Inflammation/Wound Healing Flashcards
1
Q
Which cells of the immune system has cells with TLRs? Adaptive?
A
innate = macrophages and dendritic
adaptive = lymphocytes
2
Q
What activates TLRs?
A
PAMPs
3
Q
What is the CD molecule of macrophages?
A
CD14
4
Q
What molecule does CD14 recognize?
A
LPS
5
Q
TLR activation activates which txn factor?
A
NF-KB
6
Q
What class of molecules does cycloxygenase produce?
A
prostaglandins
7
Q
What class of molecules does 5-lipoxygenase produce?
A
leukotrienes
8
Q
What are the three main prostaglandins produced from cycloxygenase? What two effects do these prostaglandins mediate?
A
PGE2/PGI2/PGD2
vasodilation and increased vascular permeability
9
Q
What prostaglandin mediates fever and pain?
A
PGE2
10
Q
Which leukotriene attracts neutrophils?
A
LTB4
11
Q
What three effects are mediated by C4, D4 and E4?
A
vasoconstriction
bronchospasm
increased vascular permeability
12
Q
Which two complement proteins can activate mast cells?
A
C3a and C5a
13
Q
Which immunoglobulin can crosslink to activate mast cells?
A
IgE
14
Q
Do mast cells release leukotrienes or prostaglandins?
A
leukotrienes
15
Q
In the classical complement pathway, which two proteins activate C1?
A
IgG and IgM
16
Q
Which ligand on bacteria can a complement protein bind? Which complement protein?
A
mannose
mannose-binding lectin
17
Q
What protein do the classical and alternative complement activation pathways meet at?
A
C3 Convertase
18
Q
Which proteins are contained within the MAC? Which C5?
A
C5-C9
C5b
19
Q
Which complement protein is a chemoattractant for neutrophils?
A
C5a
20
Q
Which complement protein is an opsonin?
A
C3b
21
Q
What is another name for Factor Twelve? What activates this factor?
A
Hageman Factor
collagen
22
Q
Which complement protein activates the Kinin system?
A
Factor twelve
23
Q
What is another name for redness?
A
rubor
24
Q
What is another name for warmth?
A
calor
25
Which molecule produces endothelial cell contraction?
histamine
26
What are the two mediators of pain?
bradykinin and PGE2
27
Which molecule from bacteria mediates fever?
LPS
28
Pyrogens from bacteria cause WHAT CELL to release which two mediators to produce fever?
macrophages
TNF and IL1
29
Which cells of the hypothalamus contain cycloxygenase? Which prostaglandin activates them?
Perivascular
PGE2
30
Which molecule mediates the release of P-selectin from WP bodies?
histamine
31
Which two proteins mediate the increase in E-selectin?
TNF and IL-1
32
Which protein do selectins BIND on inflammatory cells? What cell type is this protein found?
sialyl Lewis X
leukocytes
33
What cells express ICAM and VCAM?
endothelium
34
Which two cytokines upregulate ICAM and VCAM?
TNF and IL1
35
Which cells express integrins?
Leukocytes
36
Which two cytokines upregulate integrins?
C5a and LTB4
37
What general class of protein is deficient Leukocyte Adhesion Deficiency? Leukocyte adhesion deficiency would possess a lack of what CD molecule?
INTEGRINS
CD18
38
Which interleukin is responsible for macrophage mediated recruitment of neutrophils?
IL-8
39
Which complement protein is responsible for neutrophil attraction?
C5a
40
Which leukotriene is responsible for neutrophil attraction?
LTB4
41
What are the two main opsonins?
IgG and C3b
42
What is defective during Chediak-Higashi syndrome? Involving what protein?
protein trafficking deficiency
microtubules
43
The formation of what intracellular organelle is impaired during Chediak-Higashi Syndrome?
phagolysosome
44
Would Chediak-Higashi Syndrome result in neutropenia or neutrophilia?
neutropenia
45
What would be seen inside the leukocytes during Chediak-Higashi Syndrome? From which organelle?
fusion of giant granules
Golgi
46
What hematological defect is present duringChediak-Higashi Syndrome? Why?
defective platelet function
abnormal dense granules in platelets
47
What would be obvious during Chediak-Higashi Syndrome on physical exam? Why?
albinism
melanocytes cant disperse melanin
48
Other than albinism, what is the 2nd most common presenting symptom of Chediak Higashi syndrome?
peripheral neuropathy of DISTAL limbs
49
Which free radical is created by NADPH Oxidase?
superoxide
50
What rxn is catalyzed by Superoxide Dismutase?
superoxide to H2O2
51
What rxn is catalyzed by Myeloperoxidase?
H2O2 to HOCl
52
What enzyme is often absent during Chronic Granulomatous Disease?
NADPH Oxidase
53
Organisms possessing what enzyme are often the culprits for infection during Chronic Granulomatous Disease?
catalase
54
What is the mnemonic to remember the catalase positive organisms?
PLACESS
55
What is the P of PLACESS? Specific species?
pseudomonas
species = cepacia
56
What is the L of PLACESS?
Listeria
57
What is the A of PLACESS?
Aspergillus
58
What is the C of PLACESS?
Candida
59
What is the E of PLACESS?
E. coli
60
What are the S's of PLACESS?
Serratia
Staph
61
What stain is used to screen for CGD?
Nitroblue tetrazolium
62
What is the anti-inflammatory interleukin?
IL-10
63
What is the anti-inflammatory cytokine?
TGF-β
64
Which two immune cells are indicative of chronic inflammation?
lymphocytes and plasma cells
65
What two proteins compose the TCR Complex?
TCR and CD3
66
Regarding T-cell activation, what protein is on the APC? What protein is on the CD4 cells?
CD4 = CD28
APC = B7
67
Would IFN-γ be indicative of a TH1 or TH2 response?
TH1
68
What are the two functions of IFN-γ?
activates macrophages
IgM to IgG switching
69
Which three interleukins does TH2 secrete?
IL4
IL5
IL13
70
What is the function of IL4?
isotype switch to IgE
71
What are the two functions of IL5?
recruit eosinophils
isotype switching to IgA
72
What is the function of IL13?
functions similar to IL4
73
What is the function of IL2?
2nd activation signal to CD8 T-cells
74
Which two immunoglobulins do naive B-cells express?
IgM and IgD
75
What metal is known to cause granulomatous inflammation?
Beryllium
76
Which infection can cause granulomatous inflammation?
Cat Scratch Fever
77
What two types of infections produce a caseating granuloma?
TB and fungal infections
78
What is the function of IL12?
induces CD4 cells to differentiate into TH1 subtype
79
What two metabolites build up in lymphocytes during SCID?
adenosine and deoxyadenosine
80
At what age would X-linked agammaglobulinemia present? Why?
6 months
mothers Ab's are protective until this point
81
What three infections often present during X-linked Agammaglobulinemia?
recurrent infections
enterovirus
Giardia
82
Which has a necrotic core, caseating or non-caseating?
caseating
83
What two diseases is a patient with Common Variable Immunodeficiency at risk for developing?
Autoimmune
Lymphoma
84
What two proteins are defective during Hyper IgM Syndrome? What is the result of this?
CD40 and/or CD40L
B-cells cant undergo isotype switching
85
What is the triad of Wiskott Aldrich Syndrome?
thrombocytopenia
eczema
ecurrent infections
86
What is the major cause of death in patients with Wiskott-Aldrich Syndrome?
bleeding
87
C5-C9 defects predispose an individual to develop infections with what bug?
Neisseria
88
Hereditary Angioedema is caused by a defect in what protein? Why are the findings produced?
C1
C1 is constanly activating complement and activating
HMWK cleavage leading to bradykinin induced angioedema
89
AIRE mutations produce what sydrome? What is lost during this process?
Autoimmune Polyendocrine Syndrome
central tolerance
90
Autoimmune Lymphoproliferative Syndrome is due to mutations in what protein?
Fas apoptosis pathway
91
CD25 Polymorphisms are associated with what two diseases?
Diabetes Mellitus
Multiple Sclerosis
92
FOXP3 mutations lead to what disease?
IPEX
93
Which complement proteins are normally deficient in lupus? What is the function of these complement proteins?
early complement
clear antigen/antibody complexes
94
Which three early complement proteins are often deficient during SLE? What does this complex function as?
C1q, C2 and C4
C3 Convertase
95
Does lupus present with lymphadenopathy?
yes
96
What vascular abnormality can lupus cause?
Raynaud
97
What is the most severe form of SLE induced renal injury/
Diffuse Proliferatvie Glomerulonephritis
98
What type of endocarditis does SLE produce? Which valve? Which side?
Libmann Sacks
mitral
both sides
99
What are the two highly specific antibodies for lupus ?
anti-dsDNA
anti-smith
100
What are three important anti-phospholipid antibodies produced during lupus?
anti-cardiolipin
anti-β2 glycoprotein I
Lupus anti-coagulant
101
Anti-cardiolipin can give a false positive when screening for what disease?
Syphillis
102
What condition is anti-coagulant antibody associated with?
Hypercoaguable with elevated aPTT
103
Drug induced lupus will have auto-antibodies produced against what antigen?
Histone
104
What three drugs clasically produce lupus?
Procainamide
Isoniazid
Hydralazine
105
What should pateints with lupus avoid?
direct sunlight
106
What two glands are destroyed during Sjogrens Syndrome? What TYPE of hypersensitivity rxn?
lacrimal and salivary
type IV
107
What other disease is Sjogrens Syndrome likely to present with?
rheumatoid arthritis
108
Which three auto-antibodies does Sjogrens Syndrome often present with?
anti-SSA/Ro
anti-SSB/La
Rheumatoid Factor
109
What is the antigen for anti-SSA and anti-SSB?
ribonucleoprotein
110
Pregnant women with anti-SSA are at risk for delivering babies with what two conditions?
neonatal heart block
congenital lupus
111
What biopsy on the body can aid in the diagnosis of Sjogrens Syndrome? Where?
Lymphocytic Sialadenitis
LIP
112
What type of Lymphoma can Sjorens Syndrome produce? How does this present?
Marginal Zone Lymphoma
unilateral enlargement of the parotid
113
Which two organs undergo sclerosis during Systemic Sclerosis?
skin and visceral organs
114
Which autoantibodies present during CREST syndrome? Diffuse or limited?
anti-centromere antibodies
Limited
115
Where does Limited Type systemic sclerosis present?
hands and face
116
What four organs does Diffuse Type systemic sclerosis present?
Vessels
GI tract
lung
kidneys
117
How does Diffuse Type systemic sclerosis present in the GI tract?
esophagitis
118
How does Diffuse Type systemic sclerosis present in the Lungs?
interstitial fibrosis
pulmonary HTN
119
How does Diffuse Type systemic sclerosis present in the Vessels?
Reynaud
120
Which auto-antibody is often found during diffuse Systemic Sclerosis? What is the antigen for this AB?
anti-scl-70
DNA topoisomerase I
121
Which two autoantibodies are present during Mixed Connective Tissue Disorder?
ANA
anti-U1 ribonucleoprotein
122
What is the stem cell of the lung?
Type II pneumocytes
123
What structure are the stem cells of the GI tract contained?
mucosal crypts
124
What type of collagen is contained within fibroblasts?
Type III
125
What type of collagen is removed by collagenase? What is the cofactor for Collagenase?
Type III
zinc
126
What are the two growth factors for angiogenesis?
FGF and VEGF
127
What enzyme is copper a cofactor for?
Lysyl Oxidase
128
What does lysyl oxidase connect?
lysine and hydroxylysine
129
What type of collagen does collagenase replace type III collagen with?
Type I
130
What type of collagen is found in keloids?
Type III
131
Which cell count can increase during an acute MI?
Neutrophils
132
What type of molecule is CD14?
TLR
133
What molecule does CD14 recognize?
LPS
134
Leukotrienes cause which cells contract to increase vascular permeability?
pericytes
135
What is the four ways to activate mast cells?
Tissue trauma
C3a
C5a
cross-linked IgE by antigens
136
What is the immediate response of mast cell activation?
release of preformed histamine
137
What is the maintenance response of mast cell activation?
synthesis of leukotrienes
138
What is the function of mast cells releasing leukotrienes?
potentiating acute inflammation
139
What is another name for swelling?
tumor
140
What is another name for warmth?
calor
141
What structure mediates swelling?
post-capillary venules
142
By what mechanism do PGE2 and bradykinin produce pain?
sensitize nerve endings
143
Where does vasodilation occur?
postcapillary venule
144
What would be the first finding to arise due to Leukocyte Adhesion Deficiency?
delayed sepration of the umbilical cord
145
Would Leukocyte Adhesion Deficiency have an increased or decreased level of circulating Neutrophils? Why?
increased
inability of neutrophils to 'hang' and be marginated in the lungs
146
What are the three chemoattractant molecules for neutrophils?
LTB4, IL8, C5a
147
MPO deficiency puts a patient at an increased risk for developing infections cause by what organism?
Candida
148
How do neutrophils clear from a tissue after an infection? Forming what?
apoptosis
pus
149
Do macrophages rely more on oxygen dependent or oxygen independent killing? Via what enzyme?
oxygen independent
lysozyme
150
What is the primary mechanism by which macrophages kill pathogens?
enzymes
151
What interleukin is used to macrophages to recruit more neutrohils to a site of inflammation?
IL8
152
Which MHC molecule is located on platelets?
MHC one
153
Do CD4 or CD8 cells express FasL?
CD8
154
What is the first mechanism by which B-cells become activated? What is the result of this?
antigen binds IgM or IgD on B-cells
turns B-cell into plasma cell
155
What is the second mechanism by which B-cells become activated?
CD40 of B-cell binds CD40L on helper T-cell
156
What is the key defining feature of a granuloma?
epithelioid histiocytes
157
What two types of cells would an Epithelioid Histiocyte be surrounded by?
Giant cells
plasma cells
158
A stellate shaped granuloma is indicative of what disease?
Cat Scratch Fever
159
Would a TH1 or TH2 response generate a granuloma?
TH1
160
What is the main cytokine that drives the formation of Epithelioid Histiocytes?
IFN-gamma
161
What is the specific genetic mutation of DiGeorge Syndrome?
22q11 microdeletion
162
What two major presentations would a patient with DiGeorge Syndrome present with ?
recurrent infections
hypocalcemia
163
What is the 2nd mechanism by which a SCID may develop, other than Adenosine Deaminase?
MHC Two dysfunction
164
What cellular maturation defect is present in X-linked Agammaglobulinemia?
B-cells cant mature into plasma cells
165
What enzyme is defective in X-linked Agammaglobulinemia?
Brutons Tyrosine Kinase
166
What infections are a patient with Common Variable Immunodeficiency susceptible to?
bacterial
enterovirus
Giardia
167
Which cytokines would not be produced during Hyper IgM Syndrome? What type of infections? Where?
IgA/IgG/IgE
pyogenic
mucosal sites
168
Where on the body would a patient with Hyper IgM Syndrome most likely get an infection?
Mucosal sites
169
What is the most often site of edema during C1 Inhibitor Deficiency?
periorbital
170
What three condtions present in a apatient with Autoimmune Polyendocrine Syndrome?
Hypoparathyroidism
Adrenal Failure
recurrent Candida infections
171
What CD molecule is the Fas receptor?
CD95
172
Fas (CD95) apoptosis pathway mutations result in what syndrome?
Autoimmune Lymphoproliferative Syndrome
173
What are the three molecules of Tregs?
CD4+
CD25+
FOXP3+
174
How do Tregs suppess autoimmunity?
block T-cell activation
175
What special regulatory protein do Tregs express?
CTLA-4
176
What is the function of CTLA4? What can this lead to?
bind/inhibit B7
anergy
177
Which two anti-inflammatory cytokines can Tregs secrete?
TGF-β
IL-10
178
Which CD molecule is the IL2 Receptor?
CD25
179
FOXP3 mutations are associated with what syndrome? What does this syndrome stand for?
IPEX syndrome
Immune Dysregulation
Polyendocrinopathy
Enteropathy
X-linked
180
According to Sattar, what is the reason women more often present with autoimmune disease?
estrogen reduce apoptosis of self-reactive Bcells
181
Regarding Early Complement, what is the function of C3B?
act as opsonin to clear Ag/Ab complex
182
What is the most common early complement protein whose deficiency can lead to lupus?
C2
183
What type of hypersensitivity rxn would blood component problems be during Lupus?
Type Two
184
Which anti-body can be used as a prognostic antibody and to follow the disease activity of lupus?
anti-dsDNA
185
What are the two most common causes of death in lupus patients?
renal failure or infection
186
What are the three most typical presentations for Sjogrens Syndrome?
Dry eyes
dry mouth
recurrent dental caries
187
An immune reaction against what type of tissue is believed to initiate Systemic Sclerosis?
mesenchyme
188
Which two cell types are believed to be involved in the pathogenesis of Systemic Sclerosis? Which vasoconstrictor?
mesenchyme and endothelial
endothelin
189
What cell type can become activated during systemic sclerosis? What two cytokines are released?
Platelets
TGF-β and PDGF
190
Which part of CREST is the first to appear in a patient with systemic sclerosis?
Reynaud
191
In what layer of the epidermis are the stem cells located?
Stratum basale
192
Name two stable tissues?
liver
PCT
193
What type of collagen is seen in granulation tissue?
Type III
194
TGF-α is an important growth factor for what two cell types?
epithelial and fibroblasts
195
TGF-β is an important growth factor for what two cell types?
fibroblasts
196
PDGF is an important growth factor for what three tissues?
endothelial
smooth muscle
fibroblasts
197
What is dehiscence?
rupture of a wound
198
Interactions between what two proteins cause leukocytes to adhere to endothelium?
Integrins and CAMs
199
What is CD18?
Integrin β2
200
What type of hypersensitivity reaction is Sjogrens?
Type 4
201
Which three inflammatory mediators mediate arteriolar smooth muscle contraction?
bradykinin
prostaglandins
histamine
202
Which 3rd and 4th structure is absent during DiGeorge?
pharyngeal pouch
203
Which two viruses present during X-linked Agammaglobulinemia?
polio and coxsackie
204
What other autoimmune disease is most likely to present during Sjogrens?
Rheumatoid
205
What other autoimmune disease is Rheumatoid Factor present even though Rheumatoid Arthritis may not be present?
Sjogrens
206
What gland is involved with Sjogrens Syndrome transformring into a lymphoma?
Parotid
207
Where is LPS located on gram-negative proteins?
outer membrane
208
What is the relationship between Hagemann Factor and gram-negative bacteria?
DIC
209
What two proteins are contained in Weibel-Palade bodies?
P-selectin
vWF
210
Which species of Pseudomonas is mentioned as catalase positive?
cepacia
211
What type of cell forms a rim around a granuloma?
lymphocytes
212
Selective IgA Deficiency patients are at particular risk for what type of pathogen infection?
viral
213
What disease is particularly common in patients with IgA Deficiency?
Celiac
214
Which CD molecule mediates peripheral tolerance?
CD95
215
Which interleukin can limit MHC Two expression?
IL-10
216
What is the trigger for lupus?
UV damage
217
Can lupus cause pancytopenia? What type of hypersensitivity rxn?
yes
type two
218
Are CNS and renal involvement common on rare in drug induced lupus?
rare
219
Within how long do neutrophils undergo apoptosis with a lack of inflammatory signal?
24 hours
220
Mixed Connective Tissue has characteristics of which three diseases?
Lupus
systemic sclerosis
polymyositis
221
At what structure do prostaglandins mediate vasodilation?
arterioles
222
At what structure do prostaglandins mediate increased vascular permeability?
post-capillary venule
223
Which activates the Alternative Complement pathway?
bacterial products
224
Which cells express selectins?
endothelial
225
Why would Chediak-Higashi produce a defect in primary hemostasis?
defective dense granules in platelets
226
What is the mode of inheritance of Chediak Higashi?
autosomal recessive
227
Which stain to differentiate a TB in a TB vs. fungal caseating granuloma?
TB = AFP
228
Which stain to differentiate a Fungal in a TB vs. fungal caseating granuloma?
fungal = GMS
229
Which two specific types of Bcells are arrested in their growth during X-Linked Agammaglobulinemia?
pre-B
pro-B
230
Patients with X-Linked Agammaglobulinemia will get what three type of infections?
Bacteria
Enterovirus (polio and coxsackie)
Giardia
231
Patients with Common Variable Immunodeficiency will get what three type of infections?
Bacteria
Enterovirus (polio and coxsackie)
Giardia
232
Is CD40 or CD40L on Tcells?
CD40L
233
Is CD40 or CD40L on Bcells?
CD40
234
Where in the thymus does negative selection occur?
medulla
235
Where in the thymus does positive selection occur?
cortex
236
What kind of protein is AIRE? What is the function of AIRE?
transcription factor
transcribe self antigens
237
Which syndrome ensues if Fas Ligand is absent?
Autoimmune lymphoproliferative syndrome
238
Other than HLAB27, what gene is implicated in many autoimmune disorders?
PTPN22
239
Can lupus cause pancytopenia?
yes
240
Does PT or PTT get falsely elevated during lupus?
PTT
241
Which two organs are not affected by drug induced lupus?
CNS and renal
242
What does lupus do to CV System?
accelerated atherosclerosis
243
SSA and SSB are associated with what type of manifestation?
extraglandular
244
Which sjogren antibody can cross the placenta?
SSA
245
What is the most common cause of death in Diffuse Type Scleroderma?
pulmonary
246
What is the function of lysyl oxidase?
cross-link lysine and hydroxy-lysine
247
What type of collagen in a keloid?
type three
