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Step 1 > Path 3 > Flashcards

Path 3 Flashcards

1
Q

Toll-like receptors

A 
MO & dendritic cells
Recognize patterns (PAMPs) - CD14 on MO recognizes LPS --> upregulates NK-kB --> production of mutliple immune mediators
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2
Q

PGI, D, E2

A

Vasodilation at arteriole and inc permeability at post-capillary venule

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3
Q

PGE2

A

Fever & pain

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4
Q

LTB4

A

Attracts and activates neutrophils (IL-8, and C3b also)

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5
Q

LTC, D, E4

A

Vasoconstriction, bronchospasm, inc vascular permeability - contract smooth muscle

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6
Q

Second phase of mast cell response

A

LEUKOTRIENES

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7
Q

Classical complement pathway

A

GM makes classic cars - IgG or IgM bound to Ag –> C1 binds and activates

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8
Q

Alternative complement pathway

A

Microbial products directly activate complement

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9
Q

Mannose-binding Lectin pathway

A

MBL binds to mannose on microorganisms –> activation

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10
Q

C5a

A

Neutrophil chemotaxis

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11
Q

C3b

A

Opsonization for phagocytosis

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12
Q

Hageman Factor (XII)

A

Important role in DIC

- coagulation, fibrinolytic systems, complement, kinin

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13
Q

Factors mediating vasodilation/redness

A

Histamine
PGs
Bradykinin

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14
Q

Fever mechanism

A

LPS –> MO –> IL-1 & TNF –> COX in hypothalamus –> PGE2 –> inc temp set point

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15
Q

Neutrophil arrival

A

Margination –> Rolling –> Adhesion –> Transmigration & Chemotaxis –> Phagocytosis –> Destruction

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16
Q

Margination

A

vasodilation slows BF in post-capillary venule –> periphery of BV

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17
Q

Rolling

A

P-selectin - Weibel-Palade bodies (Histamine)
E-selectin - TNF & IL-1

Bind sialyl Lewis X on leukocytes

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18
Q

Adhesion

A

Endothelium - ICAM & VCAM via TNF, IL-1

Leukocytes - integrins via C5a, LTB4

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19
Q

Leukocyte adhesion deficiency

A

AR defect in integrins (CD18)

  • delayed umbilical cord separation
  • recurrent bacterial infection W/O pus
  • Inc circulating neutrophils
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20
Q

Neutrophil phagocytosis mech

A

Enhanced by opsonins - IgG & C3b

21
Q

Chediak-Higashi

A

AR defect in microtubules –> impaired phagolysosome formation

  • inc pyogenic infections
  • neutropenia
  • GIANT GRANULES IN LEUKOCYTES
  • ALBINISM
22
Q

MPO deficiency

A

Defective conversion from H2O2 –> HOCl
NBT normal
Inc CANDIDA infections

23
Q

MO fxns

A

Resolution/Healing - IL-10, TGF-B

Continued acute inflammation - IL-8 = more neutrophils

Abscess - wall of acute inflammation w/ fibrosis

Chronic inflammation - present Ag to CD4 –> chronic inflammation

24
Q

CD4+ activation

A

EXTRAcellular Ag - phagocytosed –> MHC II
B7 on APC binds CD28 (28/7 = 4)

TH1 –> IL-2 (CD8) & IFN-y (MO)
TH2 –> IL-4 (B-cells from IgG –> IgE) & IL-5 (eosinophils & IgA) & IL-10 (inhibits TH1)

25
Q

CD8+

A

INTRAcellular Ag - ALL nucleated cells
IL-2 from CD4 TH1

Perforin & granzymes –> APOPTOSIS
FasL binds Fas –> APOPTOSIS

26
Q

B-cell activation

A
  1. Ag bind to IgM or IgD –> plasma cells

2. B-cell Ag to CD4 on MHC II + CD40/CD40L on Th cells –> IL-4, 5 –> class switch and maturation

27
Q

Key characteristic of granuloma

A

Epithelioid histiocytes

Can see giants cells and rim of lymphocytes
MO present Ag on MHC II –> IL-12 –> TH1 –> IFN-y –> converts MO to epithelioid histiocytes

28
Q

Non-caseating granuloma

A

LACK central necrosis

  1. Foreign material - breast implant
  2. Sarcoid
  3. Beryllium
  4. Crohn
  5. Cat scratch - “stellate shaped”
29
Q

Caseating granuloma

A

Central necrosis

  1. TB - AFB stain
  2. Fungal infections - GMS stain
30
Q

DiGeorge

A

Failure of 3rd & 4th pouch
22q11 deletion

No thymus, no T-cells, HypOCa –> tetany, cardiac & facial anomalies

31
Q

SCID

A
  1. cytokine receptor defects - no B or T cell maturation
  2. ADA - buildup of de-oxyadenosine os toxic to lymphocytes
  3. MHC II deficiency - CD4 not activated = defective B & T cells

Fungal, viral, bacterial, protozoal, opportunisitc

32
Q

X-linked Agammaglobulinemia

A

TK deficiency –> B-cells can’t mature to plasma cells = no Ig

  1. Bacterial - no opsonin (IgG)
  2. Enterovirus - mucosal GI (IgA)
  3. Giardia
33
Q

Most common Ig deficiency

A

IgA deficiency

Celiac Disease

34
Q

Hyper IgM syndrome

A

Mutated CD40 (B cells) or CD40L (T cells)

Low IgA - mucosal
Low IgG - pus infections d/t poor opsonization
Low IgE

35
Q

Wiskott-Aldrich

A
  1. Thrombocytopenia
  2. Ezcema
  3. Recurrent Infection
36
Q

Most common injury/cause of death in SLE

A

Diffuse proliferative glomerulonephritis

37
Q

Libman-Sacks endocarditis

A

SLE - sterile deposits in BOTH sides of heart valve, esp mitral

38
Q

Drug-Induced lupus

A

Anti-Histone Abs

  1. Hydralazine
  2. Procainamide
  3. Isoniazid
39
Q

Anti-phospholipid syndrome

A

Subset of SLE

  1. Cardiolipin - False + syphilis test
  2. Lupus anti-coagulant - falsel elevated PTT = hypercoagulable state –> DVT, recurrent miscarriages, Budd-chiari
40
Q

Sjogren Syndrome

A

Type IV HS
Dry eyes, mouth, dental carries

Anti-Ribonucleoprotein abs
Assoc w/ RA

41
Q

Disease assoc w/ inc risk of B-cell (mantle zone) lymphoma

A

Sjorgen syndrome

- U/L enlargement of parotid

42
Q

Can’t chew a cracker, dirt in my eyes

A

Sjogren syndrome

43
Q

Anti-DNA topoisomerase I Abs

A

Diffuse scleroderma

44
Q

Anti-Centromere Abs

A

Localized scleroderma (CREST)

45
Q

Anti-U1 Ribonucleoprotein Abs

A

Mixed CT disease

46
Q

Granulation tissue

A

1st phase of repair

Fibroblasts - type III collagen
Capillaries - nutrients
Myofibroblasts - contract wound

47
Q

Scar formation

A

Type III collagen replaced w/ type I

- collagenase requires ZINC

48
Q

Keloid

A

Type III collagen

49
Q

Hypertrophic scar collagen type

A

Type I

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