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1020: Physiology FM1020 (E) > P: White blood cells and Haemostasis > Flashcards

P: White blood cells and Haemostasis Flashcards

1
Q

Innate responses

A

General processes against infectious agents
- Skin, phagocytosis of micro-organisms, destruction by stomach acids/enzymes, hydrolytic enzymes released by immune cells

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2
Q

Adaptive responses

A

Directed against specific infectious agents
- Improved on repeated exposure of the same infection

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3
Q

Subtypes of leukocytes

A

Nucleated cells
- Monocytes
- Eosinophils
- Neutrophils
- Lymphocytes
- Basophils

M+E+N = phagocytosis
B = release hydrolytic enzymes + histamine

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4
Q

Granulocytes

A

Neutrophils, Eosinophils, Basophils (BEN)
- Multiple nuclei of varying shapes
- Other name = polymorphonuclear leukocytes (PMN/PML)

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5
Q

Where do granulocytes originate from (what cells)?

A

Myelocytes (bone marrow precursor cells)

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6
Q

Genesis of myelocytes:
- Under ___ control
- Large ___ in bone marrow
- Marrow has 10x more ___ cells than ___ cells (RBC precursors)

A
  • cytokine
  • reserve pool
  • myeloid, erythroid
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7
Q

Rank granulocytes from most to least common

A

Neutrophils > Eosinophils > Basophils

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8
Q

Neutrophils:
- ___ in blood and tissues
- Circulate in ___ —> migrate into ___ (squeeze through capillaries pores = ____)
- Numbers increase +++ during ___
- ___ immunity

A
  • Phagocytosis
  • blood, tissues, diapedesis
  • infection
  • Innate
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9
Q

Eosinophils:
- Weakly ___: attack ___ too large to be engulfed (attach to them and secrete ___ enzymes)
- Can reverse tissue damage during ___

A
  • phagocytic, parasites, hydrolytic
  • allergic reactions
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10
Q

Basophils:
- ____, but act like eosinophils to release ___
- Contribute to ___ by release of chemicals (histamine, heparin, bradykinin, serotonin, lysosomal enzymes, slow-reacting substance of anaphylaxis)

A
  • Non-phagocytic, hydrolytic enzymes
  • allergic reactions
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11
Q

Monocytes:
- Circulate in blood for hours before migrating into tissues where they ___ and develop ___
- ___ infectious agents and abnormal/dying cells (including RBCs) only in tissues

A
  • increase in size +++, tissue macrophages
  • Phagocytose
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12
Q

Which leukocytes act in innate immunity vs acquired immunity?

A

Innate: monocytes, eosinophils, neutrophils, basophils and NK cells (lymphocytes)
Acquired: lymphocytes

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13
Q

What’s the largest leukocyte

A

Monocytes

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14
Q

What is the system name of the collective monocytes?

A

Reticuloendothelial system

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15
Q

Where are macrophages especially prominent in?

A
  • Lymph nodes
  • Lung alveolar walls
  • Liver sinusoidal capillaries
  • Red pulp of spleen
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16
Q

What is chemotaxis?

A

Recruitment of neutrophils + macrophages to tissue inflammation/infection

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17
Q

What’s the first line of defence?

A

Local macrophages

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18
Q

What do the secreted factors of activated macrophages promote?

A

Production of granulocytes and monocytes

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19
Q

Different stages of inflammation

A
  1. Rapid neutrophilia (large production of neutrophils by bone marrow)
  2. Increased monocyte production/recruitment and tissue macrophage buildup (hours-days)
  3. Macrophages = superior phagocytic cells (longer to regulate and transport to site of infection, but more powerful)
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20
Q

Natural Killer (NK) cells:
- Produced from ___
- Specifically target ___ and ___ infected cells
- Induce programmed cell death (___)
- Activated by ___ or macrophage-derived ___

A
  • lymphoid lineage
  • tumour, virus
  • apoptosis
  • interferons, cytokines
21
Q

Subtypes of lymphocytes

A
  1. B lymphocytes: mature into plasma cells and secrete antibodies
  2. T lymphocytes: Helper T cells secrete cytokines to activate other leukocytes. Cytotoxic T cells secrete factors that kill tumour and virus-infected cells
  3. NK cells: secrete factors that kill tumour and virus-infected cells
22
Q

Where are lymphocytes produced and stored?

A

Lymphoid tissue (lymph, glands, spleen, thymus, tonsils, bone marrow and Peyer’s patches in intestinal epithelium)

23
Q

What drives the growth and differentiation of lymphocytes?

A

Various cytokines like interleukins (ILs)

24
Q

Where are Pro-T and Pro-B cells processed before and after birth?

A

Pro-T cells: thymus gland
Pro-B cells: liver and bone marrow

25
Q

What causes the very high diversity of antigen specificity?

A

Genetic recombination

26
Q

What happens to “self” reacting cells in lymphocyte processing?

A

They’re eliminated –> remaining cells migrate to and are stored in lymphoid tissues

27
Q

What mediates the immunity of T and B cells?
T: ___-mediated
B: ___-mediated

A

T: cell-mediated
B: humoral-mediated

28
Q

Major histocompatibility complex:
- ___ + ___ cells phagocytose microorganisms + present antigenic fragments on cell surface to nearby ___
- Binding of ___ to specific cell surface ____ on lymphocytes activates these specific cells only
- Activated lymphocytes ___ rapidly - large numbers of a clone of lymphocytes released into circulation
- Macrophages secrete ___ which promotes specific clonal growth

A
  • Macrophage, dentritic, lymphocytes
  • antigens, receptors
  • reproduce
  • IL-1
29
Q

Helper T lymphocytes:
- 75% of T-cells secrete ___ (IL-2 to 6)
- Promote growth of ___
- Stimulation of ___ and ___ cells
- Activation of ___
- ___ of helper cells
- ___ destroys helper T cells

A
  • lymphokines
  • activated B cells
  • cytotoxic and suppressor T cells
  • macrophages
  • Feedback stimulation
  • HIV
30
Q

Cytotoxic T cells

A
  • Killer cells
  • Destroy micro-organisms containing activating antigen (virus infected, cancer and transplanted cells)
31
Q

Suppressor T cells
- Prevent damage of ___ by ___
- ___ tolerance
- Failure = ___ diseases

A
  • tissues, cytotoxic cells
  • Immune
  • autoimmune diseases
32
Q

B lymphocytes:
- Activated B cells differentiate into ___ (___) secreting plasma cells
- Same specificity as B cell receptor is activated by the ___ = membrane-bound ___

A
  • antibody (immunoglobulin)
  • antigen, immunoglobulin
33
Q

What’s a complement?
- A ___ protein ___ in plasma, activated by ___ complexes
- Constant portion of antibody activates ___
- ___ of sequential reactions with ____ at each stage
- Activated products ___ next component and stimulate ___
- ___: tagging of pathogen for pathogenesis
- Cell ___

A
  • ~20, cascade, antibody-antigen
  • C1
  • cascade, amplification
  • activate, innate immunity
  • Opsonisation
  • lysis
34
Q

Primary response

A
  • Small number of activated B and T cells become memory cells
  • Circulate in blood and lymphoid tissue as dormant cells
35
Q

Secondary response

A
  • B cells become plasma cells
  • T cells become helper, cytotoxic and suppressor T cells
36
Q

Steps of haemostasis

A
  1. Vascular spasm: constriction damaged blood vessels
  2. Platelet plug formation: platelets adhere to damaged endothelium to form platelet plug
  3. Blood coagulation: formation of solid blood clot at site of platelet plug
37
Q

Vascular constriction

A

Trauma to blood vessels causes contraction of vascular smooth muscle:
- Local myogenic contraction
- Local axon reflexion initiated by pain/sensory receptors at/near damaged vessels
- Local platelets in blood release thromboxane A (vasoconstrictor substance)

38
Q

Platelets
- ~4000 platelets produced from each ___ in bone marrow
- No ___
- Synthesize various factors that act on ___ + local blood vessels and tissue

A
  • megakaryocyte
  • nucleus
  • plasma proteins
39
Q

What eliminates platelets from circulation?

A

Macrophages mainly in spleen

40
Q

Formation of platelet plug
- Platelets adhere to exposed ___ fibre of damaged ___ and form a platelet plug
- Plasma protein (___ factor) triggers ___ and ___ of platelets to one another and to sites of vascular damage
- Platelets are structurally changed and release ___ + ___ –> trigger further ___/___
- Formation of a ___ platelet plug

A
  • collagen, vessel walls
  • von Willebrand, adherence, aggregation
  • ADP, thromboxane A2, adherence/aggregation
  • loose
41
Q

Formation of blood clot:
- Inactive ___ factors are activated in a cascade reaction
- ___ pathways: activated by ___/___ trauma
- ___ pathway: initiated by ___
- End stage = production of a stable ___ meshwork (blood clot) –> stabilizes temporary platelet plug

A
  • coagulation
  • extrinsic, vessel/tissue
  • intrinsic, blood factors
  • fibrin
42
Q

Coagulation cascade:
- Last step in clot formation = ___ conversion of ___ to ___ by ___
- Loose ___ stabilized by formation of covalent bonds catalysed by ____ which is activated by ___
- Thrombin has a ___ on prothrombin = ___ feedback

A
  • proteolytic, fibrinogen, fibrin, thrombin
  • fibrin meshwork, coagulation factor XIIIa, thrombin
  • proteolytic, positive
43
Q

Vitamin K:
- Needed for hepatic synthesis of ___ e.g. ___
- Deficiencies leads to ___
- Synthesised by bacteria in ___
- Vitamin K deficiency caused by obstruction of ___ and/or ___ disease
- Newborns lack ____ –> contain 50% of adult clotting factors so vitamin K is administered at birth.

A
  • clotting factors e.g. prothrombin
  • serious bleeding tendencies
  • intestinal tract
  • bile ducts, liver
  • intestinal bacterial flora
44
Q

Feedback inhibition by formation of fibrin:
- 85-90% of ___ formed from ___ is absorbed to ___
- ___ binds + removes remaining ___
- Cessation of ____

A
  • thrombin, prothrombin, fibrin
  • Antithrombin III, thrombin
  • clotting cascade
45
Q

Intravascular anticoagulants: to stop contact activation of intrinsic pathway, ____

A
  • layer of glycocalyx on endothelium
  • thrombomodulin binds + removes thrombin from plasma.
46
Q

Heparin:
- Activates ___
- Removes ___ + ___
- Used as ___ agent

A
  • Antithrombin III
  • free thrombin + upstream factors
  • anti-clotting
47
Q

Aspirin
- Blocks production of ___ by inhibiting ____
- Long-term aspirin inhibits ___

A
  • thromboxane, enzyme cyclooxygenase
  • platelet aggregation
48
Q

Prostacyclin:
- binds ___ on platelets
- increases ___
- blocks increase in ___ caused by ___
- Blocks ___

A
  • prostacyclin receptor
  • intracellular [cAMP]
  • intracellular [Ca2+], thromboxane receptor
  • platelet aggregation/adherence
49
Q

Dipyridamole:
- inhibits ___ + ___ which degrades ___
- blocks ___

A
  • thromboxane synthase, phosphodiesterase, cAMP
  • platelet aggregation/adherence

1020: Physiology FM1020 (E) (12 decks)

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