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Pathoma > Inflammation/Wound Healing > Flashcards

Inflammation/Wound Healing Flashcards

1
Q

Which cells of the immune system has cells with TLRs? Adaptive?

A

innate = macrophages and dendritic

adaptive = lymphocytes

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2
Q

What activates TLRs?

A

PAMPs

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3
Q

What is the CD molecule of macrophages?

A

CD14

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4
Q

What molecule does CD14 recognize?

A

LPS

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5
Q

TLR activation activates which txn factor?

A

NF-KB

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6
Q

What class of molecules does cycloxygenase produce?

A

prostaglandins

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7
Q

What class of molecules does 5-lipoxygenase produce?

A

leukotrienes

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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

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9
Q

What prostaglandin mediates fever and pain?

A

PGE2

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10
Q

Which leukotriene attracts neutrophils?

A

LTB4

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11
Q

What three effects are mediated by C4, D4 and E4?

A

vasoconstriction

bronchospasm

increased vascular permeability

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12
Q

Which two complement proteins can activate mast cells?

A

C3a and C5a

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13
Q

Which immunoglobulin can crosslink to activate mast cells?

A

IgE

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14
Q

Do mast cells release leukotrienes or prostaglandins?

A

leukotrienes

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15
Q

In the classical complement pathway, which two proteins activate C1?

A

IgG and IgM

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16
Q

Which ligand on bacteria can a complement protein bind? Which complement protein?

A

mannose

mannose-binding lectin

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17
Q

What protein do the classical and alternative complement activation pathways meet at?

A

C3 Convertase

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18
Q

Which proteins are contained within the MAC? Which C5?

A

C5-C9

C5b

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19
Q

Which complement protein is a chemoattractant for neutrophils?

A

C5a

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20
Q

Which complement protein is an opsonin?

A

C3b

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21
Q

What is another name for Factor Twelve? What activates this factor?

A

Hageman Factor

collagen

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22
Q

Which complement protein activates the Kinin system?

A

Factor twelve

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23
Q

What is another name for redness?

A

rubor

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24
Q

What is another name for warmth?

A

calor

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25
Q

Which molecule produces endothelial cell contraction?

A

histamine

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26
Q

What are the two mediators of pain?

A

bradykinin and PGE2

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27
Q

Which molecule from bacteria mediates fever?

A

LPS

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28
Q

Pyrogens from bacteria cause WHAT CELL to release which two mediators to produce fever?

A

macrophages

TNF and IL1

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29
Q

Which cells of the hypothalamus contain cycloxygenase? Which prostaglandin activates them?

A

Perivascular

PGE2

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30
Q

Which molecule mediates the release of P-selectin from WP bodies?

A

histamine

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31
Q

Which two proteins mediate the increase in E-selectin?

A

TNF and IL-1

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32
Q

Which protein do selectins BIND on inflammatory cells? What cell type is this protein found?

A

sialyl Lewis X

leukocytes

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33
Q

What cells express ICAM and VCAM?

A

endothelium

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34
Q

Which two cytokines upregulate ICAM and VCAM?

A

TNF and IL1

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35
Q

Which cells express integrins?

A

Leukocytes

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36
Q

Which two cytokines upregulate integrins?

A

C5a and LTB4

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37
Q

What general class of protein is deficient Leukocyte Adhesion Deficiency? Leukocyte adhesion deficiency would possess a lack of what CD molecule?

A

INTEGRINS

CD18

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38
Q

Which interleukin is responsible for macrophage mediated recruitment of neutrophils?

A

IL-8

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39
Q

Which complement protein is responsible for neutrophil attraction?

A

C5a

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40
Q

Which leukotriene is responsible for neutrophil attraction?

A

LTB4

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41
Q

What are the two main opsonins?

A

IgG and C3b

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42
Q

What is defective during Chediak-Higashi syndrome? Involving what protein?

A

protein trafficking deficiency

microtubules

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43
Q

The formation of what intracellular organelle is impaired during Chediak-Higashi Syndrome?

A

phagolysosome

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44
Q

Would Chediak-Higashi Syndrome result in neutropenia or neutrophilia?

A

neutropenia

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45
Q

What would be seen inside the leukocytes during Chediak-Higashi Syndrome? From which organelle?

A

fusion of giant granules

Golgi

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46
Q

What hematological defect is present duringChediak-Higashi Syndrome? Why?

A

defective platelet function

abnormal dense granules in platelets

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47
Q

What would be obvious during Chediak-Higashi Syndrome on physical exam? Why?

A

albinism

melanocytes cant disperse melanin

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48
Q

Other than albinism, what is the 2nd most common presenting symptom of Chediak Higashi syndrome?

A

peripheral neuropathy of DISTAL limbs

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49
Q

Which free radical is created by NADPH Oxidase?

A

superoxide

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50
Q

What rxn is catalyzed by Superoxide Dismutase?

A

superoxide to H2O2

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51
Q

What rxn is catalyzed by Myeloperoxidase?

A

H2O2 to HOCl

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52
Q

What enzyme is often absent during Chronic Granulomatous Disease?

A

NADPH Oxidase

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53
Q

Organisms possessing what enzyme are often the culprits for infection during Chronic Granulomatous Disease?

A

catalase

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54
Q

What is the mnemonic to remember the catalase positive organisms?

A

PLACESS

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55
Q

What is the P of PLACESS? Specific species?

A

pseudomonas

species = cepacia

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56
Q

What is the L of PLACESS?

A

Listeria

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57
Q

What is the A of PLACESS?

A

Aspergillus

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58
Q

What is the C of PLACESS?

A

Candida

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59
Q

What is the E of PLACESS?

A

E. coli

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60
Q

What are the S’s of PLACESS?

A

Serratia

Staph

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61
Q

What stain is used to screen for CGD?

A

Nitroblue tetrazolium

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62
Q

What is the anti-inflammatory interleukin?

A

IL-10

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63
Q

What is the anti-inflammatory cytokine?

A

TGF-β

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64
Q

Which two immune cells are indicative of chronic inflammation?

A

lymphocytes and plasma cells

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65
Q

What two proteins compose the TCR Complex?

A

TCR and CD3

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66
Q

Regarding T-cell activation, what protein is on the APC? What protein is on the CD4 cells?

A

CD4 = CD28

APC = B7

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67
Q

Would IFN-γ be indicative of a TH1 or TH2 response?

A

TH1

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68
Q

What are the two functions of IFN-γ?

A

activates macrophages

IgM to IgG switching

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69
Q

Which three interleukins does TH2 secrete?

A

IL4

IL5

IL13

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70
Q

What is the function of IL4?

A

isotype switch to IgE

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71
Q

What are the two functions of IL5?

A

recruit eosinophils

isotype switching to IgA

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72
Q

What is the function of IL13?

A

functions similar to IL4

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73
Q

What is the function of IL2?

A

2nd activation signal to CD8 T-cells

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74
Q

Which two immunoglobulins do naive B-cells express?

A

IgM and IgD

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75
Q

What metal is known to cause granulomatous inflammation?

A

Beryllium

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76
Q

Which infection can cause granulomatous inflammation?

A

Cat Scratch Fever

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77
Q

What two types of infections produce a caseating granuloma?

A

TB and fungal infections

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78
Q

What is the function of IL12?

A

induces CD4 cells to differentiate into TH1 subtype

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79
Q

What two metabolites build up in lymphocytes during SCID?

A

adenosine and deoxyadenosine

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80
Q

At what age would X-linked agammaglobulinemia present? Why?

A

6 months

mothers Ab’s are protective until this point

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81
Q

What three infections often present during X-linked Agammaglobulinemia?

A

recurrent infections

enterovirus

Giardia

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82
Q

Which has a necrotic core, caseating or non-caseating?

A

caseating

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83
Q

What two diseases is a patient with Common Variable Immunodeficiency at risk for developing?

A

Autoimmune

Lymphoma

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84
Q

What two proteins are defective during Hyper IgM Syndrome? What is the result of this?

A

CD40 and/or CD40L

B-cells cant undergo isotype switching

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85
Q

What is the triad of Wiskott Aldrich Syndrome?

A

thrombocytopenia

eczema

ecurrent infections

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86
Q

What is the major cause of death in patients with Wiskott-Aldrich Syndrome?

A

bleeding

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87
Q

C5-C9 defects predispose an individual to develop infections with what bug?

A

Neisseria

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88
Q

Hereditary Angioedema is caused by a defect in what protein? Why are the findings produced?

A

C1

C1 is constanly activating complement and activating
HMWK cleavage leading to bradykinin induced angioedema

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89
Q

AIRE mutations produce what sydrome? What is lost during this process?

A

Autoimmune Polyendocrine Syndrome

central tolerance

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90
Q

Autoimmune Lymphoproliferative Syndrome is due to mutations in what protein?

A

Fas apoptosis pathway

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91
Q

CD25 Polymorphisms are associated with what two diseases?

A

Diabetes Mellitus

Multiple Sclerosis

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92
Q

FOXP3 mutations lead to what disease?

A

IPEX

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93
Q

Which complement proteins are normally deficient in lupus? What is the function of these complement proteins?

A

early complement

clear antigen/antibody complexes

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94
Q

Which three early complement proteins are often deficient during SLE? What does this complex function as?

A

C1q, C2 and C4

C3 Convertase

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95
Q

Does lupus present with lymphadenopathy?

A

yes

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96
Q

What vascular abnormality can lupus cause?

A

Raynaud

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97
Q

What is the most severe form of SLE induced renal injury/

A

Diffuse Proliferatvie Glomerulonephritis

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98
Q

What type of endocarditis does SLE produce? Which valve? Which side?

A

Libmann Sacks

mitral

both sides

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99
Q

What are the two highly specific antibodies for lupus ?

A

anti-dsDNA

anti-smith

100
Q

What are three important anti-phospholipid antibodies produced during lupus?

A

anti-cardiolipin

anti-β2 glycoprotein I

Lupus anti-coagulant

101
Q

Anti-cardiolipin can give a false positive when screening for what disease?

A

Syphillis

102
Q

What condition is anti-coagulant antibody associated with?

A

Hypercoaguable with elevated aPTT

103
Q

Drug induced lupus will have auto-antibodies produced against what antigen?

A

Histone

104
Q

What three drugs clasically produce lupus?

A

Procainamide

Isoniazid

Hydralazine

105
Q

What should pateints with lupus avoid?

A

direct sunlight

106
Q

What two glands are destroyed during Sjogrens Syndrome? What TYPE of hypersensitivity rxn?

A

lacrimal and salivary

type IV

107
Q

What other disease is Sjogrens Syndrome likely to present with?

A

rheumatoid arthritis

108
Q

Which three auto-antibodies does Sjogrens Syndrome often present with?

A

anti-SSA/Ro

anti-SSB/La

Rheumatoid Factor

109
Q

What is the antigen for anti-SSA and anti-SSB?

A

ribonucleoprotein

110
Q

Pregnant women with anti-SSA are at risk for delivering babies with what two conditions?

A

neonatal heart block

congenital lupus

111
Q

What biopsy on the body can aid in the diagnosis of Sjogrens Syndrome? Where?

A

Lymphocytic Sialadenitis

LIP

112
Q

What type of Lymphoma can Sjorens Syndrome produce? How does this present?

A

Marginal Zone Lymphoma

unilateral enlargement of the parotid

113
Q

Which two organs undergo sclerosis during Systemic Sclerosis?

A

skin and visceral organs

114
Q

Which autoantibodies present during CREST syndrome? Diffuse or limited?

A

anti-centromere antibodies

Limited

115
Q

Where does Limited Type systemic sclerosis present?

A

hands and face

116
Q

What four organs does Diffuse Type systemic sclerosis present?

A

Vessels

GI tract

lung

kidneys

117
Q

How does Diffuse Type systemic sclerosis present in the GI tract?

A

esophagitis

118
Q

How does Diffuse Type systemic sclerosis present in the Lungs?

A

interstitial fibrosis

pulmonary HTN

119
Q

How does Diffuse Type systemic sclerosis present in the Vessels?

A

Reynaud

120
Q

Which auto-antibody is often found during diffuse Systemic Sclerosis? What is the antigen for this AB?

A

anti-scl-70

DNA topoisomerase I

121
Q

Which two autoantibodies are present during Mixed Connective Tissue Disorder?

A

ANA

anti-U1 ribonucleoprotein

122
Q

What is the stem cell of the lung?

A

Type II pneumocytes

123
Q

What structure are the stem cells of the GI tract contained?

A

mucosal crypts

124
Q

What type of collagen is contained within fibroblasts?

A

Type III

125
Q

What type of collagen is removed by collagenase? What is the cofactor for Collagenase?

A

Type III

zinc

126
Q

What are the two growth factors for angiogenesis?

A

FGF and VEGF

127
Q

What enzyme is copper a cofactor for?

A

Lysyl Oxidase

128
Q

What does lysyl oxidase connect?

A

lysine and hydroxylysine

129
Q

What type of collagen does collagenase replace type III collagen with?

A

Type I

130
Q

What type of collagen is found in keloids?

A

Type III

131
Q

Which cell count can increase during an acute MI?

A

Neutrophils

132
Q

What type of molecule is CD14?

A

TLR

133
Q

What molecule does CD14 recognize?

A

LPS

134
Q

Leukotrienes cause which cells contract to increase vascular permeability?

A

pericytes

135
Q

What is the four ways to activate mast cells?

A

Tissue trauma

C3a

C5a

cross-linked IgE by antigens

136
Q

What is the immediate response of mast cell activation?

A

release of preformed histamine

137
Q

What is the maintenance response of mast cell activation?

A

synthesis of leukotrienes

138
Q

What is the function of mast cells releasing leukotrienes?

A

potentiating acute inflammation

139
Q

What is another name for swelling?

A

tumor

140
Q

What is another name for warmth?

A

calor

141
Q

What structure mediates swelling?

A

post-capillary venules

142
Q

By what mechanism do PGE2 and bradykinin produce pain?

A

sensitize nerve endings

143
Q

Where does vasodilation occur?

A

postcapillary venule

144
Q

What would be the first finding to arise due to Leukocyte Adhesion Deficiency?

A

delayed sepration of the umbilical cord

145
Q

Would Leukocyte Adhesion Deficiency have an increased or decreased level of circulating Neutrophils? Why?

A

increased

inability of neutrophils to ‘hang’ and be marginated in the lungs

146
Q

What are the three chemoattractant molecules for neutrophils?

A

LTB4, IL8, C5a

147
Q

MPO deficiency puts a patient at an increased risk for developing infections cause by what organism?

A

Candida

148
Q

How do neutrophils clear from a tissue after an infection? Forming what?

A

apoptosis

pus

149
Q

Do macrophages rely more on oxygen dependent or oxygen independent killing? Via what enzyme?

A

oxygen independent

lysozyme

150
Q

What is the primary mechanism by which macrophages kill pathogens?

A

enzymes

151
Q

What interleukin is used to macrophages to recruit more neutrohils to a site of inflammation?

A

IL8

152
Q

Which MHC molecule is located on platelets?

A

MHC one

153
Q

Do CD4 or CD8 cells express FasL?

A

CD8

154
Q

What is the first mechanism by which B-cells become activated? What is the result of this?

A

antigen binds IgM or IgD on B-cells

turns B-cell into plasma cell

155
Q

What is the second mechanism by which B-cells become activated?

A

CD40 of B-cell binds CD40L on helper T-cell

156
Q

What is the key defining feature of a granuloma?

A

epithelioid histiocytes

157
Q

What two types of cells would an Epithelioid Histiocyte be surrounded by?

A

Giant cells

plasma cells

158
Q

A stellate shaped granuloma is indicative of what disease?

A

Cat Scratch Fever

159
Q

Would a TH1 or TH2 response generate a granuloma?

A

TH1

160
Q

What is the main cytokine that drives the formation of Epithelioid Histiocytes?

A

IFN-gamma

161
Q

What is the specific genetic mutation of DiGeorge Syndrome?

A

22q11 microdeletion

162
Q

What two major presentations would a patient with DiGeorge Syndrome present with ?

A

recurrent infections

hypocalcemia

163
Q

What is the 2nd mechanism by which a SCID may develop, other than Adenosine Deaminase?

A

MHC Two dysfunction

164
Q

What cellular maturation defect is present in X-linked Agammaglobulinemia?

A

B-cells cant mature into plasma cells

165
Q

What enzyme is defective in X-linked Agammaglobulinemia?

A

Brutons Tyrosine Kinase

166
Q

What infections are a patient with Common Variable Immunodeficiency susceptible to?

A

bacterial

enterovirus

Giardia

167
Q

Which cytokines would not be produced during Hyper IgM Syndrome? What type of infections? Where?

A

IgA/IgG/IgE

pyogenic

mucosal sites

168
Q

Where on the body would a patient with Hyper IgM Syndrome most likely get an infection?

A

Mucosal sites

169
Q

What is the most often site of edema during C1 Inhibitor Deficiency?

A

periorbital

170
Q

What three condtions present in a apatient with Autoimmune Polyendocrine Syndrome?

A

Hypoparathyroidism

Adrenal Failure

recurrent Candida infections

171
Q

What CD molecule is the Fas receptor?

A

CD95

172
Q

Fas (CD95) apoptosis pathway mutations result in what syndrome?

A

Autoimmune Lymphoproliferative Syndrome

173
Q

What are the three molecules of Tregs?

A

CD4+

CD25+

FOXP3+

174
Q

How do Tregs suppess autoimmunity?

A

block T-cell activation

175
Q

What special regulatory protein do Tregs express?

A

CTLA-4

176
Q

What is the function of CTLA4? What can this lead to?

A

bind/inhibit B7

anergy

177
Q

Which two anti-inflammatory cytokines can Tregs secrete?

A

TGF-β

IL-10

178
Q

Which CD molecule is the IL2 Receptor?

A

CD25

179
Q

FOXP3 mutations are associated with what syndrome? What does this syndrome stand for?

A

IPEX syndrome

Immune Dysregulation

Polyendocrinopathy

Enteropathy

X-linked

180
Q

According to Sattar, what is the reason women more often present with autoimmune disease?

A

estrogen reduce apoptosis of self-reactive Bcells

181
Q

Regarding Early Complement, what is the function of C3B?

A

act as opsonin to clear Ag/Ab complex

182
Q

What is the most common early complement protein whose deficiency can lead to lupus?

A

C2

183
Q

What type of hypersensitivity rxn would blood component problems be during Lupus?

A

Type Two

184
Q

Which anti-body can be used as a prognostic antibody and to follow the disease activity of lupus?

A

anti-dsDNA

185
Q

What are the two most common causes of death in lupus patients?

A

renal failure or infection

186
Q

What are the three most typical presentations for Sjogrens Syndrome?

A

Dry eyes

dry mouth

recurrent dental caries

187
Q

An immune reaction against what type of tissue is believed to initiate Systemic Sclerosis?

A

mesenchyme

188
Q

Which two cell types are believed to be involved in the pathogenesis of Systemic Sclerosis? Which vasoconstrictor?

A

mesenchyme and endothelial

endothelin

189
Q

What cell type can become activated during systemic sclerosis? What two cytokines are released?

A

Platelets

TGF-β and PDGF

190
Q

Which part of CREST is the first to appear in a patient with systemic sclerosis?

A

Reynaud

191
Q

In what layer of the epidermis are the stem cells located?

A

Stratum basale

192
Q

Name two stable tissues?

A

liver

PCT

193
Q

What type of collagen is seen in granulation tissue?

A

Type III

194
Q

TGF-α is an important growth factor for what two cell types?

A

epithelial and fibroblasts

195
Q

TGF-β is an important growth factor for what two cell types?

A

fibroblasts

196
Q

PDGF is an important growth factor for what three tissues?

A

endothelial

smooth muscle

fibroblasts

197
Q

What is dehiscence?

A

rupture of a wound

198
Q

Interactions between what two proteins cause leukocytes to adhere to endothelium?

A

Integrins and CAMs

199
Q

What is CD18?

A

Integrin β2

200
Q

What type of hypersensitivity reaction is Sjogrens?

A

Type 4

201
Q

Which three inflammatory mediators mediate arteriolar smooth muscle contraction?

A

bradykinin

prostaglandins

histamine

202
Q

Which 3rd and 4th structure is absent during DiGeorge?

A

pharyngeal pouch

203
Q

Which two viruses present during X-linked Agammaglobulinemia?

A

polio and coxsackie

204
Q

What other autoimmune disease is most likely to present during Sjogrens?

A

Rheumatoid

205
Q

What other autoimmune disease is Rheumatoid Factor present even though Rheumatoid Arthritis may not be present?

A

Sjogrens

206
Q

What gland is involved with Sjogrens Syndrome transformring into a lymphoma?

A

Parotid

207
Q

Where is LPS located on gram-negative proteins?

A

outer membrane

208
Q

What is the relationship between Hagemann Factor and gram-negative bacteria?

A

DIC

209
Q

What two proteins are contained in Weibel-Palade bodies?

A

P-selectin

vWF

210
Q

Which species of Pseudomonas is mentioned as catalase positive?

A

cepacia

211
Q

What type of cell forms a rim around a granuloma?

A

lymphocytes

212
Q

Selective IgA Deficiency patients are at particular risk for what type of pathogen infection?

A

viral

213
Q

What disease is particularly common in patients with IgA Deficiency?

A

Celiac

214
Q

Which CD molecule mediates peripheral tolerance?

A

CD95

215
Q

Which interleukin can limit MHC Two expression?

A

IL-10

216
Q

What is the trigger for lupus?

A

UV damage

217
Q

Can lupus cause pancytopenia? What type of hypersensitivity rxn?

A

yes

type two

218
Q

Are CNS and renal involvement common on rare in drug induced lupus?

A

rare

219
Q

Within how long do neutrophils undergo apoptosis with a lack of inflammatory signal?

A

24 hours

220
Q

Mixed Connective Tissue has characteristics of which three diseases?

A

Lupus

systemic sclerosis

polymyositis

221
Q

At what structure do prostaglandins mediate vasodilation?

A

arterioles

222
Q

At what structure do prostaglandins mediate increased vascular permeability?

A

post-capillary venule

223
Q

Which activates the Alternative Complement pathway?

A

bacterial products

224
Q

Which cells express selectins?

A

endothelial

225
Q

Why would Chediak-Higashi produce a defect in primary hemostasis?

A

defective dense granules in platelets

226
Q

What is the mode of inheritance of Chediak Higashi?

A

autosomal recessive

227
Q

Which stain to differentiate a TB in a TB vs. fungal caseating granuloma?

A

TB = AFP

228
Q

Which stain to differentiate a Fungal in a TB vs. fungal caseating granuloma?

A

fungal = GMS

229
Q

Which two specific types of Bcells are arrested in their growth during X-Linked Agammaglobulinemia?

A

pre-B

pro-B

230
Q

Patients with X-Linked Agammaglobulinemia will get what three type of infections?

A

Bacteria

Enterovirus (polio and coxsackie)

Giardia

231
Q

Patients with Common Variable Immunodeficiency will get what three type of infections?

A

Bacteria

Enterovirus (polio and coxsackie)

Giardia

232
Q

Is CD40 or CD40L on Tcells?

A

CD40L

233
Q

Is CD40 or CD40L on Bcells?

A

CD40

234
Q

Where in the thymus does negative selection occur?

A

medulla

235
Q

Where in the thymus does positive selection occur?

A

cortex

236
Q

What kind of protein is AIRE? What is the function of AIRE?

A

transcription factor

transcribe self antigens

237
Q

Which syndrome ensues if Fas Ligand is absent?

A

Autoimmune lymphoproliferative syndrome

238
Q

Other than HLAB27, what gene is implicated in many autoimmune disorders?

A

PTPN22

239
Q

Can lupus cause pancytopenia?

A

yes

240
Q

Does PT or PTT get falsely elevated during lupus?

A

PTT

241
Q

Which two organs are not affected by drug induced lupus?

A

CNS and renal

242
Q

What does lupus do to CV System?

A

accelerated atherosclerosis

243
Q

SSA and SSB are associated with what type of manifestation?

A

extraglandular

244
Q

Which sjogren antibody can cross the placenta?

A

SSA

245
Q

What is the most common cause of death in Diffuse Type Scleroderma?

A

pulmonary

246
Q

What is the function of lysyl oxidase?

A

cross-link lysine and hydroxy-lysine

247
Q

What type of collagen in a keloid?

A

type three

Pathoma (19 decks)

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