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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
PT can be equated to which pathway?
Extrinsic
26
What is the key protein in the fibrinolytic pathway?
Thrombomodulin (amps up PC, but disallows for fibrinolysis)
27
What molecule does Heparin bind?
AT3 (increases anticoagulation)
28
What molecule does Warfarin bind?
Vit-K oxyreductase (inhibits vit K recycling; is an anticoagulant)
29
4 Stages of Gout?
1) Asymptomatic hyperuricemia 2) Acute Gouty Arthritis 3) Intercritical Gout 4) Chronic Tophaceous Gout
30
What crystal is deposited in gout?
MSU, monosodium urate
31
Who usually is Dx'd with gout?
Men over 30 y/o, females too - only after menopause
32
What do MSU crystals look like?
Needle-shaped and negatively bifringent (yellow when parallel)
33
What synovial fluid classification accompanies gout?
Inflamed (WBC > 2,000)
34
If the Pt has a 24h excretion of uric acid > 750 mg they are an:
Overproducer of uric acid
35
If the Pt has a 24h excretion of uric acid < 750 mg they are an:
Underexcretor of uric acid
36
Are most gout patients are overproducers or underexcretors?
Underexcretors
37
What exchanger in the proximal tubule is responsible for pre-secretory/post-secretory reabsorption of uric acid?
URAT1, urate/organic anion exchanger
38
Examples of excreted, unwanted organic acids?
Lactate, Acetoacetate, Hydroxybutyrate, Succinate
39
Activators of URAT1?
nicotinate, pyrazinoate, diuretics, low-dose aspirin | decrease renal excretion of uric acid
40
Inhibitors of URAT1?
probenecid, sulfinpyrazone, losartan metabolite, high-dose aspirin (increase renal excretion of uric acid)
41
Other urate transporters?
OAT4, OAT10, GLUT9a, ABCG2
42
Which TLRs are associated with gout?
TLR 2, 4
43
MSU crystals engage _____ which activates _____ which results in IL-1β production
caspase-1 ; NLRP3 inflammasome
44
Acute gouty attack is treated with_____, ______, and ____
NSAIDs, colchicine (if no renal insufficiency), and corticosteroids
45
Chronic gouty attack is treated with_____ or _______
a uricosuric or a xanthine oxidase inhibitor
46
What HLA for gouty Koreans, Han Chinese, or Thai persons?
HLAB*5801
47
What is CPPD? Cyrstal shape, refraction?
Calcium pyrophosphate dihydrate, rhomboid-shaped, positively bifringent (blue when parallel)
48
What causes pseudo gout?
CPPD crystals into the joint space - inflammatory! | "Crystal shedding" release into synovium
49
The difference between pseudogout and gout pathophysiology? Crystals?
Pseudogout: blue CPPD rhomboid crystals, "shed" into joint space Gout: Yellow MSU needle crystals, precipitate in joint space
50
RA disease definition?
Systemic, Inflammatory, Auto-Immune disorder resulting in peripheral, symmetric, synovitis
51
RA vs OA joint symmetry presentation?
RA is symmetric, OA is asymmetric
52
Some lab values associated with RA?
RF, ESR, CRP (all elevated)
53
Sx of RA?
Morning stiffness, tissue swelling, pain, tenderness, rubor, calor
54
What lab value is specific to RA?
CCP, Anti-cyclic citrullinated peptide
55
Radiographic RA findings?
Osteopenia, symmetric loss of joint space, erosions in marginal distribution
56
Type of cells in early RA synovial fluid findings?
Mononuclear cells (LY, MO, MØ)
57
What is pannus?
Organized mass of granulation tissue in the RA joint w/ MØ's, Tcells, Bcells, and plasma cells
58
Type of cells in late RA synovial fluid findings?
PMN's and pannus
59
Caucasian RA HLA?
HLA-DRB1*0401, *0404. *0101
60
Asian RA HLA?
HLA-DRB1*0405
61
Indian RA HLA?
HLA-DRB1*1402
62
Genes associated with RA?
PTPN22, STAT4, TRAF1-C5
63
Which cytokines are really important with RA?
IL-1, TNFα, IL-17 (local) | IL-6 (systemic)
64
What two compartments should we think of with RA?
Synovial fluid compartment (all the bad cytokines) | Synovial tissue compartment (pannus!)
65
Hemophilia C is a deficiency in which factor?
Factor XI

D&D, BL Unit III (10 decks)

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