PBD Exam 2

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PBD Exam 2
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2010-10-03 22:26:41
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PBD study cards Inflammation muscle
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study cards Inflammation-muscle
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  1. Inflammatory response is____
    self limiting
  2. Cardinal signs of inflammation
    • 1) Rubor
    • 2)swelling
    • 3) heat (calor)
    • 4) Pain
    • 5) Loss of function
  3. Warm or hot
    8-10 days
  4. Cold (chronic)
    >2 weeks
  5. Neutrophils
    • 50-70%
    • Polymorphous Neutrophil (PMN)
    • granulocyte
    • Chemotaxis dependent
    • 1st cell type
  6. Eosinophils
    • 1-4%
    • allergy or parasite
    • Important in asthma, 2-3 days after PMN
  7. Lymphocyte
    • 25-35%
    • Immunity
    • viral and chronic inflammation
  8. Monocyte
    • 3-8%
    • Macrophage in tissue
    • Longer t 1/2
    • Phagocyte
  9. Macrophage important in antigen processing Via release of
    cytokines (IL-1)
  10. Basophils
    • Larger than PMN
    • Mast cells
    • Need chemotaxic
  11. Platelets
    • No DNA
    • 140,000-340,000 in circulation
  12. Platelets generate_____
    Thromboxane and Platelet activating factor
  13. Chemical mediators in acute inflammation:
    • Cell derived
    • Plasma derived
  14. Activate inflammatory response in two ways
    • 1) degranulation of stored material
    • 2) Synthesis of mmediators in response to stimuli
  15. Preformed material- Histamine
    • Dilation of post-capillary venules
    • Increased permeability resulting in exudation
  16. Histamine receptors (3)
    • H1- contracts smooth muscle (Bronchi, GI, uterus)
    • H2-Gastric acid secretion
    • H3-Neural tissue
  17. Histamine increases influx of____ in the ______
    Calcium in the mast cell

    Inhibited by increase in cAMP (epinephine)
  18. Eosinophils have certain enzymes...

    _______ breaks down leukotrienes and ______ breaks down histamines.
    Aryl sulfatase B, Histaminase
  19. Synthesized material from Arachidonic acid
    Cox-1 and Cox-2
  20. Cox-1 is _______ while Cox-2 is _______
    Constitutive, Induced
  21. PGI2 is produced by_____
    Cox-2
  22. Cox-1 plays a large role in ________
    gastric mucosal protection and renal hemodynamics
  23. PGI2 are _______ that _______ and inhibit platelets and are bronch_______
    • 1) Prostacyclins
    • 2) Vasodilate
    • 3) dilate
  24. PGD2 is made mainly from ________ and ______ platelet aggregation and are broncho______.
    • 1) Mast cells
    • 2) inhibit
    • 3) Constrictors
  25. PGE2 is made mainly from ______
    Macrophages
  26. PGE2 inflammatory responses include______,_____,and _____
    • Fever
    • Bronchial constriction
    • Vasodilate arterioles and potentiates action of histamine and kinins on permeability.
  27. PGE2 inhibitory effects to inflammatory response...
    • -decrease lysosomal enzyme release
    • -Decrease histamine release from mass cell
    • -decrease macrophage activation and generation of some cytokines
    • -inhibits degranulation
  28. Thromboxanes cause vaso______ and promote degranulation and ________ of platelets. They also induce smooth muscle ______.
    • 1)constriction
    • 2) aggregation
    • 3) constriction
  29. Leukotrienes-lipoxygenase enzyme- ______ airway response to Broncho______. They also _______ release of cytokines.
    • 1)enhance
    • 2)constrictors
    • 3)stimulate
  30. LTA4, LTB4, LTC4 are ______ substances of______. along with LTD4, LTE4, LTF4.
    • 1) slow reactive
    • 2) Anaphylaxis
  31. Platelet activating factor important in delayed stages of asthma, why?
    Recruits eosinophils into bronchial mucosa.
  32. Cytokines are __ produced constitutively, but are ______ de nova upon activation.
    • 1) NOT
    • 2) synthesized
  33. On the target cell, Cytokines act on _________ receptors.
    High affinity
  34. Interleukins are mainly produced by _____ and ______. They induce response of immune cells to injury.
    Macrophages and lymphocytes
  35. Glucocorticoids and gold inhibit
    Interleukin production and activity.
  36. Interferon are produced in response to ____ stimuli and are all ___ specific but not viral specific.
    • 1)viral
    • 2) Host
  37. Transforming growth factor
    • Widest acting cytokine
    • Mediates proliferation, differentiation, and angiogenesis.
  38. Tumor necrosis factor increase ______ production which increases _____ activity. It also _____angiogenisis.
    • 1) Cytokine (IL)
    • 2) phagocytic
    • 3) enhances
  39. Granulocyte colony stimulating factor plays a major role in _____ production and maturation.
    Neutrophil
  40. Plasma proteins cascades (5)
    • 1) Complement
    • 2) Clotting
    • 3) Fibrinolytic
    • 4) Kinin
    • 5) Immiune
  41. Complement
    REMEMBER C3 is important in almost all stages of inflammation
  42. Clotting forms fibrinous exudate to _____ exudates, microorganisms, and foreign bodies.
    trap
  43. ____ is the end product of clotting and uses _____ as the major enzyme.
    • 1) Fibrin
    • 2) Thrombin
  44. Fibrinolytic generates ______ and activates ______. It also breaks down clots.
    • Plasmin
    • Complement
  45. Kinin system activates complement and works with ____ and ____ receptors.
    • Beta 1
    • Beta 2
  46. Immune system ______ mast cell degranulation. It is activated when ____-_____ complex forms.
    • 1) Stimulates
    • 2) Antigen-antibody
  47. Hageman factor activates these systems (4)
    • Clotting
    • Fibrinolytic
    • Kinin
    • Complement
  48. Venules leak fluid and protein (_____g%) compared to (0.2-0.5g% in transudate)
    4-5%
  49. 3 steps in leukocyte infiltration "blood sludging"
    Margination (neutralize cell charge), Pavementing, and Diapedesis (stepping across).
  50. Purpose of exudate is to carry_______ to site. May contain ______ and stop spread of inflammation.
    • 1) therapeutic agents
    • 2) antibodies
  51. 2 stages of healing
    Regeneration and repair/replacement
  52. ____cells constantly divide while _____cells stop dividing when growth ceases. _____ cells are non-dividing and post mitotic cells.
    Labile, Stabile, Permanent
  53. granulation tissue is rich in ______.
    macrophages, myofibroblasts, angioblasts, and fibroblasts.
  54. Reconstructive (proliferative or fibroblastic phase). Wound is sealed by _____ which is then dissolved by _______ system and _____ tissue is formed.
    • 1) fibrin
    • 2) fibrinolytic
    • 3) granulation
  55. Cells migrate under the clot to _____ the clot from the wound surface.
    Sever
  56. Macrophages in reconstruction
    • Fibroblast activating factor
    • angiogenesis factor
  57. Wound contraction occurs via _______ of granulation tissue.
    myofibroblasts
  58. Maturation phase of repair occurs ___ weeks after injury and usually left with a _______ scar.
    • 1) 2-3 weeks
    • 2) avascular
  59. Granuloma formation begins when macrophages differentiate into ______ cells.
    Epithelioid
  60. Necrosis and _____ are common at site of chronic inflammation
    Fibrosis
  61. Glucocorticoids cause atrophy of lymph tissue, influences _____ response, _____ protein synthesis, inhibit _____ proliferation, and inhibits the healing process.
    • 1) immune
    • 2) Inhibits
    • 3) fibroblast
  62. Pyrogens are ______ or endogenous (IL-1) released from damaged tissue.
    Exogenous
  63. Benefits of fever
    eliminates pathogen quicker, no viral replication, enhances phagocytosis and interferon production
  64. Conditions increasing WBC (3)
    • Strenuous exercise
    • Sympathetic reaction
    • Inflammation or infection
  65. Viral infections ____ lymphocytes and _____ # of neutrophils.
    Increase, decrease
  66. C-reactive protein is synthesized in liver in response to ____
    IL-6
  67. Normal levels of C-reactive protein
    <3 mg/l and can increase to 1000X in inflammation
  68. Normal ESR
    • Men: 1-13 mm/hr
    • women 1-20 mm/hr
  69. Neutropenia (below ____-2000 cells)
    Agranulocytosis (<___ cells)
    Leukopenia (<4000 cells in an adult)
    • 1500
    • 200
  70. Disorders of chemotaxis are ____ and ______
    • Intrinsic- impaired locomotion
    • Extrinsic- drugs (corticosteroids) agents that increase cAMP (decrease phagocytosis)
  71. Deficiencies of chemotactic factors due to complement deficiences C_ and C_. High levels of Chemostatic Factor inactivators high in _______ disease.
    • 3
    • 5
    • Hodkins
  72. Chronic Granulomatous Disease
    phagocyte oxidase deficiencies in neutrophils.
  73. In CGD the neutrophil is incapable of destroying _________ bacteria (staph).
    Catalase positive
  74. Immune system can not respond if the molecular weight of foreign material is less than ______
    10,000
  75. ______ can not be immunogenic alone, they must bind to more than one Antibody to form the ____ complex.
    • 1) Haptens (epitopes)
    • 2) Ab-Ag
  76. Properies of immune system (3)
    • 1) Self recognition
    • 2) memory
    • 3) specificity
  77. Effector phase in immune response has 2 components a _____response and a _____ response
    • Humoral
    • Cell-mediated
  78. Induction phase involves production of __ and __ cells
    B and T
  79. B-system (Humoral) is _____ of the thymus and is most effective in the ____ phase of the blood and tissue.
    • Independent
    • Fluid
  80. Five classes of antibodies are
    • IgG- 75%, smallest, cross placental membrane
    • IgM- 10%, largest, 1st to appear.
    • IgA- 5-15%, surface protection
    • IgE- least concentrated, allergies
    • IgD <1%, activation/maturing B-cells
  81. T-system is thymus ___ and has a much more _____ response to B-system.
    • Dependent
    • Delayed
  82. Lymphocytes in T system do not need to be ______ to kill foreign cells or other bad things.
    Activated
  83. Types of hypersensitivity (4)
    • 1- IgE- Mast cell release mediators-anaphylaxis
    • 2- IgM,IgG, complement- Cell lysis, cell mediated
    • 3- " " Ag-Ab complex- immune complex
    • 4- T-Cell mediated- contact dermititis
  84. Brutons agammaglobuniemia is ______ and has a deficit in ___
    • X-linked
    • IgA
  85. Digeorges syndrome is due to cellular ______ Deficiency and has the absence of the _____ and the ____.
    • T-cell
    • Parathyroid and the thymus
  86. SCID is condition with stiking _____.... absence of ____ immune systems.
    • Lymphopenia
    • Both
  87. Wiskott aldrich system is _____ and cannot respond to polysaccharide antigens. Triad of ____ present, _______ due to platelt deficiency, and recurrent infection.
    • X-linked
    • Eczema
    • Thrombocytopenia
  88. Autoimmunity is most likely due to loss of __________
    T-suppressor cells
  89. Foreign anitgen forming immune complex is a Type _ injury.
    Type 3
  90. Rheumatic fever is an example of _____ reactivity.
    Cross reactivity
  91. T-cell suppressor function _____ with age.
    Declines
  92. Type 1 diabetes---------------------------->
    Addisons disease--------------------------->
    Thyrotoxicosis (graves disease)----------->
    Hashimotos thyroiditis-------------------->
    • B islet cell of pancreas
    • Adrenal cell cytoplasm
    • Thyroid cell surface (TSH receptor)
    • Thyroglobulin
  93. Graves disease is _______ whereas Hashimotos is ________.
    • Hyperthryoidism
    • Hypothyroidism
  94. Malignant hypertension characterized by high incidence of increase in antibodies directed against the _____________________.
    Alpha 1 adrenoreceptor
  95. Antibodies against the _____________ may play causal role in dilated cardiomyopathy.
    Beta-1 adrenergic receptors.
  96. Asthmatic patients may have Inhibitor antibodies to the ______ adrenoreceptor
    Beta 2
  97. Hashimotos hypothyroidism is an example of what type(s) of injury?
    Type 2 and type 4
  98. Lupus is greater in females because _____ enhance the immune response and _______ depress the immune response.
    • Estrogens
    • Androgens
  99. In Lupus patients must pass _____ different diagnostic criteria to be diagnosed.
    4-5 of 11
  100. three types of joints are _______, _______, and _______.
    Synarthrodial or fibrous, Cartilaginous or amphiarthrosis, and Synovial or diarthrodial.
  101. Synovium is made of 2 layers _____ and _____
    • Subintimal (vascular with mast cells, macrophages)
    • Intimal (hyaluronic acid)
  102. Synovial fluid is composed of _______acid which lubricates joints.
    Hyaluronic
  103. Mucin clot test adds ______Acid to _______ acid. With inflammation the clot formed is ______ than normal and is cloudier.
    • 1) Acetic
    • 2) Hyaluronic
    • 3) poorer
  104. Non-inflammatory joint disease has near normal _________
    Synovial fluid and synovial membrane inflammation
  105. Osteoarthritis characterized mainly by loss of __________ in synovial joints
    Articiulating cartilage
  106. Osteoarthritis primary is _______ and not assosciated with risk factors however aging is most assosciated factor.
    Idiopathic
  107. Secondary osteoarthritis is assosicated with ________ such as joint stress and trauma.
    Risk factors
  108. Articulating cartilage becomes yellowish gray due to more water and less _________. The loss of _________ is the hallmark for osteoarthritic process.
    Proteoglycans (both)
  109. Rheumatoid arthritis is a chronic _____________ disease. Characterized by inflammation of multiple joints and have ___________ of collagen. Occurs in women more frequently than men.
    • 1) systemic autoimmune
    • 2) Fibrinoid necrosis
  110. A combination of _____ and ____ are responsible for Rheumatoid arthristis. No signle agent is responsible.
    Genetics and environment
  111. Rheumatoid factor bind and form complex in blood. This is a type __ injury.
    Type 3
  112. Synovial fluid comprised of ___ which phagocytize and release many mediators including __.
    • 1) PMNs
    • 2) RF
  113. Synovial membrane transforms into a _____ which is rich with enzymes that cause cartilage and bone destruction.
    Pannus (granulation tissue)
  114. Proteases are released from monocytes and macrophages for Bone ______.
    resorption.
  115. _______ is due to diminished blood flow and causes ______ which stimulates release of hydrolytic enzymes which cause even more damage.
    • Hypoxis
    • Acidosis
  116. Rheumatoid arthritis is characterized by ________ polyarthritis and morning stiffness for ____ than 30 minutes.
    • Symmetrical
    • More
  117. Ankylosed joints
    Fused joints
  118. RF is not present in __% of patients with RA.
    30
  119. Synovial fluid viscosity is _____ with RA due to more leukocytes. In order for diagnosis to be made, must pass _ of _ diagnostic criteria.
    • Lower
    • 4 of 7
  120. Gout is due to synthesis of _______ nucleotides resulting in elevated levels of ______.
    • Purine
    • Uric acid
  121. Primary form of gout is ______ recessive and diagnosed mainly in ___.
    • X-linked
    • Men
  122. Nyhan syndrome is ______ recessive and results in _______ of uric acid.
    • X-linked
    • Overproduction
  123. In gout, increased activity of PRPP synthetase is an _______ disorder which causes ______.
    • X-linked
    • Overproductiion of purine
  124. deficiency in Glucose-6-phosphate is a _____ recessive disorder causing _______ uric acid clearance.
    • Autosomal
    • Decreased
  125. Normal uric acid levels are ______.... with gout _______
    • 4-6 in men and 3-5 in women
    • >7mg in men and >6mg in women
  126. Less leukocyte function is ___ for people with gout.
    Good
  127. acute gouty arthritis 90% of intial attacks start in a ___ joint.
    Single
  128. Intractitical gout the patient is seen to be __________.
    Asymptomatic
  129. Chronic Tophaceous gout, patients form a _____ which have ______ crystals inside.
    • Tophi
    • Uric acid
  130. Gout can result in ________ caused by kidney stones.
    "renal failure"
  131. Gout lessons to learn... dont be ____, dont do ____, and dont drink too much _____.
    • 1) Obese
    • 2) drugs that block uric acid excretion
    • 3) alcohol or eat organ meats
  132. Diagnosis of gout can be by presence of monosodium __________ in leukocytes found in the _____ fluid. Or urate crystals found in _____.
    • Urate crystals
    • Synovial
    • Tophi
  133. The ______ surrounds the skeletal muscle which consists of several _____ surrounded by the ______. Inside each __2___ there are many muscle fibers known as ______ which are surrounded by the _______.
    • 1) epimysium
    • 2) Fasicles
    • 3) myofibriles
    • 4) endomysium
  134. In muscles the ____ is known as the cell membrane and the ______ ________ is the smooth ER.
    • 1) sarcolemna
    • 2) Sarcoplasmic reticulum
  135. In the sliding filament model the _____ binds to the actin. This process requires energy in the form of ___.
    • Myosin head
    • ATP
  136. Sources of ATP for Muscle contraction include ______ phosphate, _________, and ________.
    • 1) Creatine
    • 2) Aerobic respiration
    • 3) Anaerobic respiration
  137. Sustained lack of ATP results in _______
    Rigor mortis
  138. ____ of calcium from the sarcoplasmic reticulum is essential for muscle contraction and the _______ of calcium from the _______ is essential for muscle relaxation.
    • 1) Release
    • 2) Clearance
    • 3) Sarcoplasm
  139. A motor unit is a single ________ neuron and all of the muscle fibers it innervates.
    Alpha motor
  140. Motor endplate is
    a specialized site where axon terminals from alpha motor neurons make synaptic contact with individual muscle fibers.
  141. Latent period is the time between an ______ and the first measurable increase in _________.
    • 1) action potential
    • 2) muscle tension
  142. Isometic contraction the _____ is constant even though the muscle develops _____.
    • Length
    • Tension
  143. Isotonic contraction can be either ________ or _______.
    • Cocentric- muscle shortens
    • Eccentric- muscle lengthens
  144. Tetanus is a _______ contraction in response to a repetitive stimulation. It can be ____ or _____.
    • 1) maintained
    • 2) fused
    • 3) unfused
  145. ___________ are small specialized motor neurons that innervate intrafusal muscle fibers.
    Gamma motor neurons
  146. The withdrawal reflex is split up into two movements: ______ and ______. An example of the withdrawal response involves a ___________ reflex.
    • 1) Ipsilateral- activate flexor, inhibit extensor
    • 2) contralateral- Activate extensor, inhibit flexor.
    • 3) Cross-extensor
  147. In smooth muscles thin filaments are anchored to _________. There are also no _____ in smooth muscle and they are ________.
    • Dense bodies
    • Striated
    • Mononucleated
  148. In smooth muscle there is a _____ removal of cytosolic calcium. There is also an absent of the _____, less specialized ______.
    • Slower
    • T-tubule
    • Sarcoplasmic reticulum
  149. In smooth muscle input can either be _______ or _______.
    Excitatory or inhibitory
  150. smooth muscles are electically coupled by ________.
    Gap junctions
  151. Multi unit smooth muscle fibers are not connected by ______.
    Gap junctions
  152. Contractile responses in smooth muscle can be activated by _______.
    Stretching.
  153. Most multi-unit smooth muscle cells do not generate their own ___________.
    Action potentials

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