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Block 34 metabolic -Ellen > Chronic kidney injury pt2 > Flashcards

Chronic kidney injury pt2 Flashcards

(64 cards)

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1
Q

where does B cell activation occur

A

in secondary lymphoid organs (spleen and lymph nodes)

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2
Q

where do B cell mature

A

in the bone marrow

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3
Q

how are T cells activated

A

by antigen presenting cells

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4
Q

where do APCs present foreign antigens

A

on MHC class 2 complexes

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5
Q

how do B cells recognise antigen

A

in its native form (3D shapes, protein, lipids, sugars, chemicals)

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6
Q

how do T cells recognise antigen

A

require a APC

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7
Q

CD8+ =

A

kill infected cells

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8
Q

CD4+ =

A

Help B cells

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9
Q

where do T cells have an education

A

the thymus gland

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10
Q

MHC 1 facts (4)

A
  • expressed on all nucleated cells
  • co-receptor CD8
  • internally infected cells
  • Cytotoxic T cells kill infected cell
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11
Q

MHC 2 facts (3)

A
  • expressed on B-cells, dendritic cells and macrophages (APCs)
  • CD4 co-receptor
  • T helper cells respond to external proteins
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12
Q

pathology of transplant rejection

A

T cells respond to foreign MHC and reject it

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13
Q

alloreactivity =

A

T cells binding to foreign MHC on foreign dendritic cell in a peptide independent fashion

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14
Q

polymorphism=

A

having multuple alleles of a gene within a population

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15
Q

most polymorphic gene in genome=

A

MHC

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16
Q

how do cytotoxic T cells kill target cells

A

release of perforin-granzyme complex at immunological synapse forming a secretory domain and kill by apoptosis

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17
Q

Th1 subset =

A

enable macrophages to kill intracellular cargo

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18
Q

Th2 subset=

A

cells orchestrate expulsion of parasites

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19
Q

2 types of B cell activation

A

T-cell independant

T cell dependant

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20
Q

which type of B cell activation takes longer

A

T cell dependant

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21
Q

which type of B cell activation produces low affinity antibodies that are not versatile

A

T cell independant

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22
Q

what does T cell independent B cell activation involve

A

Toll like receptors or cross linking of multiple epitopes to BCRs

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23
Q

what is formed in T cell dependant B cell activation

A

Germ centre within a follicle

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24
Q

which B cell activation form B cells that can differentiate into memory or plasma cells

A

T cell dependent B cell activation

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25
once a transplant donor has been deemed medically and clinically suitable what has to happen
attend a independent assessment
26
what does the independent assessor have to ensure (4)
- capacity for consent - understands risk - own will - no reward
27
3 tests to evaluate compatibility of organ donors
blood type crossmatch HLA testing
28
what blood type is the universal donor
O
29
what blood type is the universal recipient
AB
30
HLA =
Human leukocyte antigen - tissue typing
31
how many antigens play a major role in organ rejection
6
32
what are the 6 antigens playing a role in rejection
A B DR (2 for each letter)
33
how do you get HLAs
inherit from parents 3 from mum 3 from dad
34
crossmatch=
a test done prior to transplantation to determine if the body already has antibodies against the donor antigens
35
how is a crossmatch done
mixing blood from donor and recipient
36
what is a positive crossmatch
if the recipient's cells attack and kill the donor cells
37
what is a negative cross match
the pair is compatible
38
what are the antigens of ABO blood groups made up of
sugars
39
what does blood group O mean
the surface of the RBC has no antigens present -so no IgM antibodies against A or B
40
when are ABO IgM antibodies produced
first years of life
41
what are the antigens of Rh made up of
proteins
42
what is rhesus positive
has a D antigen (RhD) on RBC surface
43
what antibody is produced against AB
IgM
44
what is rhesus disease a type of
haemolytic disease of the new born
45
what antibodies will a Rh- mother produce against the a Rh+ baby
IgG
46
what can happen in subsequent pregnancies after a Rh- gives birth to Rh+
IgG antibodies pass the blood placental barrier into the foetus destroying RBCs
47
screening of blood prior to transfusion (8)
- ABO and RhD - Alloantibodies on RBCs - Syphilis antibodies - Hep B - Hep C - Hep E - Human T-lymphotropic virus - indirect antiglobulin test
48
what information based on donor history prior to transfusion (4)
malaria T-cruzi west nile virus CMV
49
indirect antiglobulin test=
serological crossmatch between patients plasma and transfusion -at 37 degrees
50
polycystic kidney disease most common form
autosomal dominant polycystic kidney disease
51
what characeterises PKD (3)
renal cysts extrarenal cysts intracranial aneurysms
52
long term conditions of PKD (5)
- hypertension - CVD - chronic renal failure - intracranial aneurysm - ESRD
53
diagnosis of PKD (7)
- family history (PKD/ cerebrovascular) - renal cysts - hypertension - abdo/ flank pain - haematuria - palpable kidney - dysuria, uregency, suprapubic pain
54
which part of the nephron do renal cysts develop from
tubular portion
55
pathophysiology og PKD
renal cysts compress normal renal architecture and progressively cause renal impairment
56
2 types of PKD
PKD1 | PKD2
57
most patients with PKD have
PKD1
58
in which form of PKD do most patient have adequate renal function at 70
PKD2
59
mean onset of ESRD in PKD1
54
60
investigations of PKD (7)
- renal ultrasound - CT scan - MRI - urinalysis - serum electrolytes, urea, creatinine - lipid profile - ECG
61
Treatment of PKD
Tolvaptan antihypertensives antibiotics for infection
62
Tolvaptan=
selective and competitive arginine vasopressin receptor 2 antagonist
63
what is the effect of Tolvaptain in PKD
blocks V2 receptors in renal collecting ducts preventing water absorption increasing urine volume
64
treatment of infected cysts with antibiotics with
ciprofloxacin

Block 34 metabolic -Ellen (8 decks)

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