Exam 1: Dr. Pruett Chapter 1 Flashcards
In 1849, what were recommended treatments for tetanus? (9)
Bleeding Mercury to cause vigorous vomiting Purgatives to cause clearance of colon Tobacco enema until signs of nicotine poisoning Tonics Ardent spirits Nutriment Cannabis Opium
What was medicine based on?
Logic or anecdotal evidence by authorities
What was the rationale for bleeding, purgatives, and emetics?
There was something bad in the body causing illness so “flushing” was needed
What is the gold standard for evidence based medicine?
Double blind clinical trial
What happens in a double blind clinical trial?
Neither the doctor nor the patient know if they received the experimental drug or other therapy or an inert placebo. At the end of the day, the results are decoded and analyzed
What is the null hypothesis in a double blind clinical trial?
The treatment has no effect
If statistical analysis reveals that there is less than a 5% chance that the difference between groups could be explained by natural variations, what happens?
The null hypothesis can be rejected and the drug can be regarded as having some effect
What is an example of a drug that has never been tested? How have they studied its efficacy?
Aspirin
It is compared to other drugs
What animals is the innate system present in?
All
How often is the innate system ready?
At all times
What kind of response does the innate system have?
Rapidly deployed, early-phase response
What does the innate system involve?
Germline encoded receptors that can recognize the presence of microbes or damage
How were receptors selected in the innate immune system?
Over evolution
What does the innate system recognize?
Broad groups of related microbes or other threats
Is the innate system triggered by self antigens alone?
Rarely
What is the innate immune response regulated by?
A variety of cells and molecules that are effective against a wide range of microbes
Is the efficiency of the innate system improved with repeated exposure?
No
What animals is the adaptive system present in?
Only vertebrates
What does the adaptive system require?
Selection of lymphocytes
What kind of response does the adaptive system have?
Delayed late-phase response
What does the adaptive system involve?
Gene rearrangement of receptors that are highly specific
When are receptors selected in the adaptive system?
In individual animals during maturation
What does the adaptive system recognize?
Specific single molecules
Does the adaptive system react to self antigens?
It may
What is the adaptive system response mediated by?
Antigen-specific lymphocytes that are effective against a particular antigen
How is efficiency improved in the adaptive system?
With repeated exposure to a given antigen (memory)
What are examples of extracellular innate effectors?
Complement activation
Phagocytosis by phagocytes
Extracellular killing
What is an example of intracellular innate effectors?
NK cell cytotoxicity
What are examples of extracellular adaptive effectors?
B cells
Helper T cells
Antibodies (humoral)
What are examples of intracellular adaptive effectors?
Cytotoxic T cells
Macrophage
Helper T cells
What is the secondary immune response like?
It is faster and longer
What happens when an antibody binds to bacterial toxins?
It goes through neutralization and then ingestion by a macrophage
What happens when an antibody binds to bacteria in extracellular space?
It goes through opsonization and then ingestion and lysis
What happens when an antibody binds to bacteria in plasma?
It goes through complement activation and then either opsoniziation to ingestion and lysis or straight into ingestion and lysis
What do interleukins do?
Deliver messages between leukocytes
What are the primary lymphoid organs?
Bone marrow
Thymus
What does the bone marrow do?
Produces the precursors of all cells of the innate and acquired immune systems in mammals as well as RBCs and platelets
What happens in the thymus?
Pre-T cells migrate from the bone marrow to the thymus and mature in the thymus to functions T-lymphocytes
What are the secondary lymphoid organs locations of?
Microbial clearance and acquired immune response initiation
What are the secondary lymphoid organs?
Lymph nodes
Spleen
Gut associated lymphoid tissue
Bronchial associated lymphoid tissues
What is the spleen an alternative site for?
Hematopoiesis
What happens with 90% of T cells?
The recognize self too strongly in thymic education and are killed
Why are the primary and secondary lymphoid organs in birds and fish different?
They do not have bone marrow hematopoietic function
Do lymphocytes enter through afferent lymphatic vessels?
No
Where do lymphocytes enter?
After arterioles become venules, lymphocytes enter through them and then use receptor-mediated active transport
Where can lymphocytes exit through?
Efferent lymphatic vessels
What does a germinal center indicate?
Active immune response in that location
What is the immediate source of lymphocytes?
Blood
What does the heart indirectly drive?
Efferent circulation
What are T cells needed to do?
Activate the acquire immune response of B cells
What does a ruptured spleen lead to?
Blood loss
How does antigen enter the spleen?
Via blood, not lymphatics
What does the spleen consist of?
Red pulp and white pulp
What does red pulp consist of?
RBCs and stem cells
What is the center of white pulp?
A central arteriole
What happens to someone without a spleen?
They are prone to infection
What is the primary function of the spleen?
Provide an immune response/blood filter
What is the main regulator of the immune system?
Clearance of the stimulus
The adaptive system can’t always kill microbes alone. What does the system do in the case that it cannot?
It activate the innate system to a higher degree to help remove the microbe
Know and understand chart on page 15
Know and understand chart on page 15
What percentage of microbes in the GI tract are unknown?
60%
What is the innate barrier in the reproductive tract?
Low pH
What are the innate barriers in the intestinal tract?
Rapid change in pH Lysozyme Defensins Hydrolases Bile acids Peristalsis Mucus
What are the innate barriers in the skin?
Keratinized barrier
Desquamation
Fatty acids
Dessication
What is the innate barrier in the urinary tract?
Unidirectional flushing
What are the innate barriers in the mammary gland?
Keratin plug Flushing Complement Lysozyme Lactoferrin Lactoperoxidase
What are the innate barriers in the cornea and conjunctiva?
Physical flushing
Lysozyme in lacrimal secretions
What are the innate barriers in the trachea/bronchi?
Mucus
Cilia-mediated clearance
Cough
What is the innate barrier in the upper respiratory tract?
Trapping and removal of particulates in mucus
How and why does the ciliated epithelium of the respiratory tract lining move?
Moves in a rhythmic motion by nerve cells to keep mucus moving up
