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NUR370 Pathophysiology and Pharmacology > Intro to Pathophysiology > Flashcards

Intro to Pathophysiology Flashcards

1
Q

1st Line of Defense

A

physical, mechanical and biochemical barriers

  • skin and low temperature
  • linings of the GI, genitourinary and respiratory tracts
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2
Q

Two Biochemical Barriers

A
  1. Epithelial-Derived Chemicals
    - antimicrobial peptides (AMPs): cathelicidins, defensins and collectins
  2. Bacteria-Derived Chemicals
    - normal bacterial flora
    - inhibit colonization by pathogens
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3
Q

2nd Line of Defense

A

inflammatory response

  • non-specific
  • intensity depends on the extent/severity of the injury and reactive capacity of the patient
  • vascular and cellular response
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4
Q

What causes 2nd Line of Defense?

A 
Infection
Mechanical damage
Ischemia
Nutrient deprivation
Temperature extremes
Radiation
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5
Q

What is the goal of the inflammatory response?

A

a. neutralizes/dilutes the inflammatory agent
b. remove necrotic material
c. establish an environment for healing

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6
Q

Manifestations of Inflammation

A

a. erythema - hyperemia from vasodilation
b. heat - increased metabolism
c. pain - changes in pH, nerve stimulation by chemical mediators, fluid change
d. swelling - fluid shift, accumulation of exudate
e. loss of function - due to swelling and pain

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7
Q

Vascular Response

A

Transient Vasoconstriction
- lasts only a few seconds
»
Fibrin clot, release of chemical mediators
- seal off injured area, control inflammatory process
»
Local vasodilation and hyperemia
- increase permeability, facilitate movement of WBC, fluids and nutrients

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8
Q

Cellular Response

A 
Chemotaxis, margination and diapedesis of blood leukocytes
>>
Migration of leukocytes to the site of injury
>>
Neutrophils
- 6-12 hours, forming pus when it dies
Monocytes >> Macrophages
- 3-7 days
>>
Phagocytosis
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9
Q

Chemotaxis

A

movement of a cell or organism in response to chemical stimulus, along gradient of concentration

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10
Q

Margination

A

leukocytes get close to the vessel

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11
Q

Diapedesis

A

leukocytes enter into the vessel

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12
Q

Types of Leukocytes

A

Neutrophils: phagocytosis of foreign material

Monocytes: mature into macrophages

Eosinophils: kill parasites

Basophils: secrete chemical mediators

(Nice Monkeys Eat Bananas)

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13
Q

What is the order of leukocytes from greatest to least in quantity?

A 
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils

(Nobody Likes My Emotional Breakdown)

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14
Q

What is a chemical mediator?

A

Any messenger that acts on blood vessels, inflammatory cells or other cells to contribute to any inflammatory response

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15
Q

Histamine

A

chemical mediator stored in granules of basophils, mast cells, platelets

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16
Q

What is the mechanism of action of histamine?

A

causes vasodilation and increased vascular permeability

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17
Q

Kinins

i.e. bradykinin

A

chemical mediators that arise from polypeptides that circulate in the blood in inactive form (Kininogens)

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18
Q

What is the mechanism of action of Kinins?

A

cause contraction of smooth muscle and dilation of blood vessels&raquo_space; pain

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19
Q

Complement component

C3a, C4a, C5a

A

anaphylatoxic agents generated from complement pathway activation

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20
Q

What is the mechanism of action for complement components?

A

stimulate histamine release and chemotaxis

21
Q

Prostaglandins and leukotrienes

A

chemical mediators produced from arachidonic acid

22
Q

What is the mechanism of action of prostaglandins?

A

contribute to vasodilation, capillary permeability, pain and fever
leukotriene B4 stimulates chemotaxis

23
Q

Cytokines

i.e. interferon, interleukin and growth factors

A

chemical mediator secreted by various cells of the immune system

24
Q

3rd Line of Defense

A

Adaptive Immune System

  • works together with inflammation
  • recognizes foreign substances
  • has memory to provide long-term protection
  • specific response, occurs slowly
  • can be induced by vaccination
25
Q

Antigen

A

a molecule that can react with antibodies or receptors on B and T cells
i.e. common flu virus

26
Q

Immunogenic antigen

A

an antigen that can trigger an immune response

27
Q

Immunogenicity

A

the ability of a particular substance to provoke an immune response

28
Q

Antibody

A

protein made specifically against an antigen, aka immunoglobulin

29
Q

3 Phases of the Adaptive Immune System

A
  1. Recognition phase: antigen recognition by B and T cells
  2. Activation phase: lymphocyte activation&raquo_space; proliferation and differentiation
  3. Effector phase: elimination of specific antigen
30
Q

Humoral (antibody-mediated) Immunity

A

= causes direct inactivation of a microorganism or the activation of inflammatory mediators
= protects against extracellular microbes and microbial toxins

  1. Bone marrow produces lymphoid stem cell
  2. Lymphoid stem cell matures in bone marrow and become immunocompetent B-lymphocyte
  3. Travels and circulates lymph nodes
  4. During phagocytosis (phagocytes from innate immune system), B-lymphocytes keep a bit of antigen as marker
  5. Helper T activates B cells, memory B cells and plasma cells are produced
31
Q

Memory B cells

A
  • formed following a primary infection
  • can generate an accelerated and robust antibody-mediated immune response in case of re-infection (secondary immune response)
32
Q

Plasma cells

A

factories that produce antibodies that bind to specific antigen

33
Q

What do antibodies do?

A

Direct:

a. neutralization: bind to antigen so that they can’t hook up to tissue
b. agglutination: clumping antigens together to slow them down

Indirect:
a. opsonization: marking antigen as foreign for killer cells to come and destroy them

34
Q

IgG

A
  • most prevalent
  • most of protective activity against infection
  • crosses the placenta and blood-brain barrier
35
Q

IgA

A
  • mostly in secretions

- most of protective activity in body secretions

36
Q

IgE

A
  • most rare
  • mediator of many common allergic responses
  • defends against parasitic infections
  • release histamine molecules when receptor side binds to antigen
37
Q

IgD

A
  • not well known

- functions as one type of B-cell antigen receptor

38
Q

IgM

A
  • largest

- first antibody produced during the initial or primary response to an antigen

39
Q

Primary and Secondary Immune Response

A

Primary

  • occurs during initial exposure
  • IgM antibody for a specific antigen is detected and IgG are produced

Secondary

  • more rapid than the primary response due to memory cells
  • large amount of IgG are produced, similar quantities of IgM
40
Q

Cell-mediated immunity

A

= T-cell differentiation, kills target directly or stimulates activity of other leukocytes
= protects against intracellular pathogens

  1. Bone marrow produces lymphoid stem cell
  2. Lymphoid stem cell matures in thymus and becomes immunocompetent T cell
  3. Travels to spleen
  4. Naive T cells find infected macrophages that are displaying the antigen-MHC complex
  5. Helper T activates cytotoxic T lymphocytes, T-regulatory cells and memory T cells
41
Q

Cytotoxic T lymphocytes

killer T cells

A
  • attack and kill targets directly, trigger apoptosis

- carry cell-surface marker molecules

42
Q

Helper T cells

A
  • essential role in antibody production, activates B cells telling them which antibodies to produce
  • participate in activation of cytotoxic T cells
  • activated helper T cells secrete cytokines that influence the functions of nearly all other immune cells
43
Q

Memory T cells

A
  • subset of antigen specific T cells that persist long after an infection has resolves
  • reproduce to large numbers of effector T cells upon re-exposure
44
Q

Clonal Diversity

A

production of T and B cells, in the bone marrow, with all possible receptors for antigen

45
Q

Clonal Selection

A

selection, proliferation and differentiation of individual T and B cells with receptors for a specific antigen

46
Q

Primary lymphoid organs

A 
Thymus (T cells)
Bone marrow (B cells)
47
Q

Secondary lymphoid organs

A 
Spleen (T)
Lymph nodes (B)
48
Q

Active Acquired Immunity

A

antibodies or T cells are produced after either a natural exposure to an antigen or after immunization, long lived

49
Q

Passive Acquired Immunity

A

performed antibodies or T lymphocytes are transferred from a donor to a recipient, occurs naturally or artificially, temporary or short-lived

NUR370 Pathophysiology and Pharmacology (20 decks)

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