Immunology and Inflammation Flashcards
1
Q
Which cells produce antibodies?
A
B lymphocytes
2
Q
What two cell types are present in the innate immune response?
A
Natural killer cells
Phagocytes
3
Q
What is an antigen?
A
Any substance capable of inducing a specific immune response; the target of the immune system
4
Q
Name the two types of lymphocytes
A
T lymphocytes
B lymphocytes
5
Q
Where do B lymphocytes mature?
A
Bone marrow
6
Q
What are macrophages in the liver called?
A
Kupfer cells
7
Q
Name the four ‘ALTs’
- associated lymphoid tissues (tissues of the immune system)
A
MALT - mucosa
BALT - bronchus
GALT - gut
SALT - skin
8
Q
What are the four proteins that make up the humoral factors of the immune system?
A
Acute phase proteins
Complement proteins
Antibodies
Cytokines
9
Q
What type of proteins are acute phase proteins?
What type of immunity are they involved in?
Give an example of an acute phase protein
A
α, β, γ-globulins
Innate immunity
cRP
10
Q
What type of proteins are complement?
What is the outcome of the complement cascade
A
β-globulin proteins
Innate immunity
To produce a membrane attack complex
11
Q
What type of proteins are antibodies?
What type of immunity are they involved in?
A
γ-globulin proteins
Adaptive immunity
12
Q
What is the constant region of an antibody called?
A
FC region
13
Q
What is the variable region of an antibody called?
A
Fab region
14
Q
How many IgM subunits make up an IgM molecule?
A
5
15
Q
What links the IgM and IgA subunits together?
A
J chain
16
Q
How many IgA subunits make up a molecule?
A
2
17
Q
What are the 4 likely places for infectious agents to enter the body?
A
Nasopharynx
Respiratory tract
Alimentary tract
Genito-urinary tract
18
Q
What 2 cells types are involved in innate cell-mediated immunity?
A
Polymorphonuclear leukocytes (neutrophils)
Mononuclear phagocyte system (monocytes and macrophages)
19
Q
Name 4 physical barriers to infection
A
Skin
Mucus
Respiratory cilia
Commensal organisms
20
Q
Name 4 physical biochemical barriers to infection
A
Sebaceous secretions in skin
Lysozyme in tears
Spermine in sperm
Gastric acidity
21
Q
What 2 cell types are involved in innate cell-mediate immunity?
A
Phagocytes (neutrophils + monocytes/macrophages)
Natural killer cells
22
Q
Which complement factors make the membrane attack complex?
A
C5b, 6, 7, 8, 9
23
Q
Where are MHC Class I molecules found?
A
Human cells except RBCs
24
Q
Where are MHC Class II molecules found?
A
Antigen presenting cells
25
What cell type to MHC Class I molecules present to?
Tc lymphocytes
26
What cell type to MHC Class II molecules present to?
Th lymphocytes --> interact with B lymphocytes to produce antibodies
27
Define inflammation
The body's response to injury
28
Which immune system is inflammation part of?
Innate immunity
29
List 6 causes of inflammation
Chemicals
Microbes
Foreign bodies
Dead cells
Allergens
Physical trauma
30
Define acute inflammation
The immediate defensive reaction of tissue to injury, in which vascular and exudative processes predominate
31
List the 5 macroscopic features of acute inflammation
Erythema
Oedema
Warmth
Pain
Loss of function
32
What microscopic changes take place in acute inflammation?
Exudative changes
- fluids and proteins
- emigration of leukocytes
33
Which 3 blood cells are classed as granulocytes?
Neutrophils
Eosinophils
Basophils
34
Define chronic inflammation
Prolonged and persistent inflammation; which may be a continuation of acute inflammation, or the result of an insidious insult, characterised by scar tissue formation
35
List 5 causes of chronic inflammation
Persisting infection
Persisting foreign bodies
Persisting trauma
Inadequate response
Auto-immune
36
Give some macroscopic features of chronic inflammation
Evidence of tissue destruction (necrosis)
Prolonged duration
Inflammation, injury and repair in at the same time
Loss of function
37
List the 5 types of leukocytes (WBCs)
Neutrophils
Eosinophils
Basophil
Monocyte
Lymphocyte
38
What microscopic features are seen in chronic inflammation?
Adaptive immunity response
Further leukocytes e.g.
- lymphocytes and macrophages
- eosinophils and basophils
39
List the different types of lymphocytes
T lymphocytes
- T helper
- T cytotoxic
B cells
- plasma cells
40
What type of immune response are T and B cells (lymphocytes) involved in?
Adaptive immunity
41
What type of immune response are natural killer cells (lymphocytes) involved in?
Innate immunity
42
What type of cells work to destroy antigen presenting cells?
T and B lymphocytes
43
Which leukocyte is raised in parasitic infections?
Eosinophils
44
Which leukocyte is raised in allergies?
Basophils
45
Which leukocyte is raised in bacterial infections?
Neutrophils
46
Which leukocyte is raised in viral infections?
Lymphocytes
47
Which leukocyte is raised in chronic inflammation?
Monocytes
48
Name the likely cause of raised eosinophils
Parasitic infections
49
Name the likely cause of raised basophils
Allergies
50
Name the likely cause of raised neutrophils
Bacterial infections
51
Name the likely cause of raised lymphocytes
Viral infections
52
Name the likely cause of raised monocytes
Chronic inflammation
53
What is a granuloma?
A collection of macrophages
54
What do monocytes give rise to?
Macrophages
55
What name is given to an acute accumulation of fluid?
Serous
56
What name is given to a chronic accumulation of fluid?
Fibrinous
57
List the 5 outcomes of inflammation
Repair and return
Ongoing inflammation
Change in tissue function
Dysfunction and scarring
Catastrophe
58
List 4 biochemical barriers in immunity
Sebaceous secretions in skin
Lysozyme in tears
Spermine in sperm
Gastric acidity
59
List the 8 stages of bacterial pathogenesis
Access
Adherence
Invasion
Multiplication
Evasion
Resistance
Damage
Transmission
60
List Koch's postulates
The microorganism must be found in abundance in all organisms suffering from the disease, but should not be found in healthy organisms
The microorganism must be isolated from a diseased organism and grown in pure culture
The cultured microorganism should cause disease when introduced into a healthy organism
The microorganism must be re-isolated from the inoculated, diseased experimental host and identified as being identical to the original specific causative agent.
61
What is the most common causative organism in UTIs?
What type of bacteria is it?
E. coli
Gram -ve from the colon
62
List the 4 known roles of the immune system
Immunity to infection
Inflammatory processes
Removal of senescent cells
Defence against neoplasia
63
List 6 differences between innate and adaptive immunity
```
INNATE
Primary line of defence
Immediate response
Recognises certain threats
No antigen presentation
No clonal selection
No immunological memory
```
64
What 5 components make up the innate immune system?
How long does this response last for?
Epithelial barriers
Phagocytes
Dendritic cells
Complement
NK cells
Up to 12 hours
65
What makes up the adaptive immune system?
How long does this response last for?
B lymphocytes (produce antibodies)
T lymphocytes (produce effector T cells)
12 hours - days
66
What do B lymphocytes do?
Produce antibodies
Phagocytosis
Complement activation
67
What do helper T cells do?
Respond to antigen-presenting cells
Produce cytokines
Activation of macrophages
Inflammation
Activation, proliferation and differentiation of T and B lymphocytes
68
What do Tc cells and NK cells do?
Killing of infected cell
69
Draw the complement cascade
Which parts form the membrane attack complex?
```
C5b
C6
C7
C8
C9 form membrane attack complex
```
70
Describe the role of neutrophils in the innate cell-mediated immune response
Rapid action, no adaptive benefits
Engulf microbes
71
Describe the role of monocytes and macrophages in the innate cell-mediated immune response
Present antigens to the adaptive immune system
Engulf microbes
72
List the 7 steps of phagocytosis
Chemotaxis and adherence of microbe to phagocyte
Ingestion of microbe by phagocyte
Formation of phagosome
Fusion of phagosome with lysosome to form phagolysosome
Digestion of ingested microbe by enzymes
Formation of residual body containing indigestible material
Discharge of waste material
73
How do natural killer cells (lymphocytes) detect infected or malignant cells?
How do they perform their cytotoxic roles?
Recognise the lack of MHC Class I molecules on their surface through lack of stimulation of inhibitor receptors
This leads to activation of NK cells
NK cells have pore-forming molecules that insert into the target cells and then pump in chemicals
74
What is cRP?
What is its role in innate humoral immunity?
cRP is an acute phase protein
It binds to surface molecules of bacteria and fungi (but not viruses) and promotes complement binding
75
What is the difference between the alternative and classic complement pathways?
Alternative pathway - antibody independent cell lysis. Starts from C3
Classical pathway - antibody dependent. Starts from C1 and then goes into alternative pathway
Both pathways have the same end result
76
Which complement proteins are responsible for inflammation?
C3a
C5a
77
Describe adaptive cell-mediated immunity
Comes from Tc cells
Comes from Tc cells
All cells present antigens using MHC Class I to Tc cells.
The Tc that recognise foreign antigens replicate and differentiate
Activated Tc cells attack host cells which present that antigent
Memory Tc cells have immunological memory
78
Which cells are involved in adaptive cell-mediated immunity?
Tc cells (lymphocytes)
79
Which cells are involved in adaptive humoral immunity?
B lymphocytes
80
Describe adaptive humoral immunity
B lymphocytes that produce antibodies
Microbes are phagocytosed by antigen-presenting cells
APC present antigen using MHC Class II to Th cells
The same antigen stimulates B lymphocytes
B plasma cells produce antibodies that attack that antigen
B memory cells retain immunological memory
81
What factors stimulate the immune system?
Presence of antigens
Th cells
Cytokines
82
What factors inhibit the immune system?
Removal of antigens
Ts cells
Cytokine breakdown
83
Describe the role of interleukins in the immune response
Involved in every step of adaptive immunty
12 proteins produced by Th cells which stimulate the immune system and leads to proliferation, differentiation, activation and chemotaxis
84
Describe the role of tumour necrosis factor in the immune response
Produced by MPS
Leads to fever, inflammation, enhanced immunity, septic shock
85
Describe the role of interferons in the immune response
Produced by virus-infected cells and Th cells
Activate NK and Tc cells
Activated macrophages and up regulate antigen-presentation (adaptive immune system)
86
Which cells recognise MHC Class I cells?
Tc cells
87
Which cells recognise MHC Class II cells?
Th cells
88
Which cells have MHC Class II proteins on them?
Macrophages
B cells
89
Define systemic inflammatory response syndrome (SIRS)
An inflammatory response to infection (or a non-infectious insult) that affects the whole body
```
>1 of the following:
Temp <36 >38
HR >90
RR>20
WCC <4 >12
BMs >7.7
Confusion, reduced consciousness
```
90
Define sepsis
When the body's response to infection causes injury to its own tissues & organs
91
Define infection
Invasion & multiplication of pathogenic microbes in an area of the body where they are not normally present, which usually leads to disease
92
____ + ____ = sepsis?
Infection + SIRS = sepsis
93
# Define severe sepsis
What are the red flag features of severe sepsis?
Sepsis + organ dysfunction (including septic shock)
```
Purpuric rash
HR >130
BP <90
RR >25
O2 <91%
Lactate >2mmol/l
```
94
Define septic shock
Sepsis + hypotension (90) despite fluid resuscitation + perfusion abnormalities
e.g. lactic acidosis, low UO, low GCS
95
What are the mortality rates for uncomplicated sepsis, severe sepsis and septic shock?
Uncomplicated - 10%
Severe - 35%
Septic shock - 50%
