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134 Cards in this Set

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