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Year 3 Sem 1 > Week 2 > Flashcards

Week 2 Flashcards

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1
Q

what are the 3 developmental processes of T and B lymphocytes?

A

rearrangement of their germline Ag receptor genes
selection of functional receptors
negative selection to eliminate self reactive clones

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2
Q

which are the polymeric and multimeric isotopes?

A

polymeric: IgM and IgA
monomeric: IgD, IgE, IgG

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3
Q

what are the brief functions of IgM, IgG and IgE?

A 
IgM = classical pathway activation 
IgG= placental transfer 
IgE= high affinity binding to mast cells and basophils
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4
Q

definition of BCR

A

Ab bound to transmembrane proteins that allow a signal to be sent and the epitope interacts with Ag binding site on BCR

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5
Q

what are complementary determining regions?

A

part of the variable chain in Ig
hypervariable regions within Vh and Vl - determine Ag specificity
Ab bind antigens via amino acids in CDRs

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6
Q

which gene segments are involved in the heavy chain of Ig genes?

A

V, J, D gene segments

multiple C regions

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7
Q

which gene segments are involved in the light chain of Ig genes?

A

V and J gene segments

1 constant region

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8
Q

what are the enzymes involved in DNA recombination?

A

RAG-1 & RAG-2 recombinases, kinases and ligases

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9
Q

what is the order of somatic recombination in terms of heavy and light chains?

A

heavy chain rearrange first

light chains rearrange second

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10
Q

what are the functions of the V and C regions?

A

V region- Ag binding

C region - signal transduction; interacts with effector cells and molecules

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11
Q

describe Fab and Fc receptor and how they are cleaved?

A

fab: binds Ag and has 1 V region and 1 C region
Fc: involved in Ag recognition
both can be cleaved by papain

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12
Q

general function of IgM?

A

activation of classical pathway

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13
Q

which Ab is involved in placental activation?

A

IgG1

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14
Q

what is the order for somatic recombination in light chains?

A

V and J gene segments join - RNA splicing joins VJ to C region

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15
Q

what is the order for somatic recombination in heavy chain?

A

D and J gene segments join
then V segment joins DJ complex
VDJ is joined by C segments

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16
Q

where are germinal centres located?

A

within secondary lymph nodes

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17
Q

how are germinal centres formed?

A

after Ag activates B cell it receives help from CD4 helper T cells (Tfh) and together moves into the deep follicle of LT

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18
Q

what happens in germinal centers?

A

somatic hypermutation, IgG class switching, differentiation into plasma/ memory cells

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19
Q

time course of leukocyte migration (neutrophils/ monocytes)

A

neutrophils infiltrate in the first 6-24 hours

then replaced by monocytes 24-48 hours

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20
Q

brief points about vascular response to inflammation

A

increased microvascular permeability - plasma proteins move into extravascular tissue = increased blood viscosity and stasis

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21
Q

transudate vs excudate?

A 
transudate = fluid pushed out into extravsacualr tissue due to increased HP
excudate= fluid leaks out of capillaries due to inflammation
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22
Q

brief summary of cellular response of inflammation?

A

margination and rolling of leukocytes along endothelium

adhesion to the endothelium

transmigration out of the vessel between endothelial cell

migration into interstitial tissue toward a stimulus by chemotaxis

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23
Q

3 functions of leukocytes?

A

phagocytosis
release of substances that destroy EC microbes and sea tissue
production of mediators that amplify inflammatory response = more recruitment/ activation

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24
Q

what is D-dimer?

Study These Flashcards
A

when fibrin degradation occurs D dimer results

indicates activation of fibrinolytic system

25
how does prevalence relate to predicted values?
low prevalence = low PPV and high NPV | high prevalence = high PPV and low NPV
26
goal of motivational interview?
make the patient themselves aware of the potential for change in behaviour resulting in improved health
27
3 components of motivation?
willing able ready
28
what does motivational interviewing help get rid of?
doubt and ambivalence
29
what theory does motivational interviewing use?
transtheoretical model
30
what are the 4 determinants of chronic disease?
social factors behavioural factors biological factors environmental factors
31
trans theoretical model?
``` precontemplation contemplation preparation action maintenance relapse ```
32
indications for motivational interviewing?
``` SNAP risk factors medication adherence adherence to recommended screening and dx tests gambling pain management management of CD substance use disorder ```
33
what are the 5A's?
``` ask assess advice assist arrange ```
34
Grace Model?
generate a gap - between patients current situation and what they want roll with resistance - ambivalence is normal, alter strategy if there is resistance avoid arguments - they increase resistance can do attitude - encourage self efficacy and hope express empathy - listen, communicate, acceptance/ support; gently persuade while respecting personal vie w
35
what is RULE? - in motivational interviewing
resist the righting reflex understand your patients motivation listen with empathy empower your patient
36
what are the cell derived mediators in acute inflammation?
``` histamine cytokines chemokines leukotrienes prostaglandins platelet activating factor ```
37
what are the plasma derived mediators in acute inflammation?
complement | kinins
38
what mediators are involved in vasodilation?
PG, NO, histamine
39
what mediators are involved in increased vascular permeability?
histamine, 5HT, leukotrienes, C3a C5a, substance P, PAF, BK
40
what mediators are involved in chemotaxis, leukocyte recruitment and activation?
TNF, IL1, chemokine, C3a/C5a, leukotriene B4, bacterial products
41
what mediators are involved in fever?
PG, IL1, TNF
42
what mediators are involved in pain?
BK and PG
43
what mediators are involved in tissue damage?
lysosomal enzymes or leukocytes, ROS and NO
44
risk vs hazard?
``` hazard = inherit dangerousness risk = ability to cause harm ```
45
what are the types of risk?
``` individual community acute chronic primary secondary political/ reputational ```
46
what is risk mitigation?
the systematic reduction in the extent of exposure to a risk factor and the likelihood of its occurrence
47
what is risk perception impacted by?
``` trust origin control awareness age affected nature scope imagination uncertainty familiarity specificity personal impact fun/pleasure ```
48
risk matrices?
A risk matrix is a matrix that is used during risk assessment to define the level of risk by considering the category of probability or likelihood against the category of consequence severity. This is a simple mechanism to increase visibility of risks and assist management decision making.
49
prevention paradox and risk?
low chance of something happening in a large population | high chance of something happening in a small population
50
what does the C region on the AB bind?
Complement, FC receptor | involved in signal transduction
51
what Ig isotopes are involved in opsonization?
IgG1 works best for Ab binding to pathogen | IgM works best for complement binding to pathogen
52
which bacteria must be opsonized before phagocytosed?
Pyogenic bacteria such as Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus must be opsonised before they are phagocytosed.
53
what substance do leukocytes secrete to help them cross the basement membrane?
collagenase
54
what is the course of leukocytes once they are outside the vessel?
leukocytes move to the site of infection by along a chemical gradient they bind to specific cell surface receptors which trigger the assembly of cytoskeletal contractile elements necessary for movement leukocytes move by extending pseudopods that pull cell in the direction of the extension
55
how do B cell tumours form?
malignant transformation of these cells by translocation of proto-oncogenes into the Ig loci CLL, ALL, myeloma
56
what results from defective Ig gene rearrangement?
SCID, brutons TK def
57
what results from defective class switching?
hyperIgM
58
what are the 3 'rulers' in motivational interviewing?
importance ruler readiness ruler confidence ruler

Year 3 Sem 1 (12 decks)

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