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Exam IV Flashcards

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1
Q

Granzymes

A
  • Enzyme that stimulates target cell to go into apoptosis
  • Released by NKC
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2
Q

Brain Macrophage

A

Microglia

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3
Q

Erythema

A

Redness

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4
Q

Arcuate Artery

A
  • Nephron circulation
  • Branch of the renal artery
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5
Q

MHC Class III

A
  • Complement proteins
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6
Q

Epitopes

A
  • Different shapes on the antigen that will have different antibodies stick to them
  • String of amino acids that folds in a particular way
  • Antibodies can distinguish between epitopes (3rd line)
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7
Q

Celiac Disease

A
  • Immune system attacks gluten
  • Leaky intestinal cells
  • Gut inflammation
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8
Q

Creatinine Clearance

A
  • Creatinine is the breakdown of creatine (from muscles)
  • Look at clearance…. essentially GFR
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9
Q

TCR

A

T-Cell Receptor

  • On helper T
  • CD4 is a co-receptor
  • Can see antigen in the context of MHC-2 molecule
  • MHC-2 Restricted
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10
Q

Aldosterone

A
  • Steroid hormone… acts on distal tubule

Actions

1. Increase Na permeability

2. Run Na/K pump… keep gradient, retain Na

  • K builds up in cell and diffiuses down K channel… goes into urine

3. Increase ATP production in mitochondria

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11
Q

V Region

A

Variable Region

  • 500
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12
Q

Kidney Secretion

A

From peritubular capillaries

Into tubules

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13
Q

Basophils

A
  • 0.1% of WBC
  • Produce hisamine and are involved with fighting off parasites
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14
Q

Low Cl and renin

A
  • Slow GFR
  • Means filtrate coming through nephron has been too slow… able to take out more Cl
  • increase renin
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15
Q

What kind of molecules are antibodies?

A

glycoproteins

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16
Q

IgE

A

Monomer

  • Mostly involved in allergies
  • Promotes the release of histamine
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17
Q

Monocyte –> Macrophage

A
  • Monocyte leaves cirulation at the site of immune battle
  • Crawls into battle and becomes a macrophage
  • Loses its kidney shaped membrane
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18
Q

ANF Acts On

A
  1. Kidney
  2. Adrenal Cortex
  3. Hypothalamus
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19
Q

Timing of normal immune response

A
  • IgM peak after a week
  • After 2 weeks, IgG enters the scene and IgM fades away
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20
Q

Keeping Penicillin in the body longer

A
  • Penicillin + PAH
  • Compete for same transporters on the proximal tubule
  • Increase the half life of penicillin in the blood
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21
Q

Urea Loop

A
  • Ascending limb and collecting duct are permeable to urea
  • If urea is in the collecting duct, water is reabsorbed… sucked out of the duct
  • Urea follows it and accumulates in the medulla –> absorb into ascending loop –> through distal tubule to collect duct
  • positive feedback loop that makes filtrate more and more concentrated
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22
Q

Job of the kidney

A
  • Filtration
  • Reabsorption
  • Secretion
  • Excretion
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23
Q

What holds together protein chains on antibody?

A

disulfide bonds

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24
Q

Alcohol and ADH

A
  • Alcohol inhibits ADH
  • Frequent urination
  • Diuresis beynd fluid you take in… dehydrated… hungover

-

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25
Q

Germinal Centers

A
  • Collection of immune cells
  • Organized to scan everything that enters the mouth

Sends information to the tonsils

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26
Q

Dehydration

A
  • Increase plasma osmolarity
  • Decrease blood pressure
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27
Q

Cytokines

A
  • Immune messengers
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28
Q

Cortical Nephrons

A

Have more of their body in the cortex

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29
Q

Type I Diabetes

A

Attack beta cells in pancreas

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30
Q

Hemorrhaging and Kidneys

A
  • Mesangial cells
  • Decrease blood flow and blood pressure
  • Restrict filtration
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31
Q

Neutrophil Attack

A
  • Attack cells that are nonself
  • Commit suicide
  • Secrete cytokines and free oxygen radicals
  • Kill with NETs…. neutrophil extracellular traps
  • Accumulate at the site of an infection and turn into pus
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32
Q

Edema

A

Swelling

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33
Q

How we get a concentrated urine (Henle and collecting duct)

A
  • Filtrate leaves Henle ~100 mosm
  • Enters collecting duct… higher osm. in the interstitial space
  • Water moves to higher osm
  • Osm gradient pulls water out of the collecting duct into the interstitial fluid
  • Urine filtrate ~ 1200 mosm
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34
Q

Free Iron

A
  • Microorganisms need free iron to grow
  • Stored in the liver and spleen

Fevers reduce free iron

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35
Q

Na is pumped on basolateral membrane

A
  1. Na enters the cell (from the tubule lumen) through membrane proteins moving down its chem gradient
  2. Na is pumped out into the interstitial fluid (basolateral side) by the Na/K ATPase

Energy heavy process. When we get Na moving we can get other stuff to move as well.

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36
Q

Kidney Filtration

A

From Glomerulus

Into proximal tubule

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37
Q

Angiotensin II

Vasoconstrictor

A
  • Constricts renal arterioles (especially efferent)
  • Increases GFR
  • Helps increase reabsorption in peritubular bed
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38
Q

Immune Defenses of the Mouth

A

First Line

  • Lymph passages germinal centers
  • GCs scan what enters the mouth and sends information to the tonisls
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39
Q

HLA Proteins

A

3rd Line - Human Leukocyte Antigens

  • Human MHC
  • First studied on the surface of WBCs
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40
Q

Ascending Limb

Loop of Henle

A
  • Water impermeable
  • Ion permeable… ions pumped out in thick limb until filtrate is 100 mOsm
  • Lower part is generally passive diffusion
  • Concentration of solute goes down as ascend
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41
Q

Monocyte

A
  • Kidney shaped nucleus
  • Big
  • Live in the blood circulation
  • Eat up invaders

Major Role: precursors for macrophages

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42
Q

Red Blood Cell

A
  • Lifespan is 120 days
  • Hb
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43
Q

Osmolarity of filtrate in distal tubule

A

100 mosm

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44
Q

Idiopathic Urticaria

A

Hives without a cause

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45
Q

MHCs are Polymorphic

A
  • The reason why we have such different tissue types on our surfaces
  • Protect from invading pathogens that might try to mimic surface markers on our cells
  • Populations with little genetic diversity are susceptible to pathogens
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46
Q

Non-Specific ID Model

A
  • Negative Test

Second line

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47
Q

Angtiotensin I

A
  • Travels through lungs and acted upon by ACE –> angiotensin II (active form)
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48
Q

Innate Immune System

Definition

A
  • Built in
  • Already present
  • Always on
  • Non-specific
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49
Q

Pale with fever

A
  • Vasoconstriction in the periphery
  • Conserve heat in the core
  • Shivering makes more heat
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50
Q

Plasma Load

A

mg/min

= plasma concentration (mg/mL) * renal plasma flow (mL/min)

  • Overall load into kidneys

-

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51
Q

Stem Cells in the Bone Marrow

A
  • Make all the blood cells
  • Start as a hemocytoblast… pluripotent
  • Two brances: myeloid and lymphoid progenitors
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52
Q

Cells associated with the distal tubule

A

Macula Densa Cells

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53
Q

Vasa Recta

A

“Countercurrent exchanger”

  • Readily exchanges Na, Cl, Water
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54
Q

Lysozyme

A
  • In bodily secretions
  • Punches holes in bacterial cell walls
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55
Q

Eosinophils

A
  • 1-3% of WBC
  • Involved in allergies and defense against parasites
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56
Q

Complement System

A

Second Line

- 20 or so aseemble into MAC

  • Series of protein from the liver that circulate in the blood
  • Ability to recogize foreign cells
  • See foreign cell –> assemble into membrane attack complex
  • Make a hole and kill
  • 20 proteins involved…. C3 is at the center of the whole mechanism
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57
Q

ACE Inhibitors

A
  • Inhibits Angiotensin Converting Enzyme
  • Blocks Angtiotensin-II
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58
Q

Opsonization

A
  • Complement system and killer cells target things covered in Ab
  • Antibody/antigen complex facilitates phagocytosis through….

- Neutralization of function

- Agglutination,

- Precipitation

  • All of these enhance inflammatory response
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59
Q

Constrict efferent arteriole

A
  • Renal plasma flow decreases
  • GFR increases due to back-up pressure
  • Reabsorption in the peritubular bed increases because the fluid is not moving as quickly
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60
Q

Thiazide

A
  • Blood pressure medication
  • Block sodium reuptake in the distal tubule
  • Diuertic
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61
Q

Organic Ions

A

Penicillin

PAH (para aminohippuric acid)

Aspirin

Bile Salt

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62
Q

Where does the process of reabsorption begin in the nephron?

A

Proximal tubule

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63
Q

MIF

A

Macrophage Inhibitor Factor

  • Keeps the macrophage on the scene instead of roaming the body as it usually does
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64
Q

Urushiol

A
  • Oil on the poison ivy plant
  • Delayed type hypersensitivity
  • Get fluid filled swelling (from leaky vessels)
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65
Q

Percent of reabsorption that occurs in the proximal tubule

A

75-90%

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66
Q

Exogenous Pyrogen

A

Components of bacterial cell walls can induce fevers

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67
Q

IBD / Crohn’s

A

Inflammatory bowel disease

  • NOT IBS
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68
Q

Amount of blood to kidneys

A
  • 20% of cardiac output
  • 1.2 L/ min
  • 600 mL plasma/ min
  • Split evenly between the two kidneys
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69
Q

Grave’s and Hashimoto’s

A

Body makes thyorid agonist/antagonist

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70
Q

Reabsorption in the Proximal Tubule

A
  1. Na is reabsorbed by active transport
  2. Electrochemical gradient drives anion reabsorption
  3. Water moves by osmosis following solute reabsorption
  4. Concentrates of other solutes increase as fluid volume in the lumen decreases. Permeable solutes are reabsorbed by diffusion
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71
Q

Secretion

A

Moving compounds from the blood into the proximal tubule

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72
Q

Cushing’s and Addison’s

A

Body makes cortisol agonist/antagonist

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73
Q

Lymphatic System Drainage

A

Second Line

  • Dump drainage into the thoacic duct
  • Then goes to subclavian veins
  • Collect excess fluid from the body and put back into circulation
  • Can get blockages in the thoracic duct… lymphodema
  • Drainage from the whole body except immunologically privileged sites
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74
Q

T-Helper Cell

Overview

A
  • Work with other cells to improve the immune response
  • Some say there are two populations (1 and 2)
  • Have CD4 marker on the surface
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75
Q

Transmembrane Domain

A
  • How the antibody is anchored in the membrane
  • Ab site is facing out
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76
Q

Effect of Afferent Dilation on GFR

A

Dilate - increase

Constrct - decrease

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77
Q

ANF and Kidney

A
  • Inhibit renin… stop AT-II cascade
  • Decrease AT-II, decrease reabsorption
  • Temporary increase GFR
  • Decrease Na reabsorb in tubule
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78
Q

Why inhibit ADH in pregancy?

A
  • Increase blood volume
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79
Q

Antigens

A
  • Markers on the ouside of cells that antibodies can bind to
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80
Q

Filtered Load

A
  • How much of a substance is being put into the nephrons

= ([X] in plasma) * (GFR)

mg/min

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81
Q

ADH Secretion vs. Plasma Osmolarity

A
  • Increase plasma osmolarity (dehydration)… increase ADH
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82
Q

Ammonium Ion Trap

A
  • Some H+ secreted by kidney
  • Cell removes amine group from glutamine
  • Amine binds H+ to make ammonium (pka 9.2)
  • 9.2 > 7.4 therefore stays ammonium
  • Pee the ammonium out
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83
Q

Collecting Duct

A

Reabsorb water to make a concentrated urine

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84
Q

Heterologous Transplant

A
  • Someone else’s tissue but with a matching tissue type (MHC match)
  • Usually from a relative
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85
Q

Effects of increased ADH

A
  • Increase body water
  • Increas blood volume
  • Decrease plasma osmolarity
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86
Q

ACE

A
  • Angiotensin converting enzyme

Angiotensin I –> Angiotensin II

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87
Q

Angiotensin II

Hypothalamus

A

Increases

  • Thirst
  • Salt hunger
  • ADH secretion
  • Water volume, BP, GFR
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88
Q

Lymph Capillaries

A
  • Have one way valves
  • Only flow away from tissue
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89
Q

Bowman’s Capsule

A
  • Contains the glomerulus
  • In the cortex
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90
Q

Antibody

A
  • proteins that ciruclate and have the ability to bind to a specific structure called an antigen

3rd line

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91
Q

Pyrogen

A

Second Line

  • Substances in body that cause a rise in temperature
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92
Q

Positive Test

A

Third Line

  • If you are identified as a pathogen, attack
  • Specific ID card model
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93
Q

Angiotensin II

Adrenal Cortex

A

Inc. Aldosterone and Inc. Sodium Retention

- This increases…..

  • Water retention
  • BP
  • GFR
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94
Q

Inducer T-Cells

A
  • Stimulate the production of more T-Cells when needed
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95
Q

B-Cells

A

3rd Line - Lymphocyte

  • From bone marrow
  • When activated become plasma cells
  • Activated form has lots of rough ER
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96
Q

What does an antibody actually do?

A
  • Mark for destruction
  • When foreign antigens are covered with antibodies, they are attacked more efficiently
  • When virus is covered in antibodies, cannot adhere to other cells (be infectious)
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97
Q

Two capillary beds of the nephron

A
  1. Glomerulus
  2. Peritubular
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98
Q

IL-2

A
  • T-cell growth factor
  • Sitmulates the growth of more T-cells
  • Especially those that have formed an immune synapse
  • Clonal selection
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99
Q

What part of the nephron is called the “countercurrent multiplier?”

A

Loop of Henle

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100
Q

Negative Test

A

Innate

  • Non-specific ID model… second line
  • If you do not have the right ID markers on the cell, throw them out
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101
Q

Memory cells

A
  • After two weeks, some specific Tc cells are held in reserve as memory cells
  • This is active immunity
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102
Q

ANF and Hypothalamus

A

Decrease ADH

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103
Q

Hemocytoblast

A
  • Root of all blood cells
  • Pluripotent
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104
Q

Lymphedema

A
  • Blockage of the thoracic duct
  • Common after breast cancer surgery
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105
Q

Helper T-Cell Activated Release

A
  1. MIF
  2. IL-2
  3. Stimulate thymus to push out more T cells (might involve Ti cells)
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106
Q

Plasma Clearance

A
  • Ability of kidney to remove solute from blood (mL/min)
  • How many mL of plasma are completely cleared of a given substance?
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107
Q

Lymphatic Jobs

A

Second Line

  1. Drainage
  2. Absorb fat in the gut
  3. Filter fluids it collects through checkpoints called lymph nodes
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108
Q

Buffers in the Body to maintain pH = 7.4

A
  • Proteins
  • CO2
  • Kidney
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109
Q

Skin Immune Function

A

First Line

  • Immune response when breached
  • Glands secrete immune defenses… low pH to inihbit bacterial growth… lysozyme in bodily secretions… antibodies
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110
Q

How do we create an osmotic gradient in the nephron?

A
  1. Loop of Henle
  2. Urea Loop
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111
Q

IgM

A
  • Pentamer
  • First antibody secreted during primary immune response
  • Promotes agglutination (things sticking together) reactions
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112
Q

Five Classes of Anitbodies

A

IgM

IgG

IgD

IgA

IgE

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113
Q

T- Cells

A

Lymphocyte - 3rd Line

  • From the bone marrow
  • Go to the thymus for education
  • Leave thymus and are immunocompetent
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114
Q

MHC Proteins

A

3rd Line- Major Histocompatibility Complex

  • Type of cell surface ID marker
  • Three classes
  • In humans referred to as HLA proteins
  • Polymorphic
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115
Q

Angiotensinogen and Obesity

A
  • High BP and hypertension
  • More visceral fat you have, the more angiotensinogen in circulation…
  • Increase AT-II, increase sodium/water retention, increase BP
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116
Q

Tc is MHC-1 Restricted

A
  • Can only see antigen in the context of MHC-1
  • Clonal selection
  • TCR on Tc recognize foreign antibodies on MHC-1
  • Only in synapse stimulated by IL-2
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117
Q

Cells associated with the afferent arteriole

A

Juxtaglomerular Cells

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118
Q

Allergic Response

A
  • Respond to allergen
  • B cells ab receptors bind to allergen… convert to plasma cell
  • Produce IgE which stick to surface of mast cell
  • Mast cells accumulate granules full of histamine
  • Later exposure causes histamine release
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119
Q

Osmolarity

A

particles per liter

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120
Q

Fab Sequence

A
  • Some constant areas
  • Variablity towards top (part involved in recognition)
  • Especially variable parts are hypervariable regions
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121
Q

Burn Victims

A
  • No skin, lose water, dehydration
  • Need urea to maintain osmotic gradient and promote reabsorption
  • More reabsorb, less urine, less dehydration
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122
Q

Descending Limb

Loop of Henle

A
  • Permeable to water
  • Impermeable to salt
  • Suck water out
  • Increase concentration of filtrate in tubule
  • Do this to set up ascending limb
123
Q

Autoregulation in the Kidney

A
  • Monitor Na and Cl (mostly Cl) concentrations in the distal tubule by macula densa cells
  • MDC talk to JC cells which release renin
  • Do not know how the communitcation works
124
Q

Signals for Renin Release

A
  1. NaCl (Cl more important)
  2. Sympathetic neurons signal JG cells
  3. Decrease the perfusion pressure in the afferent arteriole
125
Q

Normal release of antibody

A

IgM then IgG

126
Q

D Region

A
  • Diversity region
  • 15 of them
127
Q

Cyclosporin

A

Immunosuppressant Drug

  • Kidney transplants
128
Q

Tonsils

A
  • 6… three sets of pairs
  • Palatine are the ones you can see

- Lingual at the base of the tongue

- Adenoids are behind and above the uvula

129
Q

Immunologically Privileged Sites

A
  • Do not have normal blood circulation therefore do not have lymph
  • Cartilage, cornea
130
Q

EPO

A

Erythropoietin

  • Increase RBC production
131
Q

Third Line of Defense

A

Specific

  • Lympocytes (T-Cells)
  • B Cells
  • Cell surface ID makrers
  • Specific ID Card Model
132
Q

Fever as a defense mechanism

A

Goals

  • Slow growth of microorganisms
  • Reduce free iron
  • Increase activity of phagocytes
133
Q

Percent of filtrate that we reabsorb

A

99%

134
Q

Humoral Immunity

A

Phase III

  • Free antigen any form
  • IL-2 and IL-4
  • B cells making the antibody (effector)
135
Q

NETs

A

Neutrophil Extracellular Traps

  • Throw a bunch of fibers (DNA)
  • Ropes up invaders and holes them in place while the immmune system finishes them off
136
Q

Rheumatoid Arthritis

A

Attack connective tissue

137
Q

Newborn Mice Skin Experiment

A
  • Transplant regions of skin from another species of mice onto the skin of young mice
  • Will tolerate
  • Only young cells… no memory for immune response/ rejection
138
Q

Plasma Clearance

A
  • Ability of the kidney to remove a solute form blood

Excretion rate = ([x] in plasma) * (plasma clearance)

mg/min

  • Can use the plasma clearance of a substance that is only filtered (not reabsorb or secrete) i.e. inulin or creatine
139
Q

Cimetidine

A
  • Histamine antagonist
  • For gastric ulcers
  • Competes with cardiac drugs for arrythmia
  • Easy to overdose if taking both
140
Q

MAC

A

Membrane Attack Complex

  • Second line complement system
  • Make a hole in foreign cell and kill it

C3 is at the center of the whole mechanism

141
Q

IgG

A
  • Secreted in secondary response
  • Most abundant form of antibody in the blood
  • Monomer
142
Q

Things that are not filtered in the glomureulus

A
  • RBC
  • WBC
  • Large protein
143
Q

Skin Secretion Defenses

A
  • Low pH
  • Lysozyme
  • Antibodies
144
Q

Thoracic Duct

A
  • Gets drainage from the lymph system
  • Dumps it into the subclavian veins
  • Can get blocked… called lymphodema
145
Q

Lung Macrophage

A

Dust Cell

146
Q

Autoimmune Mimicry

A
  • T cells presented with an antigen by a virally-infected cell on its MHC-1
  • Viral antigen is the same as self-antigen (coincidence)
  • T-cells continue to attack self-antigen
147
Q

Kidney Output

A

Renin

Vitamin D3 (Calcitriol)

EPO

148
Q

Histamine

A
  • Allergic reactions
  • Cause swelling, leaky vessels, itching
  • Release promoted by IgE
149
Q

Heavy Chain Diversity

A

V*J*D

37,500

150
Q

Lupus

A

Systematic

  • Immune system attacks all over the face

Butterfly rash

151
Q

Functional Unit of the Kidney

A

Nephron

- Part in cortex, part in medulla

  • 1 million nephrons in a kidney
152
Q

Regulatory T-Cells

A
  • We think they have CD4
  • Turn down immune response
  • Unclear how they work
153
Q

Fate of H+ From Kidney

A
  • Make H2CO3
  • Combine with phosphoric acid which can be deprotonated as needed
  • Ammonium Ion Trap
154
Q

Cell Mediated Immunity

A
  • MHC-1 proteins display viral antigens
  • Tc use CD8 to recognize antigens in MHC-1 groove and form immune synapse (Tc and MHC restricted)
  • Tc cells in synapse do nothing until Th cells recognize antigens on macrophage MHC-2 receptors and secrete IL-2… then cytotoxic and replication(clonal selection)
  • Takes a week to get peak response
  • After 2 weeks, Ts cells turn down the response
155
Q

Anaphylaxis

A
  • An accute allergic reaction to an antigen to which the body has become hypersensitive
156
Q

Pathogens Evade Immune Response

A
  • Hide inside a cell
  • Knock out Th cells
  • Waxy exterior
  • Change surface antigens
157
Q

Worms and Autoimmune Diseases

A

Inhibit T Cells

  • Increase Tr activity/ stimulate release of inihibitory cytokines
  • Promoting helpful gut microflora
158
Q

Increase in blood loss

A
  • Decrease BP
  • Sympathetic input for mesangial cell contraction
  • Shuts down the glomerulus
  • Shuts down areas of kidneys to retain fluid and try to raise BP
159
Q

Neutrophils

A
  • Lifespan is 8 hours
  • Phagocytic
  • Multilobed nucleus
  • Increase in number during infection
  • Can consume invading cells

Major Job: attack cells that are nonself

160
Q

Cytotoxic T-Cells

A
  • Killing ability for certain infected cells
  • Have CD8 marker on their surface
161
Q

ADH

A
  • Increases the permeability of water in collecting duct
  • When ADH is low make a less concentrated urine because the duct is not permeable to water.
162
Q

Immune Surveillance

A

Second Line

  • Detects invaders (or cancers)
  • Eliminated things often before we know they are there!

If there is a defect in immune surveillance, more infections and cancer

163
Q

Blocking SGLT-2

A
  • Treatment for type II diabetes
  • Block glucose uptake so it does not get across
  • Glucose stays in lumen, pee it out.
164
Q

Renal Plasma Flow

A
  • Measures plasma flowing into nephrones through glo.
  • GFR varies with RPF
  • Flow rate is constant over a wide variety of arterial pressures… only fluctates at extremes
165
Q

Signals for aldosterone release

A
  • High angiotensin
  • High K+
166
Q

Enlarged Spleen

A
  • Splenomegaly
  • Lymphoma, leukemia, mono
  • Binds up platelets
  • Fewer platelets in circulation and perhaps issues clotting
167
Q

Dilate afferent arteriole

A

Increase flow and filtration

168
Q

IL in Phase III

A

2 and 4

  • Converts activated B cells to plasma cell
  • Antibody made in plasma cell is specific to pathogen
  • B cells and free antibodies bind to the antigen/invader in any form
169
Q

Light and Heavy Diversity (numbers)

A

37,500*1500 = 56 million antibody binding specificities

170
Q

Constrict afferent arteriole

A

Decrease flow and filtration

171
Q

Transport Maximum

A
  • Transporters in nephron are saturated

= (filtered load) - (excretion rate)

+ = reabsorb

- = secreted

172
Q

T-Cell Activation

A
  • Ciruclate around like regular old lymphocytes
  • When activated cell changes….

Get larger

More cytoplasm

Getting ready for battle

173
Q

Inflammation

A

Non-specific response

  • A call to arms
  • There has been a breach of the first line… assemble!
  • Makes blood vessels in the area leaky

- Edema and erythema

174
Q

B-Cell Education

A
  • Do not know where it is happening
  • Think it occurs in circulation
175
Q

Interferon

A

Second Line

  • Proteins that warn of infection
  • Cell realizes its been compromised by a pathogen… releases interferons to notify other cells
  • Alpha, beta, gamma types
  • Local cells alter metabolism to resist viruses (slow their replication processes)… reduce transcription, shorten half-life of RNA
176
Q

Graft vs. Host Disease

A
  • Try to do an allogeneic transplant with bone marrow
  • Body attacks transplanted tissue
177
Q

Where does the reabsorbed water go?

A

Vasa recta off the peritubular bed

Deep in the medulla

178
Q

Things that increase ADH

A
  • Increas plasma osmolarity
  • Decrease blood pressure
179
Q

Filtration forces

A
  • Protein not filtered in GFR
  • Blood into efferent arteriole has increase oncotic pressure
  • Use oncotic pressure to help with reabsorption

Net filtration pressure is 10 mm Hg

180
Q

Aplastic Anemia

A
  • Stop making blood cells
  • Can occur with no known cause
  • Also from exposure to chemicals, pathogens
  • Treat with a bone marrow transplant
181
Q

Three Phases of Immune Response

A

Phase I:

  • Initial, nonspecific
  • Antigen presentation
  • Th (specific)

Phase IIa: cell mediated immunity

Phase IIb: humoral immunity

182
Q

Class Switch

A
  • Preserve VDJ
  • Change c regaion (Fc)
183
Q

Inulin

A
  • Polysaccharide from plants
  • Filtered, not reabsorbed or secreted
184
Q

IgA

A
  • Dimer
  • Found in bodily secretions (breast milk, tears, saliva, mucus)
185
Q

Edward Jenner

A
  • Noticed that women who worked with cows never got smallpox (though they got cowpox- less severe, survivable)
  • Inject kid with cowpox… first vaccine
186
Q

4 things that contribute to G.O.D

A

Somatic Recombination

Combinatorial Diversity

Imprecision around J regions

Somatic Mutation

187
Q

Things that influence the kidney

A

Aldosterone

ADH

ANF

Sympathetic Nervous System

PTH

Angiotensin II

188
Q

Hygiene Hypothesis

A
  • We are too clean
  • Not enough enemies for immune system… boredom –> overrations

Evidence: Finland vs. Russia, worse in western world, farmers have less autoimmune diseases

  • Worm thing
189
Q

Self-Tolerance Mechanism in T-Cells

A
  • Prevent T cells from attacking self
  • Must receive 2 signals before attack
    1. binding of antigen to T-cell receptor
    2. Secretion/binding of a protein B7… if T cell is exposed to a self protein that is presented on a nonstimulatory cell, T cell will die or become inactive
190
Q

APC

A

Antigen Presenting Cell

  • Material presenting derives from thing eaten

Macrophage

191
Q

Plasma Cell

A
  • Th and B in synapsis
  • Th release IL-4 and B cell turns into plasma cell
  • Plasma cell works as antibody factory that is pathogen specific
  • Release ab into blood and lymph where they can bind pathogens and antigen presenting cells through opsonization
192
Q

SGLT-2

A
  • Sodium glucose transporter 2
  • In proximal tubule cells on the tubule lumen side
193
Q

MHC-1

A

Found on all cells

Diplays internally synthesized peptides

194
Q

J Region

A
  • Joining Region
  • Joining the variable parts of the C region
  • 5
195
Q

Ureter

A

Drains kidney into bladder

196
Q

Natriuresis

A
  • Excretion of Na in urine
  • Caused by ANF
  • Increase volume of urine because osmotic forces make water follow Na
197
Q

Kidney Reabsorption

A

From tubules

Into peritubular capillaries

198
Q

TCR is MHC-2 Restricted

A
  • T-cells only detect antigen when it is being presented by MHC-2
199
Q

Interleukin-1

A
  • Cytokine
  • Endogenous pyrogen
  • Stimulatesd more T-Cell synthesis (especially helper T cells)
200
Q

Killer Cell

A
  • Punch holes in cells covered in antibodies
201
Q

Artery in the kidney

A

Arcuate artery

202
Q

C3

A
  • At the center of the MAC
203
Q

Immune Synapse

A
  • Th cell attached to macrophage’s MHC-2 using TCR
  • CD4 on Th acts like co-receptor
  • Th cell is activated after synapse forms
  • Macrophage secretes IL-1
  • Th: secretes MIF and IL-2
204
Q

Where can pathogens hide?

A

Phagocytes, in an endosome TB and Plague

RBCs Malaria

Digestive Epithelium Salmonella

205
Q

Thick Limb

Loop of Henle

A
  • Filled with ion pumps for Na, K, Cl
  • Pump out enough salt so the osmolarity inside is ~ 100 mosm at the top
206
Q

Lymph Nodes

A
  • Checkpoints
  • Small organs with same lymphatic arrangement
  • Survey what happens in the fluid that passes through
  • Send warning signals if something is fishy
  • immune surveillance
207
Q

Fc

A
  • Same for all antibodies in the same class
  • Is what signals for destruction
  • Signals that antibodies are present and stuck to things
208
Q

Control of body temperature

A

hypothalamus

209
Q

Diapedesis

A
  • Phagocyte mobilization
  • Immune cells squeeze through spaces in epithelial cell lining capillaries to get to where they need to be
210
Q

Kidney Excretion

A

From collecting duct

Into urine

211
Q

Lasix

A
  • Drug
  • Diuretic
  • Inhibits ion pumps in the thick ascending limb
  • Na, Cl, K stay in the ascedning limb… go into urine, take water with them
212
Q

Glucose Absorption

A
  • Use a Na/Glucose cotransporter SGLT-2
  • Glucose moves in through GLUT-2
  • Use ATP pump that lowers Na to make gtadient
213
Q

Autologous Transplant

A
  • Get your own tissue
  • Happens in some kinds of cancer
  • Risky but can work
214
Q

Immune system “ehancers”

A
  • Science: none of them prevent infection but can minimally shorten duration of symptoms

Zinc, vitamin C, chicken soup (thins mucus, mildly anti-inflammatory)

215
Q

Second Line of Defesne

A

Innate

“Cellular mechanisms, specific proteins, other things…”

  • Lymphatic
  • Bone Marrow
  • Non-specific cells
  • Other (interferon, temperature, complement)
  • Inflammation
  • Pattern recognition receptors
  • Non-specific ID model
216
Q

Macula Densa Cells

A
  • Along the outside of the distal tubule
  • Monitor [Na] and [Cl] in tubule
217
Q

ANF

A

Atrial Natriuretic Factor

  • From right atrium of heart
  • Stretch RA - release ANF
  • Results in natriuresis (increase in urine flow mostly due to Na excretion… temporary)
  • Happens when there is too much body fluid
218
Q

Lymphocytes

A
  • 3rd Line, specific immune cells
  • About the size of an RBC
  • Large nucleus takes up most of hte cytoplasm
  • have surface mounted receptors they use to bind to target antigens

Examples: T-Cells and B-Cells

219
Q

Delayed Type Hypersensitivity

A
  • Takes 1-3 days
  • Classic example is poison ivy
220
Q

Spleen

A
  • Bag of blood and immune cells
  • Pneumonia fighting cells in the spleen
  • Many disorders worsen if spleen is not working
  • Thin membrane… can rupture/ get injured… removal
221
Q

Myasthenia Gravis

A

Affects ACh receptors in the thymus

222
Q

Immune Repertoire

A

3rd Line

  • All of your receptors and antibodies that can recognize antigens
223
Q

Natural Killer Cells

A
  • Punch holes in nonself cells
  • Secretory granules with perforin protein… dump into target cell
  • Perforin assembles into a complex that makes a big round hole
  • Also releases ranzymes
  • Important for immune surveillance
224
Q

Juxtamedullary Nephrons

A
  • Longer nephrons
  • Will focus on these ones
225
Q

Nephron Circulation

A
  • Blood intro the glomerulus through an afferent arteriole
  • Leaves via the efferent arteriole
  • Efferent art. breaks into a cappillary bed that surrounds the proximal and distal tubules called the peritubular capillary bed
226
Q

Decrease in Cl reaction cascade

A

Angioteninsogen + Renin

Angiotensin I

ACE

Angiotensin II

227
Q

Gamma Interferon

A
  • Acts as an immune cytokine
  • Has been used for some cancer treatments with some success
228
Q

Class I MHC

A
  • Glycoprotein
  • Have a groove for antigen peptide present for recognition
  • Found on all nucleated cells
  • Receptors: heavy and beta-2-microglobulin
229
Q

What happens to the 120 mL/min?

A
  • Some becomes urine
  • A LOT is reabsorbed
230
Q

Perforin

A
  • Protein released by NKC
  • Dumps into target cell
  • Assembles into a complex that makes a round hole
231
Q

Opsonization

A
  • If you have a chunk of invading organism with antibodies gets eaten more easily
232
Q

pH of body

A

7.4

233
Q

Things the nephron can reabsorb

A
  • Glucose
  • Ions
  • Water
234
Q

Peyer’s Patches

A

First Line

  • Similar to lymphoid areas
  • In intestinal tract
  • Think they’re monitoring what comes in
235
Q

How HIV infects cells

A
  • Need CD4 receptor to infect
  • Surface marker on virus attacks CD4 on T-Cells
  • Needs CCR5 co-receptor
  • There are pepople with CCR5 mutation who are immune to HIV
236
Q

Skin body weight percentage

A

15%

237
Q

Reabsorbing from the proximal tubule goes into….

A

The preitubular capillary bed

238
Q

What is our protection from high K?

A

ALDOSTERONE

239
Q

Net filtration pressure

A

10 mm Hg

240
Q

Graft Rejection

A

Example of cell mediated immunity

  • When someone rejects a graft it is usually CMI
241
Q

Loop of Henle

A
  • Sets up our osmotic gradient
242
Q

Pattern Recognition Receptors

A
  • Integral proteins in phagocytic cell membranes
  • Recognize traditional forms of pathogens (bacteria, virus, fungi, parasites) in a non-specific way
  • Sends out signals… warning for the rest of the immune system to say something has been detected
  • Worked on by Charles Janeway
243
Q

Cow Pox

A
  • Difference between cow and small pox is so small that T and B cells involved in immune response cannot tell the difference
  • Edward Jenner
244
Q

Mesangial Cells

A
  • Innervated by the sympathetic nervous system
  • Have the ability to contract and close off regions of the capillary bed (stop blood flow)
  • If hemorrhaging…. decrease blood volume and pressure, restrict filtration
245
Q

Pathogen that changes surface antigens

A

Typanosomes

246
Q

Appendix

A

2nd Line

  • Unsure what it is doing
  • Think it might be a reservoir for immune cells and certain types of gut bacteria
  • Think it helps set up a young person’s immune system
247
Q

Where does urine become concentrated?

A

Collecting Duct

248
Q

Angiotensinogen

A
  • Made in liver, circulates blood
  • Renin + Angiotensinogen –> Angiotensin I
  • Also produced by adipose tissue
249
Q

Autoimmune Diseases

A
  • Immune education goes awry and lymphocytes attack self antigens
  • Some have a genetic component
  • Triggered by autoimmune mimicry after a viral infection
250
Q

Sympathetic Neurons and JG Cells

A
  • Sympathetic resonse if decrease in blood pressure
  • Decrease BP … Increase renin
251
Q

The G.O.D. Search

A
  • Not millions of genes… different regions that can be organized in different ways

C

J

D

V

252
Q

Anergy

A

Non-reactive T-Cells

253
Q

Distal Tubule

A
  • Where filtration occurs (after we have reabsorbed in the proximal tubule and gone through the loop of Henle)
254
Q

Juxtagolmerular Apparatus

A
  • JG cells + MD cells
255
Q

MHC Class II

A

Glycoprotiens

  • Found ont he surface of immune cells (macrophages, B-cells, some T-Cells)
  • Groove for antigen peptide present for recognition
256
Q

Somatic Mutation

A
  • Get mutations during transition to plasma cell
257
Q

Angtiotensin II

A

Potent Vasoconstrictor

Acts on…

  • Adrenal cortex
  • Hypothalamus
258
Q

IgD

A
  • Monomer
  • More specialized
  • Surface of B cells… serves as a receptor
259
Q

Two controls of Aldosterone

A
  1. Renin
  2. K+ levels in the blood
260
Q

J region and diversity

A
  • Deltion in J region is not precise
  • also somatic mutation
261
Q

Four Types of T-Cells

A

Helper

Inducer

Cytotoxic

Suppressor/Regulatory

262
Q

Alpha Interpherons

A
  • Stimulate the natural killer cells
263
Q

Asthma

A

Attack tissues in airways –> inflammation

264
Q

What happens in the thymus gland (immune system)?

A

T-cell education

265
Q

CD Markers

A
  • Clusters of differentiation
  • Surface markers on immune cells
  • Important ones are CD4 and CD8

3rd Line

266
Q

Pathogen that knocks out Th cells

A

HIV

267
Q

Concetrated Urine

A
  • To combat dehydration
  • 4 times more concentrated than blood
  • U/P Ratio

1200 m osmolar / 200 m osm

268
Q

Scleroderma

A

Body makes anti-centromere antibodies

  • Too much collagen
  • alopecia, flare-ups
269
Q

Decrease Perfusion Pressure in Afferent Arterioles

A
  • Afferent arteriole can monitor pressure
  • If there is a decrease in pressure, signals an increase in renin
270
Q

Protein as a buffer

A
  • Use COOH to donate hydrogens
  • Use amino group to accept hydrogen

pK fro proteins = 7.4

Mostly R groups but could be backbone too

271
Q

Juxtaglomerular Cells

A
  • Associated with the afferent arteriole
  • Release renin into afferent arteriole
  • Get a series of reactions to stabilize GFR
272
Q

Water reabsorption without ADH

A
  • Osmotic gradient
  • Not permeable to water
  • Water goes through collecting duct
273
Q

Light Chain Diversity

A

1500

274
Q

Liver Macrophage

A

Kupffer’s Cells

275
Q

Blood Pressure Medications

A
  • Many are diuretics in the class thiazide
  • Block sodium reuptake in the distal tubule
  • Stop Na reabsorbtion, leaves in urine and water follows
  • Decrease blood volume, decrease BP
276
Q

Antigen Presentation

A

Phase I

  • Macrophage will take what it has eaten abd break it down with digestive enzymes in the lysosome
  • Take piece of peptide and put it on MHC molecule
  • Present on MHC-2
277
Q

Immunocompetent

A
  • Lymphocytes shown a bunch of self antigens in thymus
  • Any T-cell that sticks toa self antigen gets killed
  • The ones that pass the test go into the circulation and we say they are immunocompetent
278
Q

Standard Glomerular Filtration Rate

(GFR)

A
  • Kidney gets 600 mL of plasma/min

- standard GFR of 120 mLs/min

  • The other 480 mL go through the efferent tubule into the peritubular beds
279
Q

Podocytes

A
  • Specialized cells that surround capillaries
  • Control filtration
  • In charge of selection based on size
280
Q

Two types of protein chains on antibody

A

2 Heavy Chains

2 Light chains

281
Q

Adaptive Immune System

Definition

A

Very specific

282
Q

C Region

A
  • Constant Portion
  • Gene
283
Q

Macrophage as an APC

A
  • Break up virus
  • Display peptides from the virus on cell surface

Macrophage saying “invader here this is what it looks like”

  • Displayed antigen is seen by the TCR on the helper T cells
284
Q

Somatic Recombination

A
  • During the maturation of a lymphocyte –> B-Cell… chooses certain genes with four regions through random selection
  • DNA splicing

-

285
Q

Kidney Osmotic Gradient

A

Cortex: 300 m osm

Medulla: 1200 m osm

286
Q

Dendritic Cell/ Langerhan’s Cells

A
  • Skin macrophage
  • Found in the tissue exposed to the exterior
287
Q

B7

A
  • Protein that is the second signal in activating a T cell
  • If not present and bound, T cell will become inactive or die
288
Q

Excretion Rate

A

How much of a substance is being secreted in urine

= ([X] in urine) * (Urine output)

mg/min

289
Q

TB Test

A
  • Delayed hypersensitivity
  • Tuerculin skin test
  • If raised or red, have been exposed to TB (do not necessarily hvae it, but need further tests)
290
Q

How ADH Promotes Water Reabsorption

A
  1. ADH binds to membrane receptor
  2. Receptor activates cAMP second messenger system
  3. Cell interts AQP2 water pores into apical membrane
  4. Water is absorbed by osmosis into the blood
291
Q

Allergy Symptoms

A
  • Leaky vessels
  • Swelling
  • Runny nose
  • Mucus release
  • Low BP
  • Sneezing
292
Q

Pathogen with a waxy exterior

A

Leprosy

293
Q

First Line of Defense

A

Physical and biological barrier between body and the outside world

  • Skin
  • Openings in the skin
  • Peyer’s Patches
294
Q

Charles Janeway

A

Pattern Regocnition Receptors

  • Had a theory that if your innate mechanisms were not working then your immune response would be weak
  • Found PRPs
295
Q

Kidney and Secretion

A
  • Secrete things in proximal tubule
  • Organic ion transporters
  • Take ions out of the blood put them through tubule
  • Antiporter brings in ion from blood… when ion goes to lumen, exchange for a like charge from lumen
296
Q

Effect of efferent dilation on flow

A

Constrict - increase flow

297
Q

Subclavian Veins

A
  • Get fluid form the thoracic duct
  • Collect excess fluid from the body and put back into circulation
298
Q

Burn Victims and Urea

A
  • Dehydration
  • Need urea in diet (protein) to get fully functioning osmotic gradient
  • Low protein diets made dehydration worse
299
Q

ANF and adrenal cortex

A

Decrease aldosterone

300
Q

Macrophages

A

Big Eaters

  • From monocyte precursors
  • Live in tissues
  • Different names specific to different tissues
301
Q

Allogeneic Transplant

A
  • Someone else’s tissue tissue but not a tissue match
  • Will not work with bone marrow (because of immune cells)
302
Q

Clonal Selection

A
  • Going to activate and replicate only those T cells that are specific to this infection and let other T cells rest
303
Q

Humoral Immunity

A
  • B cells have antibody molecules on membrane
  • Recognize pathogen… bind and eat
  • After this, work with Th like macrophages do
  • In synapsis, Th secrete IL-4… activates B cell and turns into plasma cell

Bio II (6 decks)

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