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SEM2 BIOSCIENCE > Case 2 > Flashcards

Case 2 Flashcards

1
Q

What is the function of thymic stromal lymphopoetin (TSLP)? What cell type releases TSLP?

A

Released by epithelia in response to damage/irritation

Activates dendritic cells to produce cytokines that drive a Th2 mediated response

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2
Q

What is the consequence of major basic protein release from IgE crosslinked eosinophils?

A

Epithelial cell desquamation

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3
Q

What molecules mediate the primary phase of allergen response during an asthma attack?

A

Histamine, prostaglandins, chemotactic factors

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4
Q

What molecules mediate the secondary phase of allergen response during an asthma attack?

A

Leukotrienes C,D,E

major basic protein

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5
Q

What subset of lymphocyte drives the allergic response in asthma?

A

Th2

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6
Q

Activated phagocytes release IL4 and IL5, what are their functions?

A

IL4 causes b cell stimulation

IL5 promotes eosinophil production and attraction

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7
Q

What receptor does histamine bind on smooth muscle cells? What are the consequences of receptor activation?

A

H1 histamine receptor

Smooth muscle contraction (hence bronchoconstriction)

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8
Q

How can allergens cause bronchospasm independent of the IgE response? What characteristic of the asthmatic airway exacerbates this?

A

Allergens can irritate nerve terminals in lamina propria, causing bronchoconstriction and coughing

Epithelial cell desquamation

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9
Q

What drives the secondary response to allergen in an asthmatic attack?

A

Lymphocyte responses to degranulate contents

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10
Q

What are the molecules that drive the inflammatory response of an asthma attack?

A

Leukotrienes C,D,E

major basic protein

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11
Q

What are components of ‘the triad of the asthmatic airway’?

A

Bronchial hyper-responsiveness (IgE)
Increased mucus secretion (caused by smooth muscle contraction)
Inflammation (leukotrienes)

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12
Q

what is the function of IL9?

A

Sensitises t cell responses

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13
Q

Name the 7 characterisitics of an asthmatic airway:

A 
Goblet cell hyperplasia
Oedema
Smooth muscle hypertrophy
Th2 dominated environment
Increased mucus constrictions
Thickened basement membrane
Epithelial cell desquamation
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14
Q

How can airway anatomy explain the increased mucus secretions?

A

Mucus glands enveloped in smooth muscle layer, meaning bronchoconstriction releases content into airway lumen

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15
Q

What is the diagnostic criteria for asthma?

A

FeNO raised
FEV1:FVC lower than 70%
FEV1:FVC increase by 12% upon bronchodilator administration
Bronchial challenge testing

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16
Q

What is atopic/extrinsic asthma?

A

Caused by the environment, mediated by systemic IgE production
Common

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17
Q

What is non atopic asthma?

A

Inflammation and airway obstruction that isn’t worsened by triggers
Not common

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18
Q

What percentage of people does asthma effect on average?

A

4-20%

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19
Q

What is the hygiene hypothesis?

A

States that lack of exposure to infectious agents at a young age hinders immune system development. This results in an increased chance of atopic disease in adulthood

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20
Q

The hygiene hypothesis states that lack of exposure to allergens in early life creates an environment dominanted by which cytokine?

A

IL2

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21
Q

How the the sound of wheezing generated?

A

By vibrations of the airway walls that are nearly closed

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22
Q

How does the presence of wheeze at different stages of the breathing cycle indicate severity of airway obstruction?

A

Expiratory wheeze - moderate obstruction
Inspiration + expiratory wheeze - severe obstruction
No wheeze - emergency (airway completely blocked)

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23
Q

What mechanism does the B2 receptor use to induce bronchodilation?

A

G protein activation –> Adenylate cyclase –> cAMP –> PKA

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24
Q

What is the effect of PKA production in bronchial smooth muscle?

A

Relaxation

25
Q

Salbutamol and salmeterol are examples of what class of drug?

A

B2 adrenergic receptor agonists

26
Q

Through what mechanism does the phosphodiesterase inhibitor theophylline work?

A

increases intracellular cAMP –> PKA activated –> smooth muscle relaxation

27
Q

What drug should be given to treat aspirin induced asthma?

A

Leukotriene receptor antagonist
Montelucast
Zafirlucast

28
Q

How does ipratropium work?

A

Antagonises the muscarinic receptor, blocking parasympathetic induced bronchoconstriction

29
Q

What drug should be administered alongside salmeterol to prevent receptor desensitisation?

A

Glucocorticoids

30
Q

Fluticazone, beclomethasone, prednisolone and budenoside are all examples of what type of drug?

A

Glucocorticoids

31
Q

What is the mechanism of action of glucocorticoids?

A

Increase expression of lipocortin/annexin
phospholipase A2 inhibited
Decreased production of prostaglandins and leukotrienes

32
Q

What nerve carries input from carotid bodies?

A

Glossopharyngeal

33
Q

What nerve carries input from aortic body?

A

Vagus

34
Q

What parameters do the central chemoreceptors sense?

A

PCO2

CO2 is the only molecule that can cross the blood brain barrier

35
Q

What parameters do the peripheral chemoreceptors sense?

A

PCO2, PO2, pH

36
Q

What part of the brain controls involuntary breathing?

A

Respiratory centres in medulla oblongata

37
Q

What part of the medulla controls involuntary inspiration?

A

Dorsal respiratory centre

38
Q

What part of the medulla controls involuntary expiration?

A

Ventral respiratory centre

39
Q

What are the three sensory inputs to breathing?

A

Central chemoreceptors
Peripheral chemoreceptors
Sensory nerves in lungs, airways and chest wall

40
Q

What receptors provide sensory input to the respiratory centres of the medulla?

A

Stretch receptors
Irritant receptors
C-fibres

41
Q

Where are stretch receptors found?

A

Trachea and main bronchi

42
Q

Where are irritant receptors/c-fibres found?

A

naso-pharynx, larynx, trachea, main bronchi

43
Q

What is the function of the pontine respiratory centre?

A

Controls the rate and speed of involuntary breathing

44
Q

What are the names and functions of the two pontine respiratory centres?

A

Apneustic centre –> increases tidal volume

Pneumotaxic centre –> decreases tidal volume

45
Q

What are the four regions of the cortex that control behavioural acts of breathing?

A

Primary motor cortex
Primary sensory cortex
Supplementary motor area
pre-motor cortex

46
Q

What is locked in syndrome?

A

Severence of linkage between motor cortex and pons during a stroke

47
Q

What area of the brain controls emotional breathing responses?

A

Limbic system

48
Q

What medullary structure is responsible for producing respiratory pacemaker?

A

Pre-botzinger

49
Q

What is the EC50?

A

The amount of agonist necessary to cause 50% of maximal receptor activation

50
Q

What

A

The amount of antagonist necessary to cause 50% of maximal receptor inhibition

51
Q

What are the 6 types of antagonist?

A 
Competitive
Non-competitive
Uncompetitive
Functional
Irreversible
Indirect
52
Q

How do competitive antagonists work?

A

By competing for the same binding site as the agonist

53
Q

How do non-competitive antagonists work?

A

Binds to a different site on the same receptor

54
Q

How do functional antagonists work?

A

By binding at a different receptor site to induce the opposing physiological response

55
Q

How do uncompetitive antagonists work?

A

By binding to the activated receptor at a different site to the agonist

56
Q

What is a psychogenic illness?

A

Mind perceiving pain in the absence of any physical lesion

57
Q

Define the term ‘symptom pool’

A

A collective cultures beliefs around how to behave when ill

58
Q

What is the most effective way of treating medically unexplained symptoms?

A

CBT

SEM2 BIOSCIENCE (13 decks)

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