Exam II studying Flashcards by Morgan Evans

What is the primary cause of hyperemia?

Excessive arterial blood

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Which of the following is NOT a risk factor for thrombosis?
a) Factor V Leiden mutation
b) Protein C & S deficiency
c) High HDL levels
d) Immobility

c) High HDL levels

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Factor V Leiden mutation increases the risk of:
a) Bleeding disorders
b) Thrombosis
c) Anemia
d) Hemophilia

b) Thrombosis

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A pulmonary embolism most commonly originates from a:
a) Carotid artery thrombus
b) Deep vein thrombosis (DVT)
c) Cardiac mural thrombus
d) Fat embolism

b) Deep vein thrombosis (DVT)

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Kawasaki disease primarily affects:
a) Elderly patients
b) Infants and young children
c) Middle-aged adults
d) Immunocompromised individuals

b) Infants and young children

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Which condition is characterized by exaggerated vasoconstriction of digital arteries?

Raynaud’s

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Which of the following is a major risk factor for Buerger’s disease?
a) Hypertension
b) Smoking
c) Diabetes
d) Hypercholesterolemia

b) Smoking

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In septic shock, endothelial cells release nitric oxide, causing:
a) Vasoconstriction
b) Vasodilation
c) Increased platelet aggregation
d) Hypertension

b) Vasodilation

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Prostacyclin (PGI2) & nitric oxide have what in common?

Both inhibit platelets, both are endothelial anticoagulants

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Prostacyclin (PGI2), nitric oxide, (both inhibit platelets) adenosine diphosphatase have what in common?

All are endothelial anticoagulants

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True or false: A white infarct is caused by arterial occlusion

True

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True or false: Factor V Leiden mutation makes clotting more difficult.

False

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True or false:
1) Aortic dissection occurs when blood enters between layers of the vessel wall.
2) Malignant hypertension has a rapid progression with BP > 200/120 mmHg.

1) True
2) True

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What is Warfarin’s MOA?

Inhibits vitamin K/ depletes its reserves

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True or false:
1) Protein C and S deficiencies lead to increased bleeding.
2) Atherosclerotic aneurysms occur most frequently in the abdominal aorta and common illiac

1) False (they’re anticoagulants, so if you don’t have enough, you bleed less)
2) True

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True or false:
1) Heparin overdose can be reversed with vitamin K.
2) Coronary (localized) atherosclerosis is a cause of MIs (T/F)

1) False (Protamine Sulfate is the antidote)
2) True

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CD4 secretes what cytokines in type I rxns?

IL-4-> IgE
IL-5 -> activates mast cells
IL-13 -> allergy symptoms (sneeze, cough, runny eyes) as body is trying to flush out parasite/allergen

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What is the main function of C3b in the complement system?
A) Destroy red blood cells
B) Opsonization of pathogens
C) Neutralization of viruses
D) Antigen presentation

B) Opsonization of pathogens

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What is the role of CD8 T cells?
A) Antibody production
B) Antigen presentation
C) Killing infected cells
D) Activating neutrophils

C) Killing infected cells

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What 3 weapons do CD8 cells have?

Perforins (poke holes), fas ligand, + cytokines (activate apoptosis)

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What is the primary role of MHC II molecules on APCs?
A) Present self-antigens to CD8 T cells
B) Present foreign antigens to CD4 T cells
C) Recognize IgE antibodies
D) Destroy pathogens directly

B) Present foreign antigens to CD4 T cells

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Somatic recombination allows for diversity in what immune cells?

B cells

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What occurs during a Type II hypersensitivity reaction?
A) Immune complexes deposit in tissues
B) Antibodies attack self-cells
C) Delayed T-cell response
D) Histamine release

B) Antibodies attack self-cells

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Which hypersensitivity reaction involves antigen-antibody complexes causing tissue damage?
A) Type I
B) Type II
C) Type III
D) Type IV

C) Type III

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Which hypersensitivity reaction involves antigen-antibody complexes causing tissue damage? A) Type I B) Type II C) Type III D) Type IV

C) Type III

What condition is associated with Type IV hypersensitivity? A) Anaphylaxis B) Myasthenia gravis C) Contact dermatitis D) Hemolytic anemia

C) Contact dermatitis (think poison ivy)

Which autoimmune disease is specifically mentioned to involve autoantibodies against nuclear antigens? A) Rheumatoid arthritis B) Multiple sclerosis C) Systemic lupus erythematosus D) Myasthenia gravis

C) Systemic lupus erythematosus

What is the likely primary mechanism of rheumatoid arthritis? A) Type I hypersensitivity B) Type II hypersensitivity C) Type III hypersensitivity D) Type IV hypersensitivity

D) Type IV hypersensitivity

Which autoimmune disease targets the neuromuscular junction? A) Multiple sclerosis B) Hashimoto thyroiditis C) Myasthenia gravis D) Pemphigus

C) Myasthenia gravis (Ig shuts off Ach receptors at NMJ; type II hypersensitivity receptor)

In which phase of HIV infection does seroconversion occur? A) Acute phase B) Chronic phase C) AIDS phase D) Latency phase

A) Acute phase (takes 1-6 months)

What is the primary type of amyloidosis? A) Multiple myeloma-associated B) Reactive systemic C) Localized D) None of the above

A) Multiple myeloma-associated

Which is a common opportunistic infection in AIDS patients? A) Influenza B) Pneumocystis pneumonia C) Hepatitis A D) Lyme disease

B) Pneumocystis pneumonia

What are the 3 groups of AIDS defining conditions?

1) Serious opportunistic infxns (pneumonia, colitis), 2) Secondary neoplasms (lymphomas, kaposi sarcoma), 3) Neurologic manifestations (encephalitis, dementia)

What triggers organ transplant rejection? A) Autoantibodies B) Host T cells recognizing foreign HLA antigens C) B cell proliferation D) IgE-mediated response

B) Host T cells recognizing foreign HLA antigens

What is amyloidosis characterized by? A) Autoantibodies against connective tissue B) Deposition of fibrillar proteins in tissues C) Excessive B cell activation D) Hyperactive mast cells

B) Deposition of fibrillar proteins in tissues

List some types of amyloidosis

1) Primary (multiple myeloma) 2) Reactive systemic (chronic inflammation) 3) Others (localized)

What test is used to diagnose amyloidosis? A) PCR test B) Biopsy C) Blood culture D) ELISA

B) Biopsy

What is a function of smooth endoplasmic reticulum? A) Steroid synthesis B) Protein folding C) ATP production D) Intracellular digestion

A) Steroid synthesis

What molecule tags proteins for degradation in the proteasome? A) Ubiquitin B) ATP C) Cytochrome C D) Histamine

A) Ubiquitin

What is hypertrophy? A) Decrease in cell number B) Increase in cell size C) Replacement of one cell type with another D) Uncontrolled cell death

B) Increase in cell size

Which of the following is an example of metaplasia? A) Increased cardiac muscle size B) Change in bronchi cells due to smoking C) Loss of neurons due to aging D) Red blood cell destruction

B) Change in bronchi cells due to smoking

What type of necrosis is commonly seen in ischemia and infarction? A) Liquefactive B) Caseous C) Coagulative D) Fat

C) Coagulative

Which type of necrosis is associated with tuberculosis? A) Coagulative B) Caseous C) Liquefactive D) Fibrinoid

B) Caseous

Differentiate between intrinsic and extrinsic apoptosis; which involves mitochondria?

1) Intrinsic: mitochondria initiate apoptosis 2) Extrinsic (death receptor): cells express antigens on surface to trigger apoptosis

What is the effector caspase?

Caspase 3

What is the role of caspases in apoptosis? A) Inhibit inflammation B) Trigger DNA replication C) Execute cell death D) Repair damaged mitochondria

C) Execute cell death

What protein prevents cytochrome C from being released/ apoptosis? A) Bax B) Bak C) BCL-2 D) BAD

C) BCL-2

Describe the intrinsic pathway of apoptosis

Bax-bak homodimer comes together to let cytochrome c out of cell: 1) BCL-2 protein binds with bax (so bax can't bind to bak to let cytochrome c out) 2) When it’s time to self destruct, BAD protein is produced which binds to BCL-2 and allows bax-bak to come together and let cytochrome c out 3) This leads to initiation of caspaces 8,9, then 3 which self destructs cell

Describe PRR + PAMP functions

1) PRR (pattern recognition receptors) on phagocytes surface -Allows innate system to latch on to foreign invaders (recognize 1000s of pathogens) 2) PAMPs (pathogen associated molecular pattern) are pieces of pathogen that are essential for the pathogens life cycle that are recognizable by PRP -Same type of system that connect to DAMPs when cell is damaged -PRR (receptor) + PAMP (ligand on pathogen) initiate phagocytosis and cytokine release

List 3 medications that block TNF (leukocyte-recruiting cytokine) for chronic inflammatory disease Tx

Infliximab (Remicade) Adalimumab (Humira) Etanercept (Enbrel)

Systemic acute-phase response includes what

Fever + SIRS response

What type of molecule recognizes PAMPs (pathogen-associated molecular patterns)? A) T cells B) Phagocytes C) Antibodies D) Plasma cells

B) Phagocytes

Which is the receptor, PRR or PAMP?

PRR

Which exists on pathogens, PRR or PAMP?

PAMP

What inflammatory molecule is produced via COX-1 and COX-2 enzymes? A) Histamine B) Prostaglandins C) Complement proteins D) Cytokines

B) Prostaglandins

How do NSAIDs Tx fever?

Turn down prostaglandins

What do leukotrienes (from mast cells) do?

1) Involved in vascular and smooth muscle reactions and leukocyte recruitment 2) Key for vasodilation

What are two Arachidonic Acid Metabolites?

Prostaglandins and leukotrienes

What drug type blocks leukotrienes to treat asthma and allergies? A) NSAIDs B) COX inhibitors C) Leukotriene receptor antagonists D) Corticosteroids

C) Leukotriene receptor antagonists

List some pharmacologic suppressors of inflammation

1) **COX inhibitors** (NSAIDs to COX2) 2) Lipoxygenase inhibitors 3) **Corticosteroids** (reduce transcription of genes for COX2, phospholipase, and inflammatory cytokines) 4) **Leukotriene receptor antagonists** (stop action of leukotrienes to treat asthma/allergies)

What type of inflammation is characterized by watery exudate? A) Fibrinous B) Purulent C) Granulomatous D) Serous

D) Serous (created by injury to surface epithelium)

What cytokine is a key mediator of fever? A) TNF-alpha B) IL-1 C) IL-6 D) All of the above

D) All of the above

What acute-phase protein increases during inflammation?

CRP (C-reactive protein)

What are exogenous pyrogenes? (in fever/ acute phase response)

Bacterial products stimulate leukocytes to release cytokines (primarily IL-1 and TNF) that increase the enzymes (cyclooxygenase) that convert AA to prostaglandins

How can the liver repair itself?

Cytokines and growth factors

What type of wound healing involves more scarring and wound contraction? A) First intention B) Second intention C) Granulation tissue formation D) Primary union

B) Second intention

What are the 3 main phases of cutaneous wound healing?

1) Inflammation 2) Formation of granulation tissue 3) ECM remodeling

What cellular process contributes to aging? A) Accumulation of DNA mutations B) Increased ATP production C) Enhanced mitochondrial function D) Lower levels of reactive oxygen species

A) Accumulation of DNA mutations

Give examples of intracellular accumulations

1) **Fatty liver changes:** due to alcohol abuse, DM with obesity, non-alcoholic steatohepatitis (NASH) 2) Atherosclerosis 3) Coal miners lung: due to exogenous carbon producing anthracosis 4) Lipofuscin: yellow-brown pigment of membrane lipids (wear and tear) 5) Calcification: common on aortic valve

What are 2 effects of cellular aging?

1) Decreased cell replication (limited capacity) 2) Build up of various substance (triglycerides, cholesterol, proteins, glycogen pigments)

Suppurative inflammation is also called what?

Purulent

When does the body use Granulomatous Inflammation?

When the pathogen can't be eliminated

What acts as a cellular "doorstop"?

BCL-2 (keeps bax-bak from becoming a homodimer)

When is the extrinsic pathway of apoptosis used?

Self-reactive T cells in the thymus

How does the extrinsic pathway of apoptosis start?

Self-reactive T cell presents antigen to death receptor (TNF-alpha, Fas Fas)

What does heritability measure? A) The chance of passing a disorder to offspring B) The fraction of phenotypic variance due to genetic variation C) The likelihood of an environmental factor influencing a trait D) The presence of a trait in one individual but not their relative

B) The fraction of phenotypic variance due to genetic variation

True or false: DM is an example of a multifactorial disorder

True

How is the relative risk ratio used in studying multifactorial diseases? A) It compares affected relatives to the general population B) It identifies the exact genes responsible for a disease C) It measures the environmental impact on a disease D) It determines if a disease is Mendelian or multifactorial

A) It compares affected relatives to the general population