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nsmallwood
on FreezingBlue Flashcards.
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what levels fluctuate in stored PRBCs
- decrease 2,3DPG, pH
- increase K, lactic acid
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a 6 pack of plts should increase the plt number by
50000
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plt transfusion indications
- <10000
- <20000 if bleeding risk
- <50000 if active bleeding or preprocedure
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if plts do not rise appropriately and not felt to be from cont bleeding what is the likely cause and tx
allo imunization, need ABO matched plts if this still fails need HLA matched
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pathophys of febrile non-hemolytic transfusion rxn
preformed abs to donor wbcs
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tx of febrile nonhemolytic transfusion rxn
wbc filters (leukoreduced)
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mcc of allergic rxn to blood products
IgA def
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pathophys of delayed hemolytic transfusion rxn
preformed abs against minor rbc antigens
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pathophys of TRALI
donor abs bind recipient wbcs
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mcc of death from transfusion
clerical error with ABO incompatibility
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highest infxn complication in
bacterial with plts>RBCs
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mc bacterial contaminant
E. Coli
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blood is tested for
Hep B, C, HIV, syphilis, HTLV, West Nile
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blood products without risk of HIV or hepatitis
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dominant role in wound healing and inflammation
macrophages
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last cell to arrive
lymphocyte
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when do fibroblasts arrive
day 5 and on
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what days are macrophages around
days 3-4
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key growth factor in wound healing
PDGF
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function of PDGF
- chemotactic for inflammatory cells/fibroblast/smooth muscle
- angiogenesis
- epithelialization
- accelerates wound healing
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growth factor that is not store and is a phospholipid
PAF
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increases adhesion molecule expression
PAF
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factors that aid in angiogenesis and epithelialization
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angiogenesis factors produced by what cells in response to what
plts and macs in response to hypoxia
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inhibits lymphocytes and leukocytes
TGF-B
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function of TNF
- increase cell adhesion
- procoagulant
- activates pmns/macs
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primary function of IL-8
- chemotaxis for PMNs
- angiogenesis
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primary function is to downregulate inflammatory response
IL-10
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increases INF release
IL-18
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activates NK cells in response to virus
IL-15
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acute phase proteins decreased in inflammatory state
- albumin
- prealbumin
- transferrin
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found on leukocytes and plts and are involved in anchoring
beta-2 integrins
-
complement factors only in classic pathway
C1 2 4
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initial step in classic pathway
C1 complex
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initial pathway in alternate pathway
C3 activation
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factors only found in alternate pathway
b d properdin
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hypochlorous acid is eliminated by
taurine scavenger
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arachidonic acid pathway that is leukocyte derived
lipoxygenase
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alpha granules contain
- PF4, vWF, fibrinogen, fibronectin
- beta thromboglobulin
- PDGF/TGF beta
- V and VIII
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dense granules contain
- adenosine
- calcium
- serotonin
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main growth factors
PAF, PDGF
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early on fibroblasts produce
fibronectin and hyaluronic acid
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what allows endothelial proliferation
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wound contraction peaks at
10days
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signals fibroblasts to stop migrating and proliferating
- breakdown of provisional ECM
- increased chondroitin sulfate
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collagen deposition peaks at
3 weeks
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thrombin and fibrin act as growth factors for
endothelial cells and fibroblasts
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most important factor in healing open wounds
epithelial integrity
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most important factor in healing closed incision
tensile strength
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weakest time point for small bowel anastomosis
3-5 days
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proline hydroxylation and crosslinking require what cofactors
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aas in collagen
proline lysine
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abnormal wound healing in epidermolysis bullosa is 2/2
excessive fibroblasts
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newborn problems with innate immunity
poor phagocyte chemotaxis resulting in susceptibility to cutaneous infections
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what is the t cell receptor
cd3
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IL-2 does what
activates cytoxic T and NKs
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INF gamma does what
increases bactericidal activity of macrophages
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function of IL-4
increase ab production and class switching
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main taget cell of TH1 cells
macrophages
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Cytotoxic t cells release
perforin and granulysin
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what do granzymes do
activates caspase cascade inducing apoptosis
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NK cells when acting in a specific manor attack specific cells with
- low MHC expression
- bound antibody
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major difference in antigen recognition with B cells versus T cells
antigens are in their native form and not processed
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most important APC
dendritic cells
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T helper cells are activated by
MHC II-antigen complex
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PPD is a test of what kind of immunity
cell mediated immunity
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function of IgM
- primary immune response
- activates complement
- opsonization
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primary antibody to A and B antigens on RBCs
IgM
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IgG is associated with what type of hypersensitivity rxns
II and III
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role of IgG
- secondary immune response
- activates complement
- opsonization
- ADCC
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where does IgA go after being released from plasma cells
it is taken up by endothelial cells and released on mucosal luminal surface
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have Fc receptors
- macrophages
- PMNs
- NKs
- eosinophils/basophil
- mast cell
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number of IgG to activate complement
2 versus only one for IgM
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number of binding sites on IgM
10
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released in Type I hypersensitivity rxns and causes pain and arteriole constriction
bradykinin
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ITP is what kind of hypersensitivity rxn
II
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abs in Type II
IgG and IgM
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antibody independent hypersensitivity rxn
type IV
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physical response to type III
- rashes
- arthralgia
- fever
- LAD
- splenomegaly
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IL-2s role in cancer
- conversion of lymphocytes into lymphocyte activated killer cells and tumor infiltrating lymphocytes on exposure to in vitro antigen
- enhances endogenous T cell immune response to ca
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primary lymphoid organs
liver bone thymus
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secondary lymphoid organs
spleen LNs
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mc immune def
malnutrition
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