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D&D, BL Unit III > Feb 25 2014, Imm Mods, Coagulation, Rheum > Flashcards

Feb 25 2014, Imm Mods, Coagulation, Rheum Flashcards

1
Q

What is a hybridoma?

A

A B-cell crossed with a myeloma cell

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2
Q

What are hybridomas good for?

A

Creating mAb’s for a particular disease

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3
Q

What is HAMA? HACA? HAHA?

A

Human-Anti-Mouse-Antibody
Human-Anti-Chimeric-Antibody
Human-Anti-Humanized-Antibody

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4
Q

What domains does a chimeric Ab have?

A

Human constant/variable regions and 1 mouse vL and vH domains

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5
Q

What domains does humanized Ab have?

A

All human domains, but mouse-derived epitopes

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6
Q

What are the most powerful pro-inflammatory cytokines?

A

TNFα and IL-1α,β

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7
Q

Why are NK cells really cool in terms of fighting tumors?

A

NK cells don’t need antigenic stimulation to kill tumor cells! (can grab Fc region on a self-cell)

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8
Q

What is ADCC?

A

Antibody-Dependent Cell-mediated Cytotoxicity

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9
Q

Why do we care about CTLA-4 and PD-1?

A

They downregulate CTR’s so tumor cells won’t kill themselves. D’oh!

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10
Q

What is BiTE? What does it do?

A

Bi-specific T-cell Engager - it forms a link between T cells and tumor cells so T-cells can secrete cytokines into induce cancer cell apoptosis

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11
Q

What is CAR? What does it do?

A

Chimeric Antigen Receptors - a sophisticated BiTE mAb on steroids

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12
Q

Another name for factor II (two)?

A

Prothrombin

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13
Q

Another name for factor I?

A

Fibrinogen

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14
Q

What are the zymogens?

A

Factors II, VII, IX, X, XI, XII, XIII

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15
Q

What are the vit K dependent factors?

A

Factors II, VII, IX, X, PC, PS

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16
Q

What is the tenase complex?

A

Factor VII, Ca2+, and TF (extrinsic) or factors VIII and IX, activated by the negitive phospholipid surface (intrinsic)

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17
Q

What does VWF do?

A

Binds to Factor VIII so it won’t degrade, also promotes forming the PLT-collagen clot

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18
Q

What’s in the extrinsic pathway?

A

TF, Factor VII

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19
Q

What’s in the intrinsic pathway?

A

XII, XI, IX, VIII

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20
Q

What’s in the common pathway?

A

V, X, II (prothrombin), I (fibrinogen), XIII

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21
Q

Physiologic anticoagulants?

A

PC, PS, AT3, TFPI, tPA, plasmin

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22
Q

Hemophilia A is a deficiency in which factor?

A

Factor VIII

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23
Q

Hemophilia B is a deficiency in which factor?

A

Factor IX

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24
Q

PTT can be equated to which pathway?

A

Intrinsic

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25
Q

PT can be equated to which pathway?

A

Extrinsic

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26
Q

What is the key protein in the fibrinolytic pathway?

A

Thrombomodulin (amps up PC, but disallows for fibrinolysis)

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27
Q

What molecule does Heparin bind?

A

AT3 (increases anticoagulation)

28
Q

What molecule does Warfarin bind?

A

Vit-K oxyreductase (inhibits vit K recycling; is an anticoagulant)

29
Q

4 Stages of Gout?

A

1) Asymptomatic hyperuricemia
2) Acute Gouty Arthritis
3) Intercritical Gout
4) Chronic Tophaceous Gout

30
Q

What crystal is deposited in gout?

A

MSU, monosodium urate

31
Q

Who usually is Dx’d with gout?

A

Men over 30 y/o, females too - only after menopause

32
Q

What do MSU crystals look like?

A

Needle-shaped and negatively bifringent (yellow when parallel)

33
Q

What synovial fluid classification accompanies gout?

A

Inflamed (WBC > 2,000)

34
Q

If the Pt has a 24h excretion of uric acid > 750 mg they are an:

A

Overproducer of uric acid

35
Q

If the Pt has a 24h excretion of uric acid < 750 mg they are an:

A

Underexcretor of uric acid

36
Q

Are most gout patients are overproducers or underexcretors?

A

Underexcretors

37
Q

What exchanger in the proximal tubule is responsible for pre-secretory/post-secretory reabsorption of uric acid?

A

URAT1, urate/organic anion exchanger

38
Q

Examples of excreted, unwanted organic acids?

A

Lactate, Acetoacetate, Hydroxybutyrate, Succinate

39
Q

Activators of URAT1?

A

nicotinate, pyrazinoate, diuretics, low-dose aspirin

decrease renal excretion of uric acid

40
Q

Inhibitors of URAT1?

A

probenecid, sulfinpyrazone, losartan metabolite, high-dose aspirin
(increase renal excretion of uric acid)

41
Q

Other urate transporters?

A

OAT4, OAT10, GLUT9a, ABCG2

42
Q

Which TLRs are associated with gout?

A

TLR 2, 4

43
Q

MSU crystals engage _____ which activates _____ which results in IL-1β production

A

caspase-1 ; NLRP3 inflammasome

44
Q

Acute gouty attack is treated with_____, ______, and ____

A

NSAIDs, colchicine (if no renal insufficiency), and corticosteroids

45
Q

Chronic gouty attack is treated with_____ or _______

A

a uricosuric or a xanthine oxidase inhibitor

46
Q

What HLA for gouty Koreans, Han Chinese, or Thai persons?

A

HLAB*5801

47
Q

What is CPPD? Cyrstal shape, refraction?

A

Calcium pyrophosphate dihydrate, rhomboid-shaped, positively bifringent (blue when parallel)

48
Q

What causes pseudo gout?

A

CPPD crystals into the joint space - inflammatory!

“Crystal shedding” release into synovium

49
Q

The difference between pseudogout and gout pathophysiology? Crystals?

A

Pseudogout: blue CPPD rhomboid crystals, “shed” into joint space
Gout: Yellow MSU needle crystals, precipitate in joint space

50
Q

RA disease definition?

A

Systemic, Inflammatory, Auto-Immune disorder resulting in peripheral, symmetric, synovitis

51
Q

RA vs OA joint symmetry presentation?

A

RA is symmetric, OA is asymmetric

52
Q

Some lab values associated with RA?

A

RF, ESR, CRP (all elevated)

53
Q

Sx of RA?

A

Morning stiffness, tissue swelling, pain, tenderness, rubor, calor

54
Q

What lab value is specific to RA?

A

CCP, Anti-cyclic citrullinated peptide

55
Q

Radiographic RA findings?

A

Osteopenia, symmetric loss of joint space, erosions in marginal distribution

56
Q

Type of cells in early RA synovial fluid findings?

A

Mononuclear cells (LY, MO, MØ)

57
Q

What is pannus?

A

Organized mass of granulation tissue in the RA joint w/ MØ’s, Tcells, Bcells, and plasma cells

58
Q

Type of cells in late RA synovial fluid findings?

A

PMN’s and pannus

59
Q

Caucasian RA HLA?

A

HLA-DRB1*0401, *0404. *0101

60
Q

Asian RA HLA?

A

HLA-DRB1*0405

61
Q

Indian RA HLA?

A

HLA-DRB1*1402

62
Q

Genes associated with RA?

A

PTPN22, STAT4, TRAF1-C5

63
Q

Which cytokines are really important with RA?

A

IL-1, TNFα, IL-17 (local)

IL-6 (systemic)

64
Q

What two compartments should we think of with RA?

A

Synovial fluid compartment (all the bad cytokines)

Synovial tissue compartment (pannus!)

65
Q

Hemophilia C is a deficiency in which factor?

A

Factor XI

D&D, BL Unit III (10 decks)

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