Immune System and Lymph

Question 1

How do we make pathogens appear tasty?

Answer 1

Opsonisation

Question 2

List 4 phagocytes.

Answer 2

Neutrophils, Eosoniphils, monocytes and macrophages

Question 3

Outline the process of phagocytosis

Answer 3

Phagocytes are part of the innate immune response, they are cells that engulf pathogens. Once the foreign body is engulfed it’s said to have made a phagosome. The phagosome fuses with a lysosome to make a phagolysosome. This can break down the intruder.

Question 4

There are two methods of chemical break down of pathogens in phagocytosis, what are they?

Answer 4

Oxygen dependent by reactive oxygen species

Oxygen independent by hydrolases

Question 5

What is opsonisation?

Answer 5

Binding of opsonin to the bacteria marking it for phagocytosis.

Question 6

What is opsonin?

Answer 6

A free floating plasma protein which is part of the innate and adaptive immune response.

Question 7

What is complement?

Answer 7

Group of serum proteins involved in
Cell destruction
Inflammation
Opsonisation

Question 8

What is the complement cascade?

Answer 8

The sequential manner in which complements respond.

Question 9

How is complement activated?

Answer 9

2 pathways: classical or alternative

Classical- C1 activated when it binds to the antigen,antibody complex

Alternative- C3b is activated when it reacts directly with the antigen on the pathogen cell wall

Question 10

At what point do the complement Cascades become the same independent of the activation being classical or alternative?

Answer 10

After C3

Question 11

What’s the risk with low complement?

Answer 11

Increased risk of bacterial infection

Higher likelihood of autoimmune conditions

Question 12

What is oedema?

Answer 12

An accumulation of excess fluid (watery) in cells, tissues and serous cavities

Question 13

What’s lymphoedema?

Answer 13

Swelling in subcutaneous tissues as a result of damaged or obstructed lymphatic a or lymph nodes giving an accumulation of lymph in the region affected.

Question 14

What type of oedema does not pit?

Answer 14

Lymph

Question 15

Describe the sequence of vessel types in tissues?

Answer 15

Arteriole-metarteriole-through channel - arterial capillary- venous capillary-venule

Question 16

What are lymphatic a closely associated with?

Answer 16

Capillary beds

Question 17

What helps lymph return to the blood?

Answer 17

Thoracic pressure change
Skeletal muscle activity
Adjacent artery pulsation

Question 18

What is the purpose of the pre capillary sphincter?

Answer 18

Control blood flow depending on activity

Question 19

What happens in congested heart failure?

Answer 19

Both sides of the lungs stop working. Right side can’t cope with venous return so venous pressure increases. Left sided heart failure means you get a back up of pressure in the lungs.

Question 20

If you have right sided heart failure where is the resulting oedema?

Answer 20

Peripheral

Question 21

If you have left sided heart failure where is the associated oedema?

Answer 21

Lungs

Question 22

Where is the right side of the heart receiving blood from?

Answer 22

The body

Question 23

Where is the left side of the heart receiving blood from?

Answer 23

The lungs

Question 24

High oncotic pressure in the veins means water will move…

Answer 24

In to the vessel of help dilate the hypertonic solution of the blood

Question 25

High hydrostatic pressure in a vein will move water where?

Answer 25

Out of the vein or restrict resorption

Question 26

Which pressure type varies from arteries to veins oncotic or hydrostatic?

Answer 26

Hydrostatic

Question 27

What's arterial and venous oncotic and hydrostatic pressures?

Answer 27

Artery hydrostatic: 35mmHg Venous hydrostatic : 15mmHg Colloid oncotic pressure : 25mmHg

Question 28

What leaves the blood in tissues at capillary beds?

Answer 28

Oxygen, nutrients and glucose as well as some water

Question 29

What moves into capillaries ?

Answer 29

Carbon dioxide, waste and resorption of water as hydrostatic pressure in veins drop

Question 30

Why does high venous pressure become most apparent in the ankles?

Answer 30

Vertical pressure gradient in standing patients. Supine patients will suffer sacral oedema

Question 31

If swelling appears during the day in the ankles what type of oedema is it likely to be?

Answer 31

Peripheral oedema not due to lymphatics

Question 32

Unilateral ankle swelling through the day suggest what type of aetiology?

Answer 32

Localised not a systemic or heart failure related problem

Question 33

In hyperproteinaemic patients where there is nephrotic syndrome why is oedema seen around the eyes in the morning?

Answer 33

Lying down the eyes are higher so verticals pressure gradient allows the fluid to accumulate there

Question 34

Which oedema causes inflammatory fibrotic changes?

Answer 34

Lymphoedema

Question 35

Is there an absence of lymphoedema in the morning.

Answer 35

No

Question 36

Why do heart failure patients have discoloured legs.

Answer 36

Poor venous return to heart so capillaries burst and erythrocytes discolour the tissue as they leak out

Question 37

Which is darker fe2+ or fe3+

Answer 37

Fe3+