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week 15 > the patient > Flashcards

the patient Flashcards

1
Q

what is usually causes disease?

A

Micro organisms

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2
Q

What are disease causing organisms called?

A

pathogens

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3
Q

what happens if our multilayered defence system is breached

A

Innate immunity comes into play

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4
Q

what is the innate immune system?

A

It’s reacts quickly
Recognises a pathogen
Destroys the invaders
Induces the inflammatory response
Informs adaptive immunity

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5
Q

What is the first response mechanism?

A

instant

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6
Q

What is the second response mechanism?

A

It appears hours or days later

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7
Q

What is the complement cascade?

A

it is a collection of soluble and membrane-bound proteins made by the liver.

Found in the blood, length, extra cellular fluid. Many compliments compounds are proteases.

However, these require activation, a cascade of enzymatic reactions that occur on infection

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8
Q

how is C3b made

A

spontaneous generation of iC3 increases with the presence of a pathogen

This produces C3 (convertase)

C3b is covalently bound and tags the pathogen

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9
Q

how is this response amplified (C3b)

A

positive feedback for C3 convertase production amplifies the response

More C3 convertase = more C3b produced

C3b binds to the pathogen and coats it’s surface

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10
Q

describe regulation of compliment activation (C3b)

A

peroperdin (factor P) mentains C3b activity by preventing cleavage

This extends the lifetime of the C3 convertase, a positive control mechanism

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11
Q

how is negative feedback, in compliment, activation controlled

A

Factor H and factor I are plasma proteins.

factor H binds to C3b and makes it susceptible to cleavage by factor I

This is essential for negative control to prevent C3 depletion and over activation

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12
Q

what is another factor that increases susceptibility to factor I

A

Factor MCP

Factor MCP and factor H work in a similar manner

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13
Q

What is phagocytosis?

A

Phagocytosis is the first cellular defence in innate immunity

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14
Q

what does C5-C9 do

A

They assemble a complex that perforates the cell membrane

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15
Q

what does protectin CD59 do

A

prevents the formation of the MAC in human cells, preventing pore formation and cell lysis

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16
Q

what is calor

A

heat

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17
Q

what is dolor

A

pain

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18
Q

what is rubor

A

redness

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19
Q

what is tumor

A

swelling

20
Q

describe symptoms that relate to acute inflammation

A

Local reaction
Movement of proteins and cells from blood tissue
Predominantly neutrophils
Clearance of immune challenge
Resolution

21
Q

What does acute inflammation look like?

A

swelling comes to a point to drain (pus)

22
Q

How would you describe chronic inflammation

A

prolonged
Non resolving
Leads to loss of function
Persistent inflammatory cells and mediators

Feather disease

23
Q

What is haematopoiesis?

A

Is the formation of blood cells, red and white?

shifts during development

Occurrs throughout life in bone marrow

24
Q

What are white blood cells?

A

leukocytes
Immune system cells

25
Q

describe the neutrophils, fight and die

A

Large reserves of neutrophils are stored in the bone marrow and are released when needed to fight infection

Neutrophils travel to and into the infected tissue, were they engulf and kill bacteria. The neutrophils die in the tissue and are engulfed and degraded by macrophages.

26
Q

explain macrophages, fight and live

A

binding of bacteria to phagocytotic receptors on macrophages induces their engulfment and degradation

Binding of bacterial components to signalling receptors on macrophages induces the synthesis of inflammatory cytokines

27
Q

Describe how cells of innate immunity recognise, pathogens-pattern recognition

A

pattern recognition receptors (PRR) bind to pathogen associated molecular patterns (PAMPs)

lectins recognise carbohydrates on microbial surfaces

CR3 and iCB3 (from compliment activation)

CD14 binds to LPS

Leads to phagocytosis

28
Q

what are TLR

A

toll like receptors

a family of signalling receptors
Expressed by different cell types
Recognise different pathogens
Taylor innate immune responses to what and where
TLR signalling switches on cytokines production. This informs adaptive immunity

29
Q

What are some adaptations of neutrophils?

A

they are the most abundant white blood cell

Huge bone marrow reserve of Mature neutrophils

Products of inflammation attract neutrophils to sites of infection

Neutrophils are adapted for working without oxygen

They will die hours after entry to infected tissue. Forming pus (MYELOPEROXIDASE)

30
Q

what are mast cells

A

C3a and C5a activate mast cells
anaphylatoxins

they are resident in tissue and sub mucosae
they release histamine
they release cytokine

31
Q

Give examples of inflammatory mediators

A

cytokines
Chemokines
complement
Amiens
Lipid mediators

32
Q

why are neutrophils good eaters

A

most pathogens are recognised

There is a greater diversity of diet than macrophages

There are more antimicrobial weapons than macrophages

Death comes swiftly

33
Q

Describe the process of neutrophils eating until they die

A

bacterium is phagocytosed by neutrophil

Phagosome fuses with specific granules (azurophillic)

PH of phagosome rises, antimicrobial response is activated, and bacteria is killed

PH of phagosome decreases, fusion with lysosomes allows acid hydrolase is to degrade the bacterium completely

Neutrophil dies by apoptosis, and is phagocytosed by macrophage

34
Q

How do pathogens die
Give two examples

A

Oxygen independent and oxygen dependent

35
Q

What is oxygen independent?

A

lysozyme.
azurophillic granules
NADPH oxidase

36
Q

What is oxygen dependent?

A

assembly of active NADPH oxidase at membrane results in respiratory burst and produces powerful oxidising agents

37
Q

what is CGD

A

chronic granulomatous disease

mutations in genes for NADPH oxidase

No respiratory burst
No pH, change in phagosome
No damage to pathogens
Infections are not cleared and remain in localised nodules (granulomas)

38
Q

what do inflammatory cytokines (multitask) do

A

IL-1 and IL-6 and TNF alpha are released by macrophages in response to bacteria

These have multiple effects on the body

they are pyrogens which raise temperature
Reduce bacteria and virus growth
Enhance adaptive immunity

They stimulate the production of acute phase proteins
CRP and MBL

39
Q

how do acute phase proteins, enhance innate immunity?

A

CRP binds to bacterial and fungal cell walls

MBL binds to mannose containing carbohydrates

both are opsonins (which enhances phagocytosis)

Synthesis increases 1000 Fold in the acute phase response

40
Q

Describe how compliment activation has different intentions, but the same end result

A

there are three activation, pathways-alternative, classical and lectin

All three pathways converge at production of the C3 convertase

Activation pathways differ with time

At the start of an infection, it is mainly the alternative pathway

acute phase response produces CRP and MBL-lectin and classical pathway

41
Q

what are NK cells

A

natural killer cells

42
Q

what are the benefits of NK cells

A

they are The Killers of innate immunity

They have a large granular lymphocyte

They are the cytotoxic T cells of innate immunity

They kill and make cytokines

The activity increases from 22 100 times on exposure to the interferons

They provide an early response to virus infection until cytotoxic T cells are ready

People with no NK cells have a persistent viral infections, despite having normal adaptive immune responses

43
Q

What is the instant first response?

A

complement, phagocytes, NK

44
Q

What is the second response?

A

acute phase proteins

45
Q

what does complement activation do?

A

It’s enhances phagocytosis, which results in bacterial death, which induces inflammation

46
Q

What do neutrophils do? (three).

A

Roll, stick and migrate

47
Q

What do cytokines do?

A

they bring in the second, acute phase response

week 15 (3 decks)

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