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T14 MF4 > Physiology > Flashcards

Physiology Flashcards

1
Q

Fill in the following chart comparing innate vs. adaptive immunity

A
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2
Q

What are 5 jobs of the innate immune system?

A
  1. Prevent entry of invader
  2. Induce inflammatory response
  3. Recruit/activate immune cells (via cytokines)
  4. Transport antigens to lymphoid organs to activate AIS
  5. Destroy invaders
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3
Q

What are 5 types of innate immunity? Give examples

A
  1. Chemical barriers (low pH, enzymes)
  2. Mechanical (epithelium, fluid flow)
  3. Complement system (alternate, lectin, classical)
  4. Cells (macrophages, DCs, PMNs, NK cells, mast cells)
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4
Q

What are 5 anti-microbials produced by the epithelial surfaces inour body. Where are they located?

A
  1. Cryptidins - SI
  2. Alpha-defensins - SI
  3. Beta-defensins - skin and RT
  4. Surfactant - lungs and vagina
  5. Lysozyme - saliva and tears
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5
Q

What two signals does the innate immune response respond to? Give an example.

A

PAMPs = pathogen associated molecular patterns (ex. LPS on bacteria)

DAMPs = danger associated molecular patterns (ex. heat shock protein, DNA, purine metabolites, high-mobility group box)

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6
Q

What are the receptors of the innate immune system called?

a. What are the 2 types?
b. Give 2 extracellular examples and 6 intracellular examples

A

Pattern Recognition Receptors

a. Phagocytic and Signaling
b. Extra = TLR, phagocytic

Intra = TLR, NODS, NLRs, RIG-1, MDA5, MAVS

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7
Q

TLRs

  1. What is their structure?
  2. Which ones are on the cell surface?
  3. Which ones are inside the cell?
  4. Which cells have them?
A
  1. Single polypeptide chain
  2. 1, 2, 4, 5, 6
  3. 3, 7, 8, 9
  4. Leukocytes, epithelial cells, endothelial cells
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8
Q

What is the result of a phagocytic PRR recognizing a PAMP?

What is the result of a signaling PRR recognizing a PAMP?

A

Phagocytic = phagocytosis –> phagolysosome –> specific granules –> azurophilic granules –> death of pathogen

Signaling = NF-kbeta transcription –> release of cytokines –> vasodilation/recruitment/fever

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9
Q

What are 3 main functions of the skin?

A
  1. Protection from infection
  2. Protection against UVB light
  3. Production of vitamin B
  4. Regulation of body temperature
  5. Detection of pain, sensation, and pressure
  6. Insulation and padding
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10
Q

What are 4 different mechanisms employed by the skin to protect against infection?

A
  1. Resident macrophages in dermis and hypodermis
  2. Resident DCs in stratum spinosum
  3. Physical barrier (keratinization)
  4. Production of beta-defensin (anti-microbial)
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11
Q

What is the function of neutrophils and how do they carry it out?

A

Phagocytize small particles that aren’t taken up by macrophages

  1. Lysosomal granules releasing proteases
  2. Netosis
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12
Q

What 5 things characterize inflammation?

A
  1. Vasodilation of local blood vessels
  2. Increased capillary permeability
  3. Clotting of fluid in interstitium
  4. Migration of granulocytes and moncytes
  5. Swelling of tissue cells
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13
Q

What are the steps in neutrophil migration?

A
  1. Rolling adhesion (selectin)
  2. Tight binding (ICAM-1)
  3. Diapedesis
  4. Migration via chemotaxis
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14
Q

Which innate cell dominates in acute inflammation? Chronic inflammation?

A

Acute = neutrophils

Chronic = macrophages

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15
Q

Define pus:

A

A collection of necrotic tissue, dead neutrophils, dead macrophages, and tissue fluid

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16
Q

What 8 factors influence what our host flora will be?

A
  1. Lifestyle
  2. Age
  3. Stress
  4. Community
  5. Genetic predispositions
  6. Diet
  7. Hygiene
  8. Drugs/antibiotics
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17
Q

What are 5 common bacteria of our normal skin flora?

A
  1. Staphylococcus Epidermidis (90%)
  2. Staphylococcus Aureus
  3. Micrococcus Luteus
  4. Corynebacterium (specifically Diphtheroids)
  5. Propionibacterium (Acnes)
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18
Q

What are 2 less common but not necessarily pathogenic bacteria of our skin flora?

A
  1. Alpha-streptococcus (mostly mouth but can spread to skin)
  2. Gram-negative baccili (only moist areas)
    - Specifically Enterobacter, Klebsiella, E. Coli, Proteus
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19
Q

What are 4 major types of fungi found under the nails?

A
  1. Aspergillus
  2. Penicillium
  3. Cladosporium
  4. Mucor
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20
Q

What are normal bacterial flora of the upper respiratory tract? (7)

What 3 of these 7 have greater potential to be pathogenic?

A
  1. Anaerobes
  2. Staphylococcus
  3. Neisseriae
  4. Diphtheroids
  5. Haemophilus
  6. Mycoplasmas
  7. Alpha streptococcus

Pathogenic potential = Haemophilus, Strep Pneumoniae, Mycoplasmas

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21
Q

What is one bacteria that can colonize the stomach?

A

Helicobacter species

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22
Q

Describe bacterial quantity in the intestines.

A

The small intestine has increasing numbers from duodenum to ileum, probably because of bile/peristaltic motions

10,000/mL in D/J going up to 10^8 in Ileum

Large intestine has over 400 species (mostly anaerobic)

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23
Q

What are the predominant bacteria making up the host flora at the ileum?

A
  1. Streptococcus
  2. Lactobacillus
  3. Bacteroides
  4. Bifidobacteria
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24
Q

What are the predominant bacteria making up the host flora of the colon/feces?

A
  1. Bacteroides
  2. Bifidobacterium
  3. Eubacterium
  4. Peptostreptococcus
  5. Clostridium
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25
Q

What are 6 bacteria that colonize the vagina during puberty as part of the normal flora?

A
  1. L. Acidophilus
  2. Corynebacteria
  3. Peptostreptococcus
  4. Staphyloccus
  5. Streptococcus
  6. Bacteroides
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26
Q

What are 6 bacteria that colonize theanterior urethra as part of the normal flora?

A
  1. Staphylococcus Epidermidis
  2. Enterococcus
  3. Diphtheroids
  4. E. Coli
  5. Proteus
  6. Neisseria
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27
Q

Fill in the following chart concerning temperatures

A
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28
Q

What is the main fungi of the skin’s (body/arms) normal flora?

A

Malassezia

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29
Q

Give a few examples of normal fungal flora of:

  1. The feet
  2. The mouth
  3. The lungs
  4. The conjunctiva
  5. The urogenital tract
A
  1. Aspergillus, Candida, Cryptococcus, Saccharomyces
  2. Aspergillus, Candida, Cryptococcus, Penicillium
  3. Aspergillus, Candida, Penicillium, Paecilomyces
  4. Aspergillus, Candida, Penicillium, Rhodotorula
  5. Candida, Rhodotorula, Caldosporium, Pichia
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30
Q

What is the most common fungus of our normal gut flora?

How does its concentrations change from the mouth to colon?

A

Candida albicans.

Increases in quantity from mouth (30% of fungi) to colon (65% of fungi)

31
Q

What are 4 jobs of the adaptive immune system?

A
  1. Recognize “non-self” in the presence of “self”
  2. Generate tailored responses to specific pathogens and pathogen-affected cells
  3. Immunological memory for specific pathogens
  4. Recruiting more immune cells
32
Q

How do T and B cells recognize pathogens and pathogen-affected cells?

A

They use their TCR and BCRs to recognize pathogen in the context of MHC, which are cell surface proteins APCs or affected cells

33
Q

What is the difference between a mature B cell, a plasma cell, and a memory B cell?

A

A mature B cell has undergone maturation but has not yet responed to pathogen.

A plasma cell is a mature B cell that has responded to antigen and is actively producing antibodies against it

A memory B cell is a mature B cell that has responded to antigen and is becoming a long lasting cell with memory for that antigen

34
Q

What is the function of:

  1. CD8 T cell
  2. CD4 Follicular Helper T cell
  3. CD4 Type 1 Helper T cell
  4. CD4 Type 2 Helper T cell
  5. CD4 Regulatory Helper T cell
A
  1. Kill target pathogens
  2. Activate naive mature B cells in the lymph nodes
  3. Allow macrophages to destory the pathogens that they have phagocytosed
  4. Activate eosinophils, mast cells, and plasma cells
  5. Suppress autoreactive T cells
35
Q

Describe the process of T cell maturation

A
  1. Lymphoid progenitors migrate to the thymus and differentiate into T progenitors (rearrange beta/gamma/delta loci; rearrange alpha/gamma/delta loci)
  2. T cells undergo positive selection in the thymus when they bind antigen in the context of MHC I or II
  3. T cells then undergo negative selection in the thymus if they bind self-antigen
  4. Naive mature T ells leave te thymus, expressing CD4 and` CD8 reecptors
  5. Naive mature T cells are then stimulated by antigen to differentiate into their different types and carry out their functions
36
Q

What is the innate immune response to fungi?

A
  1. Physical barrier keeping them out
  2. Macrophages and DCs binding components of fungal wall (ex. of PRR = C-type lectin) –> ROS production –> fungal death or adaptive immunity signaling
  3. Mast cells, basophils, and eosinophils play a role
37
Q

What is the adaptive immune response to fungi?

A
  1. TH1 and TH17 respond to DC presentation –> release IFNgamma and IL17 –> recruit more neutrophils and macrophages
  2. CD8 cells –> block fungal growth and release IFNgamma
  3. B cells –> IgG and IgM are critical to clear the fungal infection
38
Q

How does our normal flora protect against infection?

A
  1. Normal flora competes with pathogens for attachment sites and nutrients, preventing its colonization
  2. Normal flora stimulates development of lymphatic tissue (ex. Peyer’s patches) leading to a better response against any invasive or opportunisitic pathogens
  3. Normal flora produces low levels of antibodies so that if something opportunistic gets out of control, the body is more ready
39
Q

What role do NK cells play in viral infections?

A

They release perforin, which forms pores in the infected host cell membrane.

They release granzymes that enter the pores.

This induces apoptosis of the infected cell

40
Q

`What are 5 ways that antibodies neutralize viral infection?

A
  1. Lysis of enveloped virions by activating complement cascade
  2. Agglutinate virions to target them for phagocytosis
  3. Interfere with viruses ability to attach to host cell in the first place (steric interference, capsid stabilization, structural changes to virus)
  4. Block viral penetration if it is able to attach (steric interference)
  5. Prevent uncaoting of a virus that has been taken up inside a host cell
41
Q

What are 2 non-neutralizaing ways that antibodies fight viral infections?

A
  1. Inhibit release of replicated viruses into the host system?
  2. Protect against viral infection of APCs
42
Q

What is the cell-mediate immune response to viral infection?

A
  1. CD8 T cells
    - Apoptosis via perforin/granzymes
    - Apoptosis via caspase signaling cascade
  2. CD4 TH1 =
    - IL2 for CD8 and NK activation
    - IFN-gamma for NK activation, MHC II upregulation, and induction of antiviral state
    - TNF-alpha for a pro-inflammatory state
43
Q

What are the 4 major functions of the lymphatic system?

A
  1. Drain excess interstitial fluid to maintain circulating blood volume
  2. Return lost plasma proteins to the bloodstream
  3. Transport dietary lipids/lipid-soluble vitamins absorbed by the GI tract
  4. Carry out immune responses
44
Q

What is chyle?

A

Lymph that is leaving the small intestine carrying lipids –> appears creamy white

45
Q

Describe the function of the thymus?

A

T cell maturation, both positive and negative selection

Production of thymic hormones that aid in T cell maturation

Clearance of dead T cells by thymic macrophages

46
Q

What is the function of lymph nodes?

A
  1. Trap foreign substances (with reticular fibers)
  2. Destroy foreign substances (with macrophages and lymphocytes)
  3. Present foreign substances to T and B cells
47
Q

What are the functions of the spleen?

A

White pulp = B and T cells carrying out their immune functions; macrophages destroying pathogens (specifically those opsonized by C3b and IgG)

Red pulp = Remove ruptured/old/defective rbc and platelets, store platelets, (produce blood cells in fetal life)

48
Q

Fill in the following chart concerning the complement system:

A
49
Q

What is the function of the blood brain barrier?

A

Protect the brain from circulating pathogens

50
Q
  1. What things can move across the BBB via passive diffusion? (7)
  2. What things can move across the BBB via selective transport? (3)
A
  1. Water, alcohol, gases, creatinine, urea, lipid-soluble molecules, most ions
  2. Glucose, amino acids, nucleosides
51
Q

What are 5 methods for moving things across the BBB?

A
  1. Paracellular aqueous transport
  2. Transcellular lipophilic transport
  3. Transport proteins
  4. Receptor-mediated transcytosis
  5. Adsorptive transcytosis
52
Q
  1. What is a normal wbc per 1 uL of CSF?
  2. In a dL of CSF, what % are lymphocytes, monocytes, and PMNs?
  3. In a dL of CSF, how many mg of protein is there?
  4. In a dL of CSF, how many mg of glucose is there?
  5. How many mL of CSF does our body make and contain per day
A
  1. 5
  2. 70% lymphocytes, 30% wbc, few PMNs
  3. 15-50mg
  4. 45-100mg
  5. Make = 500; Contain = 350
53
Q

What are 5 ways in which the comlement system eliminates pathogens?

A
  1. Opsonization
  2. Elicits the inflammatory response
  3. Interfaces with adaptive immune system
  4. Clears immune complexes and apoptotic cells
  5. Assembles membrane attack complexes
54
Q

What are the 3 main complement pathways? What are their unique players and what is their starting signal?

A
  1. Classical pathway
    - Unique = C1

Signal = C1q binds Fc portion of an antibody bound to antigen

  1. Lectin binding pathway
    - Unique = MBLP
    - MBLP binds mannose on the surface of a bacteria
  2. Alternative pathway
    - Unique = Factor B, Facor D
    - C3b binding Factor B, both free-floating in serum
55
Q

What are 4 funtions of antibodies?

A
  1. Neutralize bacterial and ciral surfaces so that its attack is ineffective
  2. Agglutinate foreign cells to target them for phagocytosis
  3. Glue serum-soluble antigens together so they precipitate out of serum and become a target for phagocytosis
  4. Activate classical complement pathway, encouring MACs
56
Q
A
57
Q

Fill in the following chart concerning the different types of immunoglobulins:

A
58
Q

Where does B cell development occur? What factors in this location allow it to happen?

A

In the bone marrow.

Cytokines released from bone marrow stromal cells that express the proper receptors for the HSC adhesion molecules

59
Q

What are the 6 stages of B cell development and what determines whether the cell has moved into the next stage?

A
  1. Common Lymphoid Progenitor
  2. Early Pro-B Cell –> expression of RAG-1 and RAG-2
  3. Late Pro-B Cell –> D and J segments spliced together
  4. Large Pre-B Cell –> VDJ combined with mu
  5. Small Pre-B Cell –> heavy chain properly combines with surrogate light chain
  6. Immature B Cell –> no self-binding to self-peptide presented by AIREs
60
Q

What are the roles of T cells in B cell activation? Where do the interactions occur?

A

TH1 cells initially activate mature B cells that bind to non-self antigen in the peri-follicular / T cell zone

TFH cells express CD40L and release IL-4/21 when activated mature B cells present non-self antigen that they also recognize. This occurs on the edge of the follicle and leads to the B cell entering the follicle, creating a germinal center, and becoming plasma/memory cells

61
Q

What do B cells undergo within the germinal center? (3)

A
  1. Proliferation
  2. Immunoglobulin class switching
  3. Somatic hypermutation –> affinity maturation
62
Q
  1. What is passive immunization.
  2. Give some examples.
  3. When is it indicated?
  4. What are some risks?
A
  1. Transfer of preformed antibodies to a recipient for transient proection without activation of that recipient’s immune system.
  2. Maternal-fetal transfer of IgG, Maternal-fetal transfer of IgA thorugh breastmilk, antiserum injections
  3. Immune deficient people, anti-toxin with immediate threat to life, unvaccinated individuals exposed to certain unvaccinated pathogens
  4. Immune response (type 1 or 3) to another animal’s antibody isotype –> anti-isotype respone

Immune response to another human’s allotype –> anti-allotype response

63
Q
  1. What is active immunization?
  2. Give some examples.
  3. What are some risks?
A
  1. Triggering the adaptive immune response to elicit protective immunity AND memory
  2. Natural infection and recovery, artificial administration of pathogen via vaccine
  3. Seizures, encephalitis, brain damage, death, disease-like symptoms
64
Q

Fill in the following chart concerning types of vaccines:

A
65
Q

What is an adjuvant? Give 3 examples and explain how they work.

A

Substances added to vaccines to enhance the immune response

  1. Aluminum salts (alum) –> slows antigen delivery of Ig to sustain immune response, recruit APC, encourages antigen to complex together for phagocytosis
  2. MF59 (oil in water) –> thought to slow antigen delivery
  3. AS04 (alum + TLR4 agonist) –> TLR4 signaling thought to encourage TH1 response
66
Q

What are some contraindications to vaccination? (5)

A
  1. Severe allergic reaction
  2. SCID or other immunological deficiencies
  3. History of intussuscpeiton (for Rotavirus)
  4. Age < 6 weeks
  5. Pregnancy
67
Q

What is a booster dose?

A

An extra administration of a vaccine after an earlier (primer) dose

68
Q

What are 8 reasons for giving a booster dose?

A
  1. The speed at which the immune system repsonds to the primary vaccine to too fast to develop a large enough store of memory B cells
  2. The vaccine is given while maternal antibodies are still circulating, dampening the child’s immune system’s learning
  3. The vaccine type doesn’t create memory B cells (ex. toxoid/subunit)
  4. The vaccine type creates small levels of memory B cells (ex. inactivated/killed)
  5. The pathogen has multiple strains
  6. Mutational evolution of the pathogen
  7. Specific exposure to a pathogen occurs
  8. Individuals are immuno-repressed at the time of vaccination creating lower levels of memory cells
69
Q

What vaccines need boosters?

A
  1. DTaP
  2. MMR
  3. Cholera
  4. Polio
  5. Rabies
  6. Plague
  7. Hepatitis A
  8. Influenza
  9. Rotavirus
  10. Pneumococcal
  11. HIB
70
Q

Define herd immunity

A

A form of indiect protection from infectious contagious disease, occurring when a large percentage of a population is immune to an infection

71
Q

Define disease elimination vs. eradication

A

Elimiantion = disease is gone in a certain population/area

Eradication = disease is gone globally

72
Q

What are 4 possible effects of herd immunity?

A
  1. Protection for those not immunized (whether by choice or necessity)
  2. Evolutionary pressure on viruses (antigenic drift or shift)
  3. Serotype replacement or shifting
  4. Possible disease eradication
73
Q

Define herd immunity threshold.

What is the math done to calculate this value?

A

The proportion of a population that must be immune to achieve herd immunity in that population

p(c) = 1 - (1/R(0))

where R(0) is the basic reproduction number (new infections caused by one new infection)

74
Q
A

T14 MF4 (7 decks)

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