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SURGERY > Systemic response to injury and metabolic support 2 > Flashcards

Systemic response to injury and metabolic support 2 Flashcards

1
Q

Mediators of inflammation

A

Cytokines, Eicosanoids, Plasma contact system, serotonin, histamine

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2
Q

-A hormone-like secreted protein.
-Protein signaling compounds that mediate a
broad sequence of cellular responses, including
cell migration, DNA replication, cell turnover, and
immunocyte proliferation

A

Cytokines

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3
Q

An exaggerated proinflammatory cytokine

response to inflammatory stimuli may result in

A
  • hemodynamic instability (i.e., septic shock) and

* metabolic derangements (i.e., muscle wasting)

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4
Q

The major precursor of

arachidonic acid is the

A 
omega-6 (n-6) polyunsaturated 
fatty acid (PUFA) linolenic acid
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5
Q

They have a broad range of physiologic roles,

including

A

neural transmission, and vasomotor

regulation, and immune cell regulation.

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6
Q

pain medications act

on your _____ to decrease inflammation.

A

prostaglandins

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7
Q

The second major family of PUFAs is the _____ which is found primarily
in cold water fish.

A

omega-3

fatty acid, alpha-linolenic acid,

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8
Q

has the
potential to dampen inflammation (by shifting
the cell membrane composition in factor of
omega 3-PUFAs over omega 6-PUFAs)

A

Omega-3 fatty acid supplementation

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9
Q 
Part of the innate immune system that 
enhances the ability of antibodies and 
phagocytic cells to clear microbes and 
damaged cells, promotes inflammation, and 
attacks the pathogens cell membrane
A

Complement

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10
Q

Group of proteins that contribute to both coagulation

and inflammation

A

KALLIKREIN-KININ SYSTEM

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11
Q

mediate several physiologic processes
including vasodilation, increased capillary,
permeability, tissue edema, and neutrophil chemotaxis

A

Kinins

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12
Q

Bradykinin and kallikrein levels are ______following

hemorrhagic shock and tissue injury

A

increased

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13
Q

Serotonin is a monoamine neurotransmitter (5-

hydroxytryptamine; 5HT) derived from ____

A

tryptophan

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14
Q

• It is a potent vasoconstrictor and also modulates
cardiac inotrophy and chronotrophy
• Released at sites of injury for neutrophil recruitment

A

SEROTONIN

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15
Q 
HISTAMINE RECEPTOR
• Mediates vasodilation, 
bronchoconstriction, intestinal 
motility, and myocardial contractility
• Mediates B and T cells responses
A

H1R binding

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16
Q

HISTAMINE RECEPTOR
• Stimulates gastric parietal cell acid
secretion

A

H2R BINDING

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17
Q

• Is a presynaptic auto-receptor in the
peripheral and central nervous system
• Participates in inflammation in the
CNS

A

H3R

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18
Q

• is a modulator of chemo attraction

and cytokine production

A

H4R

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19
Q

A major group of cytokines bind to receptors termed
______, and these selectively
associate with the Janus kinases (JAK1, JAK 2, JAK
3, TYK2)

A

type I/II cytokine receptors

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20
Q

is considered a
central communication hub for the immune system
(especially for cytokines which are major
communicators of immune response)

A

JAK-STAT signaling pathway

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21
Q

are constitutively bound to the cytokine
receptors, and on ligand binding and receptor
dimerization

A

JAK’s

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22
Q

STAT
molecules possess ______ sites that allow for
STAT dimerization.

A

“docking”

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23
Q

will stop the
activation of STAT, preventing entry to nucleus for
nuclear transcription.

A

SOCS

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24
Q

SOCS___ are

typically associated with cytokine receptor signaling,

A

1-3

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25
Q

SOCS___ are associated with growth factor

receptor signaling

A

4-8

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26
Q

Includes the receptors for catecholamines,
bradykinins, and leukotrienes, and other ligands
important to the inflammatory response

A

G-PROTEIN-COUPLED FAMILY OF RECEPTORS

27
Q

Rhodopsin-like

A

Class A

28
Q

Secretion-like

A

Class B

29
Q

Metabolic glutamate

A

Class C:

30
Q

Frizzled receptors

A

Class D

31
Q 
allow 
continued presentation of auto-antigens to the host 
immune system (which can cause further injury) – it 
will be an autopilot inflammatory response.
A

‘neutrophils extracellular traps’ or NETs,

32
Q

• Most abundant of granulocytes
• Among the first responders to sites of infection and
injury, potent mediator of inflammation.
• Short half-lives (4 to 10 hours)

A

NEUTROPHILS (PMNs)

33
Q

characterized by the
expression of high levels of proinflammatory cytokines, like TNF-α, IL-1
and IL-6.

A

M1 phenotype

34
Q

are considered to be involved in the
promotion of wound repair and the restoration of
immune homeostasis through their expression of
arginase-1 and IL-10. These are activated by anti –
inflammatory cytokines.

A

M2 macrophages

35
Q

play central roles in the
function of the immune system through their effects
on B cell antibody production, their enhancement of
specific T cell functions, and their assistance with
macrophage activation.

A

CD4 +T cells (helper)

36
Q

The more severe the injury, Th__ will be more activated.

A

2

37
Q 
are the most important antigen -
presenting cells (APCs) for initiating T-cell responses 
against protein antigens
A

DENDRITIC CELLS

38
Q

adopt an initial pro -
inflammatory phenotype by expressing and releasing
a variety of adhesion molecules, cytokines, and other
immune modulators including high mobility group 1
protein (HMGB1), interleukin (IL)-1β

A

platelets

39
Q

are also known to play an important role in

the anaphylactic response to allergens.

A

Mast cells

40
Q

Migrant cell of connective tissue, which contain

granules rich in histamine and heparin

A

Mast cells

41
Q

T or F
Endothelial cells are mainly
anticoagulant to prevent microthrombosis. In injury, in
order to stop bleeding, they induce coagulation

A

T

42
Q

Higher ______ measurements correlated with

ISS/mortality

A

syndecan-1

43
Q

Has overall anticoagulant properties mediated via the
production and cell surface expression of heparan
sulfate, dermatan sulfate, tissue factor pathway
inhibitor, protein S, thrombomodulin, plasminogen,
and tissue plasminogen activator

A

VASCULAR ENDOTHELIUM

44
Q

Family of small proteins with chemotactic and

activating effects on inflammatory cells

A

CHEMOKINES

45
Q

Key attractants for immune cell extravasation

A

CHEMOKINES

46
Q

Normal vascular smooth muscle cell relaxation is

maintained by a constant output of

A

NITRIC OXIDE

47
Q

can also reduce micro thrombosis by reducing
platelet adhesion and aggregation and interfering with
leukocyte adhesion to the endothelium

A

NITRIC OXIDE

48
Q

Endogenous NO formation is derived largely from the

action of

A

NO synthase (NOS),

which is constitutively
expressed in endothelial cells (NOS3)

49
Q

The
vasodilatory effects of NO are mediated by________, an enzyme that is found in vascular smooth
muscle cells and most other cells of the body

A

guanylyl

cyclase

50
Q

Potent vasodilator that also inhibits platelet

aggregation

A

PROSTACYCLIN (PGI2)

51
Q

best effects of PGI2

A

Cardiovascular system

52
Q

T or F
PGI2 reduces pulmonary blood
pressure and bronchial hyperresponsiveness

A

T

53
Q

T or F
PGI2 modulates renal blood flow and
glomerular filtration rate

A

T

54
Q

PGI2 ________ pulmonary blood pressure as well as

bronchial hyperresponsiveness

A

Reduces

55
Q

Family of small proteins (8 to 13 kDa) that were
first identified through their chemotactic and
activating effects on inflammatory cells

A

CHEMOKINES

56
Q

Prostacyclin acts through its receptor (a G-protein–
coupled receptor of the rhodopsin family) to stimulate
the enzyme _______, allowing the synthesis
of cAMP from adenosine triphosphate (ATP)

A

adenylate cyclase

57
Q

Potent mediators of vasoconstriction and are

composed of three members: ET-1, ET-2, and ET-3

A

ENDOTHELINS

58
Q

ET release is ______ in response to hypotension,
injury, thrombin, IL-1, angiotensin II, vasopressin,
catecholamines, and anoxia.

A

upregulated

59
Q

Prostacyclin

(prostaglandin I2, or PGI2) is derived from

A

arachidonic acid (AA),

60
Q

nitric oxide (NO) is derived from

A

L-arginine

61
Q

T or F
The increase in
• cyclic adenosine monophosphate (cAMP) and cyclic
guanosine monophosphate (cGMP) results in smooth
muscle relaxation and inhibition of platelet thrombus
formation. Endothelin (ETs) are derived from “big ET,”
and they counter the effects of prostacyclin and NO

A

T

62
Q

Promotes the activation and aggregation of platelets
and leukocytes, leukocyte adherence, motility,
chemotaxis, and invasion, as well as ROS generation

A

PLATELET ACTIVATING FACTOR

63
Q

is a major lipid constituent of the
plasma membrane. Its enzymatic processing by
cytosolic phospholipase A2 (cPLA2) or calcium-independent phospholipase A2 (iPLA2) generates
powerful small lipid molecules, which function as
intracellular second messengers

A

Phosphatidylcholine

64
Q

are a family of
peptides that are released primarily by atrial and
ventricular tissue respectively but are also
synthesized by the gut, kidney, brain, adrenal glands,
and endothelium

A

natriuretic peptides, atrial natriuretic factor (ANP)

and brain natriuretic peptide (BNP)

SURGERY (6 decks)

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