Chapter 3 Flashcards

1
Q

Exudate vs transudate

A

Exudate = extravascular fluid with high protein content and cellular debris (pus = inflammatory exudate)

Transudate = extravascular fluid with low protein content, little cellular material, and low specific gravity (occurs without increase in vascular permeability such as in liver disease, renal disease, etc.) — instead d/t osmotic or hydrostatic pressure imbalance across vessel wall

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2
Q

Describe integrin interaction between neutrophils and endothelium

A

LFA-1 found on neutrophils — binds ICAM1 and ICAM2 on endothelium

[MAC-1 on monocytes binds ICAM1 and 2 on endothelium; VLA-4 on monocytes/T cells binds VCAM-1 on endothelium; a4B7 on monocytes/Tcells binds MadCAM1 on GALT]

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3
Q

Adhesion molecule present in intercellular junction between endothelial cells involved in migration of leukocytes

A

CD31

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4
Q

Most common exogenous chemoattractant

A

Bacterial products (such as peptides possessing N-formylmethionine)

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5
Q

Which component of complement acts as a chemotactic agent

A

C5a

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6
Q

Which arachidonic metabolite participates in chemotaxis of leukocytes?

A

Leukotriene B4 (LTB4)

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7
Q

Differentiate mannose vs scavenger receptors

A

Both are phagocytic receptors

Mannose receptor = lectin that binds terminal mannose and fucose residues on microbes

Scavenger receptors = bind modified LDL particles and more

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8
Q

Describe role of ROS in intracellular destruction of microbes/debris

A

NADPH oxidized by NADPH oxidase (within lysosome and phagolysosome) while reducing O2*- to H2O2

H2O2 then converted by MPO to OCl2 which destroys microbes via halogenation or lipid peroxidation

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9
Q

Discuss role of NO in intracellular destruction of microbes/debris

A

NO produced from Arg by iNOS

NO reacts with O2*- to generate ONOO- (peroxynitrite) which kills microbes

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10
Q

Extracellular fibrillar networks of nuclear chromatin that provide a high concentration of antimicrobial substances at sites of infection and prevent spread of microbes by trapping them in the fibrils

A

NETs = neutrophil extracellular traps

[nuclear chromatin indicates nucleus is lost and neutrophil dies]

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11
Q

Source and action of histamine

A

Source: stored as preformed molecules in mast cells, basophils, platelets

Action: vasodilation, increased vascular permeability, endothelial activation

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12
Q

Cellular sources of prostaglandins

A

Mast cells

Leukocytes

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13
Q

Physiologic actions of prostacyclin, PGE2 and PGD2, and thromboxane A2

A

Prostacyclin = vasodilation, inhibits platelet aggregation

PGE2 and PGD2 = vasodilation, increased vascular permeability

Thromboxane A2 = vasoconstriction, promotes platelet aggregation

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14
Q

Physiologic actions of leukotrienes LTC4, LTD4, LTE4

[note cysteine-containing leukotrienes in particular]

A

Bronchospasm, increased vascular permeability

[can be inhibited by leukotriene receptor antagonists — useful in tx of asthma]

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15
Q

Principle cellular sources and actions of TNF

A

Source: macrophages, mast cells, T cells

Stimulates expression of endothelial adhesion molecules and secretion of other cytokines, systemic effects

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16
Q

Principle cellular sources and actions of IL-1

A

Source: macrophages, endothelial cells

Similar to TNF, greater role in fever

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17
Q

Principle cellular sources and actions of IL-6

A

Source: macrophages

Systemic effects = acute phase response

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18
Q

Principle cellular sources and actions of IL-17

A

Source: T cells

Recruitment of neutrophils and monocytes

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19
Q

Principle cellular sources and actions of IL-12

A

Source: DCs, macrophages

Increased production of IFN gamma

20
Q

Principle cellular sources and actions of IFN-gamma

A

Source: T cells, NK cells

Activation of macrophages — increased ability to kill microbes and tumor cells

21
Q

3 complement pathways and what activates them

A

Classical = fixation of C1 to IgM or IgG which has combined with Ag

Alternative = microbial surface molecules like LPS

Lectin = MBL binds carbs on microbes and directly activates C1

22
Q

Which complement proteins are considered anaphylotoxins which stimulate histamine release?

A

C3a, C5a, C4a

23
Q

Which complement protein acts as an opsonin to promote phagocytosis by macrophages and neutrophils?

A

C3b

24
Q

C1 inhibitor blocks activation of C1 in the complement system. An inherited deficiency in this inhibitor results in what condition?

A

Hereditary angioedema

25
Q

What regulatory protein inhibits formation of C3 convertases?

A

Decay accelerating factor (DAF)

[defects —> paroxysmal nocturnal hemoglobinuria]

26
Q

Morphologic types of acute inflammation

A

Serous (blisters, effusions in heart failure)

Fibrinous (fibrin in pericardium)

Purulent (staph, abscesses in pneumonia)

Ulcers

27
Q

What do eosinophils contain that is toxic to parasites and human cells?

A

MBP

28
Q

Cytokines that promote M2 activation

A

IL-4, IL-13

29
Q

2 types of granulomatous inflammation

A

Foreign body granuloma

Immune granuloma

30
Q

Morphologic features of granuloma

A

Epithelioid cells

Multinucleated giant cells

Central zone of necrosis

31
Q

Examples of diseases with granulomas

A
Tuberculosis
Leprosy
Syphilis
Cat-scratch disease
Sarcoidosis
Crohn disease
32
Q

Acute phase reactant that binds microbial cell walls, may act as opsonin and fix complement, bind chromatin, possibly aiding in clearing necrotic cell nuclei

A

CRP

[note elevated serum CRP may be risk factor in those with CAD]

33
Q

APP that binds red cells and causes them to form stacks that sediment more rapidly (basis for ESR lab)

A

Fibrinogen

34
Q

APP that has similar actions to CRP and prolonged production is a risk for secondary amyloidosis

A

Serum amyloid

35
Q

Chronically elevated levels of APP hepcidin puts the pt at risk for what condition?

A

Anemia

36
Q

Major cytokine involved in fibrosis

A

TGF-b

37
Q

Cells/molecules involved in acute and chronic asthma

A

Eosinophils

IgE Abs

38
Q

Cells/molecules involved in chronic athersclerosis

A

Macrophages

Lymphocytes

39
Q

_______ = inflamed LNs often d/t hyperplasia of lymphoid follicles and increased immune cells within

A

Lymphadenitis (aka lymphadenopathy)

40
Q

______ = inflammation of lymph vessels indicated by red streaks around a wound

A

Lymphangitis

41
Q

What enzyme protects us from lysosomal enzyme damage to our own cells?

A

Alpha-1 antitrypsin

42
Q

Things that prevent clot propagation

A

Nitric oxide
PGI2
ADP-phosphatase

[ADP is biggest platelet activator]

43
Q

Function of lipoxin A4/B4 (LXA/B4)?

A

Inhibition of inflammation by inhibiting neutrophil chemotaxis and adhesion to endothelium

44
Q

Histologically, _______ tissue appears pink, soft and granular that is characterized by proliferation of fibroblasts and new thin-walled delicate capillaries in a loose extracellular matrix

A

Granulation

45
Q

______ = growth factor for angiogenesis that recruits smooth muscle cells

_____ suppresses endothelial proliferation and migration, and enhances the production of ECM proteins

A

PDGF

TGF-B

46
Q

During scar formation, _____ are activated to remodel the deposited ECM; they are then shut down by _______

_______ are enzymes that are anchored to the PM and cleave and release EC domains of cell-associated cytokines and GFs like TNF, TGF-b, and EGF

A

MMPs; TIMPs

ADAMs (A disintegrin and metalloproteinases)