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102 Cards in this Set
- Front
- Back
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mast cell activation
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b-cell activated -> IgEs secreted -> binds Fce R on mast cell
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type I HS: initial phase release
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histamine, tyrptase (C' system and clotting), chemotactic factors (ECF, NCF)
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type I HS: late phase release
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cytokines (TNFa, IL4), phospholipase A2 releases PAF (clotting), leukotrienes (C4,D4,B4), prostaglandin D2 (bronchospasms)
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type I HS: leukotrienes
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C4/D4: vasoactive, spasmogenic; B4: chemotactic agent for inflam cells
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type II HS: results in these mechanisms:
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complement dependent rxns (lysis or phagocytosis); cell mediated cytotoxicity (apoptosis via NK cells); Ab-mediated cell dysfxn (Ab disrupts surface -> cell dysfxn)
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autoimmune hemolytic anemia
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type II; Ab against RBCs -> lyse RBCs
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pemphigus vularis
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type II; IgGs against desomosme attachments -> easily ruptured blisters
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bullus pemphigoid
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type II; Abs against hemidesmosomes -> blisters that don’t rupture easily
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goodpasture disease
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type II; Abs against collagen IV -> BM destruction -> interstitial pneumonia (lungs) or glomerulonephritis (kidney)
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myasthenia gravis
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type II; Ab agsinst Ach R -> no muscle response
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grave's disease
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type II; stimulatory Ab against TSHR -> hyperthyroidism
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burton's x-linked agammaglobulinemia (mech, diagnosis)
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defect in BTK gene -> no mature B-cells; resp infections from encapsulated bact; no germinal centers; diagnosis via flow cytometry
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isolated IgA deficiency
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defect in B-cell differentiation -> no IgA -> lots of IgG -> allergy prone
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X-linked hyper IgM deficiency
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non fxnal CD40L on T cells -> no B-cell differntiation -> lots of IgM only; infections w/ pyogenic bact; no germinal centers
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DiGeorge syndrome
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underdeveloped thymus -> no mature T cells -> B cells affected; low ears, fish mouth; pneumocystis
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common variable immunodeficiency
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no symptoms until age 15-35
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adenosine deaminase deficiency
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no ADA -> lymphoid stem cells don’t differentiate -> low in both B and T cells
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severe combined immunodeficiency: 2 forms?
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x linked form: mut in gamma chain of IL-2 R -> no mature T-cells; autosomal recessive form: ADA or HLA class I/II deficiency
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wheezing vs crowing?
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wheezing= bronchospasms; crowing = laryngeal edema
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na-bisulfate
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anti oxidant in LA; can be cause of allergy
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epi dose for bronchodilation
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0.3-0.5 mg (1/3 to 1/2 of 1:1000 cartridge)
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monocytotropic strain of HIV
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R5: seen in mucosal transmissions; eventually switches to X4
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lymphocytotrophic strain of HIV
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X4: seen in blood related transmissions; more virulent
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APOBEC3G
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host protection against HIV; creates nucleotide errors; attacked by HIV's vif protein
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tetherin
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host protection against HIV; prevents HIV release; attacked by HIV's vpu protein
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hiv diagnosis
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elisa, western blot, p24 antigen test, PCR (viral load only), trofile/tropism assay (which strain?)
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toxoplasmosis
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parasite causes encephalitis; CT/MRI shows Abs in brain
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3 families of retroviruses
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oncovirinae (cancers); lentivirinae (immunosuppression e.g. HIV); spumavirinae
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tax/tat
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viral txn
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rev/rex
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exports viral rna from the nucleus
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nef
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downregulates MHC
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HTLV co-R
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glut-1 and neurphilin 1
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preintegration complex
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integrase bound to 2 LTR regions of HIV dsDNA for chromosome insertion
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HAART
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HIV therapy; drug that targets RT+ drug that targets proteases
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stem-cell therapy
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give someone cells w/ CCR5 mutation
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HTLV
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spreads via cell-cell contact; tax encourages proliferation; can cause T cell leukemia
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herpesvirus genome
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linear dsDNA
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EBV
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infects B cells (B-cell lymphoma), infects epithelial cells (hairy leukoplakia); latent phase caues mono-like symptoms
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EBNA1 gene
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gene expressed during latent phase of EBV -> genome stability
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KSHV (HHV8)
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latency in b-cells (primary effusion lymphoma) and endothelial cells (Kaposi's sarcoma)
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LANA gene
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gene of KSHV promoting cellular proliferation and genome stability
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CMV
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disease caused by lytic cycle; large nuclear inclusion bodies on smear; causes blindness, retinitis; tx=gancyclovir
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histamine Rs
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H1: GPCR for vasodilation, bronchoconstriction, itching; H2: cAMP increase -> gastric acid secretion; H3: decrease NT release
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HA: alkylamines
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ends in maleate
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HA: ethanolamines
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benadryl, dramamine, doxylamine succinate
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HA: piperazines
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zyrtec; atarax (alcohol w/drawal)
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HA: pehenothaiazines
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promethazine, hydrochloride (used w/ general anesthesia)
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antihistamine limitation
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don’t relieve bronchospasms from asthma and anaphylaxis
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antihistamine adverse effects
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block mAch Rs -> CNS depression -> dedation, uncoordination, dry mouth, dizziness
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antihistamine in dentistry
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for allergic lesions in oral mucosa; used in tx of orofacial angioedema
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hereditary angioneurotic edema
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C1 esterase inhibitor deficiency -> bradykinin production -> capillary leakage -> chronic angioedema
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contact dermatitis: HS type?
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type IV; contact stomitis is in mouth (rare)
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2 types of drug allergies
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type A: predicatble and dose dependent; B is opposite
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COX1
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reguation of renal system; maintain mucosa integrity of stomach
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COX2
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inflammation
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only COX inhibitors that can be used for anti-inflammatory fxn?
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ibuprofen and naproxen (COX1)
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only COX2 inhibitor still used
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celecoxib (COX2 inhibs stronger, but more toxic than COX1)
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MARD: avara: side effect
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serious birth defects
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MARD: gold compounds: side effects
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lesion of mucous mbs (e.g. stomitis); blood dyscrasia
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GC uses in dentistry
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use for traumatic ulcers, stomattis, TMJ disorders, pulpal hypersensitivie, post-op complications, allergic rxns; DO NOT use for herpetic gingivostomatitis
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most common GCs used in dentristry
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prednisone and methylprednisone
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taper pt off GCs bc…
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supresses adrenal fxn -> cant make cortisol in response to stress -> acute adrenal crisis and hypotension risk
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for pt on GCs coming in for routine dental care
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double or triple pt's dose
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for pt on GCs coming in for major dental procedures…
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8 hrs before: IM of 100 mg cortisone acetate; during procedure: 300 mg of hydrocortisone; corticosteroid dosage tapered off over 2-3 day period
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Ab's abilities to actiavte C' system
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IgM > IgG > IgA
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3 phases of type III HS
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1: AB complex binds endothelial cells; 2: activates C' system (chemotactic Fs + edema); 3: neutrophils cause necrosis -> fibrin deposition to repair
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post streptococcal glomerulonephritis: HS type?
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type III
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graft rejection direct/indirect pathway
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direct: donor APCs, CD4+8, quick systemic rxn; indirect: self APCs, CD4, local chronic rxn
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t-cell activation mechanism
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TCR -> Ca binds calcineurin -> NFATc -> IL2 gene txn -> T-cell clonal expansion
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T-cell suppression drugs in transplant pts
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cyclosporin and tacrolimus
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3 means of peripheral tolerance
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fas (on t-cell) binding fasL (on e..g brain) -> apoptosis; strong binding w/ no B7 -> anergy; regulatory t-cells (testing self antigens)
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mycoplasma infection
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molecular mimicry: similar epitopes -> Abs formed against RBCs -> RBC lysis -> AI hemolytic anemia
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mixed essential cryoglobulinemia
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type III; occures in cold -> IgG complexes formed -> systemic vasculitis
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type I diabetes
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type IV HS; CD8 t cell attacks B cells of pancreas
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rheumatoid arthritis
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type IV; CD4 t-cells enter synovial space -> activate macrophates -> TNFa and IL6 released -> MMP (attacked tissue) and RANKL (osteoclasts) produced
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multiple sclerosis
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type IV; t-cells attack white matter (microglia cells) -> Abs made -> demyelination of neurons
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scleroderma
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tight skin; CD4 against self antigen in skin -> mast cells and macrophages activate fibroblasts -> fibrosis
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systemic lupus erythematosus
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defective clearance of nuclear antigens from apoptosis -> antinuclear Abs (ANAs) made -> complexes form and lodge in organs; Abs eventually made against RBCs; begins at type III, then type II; presents w/ butterfly rash and renal failure
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sjogren's disease
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CD4 and B cells enter salivary and lacrimal glands -> gland dysfxn
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amyloidosis
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protein material in tissue; in MM see light chain deposits; in alzheimers see tangle deposits
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oncogene: K-ras
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point mutation; constant activation w/ no GF present
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oncogene: HER2/neu
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amplification; GFR; breast cancer
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tumor suppresive gene: retinoblastoma
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E2F; prevents cell cylcle progression
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tumor suppressive gene: P53
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sense damage -> binds P21 -> CDK/cyclin -> cell cyle arrest -> repair/apoptosis
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herditary non polyposis colorectal cancer
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cause dby mutaitons in mismatch repair genes (MLH, MMR)
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clinical uses of acyclovir
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not CMV, not for primary oral herpes
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penciclovir
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topical cream for RHL; long 1/2 life; inhibits viral dna polymerase
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famciclovir
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oral pro-drug for RHL converted into penciclovir in the liver
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ganciclovir
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used on CMV, best tx for CMV retinitis
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cidofovir
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used on CMV when ganciclovir resistance is developed
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zidovudine (AZT)
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Anti HIV agent; blocks RT; activated by host TK -> chain termination
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saquinovir
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anti HIV agent; HIV protease inhibitor -> block viral replication
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components of atripla
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efivirenz, emtricitabine, tenofovir
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oseltamir and zanamir
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anti influenza agents; act by inhibiting neuraminidase -> inhibits viral relase from cells
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tenofovir
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anti hep B agent; prevents HIV in women; part of atripla
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anti-hep B agents
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tenovofir, lamivudine (also an anti HIV agent), entecavir (most potent), telbivudine)
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gardasil
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HPV vaccine against HPV 6,11,16,18; cervaris acts against HPV 16,18
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important genes/cytokines/effectors for eliminating cancers
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STAT1 and RAG1 (genes); perforin, gamma-delta T cells, interferon gamma and alpha
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cytokines that dampen the effects of T-cells
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TGF-Beta and IL-10
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activating/inhibitory co-stimulatory molecules of tumor immunity
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B7 and CD40L (activating); CTL4 (inhibitory
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type A IEL
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alpha-beta TCR; CD8 is alpha-beta heterodimer
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type B IEL
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alpha beta or gamma delta TCR; CD8 is alpha-alpha homodimer; can be activated by micA and micB
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