everything Flashcards
(138 cards)
1
Q
Type I hypersensitivities
A
Allergic/atopic reactions
2
Q
Type II hypersensitivities
A
Antibody binding to cell surface proteins
3
Q
Type III hypersensitivities
A
Soluble antigen (floating around; no membrane involved), IgG binds, forms immune complex; followed by complement activation and acute inflammation
4
Q
Type IV hypersensitivities
A
No antibody; involves T cell-instigated/mediated tissue damage
5
Q
Myasthenia gravis Pemphigus vulgaris Goodpasture's syndrome Graves disease Hemolytic disease of the newborn Loss of RBCs in hemolytic anemia
A
Type II hypersensitivities
6
Q
Systemic lupus erythematous
Glomerulonephritis
Arthritis/arthralgia
Arteritis
A
Type III hypersensitivities
7
Q
Lesion seen after positive TB test
Granuloma formation in latent TB
Poison ivy rash
Contact dermatitis
A
Type IV hypersensitivities
8
Q
Type III rheumatoid arthritis
A
Rheumatoid factor plus IgG complexes, deposit in joint space (synovial fluid)
9
Q
Type IV rheumatoid arthritis
A
Reaction occurs in synovial membrane-mononuclear cell infiltration leads to reorganization of joint tissue and resorption of bone
10
Q
What causes granuloma formation in TB?
A
Tuberculosis and histoplasma replicate in alveolar macrophages
11
Q
What are the three stages of Type I hypersensitivity?
A
- SENSITIZATION
Antigen exposure –> production of IgE - IMMEDIATE PHASE
Occurs within minutes of mast cell degranulation - LATE-PHASE
Results from the cytokines released from the mast cells
12
Q
What induces B cell switching to IgE?
A
IL-4 release
13
Q
What activates eosinophils?
A
IL-5
14
Q
What cell types are involved in Type IV hypersensitivities?
A
CD4 T-cells
Macrophages
CD8 T-cells
**no antibodies involved*
15
Q
What type of tissue damage is involved in Type III hypersensitivities?
A
Neutrophil-mediated tissue damage
16
Q
Which alleles are most important when matching for transplantation?
A
MHC Class I B and Class II DR
17
Q
Which cells are involved in acute rejection and chronic rejection?
A
Acute: CD8 and CD4
Chronic: CD4 only
18
Q
A antigen has ______
A
N-acetylgalactosamine
19
Q
B antigen has ______
A
D-galactosyltransferase
20
Q
What is the difference between forward and reverse typing?
A
Forward: determines antigens on patient’s or donor’s blood
Reverse: determines antibodies in patient’s or donor’s serum or plasma
21
Q
What occurs during hyperacute rejection?
A
Preformed antibodies specific to MHC, therefore B-cell mediated
22
Q
What poses the greatest risk for Graft vs. Host Disease?
A
Bone marrow
23
Q
This legislation, passed in 1962, was largely in response to reports of severe malformations in
the offspring of women in Europe who took thalidomide for sedation during their pregnancy. It
required proof of efficacy and safety for new drugs.
A
Kefauver-Harris Amendments
24
Q
What is the mechanism of an agonist?
A
Mimics the actions of an endogenous ligand
25
What is an indication of the presence of spare receptors?
EC50 less than Kd
26
Concentration at which 50% of receptors are occupied by drug
Kd
27
True/False: The relationship between [drug] at target site and [drug-receptor complex] is linear.
False
28
True/False: The relationship between dose and [drug] at target site is linear.
True
29
[Drug] which causes 1/2 maximum response
EC50
30
What is tachyphylaxis?
RAPID development of tolerance
31
Enhanced response to a drug due to an increase in the number of receptors
Supersensitivity
32
Enhancement of the effect of one drug by another which has no effect by itself
Potentiation
**parallel shift of the log dose-response curve to the left**
33
Production of a greater response than two drugs that act individually
Synergism
34
List the 3 classes of host pattern recognition receptors which respond to influenza virus
TLR-7: recognizes virus genomic DNA
NLRP3: recruited to the mitochondria to form the NLRP3 inflammasome
RIG-1: cytosolic sensor that directly interacts with the viral nucleocapsid; detects the uncapped RNA of the viral genome
35
What is the basic purpose of the NS1 protein study?
To analyze and identify the pathway that NS1 inhibits the secretion of IL-1B. This is done by inhibiting inflammasome formation.
36
What are the roles of EGFP, hCUP-2, and NS-1 plasmids?
```
EGFP = control; green fluorescent for control; lacked subunits of the inflammasome
hCUP-2 = inhibitory action of IL-1B via mt. membrane dissipation. Uncoupling proteins that reduce flow out of membrane for flow cytometry
NS-1 = used to infect macrophages
```
37
In the influenza study, they demonstrate that the function of the influenza NS1 protein differs from that of the influenza PB1-F2 protein in that the PB1 protein has what effect on cells?
PB1 dissipates the mitochondrial membrane potential. They didn't find that the mitochondrial membrane was affected by NS1.
38
What is the function of influenza virus NS1 protein in cell infections?
NS1 interacts with the inflammasome formation by reducing the speck formation and not by reducing mitochondrial membrane formation.
39
Fluoxetine
Transport inhibitor
40
Minoxidil
Ion channel opener (potassium)
41
Phenylephrine
Cell surface receptor agonist
42
Aspirin
Enzyme (cyclooxygenase) inhibitor
43
Vinca alkaloids
Disrupt structural proteins (tubulin)
44
Dimercaprol
Bind free molecules --> chelating agent for heavy metal poisoning
45
Fomivirsen
Antisense
46
Diltiazem
Calcium channel blocker
47
Tamoxifen
Estrogen receptor antagonist (nuclear)
48
Mannitol
Exerts actions due to physical properties (osmotic diuretic)
49
Cyclophosphamide
DNA alkylating agent
50
Pralidoxime
Enzyme activator
51
Propanalol
Cell surface receptor antagonist
52
Sildenafil
Inhibits signal transduction proteins
53
Loading dose equation
LD = Cp x Vd
54
Maintenace dose equation
MD / DI = [Cp x Cl] / B
55
Css equation
Css = R0 / CL = B x MD / DI x CL
56
This phase converts lipophilic molecules into more polar molecules by introducing/unmasking a polar functional group
Phase I
57
This phase converts the drug molecule to an even more polar molecule in order to be excreted in urine
Phase II
58
Which isozymes are responsible for metabolism of the largest number of drugs?
1. CYP3A4
| 2. CYP2D6
59
Where is CYP3A4 found?
GI tract
| Liver
60
What do these drugs inhibit?
```
Ketoconazole
Itraconazole
Fluconazole
Amiodarone
Ritonavir
Grapefruit juice
```
CYP3A4
61
What do these drugs induce?
St. John's Wort
Barbiturates
CYP3A4
62
What isozyme catalyzes primary metabolism of codeine and Beta-blockers?
CYP2D6
63
What inhibits CYP2D6?
Quinidine
64
What does CYP2C9 metabolize?
NSAIDs
Warfarin
Phenytoin
65
What inhibits CYP2C9?
Fluconazole
66
What drug reaction is CYP2D6-dependente?
Activation of codeine by methylation
67
Which isozyme is induced by tobacco?
CYP1A2
68
Which isozyme is the primary catalyst of propanolol metabolism?
CYP1A2
69
What drugs should St. John's Wort not be taken with?
Idinavir (induces CYP3A4)
Cyclosporin
Digoxin
70
What is the best studied drug transporter?
P-glycoprotein
71
Which drugs inhibit p-glycoprotein?
Diltiazem
Quinidine
Verapamil
72
Fusion protein that blocks T cell activation by inhibiting co-stimulation
Blocks T-cell activation by BINDING B7/CD80/CD86 ON APCs
Abatecept
73
Inhibits JAK kinases, thereby blocking cytokine signaling
Corticosteroids
74
Inhibits calceneurin from activating NFAT thereby blocking transcription of genes for IL-2 and other cytokines
Cyclosporine
| Tacrolimus
75
Recombinant TNF receptor fused to Fc of human IgG
Etancercept
76
Myasthenia gravis muscle weakness pathogenesis
Antibody to a receptor acts as an antagonist
77
Desquamation in pemphigus vulgaris
Antibody to desmoglein inhibits function of desmosomes that binds cells tightly together
78
Pathogenesis of hematuria in Goodpastures
Antibody to the non-collagenous domain of type 4 collagen leads to complement activation, neutrophil infiltration, and subsequent tissue damage
79
Myasthenia gravis hyperthyroidism pathogenesis
Antibody to a receptor acts as agonist
80
Due to generation of leukotriene B4 from activated mast cells
Shortness of breath in atopic asthma
81
Example of a T cell response to a hapten
Erythematous, itchy rash of poison ivy
82
Memory T cells elicit a Type IV hypersensitivity response with mononuclear cell infiltration into the site of antigen encounter
Granuloma formation in TB
83
Results from release of mast cell mediators that lead to vasodilation and increased vascular permeability
Wheal and flair in atopic skin test reactions
84
Activation of macrophages
Gamma-interferon
85
Bronchoconstriction
Histamine
86
Causes B cells to switch to production of IgE
IL-4
87
Chemotactic for eosinophils
IL-5
88
Chemotactic for mononuclear cells
MIP, MCP, RANTES
89
Chemotactic for neutrophils
IL-8
| Complement C5a
90
Enhanced mucuous production
IL-12
91
Increase vascular permeability
C3a
C5a
IL-4
TNF
92
Necessary for differentiation of Th1 cells
IL-23
93
Necessary for differentiation of Th17 cells
IL-2
| IL-6
94
Necessary for proliferation of T cells
IL-2
95
Kinins induce ____ and ____
Pain / itch
96
Vasodilation mediators
Leukotriene B4
| Histamine
97
Risk factors for ankylosing spondylitis
HLA-B27
| Klebsiella infections
98
What do corticosteroids block?
Phospholipase
| Arachidonic acid metabolism
99
Which drugs block calcineurin from activating NFAT?
Tacrolimus
| Cyclosporine
100
Anti-TNF drugs are used to treat.....
Rheumatoid arthritis
Psoriasis
Crohn's disease
101
What does methotrexate block?
Folate synthesis
102
Key cytokines in rheumatoid arthritis and their treatment
TNF: Infliximab, Adalimumab, Entanercept
IL-1: Anakinra
IL-6: Tocilizumab
103
Which mediators promote expression of selectin/integrin ligands?
TNF
| IL-1
104
IL-6 function
Induces release of acute phase proteins from liver
105
Endothelial effects
```
Increase:
Leukocyte adherence
PGI synthesis
Procoagulant activity
IL-1, IL-8, IL-6, PDGF
```
106
Where are MIP, MCP, and RANTES produced? What is their function?
Produced by Th1 cells, endothelial cells, and macrophages
Recruit of mononuclear cells and eosinophils
107
True/False: DAMPs interact with DRRs and PRRs.
True
108
SIRS criteria
Two of the following:
1. Fever of more than 38C or less than 36C
2. Pulse > 90
3. RR > 20 breaths per minute
4. Abnormal WBC count ( >12,000 ; <4,000 ; >10% bands)
109
THE bronchodilator
Leukotriene
110
What type of RA does Infliximab treat?
Type IV
111
What type of graph curve is used to determine the variation in sensitivity of subjects to the drug?
Quantal dose curve
112
Which inflammatory mediators are primarily responsible for prolonged swelling?
TNF
| IL-1
113
Drugs with zero order eliminatin
PEA
Phenytoin
Ethanol
Aspirin
114
Treat amphetamine OD with ______
Ammonium chloride
115
Treat methotrexate/aspirin/phenobarbital OD with ______
Bicarb
116
DI equation
DI = 1.44 x t1/2 x ln(TW)
117
Xerostomia
Xerophthalmia
Enlarged parotid
Antibodies SS-A and SS-B
Sjogren's syndrome
| Type III
118
Hematuria
Hemoptysis
Autoantibodies against collagen IV in pulmonary and glomerular basement membranes
Goodpasture's
| Type II
119
Risk factors for Reiter's syndrome
```
HLA-B27
Shigella
Yersinia
Salmonella
Chlamydia
```
120
Risk factors for MS
```
Living in higher latitudes
Females 2:1
Syphilis
Measles
Herpes
```
121
Myasthenia gravis receptor site
Acetylcholine receptors
122
Graves disease receptor site
TSH receptors
123
What are NOD-Like Receptors?
Nucleotide-binding Oligomerization Domain-like receptors
Intracellular PAMP sensors
Regulate immune response
124
What does YopM inhibit?
Activation of the Pyrin inflammasome that is initially induced by YopE
125
What is the function of caspase?
Protease that matures and cleaves pro-IL1B
126
What is the T3SSe strain of Y. pestis?
Lacks Yops but has basic machinery
127
HAV vs. HBV
HAV: regeneration (no scar)
HBV: repair by scarring
128
Sites of stem cells in the skin
Epidermis
Sebaceous gland
Hair follicle bulge
129
Functions of the ECM in tissue repair
Sequester water and minerals from circulation
Store presynthesized growth factors
Give cells a scaffolding upon which to adhere to do their tasks
130
Regeneration of labile tissues occurs under what condition?
ECM must be intact and containing healthy stem cells
131
When an incision occurs, what is the first response?
Blood clot in seconds --> begins with PDGF
132
Wounds that will heal by first intention
Small wounds that close easily:
Paper cuts
Closely approximated surgical incisions
Well vascularized, no dead tissue
133
Extravascular fluid with low protein content and low specific gravity
Key cells: mononuclear
Example: ultrafiltrate of blood
Transudate
134
Example of a serous transudate
Friction blister
| Pitting edema in CHF
135
Example of a serous exudate
Non pitting edema in cellulitis
| Middle ear infection
136
Example of a fibrinous exudate
Fluid on the heart
137
Triple response of Lewis
Red line
Flare
Wheal
138
Primary immune cell in foreign body suture granuloma
Giant cell
