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CPR Exam 2 > Immunological Aspects of Renal System > Flashcards

Immunological Aspects of Renal System Flashcards

1
Q

Which of the following would meet the criteria for Acute Kidney injury?

A. GFR greater than or equal to 60mL/min with stable serum creatine

B. Kidney damage seen for greater than 3 months

C. GFR less than 60mL/min for 3 months with an increase in SCr by 50% w/in 7 days

D. Increase in SCr by 50% within 7 days, or 0.3mg/dL in 2 days

A

Increase in SCr by 50% within 7 days, or 0.3mg/dL in 2 days

also oliguria (abnormally small amounts of urine produced)

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2
Q

In most cases, which of the following is the cause of an AKI (acute kidney injury)?

A. Inflammation brought on by an infection

B. Sterile Inflammation

C. Graft vs. Host Disease

D. Type I Hypersenstivity reaction

A

Sterile Inflammation

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3
Q

CRPs have 5 subunits like IgM, allowing it to bind DAMPs and activate complement. Which of the following binds to CRPs the same as IgM allowing the classical complement pathway to be activated?

A. C1

B. C2

C. Mannose

D. C3

A

C1

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4
Q

PAMPs are released from exogenous pathogens, and DAMPs are from endogenous damaged cells that both include Nucleic acids, lipids and proteins that bind to PRRs and cause release of pro-inflammatory mediators. Which of the following are some of the pro-inflammatory mediators?

A. TGF and IL-10

B. IL-4, IL-6, IL-1B

C. TNF-a

D. TNF-a, IL-1B, and IL-6

A

TNF-a, IL-1B, and IL-6

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5
Q

All of the following are PAMPs released from pathogens, except for which of the following that are DAMPs?

A. CpG and ds DNA

B. Lipid A

C. ATP and oxLDL

D. PGN

A

ATP and oxLDL

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6
Q

All of the following DAMPs activateNF-kB when they bind to their respective receptors. Which of the following DAMPs is released from the nucleus of a damage cell and binds the RAGE receptor?

A. HMGB1

B. Uric Acid

C. HSP

D. S100

A

HMGB1

NOTE: RAGE= Receptor of Advanced Glycation End products

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7
Q

All of the following DAMPs activateNF-kB when they bind to their respective receptors. Which of the following DAMPs is released from the nucleus of a damage cell and binds the NLR-P3 receptor?

A. HMGB1

B. Uric Acid

C. HSP

D. S100

A

Uric Acid

NOTE: HSP binds to scavenger receptor A

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8
Q

Damage to kidneys causes release og chemokines and cytokines via the activation of resident renal cells like DCs, Macrophages, and endothelial cells. According to Dr. Shnyra’s cahrt, activation of which of the following cells is a related response to Ischemia Induced Glomerulonephritis, Diabetes, and sepsis?

A. Endothelial Cell release of TNF, IL-6, and IFN-a

B. DC release of IL-12, CXCL2, IL-1B, and Type I IFNs

C. Macrophage release of ROS, IL-1B, TNF, IL-6, and chemokines

D. None of the above

A

Endothelial Cell release of TNF, IL-6, and IFN-a

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9
Q

The presence of certain cells and cytokines varies between early and late stages of an AKI. Which of the following are you most likely to see at the early stages of an AKI?

A. High concentration of Th17 releasing IFN-y, IL-6 and IL-4

B. Th1 predominating causing an increase in levels of IL-12 and IL-6

C. Th17 predominating causing an increase in levels of IL-12 and IL-6

D. High level of Alternatively activated M2 macrophages promoting anti-inflamation and wound repair

A

Th17 predominating causing an increase in levels of IL-12 and IL-6

NOTE: Th1 predominate the late phase and give off: IFN-y, IL-6 and IL-4

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10
Q

Macrophages play a role in AKI response as well. Which of the following correctly describes the role of the classical and/or alternatively activated Macrophages?

A. M1s are reprogrammed M2s that have changed their phenotype after exposure to M-CSF, IL-4 and IL-13

B. M2s release IL-10, TGF-B and proline polyamines for anti-inflammatory actions and wound repair

C. Classically activated Macrophages show up and release IL-1, IL-12, and IL-23 to promote inflammation

D. All of the above

E. A and C

F. B and C

A

B and C

B. M2s release IL-10, TGF-B and proline polyamines for anti-inflammatory actions and wound repair

C. Classically activated Macrophages show up and release IL-1, IL-12, and IL-23 to promote inflammation

NOTE: M2s are reprogrammed M1s

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11
Q

Which of the following subset of T cells releases or promotes the release of CCL20 (MIP-3) which leads to recruitment of neurtrophils, monocytes, and other mediators of inflammation that ultimately leads to the progression of immune mediate kidney damage?

A. Th1

B. Th2

C. Th17

D. Treg

A

Th17

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12
Q

Why are kidneys so susceptible to complement induced damage?

A

Filtration favors the deposisiton of immune complexs on the tissues

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13
Q

Which of the following stimualte proinflammatory response in neurtrophils and macrophages leading to inflammation that relates to the eventual necrosis of kidney cells?

A. C3b and C5b

B. Bb and C4a

C. MAC complex

D. C3a and C5a

A

C3a and C5a

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14
Q

T/F: Complement activation may occur downstream as a result of Type I and Type IV hypersensitivity reactions

A

False; Type II (Ab-mediated injury) and Type III (immune complex deposition)

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15
Q

What are the 4 main variables that determine the outcome of transplantation?

A
  1. Allographs condition
  2. Disparity betwen host and donors antigens
  3. Strength of hosts response to donors Ags
  4. Immunosupressive regimen
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16
Q

The condition of the allograft is a non-immunological factor that refers to the trauma dealt to the donor graft tissue. A damaged graft causes problems that involves what two cascades that eventually lead to hyperacute allograft rejection?

Indicate the factors involved in each cascade.

A

Clotting Cascade: fibrin and fibrinopeptide

Kinin Cascade: Bradykinin

17
Q

In-relation to the affects caused by a damaged graft:

What are the effects of Fibrinopeptide in the clotting cascade?

What are the effects of Bradykinin in the kinin cascade?

A

Fibrinopeptide increases local vascular permeability and recruits neutrophils and monocyes

Bradykinin allso in creases vascular permeability through vasodilation and contraction of smooth muscle

18
Q

Why is it that HLA-class I is the strongest barrier to transplantation?

A. HLAs have many polymorphisms

B. All nucleated cells express HLA I

C. HLAs are really large, larger than blood antigens

D. I don’t know

A

All nucleated cells express HLA I

19
Q

What tissues is blood type matcvhing or HLA matching not important, due to them being non-vascularized?

A

Cornea

Heart Valve

Bone and Tendon

20
Q

Which of the following is the correct interpretation when we see 3H-thymidine NOT being incorporated into recipient cells DNA?

A. A Micrototoxicity Test for Class I HLA indicating that there is compatitibilty and transplantation can proceed

B. A Mixed Lymphocyte Response indicating incompatitiblity between donor and recipient

C. A Microcytotoxicity Test that is positive for preformed antibodies indicating transplantation should not proceed

D. A MLR that indicates compatitibility between donor and recipients HLA Class II

A

A MLR that indicates compatitibility between donor and recipients HLA Class II

21
Q

GVHD occurs in immunocompormised reciepients due to their cells being unable to reject the allogenic cells within the graft. This is often seen in transplantation of what organs that naturally have a lot of T cells

A

Small bowels

Lung

Liver

Bone marrow

22
Q

Which of the following types of HVGD is the main mechanism a pathogenic mechanism aka an indirect response?

A. Hyperacute

B. Acute

C. Chronic

D. All of the above

A

Chronic

23
Q

Damage to kidneys causes release og chemokines and cytokines via the activation of resident renal cells like DCs, Macrophages, and endothelial cells. According to Dr. Shnyra’s cahrt, activation of which of the following cells is a related response to acute kidney injury and infections?

A. Endothelial Cell release of TNF, IL-6, and IFN-a

B. DC release of IL-12, CXCL2, IL-1B, and Type I IFNs

C. Macrophage release of ROS, IL-1B, TNF, IL-6, and chemokines

D. None of the above

A

DC release of IL-12, CXCL2, IL-1B, and Type I IFNs

24
Q

Damage to kidneys causes release og chemokines and cytokines via the activation of resident renal cells like DCs, Macrophages, and endothelial cells. According to Dr. Shnyra’s cahrt, activation of which of the following cells is a related response to most kidney disease?

A. Endothelial Cell release of TNF, IL-6, and IFN-a

B. DC release of IL-12, CXCL2, IL-1B, and Type I IFNs

C. Macrophage release of ROS, IL-1B, TNF, IL-6, and chemokines

D. None of the above

A

Macrophage release of ROS, IL-1B, TNF, IL-6, and chemokines

25
Q

What is present at hyperacute, acute, and chronic allograft rejection?

A
26
Q

T/F: RBCs contain antigens while the plasma contains the antibodies

A

True

27
Q

Alloantibodies are generally which of the following?

A. IgM

B. IgG

C. IgA

D. IgE

A

IgG

CPR Exam 2 (18 decks)

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