Buxton Exam 3 Flashcards
What are the cytokines responsible for hypotension in shock?
TNF and IL-1
What cytokines are relased from macrophages following endotoxin stimulation?
TNF-alpha
IL-1
IL-6
What are the pain things PAMPs activate?
Activate coagulation cascade
Cytokine release
Active compliment pathway
What does TNF-alpha do?
Inc vascular permeability
Up-regulate adhesion molecules on endothelial cells
Incude expression of tissue factor
What does IL-1 do?
Induce fever
Upregulate adhesion molecules on endothelial cells
What does IL-6 do?
Release of acute phase proteins from liver
Induce expression of tissue factors on endothelial cells
Clinical criteria for SIRS.
2 out of 4 Temp >38 HR > 90 bpm RR > 20 bpm WBC > 12,000/uL or <4000/uL
Clinical criteria for sepsis.
Sign of infection
Clinical criteria for severe sepsis.
Infection and organ failure and.or pt confusion
Improve w/ fluid
Clinical criteria or septic shock.
Infection, multiple organ failure
Hypotension
Does not improve w/ fluids
What is sensitization phase of type I allergic rxn?
Mast cells contain a sensitive Fc receptor portion for IgE
When Ag binds to IgE (crosslinked), mast cells are sensitized
What occurs when sensitization of mast cells is increased?
Triggers degranulation of histamines
Increases vasopermeability and in smooth muscle contraction
What is the immediate phase of a type I allergic rxn?
Allergen binds to IgE and within minutes, degranulates causing histamine release
Vasodilation, vasopermeability account for watery eyes, nose itching
Itchiness cause by the bradykinin system
What causes bronchoconstriction lead to smooth muscle contraction in asthma?
Leukotiene
What is the late phase of a type 1 allergic rxn?
infiltration of eosinophils & T cells into site of mast cell granulations several hours after the initial reaction