Module 5 Flashcards
(136 cards)
1
Q
What are the 3 patterns of chronic inflammation
A
Granulomatous, suppuration, mixed
2
Q
Granuloma is characterized by the accumulation of________. Macrophages may eventually resemble and form___________
A
Macrophages, T cells
epithelioid and giant cells
3
Q
What are the 3 types of chronic granulomatous inflammation
A
Immune, Foreign Body, Unknown Origin
4
Q
- Granuloma formation is a cellular attempt to__________
- Granulation tissue is____________
A
- CONTAIN an offending agent that is difficult to eradicate
- Newly formed connective tissue as a result of healing process
5
Q
Macrophage is the dominant cell type during chronic inflammation w/ persistent________
A
infection
6
Q
Macrophage secretes__________to activate T cells
A
cytokines & growth factors
7
Q
Lymphocytes is the dominant cell type during chronic inflammation w/__________
Once activated, tends to be_____________
A
Autoimmune & other hypersensitive diseases
Persistent & severe
8
Q
T cell activates macrophage using_________
A
IFN-gamma
9
Q
Granulomatous inflammation is dependent on_________responses
A
Lymphocytes (B,T,NK cells)
10
Q
_________is the dominant cell type for suppurant chronic inflammation
A
Neutrophils
11
Q
List 2 examples of mixed type chronic inflammation
A
rheumatoid arthritis, crohn’s dz
12
Q
What are the 2 types of NSAIDS
A
traditional, COX 2 inhibitor
13
Q
Risk of heart attack/stroke when using NSAIDS is the highest during____________
A
1st month of use w/ higher doses
14
Q
T/F, Paracetamol is analgesic and anti-inflammatory
A
F, only Analgesic & antipyretic
15
Q
Paracetamol can possibly interact w/_______
A
Warfarin
16
Q
___________can increase the tendency to bleed
A
NSAIDS
17
Q
COX converts_________to__________
A
Arachidonic Acid > Prostaglandins
18
Q
Steroid is derived from__________
A
Cholesterol
19
Q
Steroids regulate which 3 important processes ?
A
Carbs regulation, mineral balance, reproductive
20
Q
_________converts arachidonic acid to Leukotrienes
A
Lip oxygenases
21
Q
_________is the richest source of histamine ?
A
mast cell
22
Q
release of histamine can be triggered by which 2 ways ?
A
Physical trauma & cell surface receptors engagement
23
Q
How does histamine affect blood vessels & lungs ?
A
- Vasodilation of artierioles > inc. venules permeability > Oedema
- ConTRACTION of bronchial smooth muscle
24
Q
How does serotonin affect blood vessels ?
A
Vasodilation (5HT1 receptor), Vasoconstriction (5HT2 receptor)
25
Which 4 cytokines cause fever ?
IL1B, 6, 10. TNF
26
What are the 3 causes of chronic inflammation ?
Persistent infections, hypersensitivity dz, pronlonged exposure to exo/endogenous agents
27
Which cytokine cause anorexia ?
IL1B
28
IL 6 can cause ?
fever & aggresion
29
Blocking_______would inhibit the formation of granuloma and thus more susceptable to infection
TNF
30
Chemokines bind to what kind of receptors ?
GPCR
31
Chemotaxis, leucocyte recruitment and activation can be achieved by:
Leukotriene B4 (LTB4)
All of the answers are correct
Chemokines
TNF and IL-1
C3a and C5a
All
32
Which of the following is a pattern-recognition receptor?
Toll-like receptor 4
E-selectin
Complement fragment 3
Interleukin-1 receptor
TNF receptor
Toll-like receptor 4
33
Which of the following is the primary precursor for endogenous glucocorticoids?
Testosterone
Estrogen
Progesterone
Aldosterone
Coristone
Progesterone ?
34
Which of the following best defines a 'drug'?
A substance which, when introduced to the body, exerts a psychogenic effect
A substance of synthetic origin which exerts a biological effect
A substance, when metabolised by the body, exerts a biological effect
A substance, when produced by the body, exerts a biological effect
A substance which, when introduced to the body, exerts a biological effect
A substance which, when introduced to the body, exerts a biological effect
35
Which one of the following is NOT a cytokine-induced systemic manifestation of inflammation?
Fever
Secondary inflammation of vessels near lymphatics
Leukocytosis
Increased blood pressure
Increased blood pressure
36
When inflammatory lesions involve tissue damage, the process of repair is stimulated. Which of the following statements concerning repair is correct?
Fibrin is an important component of fibrous tissue
An adequate blood supply is essential for the formation of fibrous tissue
Repair only occurs in tissues composed of “permanent” cells
The fibrin meshwork is formed early and has no role in subsequent migration of cells
Repair does not involve the formation of granulation tissue
An adequate blood supply is essential for the formation of fibrous tissue
37
Which cell type is present in a granuloma but not in a granulation tissue?
Lymphocyte
Fibroblast
Epithelioid cell
Myofibroblast
Macrophage
Epithelioid cell
38
What are the 3 types of hormones ?
Steroid, Peptide, AA
39
What are the 2 adrenal steroids ?
Cortisone (glucocorticoid), Aldosterone(mineralcorticoid)
40
Suppression of inflammation & immune responses is the effect of (glucocorticoid/mineralcorticoids) ?
Gluco
41
hypertension is the effect of (glucocorticoid/mineralcorticoids)
mineral
42
Hypothalamus release_________hormone, which stimulates_________to release__________
CRH, Anterior Pituatary, ACTH
43
__________stimulates the release of Cortisol from adrenal gland ?
ACTH
44
(Gluco/Mineralcorticoids) alter water balance in concert w/_________ ?
Mineralcorticoids, Vasopressin
45
__________can undergo pathway to convert to cortisol
Progesterone
46
Glucocorticoids is made in zona________
fasciculata
47
Mineralcorticoids is made in zona________
glomerulosa
48
androgen is made in zona_________
reticularis
49
- Cushing's dysfxntion is caused by__________
- It can lead to___________
- ACTH overpdtion
- diabete, swollen face, hypertension
50
- Addison's dysfxntion is caused by____________
- Adrenal atrophy, Dec in steroid pdtion
51
COX2 is also a constitutional enzyme found in which 2 other places ?
Kidney, Vascular tissue
52
(Paracetamol/NSAIDS) inc. the risk of heart attack & strokes ?
NSAIDS
53
Ibuprofen belongs to which drug class ?
traditional NSAIDS
54
Celecoxib belong to which drug class
COX2 inhibiting NSAIDS
55
Meloxicam belongs to which drug class
COX2 inhibiting NSAIDS
56
Diclofenac belongs to which drug class ?
traditional NSAIDS
57
TNF & IL1 are critical in________activation ?
Leukocyte
58
- TNF & IL1 are produced primarily by__________
-IL1a___________
- activated macrophages & dendritic cells
- constitutively expressed in nucleus of endothelial & epithelial cells
59
__________can fxn as alarmin (DAMP)
IL1a
60
_________guide leukocytes to the site of infection/inflammation
chemokines use chemoattractant gradient
61
Complement sys. fxn in (innate/adaptive) immune sys. ?
Both
62
_______suppress inflammation
Lipoxins
63
Platelet Activating Factor (PAF) is_______derived, from some_________cells
Phospholipid, Mast
64
What is PAF's effect on vessels and permeability
Vasoconstriction, Bronchoconstriction, inc. permeability
65
What are the 4 major classes of cytokines ?
TNF, CSFs, PDGF, Interferons
66
Blocking______can block rheumatis arthritis
TNF
67
What are bradykin's effects on vessels and permeability ?
Vasodilation, smooth muscle conTRACTION, inc. permeability. (Similar to histamine)
68
________converts arachidonic acids to prostaglandins ?
Cyclo oxygenase
69
Which cell type is not present in tuberculosis granuloma
Mast cell
70
In complement sys., __________pathway activates C1
Classical
71
In complement sys.,__________pathway activates C3
Alternative
72
Bioconversion of pregnenolone to cortisol occurs in__________
Zona fasiculata
73
What is the function of fibroblast ?
Collagen synthesis
74
Which 3 cytokines are found in chronic inflammation ?
IL12, IFN-gamma, IL-17
75
Which 5 cytokines are found in acute inflammation ?
TNF, chemokines, IL1,6,17
76
Which 5 specific cytokines are produced by macrophages ?
TNF, chemokines, IL1,6,12,17
77
T lymphocytes produce which 4 cytokines ?
TNF, chemokines, IL17, IFN-gamma
78
Does TNF cause vasodilation ?
NO
79
TNF mediates which effects of inflammation ?
Fever, Chemotaxis, leukocyte RECRUITMENT/ACTIVATION
80
Prostaglandins mediates which effects of inflammation ?
Pain, Fever, Vasodilation
81
Which of the following groups of medicines do NOT appear in the top list of PBS drugs in Australia by prescription count?
SSRIs (to treat depression and anxiety)
Cardiovascular drugs
Analgesics
Anti-diabetic drugs
Antibiotics
Analgesics
82
What are the four main types of drug targets?
receptors, electron channels, carrier molecules, enzymes
receptors, ion channels, carrier molecules, catalysts
receptors, ion channels, carrier molecules, enzymes
receptors, allosteric sites, carrier molecules, enzymes
receptors, ion channels, mitochondria, enzymes
receptors, ion channels, carrier molecules, enzymes
83
Which statement is NOT a feature of chronic granulomatous inflammation
Absence of myofibroblasts
Presence of epithelioid cells
Presence of giant cells
Infiltration of basophils
Tissue damage
Infiltration of basophils
84
TNF and IL-1 have a number of effects in common, except:
Induce the production of systemic acute phase proteins
Activate fibroblasts
Inc. the procoagulant activity of the endothelium
Decrease the expression of adhesion molecules on endothelial cells
Activate synovial cells & other mesenchymal cells
Decrease the expression of adhesion molecules on endothelial cells
85
fibrosis tend to dominate in later stages of_____________
allergic dz that cause chronic inflammation
86
In granuloma, fusion of_________form giant cells
epitheliod cells
87
Regeneration is the replacement of injured cells_____________
of the same typpe
88
Repair is the replacement of injured__________
fibrous tissue
89
- Fibroblast is an example of (labile/stable/permanent) cells
- Endothelial cell is an example of (labile/stable/permanent) cells
- Stable
- Stable
90
- Gut epithelium is an example of (labile/stable/permanent) cells
Labile
91
Which 2 signals drive cell proliferation ?
growth factors from cells & integrins from ECM
92
What are the 4 sources of growth factors ?
Macrophages, endothelial, epithelial & stromal cells
93
There is no infection in (first/second) intention healing
first
94
95
Beginning of angiogenesis occurs in the____day of wound healing by first intention
first
96
What are the four steps of second intention in order ?
1. Haemostasis (Stop bleeding)
2. Inflammation (Fight bacteria)
3. Proliferation (Granulation tissue & Scar)
4. Remodelling
97
- (M1/M2) macrophage produce growth factor in inflammations
- (M1/M2) macrophage clears the microbes in inflammations
- M2
- M1
98
___________is responsible for forming Extra-Cellular Matrix
fibroblast
99
In remodelling stage of second intention wound healing, deposited collagen fibers are REORGANIZED to form a____________
stable fibrotic scar
100
Collagen synthesis & degradation are controlled by____________
MMPs & TIMPs
101
Wounds gain ~____% strength by 3 weeks ?
25
102
As scar matures, which 2 things happen ?
Progressive vascular regression & wound contraction
103
________inhibits MMPs
TIMPs
104
DEGRADATION of collagens & other ECM components are done by__________
MMPs
105
MMPs is regulated by which 4 things
TIMPs, growth factors, cytokines, ROS
106
- Bioavailability (F) =__________
- (F) determines_________
- how much is absorbed
- dose adjustment between routes of administration
107
List 4 traditional NSAIDS
Aspirin, Diclofenac, Ibuprofen, Naproxen
108
COX (1/2) is induced by inflammatory stimuli
2
109
Paracetamol has NO anti-_______effect
inflammatory
110
- Compared to traditional NSAIDS, COX 2 inhibitor may produce LESS___________adverse effect but SAME_______adverse effect
GI, renal
111
- COX 2 inhibitor produce (same/less/more) analgesic & anti-inflammatory effect as traditional NSAIDS
- COX 2 inhibitor has (similar/less/more) drug interactions as traditional NSAIDS
- same
- same
112
List 6 adverse effects of using NSAIDS
1. inc. tendency to bleed
2. GI bleeding & ulcer
3. reduced renal fxn
4. early miscarriage/ prolonged labor
5. Asthma
6. inc. risk of heart attacks
113
(Traditional NSAIDS/COX 2 inhibitor/Paracetamol) produce the least adverse effects & drug interactions
Paracetamol
114
Codeine is converted to Morphine by what enzyme
CYP2D6
115
Morphine is converted to Morphine-6-Glucuronide by what enzyme
UGT2B7
116
- Clearance (CL) is the measure of_______________
- The unit is ___/____
- (CL) determines_________
- efficiency of elim. of drug
- Volume/Time (e.g. L/hr)
- dose rate
117
- Volume of distribution (V) is the measure of_____________
- (V) determines_________
- extent of distribution
- loading dose
118
Half life (t1/2) determines___________
freq. of dosing
119
- Glucocorticoid is also known as___________
- Mineralcorticoid is also known as___________
- Cortisone
- Aldosterone
120
Steroid hormones have_______6-C rings &_____5-C rings
3, 1
121
Glucocorticoid can regulate which 5 things
Gluconeogenesis, Proteolysis, Lipolysis, Suppression of inflammation, Immune responses
122
___________drugs should not be used in Herpes Simplex Virus ?
Steroid-based
123
What are the 4 dental indications for steroid-based anti inflammatory drugs ?
1. Oral Ulceration
2. TMJ disorder
3. Post-op sequelae
4. Minimizing allergic rxns
124
Cortisol has -ve feedback loop which 2 organs in the HPA axis ?
Hypothalamus & Anterior Pituitary
125
What medicine is used for the prophylaxis of opportunistic infection if a patient was on long term steroid meds
Bactrim 80+ (400mg daily)
126
List 4 symptoms of adrenal suppression after long term steroid use
fatigue, nausea, darkening skin, dizziness upon standing
127
List 3 ways that inflammatory mediators are made
plasma derived, locally produced, cell-derived
128
________is the largest source of serotonin
GI tract
129
NSAIDS block pdtion of prostaglandins, _________block the pdtion of Leukotrienes ?
Zileuton
130
IL1, w/ IL6 together can inc. the proinflammatory subset_____
TH17
131
Expression of E & P selectins can be induced by________
TNF
132
C___&C___ can induce chemotaxis, leukocyte recruitment & activation
C3a, C5a
133
Leukotriene_________can induce chemotaxis, leukocyte recruitment & activation
B4
134
Which inflammatory mediator can also be involved in the maintenance of tissue architecture
Homeostatic Chemokines
135
Transendothelial migration
is not involved in granuloma formation
is crucial for fibrin deposition
is only essential in chronic inflammation
can involve several cell types
is only essential in acute inflammation
can involve several cell types
136
Which one of the following statements concerning inflammation is correct?
Over 50% of acute inflammatory lesions progress to chronic inflammatory lesions
The majority of macrophages in the body are located in the lung
Leucocytes roll along the endothelium by engaging with endothelial selectins
Macrophages are incapable of extensive protein synthesis
Monocytes always egress vessels before neutrophils
Leucocytes roll along the endothelium by engaging with endothelial selectins
