Systemic response to injury and metabolic support 2

Question 1

Mediators of inflammation

Answer 1

Cytokines, Eicosanoids, Plasma contact system, serotonin, histamine

Question 2

-A hormone-like secreted protein.
-Protein signaling compounds that mediate a
broad sequence of cellular responses, including
cell migration, DNA replication, cell turnover, and
immunocyte proliferation

Answer 2

Cytokines

Question 3

An exaggerated proinflammatory cytokine

response to inflammatory stimuli may result in

Answer 3

• hemodynamic instability (i.e., septic shock) and

* metabolic derangements (i.e., muscle wasting)

Question 4

The major precursor of

arachidonic acid is the

Answer 4

omega-6 (n-6) polyunsaturated 
fatty acid (PUFA) linolenic acid

Question 5

They have a broad range of physiologic roles,

including

Answer 5

neural transmission, and vasomotor

regulation, and immune cell regulation.

Question 6

pain medications act

on your _____ to decrease inflammation.

Answer 6

prostaglandins

Question 7

The second major family of PUFAs is the _____ which is found primarily
in cold water fish.

Answer 7

omega-3

fatty acid, alpha-linolenic acid,

Question 8

has the
potential to dampen inflammation (by shifting
the cell membrane composition in factor of
omega 3-PUFAs over omega 6-PUFAs)

Answer 8

Omega-3 fatty acid supplementation

Question 9

Part of the innate immune system that 
enhances the ability of antibodies and 
phagocytic cells to clear microbes and 
damaged cells, promotes inflammation, and 
attacks the pathogens cell membrane

Answer 9

Complement

Question 10

Group of proteins that contribute to both coagulation

and inflammation

Answer 10

KALLIKREIN-KININ SYSTEM

Question 11

mediate several physiologic processes
including vasodilation, increased capillary,
permeability, tissue edema, and neutrophil chemotaxis

Answer 11

Kinins

Question 12

Bradykinin and kallikrein levels are ______following

hemorrhagic shock and tissue injury

Answer 12

increased

Question 13

Serotonin is a monoamine neurotransmitter (5-

hydroxytryptamine; 5HT) derived from ____

Answer 13

tryptophan

Question 14

• It is a potent vasoconstrictor and also modulates
cardiac inotrophy and chronotrophy
• Released at sites of injury for neutrophil recruitment

Answer 14

SEROTONIN

Question 15

HISTAMINE RECEPTOR
• Mediates vasodilation, 
bronchoconstriction, intestinal 
motility, and myocardial contractility
• Mediates B and T cells responses

Answer 15

H1R binding

Question 16

HISTAMINE RECEPTOR
• Stimulates gastric parietal cell acid
secretion

Answer 16

H2R BINDING

Question 17

• Is a presynaptic auto-receptor in the
peripheral and central nervous system
• Participates in inflammation in the
CNS

Answer 17

H3R

Question 18

• is a modulator of chemo attraction

and cytokine production

Answer 18

H4R

Question 19

A major group of cytokines bind to receptors termed
______, and these selectively
associate with the Janus kinases (JAK1, JAK 2, JAK
3, TYK2)

Answer 19

type I/II cytokine receptors

Question 20

is considered a
central communication hub for the immune system
(especially for cytokines which are major
communicators of immune response)

Answer 20

JAK-STAT signaling pathway

Question 21

are constitutively bound to the cytokine
receptors, and on ligand binding and receptor
dimerization

Answer 21

JAK’s

Question 22

STAT
molecules possess ______ sites that allow for
STAT dimerization.

Answer 22

“docking”

Question 23

will stop the
activation of STAT, preventing entry to nucleus for
nuclear transcription.

Answer 23

SOCS

Question 24

SOCS___ are

typically associated with cytokine receptor signaling,

Answer 24

1-3

Question 25

SOCS___ are associated with growth factor | receptor signaling

Answer 25

4-8

Question 26

Includes the receptors for catecholamines, bradykinins, and leukotrienes, and other ligands important to the inflammatory response

Answer 26

G-PROTEIN-COUPLED FAMILY OF RECEPTORS

Question 27

Rhodopsin-like

Answer 27

Class A

Question 28

Secretion-like

Answer 28

Class B

Question 29

Metabolic glutamate

Answer 29

Class C:

Question 30

Frizzled receptors

Answer 30

Class D

Question 31

``` allow continued presentation of auto-antigens to the host immune system (which can cause further injury) – it will be an autopilot inflammatory response. ```

Answer 31

‘neutrophils extracellular traps' or NETs,

Question 32

• Most abundant of granulocytes • Among the first responders to sites of infection and injury, potent mediator of inflammation. • Short half-lives (4 to 10 hours)

Answer 32

NEUTROPHILS (PMNs)

Question 33

characterized by the expression of high levels of proinflammatory cytokines, like TNF-α, IL-1 and IL-6.

Answer 33

M1 phenotype

Question 34

are considered to be involved in the promotion of wound repair and the restoration of immune homeostasis through their expression of arginase-1 and IL-10. These are activated by anti – inflammatory cytokines.

Answer 34

M2 macrophages

Question 35

play central roles in the function of the immune system through their effects on B cell antibody production, their enhancement of specific T cell functions, and their assistance with macrophage activation.

Answer 35

CD4 +T cells (helper)

Question 36

The more severe the injury, Th__ will be more activated.

Answer 36

2

Question 37

``` are the most important antigen - presenting cells (APCs) for initiating T-cell responses against protein antigens ```

Answer 37

DENDRITIC CELLS

Question 38

adopt an initial pro - inflammatory phenotype by expressing and releasing a variety of adhesion molecules, cytokines, and other immune modulators including high mobility group 1 protein (HMGB1), interleukin (IL)-1β

Answer 38

platelets

Question 39

are also known to play an important role in | the anaphylactic response to allergens.

Answer 39

Mast cells

Question 40

Migrant cell of connective tissue, which contain | granules rich in histamine and heparin

Answer 40

Mast cells

Question 41

T or F Endothelial cells are mainly anticoagulant to prevent microthrombosis. In injury, in order to stop bleeding, they induce coagulation

Answer 41

T

Question 42

Higher ______ measurements correlated with | ISS/mortality

Answer 42

syndecan-1

Question 43

Has overall anticoagulant properties mediated via the production and cell surface expression of heparan sulfate, dermatan sulfate, tissue factor pathway inhibitor, protein S, thrombomodulin, plasminogen, and tissue plasminogen activator

Answer 43

VASCULAR ENDOTHELIUM

Question 44

Family of small proteins with chemotactic and | activating effects on inflammatory cells

Answer 44

CHEMOKINES

Question 45

Key attractants for immune cell extravasation

Answer 45

CHEMOKINES

Question 46

Normal vascular smooth muscle cell relaxation is | maintained by a constant output of

Answer 46

NITRIC OXIDE

Question 47

can also reduce micro thrombosis by reducing platelet adhesion and aggregation and interfering with leukocyte adhesion to the endothelium

Answer 47

NITRIC OXIDE

Question 48

Endogenous NO formation is derived largely from the | action of

Answer 48

NO synthase (NOS), which is constitutively expressed in endothelial cells (NOS3)

Question 49

The vasodilatory effects of NO are mediated by________, an enzyme that is found in vascular smooth muscle cells and most other cells of the body

Answer 49

guanylyl | cyclase

Question 50

Potent vasodilator that also inhibits platelet | aggregation

Answer 50

PROSTACYCLIN (PGI2)

Question 51

best effects of PGI2

Answer 51

Cardiovascular system

Question 52

T or F PGI2 reduces pulmonary blood pressure and bronchial hyperresponsiveness

Answer 52

T

Question 53

T or F PGI2 modulates renal blood flow and glomerular filtration rate

Answer 53

T

Question 54

PGI2 ________ pulmonary blood pressure as well as | bronchial hyperresponsiveness

Answer 54

Reduces

Question 55

Family of small proteins (8 to 13 kDa) that were first identified through their chemotactic and activating effects on inflammatory cells

Answer 55

CHEMOKINES

Question 56

Prostacyclin acts through its receptor (a G-protein– coupled receptor of the rhodopsin family) to stimulate the enzyme _______, allowing the synthesis of cAMP from adenosine triphosphate (ATP)

Answer 56

adenylate cyclase

Question 57

Potent mediators of vasoconstriction and are | composed of three members: ET-1, ET-2, and ET-3

Answer 57

ENDOTHELINS

Question 58

ET release is ______ in response to hypotension, injury, thrombin, IL-1, angiotensin II, vasopressin, catecholamines, and anoxia.

Answer 58

upregulated

Question 59

Prostacyclin | (prostaglandin I2, or PGI2) is derived from

Answer 59

arachidonic acid (AA),

Question 60

nitric oxide (NO) is derived from

Answer 60

L-arginine

Question 61

T or F The increase in • cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) results in smooth muscle relaxation and inhibition of platelet thrombus formation. Endothelin (ETs) are derived from “big ET,” and they counter the effects of prostacyclin and NO

Answer 61

T

Question 62

Promotes the activation and aggregation of platelets and leukocytes, leukocyte adherence, motility, chemotaxis, and invasion, as well as ROS generation

Answer 62

PLATELET ACTIVATING FACTOR

Question 63

is a major lipid constituent of the plasma membrane. Its enzymatic processing by cytosolic phospholipase A2 (cPLA2) or calcium-independent phospholipase A2 (iPLA2) generates powerful small lipid molecules, which function as intracellular second messengers

Answer 63

Phosphatidylcholine

Question 64

are a family of peptides that are released primarily by atrial and ventricular tissue respectively but are also synthesized by the gut, kidney, brain, adrenal glands, and endothelium

Answer 64

natriuretic peptides, atrial natriuretic factor (ANP) | and brain natriuretic peptide (BNP)