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FMS > FMS Week 9 > Flashcards

FMS Week 9 Flashcards

Immunology II

1
Q

Describe the hypersensitivity associated with post-strep glomerulonephritis?

A

Generalized type III (serum sickness)

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2
Q

What leukocytes are associated with artheroclerosis?

A

macrophages

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3
Q

What are some of the issue with anti-tumor T-cells?

A

pretty well regulated by T-regs; also tumor evolution

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4
Q

Describe the hypersensitivity associated with myasthenia gravis:

A

type II; antibodies against acetylcholine receptors

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5
Q

What is the role of serotonin in type I hypersensitivity?

A

causes vasodilation (preformed in mast cells)

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6
Q

What are stable tissues?

A

normally inactive “queiescent” cells; replicate minimally, but can regenerate in response to injury

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7
Q

What leukocytes are associated with arthritis?

A

lymphocytes and macrophages

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8
Q

describe the role of PDGF in wound healing:

A

platelet-derived growth factor; comes from platelets, macrophages, and endothelial cells

stimulates growth, migration, and collagen synthesis in fibroblasts

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9
Q

what type of regenerative tissue are neurons?

A

permanent

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10
Q

What are hypertrophic scars?

A

excessive scarring about 4 weeks after injury; remains within wound borders

mostly type III collagen, organized, may regress spontaneously

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11
Q

What is the primary mechanism behind the anti-anaphylactic use of epinephrine?

A

vasoconstriction; reduces swelling

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12
Q

Describe the hypersensitivity associated with PPD testing:

A

type IV (delayed-type); memory T-cells recognize tuberculin, triggers Th1 response, redness and induration 24 to 72 hours later

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13
Q

What is granulation tissue?

A

“pre-scar tissue”; early healing stages (3 to5 days post injury)

collagen and new vessels, proliferating fibroblasts and some inflammatory cells

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14
Q

What is hypersensitivity?

A

an inappropriate (or exaggerated) immune response; resulting in a disease state

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15
Q

what type of regenerative tissue are the kidneys?

A

stable

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16
Q

What is the role of endothelial cells in inflammation?

A

express adhesion molecules for leukocytes (triggered by TNF-alpha and IL-1)

Proliferate to handle increased flow

Produce chemokines and stimulate angiogenesis

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17
Q

What are some of the issues with monoclonal antibodies as anti-tumor agents?

A

anti-mAb antibodies; also tumor evolution

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18
Q

Why are autoimmune diseases self perpetuating?

A

Self injured tissues produce more self-antigens, leading to growing autoimmune response

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19
Q

Describe the hypersensitivity associated with systemic lupus erythematosus?

A

Generalized type III (serum sickness); anti-DNA antibodies

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20
Q

what is a D-dimer?

A

Clinical test for inflammation; a degredation product of fibrin that indicates clot formation

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21
Q

What is PGD2?

A

Prostaglandin D2; causes bronchoconstriction and eosinophil infiltration

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22
Q

What is FOXP3?

A

a gene expressed in Treg cells that functions as a transcription factor for other immunosuppressive genes

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23
Q

What is lipoxygenase?

A

an enzyme involved in leukotriene synthesis from arachidonic acid

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24
Q

What is AIRE?

A

autoimmune regulator protein; drives the negative selection of T-cell self-antigen

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25
Q

Describe type IV hypersensitivity:

A

no antibodies; entirely cell-mediated (memory T-cells)

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26
Q

What are the mechanisms of type II hypersensitivity?

A

opsonization/phagocytosis, complement, physiologic responses (non-injury)

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27
Q

Why is copper deficiency associated with poor wound healing?

A

lysyl oxidase is a copper dependent enzyme involved in the cross-linking of collagen during scar maturation

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28
Q

What is atopy?

A

a genetic predisposition for localized hypersensitivity

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29
Q

what are the effects of FGF?

A

fibroblast chemotaxis, stimulates angiogenesis, stimulates extracellular matrix protein synthesis

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30
Q

Difference between adult and embryonic stem cells?

A

embryonic stem cells are undifferentiated

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31
Q

Why is vitamin C deficiency associated with poor wound healing?

A

necessary for collagen synthesis

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32
Q

What is the manifestation of Sjogren’s syndrome?

A

autoimmune damage to salivary and lacrimal glands

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33
Q

What are myofibroblasts?

A

fibroblasts with contractile proteins (similarities with smooth muscle);

contract wound, develop around day 5, lost by apoptosis as scar matures

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34
Q

What are the sources of FGFs?

A

macrophages, mast cells, endothelial cells

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35
Q

What is purulent exudate?

A

plasma with both active and dead neutrophils, fibrinogen, and necrotic parencymal cells. Associated with more severe infections

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36
Q

what type of regenerative tissue are hematopoietic stem cells?

A

labile

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37
Q

Describe the hypersensitivity associated with blood type mismatch:

A

type II; RBC lysis triggered by circulating IgG

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38
Q

manifestation of mutliple sclerosis

A

weakness, coordination and ocular problems, paralysis

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39
Q

Target antigen of multiple sclerosis

A

myelin sheath of CNS

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40
Q

What is type I hypersensitivity?

A

classic allergic response; inappropriately preformed IgE (instead of IgG) antibodies from primary exposure cause mast cells to attack antigens

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41
Q

What do Tregs do?

A

They “turn down” overall immune response

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42
Q

what are eicosanoids?

A

lipid derived immune signalling molecules from cell membranes

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43
Q

Describe the hypersensitivity associated with rheumatic fever:

A

type II; strep antibodies cross-react with cardiac myocytes

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44
Q

What are labile tissues?

A

tissues that are continuously dividing to replace lost cells

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45
Q

Target antigen of type 1 diabetes

A

glutamase decarboxylase, IA-2 phosphatase, insulin from beta-cells of pancreas

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46
Q

What is a granuloma?

A

an aggregation of lymphocytes and macrophages trying to contain an offending agent that is difficult to eradicate

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47
Q

What are the means of building peipheral B-Cell tolerance?

A

Anergy, follicular exclusion (leading to apoptosis), and induced apoptosis

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48
Q

what type of regenerative tissue is the pancreas?

A

stable

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49
Q

Describe the hypersensitivity associated with autoimmune hemolytic anemia:

A

type II; drugs (like methyldopa and penicillin) bind to RBCs prior to metabolism; or in mycoplasma pneumonia the disease creates antibodies against RBCs

50
Q

What leukocytes are associated with pulmonary fibrosis?

A

macrophages and fibroblasts

51
Q

What is the manifestation of Progressive Systemic Sclerosis?

A

skin thickening due to collagen deposition, fibrosis of internal organs

52
Q

What are the symptoms of type I hypersensitivity?

A

urticaria, rhinitis, asthma, conjunctivitis, diarrhea (systemic anaphylaxis)

53
Q

What is the role of platelets in inflammation?

A

contribute to blood clots

Release ROS to recruit additional platelets, fibroblast growth factors, serotonin for vasodilation, and anti-microbial peptides

54
Q

How does desensitization work in type I hypersensitivity?

A

gradually increasing doses of allergen; response changes from IgE to IgG

55
Q

What are the issues with CAR T-cells?

A

cytokine storm

56
Q

What are DR2, DR3, DR4, and B27?

A

HLA genes that are associated with autoimmune diseases

57
Q

Describe the hypersensitivity associated with rabies or tetanus antitoxin?

A

Generalized type III (serum sickness)

58
Q

Describe the hypersensitivity associated with pemphigus vulgaris:

A

type II: antibodies against desmosomes in epidermis

59
Q

What matrix proteins are secreted by fibroblasts?

A

initially collagen III and fibronectin, later collagen I

60
Q

What are the 5 clinical signs of inflammation?

A

calor (heat), rubor (redness), tumor (swelling), dalor (pain), funtio lasea (loss of function)

61
Q

What is LTC4?

A

Leukotriene C4; causes vasoconstriction and broncoconstriction

62
Q

what type of regenerative tissue are cardiac myocytes?

A

permanent

63
Q

What is LTB4?

A

leukotriene B4; causes neutrophil and eosinophil chemotaxis

64
Q

What are the 3 steps of scar formation?

A

angiogenesis, fibroblast migration/activation, maturation over time

65
Q

Why are Arthus reactions quicker than serum sickness reactions?

A

the antibodies are already formed from primary exposure in Arthus reactions

66
Q

What is erythocyte sedimentation rate?

A

Clinical test for inflammation; fibrogenated RBCs aggregate and settle out fo suspension faster

67
Q

What is the most common target of systemic autoimmune diseases?

A

DNA/RNA or associated proteins/enzymes (intracellular autoantibodies)

68
Q

Describe the role of TGF-beta in wound healing:

A

transforming growth factor; released by platelets, T-cells, macrophages, endothelial cells, and others;

promotes collagen production, acts as an antiinflammatory by inhibiting lymphocytes

69
Q

What are Curshmann spirals?

A

spirals of inspissated mucus most commonly found in asthma histology that are thought to be casts of small bronchioles

70
Q

What is scar remodeling?

A

breakdown of type III collagens, crosslinking of collagen

key enzymes: metalloproteinase (zinc) and lysyl oxidase (copper)

71
Q

What is the main cause of tissue damage by neutrophils?

A

reactive oxygen species

72
Q

Describe type III hypersensitivity:

A

antibodies bind small antigens (usually IgG/IgM); large accumulation of these immune complexes in the tissues

73
Q

manifestation of type 1 diabetes

A

hyperglycemia (dehydration, weight loss, nerve and vessel damage)

74
Q

What is a type II hypersensitivity reaction?

A

Autoimmune response; IgG/IgM directed against tissue antigens

75
Q

What is a serous effusion?

A

an accumulation of serum in a body cavity

76
Q

What is keloid?

A

raised scars beyond borders of original wound

excessive healing/scarring; more common with dark skin; contains mixed collagen; disorganized

77
Q

what are permanent tissues?

A

“terminally differentiated”; have almost no ability to proliferate or regenerate; damage leads to scar

78
Q

what is an Arthus reaction?

A

type III hypersensitivity; localized accumulation in the tissue

79
Q

What is the role of platelet activating factor in type I hypersensitivity?

A

bronchoconstriction

80
Q

what is cyclooxygenase?

A

an enzyme involved in prostaglandin and thromboxane synthesis from arachidonic acid

81
Q

What cytokine is key to type I hypersensitivity?

A

IL-4 (from Th2; important for class switching and IgE production)

82
Q

Cellular infiltrates of acute and chronic inflammation:

A

Acute: mainly neutrophils

Chronic: mainly monocytes and lymphocytes

83
Q

What does histamine cause physiologically?

A

vasodilation (warmth), venule permeability (swelling), smooth muscle contraction (bronchospasm)

84
Q

Describe the hypersensitivity associated with multiple sclerosis?

A

type IV; cell mediated response to myelin basic protein (believed, not well understood)

85
Q

manifestation of Graves disease

A

hyperthyroidism (weight loss, weakness, elevated heart rate)

86
Q

What is a Creola body?

A

an aggregation of “benign” sloughed-off cells in the lungs; not exclusive to asthma

87
Q

Difference in timeline of 2nd intention healing?

A

more inflammation, more granulation, more contraction, more scar tissue

88
Q

Why is zinc deficiency associate with poor wound healing?

A

metalloproteinases contain zinc and are required for collagen breakdown in scar maturation

89
Q

Target antigen of autoimmune hemolytic anemia

A

Rh and other antigens on RBC membranes

90
Q

What is the significance of CTLA4 and PD-1?

A

Receptors on activated T-cells, one mechanism that allows for functional inactivation of self-reactive T-cells in the periphery

91
Q

What is the timeline of 1st intention healing?

A

1st 24 hours: Inflammation, clot formation, neutrophil invasion (increased permeability)

3-7 days: macrophages replace neutrophils, fibroblasts, angiogeneis, myofibroblasts

Weeks: remodeling, metalloporoteinases

92
Q

What is ECF-A?

A

eosinophil chemotactic factor of anaphylaxis; preformed in mast cells, attracts eosinophils

93
Q

Target antigen of myasthenia gravis

A

acetylcholine receptor

94
Q

What are the characteristics of bronchial remodelling in chronic asthma?

A

mucous plugging, goblet cell hyperplasia, epithelial injury, fibrosis of the basement membrane, increased vascularity, smooth muscle and mucous gland hypertrophy

95
Q

What is the purpose of blood clotting in inflammatory process?

A

block access/contain to infectious agents

96
Q

What pro-inflammatory cytokines are released by macrophages?

A

IL-6, TNF-alpha, IL-1-beta, IL-8 (CXCL8), IL-12

97
Q

What is serum sickness?

A

a type III hypersensitivity; generalized accumulation

98
Q

Describe the hypersensitivity associated with contact dermatitis?

A

Type IV (delayed-response cell-mediated)

99
Q

Describe the hypersensitivity associated with polyarteritis nodosa?

A

Generalized type III (serum sickness); hep B antigens

100
Q

manifestation of myasthenia gravis

A

intermittent muscle weakness, paralysis, vision and swallowing problems

101
Q

What are the issues with blocking immunosuppresive mechanisms that protect tumors?

A

autoimmunity

102
Q

Describe the hypersensitivity associated with Goodpasture syndrome:

A

type II; antibodies against type IV collagen, leading to nephritic syndrome and pulmonary hemorrhage

103
Q

Describe the hypersensitivity associated with hypersensitivity pneumonitis?

A

Localized type III (arthus reaction); “farmers lung”, reaction to previously exposed environmental antigen

104
Q

What are the means of “attack” in type II hypersensitivity?

A

phagocytosis, complement, ADCC

105
Q

Describe late symptoms of Type I hypersensitivity:

A

around 6 hours later: influx of inflammatory cells, induration (cytokines > neutrophils/eosinophils)

106
Q

What are Charcot-Leyden crystals?

A

“needle” shaped crystals associated with condesnsed granules from eosinophils in asthma and other allergic reactions

107
Q

What is fibrosis?

A

scarring; occurs in cells without regenerative capability (normal or lost due to damage)

108
Q

What is PGE2?

A

Prostaglandin E2; causes redness, edema, fever, and pain

109
Q

What leukocytes are associated with chronic transplant rejection?

A

lymphocytes and cytokines

110
Q

What are the effects of histamine release?

A

Swelling/inflammation, adrenaline, increased capillary permeability, bronchoconstriction, vessel dilation, elevated heartrate, blood clots, gastric acid secretion

111
Q

What are FGFs?

A

fibroblast growth factors

112
Q

What leukocytes are associated with asthma?

A

eosinophils and IgE

113
Q

What is LTD4?

A

leukotriene D4; causes vasoconstriction and bronchoconstriction

114
Q

What are the 2 characteristics of stem cell division?

A

self-renewal and asymmetric division (one mature daughter cell and one daughter stem cell)

115
Q

Describe early symptoms of Type I hypersensitivity:

A

within minutes: edema, redness, itching (histamine, leukotrienes, and prostaglandins)

116
Q

What is the mechanism behind Pernicious anemia?

A

Antibodies bind to intrinsic factor of gastric parietal cells and neutralize it, decreasing absorption of vitamin b12

117
Q

what type of regenerative tissue is the liver?

A

stable

118
Q

Describe first intention healing:

A

tissue surfaces are closed together, requires small amounts of tissue loss, primary mechanism is epithelial regeneration

minimal scar, minimal wound contraction

119
Q

describe second intention healing:

A

large wounds, cannot approximate edges

significant scar formation

120
Q

what type of regenerative tissue are most eipithelial cells?

A

labile

121
Q

What are leukotrienes, prostaglandins and thromboxanes derived from?

A

Eicosanoids (arachidonic acid)

122
Q

Target antigen of Graves disease

A

thyroid stimulating hormone receptor (in thyroid epithelial cells)

FMS (10 decks)

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