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66 Cards in this Set
- Front
- Back
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First Line of Defense
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Physical and mechanical barriers
Skin Linings of the gastrointestinal, genitourinary, and respiratory tracts Sloughing off of cells Coughing and sneezing Flushing Vomiting Mucus and cilia Biochemical barriers Synthesized and secreted saliva, tears, ear wax, sweat, and mucus Antimicrobial peptides Normal bacterial flora |
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Second Line of Defense
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Inflammatory response
Caused by a variety of materials Infection, mechanical damage, ischemia, nutrient deprivation, temperature extremes, radiation, etc. Local manifestations Inflammatory response Vascular response Blood vessel dilation, increased vascular permeability and leakage, white blood cell adherence to the inner walls of the vessels and migration through the vessels |
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Inflammation
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Goals
Limit and control the inflammatory process Prevent and limit infection and further damage Initiate adaptive immune response Initiate healing |
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Cellular Mediators of Inflammation
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Cellular components
Granulocytes, platelets, monocytes, and lymphocytes Cell surface receptors Pattern recognition receptors (PRRs) Pathogen-associated molecular patterns (PAMPs) Toll-like receptors Complement receptors Scavenger receptors |
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Mast Cells
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Cellular bags of granules located in the loose connective tissues close to blood vessels
Skin, digestive lining, and respiratory tract |
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Mast Cells Activation
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Activation
Physical injury, chemical agents, immunologic processes, and toll-like receptors Chemical release in two ways Degranulation and synthesis of lipid-derived chemical mediators |
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Mast Cells Degranulation
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Histamine
Vasoactive amine that causes temporary, rapid constriction of the large blood vessels and the dilation of the postcapillary venules Retraction of endothelial cells lining the capillaries Receptors H1 receptor (proinflammatory) H2 receptor (anti-inflammatory) Chemotactic factors Neutrophil chemotactic factor Attracts neutrophils Eosinophil chemotactic factor of anaphylaxis (ECF-A) Attracts eosinophils |
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Histamine
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Receptors
H1 receptor Proinflammatory Present in smooth muscle cells of the bronchi H2 receptor Anti-inflammatory Present on parietal cells of the stomach mucosa Induces the secretion of gastric acid |
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Mast Cell Synthesis of Mediators
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Leukotrienes
Product of arachidonic acid from mast cell membranes Similar effects to histamine in later stages Prostaglandins Similar effects to leukotrienes; they also induce pain Platelet-activating factor Similar effect to leukotrienes and platelet activation |
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Mononuclear Phagocyte System
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Located in strategic places throughout
Microglia Alveolar macrophages LUNGS Kupffer cells LIVER Kidney mesangial cells KIDNEY Histiocytes LOOSE CONNECTIVE TISSUE Lymph nodes LYMPH |
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2e line of defense = Inflamatory
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NOn specific; no specific cells/ antibodies. Can be cut or bacteria.
Does not have a memory Stereo typic; reaction same every time again Cascade effect; Has to be completed step 1 - 5 |
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4 Cardinal Signs of Inflammation
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redness
heat swelling Pain |
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Inflammation Response
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-Blood vessel dilation
Increased permeability + leakage WBC move to outside rim of bloodvessel and attracht certain cells to area |
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1st to arrive in inflammatory system
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Neutrophills, granular WBC Predominant Phagocytes. Arrives within 6 - 12 hrs The neutrofill is short lived, becomes component of purulent exudate. Removed through epitheliam or lymphatic system
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Complement factor that initiates Neutrophils
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C3a and C5a
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Ulcerative colitis is ?
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Ulcerative colitis is not transmural. It involves the mucosa layer and in some cases the submucosa. Ulcerative colitis is characterized by continuous lesions in the distal colon and the rectum.
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T-helper cells are also known as
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There are two types of helper cells both of which are CD 4+.
T helper cells 1 are increased or overactive in delayed hypersensitivity reaction and produce chemical mediators that stimulate T killer cells. T helper 2 cells are overactive in allergies. T helper 2 stimulates production of Ig E's. CD 8+ cells are T cytotoxic cells (killer) and T suppressor cells. |
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The HLA genes are located on chromosome./?
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The HLA genes are located on chromosome 6.
The MHC region is divided in Class 1 and Class 2 HLA genes. HLA A, B, and C are class one MHC proteins. HLA D proteins are class 2. HLA A, B, and C are found on all nucleated cells in the body. HLA D on B cells, macrophages and memory cells. |
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Class 1 MHC proteins present to CD........
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Class 1 MHC proteins present to CD8+ cells
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CD4 cells must be presented an antigen with a class .........
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CD4 cells must be presented an antigen with a class 2 MHC protein.
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Crohn's disease is characterized by
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Crohn's disease is characterized by discontinuous or skip lesions. One of the ways to make a differential diagnosis of Crohn's disease is to look for discontinuous lesion in the ileocecal area
Crohn's disease is transmural. It spreads thru lymph tissue and across the entire wall of the intestine and it can spread to other organs. This causes the formation of fistulas |
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Ig ???????? is small in size and crosses the placenta to confer passive acquired immunity to the fetus and the newborn.
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Ig G is small in size and crosses the placenta to confer passive acquired immunity to the fetus and the newborn.
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Ig ??????? is the first antibody to increase in an immune challenge
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Ig M is the first antibody to increase in an immune challenge
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IgE + Eosinifills fight off parasites
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IgE + Eosinifills fight off parasites
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Ig ???????? is the secretory antibody. It is found bound to mucosa cells and in secretions such as tears, saliva and G.I. fluids. It is a dimer and also contains a secretory piece.
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Ig A is the secretory antibody. It is found bound to mucosa cells and in secretions such as tears, saliva and G.I. fluids. It is a dimer and also contains a secretory piece.
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There are only two types of light chains Kappa and lambda. There are five classes of antibodies and five different Heavy chains which are class specific.
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There are only two types of light chains Kappa and lambda. There are five classes of antibodies and five different Heavy chains which are class specific.
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HLA B27 is associated with increased incidences of Crohn's and Ulcerative Colitis True. A large number of patients with inflammatory bowel disease have the HLA marker known as B27. It is seen in larger numbers than in these patients than in the general population.
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HLA B27 is associated with increased incidences of Crohn's and Ulcerative Colitis True. A large number of patients with inflammatory bowel disease have the HLA marker known as B27. It is seen in larger numbers than in these patients than in the general population.
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Type two hypersensitivity reactions are also known as tissue specific reactions. True These are also known as cytotoxic reactions and are directed against mainly red blood cells. Autoimmune hemolytic anemia's , Rh incompatibilities, Autoimmune Graves Disease and myasthenia gravis are type 2 reactions.
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Type two hypersensitivity reactions are also known as tissue specific reactions. True These are also known as cytotoxic reactions and are directed against mainly red blood cells. Autoimmune hemolytic anemia's , Rh incompatibilities, Autoimmune Graves Disease and myasthenia gravis are type 2 reactions.
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Addison's disease is a type ??????? reaction.
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Addison's disease is a type III reaction and is a type of hypoaldosteronism.
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Xanthine derivatives such as theophylline are classified as phosphodiesterase inhibitors. True.
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They work by blocking the enzyme phosphodiesterase which is used to break down c- AMP. If the enzyme is blocked than c- AMP levels increase and bronchial smooth mucle will relax.
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Poison ivy is an example of a Type ?????????
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Poison ivy is an example of a Type IV delayed hypersensitivity reaction. It is mediated by T killer cells not antibodies.
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Ig M is a pentamer. True/ False
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It is composed of five basic antibody units joined together. It is the largest in molecular size and the first antibody to increase during an immune challenge.
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The inflammatory reaction is sterotypic and has no memory.
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The Immune system system has memory cells and is specific.
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Ig ?????_ and _??????_ can bind complement.
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Ig G_ and _M_ can bind complement.
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Complement factors are a series of 9 - 11 plasma proteins that belong to the _???????? globulin fraction.
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Complement factors are a series of 9 - 11 plasma proteins that belong to the _Beta_ globulin fraction.
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C3b and C5b are complement factors that act as ??????
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C3b and C5b are complement factors that act as opsonins
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The mediator of the immediate (first 30 min.) permeability changes in inflammation is _??????????__.
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The mediator of the immediate (first 30 min.) permeability changes in inflammation is _Histamine__.
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In type one diabetes mellitus there is an over activity in the T helper cell ???????
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In type one diabetes mellitus there is an over activity in the T helper cell one..
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Microglia, Langerhan cells, and Kupffer cells are _ ???????
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Microglia, Langerhan cells, and Kupffer cells are _ macrophages
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The part of an antigen that is recognized as being foreign is called the _??????
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The part of an antigen that is recognized as being foreign is called the _epitope
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The major antigen processing cell is a _???????? ___.
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The major antigen processing cell is a _macrophage ___.
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Degranulation of _????? cells is the process by which Type I immediate hypersensitivity are mediated. These cells have Fc receptors for the Ig 0_?????? class.
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Degranulation of _Mast_ cells is the process by which Type I immediate hypersensitivity are mediated. These cells have Fc receptors for the Ig _E class.
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Isohemagglutinins such as anti - a and anti- b belong to the Ig. _???????__ class
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Isohemagglutinins such as anti - a and anti- b belong to the Ig. _M__ class
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. In asthma the expiratory phase of ventilation is prolonged and more difficult
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. In asthma the expiratory phase of ventilation is prolonged and more difficult
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Epinephrine is classified as a sympathoMIMIC and it is (nonselective ).
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Epinephrine is classified as a sympathoMIMIC and it is (nonselective).
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Alupent is classified as a ?????
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Alupent is classified as a noncatacholamine Beta two selective adrenergic bronchiodilator.
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diapedisis
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Movement of White blood cells out of a blood vessel is called diapedisis and is an active process.
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Myasthenia gravis is a Typ??????_ reaction that is caused by an anti ACH receptor antibodies.
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Myasthenia gravis is a Type II__ reaction that is caused by an anti ACH receptor antibodies.
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Graves disease is a Type ?????_ reaction that results in hyperthyroidism due to production of an antibody called a long acting thyroid stimulators
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Graves disease is a Type II_ reaction that results in hyperthyroidism due to production of an antibody called a long acting thyroid stimulators
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Serum sickness is a Type ?????? reaction which is caused by exposure to antibodies formed in response drugs make in non human hosts .
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Serum sickness is a Type III_ reaction which is caused by exposure to antibodies formed in response drugs make in non human hosts .
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SLE Systemic lupus erythematosus is a type _?????? immune complex reaction
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Systemic lupus erythematosus is a type _III_immune complex reaction
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Type I diabetes mellitus is a type ???? delayed hypersensitivity reaction that is mediated by _T killer cells .
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Type I diabetes mellitus is a type IV delayed hypersensitivity reaction that is mediated by _T killer cells .
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SLE can cause damage to ??????????
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SLE can cause damage to brain, liver, kidney, heart, and joints
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Standard treatment for Crohn's disease includes ?????
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Standard treatment for Crohn's disease includes corticosteroids, antibiotics and aminosalicylates. Also Infliximab which is a monoclonal antibody and cytotoxic drugs such as azathioprine.
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A string intestine seen on an x-ray usually indicates _ ??????
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A string intestine seen on an x-ray usually indicates _ Crohn's disease.
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Granulomatous lesions are common in _??????
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Granulomatous lesions are common in _Crohn's disease
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Toxic megacolon is more common in Ulcerative colitis or Crohn's disease
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Toxic megacolon is more common in Ulcerative colitis
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Discuss molecular mimicry.
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Discuss molecular mimicry. A self antigen is attacked by an ab against a foreign antigen which looks very similar to structure to the self antigen. It is usually a post infectious complication where the self antigen and the foreign antigen are so similar in epitope regions that the antibody can not tell them apart
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Acute pancreatitis is most commonly caused by ???????
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Acute pancreatitis is most commonly caused by alcoholism and other biliary diseases_.
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Fat necrosis in Acute Pancreatitis is caused by increased activation of the enzyme ?????
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serum lipase
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. Inactivation of surfactant in the lung is due to increased levels of
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serum phospholipase
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Adult respiratory distress syndrome ARDS is some times associated with
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Acute Pancreatitis
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Type I insulin dependent diabetes mellitus is highly correlated with HLA _???? and????? __
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Type I insulin dependent diabetes mellitus is highly correlated with HLA _Dr3_ and Dr4__
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What class of drugs used to treat asthma prevent mast cells degranulation?
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Cromolyn sodium
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Discuss theories on how autoimmunity may develop.
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Exposure of a sequestered antigen- a previously hidden self antigen enters the blood stream and the immune system response against it., formation of a neoantigen - a self antigen is mutated due to disease or cancer and it is treated as nonself, escape of a forbidden clone - a clone against self is not destroyed during development and it becomes active against the self antigen, and molecular mimicry (a.k.a postinfectious complications) a foreign antigen looks like a self antigen and an antibody or T cell reacts against the self antigen as if it were the foreign antigen. . Also some type of thymus problems which leads to an imbalance between T helper cells and/or T suppressor cells
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In Type I diabetes mellitus a Type IV reaction occurs first and this leads to a type II tissue specific disorder. True/Fals
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True. The first damage to occur is due to molecular mimicry and involves T killer cells. After damage by T killer cells some membrane proteins are exposed (exposure of a previously sequestered antigen ) and the B cells become activated and produce antibodies against the previouly hidden proteins. This is the part that is a type two reaction.
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