Ch 3 - 5/6 Dobson Flashcards
1
Q
Asthma is due to what cells?
A
Eosinophils, IgE Abs
2
Q
Glomerulonephritis is due to what cells?
Acute or chronic?
A
Abs and complement, neutrophils, monocytes
Acute
3
Q
Septic shock is due to what cells?
Acute or chronic?
A
Cytokines
Acute
4
Q
Arthritis is due to what cells?
Acute or chronic?
A
Lymphocytes, macrophages
Chronic
5
Q
Atherosclerosis is due to what cells?
Acute or chronic?
A
Macrophages, lymphocytes
Chronic
6
Q
Pulmonary fibrosis is due to what cells?
Acute or chronic?
A
Macrophages, fibroblasts
Chronic
7
Q
What kind of inflammation is characterized by the following: mostly neutrophils, prominent local and systemic signs, mild and self-limited tissue injury, fibrosis
A
Acute inflammation
8
Q
Primary granules (azuorphilic) contain what?
How are they described?
A
NADPH oxidase, MPO, lysosomal enzymes
Larger
9
Q
Secondary (specific) granules contain what?
Described as what?
A
Lysozyme, collagenase, gelatinase, lactoferrin, histaminase
Smaller
10
Q
What is the source of histamine?
Action?
A
Mast cells, basophils, platelets
Vasodilation, INC vascular permeability, endothelial activation
11
Q
What is the source of PGs?
Action?
A
Mast cells, leukocytes
Vasodilation, pain fever
12
Q
What is the source of LTs?
Action?
A
Mast cells, leukocytes
Inc vascular permeability, chemotaxis, leukocyte adhesion and activation
13
Q
What is the source of cytokines?
Action?
A
Macrophages, endothelial cells
Local: endothelial activation
Systemic: fever, metabolic abnormalities, hypotension (shock)
14
Q
What is the source of PAF?
Action?
A
Leukocytes, mast cells
Vasodilation, increased vascular permeability, leukocyte adhesion, chemotaxis, oxidative burst, de granulation
15
Q
What is the source of complement?
Action?
A
Plasma (made in liver)
Leukocyte chemotaxis and activation, vasodilation, direct target killing
16
Q
What is the source of kinins?
Action?
A
Plasma (made in liver)
INC vascular permeability, smooth muscle contraction, vasodilation, pain
17
Q
What PGs or LTs are responsible for vasodilation?
A
PGI2, PGE1, PGE2, PGD2
DIEE12
18
Q
What PGs or LTs are responsible for vasoconstriction?
A
TxA2, LTC4, LTD4, LTE4
19
Q
What PGs or LTs are responsible for increased vascular permeability?
A
LTC4, LTD4, LTE4
20
Q
What PGs or LTs are responsible for chemotaxis and leukocyte adhesion?
A
LTB4, HETE
21
Q
What PGs or LTs are responsible for bronchospasm?
A
LTC4, LTD4, LTE4
22
Q
What do steroids inhibit?
A
Phospholipases
Therefore the entire PG/LT pathway
23
Q
What is an inhibitor of inflammation?
What enzyme makes these?
A
LXA4 and LXB4
12-LO
24
Q
What are the key mediators of chronic inflammation?
A
IL-12
IFN-gamma
IL-17
25
What is the source of IL-12?
Action in inflammation?
DC, macrophages
INC production of IFN-gamma
26
What is the source of IFN-gamma?
Action in inflammation?
T lymphocytes, NK cells
Activation of macrophages
27
What is the source of IL-17?
Action in inflammation?
T lymphocytes
Recruitment of neutrophils and monocytes
28
What is the source of TNF?
Action in inflammation?
Macrophages, mast cells, T lymphocytes
Stimulates expression of endothelial adhesion molecules and secretion of other cytokines
29
What is the source of IL-1?
Action in inflammation?
Macrophages, endothelial cells
similar to TNF
Important in Fever
30
What is the source of IL-6?
Action in inflammation?
Macrophages
Acute phase response
31
Complement system is a collection of what kind of proteins?
Soluble
32
What are the actions of bradykinin?
INC vascular permeability
Causes contraction of smooth muscle
Dilation of blood vessels
Pain when injected into skin
33
Serous inflammation is most commonly seen in what body cavities?
Peritoneum, pleura, pericardium
34
Suppurative or liquefactive necrosis indicates what kind of infection?
Bacterial infection
35
Chronic inflammation causes include persistent infection, what are some of the most common?
Myobacteria
Virus
Fungi
Parasites
36
What kind of cells typify chronic inflammation?
Macrophages
Lymphocytes
Plasma cells
37
What activates M1 macrophages?
Microbes, IFN-gamma
38
M1 Macrophages secrete what cytokines that will increase inflammation?
IL-1, IL-12, IL-23
39
M1 macrophages can perform phagocytosis, via what mediators?
ROS, NO, lysosomal enzymes
40
What activates M2 Macrophages?
IL-4, IL-13
41
M2 macrophages secrete what cytokines for tissue repair and fibrosis?
Anti-inflammatory effects?
GFs, TGF-B
IL-10, TGF-B
42
What type of CD4 cells is responsible for defense against extracellular bacteria and fungi?
Secretes what cytokines?
TH17
IL-17, IL-22
43
Granulomatous inflammation is a form of chronic inflammation characterized by what type of cells?
Sometimes associated with what?
Activated macrophages and T lymphocytes
Central necrosis
44
What are the systemic effects of inflammation?
Fever
Acute-phase reactants
Leukocytosis
45
What are the 4 clinically important acute-phase reactants?
CRP
Fibrinogen
SAA
Hepcidin
46
Elevated CRP indicates what?
risk for MI
47
Fibrinogen is measured how?
ESR, rouleaux formation
48
Hepcidin is measured for what?
Anemia of chronic disease
49
Bacterial infections are characterized by what cells usually?
Viral?
Neutrophils
Lymphocytes
50
Decreased white cells is called what?
Leukopenia
51
Allergies and parasite infections are characterized by what?
Eosinophils
52
What is a left shift?
Putting out increased numbers of immature forms of neutrophils in the blood
53
What are organs/locations where you do not what fibrosis?
```
Eye
Lung
GI
Heart
Skin
Liver
```
54
Acute respiratory distress syndrome is due to what cells?
Neutrophils
55
Who said that inflammation is not a disease, but a stereotypic response?
John Hunter
56
Who established the concept that chemical substances like histamine mediate vascular change in inflammation?
Sir Thomas Lewis
57
Who discovered phagocytosis via observation of amebocytes?
Ellie Metchnikoff
58
What mediators are responsible for the immediate transient response?
Histamine, bradykinin, LTs
59
What stimulates transcytosis?
What else does it do?
VEGF
Promotes vascular leakage
60
What is the mainly responsible for a creating transudates fluid?
Decreased colloid osmotic pressure (liver disease) or increased protein loss (kidney disease)
61
During leukocyte rolling, what is expressed on the endothelium to slow down leukocytes?
On the leukocytes themselves?
P-selectin (from Weibel-Palade) bodes and E-selectin
L-selectin and ligands for P and E selectin
62
What do selectins bind on leukocytes?
Sialyl Lewis X bodies
63
During adhesion, what induces expression of Integrins on leukocytes?
What specific Integrins?
TNF and IL-1
VCAM-1 and ICAM-1
64
Leukocyte migration is via what?
Where does it occur?
What is involved?
Transmigration/diapedesis
Postcapillary venules
CD-31/PECAM-1
65
What is mainly responsible for chemotaxi of leukocytes?
IL-8, C5a, LTB4
66
What kind of infection is dominated by neutrophils for several days as opposed to macrophages?
Pseudomonas bacteria
67
What are the most common exogenous agents?
Bacterial products containing N-fMet
68
What is the ligand for ICAM-1, located on monocytes and DCs?
On neutrophils?
MAC-1
LFA-1
69
What are the ligands for VCAM-1, located on T cells?
VLA-4
| Alpha4-Beta7
70
What is responsible for leukocyte activation?
Increased cytosolic Ca and activation of PKC and PLA2
71
What are the major opsonins?
C3b
| IgG
72
What is the phagocytosis dependent on?
Polymerization of actin filaments
73
Oxygen to superoxide anion is done by what enzyme?
Reduction or oxidation?
Happens where most often? Accompanies what?
Called what specifically?
NADPH oxidase
Reduction
Neutrophils
Phagocytosis
Respiratory Burst
74
Superoxide anion to hydrogen peroxide by what enzyme?
SOD
75
Where are ROS produced?
Within the lysosome and phagolysosome
76
Hydrogen peroxide to hypochlorite (HOCl/OCl2) via what?
Happens where?
MPO
Azuorphilic granules of neutrophils
77
When is iNOS induced?
What does it catalyze?
When macrophages and neutrophils are activated by IFN-gamma or microbial products
Arg --> NO
78
What can cleave C3 and C5 yielding anaphylatoxins?
Neutral proteases
79
What is the major inhibitor of neutrophil elastase?
Alpha1-antitrypsin
80
What is in small (secondary) neutrophil granules?
HAP to LowerLevel Grand Central
Histaminase
Alkaline phosphatase
Plasminogen activator
Lactoferrin
Lysozyme
Gelatinase
Collagenase
81
What is in larger primary neutrophil granules?
MPO
| Acid hydrolases
82
What is lactoferrin?
Iron-binding protein
83
What is major basic protein?
Cationic protein of eosinophils, cytotoxic to parasites
84
NET formation leads to what?
Loss of nuclei, death of the cell
85
What is stored in preformed molecules and are released 1st during inflammation?
Histamine and serotonin
86
What do eicosanoids do?
Mediate inflammation and bind GPCRs
87
What activates acute phase proteins from the liver?
IL-1
| IL-6
88
What stimulates leukocyte production from the bone marrow?
TNF
IL-1
IL-6
89
What are C-C chemokines that attract monocytes, eosinophils, basophils, lymphocytes?
MCP-1
Eotaxin
MIP-1a
RANTES
90
What is the only CX3C chemokines?
What forms?
Fractalkine
Cell-surface bound and soluble form with chemoattractant activity
91
What is responsible for inhibiting viral replication?
Type I IFN
92
Inherited deficiency of this factor leads to hereditary angioedema?
C1 inhibitor
93
What blocks formation of C3 convertase?
DAF
94
What inhibits MAC formation?
CD59
95
What does PAF cause?
At low []'s what does it do?
Associated with what?
Platelet aggregation, vasoconstriction, bronchoconstriction
Induces vasodilation and increased vascular permeability
ADP
96
What is an effusion?
Fluid from plasma or secretions of mesothelial cells
97
Serous inflammation is marked by what?
What linings of the body?
Example?
Exudation of cell-poor fluid into spaces created by cell injury into body cavities lined by
Peritoneum, pleura, pericardium
Skin blistering after burn, viral infection
98
When does a fibrinous exudate develop?
Characteristic of what body cavity linings?
When vascular leaks are large or there is a local Procoagulant stimulus (cancer cells)
Meninges, pericardium, pleura
99
What bacterial infection is most common in purulent inflammation?
Example?
Staphylococci
Appendicitis
100
What are localized collections of purulent inflammatory tissue?
Produced by what?
Abscesses
Seeding of pyogenic bacteria into a tissue
101
What is a local defect, excavation of the surface of an organ or tissue that is produced by the sloughing of inflamed necrotic tissue?
Ulcer
102
What is the most common locations of ulcers?
Mucosa of the mouth, stomach, intestine, genitourinary tract AND
Skin and subcutaneous tissue of the lower extremities in older people
103
When does chronic inflammation occur?
Persistent infection
Hypersensitivity disease
Prolonged exposure to toxic agent
104
What is chronic inflammation characterized by?
Infiltration of macrophages, lymphocytes, plasma cells
Tissue destruction
Attempts at healing
105
Macrophages in the spleen and LNs are called what?
Sinus Histiocytes
106
In what condition of chronic inflammation may neutrophils be present and dominate?
Osteomyelitis
107
What comes together to form tertiary lymphoid organs in some chronic inflammatory reactions?
Examples?
Lymphocytes, APCs, plasma cells
R.A. And Hashimoto's
108
How do you identify a foreign body Granuloma?
Examples?
Center of Granuloma with polarized light, appears refractile
Talc, sutures
109
In immune granulomas, what do macrophages activate?
T cells to produce IL-2 and IFN-gamma
110
Activated macrophages in granulomas have what features?
Pink granular cytoplasm with indistinct cell boundaries called epitheloid cells
111
What are sometimes found in granulomas?
Langhans giant cells
112
In what disease/condition is there non-caseating necrosis present with granulomas?
Crohn's
Sarcoidosis
Foreign body reaction
113
What kind of tissue reaction does Myobacterium leprae cause?
Acid-fast bacilli in macrophages
| Noncaseating Granuloma
114
What type of tissue reaction does Treponema pallidum cause?
What disease?
Gemma, plasma cell inflitrate, no loss of cellular outline
Syphillis
115
What causes cat-scratch disease?
Tissue reaction?
Gram-negative bacillus
Rounded or stellate Granuloma, giant cells UNCOMMON
116
Describe the formation of Granuloma starting with macrophages and ending with epitheloid cells:
Macrophages secrete IL-12 -> Th1 -> IFN-gamma -> epitheloid cells
117
What are the clinical manifestations of the acute phase response?
```
INC BP and pulse
DEC sweating
Shivering
Chills
Anorexia
Malaise
```
118
Typhoid fever, rickets, or Protozoa results in what condition?
Leukopenia
119
Erythrocyte sedimentation rate (ESR) is used to look for rouleaux formation to test for what?
Fibrinogen
120
What is used as a marker for increased risk of MI in patients with CAD?
Elevated serum CRP
121
What acute-phase reactant has implications in anemia when present in increased [ ]'s?
Hepcidin
122
What are Labile tissues?
Examples
Continuously dividing
HSC in bone marrow, surface epithelium of skin, oral cavity, vagina, cervix, gi, uterus urinary tract
123
Describe stable tissues
Examples?
Minimally proliferative activity in normal state, quiescent (G0)
Parenchymal of liver, kidney, pancreas
Endothelial cells, fibroblasts, smooth m. Cells
124
What are the types of permanent tissue?
Cardiac
Neuronal
Skeletal muscle
125
Where do progenitor cells of the liver reside?
Canals of Hering
126
What mediator is responsible for the priming phase of liver regeneration?
Growth factor phase?
Termination phase?
IL-6
HGF and TGF-a
TGF-B
127
The sprouting of new blood vessels due in the inflammation/angiogenesis stage of scar formation is due to what?
What stimulates the proliferation of endothelial cells and the migration of macrophages and fibroblasts to the damaged area?
VEGF-A
FGF-2
128
What GFs play a role in structural maturation of new vessels and angiogenesis?
Ang1 and Ang2
129
What is the receptor for Ang1?
Tie2
130
What GF regulates sprouting and branching of new vessels via cross talk with VEGF?
Notch
131
What GF participates in the process of vessel sprouting via interactions with integrin receptors by providing scaffold for vessel growth?
ECM proteins
132
What enzymes in the ECM degrade the ECM to permit remodeling and extension of the vascular tube?
Matrix metalloproteases (MMPs)
133
What regulates the deposition of CT in scar formation?
Activated by what?
PDGF, FGF-2, TGF-B
M2 macrophages
134
What cells contribute to contraction of the scar over time?
Myofibroblasts
135
In the remodeling of CT, what degrades collagens? What are they dependent upon?
What inhibits them to shut down activity?
MMPs, metal ions (zinc)
TIMPs
136
What is anchored to the PM and cleaves and releases extracellular domains of cell-associated cytokines and GFs like TNF, TGF-B?
ADAMs
137
If the injury involves only the epithelial layer, how does wound healing progress?
Example?
Primary intention
Sutures
138
When cell loss is extensive, as in large wounds, abscesses, ulceration, and ischemic necrosis, how does healing occur?
Secondary intention
139
An accumulation of excessive amounts of collagen creating a raised scar is called what?
Hypertrophic scar
140
Scar that grows beyond the boundaries of the original wound but does not regress is called what?
Common in what population?
Characterized by what?
Common in what part of the body?
Keloid
African Americans
Type 3 collagen
Earlobe, face, upper extremities
141
Where are contractures prone to develop?
Commonly seen when?
Palms, soles, anterior thorax
After burns and compromise the movement of joints
