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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
Q

CD40

A

B cells; 2nd signal - binds CD40L on CD4 helper T cell

also on macrophages

26
Q

defining trait of a granuloma

A

epithelioid histiocytes (macrophages with lots of PINK cytoplasm) – surrounded by giant cells and rim of histiocytes

27
Q

non-caseating granuloma - definition and 4 examples

A

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
Q

granuloma formation

A

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
Q

viral and fungal infection - main cells

A

T cells

30
Q

bacteria or protozoa

A

B cells

31
Q

SCID pathology

A

lack of ADA leads to buildup of adenosine and deoxyadenosine (ie cannot breakdown into hypoxanthine) – toxic to WBCs

32
Q

X-linked agammaglobulinemia

A

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
Q

CVID

A

low immunoglobulin, similar infections but will present later in childhood

34
Q

IgA deficiency

A

most common one but usually chill; esp. at risk to viruses. anaphylaxis to blood transfusion**
CELIAC

35
Q

Hyper IgM syndrome - cause

A 
defect in CD40 - no class switching thus all other types will be low - can't opsonize well
no germinal centers
36
Q

Wiskott-Aldrich

A

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
Q

hereditary angioedema

A 
C1 inhibitor deficiency
edema esp. around EYES and mucosa
unregulated activation of kallikrein --> elevated bradykinin, low C4 
Tx includes Danazol
ACE-inhibitors CONTRAindicated
38
Q

hyper IgE (Job)

A

STAT3 mutation - no/low Th17 –> cant recruit neutrophils
eczema, bones break easy, keep baby teeth
face deformities, cold abscesses
eosinophilia

39
Q

AIRE

A

autoimmune regulator – presents self-antigens in medulla for negative selection
autoimmune polyendocrine syndrome 1

40
Q

C2 deficiency

A

lupus

41
Q

anti-dsDNA or anti-Sm

A

lupus

42
Q

2 main antiphospholipid antibodies

A
  1. anti-cardiolipin (false + VDRL and RPR)

2. lupus anticoagulant – falsely elevated PTT (they’re actually hypercoagulable - clot a lot)

43
Q

HSR type in lupus vs sjogren

A

Lupus - type III - antigen-Ig comlexes

Sjogren - type IV - lymphocyte mediated

44
Q

anti-ribonucleoprotein

A

Sjogren’s

anti-SSA/Ro or anti-SSB/La

45
Q

pregnant woman with + anti-SSA

A

baby at risk for congenital heart block and neonatal lupus

46
Q

anti-centromere (Dx and Sx)

A

limited scleroderma - CREST:

calcinosis/centromere, raynaud, esophagus dysmotility, sclerodactyly, telangiectasia

47
Q

anti-topoisomerase 1

A

anti-Scl 70 – diffuse scleroderma – crest + early visceral
lungs - MCCD - fibrosis and HTN
GI
kidneys - scleroderma crisis

48
Q

anti U1 ribonucleoprotein

A

mixed - lupus + sclerosis + polymyositis

49
Q

CD34

A

hematopoeitic stem cells in bone marrow

50
Q

granulation tissue

A

fibroblasts - lay down type III collagen + capillaries + myofibroblasts

51
Q

type III collagen

A

granulation tissue, keloid, uterus, embryo (very pliable)

52
Q

what requires 1. zinc 2. Vitamin C 3. copper

A
  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
Q

regenrative liver nodules - 2 key traits

A
  1. twin cell plates 2. No portal triads - just rows
54
Q

growth factors for 1. fibroblasts 2. angiogensis

A
  1. TGF and PDGF
  2. FGF and VEGF
    ((TGF-a = epithelium))
    ((FGF = bone dev.))
55
Q

PDGF stims growth of ? 3 things

A

fibroblasts, endothelium, smooth muscle

56
Q

PNH

A

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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