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P Intergrated Y2 > EMS lectures 4,5,6,7 > Flashcards

EMS lectures 4,5,6,7 Flashcards

1
Q

What cells are of lymphoid lineage

A

natural T killer cell, small lymphocytes, T cell, B cell and plasma cells

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2
Q

What cells are of myeloid lineage

A

megakaryocyte, RBC, mast cells, myeloblasts, thrombocytes, basophils, neutrophils, eosinophils, monocytes, macrophages

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3
Q

What are the 5 major components of the innate immune system

A 
Pattern recognition receptors
antimicrobial peptides
cells
complement components
cytokines
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4
Q

what are Pattern recognition receptors

A

antigen recognition receptor

  • specific
  • 2 groups
    • cell surface (transmembrane and intercellular receptors - TLR, NLR, RLR, CLR)
    • Fluid phase soluble molecules = c-type lectin family (collectins)

Role in neutralisation of pathogen and recruitment of adaptive response

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5
Q

Role of cell in innate immune system

Macrophage

A

Phagocytose and kill bacteria

produce inflammatory cytokines

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6
Q

Role of cell in innate immune system

Natural Killer cells

A

kill foreign and host cells that have low levels of MHC+ self peptides

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7
Q

Role of cell in innate immune system

NK T cells

A

recognize lipid antigens of intracellular bacteria by CD1 and kill infected host cells

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8
Q

Role of cell in innate immune system

Neutrophils

A

phagocytose and kill bacteria, produce antimicrobial peptides

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9
Q

Role of cell in innate immune system

eosinophils

A

kill invading parasites

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10
Q

Role of cell in innate immune system

mast cells and basophils

A

release TNF, IL6, IFN

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11
Q

Role of cell in innate immune system

Epithelia cells

A

produce antimicrobial peptides,

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12
Q

What is the adaptive immune response

A

evolution in response to changing pathogen structures

  • unique antigen receptor on each lymphocyte
  • clonal expansion of lymphocyte
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13
Q

What are the primary lymphoid organs and what is their function

A

bone marrow and thymus

lymphocyte development and selection

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14
Q

what are the secondary lymphoid organs and what is their function

A

spleen
lymph nodes
mucosal surfaces

immune responses

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15
Q

What is the mechanism of antigen presentation

A

1) Antigen internalised and broken into peptides
2) peptides associated with class 2 molecules
3) presented on cell surge
4) peptides recognised as foreign by T helper Cells
5) activated T helper cells secrete cytokines for T and B cells

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16
Q

What is the Histocompatibility antigen

- what are the classes of histocompatibility antigen

A
  • gycoprotiens expressed on mammalian cells that make us unique found on white cells
  • Human Leucocyte antigen (HLA)
  • coded for by MHC
  • Class 1 - HLA-A,B,C
  • Class 2 - HLA-DP,DQ,DR
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17
Q

What is the function of class 1 and class 2 MHC cells

A

T cells only see antigents associated with MHC proteins

Class 1 MHC presents peptides to cytotoxic T cells
Class 2 MHC presents peptides
to helper T cells

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18
Q

function of B cells

A

secrete antibodies (humeral immunity)

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19
Q

function of killer T lymphocytes

A

kill cells - cellular immunity

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20
Q

function of helper T lymphocytes

A

secrete cytokines, stimulate B and T lymphocytes

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21
Q

function of suppressor T lymphocytes

A

dampen down immune response

22
Q

Inactivation of antigens by the binding of antibodies can occur how?

A

neutralisation - coating and blocking binding sites
agglutination of microbes
precipitation of dissolved antigens
(enhances phagocytosis)

activation of complement system - causes cell lysis

23
Q

define immunosuppression

A

natural or artificial process turns off immune response

24
Q

define immunodeficiency

A

lack of efficient immune system

caused by immune suppression

25
Q

define hypersenstivity

A

undesirable reaction to an innocuous antigen in a pre senstized host with a normal immune system

26
Q

what are the types of hypersensitivity?

A

1) igE mediated reaction
2) cytotoxic reaction
3) immune complex reaction
4) cell mediated reaction

27
Q

features of type 1 hypersensitivty reaction

A

IgE mediated
realease of preformed mediator - histamine
synthesis of lipid mediator - leukotriene
- FAST onset, weal and flare
- common allergens - hay, pollen, bee stings
- assoicated disease- hay fever, allergic asthma

28
Q

Explain Immunoglobulin E

A

IgE
Produces by plasma cells from class switched B cell
production controlled by IL4 and CD40L - CD40 reaction
- low serum levels

High affinity for IgE receptor (FCeRI)on mast cells and basophils

29
Q

What does the preformed mediator do?

Histamine

A

stimulate irritant nerve receptors and smooth muscle contractions
increase vascular permiabiltiy

30
Q

What does the preformed mediator do?

kallikrein

A

activate Bradykinin

similar to histamine

31
Q

What does the preformed mediator do?

Tryptase

A

unknown

32
Q

when are preformed mediators released in the type one sensitivity reaction?

A

in the early phase

during the degranulation of mast cells

33
Q

What is the role of the eosinophils and basophils in the late phase type 1 reaction?

A

Basophils - degranulate and release preformed mediators

Eosinophils - release contents of Granules (cytotoxic proteins)

  • major source of tissue damage
  • attracted to sites of allergic inflammation by chemokines

T cells - continue reaction with production of cytokines

34
Q

explain type 2 hypersensitivity reaction

A

cytotoxic
IgM (or IgG) initiated
activated compliment cascade –> lysis
aggregation of Ig –> phagocytosis

usually affects haemopoietic cells

Associated diseases
ABO incompatibility
Autoimmune anaemias
Platelet disorders

35
Q

Explain type 3 hypersensitivity

A

Immune complex formed
FcR binds to C1q
Compliment activation generates activated complement fragments
C5a - attract neutrophils
C3b - opsonin
attempted phagocytosis of complexes = release of enzymes and free radicals

TISSUE DAMAGE = RESULT

36
Q

EXPLAIN type 4 hypersensitivty

A 
T cell mediated - CD4, MHC2
delayed reaction 
Langerhans cells present NEOANTIGENS to T cells 
T cells release cytokines
Macrophages recruited
Macrophages cause tissue damage
37
Q

Explain T cell cytotoxicity

A

CD8 MHC1 - contact demerits

Antigen presented by APC

38
Q

Explain Granulomatous reaction

A

Collection on inflammatory cells in tissues
release of cytokines by T cells cause initial response

Caused by
TB, leprosy, sarcoidosis, crohn’s

39
Q

Primary Causes of chronic inflammation

A

endogenous material

  • necrotic adipose tissue
  • uric acid crystals

exogenous material

  • implanted prosthesis
  • sutures
  • asbestos fibres

Autoimmune

  • SLE
  • rheumatoid arthritis

Primary Granulomatous

  • Sarocoidosis
  • Crohns

Infections

  • TB
  • Leprosy
  • some viral infections
40
Q

How does acute inflammation progress to chronic

give an example

A

Most commonly supprative acute inflammation

  • forms abscess
  • walls thicken
  • granulation and scaring
  • recurrent inflammation leads to chronic

e.g. cholecystitis - call bladder inflammation from stones

41
Q

What are the morphological features of chronic inflammation

A

infiltration by mononuclear cells (macrophage, lymphocytes, plasma cells)

  • tissue distruction
  • healing by fibrosis
42
Q

Role of the macrophage in chronic inflammation

A

Increase inflammation - stimulating immune system

  • release cytokines which recruits monocytes
  • proliferate and immobilise in damaged tissue
  • debride damaged tissue with proteases inducing angiogenesis and granulation
43
Q

what is leukocyte extravasion

A

the recruitment of monocytes through the endothelium of the blood vessels into the damaged area of tissues

44
Q

What is granulation tissue

A

new connective tissue and blood vessels that form on surface of wound during healing

  • fibroblasts deposit collagen
  • aim to repair by replacement of injured tissues with fibrous tissues

stimulated by macrophage debridement of damaged cells

45
Q

What is fibrosis

A

formation of excess fibrous connective tissue during repair

fibroma - if from 1 cell line
macrophage induced

46
Q

What is granulomatous inflammation

A

aggregation of macrophages, lymphocytes and histiocytic giant cells (aka langhans type giant cells)

often with caseous necrotic centre (= caseous epitheliod granuloma)

47
Q

what are histiocytic giant cells

A

formed when macrophages are unable to digest material

  • multinucleated >100
48
Q

What are granulomatous diseases

A 
Bacterial - TB, Leprosy
Parasitic - schistosomiasis
Fungal - Cryptococcus
Synthetic material - silicosis
Unknown - sarcoidosis, crohn's
49
Q

What is chronic inflammation response to MI?

A

Myocardial fibrosis

50
Q

how is inflammation involved in atheroma formation

A

macrophages adhere to epithelium and recruit other cells

51
Q

How does inflammation in MS present?

A

plasma cells and t lymphocytes are found in white matter because macrophages have broken down myelin

P Intergrated Y2 (13 decks)

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