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MD1 Revision > Foundation > Flashcards

Foundation Flashcards

1
Q

What are the determinants of pulse pressure?

A

Stroke volume

Compliance of aorta

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2
Q

What may cause low pulse pressure?

A

Distended arteries

Low stroke volume

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3
Q

What does a low pulse pressure lead to?

A

Small waveform

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4
Q

What may cause a small amplitude and upstroke of the carotid arterial waveform?

A

Slow blood ejection

Low stroke volume

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5
Q

What causes a fourth heart sound audible at the apex?

A

Atrial kick caused by decreased ventricular compliance

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6
Q

Why do you produce an atrial kick?

A

Ventricles have higher pressure so atria have to contract harder to shut atrioventricular valve

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7
Q

What murmur does an aortic stenosis cause?

A

Systolic murmur

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8
Q

Why is an aortic stenosis louder on expiration?

A

During expiration, blood being pushed into systemic circulation and out of pulmonary circulation due to greater intrathoracic pressure
More blood flow through left side of heart > louder heart sounds

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9
Q

Why do right-sided heart sounds increase in volume on inspiration?

A

During inspiration bloodflow increases to venous and pulmonary circulations, because of less intrathoracic pressure > greater preload,
More blood flow through right side of heart

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10
Q

What are the changes to the cardiovascular system when a person stands up?

A

Force of gravity causes blood to pool in lower extremities > blood pressure initially decreases
Baroreceptor reflex acts to increase heart rate and contractility

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11
Q

What is the role of a finometer?

A

Measures real-time

  • Blood pressure
  • Heart rate
  • Stroke volume
  • Cardiac output
  • Total peripheral resistance
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12
Q

How does nicotine act on the body?

A

Cholinergic receptor agonist

Acts on autonomic ganglia, skeletal muscle, and CNS

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13
Q

What are the side effects of nicotine use?

A 
Tachycardia
Mild increase in contractility
Anxiety
Tremors
Nausea
Sore throat
Mouth irritation
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14
Q

How does caffeine act on the body?

A 
Adenosine receptor agonist
Phosphodiesterase inhibitor
Acts on
- Heart
- Vasculature
- Airways
- Skeletal muscle
- CNS
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15
Q

What are the side effects of caffeine use?

A 
Tachycardia
Mild increase in contractility
Anxiety
Tremors
Sleeplessness
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16
Q

What is the definition of maximum resolving power?

A

Smallest distance between 2 points at which 2 points distinguishable

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17
Q

What is the difference between a transmitting electron microscope (TEM), and a scanning electron microscope (SEM)?

A 
TEM = cross-sections
SEM = scans surfaces
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18
Q

Why is fixation following removal of tissue from the body important?

A

Prevents autolysis and bacterial colonisation

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19
Q

How does formalin act as a fixative?

A

Chemically cross-links molecules to lock them in place

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20
Q

Describe the process of embedding

A

Fixed tissues gradually dehydrated in solutions of alcohol

Alcohol replaced with xylene

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21
Q

Why is paraffin embedding necessary?

A

To stiffen tissues > can be sectioned thinly

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22
Q

What occurs after the tissue is sectioned?

A

Sections rehydrated by passing through series of xylene and alcohol
Put on glass slides
Stained
Covered with coverslip

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23
Q

What does haematoxylin bind to?

A

Acidic/anionic compounds

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24
Q

What colour does the nucleus stain?

A

Blue/purple

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25
Q

What are tissues that stain with haematoxylin called?

A

Basophilic

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26
Q

What does eosin bind to?

A

Basic/cationic compounds

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27
Q

What colour does the cytoplasm and extracellular matrix generally stain?

A

Pink

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28
Q

What are tissues that stain with eosin called?

A

Eosinophilic

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29
Q

Define amphophilic

A

Stains with both eosin and haematoxylin

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30
Q

What cell components stain amphophilic?

A

Cytoplasm of cells producing lots of protein with abundant rough endoplasmic reticulum (RER)

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31
Q

What is the life span of platelets?

A

8-10 days

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32
Q

Where is red bone marrow contained in adults?

A

Axial skeleton and proximal femur

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33
Q

Where does foetal haematopoiesis mainly occur?

A

Foetal liver

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34
Q

How is cell production controlled in haematopoiesis?

A

Growth factors
Microenvironment
Able to respond to sudden demand for extra cells of particular type

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35
Q

What is the structure of collagen fibres?

A

3 polypeptide alpha chains which form triple helix

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36
Q

What are the three types of connective tissue fibres?

A

Embryonic connective tissue
Connective tissue proper
Specialised connective tissue

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37
Q

Where is type I collagen found?

A

Within connective tissue proper

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38
Q

Where is type II collagen found?

A

Cartilage

Intravertebral discs

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39
Q

Where is type III collagen found?

A

Reticular fibres

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40
Q

Where is type IV collagen found?

A

Basement membranes

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41
Q

Where is type VII collagen found?

A

In anchoring fibres that link basement membranes

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42
Q

Depending on how the section is cut, how may fibroblasts appear?

A

Round nuclei/long, thin nuclei

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43
Q

What is the role of reticulin fibres?

A

Provide delicate supporting framework in certain tissues; eg:

  • Bone marrow
  • Liver
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44
Q

Describe the structure of elastin

A

Central core of elastin

Surrounding network of fibrillin microfibrils

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45
Q

Why is ground substance frequently not seen on H&E sections?

A

Lost on preparation

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46
Q

What are the components of ground substance?

A 
Glycosaminoglycans (GAGs)
- Hyaluronic acid
- Proteoglycans
Glycoproteins
- Fibronectin
- Fibrillin
- Laminin
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47
Q

What is extracellular matrix composed of?

A

Fibres and ground substance

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48
Q

What are the roles of extracellular matrix?

A

Mechanical support
Control of cell growth and differentiation
Scaffolding for cell proliferation
Synthesis and storage of various growth factors

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49
Q

What are the resident cells of the extracellular matrix?

A 
Fibroblasts
Myofibroblasts
Macrophages
Mast cells
Mesenchymal stem cells
Adipocytes
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50
Q

What are the types of wandering cells that may be found in the extracellular matrix?

A

Lymphocytes
Eosinophils
Plasma cells
Basophils

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51
Q

Which cells are responsible for the synthesis of extracellular matrix?

A

Fibroblasts

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52
Q

What are some examples of dense regular connective tissue proper?

A

Tendons
Ligaments
Aponeuroses

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53
Q

Where are the nuclei located in adipocytes?

A

Sometimes visible on edge of cells

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54
Q

Why does bone stain both pink and purple with a H&E stain?

A

Ground substance stains purple

Matrix largely collagen, so stains pink

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55
Q

What are the components of the extracellular matrix in the basement membrane?

A

Predominantly type IV collagen
Heparan sulphate
Structural glycoproteins
- Involved in linking integrins of epithelial cells to extracellular matrix

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56
Q

What are the differences between bacterial and higher-order cells?

A 
Have no ER
Nucleus not membrane bound
No membrane-bound organelles
70S ribosomes, compared to eukaryotes (80S)
Replicate by binary fission
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57
Q

What are the key components of bacteria?

A 
Cytoplasmic membrane
Cytoplasmic matrix
Ribosomes
Genome 
Cell wall
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58
Q

What is the difference between prokaryotic and eukaryotic ribosomes?

A

Prokaryotic: 50S + 30S = 70S
Eukaryotic: 60S + 40S = 80S

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59
Q

How can bacteria acquire new genes horizontally?

A 
Plasmids
Transposons
Integrons
Bacteriophages
Pathogenicity islands
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60
Q

Describe a Gram positive cell wall

A

Plasma membane > thick peptidoglycan layer

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61
Q

Describe a Gram negative cell wall

A

Plasma membrane = inner membrane > thin peptidoglycan layer > periplasmic space > outer membrane

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62
Q

What is the structure of lipopolysaccharide (LPS)?

A

Lipid A attached to core polysaccharide, with repeating units of O-Ag attached

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63
Q

What is the main function of flagella?

A

Movement

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64
Q

What is the main function of fimbriae or pilli?

A

Attachment

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65
Q

What is the main function of capsules?

A

Short-term survival

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66
Q

What is the main function of endospores?

A

Long-term survival

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67
Q

What are flagella composed of?

A

Basal body

Hook filament made of flagellin protein

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68
Q

What are fimbriae composed of?

A

Pilin

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69
Q

What are endospores?

A

Specialised, resistant, dormant structures

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70
Q

What is the difference between sporulation and germination?

A 
Sporulation = bacteria to spore
Germination = spore to bacteria
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71
Q

What are the phases of bacterial growth?

A

Lag
Log
Stationary
Death

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72
Q

Define facultative anaerobes

A

Can grow with/without air

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73
Q

Define aerotolerant anaerobes

A

Can survive in oxygen but won’t grow

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74
Q

Define microaerophiles

A

Grow best in low oxygen concentrations

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75
Q

What is the set point?

A

Level at which variable varies upon

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76
Q

What is the comparator?

A

Acts to integrate sensory information > sends signal to effector

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77
Q

What is the effector?

A

Receives signal from comparator > makes change to variable

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78
Q

What is the diurnal variation in temperature?

A

0.6 degrees higher in late afternoon

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79
Q

What is the menstrual variation in temperature?

A

1 degree higher post-ovulation

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80
Q

Why is thermal energy balance crucial?

A

Metabolic enzymes have narrow operational temperature range

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81
Q

What controls body temperature?

A

Hypothalamus

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82
Q

What happens when ambient temperature is high, in terms of body temperature control?

A

Sweating occurs sooner
Sweat volume decreases
Sweat Na concentration decreases > retains fluid volume and electrolytes

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83
Q

What initiates the increase in set-point temperature during fever?

A

Pyrogens = endotoxins/cytokines

Induce synthesis of prostaglandin > raises set point temperature

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84
Q

What produces severe combined immunodeficiency (SCID)?

A

Defective common gamma chain

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85
Q

What is the hygiene hypothesis?

A

Increase in autoimmunity and allergies because of too clean environment
Immune system has to attack something, so attacks self and innocuous substances

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86
Q

What are the two arms of the immune system?

A

Innate

Adaptive

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87
Q

Does innate immunity form immunological memory?

A

No

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88
Q

Can innate immunity distinguish self from non-self?

A

Yes

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89
Q

What are the barrier tissues of innate immunity?

A

Skin

Mucosa

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90
Q

What are the soluble factors of innate immunity?

A

Complement
Cytokines and mediators
Antimicrobial peptides

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91
Q

What are the cell-associated factors of innate immunity?

A

Pattern recognition receptors (PRRs)
- Toll-like receptors (TLRs)
Cytokines and mediators
Antimicrobial peptides

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92
Q

What are the cells of innate immunity?

A 
Granulocytes
- Neutrophils
- Eosinophils
- Basophils
Monocytes/macrophages
Dendritic cells (DCs)
Natural killer (NK) cells
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93
Q

What is the speed of adaptive immunity?

A

Slow

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94
Q

What is the specificity of adaptive immunity?

A

Highly specific

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95
Q

Does adaptive immunity for immunological memory?

A

Yes

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96
Q

What are the cells of adaptive immunity?

A

T cells

B cells

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97
Q

What are various types of T cells?

A 
Th1
Th2
Th17
Tfh
Cytotoxic T cells
Semi-invariant T cells
- NKT cells
- MAIT cells
Gamma-delta T cells
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98
Q

What are the fundamental principles of immune recognition?

A

Immunological recognition
Immune effector mechanisms
Immune regulation
Immunological memory

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99
Q

What do are some innate effector mechanisms?

A

Phagocytosis
Microbicidal agents
Complement

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100
Q

What bridges innate and adaptive effector mechanisms?

A

DC collects Ag
Transports Ag to local draining lymph node
Presents Ag to naive T cells

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101
Q

What are the three main functions of B cell immunity?

A

Neutralisation
Opsonisation
Complement activation

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102
Q

What is the soluble form of the B cell receptor (BCR)?

103
Q

What curtails the immune response after it is no longer required?

A 
Inhibitory cytokines
- IL-10
- TGF-beta
Treg cells
- Contact inhibition
- Produce cytokines
104
Q

What is the point of immunological memory?

A

More rapid and more effective response on 2nd exposure to Ag

105
Q

What is meant by polarity of epithelial cells?

A

Contain different domains

  • Apical
  • Lateral
  • Basal
106
Q

Are epithelial tissues vascular?

107
Q

Describe how the structure of cilia enables it to function

A

Organised core of microtubules allowing movement in coordinated waves

108
Q

What are the different types of intercellular junctions?

A

Tight
Adherens
Desmosomes
Gap

109
Q

What are the four main groups of cell adhesion molecules (CAMs)?

A

Cadherins
Integrins
Selectins
Immunoglobulin superfamily

110
Q

What are cadherins a component of?

A

Adherens junctions

111
Q

How do cadherins function in intercellular adhesion?

A

Link to anchoring proteins, which bind to cytokeratin intermediate filaments in cell

112
Q

What is a mucosa/mucous membrane?

A

Lines body passages that communicate with exterior
Comprises of surface epithelium and underlying supportive connective tissue = lamina propria
Sometimes has underlying layer of smooth muscle = musclarin mucosae

113
Q

What is a serosa/serous membrane?

A

Lines pericardial, pleural and peritoneal cavities, and tunica vaginalis
Comprises of surface mesothelium and underlying supportive connective tissue

114
Q

What is erosion?

A

Local defect in surface epithelium due to necrosis

115
Q

What is an ulcer?

A

Local defect in mucosa/endothelium/skin due to necrosis

116
Q

What type of epithelium are simple tubular glands made of?

A

Simple columnar

117
Q

What type of epithelium are sweat glands made of?

A

Stratified cuboidal

118
Q

What do exocrine glands secrete?

A

Proteins/lipids/glycoproteins

119
Q

What is a serous secretion?

A

Protein in aqueous medium

120
Q

What exocrine glands secrete a serous secretion?

A

Pancreatic acini
Salivary glands
Lacrimal glands

121
Q

What is a mucous secretion?

A

Glycoprotein in aqueous medium

122
Q

What secretes a mucous secretion?

A

Respiratory tract
Gastrointestinal tract
Cervix

123
Q

Why do goblet cells stain white in H&E?

A

Don’t pick up stain

124
Q

What are serous acini?

A

Secretory unit formed by serous cells, usually found at terminal branches of ducts

125
Q

Describe the duct system, starting from secretory cells

A

Secretory cells secrete into acinus > secretes into lumen of duct

126
Q

What is the role of desmosomes in the epidermis?

A

Helps epidermis withstand tearing forces

127
Q

What is a virion?

A

Virus particle

128
Q

What is a capsid?

A

Protective protein shell surrounding genome

129
Q

What is a capsomere?

A

Clusters of capsid protein subunits

130
Q

What is a nucleocapsid?

A

Capsid most closely associated with viral nucleic acid

131
Q

What is a naked virus?

A

Virus without envelope

132
Q

What is a viral envelope?

A

Lipid membrane derived from host cell membrane surrounding nucleocapsid
Contains virally encoded glycoproteins

133
Q

What is a viral matrix?

A

Some viruses have protein layer connecting capsid and envelope glycoproteins

134
Q

What is the purpose of capsid symmetry?

A

To protect genome from breakdown by nucleases

135
Q

What is the purpose of multiple-shelled capsids?

A

Virus very hardy and can survive passage through gut; eg: rotavirus

136
Q

How can we gain information about viruses?

A

X-ray crystallography

Electron microscopy

137
Q

What are the types of viral genomes

A 
ssDNA
dsDNA
ssRNA
- Positive sense
- Negative sense
dsRNA
138
Q

Describe how latex agglutination can be used for diagnosing infection

A

If Ag present, will cross-link latex particles and cause clumping

139
Q

What is a solid phase assay?

A

Ag of interest attaches to solid phase > known Ab with label attached added > binds to Ag > signal

140
Q

Describe the principles of immunohistochemistry

A

Uses enzyme labels instead of fluorescent labels

If known Ab binds Ag, an anti-Ab Ab with enzymatic label binds > converts substrate to coloured product

141
Q

Describe how a capture assay is performed

A

Capture Ab attached to solid phase > Ag of interest added > binds to capture Ab > add specific Ab (with label) to Ag of interest > binds to Ag > signal

142
Q

What is DNA hybridisation?

A

Uses complementary DNA sequences with radioactive labels > bind to DNA of Ag of interest
Diagnosis with detection of bound probe

143
Q

Why are PCR primers based on 16S rRNA?

A

Each 16S rRNA strand unique for each bacterial species

144
Q

What are the two types of culture media?

A

Liquid (broth)

Solid (agar)

145
Q

What is the Widdal test and why is it used?

A

Test to determine Ab titre

146
Q

How is a solid phase assay used to detect the presence of antibodies in a patient’s serum?

A

Known Ag attached to solid phase > patient’s sample added > Ab binds to Ag > add anti-human Ig with label > binds to patient’s bound Ab

147
Q

What does a normal cell look like molecularly?

A

pH correct for function of cellular enzymes
ATP-dependent NA/K pump keeps Na out and K in
Ribosomes attached to RER continue normal protein synthesis
Cytosolic Ca concentration low
Membranes of cell, mitochondria, and lysosomes intact

148
Q

What is ischaemia?

A

Loss/reduction of blood supply

149
Q

What is hypoxia?

A

Reduced oxygen in blood supply

150
Q

What happens when a cell first becomes hypoxic?

A

Transition to anaerobic glycolysis

151
Q

What happens as the cell continues to be in a hypoxic state?

A

Lactic acid build up > pH lowered > Na/K pump fails > Na accumulates > iso-osmotic gain of water > protein synthesis reduced > ribosomes detach from RER > Ca released into cell from mitochondria and SER

152
Q

What does lowered pH in a cell look like?

A

Clumping of nuclear chromatin

153
Q

What does failure of the Na/K pump in a cell look like?

A

Cell swelling

154
Q

What does reduced protein synthesis look like in a cell?

A

Reduced cell function

155
Q

What will released Ca damage within the cell?

A

Mitochondria

156
Q

What does mitochondrial damage within a cell look like?

A

Mitochondrial swelling

157
Q

What can increased intracellular Ca do in muscle cells?

A

Impair contractile function

Can be symptomatic in heart

158
Q

Which hypoxic changes are reversible if oxygen supply is restored?

A

ATP depletion
Anaerobic glycolysis
Mitochondrial impairment
Increased cytosolic Ca

159
Q

What is the point of irreversible injury related to?

A

Sensitivity of cell/tissue to injury

Type, severity, and/or duration of injury

160
Q

What is irreversible cellular damage characterised by?

A

Severe, irreversible mitochondrial dysfunction

Membrane damage

161
Q

What is severe mitochondrial dysfunction?

A

Irreversible inability to generate ATP
Abnormal oxidative phosphorylation
Release of pro-apoptotic proteins

162
Q

What can oxidative stress damage within a cell?

A

Lipid - cell membrane
Proteins
DNA - mutations

163
Q

What happens in membrane damage of a cell?

A

Increased cytosolic Ca activates enzymes to break down cell parts
- Phospholipase
- Protease
- Endonuclease
- ATPase
Membrane of cell, mitochondria, and lysosomes disrupted

164
Q

Is cell membrane rupture clinically detectable?

A

Yes, in blood; eg:

  • Cardiac enzymes
  • Liver enzymes
  • Muscle enzymes
165
Q

What are the cytoplasmic changes in necrosis?

A

Loss of normal definition

Hypereosinophilic/Pale due to oedema or intracellular accumulations

166
Q

What is karyolysis?

A

Faded/pale/absent nuclei

167
Q

What is pyknosis?

A

Round, shrunken, condensed, basophilic nucleus

168
Q

What is karyorrhexis?

A

Speckled basophilic dots, nuclear dust/debris

169
Q

Where does coagulative necrosis occur?

A

Solid organs

170
Q

What is coagulative necrosis due to?

A

Ischaemia primarily

171
Q

What does coagulative necrosis look like macroscopically?

A

Pale, solid lesion

172
Q

What does coagulative necrosis look like microscopically?

A

Eosinophilic
Anucleate
Ghost cells
Persist for days-weeks

173
Q

Where does caseous necrosis occur?

174
Q

What is caseous necrosis due to?

A

Mycobacterium tuberculosis (Mtb) infection

175
Q

What does caseous necrosis look like macroscopically?

A

Soft
Creamy white
Cottage cheese

176
Q

What does caseous necrosis look like microscopically?

A

Amorphous eosinophilic cell debris

177
Q

Where does liquefactive necrosis occur?

A

Brain if ischaemia

Anywhere if bacterial/fungal infection

178
Q

What causes liquefactive necrosis?

A

Ischaemia in brain

Bacterial fungal infection

179
Q

What does liquefactive necrosis look like macroscopically in the brain?

A

Liquid, viscous mass

180
Q

What does liquefactive necrosis look like microscopically in the brain?

A

Eosinophilic neurons

Primarily macrophages

181
Q

What does liquefactive necrosis look like macroscopically when it is not in the brain?

A

Collection of yellow liquid = pus

182
Q

What does liquefactive necrosis look like microscopically when it is not in the brain?

A

Purulent exudate

183
Q

Where does fibrinoid necrosis occur?

184
Q

What causes fibrinoid necrosis?

A

Immune complex deposition

185
Q

What does fibrinoid necrosis look like microscopically?

A

Amorphous eosinophilic ring of deposited proteins within wall of vessel

186
Q

What does the apoptosis pathway need?

A

Functioning caspases and ATP

187
Q

What is the relationship between apoptosis and necrosis?

A

Apoptosis can occur independently, sequentially, or simultaneously with necrosis

188
Q

Is there an inflammatory response with apoptosis?

189
Q

Is there a loss of cell membrane integrity with apoptosis?

190
Q

What can trigger apoptosis?

A

Release of pro-apoptotic proteins
Death receptor-ligand interaction
Cytotoxic T cell attack

191
Q

What is autolysis?

A

Post-mortem/post-removal of tissue from body - enzymatic digestion of tissue

192
Q

What types of intracellular accumulations can sub-lethal injury cause?

A

Fat/lipid/cholesterol
Proteins
Pigment

193
Q

Distinguish histologically between the three types of muscle in cross-section

A 
Skeletal = peripheral nuclei
Cardiac = central nuclei, thick
Smooth = central nuclei,  thin
194
Q

Distinguish histologically betwen the three types of muscle in longitudinal section?

A

Skeletal muscle = peripheral nuclei, very fine striations, long
Cardiac = central nuclei, striations, branching
Smooth = central elongated nuclei, no striations, no branching

195
Q

What is the role of Z-discs in muscles?

A

Anchor thin filaments and form boundary with next sarcomere

196
Q

What is the sliding filament mechanism?

A

Neither thick nor thin filaments shorten

Cross-bridge between 2 overlaps more > sarcomere shortens > muscle contraction

197
Q

What is the role of dense bodies in smooth muscle?

A

Anchors actin filaments

Contraction draws dense bodies together > shortens cell

198
Q

What is the extent of regeneration of the three types of muscle?

A 
Skeletal = limited
Cardiac = none
Smooth = reasonable
199
Q

What is the role of myoepithelial cells?

A

Surrounds some exocrine glands

Contract via actin and myosin to squeeze out contents

200
Q

What is the role of myofibroblasts?

A

Derived from activated fibroblasts and function to pull wound closed

201
Q

What is the role of pericytes?

A

Regulate capillary blood flow by contracting around capillaries

202
Q

What are the three layers of connective tissue wrapping nerves?

A 
Epineurium = wraps whole nerve
Perineurium = wraps fascicles
Endoneurium = wraps individual axons
203
Q

In which phase of the cell cycle does DNA replication occur in?

204
Q

What do autosomal dominant pedigrees look like?

A

Vertical transmission of phenotype
Lack of skipped generations
Equal numbers of affected males and females

205
Q

What do autosomal recessive pedigrees look like?

A

Horizontal appearance of phenotype, especially among siblings
Equal numbers of affected males and females
Heterozygotes = carriers, generally healthy
Parents of affected child = obligate carriers

206
Q

What do X-linked recessive pedigrees look like?

A

Absence of father-son transmission
Apparently skipped generations when genes passed through female carriers
Affected males much more common

207
Q

What do X-linked dominant pedigrees look like?

A

Twice as common in females as males
Skipped generations uncommon
Males hemizygous

208
Q

What does mitochondrial inheritance look like?

A

Female transmission

Males don’t transmit

209
Q

What is the difference in response between acute and chronic inflammation?

A 
Acute = earliest
Chronic = later
210
Q

What is the difference in duration between acute and chronic inflammation?

A 
Acute = short, mins-days
Chronic = weeks-months-years
211
Q

What are the features of acute inflammation?

A

Neutrophils
Fluid and protein exudate
Vasodilation
Macrophages

212
Q

What are the features of chronic inflammation?

A

Macrophages
Lymphocytes
Plasma cells
Associated fibrosis/scarring

213
Q

Describe the process of leukocyte migration

A

Leukocyte rolling > integrin activation by chemokines > stable adhesion of leukocytes due to high-affinity integrins > migration through endothelium

214
Q

What are the three main types of inflammatory exudate?

A

Purulent/suppurative
Fibrnous
Serous

215
Q

What is a pathogen associated molecular pattern (PAMP)?

A

Highly conserved molecules/molecular patterns in microbes

Enable discrimination between self and foreign

216
Q

Where are TLRs located?

A

Always associated with membrane

  • Plasma
  • Endosome
217
Q

Where are RIG-I-like receptors (RLRs) located?

A

Associated with mitochondria

218
Q

What do RLRs detect?

A

Cytosolic DNA

219
Q

What do NOD-like receptors (NLRs) detect?

220
Q

What do neutrophils do?

A

Phagocytosis

Activation of bactericidal mechanisms

221
Q

What do eosinophils do?

A

Killing of Ab-coated parasites

222
Q

What do basophils do?

A

Promotion of allergic responses and anti-parasitic immunity

223
Q

What organ produces complement?

224
Q

What are the three pathways of the complement pathway?

A

Classical
Lectin
Alternative

225
Q

Where do all three complement pathways converge?

A 
C3b covalently bound to surface components of pathogen >
- Recruitment of inflammatory cells
- Opsonisation of pathogens
- Perforation of pathogen cell membrane
Death of pathogen
226
Q

What are macrophages?

A

Tissue-resident forms of circulatory monocytes

227
Q

What do macrophages do?

A

Phagocytose
Recruit other cells
Scavenge
- Clear dead cells and cell debris

228
Q

Where are mast cells found?

A

Connective tissues

229
Q

What do mast cells release?

A

Histamine
Cytokines
- IL-4
- IL-13

230
Q

What are the cardinal signs of inflammation?

A 
Heat
Redness
Swelling
Pain
Loss of function
231
Q

Which bacteria associate with cells?

A

Commensals

232
Q

Which bacteria adhere to cells?

233
Q

How do pathogenic bacteria adhere to cells?

A

Fimbriae

Non-fimbriae adhesins

234
Q

How do pathogenic bacteria enter host cells?

A

Through cells via pathogen-mediated endocytosis initiated by bacterial surface proteins
Between cells

235
Q

What are the outcomes of invasion that result in survival of bacteria?

A

Can remain within epithelium

Can translocate deeper

236
Q

How can extracellular pathogens evade phagocytosis?

A

Production of leukocidins
Production of anti-inflammatory toxins and enzymes
Interfere with host enzymmes

237
Q

How do capsules contribute to virulence?

A

Electrostatic repulsion
Resemble host components
Mask underlying structures
Prevent opsonisation

238
Q

How do antibodies work against encapsulated bacteria?

A

Abs bind to capsules and activate classical pathway of complement
IgG-coated bacteria therefore doubly opsonised

239
Q

How is adaptive immunity overcome?

A

Direct immunosuppression
Expression of weak Ags
Ag diversity
Ag modification

240
Q

How do superantigens work?

A

Cause non-specific activation of T cells and massive cytokine release > mass inflammation

241
Q

What is pharmacokinetics?

A

What body does to drug

242
Q

What is pharmacodynamics?

A

What drug does to body

243
Q

What does potency relate to?

244
Q

How does dosage differ depending on potency?

A

More potent drug will need lower dose for same effect as less potent drug

245
Q

What is a full agonist?

A

Drug elicits largest possible response

246
Q

What is a partial agonist?

A

Drug elicits lesser effect than largest possible response

247
Q

What are the possible outcomes of acute inflammation?

A

Resolution
Healing by repair
Chronic inflammation

248
Q

How long will chronic inflammation persist for?

A

Until damaging stimulus eradicated

249
Q

What are the characteristics of granulomatous inflammation?

A

Epithelioid macrophages
Multinucleate giant cells
+/- necrosis

250
Q

What causes a granulomatous inflammation?

A

Certain persistent/non-degradable Ags

251
Q

What infections can cause granulomatous inflammation?

A 
TB
Leprosy
Syphilis
Fungal infections
Parasitic infections
252
Q

What unknown causes can cause granulomatous inflammation?

A

Sarcoidosis

Crohn’s disease

253
Q

What are the two subtypes of granulomatous inflammation?

A

Immune granulomas

Foreign body granulomas

MD1 Revision (9 decks)

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