Inflammation Flashcards
1
Q
define innate immunity
A
immunity that we are born with
e.g. physical barriers, WBCs
2
Q
define acquired immunity
A
immunity that develops when a person’s immune system responds to a foreign substance or microorganism, or that occurs after a person receives antibodies from another source
e.g. B cells and T cells
3
Q
define antigen
A
a molecule able to provoke immune response
4
Q
define antibody
A
proteins produced by our immune system to protect and mark unwanted substances in the body
5
Q
what is the main goal of blood?
A
to perfuse organs
6
Q
what are the functions of blood?
A
- transport of nutrients
- transport waste away from cells
- regulate body temp
- clotting
- osmotic pressure
- protection
7
Q
what are the components of blood?
A
- plasma
- buffy coat
- erythrocytes
buffy coat and erythrocytes make up packed cell volume
8
Q
what is plasma composed of?
A
- H2O (mostly)
- plasma proteins
- solutes
9
Q
what are the plasma proteins?
A
albumins, globulins, fibrinogens
10
Q
where are plasma proteins synthesized?
A
in the liver
11
Q
what is the buffy coat composed of?
A
platelets and leukocytes (WBC)
12
Q
define hemopoiesis
A
formation of blood cells
13
Q
what is the main function of RBC’s?
A
to carry oxygen
14
Q
what is the main function of platelets?
A
clotting
15
Q
define leukopoiesis
A
formation of WBC’s
16
Q
define chemotaxis
A
mechanism used by WBC’s to migrate from the blood stream towards stimulus (pathogen/antigen) in tissues
17
Q
what is the function of neutrophils?
A
first responders to injury, engulf and digest pathogens via digestive enzymes
18
Q
neutrophils are highly responsive to which type of pathogen?
A
bacteria
19
Q
define degranulation
A
release of inflammatory mediators to aggregate more WBC’s to site of injury
20
Q
lymphocytes are highly responsive to which type of pathogen?
A
viruses
21
Q
eosinophils are highly responsive to which type of pathogen?
A
allergens
22
Q
what is a CBC diff?
A
testing that provides us with levels of cell components
23
Q
define bands
A
immature neutrophils
24
Q
what is the designated treatment for systemic allergic reactions?
A
histamine 1 antagonists
25
what is the mechanism of action of antihistamines?
block histamine binding to receptors by binding there first/stronger
26
define 1st generation antihistamines
antihistamine drugs that bind to both **CNS and peripheral receptors**, allowing CNS effects (sedation)
27
how do 1st generation antihistamines cause CNS effects?
they are able to cross the BBB and antagonize histamine in the CNS (an excitatory neurotransmitter) to cause drowsiness (sedation)
28
provide examples of 1st generation antihistamines
diphenhydram**ine** (Benadryl, Allerdryl) and chlorpherinam**ine** (Benylin)
29
define 2nd generation antihistamines
antihistamine drugs that only bind to peripheral receptors, don't have a CNS effect
30
provide examples of 2nd generation antihistamines
* fexofenad**ine** (Allegra)
* loratad**ine** (Claritin)
* desloratad**ine** (Aerius)
* cetriz**ine** (Reactine)
31
what is the first choice for systemic allergy treatment and why?
cetrizine (Reactine) because it is non-drowsy (2nd gen) and has an fast onset time & long duration of action
32
what is the treatment choice for local allergies?
* topical antihistamines
* e.g. olopatad**ine** (Patanol) eye drops
* e.g. diphenhydram**ine** (Benadryl) cream
33
describe the allergy desensitization treatment process
* allergens are administered via topical or superficial injections into the dermal
* once allergens are identified, low amounts of allergen serum are injected intramuscularly long term
34
what are the dynamics of how allergy desensitization works?
* administration of allergen serum stimulates TH-1 and T-reg cells
* TH-1 cells stimulate B cell synthesis of IgG antibody
* IgG competes with IgE at a receptor, decreasing amount of available receptors
* IgG combines with an antigen to form a unit that does not crosslink at the mast cell
* T-reg cells suppress the immune system
35
what drug class is used to treat inflammation in tissue injury?
NSAIDs to inhibit COX (COX inhibitors)
36
what are the effects of NSAID's?
* antiinflammatory (primary)
* analgesic
* antipyretic
37
what 2 types of NSAIDs do we use to treat inflammation from tissue injury?
* selective COX-2 inhibitors
* non-selective COX inhibitors
38
provide an example of a COX-2 inhibitor
celecoxib (Celebrex)
39
what non-selective COX inibitors do we use to treat inflammation in tissue injury?
* ibuprofen or ibuprofen-like
* acetysalicylc acid (Aspirin) aka ASA and ECASA
40
what are the signs and systems of anaphylaxis?
evidence of allergy + bronchoconstriction and hypotension
41
what is the 1st line treatment of anaphylaxis?
epinephrine via IM or IV administration
42
what adjunct treatments can we use for anaphylaxis once ABC's are rescued?
* dexamethasone via IV
* antihistamines via IV
43
chronic inflammation is characterized by?
inflammation lasting >10 days from the same trigger
44
what is the function of fibroblasts?
play a role in scar tissue formation
45
what effect does collagen V cause?
an increase in collagen V during repeated inflammation causes tissues to be less elastic and flexible
46
what effect does chronic inflammation have on cellular tissues?
* loss of function: less vascular, flexible and strong
* susceptibility to unusual growth and altered cellular division
47
what triggers allergic rhinitis?
inhaled allergens cause a hypersensitivity response
47
what is the incidence of allergic rhinitis in the population?
40%
48
what are the s&s of allergic rhinitis?
* rhinitis (nasal discharge, swelling of nasal mucosa)
* conjunctivitis (pink eye)
* sneezing
* itching
* headahe
49
what treatments are used for allergic rhinitis?
* antihistamines
* intranasal glucocorticoids
50
provide examples of intranasal corticosteroids used for allergic rhinitis
* Fluticas**one** (Flonase, Avamys)
* Mometas**one** (Nasonex)
* Budesonide (Rhinocort)
51
define atopy
tendency to develop allergies/heightened immune response
52
what is the incidence of atopic dermatitis in the population?
5-20% of children worldwide
53
what are risk factors for atopic dermatitis?
* allergy trigger
* family history and childhood environment
54
what are the s&s of atopic dermatitis in an infant?
* pruritic, red, scaly, crusted lesions
* found on extensor surfaces, cheeks, scalp
* prone to superinfection
55
what are the s&s of atopic dermatitis in childhood?
* less exudates
* lichenification
* plaques on flexural and friction surfaces
56
what are the s&s of atopic dermatitis in an adult?
* localized lichenification
* excoriated, fibrotic papules
* found on flexural surfaces
57
T or F: atopic dermatitis has an autoimmune tendency
TRUE
58
what are the treatments for atopic dermatitis?
* topical glucocorticoids
* antihistamines
* antibiotics or antivirals if progresses to infection
* moisturize
59
what is the atopic triad?
consists of atopic asthma, atopic dermatitis and allergic rhinitis and states that having one of these puts you at higher risk for other allergic symptamology
60
what are risk factors of psoriasis?
* family history/predisposition
* trigger
61
what are some triggers of psoriasis?
skin trauma, climate, stress, medications
62
what are the s&s of psoriasis?
* dry scaly skin patches
* often non pruritic or slight itching
63
what tratments do we use for psoriasis?
* glucocorticoids
* DMARDs
* UV light
* moisturizing creams
64
what are the effects of PBMT with UV light treatment?
* stimulation of angiogenesis
* increased collagen synthesis
* induction cell proliferation and differentiation
* mitochondrial ATP production
* modulation of cytokines and growth factors
65
define arthritis
joint inflammation
66
T or F: rheumatoid arthritis has an autoimmune tendecy
TRUE
67
what are risk factors for rheumatoid arthritis?
* family history
* gender
* triggers (antigens or noxious stimuli)
68
what tissues can rheumatoid arthritis affect?
* joints
* heart
* lungs
* kidneys
* eyes
69
define pannus
abnormal, extra layer of tissue in your joints that forms due to RA, can cause pain, swelling, and damage to your bones, cartilage, and other tissue
70
what effects does theumatoid arthritis have on the joint?
* Dysfunction of the synovial cavity
* formation of a pannus
* Destruction of surrounding tissue (bone, cartilage)
* Deformity of the tissue
* Loss of normal function
* Pain
71
what are the s&s of rheumatoid arthritis?
* **Synovial** joint inflammation in the hands, knees, cervical spin
* Systemic symptoms like fatigue and anorexia
72
what would the bloodwork of an individual with RA look like?
high C-reactive protein levels
73
what treatments do we use for rheumatoid arthritis?
* NSAIDs
* glucocorticoids
* BRMs
* DMARDs
74
what is the mechanism of action of BRM's?
administered IV or SC and inhibit proinflammatory cytokines, decreasing T and B cell response
75
provide examples of BRM drugs used to treat RA
* inflixi**mab**
* adalimu**mab**
* ustekinu**mab**
76
what is the mechanism of action of DMARDs?
* antimetabolites
* inhibit nucleotide synthesis
* inhibit cell proliferation
* inhibit WBC synthesis and function
77
what is the drug **methotrexate** used for?
a DMARD used to treat rheumatoid arthritis
78
define osteoarthritis
degenerative disorder of articular cartilage
79
what are risk factors for osteoarthrisis?
* obesity
* age
* gender
* mechanical stress
| "wear and tear arthritis"
80
what changes does OA cause in articular cartilages?
* repeptive inflammatory mediator release, leading to chronic inflammation
* decreased prosteoglycans
* weakened collagen II network and more collagen V
* cartilage tissue destruction
81
what treatments do we use for OA?
* NSAIDs for pain
* glucocorticoids
82
what is the drug **betamethasone** often used to treat?
osteoarthrisis
83
bone spurs are characteristic of which chronic inflammation disease?
osteoarthrisis
84
what are risk factors for IBDs?
* family history
* triggers
85
T or F: osteoarthrisis has an autoimmune tendency
FALSE
86
T or F: IBD's have an autoimmune tendency
TRUE
87
what are systemic s&s of IBD's?
* fever
* anemia
* fatigue and weight loss
* rash
88
what treatments are used to treat IBD?
* glucocorticoids
* aminosalicylates
* DMARDs
* stem cell treatment
89
the drug **sulfasalazine** is used to treat what?
IBD's (ulcerative collitis and Crohn's)
90
what are the active metabolites of sulfasalazine and what are their drug classes?
* 5-ASA - NSAID
* sulfapyridine - DMARD
91
what is the first line of treatment of ulcerative collitis?
5-ASA (asacol, teva, mesalamine)
92
define Crohn's disease
IBD that causes damage and inflammation **in the whole GI tract**
93
define ulcerative collitis
IBD that affects mucosa and submucosa **of the large intestine only**
94
skip lesions and fistulas are characteristic of which disease?
Crohn's disease
95
define fistulas
communication tunnels between areas of the GI tract
96
define colonoscopy
scope inserted into lower GI for imaging
97
T or F: asthma has an autoimmune tendency
FALSE
98
what is the incidence of asthma in the population?
10%
99
what are risk factors for asthma?
family history and atopy
100
what are possible causes (etiology) of asthma?
* noxious stimuli in the lungs
* chronic hypersensitivity to noxious stimuli
* chronic inflammation causes epithelial injury
* high goblet cell activity
101
what are the s&s of asthma?
* bronchial inflammation
* bronchoconstriction
* mucus production
102
define air trapping
gas exchange is inhibited as O2 cannot be inspired and CO2 cannot be expelled
103
what are asthma controller drugs?
antiinflammatory drugs that are inhaled as preventative treatment against asthma attacks
104
what is the 1st line of treatment for controlling asthma?
glucocorticoids
105
provide examples of glucocorticoids used as asthma controllers
* budesonide (Pulmicort)
* fluticas**one** (Flovent)
* beclomethas**one** (Qvar)
106
what are adjuct tx used to control asthma?
* mast cell stabilizers (cromolyn)
* leukotriene modifiers (singulair)
107
the drug, **omalizumab (Xolair)** is used to treat what?
used for long term maintenance of asthma
108
what is the mechanism of action of omalizumab (Xolair)?
* decreases expression of mast cell bound IgE
* reduction in mast cell response
* reduciton in allergic inflammation
109
what are the s&s of an asthma attack?
* Wheezing, shortness of breath, decrease/no air entry into lung lobes because airways are narrow
* Tachycardia and increased BP
* Anxiety, panic
* Fatigue due to less oxygenation
110
what is the first line of treatment to rescue from an asthma attack?
Beta2 adrenergic agonists
111
provide examples of a beta2 adrenergic agonist used to treat asthma attacks
* **Salbumatol (ventolin)**
* albuterol (ventolin)
* formeterol (Oxeze, turbohaler)
112
what is the 2nd line of treatment for asthma attacks?
anticholinergics, because they have a slower onset of action
113
the drug, **atrovent (ipratropium)** is used to treat what?
2nd line of tx for asthma attack
114
what is the first line of tx for severe asthma attack?
| i.e. in emergency situations
magnesium sulfate via IV
115
what drug classes does magnesium sulfate belong to?
* electrolyte
* enzymatic activator
* calcium channel blocker
116
what is the mechanism of action of magnesium sulfate?
* inhibits CA in smooth muscles
* reduces cellular excitability
* bronchodilation due to relaxation of smooth muscle
117
what are 2nd line or adjunct tx for emergent asthma attacks?
* epinephrine
* antihistamines
* glucocorticoids
* anticholinergics
* O2
* beta2 adrenergic agonists
118
what drug class does epinephrine belong to?
non-selective adrenergic agonists
119
what drug class does ASA belong to?
NSAIDs
120
what is ASA's mechanism of action?
COX enzyme inhibitor to reduce pain and inflammation
121
compare monocytes and macrophages
have the same function but monocytes are found in the bloodstream and macrophages are found in tissues
122
what cells are leukocytes synthesized from?
hematopoietic "myeloid" stem cells
123
what is the function of histamine?
a neurotransmitter that acts as the primary mediator of sensory stimulated inflammation
124
where is histamine stored?
mast cells
125
what are the effects of histamine release?
* vasodilation and increased capillary permeability
* stimulation of nerve endings
* bronchoconstriction and tachycardia
* itching
* urticaria
126
what are s&s of hypersensitivity reactions?
* epiphora (watery eyes)
* allergic conjunctivitis (itchy eyes)
* rinorrhea (runny nose)
* sneezing
* mild pruritus (itching)
* change in VS
127
what are glucocorticoids?
endogenous hormones given in a synthetic form (steroid drugs)
128
what is the MOA of glucocorticoids?
bind to nuclear receptors to influence gene expression
129
define gluconeogenesis
production of glucose from non glucose sources
130
what is COX-1 responsible for during tissue injury?
promote platelet aggregation to form a blood clot
131
what is COX-2 responsible for during tissue injury?
pain and inflammation
