Immunology Quiz on Antibodies and Diseases
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Questions and Answers

In a serial dilution agglutination test, what phenomenon is observed when there is an excess of antibody relative to antigen?

  • Post zone phenomenon
  • Complete antibody-antigen binding
  • Agglutination
  • Prozone phenomenon (correct)
  • Which of the following is NOT a characteristic of innate immunity?

  • It is present from birth.
  • It provides the first line of defense.
  • It lacks immunological memory.
  • It is specific to the antigen. (correct)
  • Which cell type is NOT considered an antigen-presenting cell (APC)?

  • Macrophages
  • B cells
  • T cells (correct)
  • Dendritic cells
  • Which cytokine is predominantly produced by Th1 CD4+ T cells and is involved in activating macrophages and NK cells?

    <p>IFN-γ (A)</p> Signup and view all the answers

    What is the primary mechanism of action of cytotoxic T cells?

    <p>Release of perforins and granzymes (A)</p> Signup and view all the answers

    Bruton's disease is characterized by a deficiency in which of the following?

    <p>B cell formation (C)</p> Signup and view all the answers

    Which of the following is a characteristic microscopic finding in tuberculosis?

    <p>Non-filamentous, acid-fast bacilli (A)</p> Signup and view all the answers

    What is the primary purpose of the Interferon Gamma Release Assay (IGRA) in the context of the provided information?

    <p>To diagnose tuberculosis infection (B)</p> Signup and view all the answers

    In cases of viral encephalitis, which clinical feature is described as characteristic?

    <p>Seizures (C)</p> Signup and view all the answers

    Which of the following is the most common cause of viral encephalitis overall?

    <p>Japanese encephalitis (C)</p> Signup and view all the answers

    What is the primary mode of transmission for Nipah virus?

    <p>Direct contact with fruit bats (D)</p> Signup and view all the answers

    What is the recommended duration of the intensive phase of treatment for tuberculosis, according to the provided data?

    <p>2 months (B)</p> Signup and view all the answers

    Which of the following tests is used to detect Rifampicin resistance in Mycobacterium tuberculosis?

    <p>CBNAAT (PCR) (D)</p> Signup and view all the answers

    What is the primary method of post-exposure prophylaxis (PEP) for rabies, besides wound management?

    <p>Injection of rabies immunoglobulin (IG) (D)</p> Signup and view all the answers

    A patient presents with fever, a rash, and Koplik spots. Which disease is most likely?

    <p>Measles (D)</p> Signup and view all the answers

    Which of the following is the most common etiological agent of parasitic encephalitis?

    <p>Naegleria (B)</p> Signup and view all the answers

    Which type of pseudopodia is characteristic of Acanthamoeba?

    <p>Spike or thorn-like pseudopodia (A)</p> Signup and view all the answers

    What is the primary diagnostic method for Progressive Multifocal Leukoencephalopathy (PML) in immunocompromised patients?

    <p>PCR (C)</p> Signup and view all the answers

    What is the typical age range for children affected by Progressive Multifocal Leukoencephalopathy (PML)?

    <p>5-15 years (A)</p> Signup and view all the answers

    Which free-living amoeba is associated with a chronic form of encephalitis, often granulomatous, and also keratitis, particularly in contact lens users?

    <p>Acanthamoeba (C)</p> Signup and view all the answers

    Which amoebic infection is characterized by acute primary amoebic meningoencephalitis (PAM)?

    <p>Naegleria (D)</p> Signup and view all the answers

    What is the recommended treatment for Naegleria infections?

    <p>Liposomal Amphotericin B (B)</p> Signup and view all the answers

    What is the typical clinical presentation of most poliomyelitis cases?

    <p>Flu-like symptoms (A)</p> Signup and view all the answers

    Which of the following statements is true regarding the transmission of free-living amoebae?

    <p>They are often contracted while swimming (A)</p> Signup and view all the answers

    Which amoeba exhibits bilobed nuclei and normal pseudopodia?

    <p>Sappinia (D)</p> Signup and view all the answers

    According to the Modified Jones criteria, which set of findings would be considered as major criteria for diagnosing Acute Rheumatic Fever (ARF)?

    <p>Pancarditis, Subcutaneous nodules, Erythema marginatum (A)</p> Signup and view all the answers

    A patient presents with a history of ARF, and now displays a fever of 38.6°C, arthralgia, and a CRP of 4 mg/dL. According to the Modified Jones criteria, how many of the minor criteria for low risk patients are present?

    <p>Two (A)</p> Signup and view all the answers

    What is the first-line treatment for Acute Rheumatic Fever (ARF) according to the information provided?

    <p>Amoxicillin (D)</p> Signup and view all the answers

    Which stage of HIV disease is characterized by the presence of oral candidiasis that can be removed by rubbing?

    <p>Stage 3 (C)</p> Signup and view all the answers

    Which of the following is classified as an AIDS-defining illness (Stage 4) according to provided information?

    <p>Oral hairy leukoplakia (D)</p> Signup and view all the answers

    Which of the following best describes the mechanism of action of botulinum toxin?

    <p>Inhibits excitatory neurotransmitter release (↓Ach) (A)</p> Signup and view all the answers

    What is the primary pathological effect of tetanospasmin?

    <p>Decreased muscle relaxation (B)</p> Signup and view all the answers

    Which lab diagnostic method is preferred for detection of poliovirus in stool samples?

    <p>Ag-ELISA (C)</p> Signup and view all the answers

    What is the main difference between the effects of botulinum and tetanus toxins on muscle contraction?

    <p>Botulinum toxin inhibits muscle contraction, while tetanus toxin inhibits muscle relaxation (D)</p> Signup and view all the answers

    Which of the following correctly describes the timing of fractional inactivated polio vaccine (fIPV) doses?

    <p>6 weeks and 14 weeks. (D)</p> Signup and view all the answers

    Which of the following is the most common cause of native valve infective endocarditis?

    <p>Staphylococcus aureus (B)</p> Signup and view all the answers

    Which of these clinical features is NOT associated with infective endocarditis?

    <p>Erythema marginatum (D)</p> Signup and view all the answers

    What type of culture medium is used for identifying Clostridium botulinum?

    <p>Robertson cooked meat (RCM) medium (B)</p> Signup and view all the answers

    In the context of poliovirus prophylaxis, what does OPV (Sabin) refer to?

    <p>Live oral vaccine (C)</p> Signup and view all the answers

    Apart from the use of antitoxin, what other medication may be used in the treatment of botulism?

    <p>Metronidazole (A)</p> Signup and view all the answers

    Flashcards

    Prozone Phenomenon

    The phenomenon where excess antibody concentration in a sample causes reduced or no agglutination, despite the presence of antigen. It occurs due to the formation of small, soluble antibody-antigen complexes that are not visible.

    Post-Zone Phenomenon

    The phenomenon where excess antigen concentration in a sample causes reduced or no agglutination, despite the presence of antibody. It occurs due to the formation of small, soluble antibody-antigen complexes that are not visible.

    Innate Immunity

    The immune response present by birth, providing immediate but non-specific defense against pathogens. It is the first line of defense, acting within 3-4 hours, and lacks memory.

    Acquired Immunity

    The immune response developed after exposure to a pathogen, providing specific and long-lasting protection. It is the second line of defense, acting after 5-7 days, and involves memory.

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    Cell-mediated Immunity (CMI)

    A type of immune response mediated by T cells, which directly attack infected cells or destroy pathogens. This response is crucial for fighting intracellular pathogens.

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    Humoral Immunity (HI)

    A type of immune response mediated by antibodies, which neutralize pathogens or target them for destruction. This response is crucial for fighting extracellular pathogens.

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    Antigen Presenting Cells (APCs)

    Antigen Presenting Cells (APCs) are immune cells that capture and display antigens to T cells, initiating an immune response. Examples include dendritic cells, macrophages, and B cells. They express Major Histocompatibility Complex (MHC) molecules for antigen presentation.

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    Pancarditis

    A diagnostic criterion for Rheumatic Fever involving inflammation of the heart muscle, pericardium, and valves.

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    Polyarthritis

    A diagnostic criterion for Rheumatic Fever involving inflammation of one or more joints.

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    High ESR

    A diagnostic criterion for Rheumatic Fever that includes a high ESR (erythrocyte sedimentation rate) specifically greater than or equal to 60mm per hour.

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    Stage 3 HIV

    A stage of HIV characterized by opportunistic infections such as oral candidiasis, herpes zoster, and oral hairy leukoplakia.

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    Wasting Syndrome

    A condition that defines AIDS and involves a severe wasting of body mass, often occurring in the late stages of HIV infection.

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    Interferon gamma release assay (IGRA)

    A type of test used to diagnose tuberculosis (TB) infection. It measures the amount of interferon-gamma (a protein produced by immune cells) released by blood cells when exposed to TB antigens. If a person has been infected with TB, their blood cells will release more interferon-gamma.

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    LJ culture

    A test that detects tuberculosis (TB) bacteria by growing them in a culture medium. It takes 1-2 months to get results.

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    Mantoux test

    A skin test that checks for tuberculosis (TB) infection. A small amount of TB antigen is injected into the skin. If a person has been infected, their skin will become red and hard around the injection site after 48-72 hours.

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    Viral Encephalitis

    An infection of the brain caused by a virus. Symptoms include seizures, fever, and changes in behavior.

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    Rabies

    A fatal viral disease that infects the nervous system. It's transmitted by the bite or scratch of an infected animal, like a dog or bat.

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    Measles

    A viral disease that causes a rash and fever. It can also lead to serious complications like pneumonia and encephalitis.

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    Herpes simplex virus (HSV-1) encephalitis

    An infection of the brain caused by the herpes simplex virus (HSV-1). Symptoms include fever, headache, and seizures.

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    Japanese Encephalitis

    An infection of the brain caused by the Japanese encephalitis virus. It's transmitted by mosquitoes.

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    Progressive multifocal leukoencephalopathy (PML)

    A rare, progressive brain disease caused by the JC virus. It affects people with weakened immune systems, especially those with HIV/AIDS. Symptoms include weakness, paralysis, and vision loss.

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    Primary Amoebic Meningoencephalitis (PAM)

    A rare and often fatal brain infection caused by a free-living amoeba, Naegleria fowleri. It primarily affects the brain's white matter.

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    Leukoencephalopathy (PML)

    A debilitating and progressive neurological disease that primarily affects the white matter of the brain, often in children.

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    Naegleria fowleri

    A type of amoeba that causes PAM, a rapidly progressing and often fatal brain infection.

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    Acanthamoeba

    Another amoeba that can cause brain infections, though typically chronic and less aggressive than PAM. It's associated with contact lenses.

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    Balamuthia mandrillaris

    A rare type of amoeba that can cause a chronic, granulomatous brain infection.

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    Sappinia

    A rare type of amoeba that can cause brain infections, particularly in immunocompromised individuals.

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    Temporal Lobe Encephalitis

    An inflammation of the brain, specifically affecting the temporal lobe. This can be caused by various factors.

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    Viral Myelitis (Poliomyelitis)

    A serious infection of the spinal cord that can cause paralysis. Primarily caused by the poliovirus.

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    Granulomatous Amoebic Encephalitis (GAE)

    A type of amoebic encephalitis caused by Acanthamoeba, characterized by the formation of granulomas in the brain.

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    Liposomal Amphotericin B

    A drug used to treat certain fungal infections, including those caused by Acanthamoeba. It is administered intravenously.

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    Infective Endocarditis

    Inflammation of the inner lining of the heart, particularly the heart valves, caused by bacterial or fungal infections.

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    Acute Rheumatic Fever

    A condition characterized by inflammation of the heart valves and surrounding tissue, often triggered by a previous streptococcal infection.

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    Blood & Systemic Infections

    A group of infections that originate in the bloodstream and spread throughout the body, affecting various organs and tissues.

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    Osler's Nodes

    Tiny, painful, red nodules that occur on the palms of the hands and soles of the feet, often associated with infective endocarditis.

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    Roth's Spots

    Small, reddish-brown spots that appear in the retina of the eye, often associated with infective endocarditis.

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    Janeway Lesions

    Bleeding spots, typically round and small, found on the palms of the hands and soles of the feet, often associated with infective endocarditis.

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    Native Valve Infective Endocarditis

    A bacterial infection caused by Staphylococcus aureus, commonly affecting native heart valves, often leading to infective endocarditis.

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    Malaria

    A group of protozoan parasites that cause malaria, transmitted through the bite of infected mosquitoes.

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    Trypanosomiasis

    A parasitic infection caused by Trypanosoma brucei, transmitted through the tsetse fly, causing a range of symptoms, including fever, headaches, and neurological problems.

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    Leishmaniasis

    A parasitic infection caused by a group of Leishmania parasites, transmitted by sandflies, affecting skin, internal organs, and lymph nodes.

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    Study Notes

    General Microbiology

    • Topics covered include general microbiology, hospital infection control, immunology, and laboratory diagnosis of infections (bacterial, fungal, viral, and parasitic).
    • The sections cover the central nervous system, cardiovascular system (infections of the heart and bloodstream/lymphatic infections), respiratory system, genitourinary system, gastrointestinal and hepatobiliary system, skin, subcutaneous and musculoskeletal system, and miscellaneous infections.
    • Page numbers for each section are provided.

    Microscopy & Staining

    • Kary Mullis invented the polymerase chain reaction (PCR).
    • Eva Engvall (with Peter Perlman) developed enzyme-linked immunosorbent assays (ELISA).
    • Microscopy techniques detect organism morphology (killed) and motility (live). Hanging drop is used for live motility observation.
    • Microscopy helps visualize motility: Bright field, darkfield, and phase contrast microscopes.
    • Darkfield microscopes utilize special condensers.
    • Phase microscopes use phase plates.

    Microbiology Staining

    • Gram Stain: Crystal violet/Gentian violet/methyl violet for primary staining.
    • Mordant: Gram's iodine.
    • Decolorization: Ethanol/Acetone is used to decolorize the cells.
    • Counter-stain: Saffranin/Dilute carbol fuchsin.
    • Acid-Fast Stain: Uses concentrated carbol fuchsin followed by acid-alcohol decolorization. Counter-stain with methylene blue. Acid-fast organisms retain the primary stain.
    • Different microorganisms have varying staining characteristics as determined by cell walls, and these differences are critical to identification.

    Culture & Molecular Methods

    • Culture Media:
    • Simple (nutrient agar)-appearance: white-grey colonies, exceptions yellow pigment, bluish-green pigment.
    • Enriched media (blood agar) - Normal appearance: no zone surrounding colonies, exceptions: a-hemolysis (partial), b-hemolysis (complete), and double zone/target hemolysis.
    • Differential media (MacConkey agar): Only Gram negative organisms grow.

    Microbiology: Enrichment & Transport Media

    • Enrichment media inhibits commensals in specimens like stool samples.
    • Types: Selenite F broth, Tetrathionate broth, Alkaline peptone water.
    • Transport media: Cary Blair media (best for all stool pathogens). Buffered glycerol saline (for all except vibrio and Campylobacter). Thioglycollate broth (for all except vibrio and Campylobacter).

    Culture Identification (Biochemical Tests)

    • Catalase Test: +ve: bubble, -ve: no bubble.
    • Oxidase Test: +ve: blue colour, -ve: no blue colour.
    • Urease Test: +ve : pink color, -ve : no pink color.
    • The results from these tests help identify specific microorganisms.

    Molecular Method: PCR

    • Steps: Nucleic acid extraction, nucleic acid amplification in thermocycler, and nucleic acid detection.
    • Uses: Diagnostic and prognostic tests (detecting genes, monitoring response).
    • Modifications: Conventional PCR (detects DNA only), Real-time RT-PCR (detects DNA & RNA), Semiautomated, and Automated Realtime RT-PCR

    Antimicrobial Susceptibility Testing (AST)

    • Phenotypic method: • Kirby Bauer disk diffusion (MHA). • Zone of inhibition: present: antibiotic sensitive; absent: antibiotic resistant. • MIC: minimum inhibitory concentration.

    Antimicrobial Susceptibility Testing (AST) :

    • Gram Stain: To visualize bacteria cell structure/shape
    • Special Stain: For bacterial classification.
    • Culture: To isolate bacteria/fungi on specific media.
    • Biochemical Tests: For identification.
    • Molecular Testing: For specific detection of virulence or resistance genes.

    Immunology

    • Superantigens: Presented by APC to T-cell, activate T-cells and release cytokines.
    • Antibodies: Proteins produced by plasma cells, different classes (IgG (highest serum concentration), IgA, IgM, IgD, IgE). fixing complement (acquired immunity).
    • Antigen-Antibody Reactions: Precipitation, neutralization, and agglutination reactions use to detect antigens & antibodies.
    • Immunity: Innate and acquired immunity (cell-mediated and humoral).

    Immunodeficiency Disorders

    • Humoral IDD: Bruton's, X-linked (BTK gene mutation). Leads to no B cells / B - cell defect.
    • Cellular IDD: Di George, X-linked (ILR gene mutation), Ataxia-Telangiectasia (ATM gene mutation). Lacking a specific type or a number of immune cells.
    • X-linked: WAS gene > No WASP protein, AR: ADA gene.
    • Phagocytic IDD: Defect in phagocytic process.
    • All these are hereditary, acquired or immunodeficiency syndromes/disease - causing defects in immune responses / lack of specific immune cells.

    Hypersensitivity & Transplant Immunology

    • Types of Hypersensitivity: Type 1 (Allergic), Type 2 (Cytotoxic), Type 3 (Immune complex), Type 4 (Delayed).
    • Transplant Immunity: Types of graft rejection (hyperacute, acute, and chronic), and graft vs. host disease.

    Laboratory Diagnosis of Infections (Bacterial & Fungal)

    • Bacterial Classification: Gram-positive (cocci, bacilli), Gram-negative (cocci, bacilli, coccobacilli, spirochetes), special groups (mycoplasma, chlamydia).
    • High Yield Points: Capsulated, anaerobic, intracellular types, and non-cultivable.

    Laboratory Diagnosis of Infections (Viral & Parasitic)

    • Viral Classification: DNA (enveloped, non-enveloped), RNA (enveloped, non-enveloped)
    • Other RNA enveloped viruses: Orthomyxo, Filo, Arena, Bunya, Delta, and Paramixo.
    • Other RNA Non-enveloped viruses: Picornavirus and Calicivirus.
    • Lab Diagnosis: Molecular methods (PCR), and immunological methods (Ag/Ab detection).

    Central Nervous System (CNS) Infections

    • Common organisms: Bacterial (meningitis, encephalitis, and myelitis) and viral/parasitic (encephalitis)
    • Acute Bacterial Meningitis: Etiology (pneumococcus, meningococcus, H. influenzae b, listeria), and Laboratory diagnosis (CSF, microscopy).
    • Chronic Bacterial Meningitis: Etiology (mycobacterium tuberculosis), Lab diagnosis.
    • Viral encephalitis: Etiology (measles, rabies, Japanese encephalitis, HSV-1, Nipah).
    • Parasitic Encephalitis: Etiology (Naegleria, Acanthamoeba)

    Cardiovascular System (Infections of Heart)

    • Infective endocarditis: Inflammation of endocardium (Native valve > prosthetic valve).
    • Acute rheumatic fever: Non-suppurative complication of Group A streptococcal pharyngitis
    • Clinical Features: Osler's nodes, Roth's spots, Janeway lesions, vascular phenomenon, microbiological evidence, predisposing factor (valvular disease).
    • Diagnosis: Modified Duke's Criteria (Major vs. Minor).
    • Treatment: Penicillin, Vancomycin, Gentamycin, Rifampicin.

    Cardiovascular System: Bloodstream and Lymphatic Infections

    • HIV Disease: Structure, WHO staging (stages 1-4), opportunistic infection.
    • Investigations: Antibody detection (ELISA, Western blot), rapid tests, and Criteria for diagnosis.
    • Window period: Anti-bodies are not detected (3 wks - 3 months).
    • Viral Hemorrhagic Fever (VHF): Etiology (Arenavirus: Lassa, Flavivirus: KFD, Dengue, YF, Filovirus: Ebola, Marburg, Bunya virus : Hanta, Crimean-Congo fever virus).

    Skin, Subcutaneous, and Musculoskeletal System

    • Bacterial Infections: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae, Bacillus anthracis, Clostridium perfringens.
    • Viral Infections: Herpes viruses (HHV-1, HHV-2, HHV-3).
    • Fungal Infections: Malassezia, dermatophyte infections (Tinea capitis, Tinea corporis, Tinea cruris, Tinea pedis).

    Miscellaneous Infections

    • Bacterial Toxin Related Diseases: Diseases caused by bacterial toxins (e.g., Clostridium botulinum, Clostridium tetani, Bacillus anthracis).
    • Bacterial Vector-Transmitted Diseases: Yersinia pestis (plague), Borrelia burgdorferi (Lyme disease), Borrelia recurrentis (endemic relapsing fever). Rickettsia (typhus, spotted fever). Prion diseases (CJD).

    Gastrointestinal and Hepatobiliary System

    • Helicobacter pylori: Causes peptic ulcer and gastric carcinoma.
    • Bacterial Gastroenteritis (GE): Types of toxins (pre-formed toxins and post-formed toxins)
    • Viral Gastroenteritis: Viruses implicated that produce Gastroenteritis
    • Protozoal Gastroenteritis: Organisms (Balantidium coli, Entamoeba histolytica, Giardia lamblia, Cryptosporidium, Cyclospora).

    Genitourinary System

    • Genital Ulcerative Diseases: Granuloma inguinale, Chancroid, Syphilis, Lymphogranuloma venereum (LGV)
    • Vaginitis: Caused by Trichomonas vaginalis, Candida albicans, and Gardnerella vaginalis.
    • Urethritis: Gonococcal urethritis and non-gonococcal urethritis.
    • Cystitis: Etiology (Klebsiella, Proteus, Enterococci).

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    Microbiology Revision Notes PDF

    Description

    Test your knowledge on key concepts in immunology with this quiz. Questions cover topics such as antibody-antigen interactions, innate immunity, antigen-presenting cells, and diseases like Bruton's disease and tuberculosis. Perfect for students looking to solidify their understanding of immunological principles.

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