bloodthruadap.txt

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Author:
nsmallwood
ID:
125275
Filename:
bloodthruadap.txt
Updated:
2011-12-30 13:04:08
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Description:
blood through adaptive immunity
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  1. what levels fluctuate in stored PRBCs
    • decrease 2,3DPG, pH
    • increase K, lactic acid
  2. a 6 pack of plts should increase the plt number by
    50000
  3. plt transfusion indications
    • <10000
    • <20000 if bleeding risk
    • <50000 if active bleeding or preprocedure
  4. 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
  5. cryo contains
    • vWF
    • VIII
    • fibrinogen
    • XIII
  6. pathophys of febrile non-hemolytic transfusion rxn
    preformed abs to donor wbcs
  7. tx of febrile nonhemolytic transfusion rxn
    wbc filters (leukoreduced)
  8. mcc of allergic rxn to blood products
    IgA def
  9. pathophys of delayed hemolytic transfusion rxn
    preformed abs against minor rbc antigens
  10. pathophys of TRALI
    donor abs bind recipient wbcs
  11. mcc of death from transfusion
    clerical error with ABO incompatibility
  12. highest infxn complication in
    bacterial with plts>RBCs
  13. mc bacterial contaminant
    E. Coli
  14. blood is tested for
    Hep B, C, HIV, syphilis, HTLV, West Nile
  15. blood products without risk of HIV or hepatitis
    • albumin
    • immunoglobins
  16. dominant role in wound healing and inflammation
    macrophages
  17. last cell to arrive
    lymphocyte
  18. when do fibroblasts arrive
    day 5 and on
  19. what days are macrophages around
    days 3-4
  20. key growth factor in wound healing
    PDGF
  21. function of PDGF
    • chemotactic for inflammatory cells/fibroblast/smooth muscle
    • angiogenesis
    • epithelialization
    • accelerates wound healing
  22. growth factor that is not store and is a phospholipid
    PAF
  23. increases adhesion molecule expression
    PAF
  24. factors that aid in angiogenesis and epithelialization
    • PDGF
    • FGF
    • EGF
    • IL-8
  25. angiogenesis factors produced by what cells in response to what
    plts and macs in response to hypoxia
  26. inhibits lymphocytes and leukocytes
    TGF-B
  27. function of TNF
    • increase cell adhesion
    • procoagulant
    • activates pmns/macs
  28. induces fever
    IL-1
  29. primary function of IL-8
    • chemotaxis for PMNs
    • angiogenesis
  30. primary function is to downregulate inflammatory response
    IL-10
  31. increases INF release
    IL-18
  32. activates NK cells in response to virus
    IL-15
  33. acute phase proteins decreased in inflammatory state
    • albumin
    • prealbumin
    • transferrin
  34. found on leukocytes and plts and are involved in anchoring
    beta-2 integrins
  35. complement factors only in classic pathway
    C1 2 4
  36. initial step in classic pathway
    C1 complex
  37. initial pathway in alternate pathway
    C3 activation
  38. factors only found in alternate pathway
    b d properdin
  39. hypochlorous acid is eliminated by
    taurine scavenger
  40. arachidonic acid pathway that is leukocyte derived
    lipoxygenase
  41. alpha granules contain
    • PF4, vWF, fibrinogen, fibronectin
    • beta thromboglobulin
    • PDGF/TGF beta
    • V and VIII
  42. dense granules contain
    • adenosine
    • calcium
    • serotonin
  43. main growth factors
    PAF, PDGF
  44. early on fibroblasts produce
    fibronectin and hyaluronic acid
  45. what allows endothelial proliferation
    • MMPs
    • collagenases
    • plasmin
  46. wound contraction peaks at
    10days
  47. signals fibroblasts to stop migrating and proliferating
    • breakdown of provisional ECM
    • increased chondroitin sulfate
  48. collagen deposition peaks at
    3 weeks
  49. thrombin and fibrin act as growth factors for
    endothelial cells and fibroblasts
  50. most important factor in healing open wounds
    epithelial integrity
  51. most important factor in healing closed incision
    tensile strength
  52. weakest time point for small bowel anastomosis
    3-5 days
  53. proline hydroxylation and crosslinking require what cofactors
    • alpha KG
    • vit c
    • o2
    • Fe
  54. aas in collagen
    proline lysine
  55. abnormal wound healing in epidermolysis bullosa is 2/2
    excessive fibroblasts
  56. newborn problems with innate immunity
    poor phagocyte chemotaxis resulting in susceptibility to cutaneous infections
  57. what is the t cell receptor
    cd3
  58. IL-2 does what
    activates cytoxic T and NKs
  59. INF gamma does what
    increases bactericidal activity of macrophages
  60. function of IL-4
    increase ab production and class switching
  61. T helper cells release
    • IL-2
    • INF gamma
    • IL-4
  62. main taget cell of TH1 cells
    macrophages
  63. Cytotoxic t cells release
    perforin and granulysin
  64. what do granzymes do
    activates caspase cascade inducing apoptosis
  65. NK cells when acting in a specific manor attack specific cells with
    • low MHC expression
    • bound antibody
  66. major difference in antigen recognition with B cells versus T cells
    antigens are in their native form and not processed
  67. most important APC
    dendritic cells
  68. T helper cells are activated by
    MHC II-antigen complex
  69. PPD is a test of what kind of immunity
    cell mediated immunity
  70. MC Ab in spleen
    IgM
  71. function of IgM
    • primary immune response
    • activates complement
    • opsonization
  72. primary antibody to A and B antigens on RBCs
    IgM
  73. IgG is associated with what type of hypersensitivity rxns
    II and III
  74. role of IgG
    • secondary immune response
    • activates complement
    • opsonization
    • ADCC
  75. where does IgA go after being released from plasma cells
    it is taken up by endothelial cells and released on mucosal luminal surface
  76. have Fc receptors
    • macrophages
    • PMNs
    • NKs
    • eosinophils/basophil
    • mast cell
  77. number of IgG to activate complement
    2 versus only one for IgM
  78. number of binding sites on IgM
    10
  79. released in Type I hypersensitivity rxns and causes pain and arteriole constriction
    bradykinin
  80. ITP is what kind of hypersensitivity rxn
    II
  81. abs in Type II
    IgG and IgM
  82. examples of Type III
    • serum sickness
    • SLE
  83. antibody independent hypersensitivity rxn
    type IV
  84. physical response to type III
    • rashes
    • arthralgia
    • fever
    • LAD
    • splenomegaly
  85. 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
  86. primary lymphoid organs
    liver bone thymus
  87. secondary lymphoid organs
    spleen LNs
  88. mc immune def
    malnutrition

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