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Part 1 Pathophysiology > Haemodynamic And Cell/ Immunity > Flashcards

Haemodynamic And Cell/ Immunity Flashcards

(64 cards)

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1
Q

Prothrombin time

A

Extrinsic pathway
VII X V
II(thrombin) and fibrinogen

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2
Q

PTT

A

Intrinsic pathways
XII XI IX VIII X V II(thrombin) and fibrinogen

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3
Q

Platelet alpha granules

A

P selectin
vWF, fibrinogen, V, XI, XII
Platelet factor 4, fibronectin, PDGF,
VEGF

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4
Q

Platelet dense granules

A

Serotonin
ADP ATP
calcium
Adrenaline

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5
Q

Haptoglobin

A

Carries hb releases from damaged red cells in circulation

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6
Q

Glial cell production

A

Ectodermal tissue embryo, not bone marrow

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7
Q

Agammaglobulinaemia

A

X linked primary immunodeficiency
B cells don’t mature
Recurrent resp infections

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8
Q

GPIIB/IIIA

A

integrin on plt
vwf and fibrinogen receptor
plt activation
main job fibrinogen -> coag
Blocker - tirofiban

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9
Q

Thrombomodulin

A

from endothelium - anticoag
activated protein C which inhibits tPA inhibitors -> inc plasmin

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10
Q

Virchows triad

A

hypercoagulable
stasis
injury

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11
Q

petichiae vs purpura

A

petichiae - 1-2mm, inc intravasc pressure, dec plt
purpura 3mm - fragile vessels, vasclitis, amyloid

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12
Q

causes non thrombocytopenic purpura

A

meningococcal, HSP, telangelactasia, CMV

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13
Q

cause of vasoconstriction at injury

A

endothelin

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14
Q

hyperaemia vs congestion

A

hyperaemia due to inc blood flow ACTIVE
inflammation, arteriolar dilation
Etythema,haemosiderrin laden macrophages
congestion stasis e.g. pulm oedema CCF
Cyanosis

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15
Q

Thrombi morphology

A

lines of zahn if blood flow
if post mortem red bottom white top

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16
Q

thrombi location art vs venous

A

art coronary > cerebral > femoral
venous 90% leg

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17
Q

PE

A

95% from dvt upper leg
60-80% silent
>60% occlusion bad
risk pulm haemorrhage rather than infarct due to dual blood

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18
Q

Morphology infarcts

A

red infarct venous/ dual circulation
white infarct solid organ
ischaemic coagulative necrosis takes 4-12 h to appear

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19
Q

Metabolic abnormalities in sepsis

A

insulin resistance and inc BSL
dec insulin secretion, dec GLUT4
lactic acidosis
late stage dec BSL due to adrenal insufficiency

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20
Q

cells in innate and adaptive immunity

A

macrophages and dendritic (APCs)

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21
Q

IgM

A

pentamer, 1st response by B cells, produced by foetus, doesn’t cross placenta
complement activation

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22
Q

IgG

A

2nd response, crosses placenta, opsonises
80% of Igs

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23
Q

BCell CD 40 and 21

A

40 - for activation by T helper
21 - binds EBV

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24
Q

T cells

A

60-70% of lymphocytes
helper 60% - activate B, + phagocytes, secrete cytokines
CD8 cytotoxic kill (30%)
regulatory T supress immune response

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25
NK cells
CD16 - Fc receptor for IgG CD56 Inhibitory receptor for MHCI - don't kill self early defence without prior exposure
26
Location lymphocytes secondary lymph organs
Lymph nodes - B cortical in follicles, T paracortical spleen - B follicles, T periarteriolar
27
MHCI
on all nucleated cells + platelets HLA ABC viral + tumour antigens (endogenous) --> ER then expressed CD8
28
MHC II
on phagocytes HLA D endocytosed, proteolysis exogenous antigens e.g. microbes CD4
29
HLA
A - inherited errors metabolism - haemochromatosis B - inflammatory B27 ank spond D - autoimmune, sjorgens, arthritis
30
Costimulators
+ APC -> naive t cell stiulation B7 proteins (CD80+86) recognised by CD28 on t cell
31
CD4 activation B cells and macrophages
secretes IL2 - more t cells activated expressed CD40 ligand which binds CD40 on B cells and macrophages
32
Th1
Activated macrophages and IgG defence against intracellular secrete IFNy
33
Th2
Activate IgE, mast and eosinophils Allergy and humoral immunity Secrete IL4,5,13
34
Th17
Activate neutrophils and monocytes against extra cellular bacteria mucosal immunity Secrete IL17 and 22
35
Mast cell activators
IgE, C3a+C5a, IL8, codeine, morphine, adenosine IgE coated mast calls are 'sensitise'
36
IL5
activates eosinophils
37
T1 hypersensitivity summary
sensitisation - B cell produces IgE which coats mast cell re exposure - degranulation IL4 activates Th2 (secretes more IL4) IL5 activates eosinophils IL13
38
TII hypersensitivity summary
antibody mediated reaction to antigen on cell surface complement activation + IgG and M - recognised on NK cells - perforins and granzymes
39
TIII hypersensitivity summary
antibody/ antigen complex soluble complex in blood deposited in tissue inflammation and tissue injury complement (lots of it) cause fibrinoid necrosis
40
TIV hypersensitivity summary
cell mediated CD4 and 8 IL12-->Th1 (IFNy-->macrophage) IL1+6-->Th17 (neutrophil) CD4 presents peptide secretes IL2 in autocrine manner CD8 - perforins and granzymes
41
T II examples
transfusion, haemolytic anaemia, thrombocytopenia purpura goodpastures, rheumatic fever, ANCA MG, insulin resistance diabetes
42
T III examples
SLE serum sickness, arthurs reaction post strep glomerulonephritis polyarteritis nodosa reactive arthritis farmers lung Henoch schonlein
43
T IV examples
contact dermatitis mantoux test TB MS T1DM
44
Central tolerance
in BM and thymus T cell negative selection and deletion B cell apoptosis or receptor editing
45
Peripheral tolerance
Anergy - made so won't be activated by costimulator suppression by regulatory T deletion by apoptosis
46
Hyperacute rejection
avoided by cross matching blood pre formed antibodies Ischaemic + thrombotic IgG+ complement, fibrin + plt
47
Acute rejection
antidonor ABs produced post transplant T cells - tubulitis + vasculitis B cell - complement
48
Chronic rejection
Progressive renal failure, no ABs in graft Arterioscleosis, parenchymal fibrosis
49
RNA genome contains
gag, pol, env genes
50
HIV viral glycoproteins
GP120 - binds CD4 allowing CCR5 to bind GP41 - fusion virus to cell
51
Seroconversion HIV
3-7 weeks Assoc viral like illness
52
HIV defining cancers
Kaposi - HHV8 most common, can have normal CD4 Non hodgkins CNS lymphoma - assoc EBV, low CD4 Cervical invasive
53
HIV defining viruses
HSV, VZV, CMV, PML
54
HIV defining bacterial infections
atypical mycobacteria nocardiosis disseminated salmonella
55
HIV defining Fungal + protozoal
pneumocytis, cryptococcus, histoplasmosis cryptosporidiosis, toxoplasmosis (CNS/ pneum)
56
Spherocytosis tx
tx with splenectomy or folate or blood transfusions
57
Megaloblastic anaemia
oval shaped macrocytosis with large hypersegmented neutrophils and abnormal megakaryocytes Hyperchromic anisocytosis and poikilocytosis reticulocyte count is low
58
cause reticulocytosis
haemolytic anaemia (which also causes inc bilirubin and ldh)
59
Trousseau syndrome
migratory thrombophlebitis due to hypercoagulable state
60
Types vWD
1 - autosomal dominant, deficiency (mild) 2 - autosomal dominant dysfunction (mild) 3 - autosomal recessive, complete deficiency
61
Traumatic haemolysis (exercise/ heart valve)
red cell fragments (schistocytes), burr cells, helmet cells, and triangle cells
62
Methaemoglobin
Hb containing Fe3 ferric
63
Steps haemostasis
1. vasoconstriction 2. PRIMARY - plt actovation 3. SECONDARY - clotting cascade 4. Clot stabilisation
64
Platelet activation stages
1. vWF binds GB1b and binds collagen 2. Plt changes shape 3. Granules secreted e.g. ADP to recruit more plt, TXA2 aggregates 4. GPIIbIIIa binds fibrinogen

Part 1 Pathophysiology (15 decks)

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