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Donati - Physiology Spring Quarter
Final Exam
183
Physiology
Professional
05/12/2010

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Term
Major cell type of ACUTE inflammation
Definition
neutrophil/PMN/Poly
Term
Major cell type of chronic inflammation
Definition
Lymphocytes (B and T), Monocytes, NKCs
Term
B cells mature in the
Definition
Bone marrow
Term
T cells mature in the
Definition
Thymus
Term
Innate Immune System
Definition
Physical barriers such as skin, saliva, mucus, tears. Phagocytic cells (macrophages and neutrophils). NK cells for cytotoxicity.
Term
Complements for innate immune system:
Definition
Alternative and lectin pathways.
MAC
Term
Properties of innate immune system
Definition
Non specific
Fast
Limited diversity
No memory
Primitive
Reliable (no self attack)
Term
Properties of Adaptive immune system
Definition
Slow
Diverse
Specific
Memory
Specialized (found in early vertebrates)
Term
Adaptive immune system major players:
Definition
B Cells (secretes immunoglobulin IgG) - HUMORAL!
T cells recognize T Cell receptor
All cells have MHC
Term
Three complement cascades
Definition
Classical (C1, C4, C2, C3) (Requires Ab)
Alternate (properdin)
Mannose binding Lectin or LECTIN - uses MBL to initiate the pathway
Term
All three complement cascades will result in the formation of a
Definition
C3 and C5 convertases.
After C5 convertase is made the terminal pathway is the same for all three
Term
Activation of the classical complement pathway
Definition
C1 complex - Ab binding to microbe.
Proceeds to C4b2b3b C5 convertase
Term
Activation of the alternative pathway
Definition
Anything that hydrolyzes C3 (cellophane, plasmin, venom etc)
Proceeds with C3bBb3b + properdin as C5 convertase
Term
Activation of Lectin pathway
Definition
MBL initiates - binds to bacterial surface protein (only difference from Classical pathway).
Term
Membrane Attack Complex (MAC) parts
Definition
C5b, 6, 7, 8, and 9. C9 forms the pore that causes lysis of the cell.
Term
Cytotoxic T cells express
Definition
Cd8
Term
Helper T cells express
Definition
Cd4
Term
Subtypes of Helper T Cells
Definition
Th1 and Th2
Term
All T Cells express
Definition
Cd3
Term
T Cells react to target:
Definition
TCR Binds to MHC Plus Peptide. CD4/CD8 molecule will bind separately to the MHC molecule.
Term
CD4 binds MHC ____
Definition
II
Term
CD8 binds MHC ____
Definition
I
Term
Activation of CD4 T cells
Definition
2 signals:
1st if TCR with MHC + peptide complex.
Next is CD28 + B7 interaction.
YOU NEED THIS 2nd INTERACTION FOR THE CELL TO BE ACTIVATED
Term
Active CD4 T cell activates:
Definition
macrophages and B cells
Term
When CD4 T cells activates B Cells, CD4 T cells secrete
Definition
Specific cytokines which cause the class switch of Antibodies in the B cell
Term
CD8 positive T cells bind to:
Definition
Infected Cell, and kill it. Release enzymes that create membrane pores --> apoptosis of target cell
Term
Structure of Antibodies
Definition
2 light chains, 2 heavy chains.
Light chains either LAMBDA or KAPPA.
Both light chains will always be the SAME.
Both heavy chains will be the SAME.
Term
IgA
Definition
Secretory.
Present in nasal secretions, tears, and milk. (only one that passes through epithelial membranes)
Term
IgG
Definition
Main Ab secreted in a 2nd immune reaction. (Involved in activation of classical pathway)
CROSSES PLACENTA
Term
IgM
Definition
Pentamer.
Both SURFACE AND SECRETORY.
Most prominent in FIRST primary immune response.
Term
IgD
Definition
Membrane bound ONLY (Is the B Cell receptor)
Term
IgE
Definition
Main Ab in type I hypersensitivity.
Allergic RXN, binds to basophils and mast cells.
Plays a role against PARASITES.
Term
Allogenic
Definition
Between 2 humans
Term
Xenogenic
Definition
Between 2 different species
Term
Autograft
Definition
Graft your own tissue
Term
Isograft
Definition
between identical twins
Term
Type I Diabetes is Type ____ Hypersensitivity
Definition
IV
Term
Type I, II, and III hypersensitivity are all mediated by
Definition
Antibodies
Term
Type I Hypersensitivity mediated by
Definition
IgE --> Mast Cell (histamine)
Term
Type II hypersensitivity mediated by
Definition
IgG or IgM bound to host cells. (phagocytic activity)
Term
Type III Hypersensitivity mediated by
Definition
IgG or IgM Immune Complex. (phagocytic activity)
Term
type IV hypersensitivity mediated by
Definition
Activation of CD4 and CD8 T Cells (macrophage activation --> lysis)
Term
Basic functions of the kidney
Definition
Filtration into the renal tubules.
Reabsorption into the peritubular capillaries.
Secretion back into tubules from peritubular capillaries.
SUM of all of these that gives the amount of a specific solute that is going to be excreted.
Term
Late distal and cortical collecting tubule Under ____ control
Definition
hormonal
Term
Cell types of the Late Distal and Cortical Collecting tubule
Definition
Principal Cells and Intercalated Cells
Term
Principal Cells
Definition
Reabsorption of Sodium (water follows)
Secretes potassium back into renal tubule.
Term
Intercalated Cells
Definition
Reabsorb Bicarbonate and potassium into capillaries.
Also secrete HYDROGEN.
Term
Principal Cells are sensitive to:
Definition
Aldosterone
Term
Aldosterone stimulates:
Definition
sodium REABSORPTION and potassium SECRETION
Term
Other Hormone that acts in the cortical and medullary collecting tubules:
Definition
ADH. Released upon increases in osmolarity (osmoreceptors). Synthesized in hypothalamus, Released by Posterior pituitary - aids in reabsorption of water.
Term
Ascneding - Thin Loop if Henle, Thick loop of Henle, and Early Distal Tubule are _____ impermeable to water
Definition
ALWAYS. I.E. NOT sensitive to ADH.
Term
In presence of ADH - these parts of the tubule are permeable to water
Definition
Late distal, cortical collecting tubule, medullary collecting tubule.
Term
When ADH is absent, these areas are impermeable to water:
Definition
All regions after the descending thin tubule. (Dilute Urine, no water reabsorption.
Term
Late Distal and Cortical Collecting Tubules affect _____ reabsorption
Definition
Potassium. High potassium diet leads to more potassium secretion back into the renal tubules.
Low potassium diet - leads to more reabsorption of potassium back into capillaries.
Principle cells secrete potassium back into the tubules, intercalated Cells reabsorb potassium back into the capillaries..
Term
PTH Acts on this region to stimulate Calcium reabsorption
Definition
Late distal, (thick ascending limb), distal tubules
Term
2/3 of calcium absorbed in the _____, like just about everything else, but 1/3 is reabsorbed in the ______
Definition
Proximal tubules, late distal tubule (thick ascending limb) (PTH)
Term
Phosphate reabsorbed completely in the _______
Definition
proximal tubule (PTH inhibits phosphate reabsorption)
Term
PTH Functions:
Definition
Stimulate Calcium reabsorption, decrease phosphate reabsorption
Term
Kidney Regulation of Acid levels: (3 mechanisms)
Definition
Secrete H+
Reabsorb Bicarbonate
Produce Bicarbonate
Term
All bicarbonate reabsorption requires:
Definition
Hydrogen secretion
Term
Bicarb reabsorption/hydrogen secretion is mostly occuring in the
Definition
Proximal tubules
Term
All inulin filtered is eventually
Definition
Excreted
Term
Inulin Clearance rate is ______ which is exactly what the glomerular filtration rate
Definition
125 ml/min
Term
Renal clearance rate less than inulin (125) than it neans some of that solute is being ______
Definition
reabsorbed
Term
Renal clearance rate greater than inulin (125) than it neans some of that solute is being ______ back into the renal tubule
Definition
secreted
Term
Spermatogenesis - LH acts on the _______ to secrete __________
Definition
Leydig cells
Testosterone
Term
Testosterone becomes systemic and negatively feedbacks on ______ production
Definition
LH
Term
Testosterone stimulates ________
Definition
sertoli cells
Term
FSH acts on ______ and stimulates the Process of _______
Definition
Sertoli Cells
spermatogenesis
Term
Follicular Cycle - Thecal cells stimulated by _____ to produce ______
Definition
LH
Adrogens
Term
Androgens diffuse into ______ cells under FSH stimulation
Definition
Granulosa
Term
Under FSH stimulation the granulosa cells convert androgens into _________
Definition
estrogen
Term
Estrogen positively feeds back on _________ to make more FSH receptor cells and make them more responsive to FSH
Definition
granulosa cells
Term
Acute glomerular nephritis and Acute Tubular Necrosis (ATN) are _________
Definition
Reversible
Term
Main cause of acute glomerular nephritis is _________
Definition
streptococcal infection - circulating antibody immune complexes that block filtration and cause inflammatory RXNs
Term
Ischemic ATN
Definition
Focal necrosis
Term
Nephrotoxic ATN
Definition
Continuous necrosis of cells
Term
Both ischemic and nephrotoxic ATN will form _______
Definition
casts (necrotic cell debris lodges in distal portions of tubule)
Term
% of GFR of chronic renal failure
Definition
GFR less than 20-25% of normal
Term
END STAGE renal disease (needs kidney transplant or dialysis), % of GFR:
Definition
GFR is less than 5% of normal
Term
Pathogenesis of chronic glomerulonephritis
Definition
Begins with precipitation of antigen-antibody complexes - inflammation - thick membranes - fibrosis - decreased glomerular filtration coefficient. Can lead to nephrotic syndrome.
Term
Chronic obstructive pyelonephritis pathogenesis
Definition
Due to bacterial infection - injury to renal interstitial tissue (bacteria that has traveled from the bladder) - UTI
Term
Chronic renal diseases lead to abnormal _____ function
Definition
nephron
Term
Abnormal nephron functions:
Definition
loss of water and electrolyte balance, decreased waste product excretion, uremia, anemia, osteomalacia
Term
3 primary zones of the prostate gland
Definition
Central Zone, transitional zone, peripheral zone
Term
BPH nodules form in the ______
Definition
central zone and transitional zone
Term
Prostate cancer nodules develop in the
Definition
Peripheral zone
Term
Pathophysiology of BPH - main Stimulus is
Definition
testosterone - converted to DHT in stromal cells, binds to testosterone receptor and stimulates growth, as well as stimulating growth in epithelial cells
Term
Endometriosis - regurgitation theory
Definition
Retrograde menstruation therough the fallopian tubes
Term
Endometriosis - metaplastic theory
Definition
Endometrium arises from originating tissue (skeletal muscle?)
Term
Endometriosis - dissemination theory
Definition
Endometrial cells spread via blood and lymphatics
Term
Preeclampsia symptoms
Definition
HTN, weight gain, potein in urine, edema, arterial spasm
Term
Symptoms of Eclampsia
Definition
Only when seizures are present
Term
Primary cause of tozemia (preeclampsia/eclampsia)
Definition
Blastocyst does not trigger normal placental formation - inschemia - HTN in mom, coagulation of vessels
Term
Carcinomas spread through
Definition
lymphatics (usually, but can also go through blood)
Term
Sarcomas spread through
Definition
Blood (usually, but can also go through lymphatics
Term
Oncogenes (growth promoting)
Definition
Ras, cyclin D, CDK4
Term
Tumor suppressing genes (growth inhibiting)
Definition
Rb, P53
Term
DNA Repair genes
Definition
BRCA
Term
Apoptotic genes
Definition
Bcl - 2
Term
Ras
Definition
G protein. When mutated (oncogene now, no longer a protooncogene) it continuously is bound to GTP stimulating MAP Kinase growth cascade and transcription
Term
Cyclin and CDKs
Definition
Genes that act in cell cycle progression
Term
Cyclins and CDKs act ______
Definition
together, Individually they will not function
Term
Cyclin D/CD4K acts on
Definition
G1 to S phase of cell cycle (site of most dysregulation in many tumors)
Term
Cyclin D / CD4K complex regulates this protein
Definition
Retinoblastoma (Rb)
Term
Retinoblastoma (Rb) is a
Definition
Nuclear protein - active when it is HYPOphosphorylated. Main function is a break between G1 and S phase - i.e. it prevents cell cycle progression. So when HYPERphosphorylated it allows cell cycle to progress
Term
Rb protein is active when ______ and has this effect:
Definition
HYPOphosphorylated
prevents cell cycle progression by binding E2F and prevents E2F from stimulating transcription of the gene
Term
Cyclin D/ CDK4's main job is to
Definition
Phosphorylate Rb (thereby inactivating it) which allows gene transcription and thus growth
Term
Need _____ copies of mutated Rb gene in order to get Rb cancer formation
Definition
2
Term
Familial form of Rb cancer
Definition
Born with one mutated gene, something in life triggers mutation of 2nd normal copy - tumor formation
Term
Sporadic form of Rb cancer
Definition
Born with 2 normal copies of the gene and have 2 separate mutation events that occur - leads to tumor formation
Term
P53
Definition
Main tumor suppressor gene (molecular police man). When DNA is damages P53 triggers P21 to stop cell cycle progression - next it triggers GAD 45 to repair DNA damage - if can't be repaired it triggers bax for apoptosis
Term
BRCA1 and BRCA2 are primarily _______
Definition
DNA repair genes. Primarily involved in breast cancer - regulating estrogen receptor activity
Term
Bcl-2
Definition
Apoptosis Inhibitor (balance with bax)
Term
Telomeres ______ with each mitotic event
Definition
shorten
Term
Bcl-2 mutations usually found in ______
Definition
lymphomas
Term
Germ cells and Stem Cells have _______ which replaces telomeres and prevents them from shortening too much (unlimited # of replications)
Definition
telomerase
Term
For chemical carcinogenesis we need these 2 events to occur:
Definition
Initiation and Promotion
Term
Need an extended amount of _______ after initiation to trigger tumor formation
Definition
Promoter
Term
Promotion is _____ while Initiation is ________
Definition
Reversible
Irreversible
Term
Epstein Barr Virus
Definition
Involved in Burkitt lymphoma. Effects primarily B Cells.
Mutation of oncogene MYC.
Translocation between chromosome 8 and 14.
Term
Human T Cell Leukemia Virus Type 1
Definition
Transmitted by sexual intercourse or blood transfusions.
Term
Tumor specific shared antigens (host defense against tumors)
Definition
MAGE family of genes normally silent, but expressed in tumor cells
Term
Mutated self-protein (host defense against tumors)
Definition
Carcinogens mutate various self proteins
Term
Antigens resulting from mutant oncogenes (host defense against tumors)
Definition
Mutants present only in tumor cells - does not occur naturally
Term
Overexpressed Antigens (host defense against tumor)
Definition
Present in both normal and tumor cells
Term
Viral antigens (host defense against tumor)
Definition
Viral genes (oncogenes) expressed in tumor cells
Term
Natural Killer Cells recognize __________ to attack tumors
Definition
a lack of MHC I and ALSO Antibodies bound to tumor cells (through ADCC)
Term
Cytotoxic (CD8) T Cells will recognize _________ to attack tumor cells
Definition
Mutated MHC I Peptide
Term
Macrophages can be activated to attack ______
Definition
tumor cells
Term
Antibodies can bind to foreign antigens on the surface of the ________ cell
Definition
tumor
Term
______ Immune cells can play a role in getting rid of tumor cells
Definition
ALL
Term
Grading
Definition
I - IV
Term
Staging - TNM System
Definition
T - Tumor size (1-4)
N - Lymph node involvement (0-3)
M - Metastase (0-2)
Term
Staging - AJC System
Definition
0-IV
Term
Most common risk factor for prematurity
Definition
Preterm premature rupture of placental membranes (PPROM)
Next highest is Intrauterine Infections
Term
FETAL Risk Factor for Fteal Growth Restriction
Definition
All is normal except for something inside the fetus (chromosomal, congenital infections, congenital malformations). Causes SYMMETRICAL fetal growth restriction.
Term
PLACENTAL Risk Factor for Fteal Growth Restriction
Definition
Produces ASYMMETRIC FGR. (Brain is spared)
Low blood supply to placenta.
Term
MATERNAL Risk Factor for Fteal Growth Restriction
Definition
Most common cause of FGR. Caused by HTN or toxemia, drug abuse, alcoholism, smoking, malnutrition etc.
Term
Transcervical (ascending) perinatal infections (bacterial)
Definition
Fetus acquires infection via amniotic fluid or infected birth canal. Associated with inflammation of placental membranes and umbilical cord.
Term
Transplacental (Hematologic) Perinatal Infection (Viral)
Definition
Spread through the blood.
Term
TORCH Infections cause:
(TORCH is Toxoplasma, Other, Rubella, Cytomegalovirus, Herpesvirus)
Definition
Conjunctivitis, chorioretinitis, small eyes, cataract, brain calcifications, pneumonia, hepatitis, jaundice etc.
Term
Major cause of Neonatal Respiratory Distress
Definition
Respiraory Distress Syndrome (RDS) (hyaline membrane disease)
Term
Neonatal Respiratory Distress main problem:
Definition
Infant is not synthesizing sufficient surfactant in the lungs - collapse of the alveoli - hypoxemia - CO2 retention
Term
Fetal Hydrops
Definition
General edema of the fetus
Term
Hydrops fetalis
Definition
Severe progressive fluid accumulation that can be lethal
Term
Immune Fetal Hydrops
Definition
Hemolytic Disease of the Newborn (HDN) - Blood incompatibility between mother and fetus. Typical in subsequent pregnancies. First RXN is IgM produced by mother (cannot cross placenta), 2nd RXN is IgG (which CAN cross placenta).
Causes ANEMIA (leads to edema) - and high bilirubin in infant (jaundice). Jaundice can get into brain and cause KERNICTERUS!
Term
Non-Immune hydrops
Definition
Caused by cardiovascular defects, chromosomal, or fetal anemia (All NON-Immune)
Term
Phenylketonuria (PKU)
Definition
lack oh phenylalanine hydroxylase - high blood phenylalanine
Term
Sudden Infant Death Syndrome
Definition
Brain stem abnormality - arcuate nucleus - no arousal response for cardiorespiratory control during sleep.
Term
3 most common benign tumors in infants
Definition
Hemangiomas, Lymphangiomas, Saccrococcygeal Teratomas
Term
Hemangiomas
Definition
Skin/face tumors. Flat to elevated irregular red/blue masses
Term
Lymphangiomas
Definition
Lymphatic counterpart of hemangiomas. Cavernous spaces lined by endothelial cells surrounded by lymphoid aggregates.
Term
Saccrococcygeal Teratomas
Definition
germ cell tumors
Term
Malignant Tumors
Definition
Form in blood tissue, neural tissue, and soft tissues. Most common in childhood is neuroblastoma.
Term
Neuroblastoma
Definition
Forms anywhere along the sympathetic chain, most commonly along the adrenal medulla.
Term
Retinoblastoma
Definition
Most common childhood eye tumor (posterior retina tumor). Fatal if not treated early.
Term
Urticaria (hives)
Definition
IgE Dependent degranulation of the mast cells. TYPE I Hypersensitivity
Term
Eczema
Definition
most commonly allergic contact dermatitis (poison ivy, laundry detergent etc.)
TYPE IV Hypersensitivity! (i.e. T Cell mediated)
Term
Psoriasis
Definition
Most common CHRONIC Inflammatory Dermatitis. T Cell mediated (i.e. Type IV).
Increased keratinocyte proliferation. Silver white scales.
Term
3 types of Blistering diseases
Definition
SubCORNEAL, supraBASAL, subEPIDERMAL
Term
Subepidermal blister has ______ skin covering
Definition
thickest
Term
Subcorneal blister has ________ skin covering
Definition
thinnest
Term
Pemphigous Vulgaris Affected people produce autoantibodies for
Definition
desmoglein-3. Type II Hypersensitivity RXN. (Remember, Type II is an Ab against a SPECIFIC protein)
Term
Pemphigous Vulgaris is a _______ disease
Definition
Supabasal. It can be fatal
Term
Bullous Pemphigoid is ______ disease.
Definition
autoimmune, Type II Hypersensitivity. Also it is subepidural (thick skin).
It creates Ab against hemidesmosomes in basal cell basement membrane.
Term
Vitiligo
Definition
Partial/complete loss of pigment producing melanocytes within epidermis
Term
Basal Cell Carcinoma
Definition
Sun exposure tumor. Slow growing, rarely metastisize.
Term
Squamous Cell carcinomas
Definition
2nd most common skin tumor from sun. Some can be invasive and have higher malignancy than basal cell carcinomas.
Term
Nevocellular (melanocytic) nevus (pigmented mole)
Definition
Round, regular borders, brown, small, relatively flat
Term
JUNCTIONAL pigmented moles
Definition
Flat, symmetric, uniform, small. Nests of cells at dermal.epidermal junction.
Term
COMPOUND pigmented mole
Definition
Raised dome, but still uniformly shaped and colored. Nests and cords of cells that get into the DERMAL layer.
Term
Dysplastic nevi
Definition
Darker in center, lighter in periphery, fibrotic plaques. Can be PRE CANCEROUS
Term
Malignant melanoma
Definition
Larger, irregularly shaped, multicolored
Term
Spindle Cell dominant melanoma of the eye
Definition
not as aggressive, do not tend to metastisize
Term
Epithelioid dominant melanoma of the eye
Definition
More aggressive than spindle, metastisize
Term
Embryo most susceptible to teratogens during this time period:
Definition
Week 3 to week 9 (organogenesis)
Term
Reduced susceptibility to teratogens during this period:
Definition
Fetal period (week 10 to birth)
Term
Malformations
Definition
Polydactyly (extradigits) and fusion of digits
Term
Disruptions
Definition
Amniotic bands
Term
Deformations
Definition
Uterine constraint
Term
Sequence
Definition
oligohydramnios (fetal compression) could be due to maternal toxemia or HTN
Term
Syndromes
Definition
Single causative factor that affects multiple tissues. factor could be chromosomal or viral.
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