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USMLE > Inflammation > Flashcards

Inflammation Flashcards

1
Q

Injury Byproducts, cardiac myocytes

A

Myoglobin, troponin I, CPK, CKMB

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2
Q

Injury Byproducts, skeletal muscle

A

CPK, Aldolase

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3
Q

Injury Byproducts, hepatocytes

A

AST, ALT, alk phos, GGT

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4
Q

Injury Byproducts, salivary glands

A

Amylase

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5
Q

Injury Byproducts, pancreas

A

amylase, lipase

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6
Q

Injury Byproducts RBCs

A

Heme, bilirubin

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7
Q

acute phase cytokines

A

IL-1, IL-6, TNF-alpha

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8
Q

Granulomatous disease

A

M TB, fungal, Treponema pallidum, bartonella henselae, sarcoidosis, crohn’s, berylliosis (people who work in beryllium mines)

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9
Q

elevated sed rate

A

polymyositis, polymyalgia rheumatics/temporal arteritis, RA disease activity, inflammation, malignancy, Osteomyslitis identification, Temporal arteritis, pregnancy, SLE

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10
Q

C-Reactive Protein

A

opsonizes bacteria and activates complement. Can be secreted from cells within atherosclerotic lawues to activate local endothelial cells to induce protprombotic state and increase adhesivenenss to leukocytes. Elevations predictor or MI stroke and PAD or sudden cardiac death. Can be lowered by smoking cessation, exercise, weight loss, and statins.

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11
Q

Fibrinoid necrosis is seen in

A

blood vessels

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12
Q

Key growth factors promoting angiogenesis

A

VEGF and FGF. (IL-1 and INF-gamma can increase VEGF indirectly promoting angiogenesis)

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13
Q

upper limb lymph drainage

A

axillary nodes

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14
Q

stomach lymph drainage

A

celiac nodes

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15
Q

duodenum jejunum lymph drainiage

A

superior mesenteric nodes

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16
Q

signoid colon lymph drainiage

A

Colic -> inferior mesenteric

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17
Q

Rectum (above pectinate) lymph drainage

A

internal iliac

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18
Q

anal canal lymph drainiage

A

superficial inguinal

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19
Q

Testes lymph drainage

A

polymyositis, polymyalgia rheumatics/temporal arteritis, RA disease activity, inflammation, malignancy, Osteomyslitis identification, Temporal arteritis, pregnancy, SLE

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20
Q

scrotum lymph drainage

A

superficial inguinal

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21
Q

Thigh lymph drainage

A

superficial inguinal

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22
Q

later dorsum foot lymph

A

popliteal lymph nodes

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23
Q

R lymphatic duct

A

drains R arm and R half of head

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24
Q

Thoracic duct

A

drains everything the R lymphatic duct doesn’t. Drains at the jnct of L subclavian and internal jugular veins.

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25
Q

HLA-A3

A

Hemochromatosis

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26
Q

HLA-B27

A

Psoriasis, Ankylosing Spondylitis, IBD, Reiter’s (PAIR)

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27
Q

HLA-B8

A

Grave’s

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28
Q

HLA-DR2

A

MS, Hay fever, SLE, Goodpasture’s

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29
Q

HLA-DR3

A

Diabetes I

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30
Q

DR4

A

Rheumatoid arthritis, diabetes I

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31
Q

HLA-DR5

A

Pernicious anemia, Hashimoto’s thyroiditis

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32
Q

HLA-DR7

A

Steroid-responsive nephrotic syndrome

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33
Q

TCR

A

T cell receptor that binds antigen-MHC

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34
Q

CD3

A

Marker for all T cells, associated with TCR for signal transduction

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35
Q

CD28

A

T cell second signal that binds B7(CD80 or CD86) on APC

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36
Q

CD19

A

B cell receptor

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37
Q

CD20

A

B cell marker

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38
Q

CD21

A

B cell receptor, marker for EBV

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39
Q

CD40

A

B cell and APCs, T cell has CD40L for co-stimulatory signal along with cytokines for class switching

40
Q

CD14

A

LPS receptor on macrophage

41
Q

Macrophage receptors

A

CD40, CD14, B7, MHCII, Fc and C3b receptors

42
Q

B cell receoptors

A

CD 19-21, CD40, MHCII and B7

43
Q

NK cell Marker

A

CD16 (binds Fc of IgG), CD56 (unique to NK)

44
Q

CD16

A

Binds to constant region of Fc. Found on NK cells, Macrophages, monocytes, neutrophils. Recognize and kill immunoglobulin coated cells by ADCC

45
Q

Anti-ANA

A

SLE screening

46
Q

Anti-dsDNA

A

SLE specific, especially for renal disease

47
Q

Anti-Smith

A

Anti-RNP, SLE specific

48
Q

antihistone

A

Drug-induced lupus

49
Q

anti-IgG

A

Rheumatoid factor, RA

50
Q

Anticentromere

A

scleroderma (CREST)

51
Q

Anti-CCP

A

Most specific for RA

52
Q

Anti-Scl-70

A

Anti-DNA topoisomerase, Diffuse Scleroderma

53
Q

Anti-mitochondrial

A

Primary biliary cirrhosis

54
Q

Antigliadin antiendomysial

A

Celiac disease

55
Q

anti-basement membrane

A

Goodpastures

56
Q

Anti-desmoglein

A

Pemphigus vulgaris

57
Q

Antimicrosomal, antithyroglobulin

A

Hashimoto’s

58
Q

Anti-Jo-1

A

Polymyositis, dermatomyositis

59
Q

Anti-SS-A (Ro)/Anti-SS-B(La)

A

Sjogren’s

60
Q

Anti-U1 RNP

A

Mixed Connective Tissue Disease (resonds to corticosteroids and has minimal renal involvemtn)

61
Q

Anti-smooth muscle

A

Autoimmune hepatitis

62
Q

Anti-glutamate decarboxylase

A

Type 1 diabetes mellitus

63
Q

c-ANCA

A

Wegener’s vasculitis

64
Q

p-ANCA

A

Other vasculitides

65
Q

Antiphospholipid

A

lupus or antiphospholipid syndrome (hypercoagulability with paradoxical PTT elongation, recurrent miscairrage)

66
Q

Anti-MPO-ANCA

A

Pauci immune crescentic glomerulonephritis

67
Q

Causes of Amyloidosis

A

Bence Jones(Ig light chains from MM), Secondary (serum amyloid-associated protein from chronic inflam diseases), Senile cardiac (Transthyretin), DMII (Amylin protein), Medullary thyroid carcinoma A-CAL (Calcitonin), Alzheimer’s Disease (beta-amyloid from APP), Dialysis (Beta-microglobulin from MHC class I proteins)

68
Q

CD25

A

Expressed on regulatory T cells

69
Q

Classic Compliment Pathway

A

IgG or IgM mediated (antigen-antibody complexes) - begins with C1

70
Q

Alternative pathway

A

Microbial surfaces (starts with C3)

71
Q

Lectin pathway

A

(A lectin is a protein that binds a sugar) - Starts with C1-like complex that activates C4.

72
Q

C1 esterase inhibitor deficiency

A

Hereditary angioedema. Elevated levels of Bradykinin. ACE inhibitors contraindicated

73
Q

C5 - C9 deficiency

A

Neisseria infections

74
Q

C3 deficiency

A

Severe recurrent sinus and respiratory tract infections. Increased susceptibility to Type III hypersensitivity (glomerulonephritis).

75
Q

DAF (GPI anchored enzyme)

A

Leads to hereditary paroxismal nocturnal hemoglobinuria - Complement-mediated lysis of RBCs

76
Q

Arthus Reaction

A

Type III hypersensitivity. Intradermal injection of antigen induces antibodies which form antigen-antibody comlexes in the skin. Characterized by edema necrosis and activation of complement.

77
Q

Bruton’s (x-linked) Agammaglobulinemia

A

Defective Tyrosine kinase -> blocks pro-B-cells from maturation; low Ig’s; Infections after 6 months

78
Q

Hyper IgM

A

Inability to switch classes d/t CD40L on T cells; High IgM; Recurrent infections

79
Q

Selective Ig Deficiency

A

Defect in class switching; Low IgA; Anaphylaxis on blood transfusion if IgA in blood; Milk allergies, diarrhea

80
Q

Common Variable Immune deficiency

A

Defect in B cell maturation; Low plasma cells, Low Ig’s; Risk for autoimmunity, lymphoma, sinopulmonary infections

81
Q

Thymic Aplasia

A

DiGeorge; Cleft palate, Viral/fungal infections, congenital heart defects, great vessel defects, hypocalcemia (tetany)

82
Q

IL-12 Receptor deficiency

A

Decreased Th1 response; low IFN-gamma; MYCOBACTERIAL INFECTIONS (can’t create granuloma)

83
Q

Hyper-IgE syndrome (Job’s Syndrome)

A

Th1 cells fail to produce IFN-gamma leading to decreased ability of neutrophil chemotaxis; coarse facial features, COLD abscesses, retained primary Teeth, Dermatologic problems (eczema), Increased IgE

84
Q

Chronic mucocutaneous candidiasis

A

Due to T cell dysfunction; treat with ketoconazole

85
Q

Severe Combined Immunodefiency (SCID)

A

Adenosine deaminase deficiency or Inability to synthesize class II MHC, or no IL-2 receptor; Recurrent viral, bacterial, fungal, protozoal infections d/t both T and B cell deficiency; Absent thymic shadow, germinal centers, and B cells. Treat with Bone marrow transplant

86
Q

Ataxia-Telangiectasia

A

Problem with ATM gene. Susceptibility to Radiation, Decreased IgA, Sinopulmonary deficiency, Increased risk for leukemia lymphoma, ataxia, spider angiomas

87
Q

Wiskott-Aldrich Syndrome

A

X-linked recessive defect, deletion of B and T cells; Eczema, thrombocytopenia, decreased IgM (increased IgE and IgA)

88
Q

Chediak-Higashie

A

Autosomal Recessive, problem with microtubule formation in phagosome lysosome fusion, LYSE gene; recurrent staph and strep infections; partial albinism, peripheral neuropathy

89
Q

Chronic Granulomatosis

A

NADPH deficiency; increased infections from staph, e coli, aspergillis, pseudomonas, klebsiella; nitroblue tetrazolium test; prophylaxis with IFN-gamma and SMX-TMP

90
Q

Myeloperoxidase defeciency

A

Defect in myeloperoxidase; susceptibility to catalse positive and negatice organisms; Even when peroxide is around having no myeloperoxidase, can’t make any ROS (vs in granulomatos disease myeloperoxidase is still okay)

91
Q

Why does silicosis make patients susceptible to TB

A

Macrophages consume silicosis which disrupts fusion of the phagolysosome and impairs killing important in mycobacterial infections

92
Q

Acute rejection histology

A

Vasculitis w dense lymphocytic infiltrate

93
Q

Chronic Rejection histology

A

Obliterative vascular fibrosis; fibrosis of graft tissue and blood vessels

94
Q

Live vaccines

A

MMR, Polio, varicella, yellow fever, intranasal influenza

95
Q

Killed vaccines

A

Polio (salk), Rabies, Influenza, Cholera, HepA

USMLE (14 decks)

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