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OPT 537 > Exam 1 -- Inflammation > Flashcards

Exam 1 -- Inflammation Flashcards

1
Q

What cell types are associated with acute inflammation?

A

Neutrophils

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2
Q

What cell types are associated with chronic inflammation?

A

Lymphocytes and macrophages

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3
Q

What type of inflammation is associated with new vessel growth and fibrosis?

A

Chronic

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4
Q

What type of adhesion molecule causes slowing of WBC movement along the vessel wall?

A

Selectin

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5
Q

What type of adhesion molecule causes the WBC to stop along the vessel wall?

A

Integrin

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6
Q

What substance does the WBC release in order to pass through the basement membrane?

A

Collegenase

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7
Q

What substances contribute to the chemotaxis that pulls WBCs toward the damaged area?

A

Bacterial products, C5a, LTB4, IL-8

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8
Q

What substances act as opsonins during an inflammatory response?

A

IgG and C3b (among others)

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9
Q

Although histamine is predominantly found in mast cells, where else might it be found?

A

Basophils and platelets

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10
Q

True or false: serotonin is found in mast cells

A

False; it is found primarily in platelets

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11
Q

What is the result of serotonin release during the inflammatory response?

A

Vasodilation and easier clot formation

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12
Q

Prostaglandins and leukotrienes are metabolites of what molecule?

A

Arachidonic acid

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13
Q

The cyclooxygenase pathway results in the production of what products?

A

Prostaglandins, prostacyclins, and thromboxanes

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14
Q

The lipoxygenase pathway results in the production of what products?

A

Leukotrienes (5-LO) and lipoxins (5-LO then 12-LO)

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15
Q

The end products of the COX pathway depends on the enzymes present in a particular type of cell. What cell type results in protacyclin (PGI2)?

A

Endothelial cells

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16
Q

What is the action of prostacyclin?

A

Vasodilation and inhibition of platelet aggregation

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17
Q

The end products of the COX pathway depends on the enzymes present in a particular type of cell. What cell type results in thromboxane A2 (TXA2)?

A

Platelets

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18
Q

What is the action of thromboxane?

A

Vasoconstriction and platelet aggregation

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19
Q

Which leukotriene(s) is/are responsible for neutrophil chemotaxis?

A

LTB4

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20
Q

Which leukotriene(s) is/are responsible for bronchospasm?

A

LTC4, D4, and E4

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21
Q

Which leukotriene(s) is/are responsible for vasoconstriction?

A

LTC4, D4, and E4

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22
Q

What is the action of lipoxin?

A

Vasodilation, inhibition of neutrophil chemotaxis, stimulation of monocyte adhesion

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23
Q

What is/are the actions of platelet activating factor?

A

Platelet aggregation/adhesion, vasodilation, increased permeability, stimulates synthesis of AA metabolites, chemotaxis

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24
Q

Cytokines are produced mostly by what types of cells?

A

Lymphocytes and macrophages

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25
Q

What is/are the major actions of cytokines?

A

They cause WBC adherence to the vessel endothelium (activate, aggregate, and aggravate)

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26
Q

Interleukin-1 (IL-1) is produced by what type of cell?

A

Activated macrophages

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27
Q

What is/are the actions of IL-1?

A

Activates vessel endothelium to increase WBC adhesion (activates selectins and integrins), enhances the production of AA and NO (?)

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28
Q

What are some symptoms caused by expression of IL-1?

A

Fever, lethargy, and decreased appetite

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29
Q

What is/are the actions of IL-8?

A

Chemo-attractant; activates PMNs (polymorphonuclear leukocytes), setting the stage for phagocytosis

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30
Q

Tumor necrosis factor (TNF) is produced by what type of cell?

A

Activated macrophages

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31
Q

What is/are the actions of TNF?

A

Causes aggregation and activation of neutrophils, activates vessel endothelium to increase WBC adhesion (activates selectins and integrins), increases thrombogenicity of endothelium (activates fibroblasts and increases collagen synthesis)

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32
Q

What are some symptoms caused by expression of TNF?

A

Fever, lethargy, and decreased appetite

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33
Q

<p>What is/are the actions of interferon-gamma (IFN)?</p>

A

<p>Limits spread of inflammatory process, activates macrophages and neutrophils, stimulates synthesis of NO, protects against viral infection (inhibits viral replication), induces production of IgG from plasma cells</p>

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34
Q

<p>What is/are the actions of NO?</p>

A

<p>Vasodilation (most potent vasodilator), microbiocide, antagonizes platelet activation, decreases leukocyte achesion</p>

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35
Q

Which complement molecules form the MAC?

A

C5b, C6-C9

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36
Q

Which complement molecules act as chemoattractants?

A

C5a and C5-C7 complex

37
Q

Which complement molecules are important in opsonization?

A

C3b

38
Q

Which complement molecules increase vascular permeability by mast cell degranulation?

A

C3a, C5a

39
Q

What actions are the end result of the kinin cascade?

A

Vasodilation, increased vascular permeability, bronchial constriction, PGI2 and NO release

40
Q

After fibrin has formed a clot, which molecule has the potential to break it down?

A

Plasmin; its precursor, plasminogen, entered the area with the fibrinogen and is activated by the endothelium once this has healed

41
Q

Describe transudate in terms of protein and cellular content.

A

Low protein content and few cells

42
Q

Describe exudate in terms of protein and cellular content.

A

High protein content and some WBC and RBC

43
Q

Which cytokine activates immature macrophages?

A

Interferon gamma

44
Q

Mast cells release what types of molecules?

A

Histamine and AA metabolites

45
Q

What type of modified macrophage is found in gramulomatous inflammation?

A

Epithelioid cells

46
Q

<p>What is the name for the mass of modified macrophages that accumulates during granulomatous inflammation?</p>

A

<p>Giant cell (made from epitheloid cells, which are modified macrophages)</p>

47
Q

Granulomatous inflammation is characteristic of what type of hypersensitivity?

A

Type IV hypersensitivity

48
Q

What types of agents may cause a granulomatous inflammation?

A

Bacteria, fungi, inorganic materials

49
Q

What types of granulomas are there?

A

Foreign body and immune

50
Q

What is another term for acute phase reaction?

A

Systemic inflammatory response syndrome

51
Q

Which cytokines are the most important in acute phase reaction?

A

TNF, IL-1, IL-6

52
Q

What are common features of the acute phase reaction (APR)?

A

Fever, fatigue, malaise, elevated WBC, elevated HR and BP, anorexia

53
Q

Which proteins have elevated levels during acute phase reaction?

A

C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA)

54
Q

Erythrocyte sedimentation rate is used to measure levels of what protein?

A

Fibrinogen

55
Q

What is a normal ESR result for a male?

A

Half of the age in years (in mm/hr)

56
Q

What is a normal ESR result for a female?

A

Half of (the age in years plus 10) (in mm/hr)

57
Q

What is the role of CRP?

A

Binds to cell wall of bacteria and fungi as opsonin and activates complement

58
Q

What is a normal value for CRP?

A

0-0.5 mg/dL

59
Q

<p>What is the role of SAA?</p>

A

<p>Recruits immune cells to inflammatory sites; induces enzymes that degrade ECM; is also associated with cancer (especially breast) and RA</p>

60
Q

What is a normal value for SAA?

A

0

61
Q

What four classes of drugs are important for ODs in terms of inflammation?

A

Antihistamines, mast cell stabilizers, NSAIDs, corticosteroids

62
Q

What is a key difference between hyperplasia and neoplasia?

A

Hyperplasms continues to respond to regulatory systems; neoplasms do not.

63
Q

What is metaplasia?

A

A cell type changing to another cell type to cope with the environmental factors

64
Q

What is dysplasia?

A

Disorderly proliferation of cells (but not neoplastic); sometimes called precancer

65
Q

What is another name for Type I hypersensitivity?

A

Anaphylactic (also, atopic)

66
Q

Which Ab is involved in Type I reaction?

A

IgE

67
Q

Which leukocytes are involved in Type I reactions?

A

Mast cells and basophils

68
Q

Why must care be taken after the immediate anaphylactic crisis is resolved?

A

Arachidonic acid metabolites are being created and will cause further problems 2-10 hours later

69
Q

What is another term for Type II hypersensitivities?

A

Antibody-mediated

70
Q

What are the three basic mechanisms of Type II reactions?

A

Opsonization and phagocytosis; inflammation; Ab-mediated cellular dysfunction

71
Q

Briefly outline opsonization and phagocytosis during a Type II reaction.

A

Drug on cell surface makes cell look foreign; Ab (IgG or IgM) attaches to cell and activates complement; cell is either destroyed by MAC, or C3a attracts neutrophils and macrophages while C3b serves as opsonin.

72
Q

What are two examples of Type II reactions involving opsonization and phagocytosis?

A

Hemolytic anemia; transfusion hemolysis

73
Q

Briefly outline inflammation during a Type II reaction.

A

Ab binds to cellular or tissue “Ag;” complement is activated and neutrophils and monocytes are recruited; these release inflammatory mediators which cause tissue damage due to frutrated phagocytosis

74
Q

What are two examples of Type II reactions involving inflammation?

A

Acute rheumatic fever, Mooren ulcer

75
Q

Briefly outline Ab-mediated cellular dysfunction during a Type II reaction.

A

Ab binds to or blocks a receptor, thus interfering with normal tissue function

76
Q

What are two examples of Type II reactions involving Ab-mediated cellular dysfunction?

A

MG and Grave’s disease

77
Q

What is another name for Type III hypersensitivity?

A

Immune complex mediated

78
Q

Briefly outline a Type III reaction.

A

Ag-Ab complex deposits in tissue and activates complement system; inflammation and tissue damage occur

79
Q

Which areas of the body are common sites of Type III reactions?

A

Blood vessels, kidneys, and joints

80
Q

What are three examples of Type III reactions?

A

Reaction arthritis (ReA), Systemic lupus erythematosus (SLE), Sjogren’s syndrome

81
Q

What is another name for Type IV hypersensitivity?

A

Cell-mediated (or delayed)

82
Q

True or false: Type IV reactions are a function of T cells, not antibodies

A

True.

83
Q

What are the two types of Type IV reactions?

A

Delayed-type hypersensitivity (DHT); T-cell mediated cytotoxicity

84
Q

In delayed-type hypersensitivity, which T cell is responsible for the reaction?

A

CD4+

85
Q

What are two examples of Type IV delayed-type reactions?

A

Tuberculin reaction, contact dermatitis

86
Q

In T-cell mediated cytotoxicity, which T cell is responsible for the reaction?

A

CD8+

87
Q

By what method do CD8+ cells cause damage?

A

They themselves release perforin and granzymes

88
Q

What are some examples of Type IV T-cell mediated cytotoxicity reactions?

A

T1DM, MS, Hashimoto thyroiditis

OPT 537 (21 decks)

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