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Flashcards in Inflammation/Wound Healing Deck (247)
1

Which cells of the immune system has cells with TLRs? Adaptive?

innate = macrophages and dendritic

adaptive = lymphocytes

2

What activates TLRs?

PAMPs

3

What is the CD molecule of macrophages?

CD14

4

What molecule does CD14 recognize?

LPS

5

TLR activation activates which txn factor?

NF-KB

6

What class of molecules does cycloxygenase produce?

prostaglandins

7

What class of molecules does 5-lipoxygenase produce?

leukotrienes

8

What are the three main prostaglandins produced from cycloxygenase? What two effects do these prostaglandins mediate?

PGE2/PGI2/PGD2

vasodilation and increased vascular permeability

9

What prostaglandin mediates fever and pain?

PGE2

10

Which leukotriene attracts neutrophils?

LTB4

11

What three effects are mediated by C4, D4 and E4?

vasoconstriction

bronchospasm

increased vascular permeability

12

Which two complement proteins can activate mast cells?

C3a and C5a

13

Which immunoglobulin can crosslink to activate mast cells?

IgE

14

Do mast cells release leukotrienes or prostaglandins?

leukotrienes

15

In the classical complement pathway, which two proteins activate C1?

IgG and IgM

16

Which ligand on bacteria can a complement protein bind? Which complement protein?

mannose

mannose-binding lectin

17

What protein do the classical and alternative complement activation pathways meet at?

C3 Convertase

18

Which proteins are contained within the MAC? Which C5?

C5-C9

C5b

19

Which complement protein is a chemoattractant for neutrophils?

C5a

20

Which complement protein is an opsonin?

C3b

21

What is another name for Factor Twelve? What activates this factor?

Hageman Factor

collagen

22

Which complement protein activates the Kinin system?

Factor twelve

23

What is another name for redness?

rubor

24

What is another name for warmth?

calor

25

Which molecule produces endothelial cell contraction?

histamine

26

What are the two mediators of pain?

bradykinin and PGE2

27

Which molecule from bacteria mediates fever?

LPS

28

Pyrogens from bacteria cause WHAT CELL to release which two mediators to produce fever?

macrophages

TNF and IL1

29

Which cells of the hypothalamus contain cycloxygenase? Which prostaglandin activates them?

Perivascular

PGE2

30

Which molecule mediates the release of P-selectin from WP bodies?

histamine

31

Which two proteins mediate the increase in E-selectin?

TNF and IL-1

32

Which protein do selectins BIND on inflammatory cells? What cell type is this protein found?

sialyl Lewis X

leukocytes

33

What cells express ICAM and VCAM?

endothelium

34

Which two cytokines upregulate ICAM and VCAM?

TNF and IL1

35

Which cells express integrins?

Leukocytes

36

Which two cytokines upregulate integrins?

C5a and LTB4

37

What general class of protein is deficient Leukocyte Adhesion Deficiency? Leukocyte adhesion deficiency would possess a lack of what CD molecule?

INTEGRINS

CD18

38

Which interleukin is responsible for macrophage mediated recruitment of neutrophils?

IL-8

39

Which complement protein is responsible for neutrophil attraction?

C5a

40

Which leukotriene is responsible for neutrophil attraction?

LTB4

41

What are the two main opsonins?

IgG and C3b

42

What is defective during Chediak-Higashi syndrome? Involving what protein?

protein trafficking deficiency

microtubules

43

The formation of what intracellular organelle is impaired during Chediak-Higashi Syndrome?

phagolysosome

44

Would Chediak-Higashi Syndrome result in neutropenia or neutrophilia?

neutropenia

45

What would be seen inside the leukocytes during Chediak-Higashi Syndrome? From which organelle?

fusion of giant granules

Golgi

46

What hematological defect is present duringChediak-Higashi Syndrome? Why?

defective platelet function

abnormal dense granules in platelets

47

What would be obvious during Chediak-Higashi Syndrome on physical exam? Why?

albinism

melanocytes cant disperse melanin

48

Other than albinism, what is the 2nd most common presenting symptom of Chediak Higashi syndrome?

peripheral neuropathy of DISTAL limbs

49

Which free radical is created by NADPH Oxidase?

superoxide

50

What rxn is catalyzed by Superoxide Dismutase?

superoxide to H2O2

51

What rxn is catalyzed by Myeloperoxidase?

H2O2 to HOCl

52

What enzyme is often absent during Chronic Granulomatous Disease?

NADPH Oxidase

53

Organisms possessing what enzyme are often the culprits for infection during Chronic Granulomatous Disease?

catalase

54

What is the mnemonic to remember the catalase positive organisms?

PLACESS

55

What is the P of PLACESS? Specific species?

pseudomonas

species = cepacia

56

What is the L of PLACESS?

Listeria

57

What is the A of PLACESS?

Aspergillus

58

What is the C of PLACESS?

Candida

59

What is the E of PLACESS?

E. coli

60

What are the S's of PLACESS?

Serratia

Staph

61

What stain is used to screen for CGD?

Nitroblue tetrazolium

62

What is the anti-inflammatory interleukin?

IL-10

63

What is the anti-inflammatory cytokine?

TGF-β

64

Which two immune cells are indicative of chronic inflammation?

lymphocytes and plasma cells

65

What two proteins compose the TCR Complex?

TCR and CD3

66

Regarding T-cell activation, what protein is on the APC? What protein is on the CD4 cells?

CD4 = CD28

APC = B7

67

Would IFN-γ be indicative of a TH1 or TH2 response?

TH1

68

What are the two functions of IFN-γ?

activates macrophages

IgM to IgG switching

69

Which three interleukins does TH2 secrete?

IL4

IL5

IL13

70

What is the function of IL4?

isotype switch to IgE

71

What are the two functions of IL5?

recruit eosinophils

isotype switching to IgA

72

What is the function of IL13?

functions similar to IL4

73

What is the function of IL2?

2nd activation signal to CD8 T-cells

74

Which two immunoglobulins do naive B-cells express?

IgM and IgD

75

What metal is known to cause granulomatous inflammation?

Beryllium

76

Which infection can cause granulomatous inflammation?

Cat Scratch Fever

77

What two types of infections produce a caseating granuloma?

TB and fungal infections

78

What is the function of IL12?

induces CD4 cells to differentiate into TH1 subtype

79

What two metabolites build up in lymphocytes during SCID?

adenosine and deoxyadenosine

80

At what age would X-linked agammaglobulinemia present? Why?

6 months

mothers Ab's are protective until this point

81

What three infections often present during X-linked Agammaglobulinemia?

recurrent infections

enterovirus

Giardia

82

Which has a necrotic core, caseating or non-caseating?

caseating

83

What two diseases is a patient with Common Variable Immunodeficiency at risk for developing?

Autoimmune

Lymphoma

84

What two proteins are defective during Hyper IgM Syndrome? What is the result of this?

CD40 and/or CD40L

B-cells cant undergo isotype switching

85

What is the triad of Wiskott Aldrich Syndrome?

thrombocytopenia

eczema

ecurrent infections

86

What is the major cause of death in patients with Wiskott-Aldrich Syndrome?

bleeding

87

C5-C9 defects predispose an individual to develop infections with what bug?

Neisseria

88

Hereditary Angioedema is caused by a defect in what protein? Why are the findings produced?

C1

C1 is constanly activating complement and activating
HMWK cleavage leading to bradykinin induced angioedema

89

AIRE mutations produce what sydrome? What is lost during this process?

Autoimmune Polyendocrine Syndrome

central tolerance

90

Autoimmune Lymphoproliferative Syndrome is due to mutations in what protein?

Fas apoptosis pathway

91

CD25 Polymorphisms are associated with what two diseases?

Diabetes Mellitus

Multiple Sclerosis

92

FOXP3 mutations lead to what disease?

IPEX

93

Which complement proteins are normally deficient in lupus? What is the function of these complement proteins?

early complement

clear antigen/antibody complexes

94

Which three early complement proteins are often deficient during SLE? What does this complex function as?

C1q, C2 and C4

C3 Convertase

95

Does lupus present with lymphadenopathy?

yes

96

What vascular abnormality can lupus cause?

Raynaud

97

What is the most severe form of SLE induced renal injury/

Diffuse Proliferatvie Glomerulonephritis

98

What type of endocarditis does SLE produce? Which valve? Which side?

Libmann Sacks

mitral

both sides

99

What are the two highly specific antibodies for lupus ?

anti-dsDNA

anti-smith

100

What are three important anti-phospholipid antibodies produced during lupus?

anti-cardiolipin

anti-β2 glycoprotein I

Lupus anti-coagulant

101

Anti-cardiolipin can give a false positive when screening for what disease?

Syphillis

102

What condition is anti-coagulant antibody associated with?

Hypercoaguable with elevated aPTT

103

Drug induced lupus will have auto-antibodies produced against what antigen?

Histone

104

What three drugs clasically produce lupus?

Procainamide

Isoniazid

Hydralazine

105

What should pateints with lupus avoid?

direct sunlight

106

What two glands are destroyed during Sjogrens Syndrome? What TYPE of hypersensitivity rxn?

lacrimal and salivary

type IV

107

What other disease is Sjogrens Syndrome likely to present with?

rheumatoid arthritis

108

Which three auto-antibodies does Sjogrens Syndrome often present with?

anti-SSA/Ro

anti-SSB/La

Rheumatoid Factor

109

What is the antigen for anti-SSA and anti-SSB?

ribonucleoprotein

110

Pregnant women with anti-SSA are at risk for delivering babies with what two conditions?

neonatal heart block

congenital lupus

111

What biopsy on the body can aid in the diagnosis of Sjogrens Syndrome? Where?

Lymphocytic Sialadenitis

LIP

112

What type of Lymphoma can Sjorens Syndrome produce? How does this present?

Marginal Zone Lymphoma

unilateral enlargement of the parotid

113

Which two organs undergo sclerosis during Systemic Sclerosis?

skin and visceral organs

114

Which autoantibodies present during CREST syndrome? Diffuse or limited?

anti-centromere antibodies

Limited

115

Where does Limited Type systemic sclerosis present?

hands and face

116

What four organs does Diffuse Type systemic sclerosis present?

Vessels

GI tract

lung

kidneys

117

How does Diffuse Type systemic sclerosis present in the GI tract?

esophagitis

118

How does Diffuse Type systemic sclerosis present in the Lungs?

interstitial fibrosis

pulmonary HTN

119

How does Diffuse Type systemic sclerosis present in the Vessels?

Reynaud

120

Which auto-antibody is often found during diffuse Systemic Sclerosis? What is the antigen for this AB?

anti-scl-70

DNA topoisomerase I

121

Which two autoantibodies are present during Mixed Connective Tissue Disorder?

ANA

anti-U1 ribonucleoprotein

122

What is the stem cell of the lung?

Type II pneumocytes

123

What structure are the stem cells of the GI tract contained?

mucosal crypts

124

What type of collagen is contained within fibroblasts?

Type III

125

What type of collagen is removed by collagenase? What is the cofactor for Collagenase?

Type III

zinc

126

What are the two growth factors for angiogenesis?

FGF and VEGF

127

What enzyme is copper a cofactor for?

Lysyl Oxidase

128

What does lysyl oxidase connect?

lysine and hydroxylysine

129

What type of collagen does collagenase replace type III collagen with?

Type I

130

What type of collagen is found in keloids?

Type III

131

Which cell count can increase during an acute MI?

Neutrophils

132

What type of molecule is CD14?

TLR

133

What molecule does CD14 recognize?

LPS

134

Leukotrienes cause which cells contract to increase vascular permeability?

pericytes

135

What is the four ways to activate mast cells?

Tissue trauma

C3a

C5a

cross-linked IgE by antigens

136

What is the immediate response of mast cell activation?

release of preformed histamine

137

What is the maintenance response of mast cell activation?

synthesis of leukotrienes

138

What is the function of mast cells releasing leukotrienes?

potentiating acute inflammation

139

What is another name for swelling?

tumor

140

What is another name for warmth?

calor

141

What structure mediates swelling?

post-capillary venules

142

By what mechanism do PGE2 and bradykinin produce pain?

sensitize nerve endings

143

Where does vasodilation occur?

postcapillary venule

144

What would be the first finding to arise due to Leukocyte Adhesion Deficiency?

delayed sepration of the umbilical cord

145

Would Leukocyte Adhesion Deficiency have an increased or decreased level of circulating Neutrophils? Why?

increased

inability of neutrophils to 'hang' and be marginated in the lungs

146

What are the three chemoattractant molecules for neutrophils?

LTB4, IL8, C5a

147

MPO deficiency puts a patient at an increased risk for developing infections cause by what organism?

Candida

148

How do neutrophils clear from a tissue after an infection? Forming what?

apoptosis

pus

149

Do macrophages rely more on oxygen dependent or oxygen independent killing? Via what enzyme?

oxygen independent

lysozyme

150

What is the primary mechanism by which macrophages kill pathogens?

enzymes

151

What interleukin is used to macrophages to recruit more neutrohils to a site of inflammation?

IL8

152

Which MHC molecule is located on platelets?

MHC one

153

Do CD4 or CD8 cells express FasL?

CD8

154

What is the first mechanism by which B-cells become activated? What is the result of this?

antigen binds IgM or IgD on B-cells

turns B-cell into plasma cell

155

What is the second mechanism by which B-cells become activated?

CD40 of B-cell binds CD40L on helper T-cell

156

What is the key defining feature of a granuloma?

epithelioid histiocytes

157

What two types of cells would an Epithelioid Histiocyte be surrounded by?

Giant cells

plasma cells

158

A stellate shaped granuloma is indicative of what disease?

Cat Scratch Fever

159

Would a TH1 or TH2 response generate a granuloma?

TH1

160

What is the main cytokine that drives the formation of Epithelioid Histiocytes?

IFN-gamma

161

What is the specific genetic mutation of DiGeorge Syndrome?

22q11 microdeletion

162

What two major presentations would a patient with DiGeorge Syndrome present with ?

recurrent infections

hypocalcemia

163

What is the 2nd mechanism by which a SCID may develop, other than Adenosine Deaminase?

MHC Two dysfunction

164

What cellular maturation defect is present in X-linked Agammaglobulinemia?

B-cells cant mature into plasma cells

165

What enzyme is defective in X-linked Agammaglobulinemia?

Brutons Tyrosine Kinase

166

What infections are a patient with Common Variable Immunodeficiency susceptible to?

bacterial

enterovirus

Giardia

167

Which cytokines would not be produced during Hyper IgM Syndrome? What type of infections? Where?

IgA/IgG/IgE

pyogenic

mucosal sites

168

Where on the body would a patient with Hyper IgM Syndrome most likely get an infection?

Mucosal sites

169

What is the most often site of edema during C1 Inhibitor Deficiency?

periorbital

170

What three condtions present in a apatient with Autoimmune Polyendocrine Syndrome?

Hypoparathyroidism

Adrenal Failure

recurrent Candida infections

171

What CD molecule is the Fas receptor?

CD95

172

Fas (CD95) apoptosis pathway mutations result in what syndrome?

Autoimmune Lymphoproliferative Syndrome

173

What are the three molecules of Tregs?

CD4+

CD25+

FOXP3+

174

How do Tregs suppess autoimmunity?

block T-cell activation

175

What special regulatory protein do Tregs express?

CTLA-4

176

What is the function of CTLA4? What can this lead to?

bind/inhibit B7

anergy

177

Which two anti-inflammatory cytokines can Tregs secrete?

TGF-β

IL-10

178

Which CD molecule is the IL2 Receptor?

CD25

179

FOXP3 mutations are associated with what syndrome? What does this syndrome stand for?

IPEX syndrome

Immune Dysregulation

Polyendocrinopathy

Enteropathy

X-linked

180

According to Sattar, what is the reason women more often present with autoimmune disease?

estrogen reduce apoptosis of self-reactive Bcells

181

Regarding Early Complement, what is the function of C3B?

act as opsonin to clear Ag/Ab complex

182

What is the most common early complement protein whose deficiency can lead to lupus?

C2

183

What type of hypersensitivity rxn would blood component problems be during Lupus?

Type Two

184

Which anti-body can be used as a prognostic antibody and to follow the disease activity of lupus?

anti-dsDNA

185

What are the two most common causes of death in lupus patients?

renal failure or infection

186

What are the three most typical presentations for Sjogrens Syndrome?

Dry eyes

dry mouth

recurrent dental caries

187

An immune reaction against what type of tissue is believed to initiate Systemic Sclerosis?

mesenchyme

188

Which two cell types are believed to be involved in the pathogenesis of Systemic Sclerosis? Which vasoconstrictor?

mesenchyme and endothelial

endothelin

189

What cell type can become activated during systemic sclerosis? What two cytokines are released?

Platelets

TGF-β and PDGF

190

Which part of CREST is the first to appear in a patient with systemic sclerosis?

Reynaud

191

In what layer of the epidermis are the stem cells located?

Stratum basale

192

Name two stable tissues?

liver

PCT

193

What type of collagen is seen in granulation tissue?

Type III

194

TGF-α is an important growth factor for what two cell types?

epithelial and fibroblasts

195

TGF-β is an important growth factor for what two cell types?

fibroblasts

196

PDGF is an important growth factor for what three tissues?

endothelial

smooth muscle

fibroblasts

197

What is dehiscence?

rupture of a wound

198

Interactions between what two proteins cause leukocytes to adhere to endothelium?

Integrins and CAMs

199

What is CD18?

Integrin β2

200

What type of hypersensitivity reaction is Sjogrens?

Type 4

201

Which three inflammatory mediators mediate arteriolar smooth muscle contraction?

bradykinin

prostaglandins

histamine

202

Which 3rd and 4th structure is absent during DiGeorge?

pharyngeal pouch

203

Which two viruses present during X-linked Agammaglobulinemia?

polio and coxsackie

204

What other autoimmune disease is most likely to present during Sjogrens?

Rheumatoid

205

What other autoimmune disease is Rheumatoid Factor present even though Rheumatoid Arthritis may not be present?

Sjogrens

206

What gland is involved with Sjogrens Syndrome transformring into a lymphoma?

Parotid

207

Where is LPS located on gram-negative proteins?

outer membrane

208

What is the relationship between Hagemann Factor and gram-negative bacteria?

DIC

209

What two proteins are contained in Weibel-Palade bodies?

P-selectin

vWF

210

Which species of Pseudomonas is mentioned as catalase positive?

cepacia

211

What type of cell forms a rim around a granuloma?

lymphocytes

212

Selective IgA Deficiency patients are at particular risk for what type of pathogen infection?

viral

213

What disease is particularly common in patients with IgA Deficiency?

Celiac

214

Which CD molecule mediates peripheral tolerance?

CD95

215

Which interleukin can limit MHC Two expression?

IL-10

216

What is the trigger for lupus?

UV damage

217

Can lupus cause pancytopenia? What type of hypersensitivity rxn?

yes

type two

218

Are CNS and renal involvement common on rare in drug induced lupus?

rare

219

Within how long do neutrophils undergo apoptosis with a lack of inflammatory signal?

24 hours

220

Mixed Connective Tissue has characteristics of which three diseases?

Lupus

systemic sclerosis

polymyositis

221

At what structure do prostaglandins mediate vasodilation?

arterioles

222

At what structure do prostaglandins mediate increased vascular permeability?

post-capillary venule

223

Which activates the Alternative Complement pathway?

bacterial products

224

Which cells express selectins?

endothelial

225

Why would Chediak-Higashi produce a defect in primary hemostasis?

defective dense granules in platelets

226

What is the mode of inheritance of Chediak Higashi?

autosomal recessive

227

Which stain to differentiate a TB in a TB vs. fungal caseating granuloma?

TB = AFP

228

Which stain to differentiate a Fungal in a TB vs. fungal caseating granuloma?

fungal = GMS

229

Which two specific types of Bcells are arrested in their growth during X-Linked Agammaglobulinemia?

pre-B

pro-B

230

Patients with X-Linked Agammaglobulinemia will get what three type of infections?

Bacteria

Enterovirus (polio and coxsackie)

Giardia

231

Patients with Common Variable Immunodeficiency will get what three type of infections?

Bacteria

Enterovirus (polio and coxsackie)

Giardia

232

Is CD40 or CD40L on Tcells?

CD40L

233

Is CD40 or CD40L on Bcells?

CD40

234

Where in the thymus does negative selection occur?

medulla

235

Where in the thymus does positive selection occur?

cortex

236

What kind of protein is AIRE? What is the function of AIRE?

transcription factor

transcribe self antigens

237

Which syndrome ensues if Fas Ligand is absent?

Autoimmune lymphoproliferative syndrome

238

Other than HLAB27, what gene is implicated in many autoimmune disorders?

PTPN22

239

Can lupus cause pancytopenia?

yes

240

Does PT or PTT get falsely elevated during lupus?

PTT

241

Which two organs are not affected by drug induced lupus?

CNS and renal

242

What does lupus do to CV System?

accelerated atherosclerosis

243

SSA and SSB are associated with what type of manifestation?

extraglandular

244

Which sjogren antibody can cross the placenta?

SSA

245

What is the most common cause of death in Diffuse Type Scleroderma?

pulmonary

246

What is the function of lysyl oxidase?

cross-link lysine and hydroxy-lysine

247

What type of collagen in a keloid?

type three