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Pathoma > 02 Inflammation and healing > Flashcards

02 Inflammation and healing Flashcards

1
Q

TLRs - example and mechanism

A

CD14 (coTLR4) on machrophages binds LPS (a PAMP)

TLR cranks up NF-kB - nuclear transcription factor

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2
Q

mediators of pain

A

PGE2 and bradykinin

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3
Q

PGI2 / D2 / E2

A

dilation, permeability

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4
Q

LTC/D/E 4

A

vasoconstriction, bronchospasm, permeability

slow part of anaphylaxis (MAST cells)

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5
Q

Mast cell activation - 3

A
  1. tissue trauma
  2. C3a and C5a
  3. IgE cross linking antigen
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6
Q

neutrophil go-go

A

LTB4
C5a
IL-8
bacterial products

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7
Q

classic complement pathway

A

C1 binds IgG or IgM that is already bound to antigen

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8
Q

C3b

A

opsonin

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9
Q

Hageman factor XII - source, trigger, and 3 mechanisms

A

from liver; collagen exposure

  1. coagulation AND fibrinolysis
  2. comlement
  3. Kinin system (HMWK –> brady)
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10
Q

fever mechanism

A

IL-1 and TNF from macrophages ramp up COX, PGE2 raises temperature set point

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11
Q

rolling - ? binds ?

A

selectins (speed bumps) on endothelium bind sialyl lewis X on WBC

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12
Q

2 selectin types and stimuli

A

P-selectin - Weibel-Palade - histamine

E-selectin - TNF and IL-1

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13
Q

adhesion - ? binds ? and stimuli for each

A

ICAM and VCAM on endothelium - TNF and IL-1

Integrins on WBC - C5a and LTB4

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14
Q

leukocyte adhesion deficiency - cause and Sx

A

integrin defect - CD18

  1. delayed separation of umbilical cord
  2. tons of neutrophils in blood
  3. recurrent bacterial infections that LACK PUS
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15
Q

site of transmigration

A

post-capillary venules

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16
Q

Chediak-HIGAshi

A 
protein traffic defect - cannot make PHAGOLYSOSOME
Hemostasis defect
Infections
Giant granules in WBCs
Albino
neutropenia, periph neuropathy
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17
Q

O2-dependent killing

A

O2 –> NADPH oxidase (CGD) – oxidative burst of superoxide radicals –> SOD –> H2O2 –> MPO –> HOCl

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18
Q

anti-inflammatory cytokines

A

IL-10 and TGF-B

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19
Q

2nd signal for CD4 Tcells

A

B7 on APC binds CD28 on CD4 Tcell

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20
Q

Th1 subset

A

IL-12 is stimulus, secrete IFN-y (IgM –> IgG) and IL-2

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21
Q

Th2

A

IL-4 IL-5 IL-10 IL-13

IgE, IgA, eosinophils

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22
Q

CD8+ 2nd signal and 2 killing mechanisms

A

IL-2 from Th1 cells
1. perforin and granzyme
2. espression of FasL
both trigger apoptosis

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23
Q

MHC-I
A3
B8
B27

A

all nucleated cells + platelets
presents INTRAcellular antigens i.e. cytosol, viral
Ag peptide delivered to RER by TAP then loaded on MHC-I [1 long chain, 1 short chain]
B2-microglobulin
A3 = hemochromatosis, B8 - MG

24
Q

MHC-II

DR2 vs 3 vs 4

A

on APCs
presents EXTRAcellular antigens (foreign protein ie bacteria)
Ag is loaded after release of invariant chain in an acidic endosome
DR2 - MS and Goodpasture
DR3 - SLE
DR4 - RA

25
CD40
B cells; 2nd signal - binds CD40L on CD4 helper T cell | also on macrophages
26
defining trait of a granuloma
epithelioid histiocytes (macrophages with lots of PINK cytoplasm) -- surrounded by giant cells and rim of histiocytes
27
non-caseating granuloma - definition and 4 examples
do NOT have central necrosis aka still have nuclei, not as dark as caseating in middle 1. rxn to foreign material 2. sarcoid // berrylium 3. Crohn 4. bartonella (cat scratch - neck, star-shape)
28
granuloma formation
macrophage presents antigen to CD4 via MHC-II --> macrophage secretes IL-12 --> Th1 subtype --> IFN-y --> macrophage converts to histiocyte or giant cells TNF-a maintains granuloma in TB
29
viral and fungal infection - main cells
T cells
30
bacteria or protozoa
B cells
31
SCID pathology
lack of ADA leads to buildup of adenosine and deoxyadenosine (ie cannot breakdown into hypoxanthine) -- toxic to WBCs
32
X-linked agammaglobulinemia
pre/pro-B cells cannot mature thus you get total lak of immunoglobulin mutated Bruton tyrosine kinase "brutal tyrant" on chromosome 20 presents at 6mo w/ bacterial, enterovirus, giardia absent lymph nodes / tonsils avoid live vaccines
33
CVID
*low* immunoglobulin, similar infections but will present later in childhood
34
IgA deficiency
most common one but usually chill; esp. at risk to viruses. anaphylaxis to blood transfusion** *CELIAC*
35
Hyper IgM syndrome - cause
``` defect in CD40 - no class switching thus all other types will be low - can't opsonize well no germinal centers ```
36
Wiskott-Aldrich
WATER thrombocytopenia, eczema, recurr infection bloody diarrhea, nosebleeds X-linked -- "WiXott-Aldrich" WASP gene - anchors membrane receptors - cannot present antigens. actin. major cause of death = bleeding
37
hereditary angioedema
``` C1 inhibitor deficiency edema esp. around EYES and mucosa unregulated activation of kallikrein --> elevated bradykinin, low C4 Tx includes Danazol ACE-inhibitors CONTRAindicated ```
38
hyper IgE (Job)
STAT3 mutation - no/low Th17 --> cant recruit neutrophils eczema, bones break easy, keep baby teeth face deformities, cold abscesses eosinophilia
39
AIRE
autoimmune regulator -- presents self-antigens in medulla for negative selection autoimmune polyendocrine syndrome 1
40
C2 deficiency
lupus
41
anti-dsDNA or anti-Sm
lupus
42
2 main antiphospholipid antibodies
1. anti-cardiolipin (false + VDRL and RPR) | 2. lupus anticoagulant -- falsely elevated PTT (they're actually hypercoagulable - clot a lot)
43
HSR type in lupus vs sjogren
Lupus - type III - antigen-Ig comlexes | Sjogren - type IV - lymphocyte mediated
44
anti-ribonucleoprotein
Sjogren's | anti-SSA/Ro or anti-SSB/La
45
pregnant woman with + anti-SSA
baby at risk for congenital heart block and neonatal lupus
46
anti-centromere (Dx and Sx)
limited scleroderma - CREST: | calcinosis/centromere, raynaud, esophagus dysmotility, sclerodactyly, telangiectasia
47
anti-topoisomerase 1
anti-Scl 70 -- diffuse scleroderma -- crest + early visceral lungs - MCCD - fibrosis and HTN GI kidneys - scleroderma crisis
48
anti U1 ribonucleoprotein
mixed - lupus + sclerosis + polymyositis
49
CD34
hematopoeitic stem cells in bone marrow
50
granulation tissue
fibroblasts - lay down type III collagen + capillaries + myofibroblasts
51
type III collagen
granulation tissue, keloid, uterus, embryo (very pliable)
52
what requires 1. zinc 2. Vitamin C 3. copper
1. collagenase - replaces type III collagen w/ type I 2. hydroxylation of proline and lysine residues on procollagen in the RER (early step) 3. lysyl oxidase - forms covalent crosslinks in final step (between lysine and hydroxylysine of tropocollagen strands)
53
regenrative liver nodules - 2 key traits
1. twin cell plates 2. No portal triads - just rows
54
growth factors for 1. fibroblasts 2. angiogensis
1. TGF and PDGF 2. FGF and VEGF ((TGF-a = epithelium)) ((FGF = bone dev.))
55
PDGF stims growth of ? 3 things
fibroblasts, endothelium, smooth muscle
56
PNH
defect in PIGA --> cannot make anchors for complement inhibitors (CD55/DAF or CD59). RBCs get gobbled by complement.

Pathoma (4 decks)

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