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Flashcards in Path 3 Deck (49)
1

Toll-like receptors

MO & dendritic cells
Recognize patterns (PAMPs) - CD14 on MO recognizes LPS --> upregulates NK-kB --> production of mutliple immune mediators

2

PGI, D, E2

Vasodilation at arteriole and inc permeability at post-capillary venule

3

PGE2

Fever & pain

4

LTB4

Attracts and activates neutrophils (IL-8, and C3b also)

5

LTC, D, E4

Vasoconstriction, bronchospasm, inc vascular permeability - contract smooth muscle

6

Second phase of mast cell response

LEUKOTRIENES

7

Classical complement pathway

GM makes classic cars - IgG or IgM bound to Ag --> C1 binds and activates

8

Alternative complement pathway

Microbial products directly activate complement

9

Mannose-binding Lectin pathway

MBL binds to mannose on microorganisms --> activation

10

C5a

Neutrophil chemotaxis

11

C3b

Opsonization for phagocytosis

12

Hageman Factor (XII)

Important role in DIC
- coagulation, fibrinolytic systems, complement, kinin

13

Factors mediating vasodilation/redness

*Histamine*
PGs
Bradykinin

14

Fever mechanism

LPS --> MO --> IL-1 & TNF --> COX in hypothalamus --> PGE2 --> inc temp set point

15

Neutrophil arrival

Margination --> Rolling --> Adhesion --> Transmigration & Chemotaxis --> Phagocytosis --> Destruction

16

Margination

vasodilation slows BF in post-capillary venule --> periphery of BV

17

Rolling

P-selectin - Weibel-Palade bodies (Histamine)
E-selectin - TNF & IL-1

Bind sialyl Lewis X on leukocytes

18

Adhesion

Endothelium - ICAM & VCAM via TNF, IL-1

Leukocytes - integrins via C5a, LTB4

19

Leukocyte adhesion deficiency

AR defect in integrins (CD18)
- delayed umbilical cord separation
- recurrent bacterial infection W/O pus
- Inc circulating neutrophils

20

Neutrophil phagocytosis mech

Enhanced by opsonins - IgG & C3b

21

Chediak-Higashi

AR defect in microtubules --> impaired phagolysosome formation

- inc pyogenic infections
- neutropenia
- GIANT GRANULES IN LEUKOCYTES
- ALBINISM

22

MPO deficiency

Defective conversion from H2O2 --> HOCl
NBT normal
Inc CANDIDA infections

23

MO fxns

Resolution/Healing - IL-10, TGF-B

Continued acute inflammation - *IL-8* = more neutrophils

Abscess - wall of acute inflammation w/ fibrosis

Chronic inflammation - present Ag to CD4 --> chronic inflammation

24

CD4+ activation

EXTRAcellular Ag - phagocytosed --> MHC II
B7 on APC binds CD28 (28/7 = 4)

TH1 --> IL-2 (CD8) & IFN-y (MO)
TH2 --> IL-4 (B-cells from IgG --> IgE) & IL-5 (eosinophils & IgA) & IL-10 (inhibits TH1)

25

CD8+

INTRAcellular Ag - ALL nucleated cells
IL-2 from CD4 TH1

Perforin & granzymes --> APOPTOSIS
FasL binds Fas --> APOPTOSIS

26

B-cell activation

1. Ag bind to IgM or IgD --> plasma cells

2. B-cell Ag to CD4 on MHC II + CD40/CD40L on Th cells --> IL-4, 5 --> class switch and maturation

27

Key characteristic of granuloma

*Epithelioid histiocytes*

Can see giants cells and rim of lymphocytes
MO present Ag on MHC II --> IL-12 --> TH1 --> IFN-y --> converts MO to epithelioid histiocytes

28

Non-caseating granuloma

LACK central necrosis

1. Foreign material - breast implant
2. Sarcoid
3. Beryllium
4. Crohn
5. Cat scratch - "stellate shaped"

29

Caseating granuloma

Central necrosis

1. TB - AFB stain
2. Fungal infections - GMS stain

30

DiGeorge

Failure of 3rd & 4th pouch
22q11 deletion

No thymus, no T-cells, HypOCa --> tetany, cardiac & facial anomalies

31

SCID

1. cytokine receptor defects - no B or T cell maturation

2. ADA - buildup of de-oxyadenosine os toxic to lymphocytes

3. MHC II deficiency - CD4 not activated = defective B & T cells

Fungal, viral, bacterial, protozoal, opportunisitc

32

X-linked Agammaglobulinemia

TK deficiency --> B-cells can't mature to plasma cells = no Ig

1. Bacterial - no opsonin (IgG)
2. Enterovirus - mucosal GI (IgA)
3. Giardia

33

Most common Ig deficiency

IgA deficiency

*Celiac Disease*

34

Hyper IgM syndrome

Mutated CD40 (B cells) or CD40L (T cells)

Low IgA - mucosal
Low IgG - pus infections d/t poor opsonization
Low IgE

35

Wiskott-Aldrich

1. Thrombocytopenia
2. Ezcema
3. Recurrent Infection

36

Most common injury/cause of death in SLE

Diffuse proliferative glomerulonephritis

37

Libman-Sacks endocarditis

SLE - sterile deposits in BOTH sides of heart valve, esp mitral

38

Drug-Induced lupus

Anti-Histone Abs

1. Hydralazine
2. Procainamide
3. Isoniazid

39

Anti-phospholipid syndrome

Subset of SLE

1. Cardiolipin - False + syphilis test
2. Lupus anti-coagulant - falsel elevated PTT = hypercoagulable state --> DVT, recurrent miscarriages, Budd-chiari

40

Sjogren Syndrome

Type IV HS
Dry eyes, mouth, dental carries

Anti-Ribonucleoprotein abs
Assoc w/ RA

41

Disease assoc w/ inc risk of B-cell (mantle zone) lymphoma

Sjorgen syndrome
- U/L enlargement of parotid

42

Can't chew a cracker, dirt in my eyes

Sjogren syndrome

43

Anti-DNA topoisomerase I Abs

Diffuse scleroderma

44

Anti-Centromere Abs

Localized scleroderma (CREST)

45

Anti-U1 Ribonucleoprotein Abs

Mixed CT disease

46

Granulation tissue

1st phase of repair

Fibroblasts - type III collagen
Capillaries - nutrients
*Myofibroblasts - contract wound*

47

Scar formation

Type III collagen replaced w/ type I
- collagenase requires *ZINC*

48

Keloid

Type III collagen

49

Hypertrophic scar collagen type

Type I