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Optometry Class OP2503 > Inflammatory Conditions > Flashcards

Inflammatory Conditions Flashcards

1
Q

what are the key differences between the innate and adaptive immune response?

A

-innate is non specific whereas adaptive is specific
-innate is rapid response whereas adaptive is slower to respond
-innate has no memory whereas adaptive recognises previous pathogens
-innate limits and contains infection until adaptive system is ready whereas adaptive takes over from innate system to eradicate the pathogen

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2
Q

what does the ‘first line of defence’ consist of?

A

physical and mechanical barriers

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3
Q

give some physical barriers

A

-keratinised stratified squamous epithelium - skin epidermis which sheds so helps to remove microorganisms
-mucous membranes line the body cavities, digestive and respiratory tracts- mucous is sticky so helps trap debris and microbes
-hair traps large particles
-cilia moves mucus and dust particles

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4
Q

give examples of mechanical barriers

A

coughing, sneezing and swallowing to remove mucus

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5
Q

give 3 innate immune responses

A

inflammation
complement cascade
cells of innate immunity

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6
Q

give examples of acute and chronic inflammation?

A

-cuts
-bruises
-sports injury
-simple infections like flu

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7
Q

what are the 4 cardinal signs of infection?

A

redness
heat
swelling
pain

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8
Q

what are the main aims of inflammation?

A

-attempt to dispose of pathogen, toxin/ foreign material at the site
-prevent spread of pathogens
-prepare site for tissue repair or wound healing

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9
Q

what are the main stages of the actue inflammatory reaction?

A
  1. Tissue injury or pathogens activate
    mast cells resident in tissues
  2. Activated mast cells produces
    histamine, which causes blood
    vessels to dilate (vasodilation) and
    increased capillary permeability,
    resulting in
  3. Leakage of blood plasma
    containing proinflammatory
    proteins (cytokines / chemokines)
  4. Further activation of resident cells
    and release of cytokines
  5. Emigration of phagocytes
    Initiation of clotting mechanism
    along with tissue repair
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10
Q

give some diseases due to chronic inflammation

A

-rheumatoid arthritis
-psoriasis
-inflammatory bowel diseases

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11
Q

what is an allergy?

A

an inflammatory response against a specific allergen or antigen which can range from minor irritation to anaphylaxis

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12
Q

where can allergic reactions cause inflammation

A

skin, sinuses, airways, digestive system or conjunctiva

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13
Q

what immune response is the complement system part of?

A

innate immune systenm

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14
Q

what 3 ways does the complement system destroy microbes?

A

-inflammation
-opsoisation
-cystolysis

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15
Q

where does complement system come from?

A

plasma proteins produced in liver that circulate in the blood

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16
Q

What are the two types of leukocytes?

A

-polymorphonuclear granulocytes
-mononuclear agranulocytes

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17
Q

give the three Polymorphonuclear granulocytes and what they do

A

-neutrophils: mobile phagocytic specialists, first in bacterial infection, scavenge to clean up debris
-eosinophils: increase in allergic conditions e.g. parasitic infection
-basophils: synthesise, store and release histamine and heparin

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18
Q

give the two mononuclear agranulocytes and what they each do

A

-phagocytes, last 1-2 days in blood and months - years in tissue as large mature macrophages
- lymphocytes which consist of B cells that make plasma cells and antibodies and then T cells which are part of cell mediated immunity

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19
Q

what are the functions of leukocytes?

A
  • Defence against invading
    pathogens
  • Remove cellular debris
  • ‘Immune surveillance’:
    identifying and destroying
    abnormal cells (e.g. cancer)
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20
Q

what happens to B cells before they reach the lymphatic system compared to t cells?

A

B cells mature in the red bone marrow and then travel to various sites in the lymphatic system whereas T cells develop in the bone marrow, travel to the thymus and then mature before being released into the lymphatic system

21
Q

what are the 5 types if antibodies?

A

gA, IgD, IgE, IgG,
IgM

22
Q

what are the 5 functions of antibodies?

A

-agglutination/aggregation on target surface
-Mark cells for destruction by
complement system (opsonisation)
-Activate complement system
-Enhance phagocytosis
-Stimulate natural killer cells

23
Q

what are the different types of T cells?

A

-cytotoxic T cells
-Helper T cells
-T memory cells
-Regulatory T cells (less common as they limits extent of immune response)

24
Q

what do cytotoxic T cells do?

A

1.bind with target cell
2. release perforin
3. create pores in cell membrane triggering lysis
4. release granzymes which are like digestive enzymes which trigger destruction of the cell

25
Q

what are 5 functions of helper T cells?

A

*Increase antibody function
*Increase action of cytotoxic T cells
*Chemotaxis (neutrophils & monocytes)
*Macrophage inhibition factor
*Activates eosinophils

26
Q

what is the uvea?

A

middle layer of the eye between sclera and retina consisting of iris cilliary body, choroid and rpe

27
Q

what are the different types of uveitis and what do they consist of?

A
  • Anterior Uveitis = Anterior chamber
  • Intermediate = vitreous and plan plana
  • Posterior = Retina, choroid
  • Panuveitis = entire uveal tract
28
Q

what are the three causes of uveitis?

A

-infection
-autoimmune
-masquerade = underlying disease like malignancy

29
Q

what % of intermediate uveitis cases are idiopathic?

A

50%

30
Q

what are the symptoms of intermediate uveitis?

A
  • Blurred vision
  • Floaters
  • Normally painless
  • No redness
31
Q

how can you classify intermediate uveitis?

A

using SUN classification (check ss)

32
Q

what are the signs of intermediate uveitis?

A
  • VA – dependant on severity and presence of CMO
  • May have spill over inflammation in AC
  • Vitreous cells
  • Vitreous haze and condensation
  • Snowballs – whote focal collectionsof inflammatory cells and
    exudate
  • Snowbanking – peripheral fibrovascular plaque
  • Peripheral periphelbitis – mild peripheral vascular sheathing
  • CMO occurs in up to 50%
33
Q

what conditions can be secondary to intermediate uveitis?

A

-cataract
-secondary glaucoma

34
Q

what are causes of intermediate uveitis?

A
  • 50% idiopathic / undifferentiated
  • Multiple sclerosis
  • Sarcoidosis
  • Lyme disease
  • Syphilis
  • TB
35
Q

give 3 masquerade causes of intermediate uveitis

A
  • Lymphoma
  • Endophthalmitis
  • toxoplasmosis
36
Q

what is the posterior pole?

A

the space of the retina between the optic disk and the macula

37
Q

what imaging would you do for a suspected naevus?

A
  • OCT to show reassuring lack of
    features
  • Auto fluorescence may show subtle
    changes which could be suspicious
  • Ultrasound
38
Q

what are the review guidelines of a neauvus?

A

-No suspicious features – 6 months until stability established – normally 1 year then annual review - Optometry
-1 or 2 suspicious features every 4-6 months – Secondary care
-3 or more suspicious features refer for ocular oncology assessment – Tertiary care

39
Q

what is the most common intraocular malignancy?

A

melanoma

40
Q

look at ss to see how to help remember melanoma signs

A

ok

41
Q

what is a choroidal haemangioma?

A

A mass of varying sized vascular channels
within the choroid
* May cause exudative detachment

42
Q

what are the signs of choroidal haemangioma?

A
  • An oval orange mass with indistinct
    margins
  • Sub retinal fluid may cause symptoms
  • ICG shows strongly hyperfluresent
    vessels
43
Q

what are vasoproliferative tumours secondary to?

A

uveitis, trauma, retinal
dystrophies

44
Q

what are the treatments for vasoproliferative tumours?

A
  • Cryotherapy or brachytherapy
  • May induce regression
  • Prognosis poor if macular involvement
45
Q

name ocular tumours associated with the choroid and sclera

A
  • naevus
  • melanoma
  • Choriodal haemangioma
  • melanocytoma
  • osteoma
  • Metastatic disease
46
Q

name ocular tumours associated with the neural retina

A

-retinoblastoma
-retinal astrocytoma
-tuberous scerosis

47
Q

name ocular tumours associated with retinal vasculature

A
  • Capillary haemangioma
  • Caverous haemangioma
  • Racemose haemangioma
  • Vasoproliferative tumour
48
Q

name ocular tumours associated with the RPE

A
  • CHRPE (Congenital
    hypertrophy of the RPE)
  • Combined harmatoma of retina and RPE
  • Congential simple hamartoma of the RPE
  • Adenoma nd adenocarcinoma of the RPE
49
Q
A

Optometry Class OP2503 (15 decks)

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