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Block 2 > Immunology and Inflammation > Flashcards

Immunology and Inflammation Flashcards

1
Q

Which cells produce antibodies?

A

B lymphocytes

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2
Q

What two cell types are present in the innate immune response?

A

Natural killer cells

Phagocytes

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3
Q

What is an antigen?

A

Any substance capable of inducing a specific immune response; the target of the immune system

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4
Q

Name the two types of lymphocytes

A

T lymphocytes

B lymphocytes

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5
Q

Where do B lymphocytes mature?

A

Bone marrow

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6
Q

What are macrophages in the liver called?

A

Kupfer cells

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7
Q

Name the four ‘ALTs’

- associated lymphoid tissues (tissues of the immune system)

A

MALT - mucosa

BALT - bronchus

GALT - gut

SALT - skin

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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

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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

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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

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11
Q

What type of proteins are antibodies?

What type of immunity are they involved in?

A

γ-globulin proteins

Adaptive immunity

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12
Q

What is the constant region of an antibody called?

A

FC region

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13
Q

What is the variable region of an antibody called?

A

Fab region

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14
Q

How many IgM subunits make up an IgM molecule?

A

5

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15
Q

What links the IgM and IgA subunits together?

A

J chain

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16
Q

How many IgA subunits make up a molecule?

A

2

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17
Q

What are the 4 likely places for infectious agents to enter the body?

A

Nasopharynx

Respiratory tract

Alimentary tract

Genito-urinary tract

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18
Q

What 2 cells types are involved in innate cell-mediated immunity?

A

Polymorphonuclear leukocytes (neutrophils)

Mononuclear phagocyte system (monocytes and macrophages)

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19
Q

Name 4 physical barriers to infection

A

Skin

Mucus

Respiratory cilia

Commensal organisms

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20
Q

Name 4 physical biochemical barriers to infection

A

Sebaceous secretions in skin

Lysozyme in tears

Spermine in sperm

Gastric acidity

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21
Q

What 2 cell types are involved in innate cell-mediate immunity?

A

Phagocytes (neutrophils + monocytes/macrophages)

Natural killer cells

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22
Q

Which complement factors make the membrane attack complex?

A

C5b, 6, 7, 8, 9

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23
Q

Where are MHC Class I molecules found?

A

Human cells except RBCs

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24
Q

Where are MHC Class II molecules found?

A

Antigen presenting cells

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25
Q

What cell type to MHC Class I molecules present to?

A

Tc lymphocytes

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26
Q

What cell type to MHC Class II molecules present to?

A

Th lymphocytes –> interact with B lymphocytes to produce antibodies

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27
Q

Define inflammation

A

The body’s response to injury

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28
Q

Which immune system is inflammation part of?

A

Innate immunity

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29
Q

List 6 causes of inflammation

A

Chemicals

Microbes

Foreign bodies

Dead cells

Allergens

Physical trauma

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30
Q

Define acute inflammation

A

The immediate defensive reaction of tissue to injury, in which vascular and exudative processes predominate

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31
Q

List the 5 macroscopic features of acute inflammation

A

Erythema

Oedema

Warmth

Pain

Loss of function

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32
Q

What microscopic changes take place in acute inflammation?

A

Exudative changes

  • fluids and proteins
  • emigration of leukocytes
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33
Q

Which 3 blood cells are classed as granulocytes?

A

Neutrophils

Eosinophils

Basophils

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34
Q

Define chronic inflammation

A

Prolonged and persistent inflammation; which may be a continuation of acute inflammation, or the result of an insidious insult, characterised by scar tissue formation

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35
Q

List 5 causes of chronic inflammation

A

Persisting infection

Persisting foreign bodies

Persisting trauma

Inadequate response

Auto-immune

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36
Q

Give some macroscopic features of chronic inflammation

A

Evidence of tissue destruction (necrosis)

Prolonged duration

Inflammation, injury and repair in at the same time

Loss of function

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37
Q

List the 5 types of leukocytes (WBCs)

A

Neutrophils

Eosinophils

Basophil

Monocyte

Lymphocyte

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38
Q

What microscopic features are seen in chronic inflammation?

A

Adaptive immunity response

Further leukocytes e.g.

  • lymphocytes and macrophages
  • eosinophils and basophils
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39
Q

List the different types of lymphocytes

A

T lymphocytes

  • T helper
  • T cytotoxic

B cells
- plasma cells

40
Q

What type of immune response are T and B cells (lymphocytes) involved in?

A

Adaptive immunity

41
Q

What type of immune response are natural killer cells (lymphocytes) involved in?

A

Innate immunity

42
Q

What type of cells work to destroy antigen presenting cells?

A

T and B lymphocytes

43
Q

Which leukocyte is raised in parasitic infections?

A

Eosinophils

44
Q

Which leukocyte is raised in allergies?

A

Basophils

45
Q

Which leukocyte is raised in bacterial infections?

A

Neutrophils

46
Q

Which leukocyte is raised in viral infections?

A

Lymphocytes

47
Q

Which leukocyte is raised in chronic inflammation?

A

Monocytes

48
Q

Name the likely cause of raised eosinophils

A

Parasitic infections

49
Q

Name the likely cause of raised basophils

A

Allergies

50
Q

Name the likely cause of raised neutrophils

A

Bacterial infections

51
Q

Name the likely cause of raised lymphocytes

A

Viral infections

52
Q

Name the likely cause of raised monocytes

A

Chronic inflammation

53
Q

What is a granuloma?

A

A collection of macrophages

54
Q

What do monocytes give rise to?

A

Macrophages

55
Q

What name is given to an acute accumulation of fluid?

A

Serous

56
Q

What name is given to a chronic accumulation of fluid?

A

Fibrinous

57
Q

List the 5 outcomes of inflammation

A

Repair and return

Ongoing inflammation

Change in tissue function

Dysfunction and scarring

Catastrophe

58
Q

List 4 biochemical barriers in immunity

A

Sebaceous secretions in skin

Lysozyme in tears

Spermine in sperm

Gastric acidity

59
Q

List the 8 stages of bacterial pathogenesis

A

Access

Adherence

Invasion

Multiplication

Evasion

Resistance

Damage

Transmission

60
Q

List Koch’s postulates

A

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
Q

What is the most common causative organism in UTIs?

What type of bacteria is it?

A

E. coli

Gram -ve from the colon

62
Q

List the 4 known roles of the immune system

A

Immunity to infection

Inflammatory processes

Removal of senescent cells

Defence against neoplasia

63
Q

List 6 differences between innate and adaptive immunity

A 
INNATE
Primary line of defence
Immediate response
Recognises certain threats
No antigen presentation
No clonal selection
No immunological memory
64
Q

What 5 components make up the innate immune system?

How long does this response last for?

A

Epithelial barriers

Phagocytes

Dendritic cells

Complement

NK cells

Up to 12 hours

65
Q

What makes up the adaptive immune system?

How long does this response last for?

A

B lymphocytes (produce antibodies)

T lymphocytes (produce effector T cells)

12 hours - days

66
Q

What do B lymphocytes do?

A

Produce antibodies

Phagocytosis

Complement activation

67
Q

What do helper T cells do?

A

Respond to antigen-presenting cells

Produce cytokines

Activation of macrophages

Inflammation

Activation, proliferation and differentiation of T and B lymphocytes

68
Q

What do Tc cells and NK cells do?

A

Killing of infected cell

69
Q

Draw the complement cascade

Which parts form the membrane attack complex?

A 
C5b
C6
C7
C8
C9 form membrane attack complex
70
Q

Describe the role of neutrophils in the innate cell-mediated immune response

A

Rapid action, no adaptive benefits

Engulf microbes

71
Q

Describe the role of monocytes and macrophages in the innate cell-mediated immune response

A

Present antigens to the adaptive immune system

Engulf microbes

72
Q

List the 7 steps of phagocytosis

A

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
Q

How do natural killer cells (lymphocytes) detect infected or malignant cells?

How do they perform their cytotoxic roles?

A

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
Q

What is cRP?

What is its role in innate humoral immunity?

A

cRP is an acute phase protein

It binds to surface molecules of bacteria and fungi (but not viruses) and promotes complement binding

75
Q

What is the difference between the alternative and classic complement pathways?

A

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
Q

Which complement proteins are responsible for inflammation?

A

C3a

C5a

77
Q

Describe adaptive cell-mediated immunity

A

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
Q

Which cells are involved in adaptive cell-mediated immunity?

A

Tc cells (lymphocytes)

79
Q

Which cells are involved in adaptive humoral immunity?

A

B lymphocytes

80
Q

Describe adaptive humoral immunity

A

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
Q

What factors stimulate the immune system?

A

Presence of antigens

Th cells

Cytokines

82
Q

What factors inhibit the immune system?

A

Removal of antigens

Ts cells

Cytokine breakdown

83
Q

Describe the role of interleukins in the immune response

A

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
Q

Describe the role of tumour necrosis factor in the immune response

A

Produced by MPS

Leads to fever, inflammation, enhanced immunity, septic shock

85
Q

Describe the role of interferons in the immune response

A

Produced by virus-infected cells and Th cells

Activate NK and Tc cells

Activated macrophages and up regulate antigen-presentation (adaptive immune system)

86
Q

Which cells recognise MHC Class I cells?

A

Tc cells

87
Q

Which cells recognise MHC Class II cells?

A

Th cells

88
Q

Which cells have MHC Class II proteins on them?

A

Macrophages

B cells

89
Q

Define systemic inflammatory response syndrome (SIRS)

A

Aninflammatory responseto 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
Q

Define sepsis

A

When the body’s response to infection causes injury to its own tissues & organs

91
Q

Define infection

A

Invasion & multiplication of pathogenic microbes in an area of the body where they are not normally present, which usually leads to disease

92
Q

____ + ____ = sepsis?

A

Infection + SIRS = sepsis

93
Q

Define severe sepsis

What are the red flag features of severe sepsis?

A

Sepsis + organ dysfunction (including septic shock)

Purpuric rash
HR >130
BP <90
RR >25
O2 <91%
Lactate >2mmol/l
94
Q

Define septic shock

A

Sepsis + hypotension (90) despite fluid resuscitation + perfusion abnormalities
e.g. lactic acidosis, low UO, low GCS

95
Q

What are the mortality rates for uncomplicated sepsis, severe sepsis and septic shock?

A

Uncomplicated - 10%

Severe - 35%

Septic shock - 50%

Block 2 (10 decks)

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