Inflammation And Repair

Question 1

What accumulates in interstitial space during acute inflammation

Answer 1

Neutrophils and edematous fluid

Question 2

Present on macrophages qnd dendritic cells which recognize pathogen associated molecular patterns and lets body know there is infection

Answer 2

Toll like receptors

Question 3

Toll like receptor on macrophage which recognizes lipopolysaccharide on gram neg bacteria

Answer 3

CD14

Question 4

Key protein upregulated when toll like receptors are activated and turns on inflammatory response

Answer 4

NF kappa B

Question 5

Inflammatory mediator released from cell membrane by phospholipase A2

Answer 5

Arachidonic acid

Question 6

Product of cyclooxygenase pathway from arachidonic acid

Answer 6

Prostaglandin

Question 7

PGI2, PGD2 and PGE2 mediates which actions

Answer 7

Vasodilation pf arterioles, increased vascular permeabity of post capillary venule

Question 8

Prostaglandin which mediates fever and pain

Answer 8

PGE2

Question 9

Product of lipooxygenase pathway from arachidonic acids

Answer 9

Leukotrienes

Question 10

Leukotriene which attracts and activates neutrophils

Answer 10

LTB4

Question 11

Four substances which attracts and activates neutrophils

Answer 11

Ltb4
C5a
IL8
Bacterial products

Question 12

Leukotrienes which mediate vasoconstriction, bronchospasm, and increased vascular permeabity

(Smooth muscle contraction)

Answer 12

LTC4, LTD4, LTE4

Question 13

Three ways mast cells can be activated

Answer 13

Tissue trauma
C3a and C5a
Cross linking of IgE by antigen

Question 14

Histamine granules mediate?

Answer 14

Vasodilation of arterioles, increased vascular permeabity

Question 15

What is the delayed response of mast cells?

Answer 15

Release of leukotrienes to allow continuation of inflammatory responser

Question 16

Proinflammatory serum proteins which circulate as inactive precursors

Answer 16

Complement

Question 17

Three mechanisms of complement activation

Answer 17

Classical pathway - C1 binds to IgG or IgM bound to antigen
Alternative pathway - Microbial products directly activate
Mannose-binding lectin pathway - MBL binds mannose on microorganisms and activates complement

Question 18

Pathway to formation of membrane attack complex from complement activation

Answer 18

C3 convertase generated converts C3 to C3a and C3b
C3b helps produce C5 convertase to convert C5 to C5a and C5b
C5b produces C6-C9 which is part of membrane attack complex

Question 19

Complement which is chemotactic for neutrophils

Answer 19

C5a

Question 20

Complement which trigger mast cell degranulation

Answer 20

C3a and C5a

Question 21

Complement which is an opsonin for phagocytosis

Answer 21

C3b

Question 22

Inactive proinflammatory protein produced in liver which is activated upon exposure to subendothelial or tissue collagen

Answer 22

Hageman factor

Question 23

Hageman factor plays an important role in which two disease entities

Answer 23

DIC

Gram negative sepsis

Question 24

Hageman factor activates which three system

Answer 24

Coagulation and fibrinolytic systems
Complement system
Kinin system

Question 25

Bradykinin mediates what

Answer 25

Vasodilation, increased vascular permeability, pain

Question 26

Mechanisms of fever generation

Answer 26

Macrophage release IL1 and TNF Perivascular cells of hypothalamus have increased COX activity PGE2 increases which raises temp set point

Question 27

Match the tcell receptor complex for t cells CD4 and CD8 MHC class I and II

Answer 27

``` CD4 - MHC class II CD8 - MHC class I ```

Question 28

Function of MHC

Answer 28

Binds to antigen and Presents antigen to Tcell

Question 29

Mechanism for CD4 tcell activation

Answer 29

Extracellular antigen is phagocytosed on APC and is presented on MHC class II B7 (second signal) on APC binds CD 28 on CD 4 T cell as activation signa

Question 30

Examples of antigen presenting cells

Answer 30

Macrophage, dendritic cell

Question 31

Mechanism of activated CD4 helper t cell

Answer 31

Secrete cytokines which help B cells or CD 8

Question 32

Cytokines secrete by TH1 and fx

Answer 32

IL-2 - activates CD8 T cell | IFN gamma - activates macrophage

Question 33

Cytokines secreted by TH2 and fx

Answer 33

``` IL-4 class switching to IgG and IgE IL-5 eosinophil chemotaxis and activation, maturation of B cells to plasma cell, class switching to IgA IL-10 inhibits Th1 phenotype ```

Question 34

Mechanism of cell killing of CD8

Answer 34

Secrete perforins and granzyme to induce apoptosis Expression of FasL, binds Fas on target cell to activate apoptosis

Question 35

Naive B cells express which Immunoglobulin

Answer 35

IgM and IgD

Question 36

Mechanism of B cell activation

Answer 36

Antigen binding by surface IgM or IgD, activating B cell to secrete that immunoglobulin B cell present antigen to CD4 via MHC II and CD40 receptor on B cell binds to CD40L on helper Tcell, activating it to secrete IL4 and IL5 promoting ig switch and maturation to plasma cell

Question 37

Morphology of granuloma

Answer 37

Epitheloid histiocytes (macrophage with abundant pink cytoplasm) - key feature of granuloma Surrounded by giant cell and lymphocytes

Question 38

Caseating vs noncaseating granuloma

Answer 38

Caseating has central necrosis

Question 39

Mechanism of granuloma formation

Answer 39

Macrophage present antigen to CD4 via MHC II Macrophage secrete IL 12 CD4 differentiates to Th1 subtype, which secretes IFN gamma and converts the macrophage to epitheloid histiocyte and giant cell

Question 40

Marker for hematopoeitic stem cells (CD?)

Answer 40

CD34+

Question 41

Types of tissues based on repair and give example

Answer 41

Labile -rapidly regenerating. Bowel, marrow, skin Stable tissue - quiescent but can re enter cell cycle - hepatocytes, proximal renal tubule Permanent tissue - no significant regeneration. Myocardium, skeletal muscle, neurons

Question 42

Regeneration vs repair

Answer 42

Regeneration - replaced with native tissue | Repair - fibrous tissue

Question 43

Components of granulation tissue

Answer 43

Fibroblast (deposit type III collagen), myofibroblast (contract wound), and capillary

Question 44

Types of collagen

Answer 44

Type I - bone. Strong tensile strength, support Type II - cartilage Type III - pliable. Blood vessels, granulation, embryonic tissue Type IV - basement membrane

Question 45

Collagen in granulation vs collagen in scar? What enzyme removes type III and cofactor required?

Answer 45

Granulation -type 3 Scar -type 1 Collagenase Zinc

Question 46

Growth factors functions if | TGF alpha, beta, PDGF, FGF, VEGF

Answer 46

``` TGF alpha -epithelial and fibroblast Beta - fibroblast. inhibits inflammation PDGF - (platelet derived GF) endothelium, smootg muscle, FGF FGF - angiogenesis, skeletal muscle VEGF - angiogenesis ```

Question 47

Primary vs Secondary intention

Answer 47

Primary -wound edges brought together, minimal scar | Secondary - edges not approximate, granulation tissue fills defect, scar formation and wound contraction

Question 48

Function of Vitamin C in wound healing

Answer 48

Procollagen needs to crosslink by hydroxylation Gly-Pro/Lys-Hydroxypro/lys Vitamin C hydroxylates pro and lys, and the hydroxylated ends allow crosslinking of more procollagen molecules to become mature collagen

Question 49

Function of copper in wound healing

Answer 49

Lysyl oxidase cross links lysine and hydroxylysine?

Question 50

Keloid is excess deposition of which type of collagen

Answer 50

Type III