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SEM2 BIOSCIENCE > Case 2 > Flashcards

Case 2 Flashcards

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1
Q

What is the function of thymic stromal lymphopoetin (TSLP)? What cell type releases TSLP?

A

Released by epithelia in response to damage/irritation

Activates dendritic cells to produce cytokines that drive a Th2 mediated response

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2
Q

What is the consequence of major basic protein release from IgE crosslinked eosinophils?

A

Epithelial cell desquamation

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3
Q

What molecules mediate the primary phase of allergen response during an asthma attack?

A

Histamine, prostaglandins, chemotactic factors

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4
Q

What molecules mediate the secondary phase of allergen response during an asthma attack?

A

Leukotrienes C,D,E

major basic protein

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5
Q

What subset of lymphocyte drives the allergic response in asthma?

A

Th2

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6
Q

Activated phagocytes release IL4 and IL5, what are their functions?

A

IL4 causes b cell stimulation

IL5 promotes eosinophil production and attraction

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7
Q

What receptor does histamine bind on smooth muscle cells? What are the consequences of receptor activation?

A

H1 histamine receptor

Smooth muscle contraction (hence bronchoconstriction)

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8
Q

How can allergens cause bronchospasm independent of the IgE response? What characteristic of the asthmatic airway exacerbates this?

A

Allergens can irritate nerve terminals in lamina propria, causing bronchoconstriction and coughing

Epithelial cell desquamation

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9
Q

What drives the secondary response to allergen in an asthmatic attack?

A

Lymphocyte responses to degranulate contents

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10
Q

What are the molecules that drive the inflammatory response of an asthma attack?

A

Leukotrienes C,D,E

major basic protein

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11
Q

What are components of ‘the triad of the asthmatic airway’?

A

Bronchial hyper-responsiveness (IgE)
Increased mucus secretion (caused by smooth muscle contraction)
Inflammation (leukotrienes)

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12
Q

what is the function of IL9?

A

Sensitises t cell responses

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13
Q

Name the 7 characterisitics of an asthmatic airway:

A 
Goblet cell hyperplasia
Oedema
Smooth muscle hypertrophy
Th2 dominated environment
Increased mucus constrictions
Thickened basement membrane
Epithelial cell desquamation
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14
Q

How can airway anatomy explain the increased mucus secretions?

A

Mucus glands enveloped in smooth muscle layer, meaning bronchoconstriction releases content into airway lumen

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15
Q

What is the diagnostic criteria for asthma?

A

FeNO raised
FEV1:FVC lower than 70%
FEV1:FVC increase by 12% upon bronchodilator administration
Bronchial challenge testing

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16
Q

What is atopic/extrinsic asthma?

A

Caused by the environment, mediated by systemic IgE production
Common

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17
Q

What is non atopic asthma?

A

Inflammation and airway obstruction that isn’t worsened by triggers
Not common

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18
Q

What percentage of people does asthma effect on average?

A

4-20%

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19
Q

What is the hygiene hypothesis?

A

States that lack of exposure to infectious agents at a young age hinders immune system development. This results in an increased chance of atopic disease in adulthood

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20
Q

The hygiene hypothesis states that lack of exposure to allergens in early life creates an environment dominanted by which cytokine?

A

IL2

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21
Q

How the the sound of wheezing generated?

A

By vibrations of the airway walls that are nearly closed

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22
Q

How does the presence of wheeze at different stages of the breathing cycle indicate severity of airway obstruction?

A

Expiratory wheeze - moderate obstruction
Inspiration + expiratory wheeze - severe obstruction
No wheeze - emergency (airway completely blocked)

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23
Q

What mechanism does the B2 receptor use to induce bronchodilation?

A

G protein activation –> Adenylate cyclase –> cAMP –> PKA

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24
Q

What is the effect of PKA production in bronchial smooth muscle?

25
Salbutamol and salmeterol are examples of what class of drug?
B2 adrenergic receptor agonists
26
Through what mechanism does the phosphodiesterase inhibitor theophylline work?
increases intracellular cAMP --> PKA activated --> smooth muscle relaxation
27
What drug should be given to treat aspirin induced asthma?
Leukotriene receptor antagonist Montelucast Zafirlucast
28
How does ipratropium work?
Antagonises the muscarinic receptor, blocking parasympathetic induced bronchoconstriction
29
What drug should be administered alongside salmeterol to prevent receptor desensitisation?
Glucocorticoids
30
Fluticazone, beclomethasone, prednisolone and budenoside are all examples of what type of drug?
Glucocorticoids
31
What is the mechanism of action of glucocorticoids?
Increase expression of lipocortin/annexin phospholipase A2 inhibited Decreased production of prostaglandins and leukotrienes
32
What nerve carries input from carotid bodies?
Glossopharyngeal
33
What nerve carries input from aortic body?
Vagus
34
What parameters do the central chemoreceptors sense?
PCO2 | CO2 is the only molecule that can cross the blood brain barrier
35
What parameters do the peripheral chemoreceptors sense?
PCO2, PO2, pH
36
What part of the brain controls involuntary breathing?
Respiratory centres in medulla oblongata
37
What part of the medulla controls involuntary inspiration?
Dorsal respiratory centre
38
What part of the medulla controls involuntary expiration?
Ventral respiratory centre
39
What are the three sensory inputs to breathing?
Central chemoreceptors Peripheral chemoreceptors Sensory nerves in lungs, airways and chest wall
40
What receptors provide sensory input to the respiratory centres of the medulla?
Stretch receptors Irritant receptors C-fibres
41
Where are stretch receptors found?
Trachea and main bronchi
42
Where are irritant receptors/c-fibres found?
naso-pharynx, larynx, trachea, main bronchi
43
What is the function of the pontine respiratory centre?
Controls the rate and speed of involuntary breathing
44
What are the names and functions of the two pontine respiratory centres?
Apneustic centre --> increases tidal volume | Pneumotaxic centre --> decreases tidal volume
45
What are the four regions of the cortex that control behavioural acts of breathing?
Primary motor cortex Primary sensory cortex Supplementary motor area pre-motor cortex
46
What is locked in syndrome?
Severence of linkage between motor cortex and pons during a stroke
47
What area of the brain controls emotional breathing responses?
Limbic system
48
What medullary structure is responsible for producing respiratory pacemaker?
Pre-botzinger
49
What is the EC50?
The amount of agonist necessary to cause 50% of maximal receptor activation
50
What
The amount of antagonist necessary to cause 50% of maximal receptor inhibition
51
What are the 6 types of antagonist?
``` Competitive Non-competitive Uncompetitive Functional Irreversible Indirect ```
52
How do competitive antagonists work?
By competing for the same binding site as the agonist
53
How do non-competitive antagonists work?
Binds to a different site on the same receptor
54
How do functional antagonists work?
By binding at a different receptor site to induce the opposing physiological response
55
How do uncompetitive antagonists work?
By binding to the activated receptor at a different site to the agonist
56
What is a psychogenic illness?
Mind perceiving pain in the absence of any physical lesion
57
Define the term 'symptom pool'
A collective cultures beliefs around how to behave when ill
58
What is the most effective way of treating medically unexplained symptoms?
CBT

SEM2 BIOSCIENCE (13 decks)

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