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USMLE > Inflammation > Flashcards

Flashcards in Inflammation Deck (95):
1

Injury Byproducts, cardiac myocytes

Myoglobin, troponin I, CPK, CKMB

2

Injury Byproducts, skeletal muscle

CPK, Aldolase

3

Injury Byproducts, hepatocytes

AST, ALT, alk phos, GGT

4

Injury Byproducts, salivary glands

Amylase

5

Injury Byproducts, pancreas

amylase, lipase

6

Injury Byproducts RBCs

Heme, bilirubin

7

acute phase cytokines

IL-1, IL-6, TNF-alpha

8

Granulomatous disease

M TB, fungal, Treponema pallidum, bartonella henselae, sarcoidosis, crohn's, berylliosis (people who work in beryllium mines)

9

elevated sed rate

polymyositis, polymyalgia rheumatics/temporal arteritis, RA disease activity, inflammation, malignancy, Osteomyslitis identification, Temporal arteritis, pregnancy, SLE

10

C-Reactive Protein

opsonizes bacteria and activates complement. Can be secreted from cells within atherosclerotic lawues to activate local endothelial cells to induce protprombotic state and increase adhesivenenss to leukocytes. Elevations predictor or MI stroke and PAD or sudden cardiac death. Can be lowered by smoking cessation, exercise, weight loss, and statins.

11

Fibrinoid necrosis is seen in

blood vessels

12

Key growth factors promoting angiogenesis

VEGF and FGF. (IL-1 and INF-gamma can increase VEGF indirectly promoting angiogenesis)

13

upper limb lymph drainage

axillary nodes

14

stomach lymph drainage

celiac nodes

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duodenum jejunum lymph drainiage

superior mesenteric nodes

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signoid colon lymph drainiage

Colic -> inferior mesenteric

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Rectum (above pectinate) lymph drainage

internal iliac

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anal canal lymph drainiage

superficial inguinal

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Testes lymph drainage

polymyositis, polymyalgia rheumatics/temporal arteritis, RA disease activity, inflammation, malignancy, Osteomyslitis identification, Temporal arteritis, pregnancy, SLE

20

scrotum lymph drainage

superficial inguinal

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Thigh lymph drainage

superficial inguinal

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later dorsum foot lymph

popliteal lymph nodes

23

R lymphatic duct

drains R arm and R half of head

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Thoracic duct

drains everything the R lymphatic duct doesn't. Drains at the jnct of L subclavian and internal jugular veins.

25

HLA-A3

Hemochromatosis

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HLA-B27

Psoriasis, Ankylosing Spondylitis, IBD, Reiter's (PAIR)

27

HLA-B8

Grave's

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HLA-DR2

MS, Hay fever, SLE, Goodpasture's

29

HLA-DR3

Diabetes I

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DR4

Rheumatoid arthritis, diabetes I

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HLA-DR5

Pernicious anemia, Hashimoto's thyroiditis

32

HLA-DR7

Steroid-responsive nephrotic syndrome

33

TCR

T cell receptor that binds antigen-MHC

34

CD3

Marker for all T cells, associated with TCR for signal transduction

35

CD28

T cell second signal that binds B7(CD80 or CD86) on APC

36

CD19

B cell receptor

37

CD20

B cell marker

38

CD21

B cell receptor, marker for EBV

39

CD40

B cell and APCs, T cell has CD40L for co-stimulatory signal along with cytokines for class switching

40

CD14

LPS receptor on macrophage

41

Macrophage receptors

CD40, CD14, B7, MHCII, Fc and C3b receptors

42

B cell receoptors

CD 19-21, CD40, MHCII and B7

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NK cell Marker

CD16 (binds Fc of IgG), CD56 (unique to NK)

44

CD16

Binds to constant region of Fc. Found on NK cells, Macrophages, monocytes, neutrophils. Recognize and kill immunoglobulin coated cells by ADCC

45

Anti-ANA

SLE screening

46

Anti-dsDNA

SLE specific, especially for renal disease

47

Anti-Smith

Anti-RNP, SLE specific

48

antihistone

Drug-induced lupus

49

anti-IgG

Rheumatoid factor, RA

50

Anticentromere

scleroderma (CREST)

51

Anti-CCP

Most specific for RA

52

Anti-Scl-70

Anti-DNA topoisomerase, Diffuse Scleroderma

53

Anti-mitochondrial

Primary biliary cirrhosis

54

Antigliadin antiendomysial

Celiac disease

55

anti-basement membrane

Goodpastures

56

Anti-desmoglein

Pemphigus vulgaris

57

Antimicrosomal, antithyroglobulin

Hashimoto's

58

Anti-Jo-1

Polymyositis, dermatomyositis

59

Anti-SS-A (Ro)/Anti-SS-B(La)

Sjogren's

60

Anti-U1 RNP

Mixed Connective Tissue Disease (resonds to corticosteroids and has minimal renal involvemtn)

61

Anti-smooth muscle

Autoimmune hepatitis

62

Anti-glutamate decarboxylase

Type 1 diabetes mellitus

63

c-ANCA

Wegener's vasculitis

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p-ANCA

Other vasculitides

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Antiphospholipid

lupus or antiphospholipid syndrome (hypercoagulability with paradoxical PTT elongation, recurrent miscairrage)

66

Anti-MPO-ANCA

Pauci immune crescentic glomerulonephritis

67

Causes of Amyloidosis

Bence Jones(Ig light chains from MM), Secondary (serum amyloid-associated protein from chronic inflam diseases), Senile cardiac (Transthyretin), DMII (Amylin protein), Medullary thyroid carcinoma A-CAL (Calcitonin), Alzheimer's Disease (beta-amyloid from APP), Dialysis (Beta-microglobulin from MHC class I proteins)

68

CD25

Expressed on regulatory T cells

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Classic Compliment Pathway

IgG or IgM mediated (antigen-antibody complexes) - begins with C1

70

Alternative pathway

Microbial surfaces (starts with C3)

71

Lectin pathway

(A lectin is a protein that binds a sugar) - Starts with C1-like complex that activates C4.

72

C1 esterase inhibitor deficiency

Hereditary angioedema. Elevated levels of Bradykinin. ACE inhibitors contraindicated

73

C5 - C9 deficiency

Neisseria infections

74

C3 deficiency

Severe recurrent sinus and respiratory tract infections. Increased susceptibility to Type III hypersensitivity (glomerulonephritis).

75

DAF (GPI anchored enzyme)

Leads to hereditary paroxismal nocturnal hemoglobinuria - Complement-mediated lysis of RBCs

76

Arthus Reaction

Type III hypersensitivity. Intradermal injection of antigen induces antibodies which form antigen-antibody comlexes in the skin. Characterized by edema necrosis and activation of complement.

77

Bruton's (x-linked) Agammaglobulinemia

Defective Tyrosine kinase -> blocks pro-B-cells from maturation; low Ig's; Infections after 6 months

78

Hyper IgM

Inability to switch classes d/t CD40L on T cells; High IgM; Recurrent infections

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Selective Ig Deficiency

Defect in class switching; Low IgA; Anaphylaxis on blood transfusion if IgA in blood; Milk allergies, diarrhea

80

Common Variable Immune deficiency

Defect in B cell maturation; Low plasma cells, Low Ig's; Risk for autoimmunity, lymphoma, sinopulmonary infections

81

Thymic Aplasia

DiGeorge; Cleft palate, Viral/fungal infections, congenital heart defects, great vessel defects, hypocalcemia (tetany)

82

IL-12 Receptor deficiency

Decreased Th1 response; low IFN-gamma; MYCOBACTERIAL INFECTIONS (can't create granuloma)

83

Hyper-IgE syndrome (Job's Syndrome)

Th1 cells fail to produce IFN-gamma leading to decreased ability of neutrophil chemotaxis; coarse facial features, COLD abscesses, retained primary Teeth, Dermatologic problems (eczema), Increased IgE

84

Chronic mucocutaneous candidiasis

Due to T cell dysfunction; treat with ketoconazole

85

Severe Combined Immunodefiency (SCID)

Adenosine deaminase deficiency or Inability to synthesize class II MHC, or no IL-2 receptor; Recurrent viral, bacterial, fungal, protozoal infections d/t both T and B cell deficiency; Absent thymic shadow, germinal centers, and B cells. Treat with Bone marrow transplant

86

Ataxia-Telangiectasia

Problem with ATM gene. Susceptibility to Radiation, Decreased IgA, Sinopulmonary deficiency, Increased risk for leukemia lymphoma, ataxia, spider angiomas

87

Wiskott-Aldrich Syndrome

X-linked recessive defect, deletion of B and T cells; Eczema, thrombocytopenia, decreased IgM (increased IgE and IgA)

88

Chediak-Higashie

Autosomal Recessive, problem with microtubule formation in phagosome lysosome fusion, LYSE gene; recurrent staph and strep infections; partial albinism, peripheral neuropathy

89

Chronic Granulomatosis

NADPH deficiency; increased infections from staph, e coli, aspergillis, pseudomonas, klebsiella; nitroblue tetrazolium test; prophylaxis with IFN-gamma and SMX-TMP

90

Myeloperoxidase defeciency

Defect in myeloperoxidase; susceptibility to catalse positive and negatice organisms; Even when peroxide is around having no myeloperoxidase, can't make any ROS (vs in granulomatos disease myeloperoxidase is still okay)

91

Why does silicosis make patients susceptible to TB

Macrophages consume silicosis which disrupts fusion of the phagolysosome and impairs killing important in mycobacterial infections

92

Acute rejection histology

Vasculitis w dense lymphocytic infiltrate

93

Chronic Rejection histology

Obliterative vascular fibrosis; fibrosis of graft tissue and blood vessels

94

Live vaccines

MMR, Polio, varicella, yellow fever, intranasal influenza

95

Killed vaccines

Polio (salk), Rabies, Influenza, Cholera, HepA