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Year 3 Sem 1 > Week 11 > Flashcards

Week 11 Flashcards

1
Q

what is type 1 hypersensitivity?

A

IgE mediated hypersensitivity - IgE bound to mast cells via Fc portion

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2
Q

what is type 2 hypersensitivity?

A

Ab mediated cytotoxic hypersensitivity

- cells are destroyed by bound Ab either by activation of complement or cytotoxic T cell (ADCC)

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3
Q

what is the biphasic response in effector phase of type 1 hypersensitivity?

A

initial: preformed mediator release (vasodilation, vascular leakage, SM spasm)
late phase: inflammatory cell influx (mucosal edema, music secretions, leukocyte infiltration, epithelial damage, bronchospasm)

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4
Q

where dose mast cell degradation and activation occur in type1?

A

GIT
nasal passage, eyes, airways
BV

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5
Q

what is type 3 hypersensitivity?

A

immune complex hypersensitivity
Ag:Ab complexes are deposited into sites of tissues which activates complement and attracts more neutrophils to the site of infection

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6
Q

what is type 4 hypersenstivity?

A

cell mediated hypersensitivity

Th1 cells secrete cytokines and activate macrophages which can accumulate at the site and CTLs

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7
Q

what are some immune complex related disease?

A 
bacterial
viral
parasitic
autoimmune
serum sickness
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8
Q

how does a hapten work?

A

it can only trigger an immune response when coupled with an Ag
small molecules that contact skin and bind host proteins and converting that self Ag to highly immunogenic foreign peptides- bind to skin APC and activate T cells
upon subsequent exposure that same hapten triggers a memory T cell response

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9
Q

what are the 5Rs of radiotherapy?

A 
radiosensitivity 
repair
redistribution 
repopulation 
re-oxygenation
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10
Q

what causes acute effects to radiotherapy?

A

suppression of cell proliferation in tissues with high cell turnover (bone marrow, GI, airway mucosa)

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11
Q

what causes the late adverse effects of radiotherapy?

A

damage to non-proliferating tissues which cannot compensate for cell death

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12
Q

what is biphasic response of the effector phase in type 1 hypersensitivity

A

initial response is <15 min, release of preformed mediators = vasodilation, vascular leakage and smooth muscle spasm

late phase reaction is 4-24 hours, inflammatory influx = mucosal edema, mucosal secretions, leukocyte infiltration, epithelial damage, bronchospasm

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13
Q

where are mast cells found?

A

CT throughout the body, GIT, resp tract, heart

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14
Q

when are the connective tissue mast cells degranulated?

A

intravenous or subcutaneous mast cell degranulation

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15
Q

when are the mucosal mast cells degranulated?

A

inhalation or ingestion of allergen

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16
Q

symptoms of mast cell degranulation with intravenous allergen?

A

widespread histamine release which acts on BV to increase permeability = hives or anaphylactic shock

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17
Q

symptoms of mast cell degranulation with subcutaneous allergen?

A

local histamine release causes wheal and flare (red and swelling)
topical allergen penetrating can also be a cause of atopic asthma

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18
Q

symptoms of mast cell degranulation with inhaling an allergen?

A

allergic rhinitis - due to increased mucus production and nasal irritation

asthma due to contraction of bronchial smooth muscle and increased mucus secretion

19
Q

symptoms of mast cell degranulation with ingestion of allergen?

A

contraction of intestinal SM induced vomitting

outflow fluid into the gut causes diarrhea

20
Q

clinical signs of anaphylaxis?

A 
pale gums 
cold limbs
increased HR
weak pulse
urticaria (increased V perm)
angioedema 
dyspnoea
hypoxia
hypotension 
contraction of intestinal SM = cramp and diarrhea
swelling of lips, tongue, larynx = block respiration 
bronchoconstriction blocks expiration
21
Q

examples of type 2 hypersensitivity?

A

incompatible blood transfusion
hemolytic disease newborn
hyperacute graft rejection

22
Q

tx for anaphylactic reaction?

A

adrenalin which reforms the tight junctions of endothelial cell and relaxation of bronchial SM and heart

23
Q

arthus reaction?

A

type 3 hypersensitivity
following penetration of Ag locally - ind gets vaccinated but already has pre-existing Ab to this Ag thus forms an immune complex initiating an inflammatory response

Arthus reactions (type III hypersensitivity reactions) are rarely reported after vaccination and can occur after tetanus toxoid–containing or diphtheria toxoid–containing vaccines. An Arthus reaction is a local vasculitis associated with deposition of immune complexes and activation of complement.

24
Q

serum sickness?

A

eg, snake venom give the ind anti-venom serum however they already have Ab against anti-venom = form immune complex

bitten again = anti-anti venom Ab will bind anti venom serum and cause vasculitis

25
Q

what are haptens?

A

small molecules that contact skin and bind host proteins thus converting self Ag into highly immunogenic foreign peptide which skin APCs can take up and sensitize naive hapten specific CD4 and CD8 T cells

upon subsequent exposure to the same hapten the hapten specific memory T cells in skin are activated = Th1 and CTLs

26
Q

role of Th1 and CTLs in haptens?

A

Th1 secretes cytokines IFNy which activates macrophages to secrete IL1, IL6 and TNF

TH1 also activates keratinocytes which secrete IL1 and TNF

27
Q

example of type 4 hypersensitivity?

A

mantoux skin test
IBD
RA
MS

28
Q

what is injury prevention?

A

prevention from an accident from occurring which would have resulted in injury
reduction in the exchange of energy thus reducing the severity in injury

29
Q

draw out haddon matrix for road trauma

A

see notes

30
Q

what is the hierarchy of control? purpose?

A

system used to minimize and eliminate exposure to hazards

its unlikely people will change unless its made a rule or a law (eg, seat belts)

31
Q

different components of hierarchy of control?

A

elimination- physically remove hazard
substitution- replace hazard
engineering controls- isolate people from hazard
administrative controls- change the way people work
personal protective equipment - protective the work with gloves etc

32
Q

5 steps of project planning?

A 
identify the problem
analyze the problem
design solutions
plan your program 
evaluate (use SMART)
- specific, measurable, achievable, relevant, timely
33
Q

photon therapy?

A 
better for deeper tumours 
travel in beam
like visible light 
inverse square law 
entry and exit dose
34
Q

electron therapy

A

for superficial tumours
entry dose only
small light particles that cannot penetrate all the way

35
Q

what are the signs of early radiation toxicity?

A

alopecia
denudation of skin
erythema
inflammation

caused by suppression of cell proliferation in tissues with high cell turnover
radiation causes local damage of DNA in healthy cells and release of ROS

36
Q

what are the signs of late radiation toxicity?

A 
microvascular damage
fibrosis
telangectasia 
atrophy
necrosis
LOF
hypo/hyperpigmentation
glomerulonephritis

caused by damage to non-proliferating cells which are unable to compensate for cell death

37
Q

which cancers are sensitive / resistant to radiotherapy?

A

sensitive: lymphoma, small cell, seminoma
resistant: pancreatic, renal, glioblastoma, melanoma

38
Q

why do we fractionate radiotherapy treatment?

A

to allow hypoxic cells to become oxic (reoxygenation)
to allow greater chance of targeting sensitive stages of the cell cycle (redistribution)
to allow healthy cells to repair from radiotherapy as tumour cells don’t repair (repair)

39
Q

how does radiotherapy work on a molecular and cellular level?

A

direct damage to DNA: radiation physically breaks sugar phosphate backbones of base pairs of DNA

indirect damage to DNA: due to production of toxic free radicals from interaction of radiation with water/ oxygen within cell

both result in single and double stranded breaks that if not repaired will accumulate and lead to reproductive death
double stranded breaks may persist without accurate repair resulting in mutations

40
Q

external beam radiation therapy

A

delivered in photon beams

41
Q

internal beam radiation

A

delivered from radiation sources placed inside or on the body
radioactive isotopes sealed in pellets implanted using delivery devices

can deliver higher doses to some cancers than some external beam while causing less damage to healthy cells

42
Q

systemic radiation therapy

A

oral/ parenteral administration of radioactive substance bound to a monoclonal ab
used target delivery to specific tissues

43
Q

3 principles to radiation safety?

A

time
distance
shielding

Year 3 Sem 1 (12 decks)

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