Infection in upper respiratory tract usually through inhalation of droplets from another infected person
After a strain of influenza has moved through a population most people are immune
New strains develop f…
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Asian Bird Flu (Avian Influenza)
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First documented in Hong Kong
H5N1 resulted in 18 cases and 6 deaths
High concern because of high rate of mutations, has ability to acquire genes from other viruses
Highly virulent in some humans
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Common Cold
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Caused by Rhinovirus, coronavirus and others
Respiratory Synsitical Virus (RSV)
Parainfluenza virus is more common in children
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Measles
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Rubeola virus; cough, fever, eventually a rash
Part of the MMR vaccine; lifetime immunity
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Mumps
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Spread by airborne droplets
Inflammation of salivary glands, swelling of neck
Part of MMR vaccine
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Rubella
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Milder symptoms than measles
Part of MMR vaccine
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Varicella-zoster virus
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Cause of chickenpox
Highly contagious by airborne route-enters respiratory tract
Viruses become activated later in life to cause shingles
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CDC category A biological agents
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easily disseminated or highly contagious; high mortality rate
Bacterial: Anthrax, botulism, plague, tularemia
Viral: smallpox, viral hemorrhagic fevers
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Smallpox
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Variola virus
Development of rash, progress to postules
Septic shock and toxemia
Eradicated because humans are only reservoir, no asymptomatic carriers, short period of inactivity, and effective vaccine
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Viral Hemorrhagic Fever
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Members of 4 virus families
1. marburg
2. lassa VHF
3. crimean congo
4. ebola
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Anthrax
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Gram (+) Bacillus anthracis
spore forming rod
Spores germinate to cause infection
Transmitted through cuts, respiratory tract and gastro-intestinal
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Plague
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Yersinia pestis
Pneumonic plague- infect lungs
Bubonic plague- infect lymph nodes through skin from fleas
Septicemic- bacteria infect blood
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Tularemia
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Fanciscella tularensis
Skin ulcers, swollen and painful lymph glands, inflamed eyes, sore throat, oral ulcers, or pneumonia
Occurs widely in nature, easy to isolate
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Staphylococcus Infections
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Direct contact: person to person by fluids or blood
Common infection sites: normal flora of skin, acne, boils, impetigo, blood, meningitis entereditis, wound infections, otidis media, endocarditis
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S. aureus
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Produces several virulence factors
1. Hemolysins-lyse red blood cells
2. Coagulase- cases blood to clot, protects infection site from host immune system
3. Leukocidin- destroys leukocytes of immune system
4. Proteases, lipases, others
5. Protein A
6. Toxic shock syndrome- causes hyp…
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Helicobacter pylori
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Infects mucosa of stomach
Several virulence factors
Survives extreme environments of pH because of the enzyme urease
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Neisseria gonorrhoeae
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Gram (-), non-motile, aerobic
Infect mucous membranes of genitourinary tract, eye, rectum, throat
Treated with penicillin in the past, now new resistant forms
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Treponema pallidum
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Syphillis
Entry through breaks in the epithelium
Disease can progress in 3 stages
1. forms chancre
2. spread to tissue causing characteristic skin rash (secondary)
3. Latent stage, not infectious, can last years; lesions eventually form on skin, bone, nervous system (tertiary)
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Chlamydia trachomatis
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Most common= Chlamydial non-gonococcal urethritis
Life cycle results in destruction of host cells
1. The extracellular elementary body enters host cell
2. Differentiates to the metabolically active reticulate bodies which multiply
3. Reticulate bodies differentiate into more elementar…
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Herpes
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Viral pathogen
HSV 1: cold sores, blisters, transmitted by direct contact; latent and recurrent infections common
HSV 2: painful blisters on genitalia, transmitted by sexual contact
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HIV
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Infects cells that have surface proteins celled CD 4 and CCR5
High CD4 containing cells in immune system
CCR5 also involved in binding of the virus and fusion
Viral protein GP120 binds to CD4 and CCR5 host proteins
Causes AIDS
HIV 1: 99% of all AIDS
HIV 2: less virulence
No cure b…
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Hepatitis A, B, and C
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Hep A: person to person or by contaminated food, especially shellfish from sewage polluted areas; infection mild; 30% of pop has antibodies, vaccine available
Hep B: vaccine available; 350 million have chronic case; 25% of children will die of cirrhosis of liver; transmitted through bloo…
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Rabies
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Rhaboviridae (family of over 150 viruses)
Transmitted by bites, but respiratory is possible (saliva)
Infects spinal cord, brainstem, and cerebellum
Incubation is 1-2 weeks in animals; several to 9 months in humans
Treatment usually involves live attenuated vaccine; plus anti-rabies im…
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Hantavirus
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Related to hemorrhagic fever viruses (i.e. Ebola)
Transmitted by deer mouse host; inhalation of dried fecal material from infected animal
Diseases: hantavirus pulmonary syndrome- fever, muscle aches, decreased blood platelets, lungs fill with fluid; hemorrhagic fever with renal syndrome…
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Rocky Mountain Spotted Fever
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Rickettsia rickettsii
3-12 days incubation, fever, headache, eventually severe rash and diarrhea and vomiting
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Ehrlichiosis and Anaplasmosis
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Potomic fever (horses)
Mainly flu-like symptoms but can become life-threatening
Caused by members of Ehrlichia and related genera
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Typhus
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Rickettsia prowazekii
Human to human contact; head lice
Called war fever, more soldiers died from this in WWI than fighting
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Q Fever
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Coxiella burnetii
Ticks spread disease to animal; contact with animal urine, feces, milk or other fluids can lead to animal to human transmission
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Borrelia burgdorferi
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Lyme disease
Infection by deer tick
3 stages
1. First 7-10 days expanding red ring around tick bite
2. Dissemination of organism: several weeks to months neurological problems, hear inflammation, arthritis
3. Years later, demyelination of neurons with symptoms like Alzheimers
About…
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Soil bacterial pathogens
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1. Clostridium tetani: spores germinate in anoxic conditions of deep puncture wounds; ubiquitous soil microbe
2. Clostridium botulinum: ubiquitous anaerobe, spore-forming
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Histoplasma capsulation
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Histoplasmosis; infects lungs
Contracted by inhalation of spores from bird or bat droppings
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Coccidioides immitis
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Coccidioidmycosis
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Trichophyton
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Athelete's foot
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Antigen
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Any molecule that stimulate a response in lymphocytes; examples include proteins, polysaccharides
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Phagocyte
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recognize pathogen-associated molecular patterns (PAMP)- structures that are part of the cell surface of many commonly encountered pathogens
a type of macrophagephagocyte becomes activated to ingest and destroy the pathogenwhite blood cells ready to ingest pathogen
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Leukocyte
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White blood cells are nucleated, also known as phagocyte
Cells of the immune system involved in defending the body against both infectious and foreign materials
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Neutrophil
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Are the most numerous white cells
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Macrophage
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Activated phagocyte; destroys pathogen
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Pathogen-associated molecular pattern (PAMP)
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Structures that are part of the cell surface of many commonly encountered pathogens
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Pattern recognition molecules
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Receptors on the phagocytes
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T-cell Receptors
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Each T-cell recognizes a single specific antigen, which binds to T-cell receptors
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Natural Immunity
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Acquired by exposure to a pathogen
Pathogens that infect immune system components can interfere with natural immunity
In HIV, T-helper cells are destroyed
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Active Immunity
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A form of artificial immunity
Vaccination produces response that provides immunity
In some cases, additional subsequent booster vaccinations provide for longer immunity
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Passive Immunity
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No response of the immune system is involved
Examples
1. (artificial) Injection of antiserum (serum containing antibodies against the specific pathogen or toxin) or purified immunoglobulin into a recently infected person
2. (natural) Newborns receive IgG antibodies across the placenta…
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Artificial Immunity
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Induced immunity by vaccination; using antigens from pathogens
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Epithelium
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Superantigens can pass through the epithelium
Bind outside the MHC T-cell receptor binding site
Result in activation of large numbers of T-cells and production of cytokines throughout the body
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Humoral Immunity
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Adaptive immunity: role of B cells
B cells are responsible for antibody-mediated immunity, which is also celled humoral immunity
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Adaptive Immunity
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Specific of acquired immunity
Acquired ability to recognize and destroy specific pathogens or their toxic products
Relies on previous exposure to pathogen
Three main functions
1. Recognize a pathogen and their toxins
2. Discriminate between a pathogen and normal body cells (tolerance…
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Innate Immunity
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Natural or nonspecific immunity
Nonspecific mechanisms that work against all potential microbial pathogens; does NOT rely on previous exposure to a pathogen
Examples:
Production of mucus helps remove pathogens before binding
Unfavorable pH in certain body areas
Epithelial protective …
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T-cells
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Originate in bone marrow
Only recognizes antigens on the surface of host cells that are presented on a protein complex: the major histocompatibility complex (MHC)
Mature in the thymus
T cell subtypes:
Tc cytotoxic cells
Th helper T cells- two types
1. Th 1- release cytokines (small …
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Antibodies
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AKA Immunoglobulins
Produced by B cells that have been activated
Composed of 5 major classes based on physical and immunological properties and distribution (IgG, IgA, IgM, IgD, IgE)
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IgG Antibody
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Composed of...
1. 2 lights chains: a sequence-variable antigen-binding domain and a constant domain
2. 2 heavy chains: a variable and 3 constant chain
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Antibody Binding
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T-cell receptors recognize small regions of large molecules called epitopes (antigenic determinants)
For protein antigens, usually 4-6 adjacent amino acids (may be from different parts of polypeptide chain)
Antibodies bind to pathogens and target them for destruction by phagocytes and…
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Vaccines
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Artifical active immunity induced by an antigen or mixture of antigens
Material used in vaccines:
1. Toxoid: exotoxins that have been chemically inactivated but are still antigenic
2. Inactivated pathogen: pathogens are killed by reaction with chemical compounds or heat (pathogen is d…
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Flu Vaccine
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CDC maintains global surveillance
2 types of seasonal influenza vaccine:
1. Trivalent vaccine is injected into the muscle of the upper arm or thigh (killed virus)
2. The live attenuated vaccine is given as a nasal spray (weakened live virus)
Included in the vaccine is one A (H3N2) vi…
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Superantigens
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Bacterial exotoxins that interact indirectly with host cells
Results in excessive inflammatory response, resulting in host tissue damage
Produced by certain viral and bacterial pathogens
Are usually small proteins
Can pass through the epithelium; bind outside MHC T-cell receptor site
…
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Study Guide: Final Exam