Chapter 3 Flashcards
What are 3 important opsonins for phagocytosis?
- IgG
- mannose binding lectin
- C3b
Pt comes in with persistent infection and they are found to have catalase positive organisms in their system. Why is the infection not resolving?
Catalase (along with glutathione peroxidase ) are ANTIOXIDANTS and they destroy free radicals.
microbes are killed by free radicals and there fore if they synthesize catalse they are avoiding death
Describe a consequence of MPO deficiency?
MPO (myeloperoxidase) is the enzyme important for free radical formation.
If lacking, patient would be susceptible to infections by microbes
What is the O2 dependent mechanism of killing organisms?
Reactive oxygen species (in PRIMARY GRANULES )
What is the O2 independent mechanism of killing organisms?
enzymes present in leukocyte such as lysozyme and major basic protein (SECONDARY GRANULES)
After an ACUTE inflammatory response, what is involved in RESOLUTION of inflammatory stimulus?
Neutrophils undergoing Apoptosis
Release of TGF B and IL-10
What is the role of IL-8 in inflammation?
Macrophages release this to RECRUIT NEUTROPHILS to continue inflammation
What are the 3 main ENDOGENOUS chemoattractants?
- IL-8
- C5a
- LTB4
Mutation in CD31 protein interferes with what step in acute inflammation?
TRANSMIGRATION of leukocytes through the endothelium
CD31 allows for migration through inter-endothelial spaces
Cytosolic sensors of cell damage play an important role in acute inflammation. If there was a gain of function mutation of these sensors it would continuously trigger activation of inflammasomes what antagonist would you use to treat this?
a. IL-10 antagonist
b. IL-2 antagonist
c. IL-1 antagonist
d. IL-5 antagonist
IL- 1 antagonist
inflammasomes lead to activation of IL-1 cytokine
Which of the following would NOT be seen in renal failure?
a. hypercalcemia
b. exudate
c. metastastic calcification
d. transudate
Answer B. exudate involves an INFLAMMATION
D: this is non inflammatory in nature and is associated with renal , liver, or heart FAILURE
A,C are both related to renal failure (See metastatic calcification)
Histamine, Bradykinin and prostaglandins all contribute to which cardinal sign of inflammation?
(Redness)Rubor and Heat
these are all vasoactive mediators released by endothelium nd immune cells
LC4, LD4, and LT4 along with histamine all contribute to which cardinal sign of inflammation?
Swelling
Leukotrienes are involved in bronchospasma and vascular permeability which would contribute to EDEMA
Histamine does something similar
Which cytokines are implicated with CHRONIC inflammation?
IL-12. IFNy. IL-17
***Pt comes in with 2 cm erythematous abscess on her right shoulder. Abscess has been there for about 2 weeks now and doctor decides to incise and drain it. Large amount of pus drains from the incision site. What type of inflammation would you describe this as? and WHY?
ACUTE inflammation
PUS formation is due to the presence of large amounts of NEUTROPHILS. Even if the infection persisted for 2 weeks this is still considered an ACUTE process.
What is a KEY** characteristic of granuloma?
Epitheliod Histiocytes
aggregation of macrophages
You are in the lab looking at some lab test and histological slides of a patient with tuberculosis. Which of the following do you NOT expect this patient to have?
a. increase Th1 cells
b. lack of central necrosis
c. increased TNF alpha
d. Increase presence of Langhans type cells
Answer B.
TB is a form of CASEOUS granuloma:
- central area of necrosis
- increased IL-12 that activates Th1 cells (caseous granuloma has persistent T cell mediated response
- TNF alpha is important for MAINTAINING granulomas
- increased Langhans cells which are fused macrophages
What cytokine MAINTAINS granulomas?
TNF alpha
What is the difference between granulation tissue and granuloma?
Granuloma: is subtype of chronic inflamm. characterized by epitheliod histiocytes
GRanulation tissue: is initial phase of tissue when forming a scar
made up of fibroblasts , myoepethial cells and capillaries.
What cytokine is important for connective tissue deposition in scar tissue formation?
TGF B ( secreted by M2 macrophages and promotes fibroblast proliferation )
Your med school classmate got a paper cut. You use a butterfly bandage to bring the edges of the wound together with minimal scar formation. Which of the following is involved in healing of this wound?
a. wound contraction
b. clot as a scaffold
c. conversion of type 3 collagen to type 1
d. intense inflammatory response
B. clot formation is used as an initial scaffold in PRIMARY INTENTION wound healing
A,C,D are all related to SECONDARY intention
Your med school classmate got a paper cut. You use a butterfly bandage to bring the edges of the wound together with minimal scar formation. Which of the following is involved in healing of this wound?
a. wound contraction
b. clot as a scaffold
c. conversion of type 1 collagen to type 3
d. intense inflammatory response
B. clot formation is used as an initial scaffold in PRIMARY INTENTION wound healing
A,D are all related to SECONDARY intention
- edges are NOT approximated
- leaves a big scar
- involves wound contraction by myofibroblasts
- has larger granulation tissue formation
C. Type 3 collagen is converted to Type 1 in scar tissue
What is formed when there is EXCESS production of scar tissue that is out of proportion to the wound?
Keloid
What do you expect to see around days 5-7 in scar tissue formation?
a. increased presence of M2s
b. increased TGF B and FGF
c. increased Type 1 collagen
d. decreased growth factors
B. TGF B and FGF dominate days 5-7 as they cause fibroblast recruitment, ECM depostition and agiogenesis.
A. is seen in the FIRST 24 hours
C. is seen WEEKS after during scar formation
D. you would see INCREASED growth factors in scar tissue formation
What cells release IL-17?
T lymphocytes
What cells release TNF alpha?
macrophages, mast cells, T lymphocytes
What cells release IL-12?
Macrophages (M1) and dendritic cells
What T cell type targets eusinophils by releasing IL-4 and IL-5 ?
Th2 (for parasites)
In the presence of Extracellular bacteria which T cell targets recruitment of neutrophils ?
Th 17 for EXTRAcellular bacteria
Th 1 recruits macrophage for INTRAcellular bacteria
In what type of inflmmation would you note tertiary lymphoid organs?
CHRONIC :
made up of lymphocytes , antigent presenting cells and plasma cells
Give an example of a condition in which you would note tertiary lymphoid organs?
Anything Autoimmune which is characterized as CHRONIC inflammation
ex. hashimoto or rheumatoid arthritis
What cell releases histamine, leukotrienes and prostaglandins?
Mast cells
What is the source of Bradykinin and C5a or C53 ?
Complement and Kinins come from plasma (Produced in LIVER)
Deficiency of what factor leads to paroxysosomal noctural hemoglobinuria (PNH)?
DAF factor : prevents formation of C3 convertase
What inhibitor prevents the formation of MAC complex?
CD59 inhibitor
Deficiency in what ___ leads to deficiency in both DAF and CD59 inhibitors?
GP1 anchors, these anchor the inhibtors to membrane
Which cytokine is implicated in the Acute phase protein response?
IL-6
In what time period of wound healing would you see increased fibroblasts and collegenases?
in REMODELING phase which is a FEW WEEKS
A zinc deficiency would effect what part of wound healing?
REMODELING because collegenases are dependent on zinc (metal ion)
in adhesion process ICAM/VCAM are present on __________ and VLA-4 / LFA-1 are present on ?
vasculature; leukocyte
What are some angiogenic factors that contribute to wound healing?
VEGF, FGF, TGF B
What process requires notch signaling?
Angiogenesis in scar formation
A hypertrophic scar is a result of increased__________
collagen type III
What type of cells would you find in someone with pulmonary fibrosis?
macrophages and FIbroblasts
