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Year 3 Sem 1 > Week 2 > Flashcards

Week 2 Flashcards

1
Q

what are the 3 developmental processes of T and B lymphocytes?

A

rearrangement of their germline Ag receptor genes
selection of functional receptors
negative selection to eliminate self reactive clones

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2
Q

which are the polymeric and multimeric isotopes?

A

polymeric: IgM and IgA
monomeric: IgD, IgE, IgG

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3
Q

what are the brief functions of IgM, IgG and IgE?

A 
IgM = classical pathway activation 
IgG= placental transfer 
IgE= high affinity binding to mast cells and basophils
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4
Q

definition of BCR

A

Ab bound to transmembrane proteins that allow a signal to be sent and the epitope interacts with Ag binding site on BCR

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5
Q

what are complementary determining regions?

A

part of the variable chain in Ig
hypervariable regions within Vh and Vl - determine Ag specificity
Ab bind antigens via amino acids in CDRs

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6
Q

which gene segments are involved in the heavy chain of Ig genes?

A

V, J, D gene segments

multiple C regions

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7
Q

which gene segments are involved in the light chain of Ig genes?

A

V and J gene segments

1 constant region

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8
Q

what are the enzymes involved in DNA recombination?

A

RAG-1 & RAG-2 recombinases, kinases and ligases

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9
Q

what is the order of somatic recombination in terms of heavy and light chains?

A

heavy chain rearrange first

light chains rearrange second

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10
Q

what are the functions of the V and C regions?

A

V region- Ag binding

C region - signal transduction; interacts with effector cells and molecules

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11
Q

describe Fab and Fc receptor and how they are cleaved?

A

fab: binds Ag and has 1 V region and 1 C region
Fc: involved in Ag recognition
both can be cleaved by papain

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12
Q

general function of IgM?

A

activation of classical pathway

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13
Q

which Ab is involved in placental activation?

A

IgG1

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14
Q

what is the order for somatic recombination in light chains?

A

V and J gene segments join - RNA splicing joins VJ to C region

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15
Q

what is the order for somatic recombination in heavy chain?

A

D and J gene segments join
then V segment joins DJ complex
VDJ is joined by C segments

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16
Q

where are germinal centres located?

A

within secondary lymph nodes

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17
Q

how are germinal centres formed?

A

after Ag activates B cell it receives help from CD4 helper T cells (Tfh) and together moves into the deep follicle of LT

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18
Q

what happens in germinal centers?

A

somatic hypermutation, IgG class switching, differentiation into plasma/ memory cells

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19
Q

time course of leukocyte migration (neutrophils/ monocytes)

A

neutrophils infiltrate in the first 6-24 hours

then replaced by monocytes 24-48 hours

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20
Q

brief points about vascular response to inflammation

A

increased microvascular permeability - plasma proteins move into extravascular tissue = increased blood viscosity and stasis

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21
Q

transudate vs excudate?

A 
transudate = fluid pushed out into extravsacualr tissue due to increased HP
excudate= fluid leaks out of capillaries due to inflammation
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22
Q

brief summary of cellular response of inflammation?

A

margination and rolling of leukocytes along endothelium

adhesion to the endothelium

transmigration out of the vessel between endothelial cell

migration into interstitial tissue toward a stimulus by chemotaxis

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23
Q

3 functions of leukocytes?

A

phagocytosis
release of substances that destroy EC microbes and sea tissue
production of mediators that amplify inflammatory response = more recruitment/ activation

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24
Q

what is D-dimer?

A

when fibrin degradation occurs D dimer results

indicates activation of fibrinolytic system

25
Q

how does prevalence relate to predicted values?

A

low prevalence = low PPV and high NPV

high prevalence = high PPV and low NPV

26
Q

goal of motivational interview?

A

make the patient themselves aware of the potential for change in behaviour resulting in improved health

27
Q

3 components of motivation?

A

willing
able
ready

28
Q

what does motivational interviewing help get rid of?

A

doubt and ambivalence

29
Q

what theory does motivational interviewing use?

A

transtheoretical model

30
Q

what are the 4 determinants of chronic disease?

A

social factors
behavioural factors
biological factors
environmental factors

31
Q

trans theoretical model?

A 
precontemplation
contemplation
preparation
action
maintenance
relapse
32
Q

indications for motivational interviewing?

A 
SNAP risk factors
medication adherence
adherence to recommended screening and dx tests
gambling
pain management 
management of CD 
substance use disorder
33
Q

what are the 5A’s?

A 
ask
assess
advice
assist
arrange
34
Q

Grace Model?

A

generate a gap - between patients current situation and what they want
roll with resistance - ambivalence is normal, alter strategy if there is resistance
avoid arguments - they increase resistance
can do attitude - encourage self efficacy and hope
express empathy - listen, communicate, acceptance/ support; gently persuade while respecting personal vie w

35
Q

what is RULE? - in motivational interviewing

A

resist the righting reflex
understand your patients motivation
listen with empathy
empower your patient

36
Q

what are the cell derived mediators in acute inflammation?

A 
histamine
cytokines
chemokines
leukotrienes 
prostaglandins 
platelet activating factor
37
Q

what are the plasma derived mediators in acute inflammation?

A

complement

kinins

38
Q

what mediators are involved in vasodilation?

A

PG, NO, histamine

39
Q

what mediators are involved in increased vascular permeability?

A

histamine, 5HT, leukotrienes, C3a C5a, substance P, PAF, BK

40
Q

what mediators are involved in chemotaxis, leukocyte recruitment and activation?

A

TNF, IL1, chemokine, C3a/C5a, leukotriene B4, bacterial products

41
Q

what mediators are involved in fever?

A

PG, IL1, TNF

42
Q

what mediators are involved in pain?

A

BK and PG

43
Q

what mediators are involved in tissue damage?

A

lysosomal enzymes or leukocytes, ROS and NO

44
Q

risk vs hazard?

A 
hazard = inherit dangerousness
risk = ability to cause harm
45
Q

what are the types of risk?

A 
individual
community 
acute
chronic
primary
secondary 
political/ reputational
46
Q

what is risk mitigation?

A

the systematic reduction in the extent of exposure to a risk factor and the likelihood of its occurrence

47
Q

what is risk perception impacted by?

A 
trust
origin
control
awareness
age affected
nature
scope
imagination
uncertainty
familiarity
specificity 
personal impact 
fun/pleasure
48
Q

risk matrices?

A

A risk matrix is a matrix that is used during risk assessment to define the level of risk by considering the category of probability or likelihood against the category of consequence severity. This is a simple mechanism to increase visibility of risks and assist management decision making.

49
Q

prevention paradox and risk?

A

low chance of something happening in a large population

high chance of something happening in a small population

50
Q

what does the C region on the AB bind?

A

Complement, FC receptor

involved in signal transduction

51
Q

what Ig isotopes are involved in opsonization?

A

IgG1 works best for Ab binding to pathogen

IgM works best for complement binding to pathogen

52
Q

which bacteria must be opsonized before phagocytosed?

A

Pyogenic bacteria such as Haemophilus influenzae, Streptococcus
pneumoniae, Streptococcus pyogenes and Staphylococcus aureus must
be opsonised before they are phagocytosed.

53
Q

what substance do leukocytes secrete to help them cross the basement membrane?

A

collagenase

54
Q

what is the course of leukocytes once they are outside the vessel?

A

leukocytes move to the site of infection by along a chemical gradient
they bind to specific cell surface receptors which trigger the assembly of cytoskeletal contractile elements necessary for movement
leukocytes move by extending pseudopods that pull cell in the direction of the extension

55
Q

how do B cell tumours form?

A

malignant transformation of these cells by translocation of proto-oncogenes into the Ig loci
CLL, ALL, myeloma

56
Q

what results from defective Ig gene rearrangement?

A

SCID, brutons TK def

57
Q

what results from defective class switching?

A

hyperIgM

58
Q

what are the 3 ‘rulers’ in motivational interviewing?

A

importance ruler
readiness ruler
confidence ruler

Year 3 Sem 1 (12 decks)

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