2. Inflammation, Inflammatory Disorders, and Wound Healing Flashcards Preview

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Flashcards in 2. Inflammation, Inflammatory Disorders, and Wound Healing Deck (85):
1

What activates TLRs?

PAMPs

2

What is the TLR4 co-receptor on macrophages that recognizes LPS (gram negative bacteria)?

CD14

3

What is the role of prostaglandins (E2, D2, and I2)?

vasodilation and increased vascular permeability

4

What is the more specialized role of PGE2?

mediates Fever and Pain

5

What is the role of LTC4, LTD4, and LTE4?

Vasoconstriction, bronchospasm, increased vascular permeability

6

What are the 4 mediators of neutrophil migration?

LTB4
C5a
IL-8
Bacterial products

7

In what 3 ways are mast cells activated?

-Tissue trauma
-Complement C3a or C5a
-Crosslinking of cell-surface IgE by Ag

8

What are the actions of histamine?

Vasodilate arterioles
Increase vascular permeability (at post capillary venules)

9

What allows for delayed and prolonged response to histamine?

Leukotrienes

10

What can Hageman factor (Factor XII) lead to?

DIC (gram negative sepsis)

11

What are the roles of bradykinin?

Mediates vasodilation
Increased vascular permeability
Pain mediating

12

What causes the rubor and calor of inflammation?

vasodilation

13

What causes the tumor of inflammation?

increased vascular permeability and tissue damage

14

What causes the fever of inflammation?

Macrophages release IL-1 and TNF which increase COX activity from the hypothalamus and increase PGE2 to raise the temperature set point

15

What molecules lead to "rolling" of neutrophils?

selectins

16

From where are P-selectins released and what is the stimulus?

histamine causes release of P-selectin from Weibel Palade bodies

17

What induces the release of E-selectins?

TNF and IL-1

18

To what do selectins bind on leukocytes?

sialyl Lewis X

19

What molecules lead to adhesion of the leukocytes?

ICAM and VCAM (upregulated by TNF and IL-1)

20

What is the cause of Leukocyte adhesion deficiency?

AR defect of integrins (CD18 subunit)

18 yo LADs have no INTEGRity

21

Into what type of vessels do leukocytes transmigrate across?

postcapillary venules

22

What is the underlying problem in Chediak-Higashi Syndrome?

protein trafficking defect due to decreased microtubule system (so no phagolysosomes can be formed)

23

In the O2 dependent killing pathway, what defect will NOT show blue NBT dye?

Chronic granulomatous disease

24

What is the underlying cause of chronic granulomatous disease?

AR or XL NADPH oxidase defect

25

What type of bacterial infection is seen in chronic granulomatous disease?

Catalase Positive bacteria

26

List the most high yield catalase positive bacteria.

Staph Aureus
Pseudomonas cepacia
Serratia marcescens

27

In the O2 dependent killing pathway, what defect will show blue NBT dye?

MPO deficiency (because there is a normal NADPH oxidase)

28

What is the presentation of a patient with NADPH oxidase deficiency?

Candida infections (but mostly asymptomatic)

29

What happens to neutrophils post inflammation?

they undergo apoptosis

30

How do macrophages destroy phagocytosed bacteria?

enzymes (ex. lysozyme) in secondary granules that use O2 dependent killing

31

List the two anti-inflammatory cytokines released from macrophages during resolution and healing.

IL-10
TGF-beta

32

What cytokine released by macrophages recruits additional neutrophils for "continued acute inflammation"?

IL-8

33

What type of T cell recognizes MHC class I?

CD8+

34

What type of T cell recognized MCH class II?

CD4+

35

What is the secondary activation signal for CD4+ T cells?

B7 on APC binds to CD28 on the T cell

36

What is secreted by Th1 cells?

INF-gamma
IL-2

37

What is secreted by Th2 cells?

IL-4
IL-5
IL-13
IL-10

38

What is the secondary activation signal for CD8+ T cells?

IL-2 from CD4+ Th1 cells

39

How do CD8+ T cells kill cells?

Perforin makes pores, granzyme enters, activation of caspase, apoptosis

OR

Express FasL which binds to Fas on target cells

40

B cells present antigen to what kind of T cell?

CD4+ T cells

41

What is the second activation signal that B cells give to their CD4+ T cells?

CD40 on B cell binds to CD40L on T cell

42

What is the defining characteristic of granulomatous inflammation?

epithelioid histiocytes

43

What are the other two features of granulomas that are commonly seen (other than epithelioid histiocytes)?

giant cells and rim of lymphocytes

44

List the top 5 causes of noncaseating granulomas.

-Foreign material
-Sarcoidosis
-Beryllium exposure
-Crohn disease
-Cat-scratch disease (stellate shaped)

45

What do you immediately do when you see a caseating granuloma?

AFB for Tb
GMS for fungal infections
(differentiate between the two causes)

46

What is the first step a macrophage does to form a granuloma?

present antigen via MHC class II to CD4+ helper cell

47

What does a macrophage do after presenting antigen via MHC Class II to CD4+ helper cell?

secretes IL-12 to induce the CD4+ to differentiate into Th1

48

What do Th1 cells secrete to convert macrophages into epithelioid histiocytes?

IFN-gamma

49

What is the developmental defect in DiGeorge syndrome?

failure of the 3d and 4th pharyngeal pouches to develop

50

What is the chromosome mutation in DiGeorge?

22q11 microdeletion

51

What is one of the underlying causes of SCID?

Adenosine deaminase (ADA) deficiency

52

What is ADA?

necessary enzyme for deaminaion of adenosine and deoxyadenosine for excretion as waste products (if these are not excreted, they build up and are toxic to lymphocytes)

53

What is mutated in XLA?

Bruton tyrosine kinase

54

What are the 3 infections that occur due to lack of B cells?

bacterial (can't opsonize)
Enterovirus (low mucosal IgA)
Giardia lamblia (low IgA in GI)

55

People with CVID are at increased risk for what 2 conditions?

Autoimmune Disease
Lymphoma

56

In what condiiton is IgA deficiency commonly seen?

Celiac disease

57

What is the cause of Hyper IgM?

Mutated CD40L or CD40 receptor so helper T cells cannot get the secondary activation signal from B cells and no class switching occurs

58

With what type of deficiency are Neisseria infections most common?

C5-C9 deficiencies

59

What is the most common renal disease seen in SLE?

diffuse proliferative glomerulonephritis
OR
Membranous glomerulonephritis

60

What is the characteristic auto-antibody seen in drug-induced SLE?

anti-histone antibody

61

What 3 drugs cause drug-induced lupus?

hydralazine
procainamide
isoniazid

62

How do you definitely diagnose Sjogren's syndrome?

Biopsy of salivary glands shows lymphocytic sialadenitis

63

What are the two types of scleroderma?

Limited
Diffuse

64

Which type of scleroderma is associated with CREST?

limited

65

What is CREST?

Calcinosis (and anti-Centromere Ab)
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias on skin

66

Which type of scleroderma has a better prognosis?

limited

67

Which type of antibodies are seen in diffuse scleroderma?

anti-DNA topoisomerase II

68

What antibodies are seen in Mixed CT disease?

antibodies against U1 ribonucleoprotein and ANA

69

What is the marker of hematopoietic stem cells?

CD34+

70

Which type of tissue cannot repair and must scar?

permanent tissues (ex. myocardium, skeletal muscle, neurons)

71

What goes on with collagen in healing?

Type III collagen is replaced by ype I collagen

72

Type I collagen is seen in what tissues?

bONE

73

Type II collagen is seen in what tissues?

cart2lidge

74

Type III collagen is seen in what tissues?

granulation tissue, embryos

75

Type IV collagen is seen in what tissues?

basement membrane

76

Name the epithelial and fibroblast growth factor.

TGF-alpha

77

Name the fibroblast growth factor that also inhibits inflammation.

TGF-beta

78

Name the growth factor for endothelium, smooth muscle and fibroblasts.

PDGF

79

List the growth factor used for angiogenesis and mediation of skeletal development.

FGF

80

List the growth factor used for angiogenesis only.

VEGF

81

How does a wound come together with secondary intention?

myofibroblasts contract the wound

82

Why is Vitamin C needed for wound healing?

Procollagen needs Vit C for hydroxylation before it can be cross-linked

83

Why is copper needed for wound healing?

needed by lysyl oxidase for collagen crosslinking

84

Why is zinc needed for wound healing?

collagenase cofactor to remove type III collagen

85

What is the name for a proliferation of type III collagen way out of proportion to a wound?

keloid