Molecular Medicine Flashcards
(191 cards)
1
Q
What are the phases of the cell cycle?
A
G0: Resting phase
G1: Gap 1 - cell increase in size
S: Synthesis of DNA, RNA, Histome and centromere duplication
G2: Gap 2 - cells continue to increase in size
Mitosis
G0
2
Q
What phase of the cell cycle determine the length of the cell cycle?
A
Gap 1
3
Q
What governs G1 phase?
A
p53
4
Q
What regulatory proteins govern transition from G1 to S phase the cell cycle?
A
Cyclin D / CDK4
Cyclin D / CDK6
Cyclin E / CDK2:
5
Q
What regulatory protein governs synthesis phase?
A
Cyclin A / CDK2: active in S phase
6
Q
What regulatory protein governs transition from G2 to m phase?
A
Cyclin B / CDK1: regulates transition from G2 to M phase
7
Q
What is the shortest phase of the cell cycle?
A
Mitosis
8
Q
What are the features of mitosis?
A
Somatic cells
Genetically identical to parent cell
Results in 2 diploid daughter cells
9
Q
What are the features of meiosis?
A
Gamete cells
Contain one homologue - genetically different
4 haploid cells
10
Q
What are the phases of mitosis?
A
Interphase: G0, S phase and G2
Mitosis: M phase
Prometaphase
Metaphase
Anaphase
Telophase
Cytokinesis
G0
11
Q
What occurs in prometaphase?
A
Nuclear membrane breaks down allowing the microtubules to attach to the chromosomes
12
Q
What occurs in metaphase?
A
Chromosomes aligned at middle of cell
13
Q
What occurs in anaphase?
A
The paired chromosomes separate at the kinetochores and move to opposite sides of the cell
14
Q
What occurs in telophase?
A
Chromatids arrive at opposite poles of cell
15
Q
What occurs in cytokinesis?
A
Actin-myosin complex in the centre of the cell contacts resulting in it being ‘pinched’ into two daughter cells
16
Q
What is the CD of haematopietic stem cells?
A
CD34
17
Q
What is the CD of T helper cells?
A
CD4, TCR, CD3, CD28
18
Q
What is the CD of cytotoxic T cells?
A
CD8, TCR, CD3, CD28
19
Q
What is the CD of regulatory T cells?
A
CD4, CD25, TCR, CD3, CD28
20
Q
What are the CD of B cells?
A
CD19, CD20, CD40, MHC II, B7
21
Q
What are the CD of macrophages?
A
CD14, CD40, MHC II, B7
22
Q
What are the CD of NK cells?
A
CD16, CD56
23
Q
What is the function of CD 1?
A
This is the MHC MHC molecule that presents lipid molecules
24
Q
What is the function of CD 2?
A
Found on thymocytes, T cells, and some natural killer cells that acts as a ligand for CD58 and CD59 and is involved in signal transduction and cell adhesion
25
What is the function of CD 3?
The signalling component of the T cell receptor (TCR) complex
26
What is the function of CD 4 ?
Found on helper T cells.
Co-receptor for MHC class II
Used by HIV to enter T cells
27
What is notable about CD 5 ?
Found in the majority of mantle cell lymphomas
28
What is CD8?
Found on cytotoxic T cells.
Co-receptor for MHC class I
Found on a subset of myeloid dendritic cells
29
What is the cell surface rector for macrophages?
CD 14
30
What CDs are expressed on reed steinberg cells?
CD 15 and CD 30
31
What is the function of CD 16?
Bind to the Fc portion of IgG antibodies
Fc component is the antibody class component
32
What is CD 21 located on ?
EBV
33
What is the function of Cd 95?
Acts as the FAS receptor, involved in apoptosis
34
What is the function of CD 56?
Unique marker for natural killer cells
35
What is the function of the rough endoplasmic reticulum?
Translation and folding of new proteins
manufacture of lysosomal enzymes
site of N-linked glycosylation
36
What cells typically have large rough endoplasmic reticulum?
Extensive RER include pancreatic cells, goblet cells, plasma cells
37
What is the function of the smooth endoplasmic reticulum?
Steroid, lipid synthesis
38
What cells have large smooth endoplasmic reticulum?
extensive SER include those of the adrenal cortex, hepatocytes, testes, ovaries
39
What is the function of Golgi apparatus?
Modifies, sorts, and packages these molecules that are destined for cell secretion
40
What is the function of mitochondria?
Aerobic respiration. Contains mitochondrial genome as circular DNA
41
What occurs in the nucleus?
DNA maintenance
RNA transcription
RNA splicing
42
What is the function of the nucleolus?
Ribosome production
43
What is the function of the function of a ribosome?
Translation
44
What is the function of the proteasome?
Along with the lysosome pathway involved in degradation of protein molecules that have been tagged with ubiquitin
45
What is the function of complement proteins?
Circulating plasma proteins involved in inflammatory and immune reaction of the body.
Complement proteins are involved in chemotaxis, cell lysis and opsonisation
46
What disease is associated with deficiency of C1 inhibitor deficiency?
Hereditary angiodema
Probable mechanism is uncontrolled release of bradykinin resulting in oedema of tissues
47
What disease is associated with classical pathway complement protein deficiency?
Immune complex diseases
HSP and SLE
48
What are the complement proteins in the classical pathway?
C1q, C1rs, C2, C4 deficiency (classical pathway components)
49
What is associated with a C3 deficiency?
Bacterial infections
50
What is associated with C5 deficiency?
Leiner disease
- recurrent diarrhoea, wasting and seborrhoeic dermatitis
51
What is associated with C5-C9 deficiency?
encodes the membrane attack complex (MAC)
particularly prone to Neisseria meningitidis infectio
52
What complement proteins encode MAC?
C5-C9
53
What is the function of IL-1?
Produced by macrophages
Induces fever
Acute inflammation
54
What is the function of IL-2?
Produced by Th-1 cells
Stimulates growth and differentiation of T cell response
55
What is the function of IL-3?
Produced by activated T helper cells
Stimulates differentiation and proliferation of myeloid progenitor cells
56
What is the function of IL-4?
Produced by Th2 cells
Stimulates proliferation and differentiation of B cells
57
What is the function of Il-5?
Produced by Th2 cells
Stimulate production of eosinophils
58
What is the function of IL -6?
Produced by Macrophages, Th2 cells
Stimulates differentiation of B cells
Induces fever
59
What is the function of IL - 8?
" Eight - brings a mate"
Produced by Macrophages
Neutrophil chemotaxis
60
What is the function of IL - 10?
Produced by Th2 cells
Inhibits Th1 cytokine production
Also known as human cytokine synthesis inhibitory factor and is an 'anti-inflammatory' cytokine
61
What is the function of IL -12?
Dendritic cells, macrophages, B cells
Activates NK cells and stimulates differentiation of naive T cells into Th1 cells
62
Function of TNF alpha?
Produced by macrophages
Induces fever
Neutrophil chemotaxis
63
What is the function of Interferon-γ?
Activates macrophages
64
What is the function of endothelin?
potent, long-acting vasoconstrictor and bronchoconstrictor
Thought to be behind primary pulmonary hypertension (endothelin antagonists are now used), cardiac failure, hepatorenal syndrome and Raynaud's.
65
What is the mechanism by which endothelin works? What promotes release and inhibits release?
G-protein linked to phospholipase C leading to calcium release
Promotes release: angiotensin II, ADH, hypoxia, mechanical shearing forces
Inhibits release: Nitric oxide. prostacyclin
66
What diseases are associated with HLA-A3?
Haemochromatosis
67
What encodes the HLA antigen?
Chromosome 6
A,B,C - class one antigens
DP, DQ, DR - class two antigens
68
What diseases are associated with HLA-B51?
Behçet's disease
69
What diseases are associated with HLA-B27?
ankylosing spondylitis
reactive arthritis
acute anterior uveitis
Ulcerative colitis
70
What diseases are associated with HLA-DQ2 or HLA-DA8?
Coeliac disease
71
What disease are associated with HLA-DR2?
narcolepsy
Goodpasture's
72
What disease are associated with HLA-DR3?
dermatitis herpetiformis
Sjogren's syndrome
primary biliary cirrhosis
73
What disease are associated with HLA-DR4?
type 1 diabetes mellitus*
rheumatoid arthritis - in particular the DRB1 gene (DRB1*04:01 and DRB1*04:04 hence the association with DR4)
74
What is the mechanism of type 1 hypersensitivity reaction?
Antigen reacts with IgE bound to mast cells
75
What is the mechanism of type 2 hypersensitivity reaction?
IgG or IgM binds to antigen on cell surface
76
What is the mechanism of type 3 hypersensitivity reaction?
Free antigen and antibody (IgG, IgA) combine
77
What is the mechanism of type 4 hypersensitivity reaction?
Cell mediated - T cell
78
What is the mechanism of type 5 hypersensitivity reaction?
Antibodies that recognise and bind to the cell surface receptors.
This either stimulating them or blocking ligand binding
79
What are example of type 2 hypersensitivity reaction?
Autoimmune haemolytic anaemia
* ITP
* Goodpasture's syndrome
* Pernicious anaemia
* Acute haemolytic transfusion reactions
* Rheumatic fever
* Pemphigus vulgaris / bullous pemphigoid
80
What are example of type 3 hypersensitivity reaction?
* Serum sickness
* Systemic lupus erythematosus
* Post-streptococcal glomerulonephritis
* Extrinsic allergic alveolitis (especially acute phase)
81
What are examples of type 4 hypersensitivity reactions?
* Tuberculosis / tuberculin skin reaction
* Graft versus host disease
* Allergic contact dermatitis
* Scabies
* Extrinsic allergic alveolitis (especially chronic phase)
* Multiple sclerosis
* Guillain-Barre syndrome
82
What are examples of type 5 hypersensitivity reaction?
* Graves' disease
* Myasthenia gravis
83
What is the function of neutrophils?
Innate immune system
Primary phagocytic cell in acute inflammation
Granules contain myeloperoxidase and lysozyme
Most common type of white blood cell
Multi-lobed nucleus
84
What is the function of basophils?
Innate immune system
Releases histamine during allergic response
Granules contain histamine and heparin
Expresses IgE receptors on the cell surface
Bi-lobed nucleus
85
What is the function of mast cells ?
Innate immune system
Present in tissues and are similar in function to basophils but derived from different cell lines
Releases histamine during allergic response
Granules contain histamine and heparin
Expresses IgE receptors on the cell surface
86
What is the function of eosinophils?
Innate immune system
Defends against protozoan and helminthic infections
Bi-lobed nucleus
87
What is the function of monocytes?
Innate immune system
Diffferentiates into macrophages
Kidney shaped nucleus
88
What is the function of macrophages?
Innate immune system
Involved in phagocytosis of cellular debris and pathogens
Acts as an antigen presenting cell
Major source of IL-1
89
What is the function of NK cells?
Innate immune system
Induce apoptosis in virally infected and tumour cells
90
What is the function of dendritic cells?
Acts as an antigen presenting cell
91
What is the function of helper T cells?
Adaptive immune system
Involved in the cell-mediated immune response
Recognises antigens presented by MHC class II molecules
Expresses CD4
Also expresses CD3, TCR & CD28
Major source of IL-2
Mediates acute and chronic organ rejection
92
What is the function of cytotoxic T cells?
Adaptive immune system
Involved in the cell-mediated immune response
Recognises antigens presented by MHC class I molecules
Induce apoptosis in virally infected and tumour cells
Expresses CD8
Also expresses CD3, TCR
Mediates acute and chronic organ rejectio
93
What is the function of B cells?
Adaptive immune system
Major cell of the humoral immune response
Acts as an antigen presenting cell
Mediates hyperacute organ rejection
94
What is the function of plasma cells?
Adaptive immune system
Differentiated from B cells
Produces large amounts of antibody specific to a particular antigen
95
What is the function IgG?
* Enhance phagocytosis of bacteria and viruses
* Fixes complement and passes to the fetal circulation
* Most abundant isotype in blood serum
96
What is the function if IgA ?
* IgA is the predominant immunoglobulin found in breast milk. It is also found in the secretions of digestive, respiratory and urogenital tracts and systems
* Provides localized protection on mucous membranes
* Most commonly produced immunoglobulin in the body (but blood serum concentrations lower than IgG
.)
* Transported across the interior of the cell via transcytosis
97
What shape is IgA?
Monomer or dimer
98
What shape if IgM?
Pentamer
99
What is the function of IgM?
* First immunoglobulins to be secreted in response to an infection
* Fixes complement but does not pass to the fetal circulation
* Anti-A, B blood antibodies (note how they cannot pass to the fetal circulation, which could of course result in haemolysis)
100
What is the function of IgD?
* Role in immune system largely unknown
* Involved in activation of B cells
101
What is the function of IgE?
* Mediates type 1 hypersensitivity reactions
* Synthesised by plasma cells
* Binds to Fc receptors found on the surface of mast cells and basophils
* Provides immunity to parasites such as helminths
* Least abundant isotype in blood serum
102
What is interferon?
Interferons (IFN) are cytokines released by the body in response to viral infections and neoplasia. They are classified according to cellular origin and the type of receptor they bind to.
103
What type of receptors do IFN alpha and beta bind to ?
Type 1 receptors
104
What type of receptors do IFN gamma bind to ?
Type 2 receptors
105
What is the function if IFN alpha?
Produced by leucocytes
Antiviral action
Useful in hepatitis B & C, Kaposi's sarcoma, metastatic renal cell cancer, hairy cell leukaemia
Adverse effects include flu-like symptoms and depression
106
What is the function of IFN beta?
Produced by fibroblasts
Antiviral action
Reduces the frequency of exacerbations in patients with relapsing-remitting MS
107
What is the function of IFN gamma?
predominately natural killer cells. Also by T helper cells
weaker antiviral action, more of a role in immunomodulation particularly macrophage activation
may be useful in chronic granulomatous disease and osteopetrosis
108
How is iron absorbed in the body?
Upper small intestine especially the duodenum
about 10% of dietary iron absorbed
Fe2+ (ferrous iron) much better absorbed than Fe3+ (ferric iron)
109
What increases and decreases amount of iron absorbed?
Increased: Vitamin C, gastric acid
Decreased: Proton pump inhibitors, tetracycline, gastric achlorhydria, tannin (found in tea)
110
How is iron dstirbuted in the body?
Total body iron = 4g
haemoglobin = 70%
ferritin and haemosiderin = 25%
myoglobin = 4%
plasma iron = 0.1%
111
How is iron transported and stored in the body ?
carried in plasma as Fe3+ bound to transferrin
stored as ferritin in tissues
lost via intestinal tract following desquamation
112
What is the function of leukotrines?
mediators of inflammation and allergic reactions
cause bronchoconstriction, mucous production
increase vascular permeability, attract leukocytes
leukotriene D4 has been identified as the SRS-A (slow reacting substance of anaphylaxis)
113
How are leukotrines formed?
Arachidonic acid metabolism
formed from arachidonic acid by action of lipoxygenase
114
Why is it thought asthmatic react to NSAIDS?
NSAID induced bronchospasm in asthmatics is secondary to the express production of leukotrienes due to the inhibition of prostaglandin synthetase
115
At what speed does Ligand-gated ion channel receptors work?
Fast
116
What are examples of ligand-gate ion channels?
Nicotinic acetylcholine
GABA-A
GABA-C
Glutamate receptors
117
What are examples of tyrosine kinase receptors?
Insulin, insulin-like growth factor (IGF), epidermal growth factor (EGF)
118
What are examples of guanylate cyclase receptors?
contain intrinsic enzyme activity
Atrial natriuretic factor
Brain natriuretic peptide
119
How does as G protein couple receptor work, and typically what processes does it affect?
What are the three types of G protein?
Generally mediate slow transmission and affect metabolic processes
Gs, Gi and Gq
120
What is the mechanism of action of Gs protein coupled receptors?
Stimulates adenylate cyclase → increases cAMP → activates protein kinase A
121
What is the mechanism of Gi protein coupled receptors?
Inhibits adenylate cyclase → decreases cAMP → inhibits protein kinase A
122
What is the mechanism of Gq protein coupled receptors?
Activates phospholipase C → splits PIP2 to IP3 & DAG → activates protein kinase C
123
What type of receptor is B1 receptor? Example of receptor?
GS protein
Beta-1 receptors
- epinephrine
- norepinephrine
- dobutamine)
124
Example of GS protein coupled receptors?
B1 receptor
Beta-2 receptors (epinephrine, salbuterol)
H2 receptors (histamine)
D1 receptors (dopamine)
V2 receptors (vasopressin)
Receptors for ACTH, LH, FSH, glucagon, PTH, calcitonin, prostaglandins
125
Example of Gi protein coupled receptor?
* M2 receptors (acetylcholine)
* Alpha-2 receptors (epinephrine, norephinephrine)
* D2 receptors (dopamine)
* GABA-B receptor
126
Examples of Gq protein coupled receptors?
* Alpha-1 receptors (epinephrine, norepinephrine)
* H1 receptors (histamine)
* V1 receptors (vasopressin)
* M1, M3 receptors (acetylcholine)
127
Examples of non-receptor tyrosine kinases?
PIGG(L)ET: Prolactin, Immunomodulators (cytokines IL-2, Il-6, IFN), GH, G-CSF, Erythropoietin and Thromobopoietin
128
What direction does dynein move on a microtubule?
dynein moves in a retrograde fashion, down the the microtubule towards the centre of the cell (+ve → -ve)
129
What direction does kinesin move on a microtubule?
kinesin moves in an anterograde fashion, up the microtubule away from the centre, towards the periphery (-ve → +ve)
130
What does southern blotting detect?
DNA
131
What does northern blotting detect?
RNA
132
What does western blotting detect?
Protein
133
How does an ELISA work?
Type of biochemical assay used to detect antigens and antibodies
a colour changing enzyme is attached to the antibody if looking for an antigen and to an antigen if looking for an antibody
the sample therefore changes colour if the antigen or antibody is detected
134
What is the action of leptin in obesity?
Leptin on satiety centres in the hypothalamus and decreases appetite. More adipose tissue (e.g. in obesity) results in high leptin levels.
Leptin stimulates the release of melanocyte-stimulating hormone (MSH) and corticotrophin-releasing hormone (CRH). Low levels of leptin stimulates the release of neuropeptide Y (NPY)
135
What is the action of leptin in obesity?
Leptin on satiety centres in the hypothalamus and decreases appetite. More adipose tissue (e.g. in obesity) results in high leptin levels.
Leptin stimulates the release of melanocyte-stimulating hormone (MSH) and corticotrophin-releasing hormone (CRH). Low levels of leptin stimulates the release of neuropeptide Y (NPY)
136
What is the action of ghrelin in obesity?
Ghrelin induces hunger
137
What are onocogenes?
Derived from protooncogenes (normal genes for cell growth and differentiation)
A 'gain of function' results in an increased risk of cancer.
Only one mutated copy of the gene is needed for cancer to occur - a dominant effect.
138
What are onocogenes?
Derived from protooncogenes (normal genes for cell growth and differentiation)
A 'gain of function' results in an increased risk of cancer.
Only one mutated copy of the gene is needed for cancer to occur - a dominant effect.
139
What cancer is associated with the oncogenes ABL?
CML
140
What cancer is associated with the oncogenes c-MYC?
Burkitt's lymphoma
141
What cancer is associated with the oncogenes n-myc?
Neuroblastoma
142
What cancer is associated with the oncogenes BCL2?
Follicular lymphoma
143
What cancer is associated with the oncogenes RET?
Multiple endocrine neoplasia type 1 and type 2
144
What cancer is associated with the oncogenes RAS?
Pancreatic and others
145
How do tumour suppressor and oncogenes mutations differ?
Tumor suppressor genes - loss of function results in an increased risk of cancer
Oncogenes - gain of function results in an increased risk of cancer
146
What cancers are associated with EBV?
Burkitt's lymphoma
Hodgkin's lymphoma
Post transplant lymphoma
Nasopharyngeal carcinoma
147
What cancers are associated with HPV 16/18?
Cervical cancer
Anal cancer
Penile cancer
Vulval cancer
Oropharyngeal cancer
148
What cancers are associated with human heperes 8 virus?
Kaposi sarcoma
149
What cancers are associated with Hep B and Hep C?
Hepatocellular carcinoma
150
What cancers are associated with human T lymphoctyic virus?
Tropical spastic paraparesis
Adult T cell leukaemia
151
Where is p53 located?
Chromosome 17 p ( short)
152
What is the function of p53?
cell cycle, preventing entry into the S phase until DNA has been checked and repaired. It may also be a key regulator of apoptosis
153
What genetic disease is associated with p53 mutation?
Li-Fraumeni syndrome is a rare autosomal dominant disorder characterised by the early onset of a variety of cancers such as sarcoma, breast cancer and leukaemias. It is caused by mutation in the p53 gene.
154
What is penetrance?
enetrance describes the proportion of a population of individuals who carry a disease-causing allele who express the related disease phenotype
155
What is expressivity?
Expressivity describes the extent to which a genotype shows its phenotypic expression in an individual.
156
What is the mechanism of polymerase chain reaction?
Initial prep
sample of DNA is added to the test tube along with two DNA primers
a thermostable DNA polymerase (Taq) is added
The following cycle then takes place
mixture is heated to almost boiling point causing denaturing (uncoiling) of DNA
mixture is then allowed to cool: complimentary strands of DNA pair up, as there is an excess of the primer sequences they pair with DNA preferentially
The above cycle is then repeated, with the amount of DNA doubling each time
157
What is the use of PCR?
prenatal diagnosis, detection of mutated oncogenes and diagnosis of infections.
158
What are receptors of the cAMP system?
Epinephrine
- α2, β1, β2
Acetylcholine
- M2
159
What ligands work by cAMP?
ACTH, ADH, calcitonin, FSH, glucagon, hCG,LH, MSH, PTH, TSH, GHRH*
160
What is the primary effector in the cAMP system?
Adenylyl cyclase
161
What are receptors of the Phosphoinositol system?
Epinephrine
- α1
Acetylcholine
- M1, M3
162
What are the ligands of the Phosphoinositol system?
angiotensin II, GnRH, GHRH*, Oxytocin, TRH
163
What is the primary effector of the phosphoinositol system?
Phosphlipase C
164
What are the ligands of the cGMP system?
ANP, Nitric oxide
165
What are the ligands of the tyrosine kinase system?
Insulin, growth hormone, IGF, PDGF
166
What is the primary effector of the tyrosine kinase ?
Receptor tyrosine kinase
167
What is the function of Th1 cells?
involved in the cell-mediated response and delayed (type IV) hypersensitivity
secrete IFN-gamma, IL-2, IL-3
168
What is the function of Th2 cells?
involved in mediating humoral (antibody) immunity
e.g. stimulating production of IgE in asthma
secrete IL-4, IL-5, IL-6, IL-10, IL-13
169
What is anticipation?
In repeat sequences, these expansions are unstable and may enlarge which may lead to an earlier age of onset in successive generations -
170
Trinucleotide repeat disorders?
Fragile X (CGG)
Huntington's (CAG)
myotonic dystrophy (CTG)
Friedreich's ataxia* (GAA)
spinocerebellar ataxia
spinobulbar muscular atrophy
dentatorubral pallidoluysian atrophy
171
What chromosome is HLA on?
chromosome 6
172
If something is tagged with mannose-6-phosphate where is it destined to go?
Lysosome
173
What cancers are associated in goblin syndrome?
Multiple basal cell carcinomas of the skin, along with odontogenic keratocysts (locally aggressive mandibular cysts), rib and vertebral anomalies, intracranial calcification, skeletal abnormalities, medulloblastoma and bilateral ovarian fibromas.
174
What cancers are associated with Lynch syndrome?
hereditary non-polyposis colorectal cancer) is an autosomal dominant condition that is associated with colorectal cancer, along with malignancies of the endometrium, ovary, stomach, small intestine, hepatobiliary tract, brain and skin.
175
What cancers are associated with Von Hippel-Lindau syndrome ?
haemangioblastomas, renal cysts and renal cell carcinoma, pancreatic neuroendocrine tumours, pheochromocytoma and endolymphatic sac tumours.
176
What cancers are associated with MEN2?
medullary thyroid cancer, parathyroid tumours and phaeochromocytoma,.
177
What are the features of Kearns Sayer disease? And inheritance?
Mitochondrial
Kearns-Sayre syndrome
mitochondrial inheritance
onset < 20-years-old
external ophthalmoplegia
retinitis pigmentosa
178
How does breakdown of molecules from lysosomes vs breakdowns via proteasome differ?
Lysosome: large proteins and polysaccharides
Proteasome: polypeptides
179
At what stage of the cell cycle does vincristine work?
Metaphase
Disrupts microtubules preventing aligning in middle
180
What molecular technique is useful for determining extra chromosome copies?
FISH
181
What is the most common molecular mechanism for Down syndrome?
Nondisjunction (maternal)
Failure of homologous chromosomes to separate in anaphase I or the failure of sister chromatids to separate in anaphase II
182
What is the most prevalent immunoglobulin to least?
G A M (D) E
183
What does Il1 stimulate?
secreted mainly by macrophages and monocytes and acts as a costimulator of T cell and B cell proliferation.
184
What are the actions of IL-1?
release by the endothelium of vasoactive factors such as PAF, nitric oxide and prostacyclin it also causes vasodilation and increases vascular permeability.
Along with IL-6 and TNF, it acts on the hypothalamus causing pyrexia
185
What is anakinra used for?
anakinra
IL-1 receptor antagonist
used in the management of rheumatoid arthritis
186
What is canakinumab used for?
canakinumab
monoclonal antibody targeted at IL-1 beta
used systemic juvenile idiopathic arthritis and adult-onset Still's disease
187
What HLA type is reactive arthritis associated with?
HLA - B27
188
Features of cholesterol embolism?
eosinophilia
purpura
renal failure
livedo reticularis
189
What blood test should be sent for all chronic heart failure patients?
NT pro BNP
190
Drugs that should be added in heart failure?
1. ACEI + Beta blocker
2. Adjunct Aldosterone antagonist
Third line:
Ivabradine
Digoxin
Sacubitril-valsartan
Hydralazine
191
Criteria to introduce ivabradine in
