Chapter 14. Disease and Epidemiology (Continues from exam 3)
11. Learn the classification of a disease based on its frequency: sporadic, endemic, etc. and provide at
    least one example.
12. Learn the terms that are used in epidemiology uses to track the number of cases and their frequency in
    a population (incidence, prevalence).
13. Be familiar with terms used to describe the severity or duration of a disease: acute vs chronic, and
    latent. Do not forget to include local vs systemic and to become familiar with terms such as
    bacterimia and septicemia.
14. Define herd immunity (not covered in class).
15. Be familiar with the stages in the development of a disease based on signs/symptoms: incubation,
    prodromal, etc. Remebember, they overlapped!
16. Identify four predisposing factors for disease (i.e age, nutrition, etc).
17. Know what is meant by the reservoir of infection for a particular pathogen and be able to give
    specific examples for each of them.
18. Contrast human, animal, and nonliving reservoirs, and give one example of each.
19. Be able to define and give examples of the terms pathogenicity and virulence.
20. Be familiar with the transmission of a disease: (provide examples and be able to match them)
     a) Contact, indirect through a fomite and droplet transmission (< 1 meter)
     b) Airborne, waterborne, foodborne
     c) Mechanical and biological vectors.
21. List a couple of probable reasons for emerging infectious diseases, and name one example for each
    reason (not covered in class).

Chapter 15. Microbial pathogenicity
1. Be familiar with the portals of entry and portals of exit for infectious agents. Provide examples.
2. Be able to describe the process of disease development from initial entry into the body until
    clearance of microorganisms occurs or disease develops.
3. Why microorganisms need to adhere? What are these adherance factors?
4. What is an ID50, LD50?
5. Be familiar with how bacteria can avoid the immune system? How can microorganisms stay one step
    ahead of the immune system and escape their destruction?
6. How can bacterial pathogens damage host cells? Know the properties of endotoxins and
    exotoxins. Be prepared to provide comparisons between each group and particular examples for
    exotoxins. What is the model for exotoxins? How can fever be produced by LPS?

Chapter 16. Non-specific immunity
1. General knowledge of what non-specific immunity means. How it works to protect us against
    infection? What it means first, second  and third line of defense?
2. How is the first and second  line different from the third line of defense?
3. Know the relative effectiveness of the primary physical barriers to infection, skin and mucous
    membranes.
4. Be able to describe the "self-cleaning" mechanism or the mucociliary escalator active on the
    respiratory mucous membranes.
5. Know the functions of products such as transferrin, lysozyme, as well as processes such as cell
    sloughing which function to protect the body against infection.
6. Be able to understand the role played by the second line of defense
    a) What is phagocytosis? What are the cells of the immune system? What are the granulocytes,
        agranulocytes? Why is phagocytosis important? What are the most important phagocytic cells? How
        phagocytes kill microorganisms? Be able to identify two organisms that can avoid
        destruction by phagocytes.  Briefly describe the differences in the role played by neutrophils and
        macrophages.  Describe the physical process (or steps) of phagocytosis of a bacterial cell by a
        macrophage.
    b) What is fever? How can fever be beneficial/deleterious to microorganisms? How is fever
        triggered?
    c) What is complement? How complement works to protect us from infection? Know the general
        steps on complement activation. How many pathways are present? What are the consequences of
        having a genetic defect in C2 or C3?
    d) What is inflammation? How inflammation can be important during infection? What triggers
        inflammation? Define a chemotactic factor and indicate what types of human cells that would be
        drawn to a site of an infection by chemotactic factors (diapedesis). Outline the events that occur in
        an inflammatory response including diapedesis.  Be able to give a generalized explanation as to the
        various protective effects associated with an inflammatory response in a focus of infection.
    e) Define the role of interferons (alpha and beta) during viral infections.

Chapter 17. The Specific Immune Response
1. At this point you should be able to tell the difference between nonspecific immunity and acquired
    immunity. Why it is called acquired?
2. Differentiate between active immunity and passive immunity.
3. Be able to provide examples for both natural and artificial immunity.
4. Be able to describe and differentiate between an antigen and an antibody.
5. Be able to describe the properties that would make a particular molecule a good antigen.
6. Be able to differentiate between hapten and antigen.
7. Describe the term antigenic determinant.  What are these areas on antigens? What is the difference
    between an antigen and antigenic determinant (epitope). How does this distinction result in a protein
    “antigen” on the surface of a viral or bacterial pathogen giving rise to an antibody response
    (polyclonal response) consisting of 20 or more different antibody specificities?
8. Describe the ontogeny (origen) of B cells and T cells.  Where these cells mature and differentiate?
    What occurs during these processes? Be able to provide examples of primary and secondary
    lymphoid organs and understand that cells that leave primary lymphoid organs have undergone a
    rigorous "quality control" process.
9. Be able to describe the general property of humoral immunity. What cell produces antibodies?
10. Describe the process of clonal expansion.  What is the relevance of this event?
11. Describe the structure of an antibody (IgG) molecule.
12. What is the relevance of the Fab and the Fc portions of an antibody molecule.  Describe why these
    regions are important aspects of such activation.
13. Be familiar with the properties of the different antibody classes (IgG, IgM, IgA, IgD and
    IgE classes). Be able to provide at least two functions for each of them.
14. Be able to describe the difference between the primary and secondary immune response. Why a
    secondary response is faster and more "concentrated"?
15. Understand the various ways that specific antibody provides protection against microbial
    pathogens (i.e. neutralization, etc).
16. What are the different types of T cells? What function do these cells play? What are cytokines?
    What role do Th and Tc cells play?
17.  Be able to describe and explain the activation pathways of both Th and Tc cells. What are MHC
    molecules? What role endogenous and exogenous antigens play in the presentation and activation of
    T cell?
18. The cell mediated immune response works by two general mechanisms: 1) activation of
    macrophages (CD4 helper cells secreting interferon gamma ) and 2) killing of human cells carrying
    foreign antigens by CD8 cytotoxic cells by direct contact.
19. Be familiar with how B and T cells are different or similar (i.e. surface receptors, how they see the
    antigen, etc).
20. Do not worry about the functions your text ascribes to Tdh (delayed hypersensitivity) and Ts
    (suppressor) cells. There is no evidence these cells exists.
21. Be familiar with the figures presented in class that illustrate how Th and Tc get involved as part of
    the cellular immune response.
22. Remember the role of NK cells in this process. What is your interpretation of MHC restriction and
    why we say that NK cells are not MHC restricted?
 
Chapter 19. Hypersensitivity Reactions
1. What are hypersensitivity reactions?
2. Be able to provide for each of the 4 types:
    a) players involved,
    b) mechanisms,
    c) prevention, and
    d) at least two examples (use Table 19.1 in your book).
3. What is the difference between immediate versus delayed hypersensitivities?
4. Be able to identify the typical blood groups in humans. What makes the universal donor "universal"?

Chapter 19. Immunodeficiencies and transplantation
1. Be able to describe the different types of transplantation reactions.
2. What role do MHC (HLA in humans) molecules play in transplantation reactions?
3. Be able to have an idea of the possible mechanisms leading to tissue rejection.
4. Be able to understand the difference and to provide examples of primary and secondary
    immunodeficiencies.

Update for last materials
1. If we have time, we will survey microorganisms from different tissues, their transmission, virulence, and
    disease-causing abilities.