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121 > Module 1B > Flashcards

Module 1B Flashcards

1
Q

Are immune responses and inflammation the same

A
  • No we can have both at the same time
    • An immune wo a inflammation and opposite
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2
Q

What do all blood cells come from

A

Pluripotent hematopoietic stem cells (HSCs)

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3
Q

Hematopoiesis (what are the cells differentiated into)

A
  • When blood cells are exposed to cytokines and surrounding stromal cells they differentiate into
    • Megakaryocytes
    • Erythrocytes
      Leukocytes
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4
Q

Megakaryocytes

A

Thrombocytes (platelets)

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5
Q

Erythrocytes

A

Red blood cells

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6
Q

Leukocytes

A
  • White blood cells
    -Includes lymphocytes, granulocytes, monocytes, macrophages, neutrophils, eosinophils
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7
Q

Innate immunity

A
  • Refers to the host defense mechanisms that are immediately available on exposure to pathogens because they are always present
    -Includes epithelial barriers, mucous membranes
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8
Q

What cells are in the innate immune system

A
  • Granulocytes
  • Mononuclear phagocytes
  • Natural killer cells
    -Dendritic cells
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9
Q

Granulocytes

A
  • Neutrophils, eosinophils, basophils, mast cells
    • Often the first cells to arrive at the site of injury
    • Characterized by granules in their cytoplasm and their varying shapes of the nucleus
    • Engulf and kill pathogens in their cytoplasmic granules to kill the pathogen and also enhance inflammatory response
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10
Q

Neutrophils

A

Phagocytize microbial invaders

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11
Q

Eosinophils

A
  • Phagocytize parasites, boost immune signal
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12
Q

Mast cells

A
  • Know for histamine release
    Found in mucous membranes exposed to environment
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13
Q

Basophils

A
  • A lot like mast cells
    -Boost immune signal
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14
Q

Mononuclear phagocytes

A
  • Monocytes and macrophages
    • Monocytes are baby macrophages
    • Monocytes circulate in the blood and when they go into tissue they can grow 5-10x into macrophages
    • Remain motile and reside in reticular connective tissue
    • Also release pro inflammatory molecules like cytokines or eicosanoids
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15
Q

Natural killer cells

A
  • Cytotoxic lymphocytes that target tumour and virus infected cells not a specific antigen
  • (check other white blood cells to see if they are damaged or infected
    -Selectively pick damaged or infected host cells as there is an abnormal expression of surface molecules on damaged cells
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16
Q

Dendritic cells

A
  • Connection between innate and adaptive immunity
  • Reside in tissues and stimulate adaptive immune response
  • Immature ones patrol peripheral tissues and capture pathogens through phagocytosis
    -Mature ones then migrate to the lymphoid organs to present the antigens they discovered to the T-cells
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17
Q

Adaptive immune system

A
  • Characterized by antigen specificity and immunological memory
    -More complex process as requires antigen processing and recognition
    -Takes days to develop a response
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18
Q

Cells in the adaptive immune system

A
  • B cells
    -T cells
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19
Q

B cells

A
  • A naïve b cell encounters a pathogen ad binds to it through immunoglobin (b cell receptor)
    • The B cell multiplies
    • Its offspring differentiate into plasma cells or memory cell cells (guided by interleukins
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20
Q

Plasma cells

A

Short lived and secrete antibodies

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21
Q

Memory B cells

A
  • Long lived (years) and express the same immunoglobin as the parent B cell
    -Responsible for a quick secondary response when coming into contact with the same pathogen
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22
Q

T cells

A
  • Express receptors that only recognize antigens that are expressed by the dendritic cells or other antigen presenting cells (memory B cells)
    • Three types: Tc, Th, Memory T cells
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23
Q

Cytotoxic CD8+ T cells

A
  • Tc cells
    • Destroy host cells that are infected
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24
Q

Helper CD4+ T cells

A
  • Th cells
    • Secrete cytokines that enhance the function of other cells to help in getting rid of the pathogen
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25
Q

Memory T cells

A
  • Can persist for years and mount a quick response on re exposure
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26
Q

Antibody

A
  • Is not on a plasma membrane
    • Y shaped glycoprotein created by the body in response to a specific antigen
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27
Q

Immunoglobulin

A
  • On the transmembrane
    • Y shaped glycoprotein created by the body in response to a specific antigen
    • 5 types - different heavy change poly peptide sequence that behave differently
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28
Q

IgG, IgM, IgA, IgD, IgE

A

IgG
- 75% of Ig
- Secondary response
- 4 subclasses
- Passes through placenta
- Studied to judge immune response

IgM
- On B cells or a pentamer
- Primary response
- Involved in autoimmune dx

IgA
- Epithelial surfaces and mucous membranes
- 2 subclasses
- Makes pathogen weaker

 IgD
- Unknown function
- Transmembrane

IgE
- Allergic response to pollen, fungus, spores, and parasites…
- Fast response
- Involved in asthma, eczema….
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29
Q

The lymphatic system

A

A network of lymphatic vessels connected to lymph nodes

30
Q

What are lymph capillaries made up of

A
  • Smaller ones are made of Single endothelial layers
    -Larger vessels are surrounded by layers of smooth muscle cells\
31
Q

What does the lymphatic system do

A
  • Collects plasma continuously leaking out from blood vessels into the interstitial spaces and returns the fluid (lymph) to the blood
32
Q

Which way does the lymphatic system flow

A
  • Only flows upwards toward the neck with rhythmic contractions of smooth muscle
33
Q

Where do B and T cells travel

A

Both the blood and lymph

34
Q

What are primary lymphoid organs responsible for

A
  • For lymphocyte maturation and development
    -Bone marrow and thymus
35
Q

Where does B cells and T cells mature and develop

A
  • B cells completely differentiate and mature in the bone marrow
    • T cells originate in the bone marrow but mature in the thymus
36
Q

What are the maturation processes of B and T cells guided by

A

Interleukins

37
Q

What are the secondary lymphoid organs and what do they do

A
  • Where mature lymphocytes interact with antigen presenting cells (APCs), antigen is localized so that it can be exposed to mature lymphocytes
    -Spleen, lymph nodes, tonsils, appendix, peyers patch, adenoids
38
Q

Spleens job within the immune system

A
  • Has a red pulp where old or injured erythrocytes are recycled
  • White pulp which consists of lymphocytes
    -Connected via blood vessels rather then lymphatic vessels
39
Q

Lymph nodes

A

Are round specialized structures positioned along the lymphatic vessels like beads on a chain

40
Q

What do swollen lymph nodes mean

A

sign of infection

41
Q

How does lymphocyte recirculation occur

A
  1. B and T cell development in bone marrow and thymus enter blood stream
    1. When they reach a secondary lymphoid order they enter it
      a) If antigen is detected: stays in the tissue and becomes activated
      b) No antigen detected: exits through lymph and re enters bloodstream
      3) Allows continuous monitoring of the secondary lymphoid organs for infection
42
Q

How are pathophysiology and pharmacology connected

A

Many different infections or diseases will all have anti inflammatory and sometimes immuno-suppressants in treatment

43
Q

Type 1 diabetes mellitus

A

Immune mediated destruction of B cells in pancreas that secrete insulin

44
Q

Rheumatoid arthritis

A

Immune mediated destruction of joints

45
Q

Hashimoto’s thyroiditis

A

Immune mediated destruction of the thyroid gland

46
Q

How does bacteria cause disease (2)

A
  • Bacteria grow rapidly and cause disease by sheer numbers (usually)
    -Bacteria produce toxins that cause disease (e.g. botulinum toxin –> botulism)
47
Q

How do antibiotics target bacteria

A
  • Depending if they are gram positive or negative (Gram negative has an outer membrane and peptidoglycan while gram positive only has peptidoglycan
    • Bacilli cocci or spirilla
    • Aerobic or anaerobic
48
Q

How are antibiotics classified

A

Either by their structure or mechanism of action (MOA)

49
Q

MOA

A
  • Mechanism of action
    -The process by which a molecule such as a drug functions to produce a pharmacological effect
50
Q

Bactericidal

A

Drugs that kill/ destroy the bacteria entirely all by themselves

51
Q

Bacteriostatic

A
  • Drugs that slow down the growth of the bacteria
    -Need to bodies immune system to dispose of the bacteria
52
Q

If an individual is immunosuppressed what would they take (bacteriostatic or bactericidal)

A

Bactericidal

53
Q

Broad spectrum antibiotics

A
  • Drugs that are effective against a wide variety of bacteria
    -Prescribed empirically when we don’t know specific pathogen
54
Q

Narrow spectrum antibiotics

A
  • Drugs that are effective against very specific microorganism or restricted group
    -Prescribed when pathogen is clear
55
Q

When choosing an antibiotic to prescribe what do we need to consider

A
  • C & S = culture and sensitivity
  • Local epidemiological info = the geographic area
  • Site of infection
  • Immune system status
  • Kidney and liver function
  • Variables affecting pharmacokinetics (must keep above min concentration or resistance can occur)
  • Patient allergies or intolerances
  • Dosage forms available
    -Ease of administration and adherence issues
56
Q

Penicillin’s

A
  • Also known as beta lactams
  • Disrupt bacterial cell walls
  • Bactericidal
    -Contain a beta lactam ring needed to bind to the penicillin binding protein and destroy it
57
Q

Penicillin binding protein

A
  • A protein only in bacterial cell walls that penicillin binds to and weakens the cell wall which allows fluid to enter and destroy the cell
58
Q

How do bacteria defend against penicillin

A
  • Produce a beta lactamase (penicillinase) that breaks the beta lactam ring leaving It ineffective and causes penicillin resistance
59
Q

How can we still use penicillin against bacteria that have a beta lactamase

A
  • Can add other drugs such as clavulanic acid (amoxiclav)
    -This drug inhibits B- lactamases of some microorganisms
60
Q

What is cyclosporine

A
  • Inhibits production and release of interleukin II and inhibits interleukin II-induced activation which inhibits the self activation of T- lymphocytes
  • Not specific
    -Suppresses entire immune system
61
Q

What is methotrexate

A
  • Folate antimetabolite that inhibits DNA synthesis, repair, and cellular replication
  • How does it do this: inhibits dihydrofolate reductase, inhibiting the formation of reduced folates, and thymidylate synthetase, resulting in inhibition of purine and thymidylic acid synthesis, thus interfering with DNA synthesis, repair and cellular replication; it is cell cycle specific for the
    S phase of the cycle

-actively proliferative tissues (ones that undergo rapid cell division) are more susceptible (target)

62
Q

What diseases/ conditions is methotrexate used in

A
  • Rheumatoid arthritis: unknown how
  • Psoriasis: target rapidly proliferating epithelial cells in the skin
  • Crohn’s disease: may have immune modulator and anti inflammatory activity
    -First introduced to treat leukemia (blood cancer)
63
Q

What is Allergic rhinitis

A
  • Common abnormal immune response to harmless environmental allergens
    -Mediated by IgE–> histamine release from mast cells
64
Q

Symptoms of allergic rhinitis

A
  • nasal, ocular, and palatal pruritus(itching)
  • paroxysmal sneezing
  • Rhinorrhea
    -nasal congestion
65
Q

Early phase of allergic rhinitis

A
  • Within 5 mins of exposure to allergen due to histamine (sneezing, increase in nasal secretions)
    -Leads to: swelling of mucosa and reduced airflow, release of mediators that vasoconstrictors
66
Q

Late phase of allergic rhinitis

A
  • Occurs 2-4 hours after exposure, resolves after 12-24 hours after allergen is not present
    • Symptoms: erythema, induration (hardening of tissue), heat, burning, and itching and microscopically by a significant influx of mainly eosinophils and mononuclear cells
    • Can develop into sinusitis, auditory tube dysfunction, hyposmia (loss of smell), sleep disturbances, chronic mouth breathing, asthma exacerbations
67
Q

How is allergic rhinitis treated

A
  • Through the use of drugs that target histamine
    -Antihistamines block histamine receptors
68
Q

What does blocking mean

A

Binding to a receptor with no biological response

69
Q

Histamine

A
  • A bioactive amine packaged in dense intracellular granules
  • Mast cells are known to release it
  • When released bind to histamine receptors
    -H1, H2, H3
70
Q

Three types of histamine receptors

A
  • H1: smooth muscle of vascular system, bronchial tree, digestive tract, nasal glands
    Causes allergies, allergic reactions
    • H2: the lining of stomach, produce gastric acid
      Blocking the receptors reduces acidity of gastric contents
    • H3: found in CNS, involved in releasing neurotransmitters like dopamine…
      No current therapeutic products
71
Q

1st generations antihistamines

A
  • Block H1 receptors
    • Shorter acting, cause more drowsiness, and work faster then 2nd gen
    • Used mostly to treat allergic response but can be used for sleep aid
    • Diphenhydramine and chlorpheniramine are most common
      • Significant sedation
72
Q

2nd Generation antihistamines

A
  • Block H1 receptors
    • Longer acting (12-24h), less sedating, take longer to start working then gen 1
    • Safe to use daily for years
    • Take daily to prevent symptoms during troubling season
    • Not specific for antigen

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