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134 Cards in this Set
- Front
- Back
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2 outcomes of abscess
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encapsulation or rupture
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abscess rupture to peritoneum
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peritonitis
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abscess rupture to blood vessel
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systemic circulation of septic material (usually death)
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fever - purpose
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kill bacteria - human cells survive
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critical temps for fevers
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105 degrees - protein denatures, 107 degrees - multiple organ failure and death.
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4 agents or chronic inflammation
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microorganisms, foreign bodies, toxins, auto-immune reactions
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chronic inflam main events
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cellular infiltrate, tissue destruction, repair by scar
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granuloma
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chronic infection, macrophages differentiate - epitheloid cells, cluster
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2 cell types assoc w granuloma
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multinucleated giant cell, langhans cell
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4 disorders assoc w granulomatous inflam
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tuberculosis, syphilis, leprosy, crohns
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langhans cell characteristics
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nuclei around periphery, horseshoe shape
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granuloma significance
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storage facility for infectious agents body can’t destroy?
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another name for antibodies
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immunoglobulins
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antibody purpose
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form complex with antigen - complex marked for destruction
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2 modes of destruction AbAg complex
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direct lysis, complement activation
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cells with FC receptors
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macrophages, NK cells, eosinophils, neutrophils
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direct lysis of AgAb complexes how
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cell with FC receptor engages FC fragment, releases lysosomes - destroys complex
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2 basics of complement system
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hydrolytic enzymes directly lyse infectious agents or chemical mediators initiate acute inflammation, attract neutrophils to phagocytose
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intruder mediation by antibodies
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HUMOURAL immunity
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immunity conferred by Tcells etc
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CELLULAR immunity
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2 main classes Tlymphocytes
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CD4s assist others, CD8s kill directly
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3 types of antigen presenting cells
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dendritic(skin), macrophages, langerhans
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to activate Tcells, antigen must be
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cell-bound
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distinguish self from non-self
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major histocompatibility protein (MHP)
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two types of MHP & locations
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Class I - all cells, Class II - ONLY antigen presenting cells
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MHC protein recognition
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CD4s recognize class II, CD8s only class I
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cytokine, source activates Bcells
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interleukin produced by Type2 CD4s
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cytokine source - activates macrophages
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Interferon Gamma, produced by Type1 CD4s
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macrophage activation results
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increased size, lysosomal enzymes, ability to digest/kill, secretion of growth factors(endothelial cells, fibroblasts), hydrolytic enzymes
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macrophages kill what and how
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tuberculosis, parasites, fungi, tumour cells, organ transplants - via direct lysis or phagocytosis
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CD8s kill antigens how
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proteolytic enzymes -- osmotic lysis
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CD8s mostly kill
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virus infected cells, tumour cells, organ trans (non-self)
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viral destruction in liver problem
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CD8s kill HepB infected liver cell, destroy liver tissue
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stimulates scar repair in chronic inflam
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activated macrophages secrete growth factors
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scar tissue repair- what two celltypes prolif?
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fibroblasts(collagen) endothelial cells (angiogenesis)
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young vs. old scar tiss.
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collagen incr. over time, incr. density. vessels, fibroblasts decrease over time
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purpose of vessel dev. - scar tissue
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bring nutrients to dev. tissue
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Type I hypersensitivity mediated by Ig?
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IgE
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What is Type I hypersensitivity?
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allergy - rapid immune reaction w/in minutes
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2 cell types central to Type I hypersensitivity
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mast cells and basophils
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mast cells - what and where
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from marrow, wide dist. in body, esp. around nerves, vessels, subepithelial where Type I reacts occur
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Mast cells/basophils activated how?
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crosslinking IgE receptors
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diff btwn mast cells and basophils
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basophils in blood, small numbers
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type of helper cell assoc. w Type I hypersens
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Type 2 CD4s
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What is produced by Type 2 CD4s
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Interleukins 4 and 5
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genetic predisposition to type 1 hypersensitivity called
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atopic disease (allergy) IgE diseases
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hay fever also known as
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allergic rhinitis
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other IgE mediated diseases
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asthma, dermatitis, gastrointestinal food allergy
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released upon exposure to allergen?
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histamines, leukotrines
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SRS-A
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slow-reacting substance of anaphylaxis
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ECF-A
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eosinophil chemotactic factor of anaphylaxis
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type 1 mediators act on what?
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vessels, sm. musc, secretory glands
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Type 1 mediators cause what?
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edema, cellular infiltrate, clinical features of allergy
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common in blood/nasal secretions during attack
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eosinophils
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IL4 is what
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IgE switch factor, produced by Th2, activates Bcells
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HDN is what
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hemolytic disease of newborn - Rh incompatibility
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HDN example of what type hypersensitivity
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Type II
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Antigen for Rh also called what
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D
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produced in mother in HDN following second child?
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IgG antibodies, which cross placenta
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problem with IgG crossing placenta?
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attack fetal erythrocytes
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result of IgG placental crossing
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hemolytic anemia of fetus
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natural antibodies reactive with AB blood groups
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IgM - can’t cross placenta
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2 examples of Type II hypersensitivity
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organ rejection, myasthenia gravis
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define RA (rheumatoid arthritis)
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chronic systemic inflammatory autoimmune disease of the joints
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what histocompatibility complex assoc. with rheum arth
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HLA-D4, and HLA- DR4
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etiology of RA
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unknown
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what are rheumatoid factors
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immunoglobulins specific for FC fragment of IgG - an antibody against ones own antibody Immunoglobulin
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2 examples Type III hypersensitivity
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serum sickness, arthus phenomenon
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inflammatory factors associated with rheumatoid arthritis
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histamine release, cytokine production (neutrophils, monocytes), white cells to synovial space
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problem with inflammation of joints
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tissue destruction, more lysosomes released
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define pannus
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vascular mass of lymphocytes around area of necrosis where bone and cartilage have degraded
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progression of rheum arth causes
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fusion of articular surfaces, dehabilitation, fibrous granulomar replacement of bone and cartilage
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cause of tuberculosis
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mycobacterium tuberculosis (or mycobac.T.bovine)
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TB is what type of hypersensitivity disease
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Type IV
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most common site of TB infection
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lungs, but can be anywhere
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TB inflammation type
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focal granulomatous with central caseous necrosis
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what helped prevent widespread TB during orig outbreak
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invention of pasteurization, milk pasteurizing
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tuberculosis vaccine
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BCG - bacille Camette Geurin
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Test for TB
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PPD purified protein derivative
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type of hypersensitivity reaction in TB
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delayed 24 - 72 hr Type IV reaction
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contact sensitivity
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delayed hypersensitivity to chloride or nickel salts, also type IV
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exogenous infection
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from exterior
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endogenous infection
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from interior - ones own flora attacking system
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3 methods of infection
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direct contact, ingestion, innoculation
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how well an organism can produce symptoms
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pathogenicity
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how severe symptoms are that are prod. by organism
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virulence
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poisons secreted by bacteria
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exotoxins
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examples of 3 exotoxins
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diptheria, tetanus, enterotoxin
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diptheria pathology
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sore throat - death. destroys epithelium and mucous memb, leaving fibrous necrotic tissue, esp. in throat.
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tetanus pathology
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neurotoxin, interrupts motor nerve signals, causes spasm
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enterotoxin
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food poisoning - staphylococcus
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endotoxins released when
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when bacteria destroyed
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3 bacterial metabolic examples - contrib. to disease
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hyaluronidase, streptokinase, coagulase
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metabolite - dissolves conn. tissue
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hyaluronidase
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metabolite - demineralizes tooth enamel
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plaque acid
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metabolite - breaks down fibrin
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streptokinase
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metabolite, breaks down DNA
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streptoadornase
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3 examples where foreign organisms multiply - prod. inflammation
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shigellosis(dysentry), Salmonella Typhi (Typhoid Fever), Spirochete(necrotizing ulcerative gingivitis)
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organism in bloodstream from infection called
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bacteremia
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another name for blood poisoning
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sepsis
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3 main factors - infection resistance
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patient factors(immunity, nutrition, biochem, secretions), organism virulence, site of infection, level of blood supp.
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atrophy caused by plasma protein deposition in tissue
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amyloidosis
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rhesis prophylaxis
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Anti-D given to mother after birth, leaves her desensitized for subsequent childbirth
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autoimmune disease where antibodies clog acetylcholine receptors
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myasthenia gravis - causes generalized muscular weakness
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chronic inflammatory disease of bowel
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crohns disease - alternating ulcers of GI tract
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How to identify granuloma
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multinucleated giant cells
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chronic rheumatic fever can lead to risk of
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infective endocarditis - heart valve deformity, incompetency
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asthma
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mast cell histamine release-mucous hypersecretion-more goblet cells - bsmt. memb. thickening-sm. vessel constriction
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5 HIV related infections
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fungus in meninges, cytomegalovirus - gigantic langhans cell, lung yeast infection, carposis sarcoma, lymphoma
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2 processes in wound healing
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regeneration or replacement
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cell entry to tissue via
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regeneration
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proteins that regulate cell cycle
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cyclins
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3 types proliferative potential states in cells
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labile, stable, or permanent
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continuously regenerating cells
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labile, from stem cells, eg: marrow, epithelia
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cells which can but don’t normally divide
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stable- divide if injured, eg: liver, fibroblasts, sm. musc
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cells which can’t divide
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permanent - skeletal musc, cardiac, neurons
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cycle stage cells at
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G0 - resting(quiescent)
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matrix btwn cells - origin, composition
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interstitial matrix:fibroblasts-amorphous gel, collagen, elastin, proteoglycan, glycoproteins
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bsmt membrane composition
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platelike mesh, type IV collagen, glycoproteins
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extracellular matrix active in tissue repair how
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mech support, determine orientation, control regulate growth and differentiation, pres: regulatory molecules
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collagen - describe
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fibrous structure proteins from fibroblasts Xlink by VitC in triple helix
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source of cell growth factors
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activated macrophages
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3 examples growth factors
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epidermal, fibroblast, cytokines
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4 steps in scarring
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angiogenesis, fibroblast mig., prolif, deposition of matrix, maturation, reorganization of fibrous tiss.
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basic substrate extracell. matrix forms on and timing
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granulation tissue at abt. 3 days
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mature scars are?
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avascular
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char. of first intention healing
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more epithelial regen than fibrosis
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1st intention - process
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neutrophils, mitosis; epithelial migration, new bsmt memb.; macrophages, granulation tissue, collagen fibres; epidermis - collagen fibre bridge
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char. of 2nd intention healing
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fibrosis rather than epithelial regen
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example 2nd intention
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ulcer (eg Diabetes)
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process 2nd intention
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big inflamm. reaction, lots of granulation tissue, wound CONTRACTS
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3RD intention
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delayed closure to allow some natural disinfection
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exuberant collagen production in 1st intention wound
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keloid
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types of factors effecting healing
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local(infection, foreign body, blood supp, temp.) Systemic(immunosup.,vasc.disease, nutrition, alcohol)
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