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Immunology > Midterm > Flashcards

Midterm Flashcards

1
Q

Inflammation is a protective response, as part of the ___ immune system

A

Innate

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2
Q

What is PRISH

A

The signs of inflammation

Pain 
Redness
Immobility 
Swelling
Heat
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3
Q

What are some major triggers of inflammation

A

Pathogenic organisms

Damaged tissue

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4
Q

How do pathogens and damaged tissue trigger inflammation

A

By binding to pattern recognition receptors in complement and sentinel cells such as macrophages, dendritic macrophages and mast cells

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5
Q

What are the mechanisms of inflammation? What signs of inflammation are each responsible for?

A

Vasodilation: in response to histamine and prostaglandins by macrophages, mast cells and basophils -this increases blood flow (redness and heat)

Increased capillary permeability: also in response to histamine and prostaglandins -causes increases fluid in the area (swelling)

Increased sensitivity to pain due to mediators released by sentinel cells (immobility)

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6
Q

Initially the predominant inflammatory cell is the

A

Neutrophil -activated by mediators from activated complement and sentinel cells

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7
Q

Initially, blood tests will show ___ levels of neutrophils. Why is this?

A

Low levels

Because all the neutrophils have migrated to areas of inflammation

As the body catches up the blood neutrophil levels will increase

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8
Q

Describe the neutrophils role in inflammation

A

Activated by mediators from activated complement and sentinel cells

The neutrophils attach to endothelium of capillaries

These migrate to the tissues and are further activated when they bind to molecules from pathogens or damaged tissue at their pattern recognition receptors

These phagocytose and kill ingested material

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9
Q

Neutrophils have a short life, what so dead neutrophils collect as

A

Pus -made of dead neutrophils, cells and bacteria

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10
Q

Describe the activation of clotting

A

Proteins in the exudate include clotting factors and fibrinogen

Clotting is activated by damaged tissue

Fibrin net is formed from fibrinogen -acts as a net to trap pathogens and can form capsules around the specific site

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11
Q

With chronic inflammation, neutrophils decrease (neutropenia), what cell predominates in chronic inflammation tissue

A

Macrophages and lymphocytes

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12
Q

Describe healing of inflamed tissue

A

Initial insult/cause is removed by phagocytosis

Inflammatory mediators production stops and inflammation decreases

Damaged tissue is replaced by new tissue and/or fibrous tissue (scarring)

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13
Q

Moderate and severe inflammation is often accompanied by

A

A whole body systemic response

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14
Q

What are the ways the whole body responds to severe inflammation

A

Changes in neutrophil count

Fever

Removal of trace nutrients from the blood

Decrease in appetite

Breakdown of muscle to fuel metabolism

Acute phase proteins

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15
Q

What are the changes on neutrophils levels with severe inflammation

A

Initially neutrophils in blood will decrease (neutropenia) as they move to the site of inflammation

Bone marrow increases production in response to inflammation

Neutrophil count then increases (neutrophilia) usually in response to moderate inflammation

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16
Q

True or false

Mild inflammation still results in a change in neutrophil blood levels

A

False

There is often no to very little change

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17
Q

Describe a fever with the systemic response to inflammation

A

Actions on the hypothalamus -Prostaglandins mediated

This increases the “set point” in body temp

The body responds by shivering/huddling/raised hair coat because it is told it is cold (not at the set point)

This directly inhibits growth of some pathogens (can’t survive high temps)

Increases activity of some immune cells including neutrophils/macrophages/T cells

When a fever breaks the set point is set lower and the body is told it’s hot

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18
Q

Why is there a fine line in terms of temperature within the body that it should not cross

A

If it gets too high proteins will start to denature

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19
Q

Why would the body remove trace nutrients from the blood in a systemic response to severe inflammation

A

Mainly iron

Low iron availability and fever (alone or together) work to limit the growth of bacteria and viruses

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20
Q

Why would the body decrease appetite in response to severe inflammation

A

May allow better control of nutrient intake so that less nutrients are available for microbes

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21
Q

What is a decrease in appetite used as in the medical field

A

A clinical sign

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22
Q

What are acute phase reaction proteins

A

A part of the response to inflammation, the liver produces a group of proteins (innate system response)

Some are part of the clotting system (fibrinogen and prothrombin)

Some remove iron

Some are complement system proteins (opsonization, attract immune cells)

Some degrade inflammatory products (plasminogen breaks down blood clots) to control inflammation

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23
Q

Why are fibrinogen and prothrombin measured on a CBC panel?

A

If they are present, it is an indicator of acute inflammation

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24
Q

What are some ways you can control inflammation

A

Cold
Antihistamines
NSAIDs
Corticosteroids

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25
Q

Why does cold help control inflammation

A

Effective in early stages of some types of inflammation

Stops destructive enzymes

especially effective in laminitis

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26
Q

Antihistamines are especially effective in

A

Allergic reactions

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27
Q

What are NSAIDs

A

Non steroidal anti inflammatory drugs

Block the synthesis of some/all prostaglandins, thromboxanes,

Reduce swelling, heat, pain and fever

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28
Q

What are corticosteroids

A

Not effective on fevers

Blocks the activation of cells when a pattern recognition receptor is bound to

Acts EARLY in inflammation cycle

Can be immunosuppressive because it is a steroid

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29
Q

Describe what could cause inflammation characterized by swelling under the skin that “pits” on pressure with no heat, pain or redness

A

Leaky capillaries result in increase educate -low proteins in the blood (albumin)

Usually non inflammatory edema

Seen with congestive heart failure

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30
Q

Describe what could cause inflammation characterized by swelling under the skin, feels soft and fluctuant with no heat, may be painful and may be discoloured red through purple

A

Bleeding

Hematoma

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31
Q

Describe what could cause inflammation characterized by swelling under the skin, feels soft and fluctuant with no heat, no pain and no discolouration

A

Lipoma or Seroma

Fluid of blood is leaking out

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32
Q

Pitting is a sign that fluid is within the tissue (connective tissue) rather than

A

Free fluid (hematoma)

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33
Q

Describe T Lymphocytes

A

Mature in the thymus, reside in lymph nodes and spleen

Circulate through blood and tissues

Function: adaptive immune response (cell mediated) specific in response, when activated they clone themselves (genetically identical with the same antigen receptors)

Several different types: helper, suppressor, cytotoxic, memory

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34
Q

What is the difference between different types of T cells

A

All genetically identical with the same antigen receptor but have different effects once activated by its antigen

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35
Q

Describe B Lymphocytes

A

Found mainly in the lymph nodes and spleen and some in blood (these migrate to the lymph nodes)

Function: humoral adaptive immunity: recognize specific antigens and differentiate into plasma cells

When activated: they clone themselves and some become plasma cells which make antibodies, some become memory B cells that float around waiting for their specific antigen

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36
Q

Describe bone marrow

A

Site of formation of white and red blood cells

Maturation of red blood cells and many white blood cells

Site where lymphocytes are first formed (move to thymus to mature)

37
Q

Describe the thymus

A

Largest in early life and decrease with age

Lymphocytes migrate from the bone marrow to the thymus and multiply in the thymus while randomly making new antigen receptors

38
Q

Why do most T cell die in the thymus

A

They get killed off if they do not react to nonself cells or if they react to self cells

Only useful T cells are released from the thymus

39
Q

Describe the lymph nodes

A

Contain many T and B cells, antigen presenting cells (dendritic macrophages) and plasma cells (activated B cells)

Lymph that is filtered through the lymph nodes brings immune cells and antigens with it

40
Q

What is the clinical significance of lymph nodes

A

Lymph nodes increase in size with inflammation and when there are tumors present

We palpate to detect disease and localize the nodes

Sites: submandibular, superficial cervical, axillary, popliteal, inguinal

41
Q

With dental disease, what lymph node is normally enlarged

A

Submandibular

42
Q

If ALL lymph nodes are enlarged, what does this indicate

A

Lymphomas (tumors in the lymph nodes)

Or a systemic infection

43
Q

Describe the spleen

A

Similar function to lymph nodes but it filters blood

Red pulp: removes old red blood cells and contain monocytes

White pulp: rich in T and B cells

44
Q

What are the 3 main receptors of the adaptive immune system that help determine self from nonself

A

Pattern recognition receptors

Lymphocyte antigen receptors

Major histocompatibility receptors

45
Q

What are pattern recognition receptors

A

Recognize components commons to groups of pathogens or damaged tissue

46
Q

What are lymphocyte antigen receptors

A

Each lymphocyte recognizes a specific antigen found on non self pathogens

47
Q

How was the major histocompatibility complex discovered

A

Scientist could transfer tumor tissue between closely related mice but not mice of different strains unless you killed their immune system

Discovered that tissues carry antigens unique to that individual (called MHC)

48
Q

What is the MHC Type 1 molecules

A

Marks cells as “self” found on cell surfaces. These are all the same in a given individual. This is how NK cells recognize cells as self and do not kill them

Binds to internal proteins and displays them on the cell surface: have a binding site for lymphocytes so they can check the internal proteins of the cell. This help T cells recognize pathogens or non self cells

49
Q

All nucleated cells in the body display some MHC antigens, EXCEPT what? What does this make easier to accomplish?

A

red blood cells

Blood transfusions

50
Q

What are MHC type 2 molecules

A

Found on professional phagocytes

Binds to molecules released when pathogens or damaged tissue is phagocytosed and displays it on the cell surface

Similar to type 1

51
Q

What are MHC type 3 molecules

A

These are pattern recognition receptors that help signal molecules

52
Q

What are lymphocyte antigen receptors

A

Very diverse: millions of types

Found in T and B cells (not NK)

T cells have antibody-like receptors

On each lymphocyte the receptor only binds to one specific antigen)

Formed from a limited number of genes: each gene codes for a part of the binding site, the genetic material is randomly modified and rearranged. Results in millions of different binding sites.

In the process of differentiating, only cells with non self receptors are allowed to survive

53
Q

What are the 2 types of receptors T lymphocytes have?

A

Lymphocytes antigen receptors

MHC receptors

54
Q

Describe how the MHC receptors and lymphocytes antigen receptors work together on a T cell

A

These are next to each other

The T cell binds to other cells using MHC to see if the cell is “self” and then tests the antigens present using the lymphocyte antigen receptor

If it does not have MHC the T cell is activated and the cell is destroyed, if it has antigens present the T cell is activated to start multiplication of that T cell

55
Q

Where are T cells found

A

Initially produced in the bone marrow and move to the thymus to mature

Once mature, they move to lymph nodes and other lymphoid organs

Some circulate in blood and lymph

When activated they move to areas of inflammation and draining lymph nodes

56
Q

What is the T cell “education” or maturation

A

Occurs in the thymus

Initially T cells are selected for cells that will recognize MHC so they can communicate with other cells

Further selected for T cells with lymphocytes antigen receptors that are NOT activated by self antigens -only non self antigens

57
Q

What is tolerance

A

The failure of the immune system to respond to an antigen

58
Q

What are normal T cells tolerant to

A

Tolerant to normal tissue and cells

59
Q

When might tolerance become an issue? Give an example?

A

If the body becomes tolerant to something harmful to the body

Occurs with cows infected with Bovine Viral Diarrhea (BVD) at 45-120 days of gestation. T lymphocytes that react with BVD are killed off in the thymus because the body thinks it’s normal. This results in a persistent infection (now tolerant to it)

60
Q

Explain how T lymphocytes are activated

A

Occurs when a T cell lymphocyte antigen receptor binds to its specific antigen (typically an abnormal protein displayed in an MHC molecule)

Ex. Virus infected cell with the virus antigen on its surface

Ex. Dendritic macrophages displaying bits of material on its surface after phagocytosing something

61
Q

What are dendritic cells

A

These reside in tissue to identify pathogens and damaged tissue using pattern recognition receptors. They degrade ingested material and display components of the ingested material on their surface with their MHC molecule

They then move to lymph nodes where they activate the specific T cell with the receptor to its antigen on its surface

62
Q

What is initial activation of T cells called

A

Priming

63
Q

Once T cells are activated they clone themselves and differentiate into different T cells, describe these, what is similar and different about each?

A

The different types are all genetically identical with the same antigen receptors but have different effects once activated

Regulatory or Suppressor T cells

Some stimulate inflammation

Cytotoxic T cells (destroy cells by releasing interferon or perforin)

Memory T cells (allows for a more rapid response at a subsequent infection)

64
Q

What is interferon

A

Shuts down the virus production within a cell

65
Q

What is perforin

A

Punches holes into the infected cell causing it to rupture and die

66
Q

Describe T cell mediated immunity

A

Takes time to develop (days to months)

Specific for a particular antigen

Involved in memory so there is a more rapid and efficient response at the next presentation (adaptive immunity)

Differentiates between self and non self

67
Q

Describe B lymphocytes

A

Produced and mature in bone marrow or lymphoid tissue in the gut

Then travel through the blood to populate the lymph nodes, spleen and all other lymphoid tissue

Produce immunoglobulins (antibodies) - some is bound to the cell surface to act as a receptor (lymphocyte antigen receptor)

68
Q

Describe B cell activation

A

2 stage process

B cell binds to its antigen using its surface immunoglobulin receptor (antigen can be free or cell bound) (MHC not needed)

Needs a second signal to complete activation: can be from using the pattern recognition receptor by binding to a particle common to pathogens or activated by helper T cells (when T cells are activated by binding to its antigen it secretes cytokines and express surface molecules that activate B cells)

69
Q

What happens when B cells are activated

A

Divide and produce clones of themselves (all respond to the same antigen) this strengthens the response

Some become memory B cells

Some become plasma cells

70
Q

What are plasma cells

A

Antibody factories

Secrete immunoglobulin: released into circulation, bind to antigen and inactivates it

71
Q

What are memory B cells

A

Persist for years

Responds rapidly when an antigen is seen in subsequent exposures (numbers and efficiency increase with exposures)

Benefits: rapid production of effective antibodies, used as the basis for vaccination

72
Q

What is a anamnestic response

A

Secondary response

73
Q

Antibodies are part of the ____ adaptive immune system

A

Humoral

74
Q

Immunoglobulins are produced by ___ cells derived from B cells

A

Plasma cells

75
Q

Immunoglobulins are useful in

A

Host defence (binding and neutralization)

Vaccination

Testing

76
Q

How are immunoglobulins used diagnostically

A

To detect infections

Rising titers indicate a recent infection

77
Q

How are immunoglobulins used to fight infections

A

Vaccines boost antibody titers (basis for judging their effectiveness) and stimulate the immune system to make more

Hyperimmune sera are given to fight off infections

78
Q

What are the 4 types of immunoglobulins and how are the similar/different

A

IgM, IgA, IgG, IgE

Each class binds to the same antigen but their structure and effects vary

79
Q

Where can you find immunoglobulins

A

Produced by B cells and plasma cell

B cells put immunoglobulins on their surface to act as a receptor (lymphocyte antigen receptor)

Plasma cells excrete immunoglobulins into the body fluids

80
Q

What is the basic structure of immunoglobulins

A

Y shaped

Head: 2 binding sites per “Y”

Tail: constant within a class of antibodies, this determines the class, responsible for the different effects of the immunoglobulins when the head binds to its antigen

81
Q

What is IgM

A

The first made in response to an antigen

It is a pentamer -has 10 binding sites (5 Ys = 2 binding sites each)

Large molecule restricted to plasma

Binds very weakly

82
Q

Once activated, what does IgM do

A

Inactivates pathogens by

1) agglutination: creates clumps by binding antigens together (very good at this)
2) neutralization: binds to antigens making them ineffective -blocks the ability for the antigens to bind to host cells
3) complement activation: classical pathway activation that results in stimulation of inflammation, opsonization and the membrane attack complex

83
Q

What is IgG

A

As the immune response progresses, it switches to making IgG

This is the major antibody in serum/blood and tissue

Monomer: Smaller than IgM so it can move to sites of inflammation

84
Q

What does IgG do once activated

A

Agglutination of antigens (not as good as IgM)

Neutralization (binds much tighter than IgM, blocks adhesion sites on pathogens and binds and blocks toxins)

Complement activation

Opsonization by direct binding

Antibody dependent cell mediated cytotoxicity (too big to be phagocytosed so the antigen IgG complex binds to NK cells which can then kill the cells) (antigen-antibody complex may also bind to neutrophils and eosinophils to stimulate them to release oxidants)

85
Q

What is IgA

A

The major antibody of the mucosal surfaces (resp and GI tract)

Gut lymphoid tissue is a major site of IgA production

Secreted as a dimer with a secretory piece -transportation for epithelial cells, gives resistance to digestive enzymes (prevents destruction from digestive enzymes)

IgA gets produced the most in a day then all others -large amounts in order to protect the entry points of the body

86
Q

What does activation of IgA result in

A

Neutralization

Tail can activate phagocytosis (opsonization) but does not activate complement

87
Q

What is IgE

A

Mainly produced by plasma cells just below the body surfaces

Some binds to the surface of mast cells and basophils Before it binds to its antigen (waits for the antigen to come along)

This is a sentinel antibody, when it binds to the antigen it causes degranulation

Triggers inflammation

Very important in parasite defence and allergies

88
Q

Describe free IgE

A

Small amounts

Head of IgE binds to pathogens And the tail complex attracts and binds to eosinophils which release enzymes that digest the parasite

Example Of antibody dependent cell mediated cytotoxicity

Immunology (13 decks)

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