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PBD Quiz 5
UFCOP
101
Medical
Graduate
09/30/2008

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Term
5 Purposes of Exudate
Definition
Carry therapeutic agents to the site, contain endogenous antibacterial agents such as complement, many contain antibodies, fibrin to stop spread of inflammation
Term
Normal WBC count
Definition
4000-10000/uL
Term
Neutropenia
Definition
# neutrophils below 1500-2000 cells/uL. Occurs in people with disease that affects bone marrow (Leukemia, drug induced agranulocytosis, cyclic neutropenia, adrenocorticosteroid treatment)
Term
Agranulocytosis
Definition
less that 200cell/uL of WBCs
Term
Leukopenic
Definition
leukocytes less than 4000cells/uL- in adult
Term
Where do PMNs come from?
Definition
Bone
Term
What is the most rare cause of neutropenia in patients?
Definition
Cyclic Neutropenia
Term
Intrinsic Cellular Disfunction
Definition
Leads to impaired locomotion (ie lazy leukocyte syndrome)
Term
Defects of Leukocytic function: Extrinsic Factors
Definition
drugs-corticosteroids, agents that increase cAMP levels in the cell
Term
What disease patients have an abnormally high level of chemotactic inactivating factors (CFI)?
Definition
Hodgkins Disease patients
Term
Defects of Leukocytic Function
Definition
Disorders of chemotaxis and phagocytosis
Term
Impaired degranulation may be a significant factor in the pathogenesis of _______________.
Definition
Tuberculosis
Term
Disorders of phagocytosis
Definition
Defective attachment due to inadequate opsonization and in complement deficiencies.
Term
Chronic Granulomatous Disease
Definition
A syndrome of phagocyte oxidase deficiencies in neutrophils. Cause of repeated infections due to inability of neutrophils to kill bacteria normally.
Term
The defective neutrophil in Chronic Granulomatous Disease is incapable of destroying __________ ___________ bacteria (staph) and fungi.
Definition
catalase positive
Term
In Chronic Granulomatous Disease, the neutrophil cannot make __________.
Definition
H2O2, there is no NADPH oxidase available
Term
Catalase negative bacteria
Definition
STREP, not major pathogens in CGD
Term
What organ in vulnerable to infection in CGD patients?
Definition
virtually every organ, although most frequently colonized or exposed to infectious agents are most commonly involved (ie skin, respiratory and GI tract infections)
Term
Duration of Chronic Inflammation
Definition
Lasts longer than 2 weeks
Term
Chronic inflammation can exist with an acute phase. True or False?
Definition
True
Term
Characteristics of Chronic Inflammation
Definition
Dense infiltration of lymphocytes and macrophages (compared to neutrophil-rich exudate of acute inflammation)
Term
When a macrophage cannot protect the host from tissue damage the body forms a _____________.
Definition
Granuloma- walls off and isolates the infection
Term
When macrophages differentiate into ____________, granuloma formation begins.
Definition
Epitheloid cells
Term
Giant Cells
Definition
Fused multinucleated macrophages that are active phagocytes- survive a few days
Term
Granuloma associated with TB
Definition
Granuloma forms in the lungs and begins to destroy the lungs
Term
What are common events at the site of inflammation?
Definition
Necrosis and Fibrosis
Term
"Frustrated Healing"
Definition
destruction and inflammation are occuring at the same time as attempts of healing
Term
Depending on the cause of the granuloma may have more of one type of cell.
Definition
Lymphocytes: TB
Eosinophils: parasites
Neutrophils: Fungal
Term
Hormonal systemic manifestations
Definition
Inhibit systemic spread of inflammatory response.
Term
What stimulates the adrenal gland to increase output of glucocorticoids?
Definition
Cytokines
Term
Glucocorticoids
Definition
reduce inflammation through negative feedback loop. large amounts of cause atrophy of lymph tissue, depress protein synthesis (Immunoglobulin), reduces population of WBC, influences immune response, inhibits fibroblast proliferation, inhibits healing process
Term
Fever
Definition
regulated at a higher temperature
Term
What causes fever?
Definition
pyrogens, interleukin-1 released from damaged tissue
Term
"febrile"
Definition
fever
Term
What is an endogenous antipyretic?
Definition
Arginine Vasopressin
Term
Benefits of fever
Definition
hastens elimination of pathogen, impairs viral replication, decreases iron and zinc and increases copper to enhance phagocytosis and production of interferon, increased action of antibiotics
Term
Fever is not beneficial if over _______.
Definition
104
Term
3 stages of fever
Definition
cold state, hot state, defervenscence
Term
Fever is a ______________!
Definition
Symptom
Term
Leukocytosis
Definition
increase in number of circulation leukocytes > 10000 cells/mm3
Term
Conditions that increase WBC
Definition
strenuous exercise, sympathetic reactions, inflammation and infection
Term
What indicates prolonged inflammation?
Definition
large numbers of immature neutrophils
Term
In a viral infection, usually have increase in ____________ and a decrease in _____________.
Definition
lymphocytes, neutrophils
Term
C-reactive protein
Definition
once inflammation levels increase to 1000x higher, linked to CV disease, make increase uptake of LDL, can activate complement
Term
What is elevated in diabetes, syndrome X, aging and increase BW?
Definition
C-reactive protein
Term
Normal ESR in men and women?
Definition
1-13 mm/hr in men, 1-20 mm/hr in women
Term
2 sets of biological processes called into play in healing of local injury
Definition
regeneration and repair or replacement
Term
Regeneration
Definition
cells are replaced by cells of the same kind
Term
Labile Cells
Definition
continuously dividing or mitotic cell. typically called stem cells
Term
Stable Cells
Definition
discontinuous replicators or quiescent, mitotic cells. normally stop dividing when growth stops.
Term
Permanent cells
Definition
non dividing, post mitotic cells (heart, brain)
Term
A scar is made of what type of tissue?
Definition
Collagen
Term
Repair
Definition
occurs when regeneration is not possible, replacement of lost tissue by a mass of connective tissue
Term
Granulation tissue
Definition
highly vascularized, tissue rich in myofibroblasts, macrophages, angioblasts, and fibroblasts (lay down the collagen)
Term
Primary healing
Definition
healing by first intention, ie a paper cut or a surgical cut
Term
Secondary healing
Definition
qualitatively the same as primary healing but quantatively different
Term
Reconstructive
Definition
Proliferative or fibroblastic phase begins 3-4 days after the initial injury
Term
Fibrin provides a meshwork for ___________.
Definition
Collagen
Term
What is necessary for healing to proceed?
Definition
the fibrin clot must be dissolved
Term
What surrounds the granulation tissue made after to fibrin clot has been dissolved?
Definition
macrophages and fibroblasts
Term
Macrophages secrete _____________ for healing.
Definition
mediators; Fibroblast activating factor, angiogenesis factor, stimulation of epithelial cells to seal the wound, collagenase
Term
2 functions of newly formed blood cells in reconstruction
Definition
provide route for scavenger cells to remove scab and tissue debris and allow influx of blood, O2 and nutrients
Term
Epithelialization
Definition
clot/scab is dissolved and the granulation tissue is formed to protect the wound.
Term
Cofactors of collagen synthesis
Definition
iron, oxygen, vitamin C, alpha-ketoglutarate
Term
Fibroblasts produce __________ ___________.
Definition
growth factors (cytokines)
Term
What is the final stage of reconstruction?
Definition
wound contraction via myofibroblasts
Term
3 characteristics of the reconstructive phase
Definition
fibroblast proliferation, wpithelialization, and cellular differentiation
Term
Maturation Phase
Definition
also known as differentiation or remodeling, takes years to complete, scar tissue is remodeled--> avascular scar (capillaries removed)
Term
Immunogens
Definition
preformed components of the immune system that react with antigens
Term
Foreign antigens are usually high molecular weight substances. True or Flase?
Definition
True
Term
Epitopes
Definition
Determinate groups on immunogens essential to the rxn
Term
Haptens
Definition
small molecules that can initiate an immune response when attached to the determinate group
Term
Properties of the immune system
Definition
self-recognition, memory, specificity
Term
Key cells of the immune system
Definition
lymphocytes
Term
two components of the effector phase
Definition
humoral response and cell mediated response
Term
B-system
Definition
humoral phase
Term
Immunoglobins are produced by _________ cells.
Definition
plasma
Term
Antibodies
Definition
Immunoglobins
Term
What is the thymus independent system?
Definition
the B-system or humoral
Term
What fragment on an immunoglobin attached the antigen?
Definition
Fab fragment
Term
Structure of Immunoglobin
Definition
4 peptide chains, 2 heavy and 2 light, have fixed and variable portions
Term
What part of the Immunoglobin is biologically active?
Definition
heavy fixed portion, Fc fragment
Term
IgG
Definition
75%, smallest, fix complement, usually first to see on second exposure to antigen, readily enters tissues, only one to cross placental membrane
Term
What two types of immunoglobins activate complement?
Definition
IgG and IgM
Term
IgG gives ____________ immunization to the infant.
Definition
Passive
Term
Which immunoglobin has the longes half life?
Definition
IgG~ 23days
Term
IgG can act as an Opsonin. True or False?
Definition
True
Term
IgM
Definition
largest, pentamer, first to appear in primary response to antigen
Term
IgA1
Definition
found in blood
Term
IgA2
Definition
found in secretions (breast milk, tears, saliva)
Term
IgA
Definition
provides surface protection, T1/2~7 days, first line of defense, prevents attachment of viruses and bacteria to epithelial cells
Term
IgE
Definition
attaches to mast cells, basophils, responsible for many allergies
Term
B-system gives ______________ response
Definition
immediate
Term
Characteristics of T-system
Definition
thymus dependent, sensitized lymphocytes, delayed response, more discriminatory, reaches more sequestered areas of the body
Term
5 types of T-cells
Definition
cytotoxic, CD4-helper, suppressor, memory cells, lymphokine
Term
Both B and T systems work together. True or False?
Definition
True
Term
Natural Killer Cells
Definition
10-15% of lymphocytes, cells do not need to be activated, enhanced by exposure to IL-2
Term
Immune system works like a ______________ ______________ system.
Definition
Negative Feedback
Term
Allergy
Definition
exaggerated response against environmental antigens
Term
Autoimmunity
Definition
misdirected response against hosts own cells- lose self recognition property
Term
Two types of acquired immunity
Definition
Active- produced after exposure to an antigen
Passive- preformed antibody
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