Module 1: Foundation, Structure And Defence Flashcards
Some gram __________ bacteria can make endospores
Positive
What is antigenic drift?
What is antigenic shift?
Antigenic drift: Small mutations causing changes in H and N on surface of virus
H = hemagglutinin
N = neuraminidase
Antigenic shift: sudden major change caused by transfer of genetic information between two different viruses invading the same cell
What is catabolism?
What is anabolism?
Catabolism: break down
Anabolism: synthesis
Enzymes work by stabilising the ____________ _____ of a chemical reaction.
This lowers the _____________ __________.
Enzymes work by stabilising the transition state of a chemical reaction.
This lowers the activation energy.
What is:
- Hypertrophy?
- Hyperplasia?
- Atrophy?
- Involution?
- Metaplasia?
- Neoplasia?
- Hypertrophy: Increase in cell size
- Hyperplasia: Increase in number of cells
- Atrophy: Decrease in cell size
- Involution: Reduction in number of functioning cells
- Metaplasia: Change in type of cell
- Neoplasia: New growth
What are the 5 Cardinal signs of inflammation and what do they mean?
Rubor = redness Calor = heat Tumor = swelling Dolor = pain Functio laesa = loss of function
Name and explain which two places inflammatory mediators are derived from…
Cell derived: locally from cells at site
Plasma derived: synthesised in the liver and activated at the site
What are the 3 main ways of action for antibiotics?
For each way, give examples of the major groups…
- Interfere with bacteria cell wall
Major groups: beta-lactams, glycopeptides and bacitracin - Interfere with protein synthesis
Major groups: tetracyclines, aminoglycosides, chloramphenicol and Macrolides - Interfere with DNA replication
Major groups: quinolones, metronidazol, rifampicin and co-trimoxazole
Give the name, age and description of all 8 of Erikson’s developmental stages…
Infancy = birth to 18 months = trust vs mistrust
Early childhood = 18 months to 3 years = autonomy vs shame
Play age = 3-5 years = initiative vs guilt
School age = 6-12 years = industry vs inferiority
Adolescence = 12-18 years = identity vs role confusion
Young adulthood = 18-35 years = intimacy and solidarity vs isolation
Middle adulthood = 35-55/65 years = generativity vs self absorption or stagnation
Late adulthood = 55/65-death = integrity vs despair
What 7 motor reflexes is a child born with?
Which 3 of these remain?
Rooting, stepping, moro, babinski, eye blink, sucking and gag
The following 3 remain: eye blink, sucking and gag
What are the 4 possible outcomes of acute inflammation?
- Tissue resolution
- Repair (fibrosis)
- Abscess formation
- Chronic inflammation
Resolution arises from damage to what?
Repair arises from damage to what?
Resolution arises from damage to parenchyma in labile/stable tissues.
Repair arises from damage to parenchyma and stroma.
What are the stages of healing by fibrosis? Explain them briefly…
- Granulation tissue
Macrophages, fibroblasts and angiogenesis - Fibrosis and scar formation
Fibroblasts lay down matrix. Collagen laid down to increase strength of tissue, forming a scar - Remodelling
Over time the number of blood vessels are reduced and a pale scar remains
What is an abscess?
Focal collection of pus (neutrophils, dead cells and fluid)
This necrotic core is surrounded by neutrophils and fibroblasts
There are two basic types of secreted mediators of immunity: anti-microbial and regulatory/inflammatory. Give examples of 4 mediators from each group…
Anti-microbial:
immunoglobulins, complement proteins, interferons and lyric enzymes
Regulatory/inflammatory:
Cytokines, chemokines, prostaglandins, leukotrienes and histamine
What cells are involved in innate immunity?
What cells are involved in adaptive immunity?
Innate immunity:
Neutrophils, eosinophils, basophils, mast cells, monocytes, macrophages, dendritic cells and NK cells
Adaptive immunity: Tc lymphocytes (CD8+), Th lymphocytes (CD4+) and B lymphocytes
What are the 9 immunoglobulin isotypes?
Which one is a dimer?
Which one is a pentamer?
IgM IgG (4 types) IgA (2 types) IgE IgD
IgA is a dimer
IgM is a pentamer
- What are the 3 pathways for complement activation?
2. What step does each pathway start off with?
- Mannose binding lectin pathway, classical pathway and alternative pathway
2.
Mannose binding lectin pathway:
Microbial mannose + MBL + MASP
Classical pathway:
Antigen + IgM/IgG + C1q + C1r + C1s
Alternative pathway:
Interaction with microbial surface
- When C3 is converted, what are the outcomes and what do each do?
- When C5 is converted, what are the outcomes and what do each do?
- C3 -> C3b = opsonisation
C3a = mast cell activation and neutrophil recruitment - C5 -> C5a = mast cell activation and neutrophil recruitment
C5b = membrane attack complex and therefore lysis
What are the 3 key features of the acute phase response?
- Fever - effect on hypothalamus
- Increased release of leukocytes from the bone marrow
- Acute phase proteins released from the liver
Define the following:
- Drug affinity
- Drug efficacy
- Drug potency
- Tolerance
- Drug affinity = how tightly a ligand binds to a receptor
- Drug efficacy = the ability of an agonist to produce a biological effect
- Drug potency = amount of drug required to produce an effect of given intensity
- Tolerance = gradual decrease in responsiveness to a drug
Lymphatic system: most of the body drains into the ______ ________ _________ _______ via the __________ _________.
The top right hand corner of the body drains into the _______ _______ ________.
Most of the body drains into the left internal jugular vein via the thoracic duct.
The top right hand corner of the body drains into the right lymphatic duct.
- What is the outcome of a B-cell recognition of an antigen?
- What is the outcome of a T-cell recognition of an antigen?
- Anti-bodies
2. Cytokines
Tc cell receptor = CD? = HLA class ?
Th cell receptor = CD? = HLA class ?
Tc cell receptor = CD8 = HLA class 1
Th cell receptor = CD4 = HLA class 2
- What is the immune function of CD8 Tc cells?
2. What is the immune function of CD4 Th cells?
- CD8 Tc cell: surveillance of all cells .eg. to kill virally infected cells
- CD4 Th cell: controlled and appropriate activation of immune cells .eg. For bacterial digestion by macrophages
What are the 2 basic layers and the space in between in GRAM POSITIVE bacteria?
What are the 3 basic layers and the space in between in GRAM NEGATIVE bacteria?
Gram positive (top to bottom):
- thick peptidoglycan layer and call membrane with periplasmic space in between.
- Cell membrane has membrane proteins.
Gram negative (top to bottom):
- Outer membrane layer with lipopolysaccharides, phospholipids and porins
- Peptidoglycan layer with lipoproteins shared with outer membrane layer
- Periplasmic space
- Cell membrane with membrane proteins
What are the 3 basic components of a virus particle?
Nucleic acid (genome) Protein coat (capsid) Lipid envelope
Name and briefly explain the 6 stages of viral replication…
- Attachment: viral ligand + cellular receptor
- Entry: endocytosis + fusion
- Uncoating
- Macromolecular synthesis: multiple copies of viral genome and viral proteins
- Assembly
- Release: budding + cell lysis
What are the 4 effects of viruses on cells?
- Acute cell death
- Chronic infection
- Latency
- Transformation
What are the 5 types of intercellular cell junctions and what 4 roles do they do?
Zonula adherens and desmosomes:
Structural role - attach cells to eachother and to cytoskeleton
Hemidesmosomes:
Anchoring role - attach epithelial to basement membrane
Tight junctions:
Barrier role - prevent passage of substances between cells
Gap junctions:
Communication role - communication between cells
What is the difference between the secretions of endocrine glands and exocrine glands?
Endocrine glands: release secretions directly into blood to act on different tissues
Exocrine glands: secrete products onto epithelial surface directly or via a duct
What are the 3 ways of approaching an ethical problem, and what does each mean?
- Consequentialism: best outcome for majority
- Deontology: rational, moral rules regarding action
- Virtue ethics: what would a virtuous agent do in the circumstances?
What are the 4 components of Beauchamp and Childress’ 4 principles approach?
Respect for autonomy
Beneficence
Non maleficence
Justice
- What is a cytokine?
- Where does it bind?
- What does it trigger?
- Give 4 examples of cytokines…
- Cytokine: secreted proteins that regulate cellular activities
- Bind to cell surface receptors
- Trigger intra-cellular signalling pathways
- Interleukins, tumour necrosis factors, interferons and chemokines
What are the anti-viral effects of antibodies in the following situations:
- Antibody alone
- Antibody + complement
- Antibody bound to infected cell
- Antibody alone: blocks binding and entry to cells
- Antibody + complement: damage to enveloped virus and opsonisation for phagocytosis
- Antibody bound to infected cells: antibody dependent cellular toxicity
What 3 things does a killer cell use to kill a cell?
- Perforins
- Granzymes
- Fas ligand
Embryology
- What day is the morula formed?
- What day is the blastocyst formed and what are the 3 cell types present?
- What day does implantation occur?
- Morula: day 3
- Blastocyst: day 5, embryoblast, trophoblast and blastocoele
- Implantation: day 6
Embryology
1. What 3 things happen on day 8?
- What happens on day 9?
1. Amniotic cavity formation Bilaminar disc (epiblast and hypoblast) Syncytiotrophoblast invades endometrium
- Primary yolk sac formation
Embryology
- What cavity is formed on day 13?
- How is it formed?
- What other connecting feature is formed?
- Chorionic cavity
- Formed by cavitation of extraembryonic mesoderm
- Connecting stalk from extraembryonic mesoderm
Embryology
- The primitive streak is an indentation of which tissue type?
- What is the name of the process that happens during days 14-19 and what is formed as a result of it?
- Ectoderm
2. Gastrulation - 3 germ cell layers formed
Embryology
What are the 3 germ cell layers called and what will they give rise to?
Ectoderm: skin and neural tissue
Endoderm: epithelial lining of the gut, respiratory and urinary systems
Mesoderm: muscle, bone, connective tissue, some organs and lining of body cavities
Embryology
- What is the name of the process that occurs on day 19 and what does it result in the formation of?
- What day does the cranial neuropore close and what day does the caudal neuropore close?
- Neurulation: Formation of the neural tube
- Cranial neuropore closes on day 25
Caudal neuropore closes on day 27
Embryology
- What is the intraembryonic coelom?
- What weeks does the development of the face occur?
- Cavity within mesoderm that becomes body cavity (thorax and abdomen)
- Development of face: weeks 4-8
Embryology
- When is an embryo at highest risk of a structural abnormality?
- When is an embryo at highest risk of a functional abnormality?
- Structural abnormality: weeks 3-8
2. Functional abnormality: weeks 8 onwards
State the two types of reversible injury and describe them in 3 points each…
- Swelling = oncosis
- metabolism disturbance
- sodium influx into cell
- water influx into cell causing swollen pale cytoplasm - Fatty change = steatosis
- fatty acid metabolism in liver forms triglycerides
- accumulation of triglycerides in liver cells
- lipid globules in cytoplasm
Name the two types of cell death and briefly explain them…
Are they pathologic, physiologic or both?
- Necrosis = severe damage to cell membrane, enzymes leak from lysosomes into cytoplasm, digesting the cell. Cell contents leak out and there is a local reaction.
PATHOLOGIC - Apoptosis = cells kill themselves due to lack of growth hormones or damage to DNA/proteins. Energy dependent.
PATHOLOGIC AND PHYSIOLOGIC
- What are the two major pathways of apoptosis and what is the key component in each?
- Which enzyme do both pathways activate? Which enzyme is then activated after this?
- Intrinsic pathway: mitochondria
Extrinsic pathway: Fas ligand - Caspases
Then nucleases
- What is ischaemia?
2. What is an infarction?
- Ischaemia: impaired vascular perfusion, depriving tissue of vital nutrients
- Infarction: death of tissue as a result of ischaemia
What 3 main cellular events occur during ischaemia?
- Reduction/loss of oxygen
- Membrane pumps fail
- Reactive oxygen species damages cells
- Define pharmacokinetics using the ADME acronym…
- Define A
- Define D
- Define M
- Define E
- Pharmacokinetics: the study of the time course of drug absorption, distribution, metabolism and excretion.
- Absorption: process of transfer of the drug from the site of administration into the general/systemic circulation
- Distribution: process by which a compound is transferred from the general circulation to other parts of the body and into the tissues
- Metabolism: processes by which a drug is chemically altered in a way that facilitates its action or enhances its elimination from the body
- Excretion: processes by which drugs or their metabolites are removed from the body
- What are the first 3 anaerobic systems for energy in order of onset from shortest duration to longest?
- What aerobic system comes into place after this?
- ATP, phospho-creatine and glycolysis
2. Oxidative phosphorylation
The TCA cycle: For every 1 glucose (2 acetyl CoA), the TCA cycle will generate how many of the following... CO2? NADH? FADH2? ATP?
4 CO2
6 NADH
2 FADH2
2 ATP
Define the following:
- Prevalence
- Sensitivity
- Specificity
- Prevalence: the proportion of people in a population who have a given disease or attribute
- Sensitivity: proportion of people who have the disease and are correctly identified as such by the test
- Specificity: the proportion of people who do not have the disease and are correctly identified as such
What energy substrates are used in the following conditions:
- Postprandial?
- Between meals?
- Starvation?
- Glucose (glycolysis)
- Fatty acids (beta oxidation)
- Fatty acids and ketone bodies
