Which of the following microbes expresses protein A:
Microorganisms must attach themselves to host tissues to colonise them and each organism has a different strategy.
For example:
Microorganism | Mechanism of Attachment |
---|---|
Neisseria gonorrhoeae | Adheres to the genital mucosa using fimbriae |
Influenza | Attaches by its haemagglutinin antigen |
Giardia lamblia | Attaches to gut mucosa via a specialised sucking disc |
HIV | Binds strongly to CD4 antigen |
Plasmodium falciparum | Causes red cell protein expression facilitating cerebral malaria |
Once past natural barriers, to survive in the human host, microorganisms must overcome the host immune defences.
For example:
Microorganism | Mechanism of Evading Host Defence |
---|---|
Neisseria meningitidis | Secretes an IgA protease that degrades host immunoglobulin |
Staphylococcus aureus | Expresses protein A, which binds host immunoglobulin, preventing opsonisation and complement activation |
Streptococcus pneumoniae | Has a polysaccharide capsule which inhibits phagocytosis by neutrophils |
Vibrio cholerae | Motile by virtue of its flagellum, increasing its virulence |
Gram-negative organisms | Lipopolysaccharide coat makes them resistant to the effect of complement |
Trypanosoma spp. | Alter surface antigens to evade antibodies |
In addition to these mechanisms, some microorganisms have the ability to generate damaging exotoxins:
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Biochemistry | Normal Value |
---|---|
Sodium | 135 – 145 mmol/l |
Potassium | 3.0 – 4.5 mmol/l |
Urea | 2.5 – 7.5 mmol/l |
Glucose | 3.5 – 5.0 mmol/l |
Creatinine | 35 – 135 μmol/l |
Alanine Aminotransferase (ALT) | 5 – 35 U/l |
Gamma-glutamyl Transferase (GGT) | < 65 U/l |
Alkaline Phosphatase (ALP) | 30 – 135 U/l |
Aspartate Aminotransferase (AST) | < 40 U/l |
Total Protein | 60 – 80 g/l |
Albumin | 35 – 50 g/l |
Globulin | 2.4 – 3.5 g/dl |
Amylase | < 70 U/l |
Total Bilirubin | 3 – 17 μmol/l |
Calcium | 2.1 – 2.5 mmol/l |
Chloride | 95 – 105 mmol/l |
Phosphate | 0.8 – 1.4 mmol/l |
Haematology | Normal Value |
---|---|
Haemoglobin | 11.5 – 16.6 g/dl |
White Blood Cells | 4.0 – 11.0 x 109/l |
Platelets | 150 – 450 x 109/l |
MCV | 80 – 96 fl |
MCHC | 32 – 36 g/dl |
Neutrophils | 2.0 – 7.5 x 109/l |
Lymphocytes | 1.5 – 4.0 x 109/l |
Monocytes | 0.3 – 1.0 x 109/l |
Eosinophils | 0.1 – 0.5 x 109/l |
Basophils | < 0.2 x 109/l |
Reticulocytes | < 2% |
Haematocrit | 0.35 – 0.49 |
Red Cell Distribution Width | 11 – 15% |
Blood Gases | Normal Value |
---|---|
pH | 7.35 – 7.45 |
pO2 | 11 – 14 kPa |
pCO2 | 4.5 – 6.0 kPa |
Base Excess | -2 – +2 mmol/l |
Bicarbonate | 24 – 30 mmol/l |
Lactate | < 2 mmol/l |