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60 Cards in this Set

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Major HLA types
A B C D
B27 associated with
Acute anterior uveitis
ankylosing spondylitis
Reiter's syndrome
DR4 associated with
rheumatoid arthritis
diabetes-insulin dep
DR3 associated with
Sjogren's
Graves
SLE
diabetes- insulin dep
(1) Major systemic APC
(2) Major ocular APC
(3) Main ocular phagocytic cell
(1) macrophage
(2) Langerhans cells -non-(3) macrophage derived
PMNs
Importance of Langerhans cells being non-macrophage derived
leads to the Ab response that avoids activation of eosinophils, mast cells, basophils, etc. which can harm the epithelium
Macrophages are not found in the eye?
T or F
F
found in reduced numbers
Characteristics of macrophages in the eye
(1) do NOT produce IL-12 (IFN-gama stimulator to cell killing)
(2)do NOT express CD40
(3)DO express high levels of TGF-B( down regulates inflammatory side)
Tears contain Ig_?
IgM
IgG
IgA
Major presence of Ab in tears is________ which is produced in the ____________.
SIgA
Lacrimal gland
__________reduce the production of SIgA and _______is required for the production of secretory component.
Androgens
insulin
Cornea contains lymphatics and vascular supply.
T of F
False
Cytokines present in the eye.
IL-1
IL-6
IL-8
IL-10
IL-___ important in that over action results in corneal melting.
IL-1
IL-___ important in that is allows for clearance of herpetic lesions
IL-10
Present of all ocular T-cells and results is ______.
FAS ligand
apoptosis
Over action during wound healing results in chronic ulceration.
MMPs
IL-1 also elevated
Dry eye causes up regulation of____ need to treat with _____.
IL-1
Restasis
NK cells are inactivated in this area. High levels of TGF-B are present of keep ______ out.
Anterior chamber
T-cells
Implicated in capsular opacitication post-surgery.
TGF-B
Key immune players in the retina but do NOT express MHCII of produce IL-1.
T-cell down regulated and FAS is present.
Mueller cells
MMPs
MMM-9 are indicated in ___________.
Diabetic Ret.
Angioenic factor
VEGF
(vascular endothelial growth factor)
Antiangiogenic factor
PEDF
(pigment epithelium derived factor)
Important in controlling neovascularization.
Balance of VEGF and PEDF
Predominate Ab with 1st exposure until _______ is produced _________ days later.
IgM
IgG- produced 7-14 days after
Predominate Ab with 2nd exposure due to _________.
IgG due to sensitized B-cells.
IgM same.
Ocular disease associated with Type I (IgE/Mast cell/Basophils)
Acute allergic conjunctivitis
Ocular disease associated with Type II (Ab-dep)
Stevens-Johnson syndrome
Ocular disease associated with Type III (I-C medicated)
Arteritis
marginal ulcers
Ocular disease associated with Type IV (cell cytotoxicity mediated)
GPC
A tissue or organ system that has become so specialized in its cellular structure that it is no longer recognized as "self" by normal immune cells and therefore must be shielded from the body's immune mechanisms
Immune Privilege
Examples of ocular structures that have immune privilege
A/C
subretinal space
RPE
vitreous
Lymphatics are present and vascular elements are NOT tight-junctioned in structures of the eye with immune privilege.
T or F
False
Venous drainage of the eye forces ________ to the spleen and leaves an __________response instead of an ______________ response.
antigens
antibody
inflammatory
If an area has immune privilege, an immune response ____________ develop.
WILL but with time
Y402H gene and ________ are strongly correlated (50%).
Macular degeneration.
Y402H gene will be activiated if ________ is mutated.
complement factor H (CFH)
Leads to complement activation and drusen.
mutated complement factor H (CFH)
The CFH protein can be modified by_________ and elevated level of _________.
smoking
C-reactive protein (CRP)
Activation of complement causes
cell lysis
inflammation
Inflammation and hypoxia cause the release of ________ from BV and disrupts the balance of __________ and leads to ______________
VEGF
VEGF/PEDF
neovascularization
Complement factor H roles
(1) decreases the activity of the alternate complement pathway
(2) bind to heparin
(3) bing to C-reactive protein (CRP)
(4)bind to appropriate receptors on retina
Spring Allergies
flowering grass (bermuda, timothy)
ornamental flowers
NOT Pine pollen (too big)
Fall Allergies
Ragweed
(NOT Goldenrod which is taller)
Year-round allergies
Animal saliva
Dander
Dust mites
(10% pillow wt if replaced by dust mite droppings each year YUUUCCCKKKKKKKKK)
3 types of Mast Cells
(1) Chymase (+)
(2) Tryptase (+)
(3) Chymase (+) and Tryptase (+)
Most common Mast cell on ocular surface.
Tryptase (+)
Degranulation of Tryprase (+) causes:
(1) degranulation and release of histamine and heparin
(2) chemotactic factors for eopsinphils, leukotrienes, & platelet activating factor
(3) mediator in 2 attract more inflammatory cells and enhance degranulation
Mast cell process
(1) IgE to antigen
(2) complex links receptors on mast cell (priming)
(3)elevate cGMP= degranulation by elevate production of phospholipase A2
(4) begins arachidonic acid cascade
Effect of histamine
decrease degranulation by INCREASING cAMP
Effect of B-adrenergics
decrease degranulation by INCREASING cAMP
Effect of prostaglandins
decrease degranulation by INCREASING cAMP via cyclase
Effect of phosphodiesterase inhibitors
STOP conversion of cAMP to 5'AMP
Effect of alpha-agonist
Increase cGMP which increase degranulation
Effect of cholinergics
Increase cGMP which increase degranulation
Effect of steroids
(1) shuts down mRNA production of phosphodiesterase A2
(2) which reduces amt arachidonic acid produced
(3) increase cAMP levels and stabilize the cell
(4) AA cascade reduced LT & PG & chemotactic factors
(5) BV constrict
(6) chemotaxis inhibited
Immune function and macrophage activity is reduced by ____________.
Steroids
What is the Conjunctival Challenge?
Test by the FDA to determine whether or not a new drug has the ability to combat allergic responses. use of baseline rxn against drug.
Factors graded on the conjunctival challenge.
(1) redness
(2) watering
(3) chemosis