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Pathoma 2 Flashcards

1
Q

acute vs chronic inflamm: edema and neutrophils in tissue

A

acute

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2
Q

acute vs chronic inflamm: innate immunity w/limited specificity

A

acute

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3
Q

TLR’s activated by:

A

PAMPs = pathogen associated molecular patterns

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4
Q

TLR on macrophages that recognizes LPS

A

CD14

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5
Q

TLR’s are present on cells of innate/adaptive/both?

A

both

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6
Q

TLR activation upregulates:

A

NF-kB

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7
Q

arachidonic acid is released via what enzymes?

A

phospholipase A2 and C

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8
Q

COX produces _______, which mediate:

A

PGI2, D2, E2 (also pain & fever): vasodilation, inc. vasc. permeability

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9
Q

5-lipoxygenase produces ________, which mediate:

A

LTB4: attracts/activates neutrophils; LTC4, D4, E4: vasoconstriction, bronchospasm, inc. vasc. permeability (anaphylaxis)

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10
Q

mast cells activated by what 3 things:

A

tissue trauma, C3a/C5a, cross-linking of IgE by antigen

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11
Q

immediate mast cell response:

A

preformed histamine granules

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12
Q

delayed mast cell response:

A

arachidonic acid metabolites, esp. LT’s

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13
Q

mannose-binding lectin complement pathway

A

MBL binds mannose on microorganisms

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14
Q

alternative complement pathway

A

microbial products directly activate complement

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15
Q

classical complement pathway

A

C1 binds IgG or IgM bound to antigen

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16
Q

all complement pathways result in production of:

A

C3 convertase (C3–> C3a + C3b)–> C5 convertase (C5–> C5a + C5b)

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17
Q

MAC made up of:

A

C5b-C9

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18
Q

neutrophil chemotaxis

A

C5a, LTB4, IL-8, 5-HETE, bacterial products

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19
Q

opsonins for phagocytosis

A

IgG, C3b

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20
Q

hageman factor

A

factor XII, role in DIC w/acute gram neg sepsis, complement and kinin systems

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21
Q

kinin system

A

kinin cleaves HMWK–> bradykinin (vasodilation, inc. vasc. permeability, pain)

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22
Q

mediators of pain:

A

PGE2, bradykinin

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23
Q

rubor

A

redness

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24
Q

calor

A

warmth

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25
mediators of rubor and calor:
histamine, PGI/E/D, bradykinin
26
mediators of tumor (swelling):
histamine, tissue damage
27
dolor
pain
28
mediators of fever:
pyrogens (LPS)--\> IL-1, TNF--\> inc. COX--\> inc. PGE2
29
phases of acute inflammation: 12 hrs, 24 hrs, 48 hrs
edema, neutrophils, macrophages
30
speed bumps in neutrophil rolling
P-selectin from Weibel-Palade bodies (histamine); E-selectin (TNF, IL-1)
31
selectins bind ______ on WBC's
sialyl lewis X
32
ICAM and VCAM upregulated by
TNF, IL-1
33
firm adhesion via:
CAMS, integrins
34
integrins upregulated by:
C5a, LTB4, IL-8, 5-HETE, bacterial products
35
leukocyte adhesion def. (LAD)
AR defect of integrins (CD18); delayed separation of umbilical cord, inc. neutrophils, recurrent bacterial infections lacking pus
36
protein trafficking defect w/impaired phagolysosome formation
chediak higashi syndrome, AR
37
chediak higashi sx:
neutropenia, defective primary hemostasis, albinism, peripheral neuropathy
38
oxidative burst
O2--\> O2 radical by NADPH oxidase--\> H2O2 by SOD--\> HOCl radical by MPO
39
CGD
NADPH oxidase defect, X linked or AR
40
catalase positive organisms:
s. aureus, pseudomonas cepacia, serratia marcescens, nocardia, aspergillus
41
screening for CGD:
nitroblue tetrazolium test (colorless is there's a defect)
42
MPO def. increases risk for:
Candida infections
43
anti-inflammatory cytokines:
IL-10, TGF-beta from macrophages
44
cytokine released from macrophages for continued acute inflamm:
IL-8
45
acute vs chronic inflamm: lymphocytes and plasma cells in tissue
chronic
46
acute vs chronic inflamm: delayed adaptive immunity w/specificity
chronic
47
where does TCR undergo rearrangement--\> CD4 vs CD8?
thymus
48
TCR and CD3 is used for:
antigen surveillance
49
2nd activation signal for CD4 T cells:
B7 on APC binds CD28 on CD4 T cell
50
TH1 secretes:
IL-2 (T cell growth factor and CD8 activator), IFN-gamma (macrophage activator)
51
TH2 secretes:
IL-4 (B cell class switching--\> IgG, IgE), IL-5 (eosinophil chemotaxis/activation, B cell--\> plasma cell w/class switching to IgA), IL-10 (inh. TH1)
52
expressed by all nucleated cells and PLT's
MHC I
53
2nd activation signal for CD8 T cells:
IL-2 from CD4 TH1
54
how do CD8 T cells kill?
perforin, granzyme, FasL
55
where do B cells undergo Ig rearrangements?
bone marrow
56
naïve B cells express:
IgM, IgD
57
2nd activation signal for B cells:
CD40 rec. on B cell binds CD40L on TH cell
58
epithelioid histiocytes
macrophages w/abundant pink cytoplasm--\> granuloma
59
noncaseating granulomas:
rxn to FB, sarcoidosis, beryllium exposure, crohn's disease, cat scratch disease
60
caseating granulomas:
TB and fungal infections
61
granuloma formation
IL-12 from macrophages--\> TH1 cells--\> IFN-gamma--\> epithelioid histiocytes and giant cells
62
digeorge syndrome
3rd/4th pharyngeal pouches, 22q11 microdeletion, T cell def. and hypocalcemia
63
SCID etiologies:
cytokine rec. defects, ADA def., MHC class II def.
64
SCID tx:
sterile isolation and stem cell transplantation
65
X-linked agammaglobulinemia
disordered B cell maturation, mutated bruton tyrosine kinase (Btk), X-linked
66
CVID
low Ig's due to B cell or TH cell defects; inc. risk for autoimmune dz and lymphoma
67
most common Ig def.
IgA
68
hyper-IgM syndrome
mutated CD40L or CD40 rec. = no cytokines for class switching
69
WAS
thrombocytopenia, eczema, recurrent infections, WASR gene, X-linked
70
C5-C9 def.
neisseria infections
71
C1 inh. def.
hereditary angioedema of skin and mucosal surfaces
72
anergy of lymphocytes is due to:
recognition of antigen in peripheral lymphoid tissue w/no 2nd signal
73
SLE hypersensitivity
type II and III
74
SLE most common cause of death
diffuse proliferative GN and infection
75
small sterile deposits on both sides of mitral valve
libman-sacks endocarditis w/SLE
76
specific antibody for SLE
anti-dsDNA
77
ANA
sensitive for SLE but not specific
78
antihistone Ab
drug-induced SLE due to: hydralazine, procainamide, INH
79
anticardiolipin and lupus anticoagulant
antiphospholipid antibody syndrome: false pos. syphilis, falsely inc. PTT
80
sjogren's hypersensitivity
type IV
81
SSA (Ro)/SSB (La)
anti-ribonucleoprotein antibodies
82
sjogren's w/inc. risk for _____ w/unilat. enlargement of parotid
B cell (marginal zone) lymphoma
83
most commonly involved organ w/diffuse scleroderma:
esophagus
84
anti-centromere Ab's
CREST syndrome
85
anti-topo I (Scl-70) Ab's
diffuse scleroderma
86
Ab's against U1-ribonucleoprotein
mixed CT disease (SLE, systemic scleroderma, polymyositis)
87
labile tissues
continuously regenerate: bowels, skin, bone marrow
88
stable tissues
regenerate when necessary: liver by compensatory hyperplasia after resection
89
permanent tissues
myocardium, skeletal m., neurons
90
scar formation
type III collagen (granulation, embryonic, uterus, keloids) replaced w/type I collagen (skin, bone, tendons, organs)
91
what removes type III collagen, using _____ as a cofactor?
collagenase, zinc
92
TGF-alpha
EGF and FGF
93
TGF-beta
FGF, inh. Inflamm.
94
PDGF
endothelium, smooth m., fibroblasts
95
FGF
angiogenesis, skeletal dev.
96
VEGF
angiogenesis
97
healing via secondary intention
edges not approximated, granulation tissue, myofibroblast contraction w/scar
98
what vitamin/mineral def. result in delayed wound healing?
vit. C (hydroxylation), copper (lysyl oxidase), zinc (collagenase)
99
dehiscence
rupture of a wound
100
hypertrophic scar
excess scar tissue localized to wound
101
keloid
excess type III collagen, african americans, earlobes/face/UE's

Pathoma (3 decks)

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