Chiropractic Boards Study Material: Microbiology - Immunology & Epidemiology/Disease Control - Part 1

What type of vaccine is MMR (Measles, Mumps, Rubella), Rotavirus, Flu, and Varicella/Zoster?

Live Attenuated

What type of vaccine is DTaP for Diphtheria & Tetanus specifically? How about DTaP for Pertussis part?

Toxoid

Subunit

What type of vaccine is Hib?

Conjugate

What type of vaccine for Pneumonia is Prevnar13? Pneumovax23?

Conjugate

Polysaccharide

What type of vaccine is Meningococcal (Meningitis), Hep B, and HPV (Gardasil)?

Recombinant

What type of vaccine is IPV (Polio), Hep A, & the Flu?

Whole inactivated

What are the 3 phagocytic cells of the immune system?

1) Neutrophils

2) Monocytes

3) Macrophages

What are the 3 cells of the immune system that release inflammatory mediators

1) Basophils

2) Mast cells

3) Eosinophils

What are the cells of the innate immune system? Adaptive immune system?

Innate = Macrophages

Adaptive = T cells

What cell of the innate immune system starts off as a monocyte and prevents antigen to T cells?

Macrophages

What are the two functions of macrophages?

1) Produce cytokines (activate helper & cytotoxic T cells, killing pathogen or tumor cells)

2) Natural Killer cells (inactivate pathogens)

Which type of T cell kills virus-infected cells w/ or w/o antibodies, triggering the target cells to commit cell death?

Killer T cell

Which type of T cell helps in antigen recognition and regulation (helper & suppression)?

Helper T cells

What are the 2 functions of helper T cells?

1) Secrete cytokines (protein molecules; IL-2 or INF gamma)

2) Activate Th & Tk, and kill pathogen or tumor

What type of T cell helps other T cells to keep "under control"?

Regulatory T cell

What is the target (ex: viral protein) of an antibody or T cell? The antibody binds to what part of this?

Antigen

antibody binds to the EPITOPE part of antigen

How is a part of the antigen recognized by the immune system?

T-cell receptors binds to peptide that is a fragment of an antigen

What proteins "present" antigens for T cells to "see"?

Histocompatibility Complex Proteins

Which of the 2 classes of histocompatibility complex proteins is found on the surface of most cells in the body and informs killer T cells what's going on INSIDE other cells?

Class I

Which of the 2 classes of histocompatibility complex proteins is made by antigen presenting cells (ex: macrophage), and informs helper T cells of problems OUTSIDE the cells?

Class II

What part of the immune system doesn't kill anything, but it tags an invader for death ("kiss of death")?

Antibody

What type of antibody can dock on a virus that is still outside the cell and tag it for death by using opsonization?

Neutralizing antibodies

What is the tagging that prepares an invader to be eaten by antibodies?

Opsonization

What part of the immune system contains 20 different proteins that work together to destroy invaders/signal the immune system to attack? Where are these proteins made?

Complement system

Made in LIVER

The complement system must be activated in order to function and builds what multi-functional cells that enhance phagocytotic cells, alert other cells of being attacked, and acts VERY FAST? What complement proteins is this made up of?

Membrane attack complexes (MACs; C5 - C9)

Which pathway of the complement system depends on antibodies for activation to form an antibody-antigen complex?

Classical pathway

For activation of the classical pathway, ______ or ______ bind to the surface of the pathogen, allowing the C1 complex ( ___+____+____) to bind, and cleave what 2 complement molecules?

IgM or IgG

C1q + C1r + C1s

C4 --> C4a + C4b & C2 --> C2a + C2b

What is the C3 convertase for the Classical pathway? The C5 convertase?

C3 convertase = C4b2a

C5 convertase = C4b2a3b

Which pathway of the complement system involves mannose binding lectin, then lectin binding a carbohydrate molecule on a pathogen?

Mannan-binding Lectin Pathway (Lectin Pathway)

For activation of the Lectin pathway, _______ will bind to mannose (PAMPs), leading to a conformational change from __________ to ___________. This allows the cleavage of what 2 complement molecules?

MLB

MASP1 --> MASP2

C4 --> C4a + C4b & C2 --> C2a + C2b

What is the C3 convertase for the Lectin pathway? The C5 convertase?

C3 convertase = C4b2a

C5 convertase = C4b2a3b

NOTE: SAME as classical pathway!

What complement system is antibody independent?

Alternative pathway

For the activation of the alternative pathway, ______ will be cleaved into ____+____. ______ will bind to PAMPs on the pathogen surface. What other factors are involved in the cleavage of this complement molecule?

C3 --> C3a + C3b

C3b binds to PAMPs on pathogen surface

C3b + Factor B = C3bB + Factor D = C3bBb

What is the C3 convertase for the alternate pathway? The C5 convertase?

C3 convertase = C3bBb

C5 convertase = C3bBbC3b

NOTE: anytime you see C3 that = alternate; if you see C4 that = classical/lectin pathway

What are the 5 functions of the complement system (Lectin specifically)?

1) Trigger inflammation

2) Chemotactically attracts phagocytes to infection

3) Promotes attachment antigen and 2nd signal for B lymphosytes

4) Causes lysis of gram negative bacteria and foreign epitopes

5) Harmful immune complexes removed from body

What type of hypersensitivity reaction is an immediate hypersensitivity, with IgE, mast cells, basophils, and allergic mediators?

Type I

NOTE: "I AM IT" = 1, 2, 3/4

What type of hypersensitivity reaction is immune complex mediated with IgG, antibody-mediated inflammation, and some autoimmune disease?

Type III

NOTE: "I AM IT" = 1, 2, 3/4

What type of hypersensitivity reaction is T cell mediated and delayed?

Type IV

NOTE: "I AM IT" = 1, 2, 3/4

What type of hypersensitivity reaction is antibody mediated using IgG and IgM to cause cell lysis (some autoimmune disease)?

Type II

NOTE: "I AM IT" = 1, 2, 3/4

I = immediate hypersensitivity

AM - Antibody mediated

I = Immune complex mediated

T = T cell mediated

Blood group incompatibility, Pernicious anemia, Myasthenia gravis & Graves are all examples of what type of hypersensitivity reaction?

Type II

SLE, RA, Rheumatic fever, & Serum Sickness are all examples of what type of hypersensitivity reactions?

Type III

Infections, Dermatitis, Graft rejection, & Poison Ivy are all examples of what type of hypersensitivity reactions?

Type IV

Anaphylaxis, Hay fever, Asthma, & Diabetes are all examples of what type of hypersensitivity reactions?

Type I

WHO reports:

2002 = ______ outbreak in CHINA

2003 = _________ outbreak in ASIA

2012 = ____________ virus in Yosemite State Park

2012 = ___________ virus, ___________, & __________

2013 = _________ labeled the most common foodborne disease, and __________ the 2nd MC foodborne disease

2013 = _______ million new cases of TB & _____ million deaths from TB.

SARS

Avian flu

Hantavirus

West Nile virus, Meningitis, & Pertussus

Norovirus & Salmonella

8.8 million, 1.4 million

What is the study of diseases associated with over/under activity of immune repsonse?

Immunopathologies

What condition is caused by proteins from mold or plant spores?

Hay fever

What condition is caused by dust mites, cockroaches, rodents, and household pets?

Asthma

Allergic individuals (atopic) make large amounts of _______ antibody

IgE antibody

In allergic individuals, what cell is involved int he response/degranulation?

MAST CELL

--important--

In allergic individuals, what are the small compounds such as histamine and other enzymes/chemicals?

Granules

In allergic individuals, what cell lives 1 day in blood but when attached to mast cells lives several weeks?

IgE antibodies

In allergic individuals, what cell attaches to the IgE?

Basophils

In allergic individuals, what cell is involved in chronic allergic reactions?

Eosinophil

What conditions are tolerance of "self" becoming compromised?

Autoimmune diseases

What autoimmune condition is self-reactive lymphocytes repeatedly stimulated, with swollen lymph nodes?

Canale-Smith Syndrome

What autoimmune condition is an organ specific immune disease with B cells in the pancreas as the target?

Insulin-dependent diabetes mellitus

What autoimmune condition is self-reactive antibodies binding to receptors for acetylcholine (NT)?

Myasthenia gravis

What autoimmune condition affects the CNS with self-reactive T cells destroying the myelin sheaths since macrophages are recruited by cytokines secreted by T cells and the activated T cells can cross the BBB?

Multiple Sclerosis

What autoimmune condition is chronic inflammation of the joints, with IgM-IgG antibodies activating macrophages to increase the inflammatory reaction?

Rheumatoid arthritis

What autoimmune condition affects about 250,000 people in the US (90% of which are women) caused by the breakdown of B & T cells that make IgG antibodies, with a red facial MALAR (butterfly/red wolf) rash, and inflammation of the lungs, arthritis, kidney damage, hair loss, paralysis, and convulsions?

Lupus Erythematosus

What immunodeficiency disease is where THYMIC tissue is missing, so individuals as susceptible to life-threatening infections due to NO T cells?

DiGeorge syndrome

What immunodeficiency disease is where there are NO T or B cells?

Severe Combined Immunodeficiency (SCID)

What immunodeficiency disease is caused by HIV-1 and targets helper T cells, macrophages, & dendritic cells, and once infected, will cause the acquisition of more immunodeficiencies such as pneumocystis carinii or Kaposi's sarcoma?

AIDS

What type of vaccine is designed NOT to infect the recipient, but cannot 100% guarantee to kill all the virus? What is an example of this type of vaccine?

Noninfectious vaccines

Polio virus vaccine

Noninfectious vaccines generate what types of cells?

Generate memory Th & B cells

-- NOT memory Tk cells

What type of vaccine are WEAKENED forms of the microbe and is the type that most vaccines are? What is an example of this vaccine?

Attenuated vaccines

MMR (mumps, measles, rubella)

What type of cells are produced by attenuated vaccines?

Memory Tk cells

What type of vaccine is genetically engineered, introducing a single gene from pathogenic microbe into the virus and is called the "trojan horse"? Can this vaccine cause disease?

Carrier vaccine

NO doesn't cause disease

What type of vaccine is the injection of a piece of DNA which has flu virus gene?

DNA vaccines

Immunodepressed individuals cannot tolerate what type of vaccine?

Attenuated vaccines (since weakened but live vaccine)

What type of immunity comes from live (attenuated) or killed viruses?

Active Immunity

What type of immunity occurs naturally? What are the 2 ways this can develop?

Passive immunity

1) Mother's milk

2) Administer (injection) preformed antibodies in immune globulins

What type of immunity is from both immune globulins (immunoglobulins, gamma globulins) and vaccines?

Passive-active immunity

What is the study and diagnostic use of antigen-antibody interaction sin blood serum?

Immune response/serology

What occurs in immune response/serology when antigen-antibody mixed, is insoluble, and has huge complexes formed?

Precipitates

What immune response/serology is used to test for fungal antigens?

Immunodiffusion (Ouchterlony test)

What immune response/serology separates molecules to look for particular classes of antibodies, and used specifically for what autoimmune disease?

Immunoelectrophoresis

Lyme disease (Borrelia burgdorferi)

What immune response/serology is sensitive & specific and used to ascertain whether patient is exposed to a particular virus?

Viral neutralization

What immune response/serology is clumping of RBCs and is NOT an antibody-antigen reaction, used for influenza?

Viral Hemagglutination Inhibition Test

What immune response/serology detects the presence of specific antibodies in serum?

Complement fixation test

What immune response/serology has a dye used and is used to pick up Mycobacterium tuberculosis for example?

Fluorescent antibody test

What immune response/serology is where enzymes label antibodies for HIV?

ELISAs (Enzyme-linked immunosorbent assay)

What immune response/serology verifies presence of antibodies against HIV and is an AIDS confirmation test?

Western Blot (immunoblots)

What immune response/serology are rapid ELISAs?

Immunofiltration assays

What immune response/serology is used in blood typing and pregnancy testing, as well as salmonellosis, brucellosis, gonorrhea, rickettsia, mycoplasma, yeast, typhoid fever, & meningitis?

Agglutination

For the crystal violet primary dye and the alcohol rinse as the decolorizer, what color did gram+ end up?

Purple

For the gram's iodine mordant and safranin counterstain, what color did gram- end up?

Red

What cell presents antigens to the T cell?

Macrophages

What cell inactivates pathogens?

NK cells

What Federal Health agency is the national public health agency?

United Stated Public Health Service

What Federal Health agency is the epidemiological studies department that researches disease etiology/prevention, gives recommendations for immunization schedules, and works with public health organizations of other countries (ATL, Georgia)?

Center for Disease Control

What Federal Health agency coordinates efforts to improve public health in world?

World Health organization

What Federal Health agency reviews reports of public health assessment before information is disclosed to the public?

Agency for Toxic Substance and Disease Registry

What is the Special US Environmental Protection Agencies list of national hazardous waste sites?

National Priorities List

What State agency is responsible for chiropractic licensing and other health related issues such as infected meat or food product recall?

Department of HEALTH

What State agency protects air, water, & land?

Department of Environment Protection

What State agency serves health needs, especially underprivileged?

Public Health Department

What State agency protects & promotes health of people living around HAZARDOUS waste sites?

Public Health Assessment

What are the 6 steps of the public health assessment?

1) Department of health -- reports specific toxin at a specific site

2) EPA -- puts toxin/site location on National Priorities list

3) Department of health -- evaluates level or amount, human exposure, and potential damage

4) Department of health -- makes recommendations

5) EPA & Department of environmental protection -- clean up the problem & collect samlpes

6) Agency for toxic substance, Disease Registry, & EPA -- review allr eports before published & distributed to communities

Salk treated polio virus with formaldehyde to _______ the virus, while Sabin used _______ & attenuated virus for his vaccine.

KILL

LIVE & attenuated