I. BLOOD1. What components make up blood?1. 42% Red blood cells (Hematocrit)2. 1% White Blood Cells3. 50% PlasmaNa+,K+,Ca2+,H+, proteins (clotting proteins-fibrinogen)2. What are the 7 types of blood leukocytes?1. B cells2. T cells3. Monocytes (tissue or blood)4. Macrophages (mature monocytes-tissue or blood)5. Neutrophils6. Easinophils7. Basophils3. Explain hematopoesis- what are the cytokines involved and what is being produced?Cytokines: 3 types1. EPO (kidney)erythrocytes (lifespan 90-120 days)2. TPO megakaryocytes and platelets3. Colony stimulating factors, interleukins all cell typesFetal life: in red bone marrow prevalentadulthood: only in femur, pelvis and ribsNeutrophils produced at highest rate because have shortest life spanPluripotent hematopoetic stem cellsuncommitted stem cellsfully committed progenitor cells (no longer stem)4. What are the basic steps of hemostasis or blood clotting?- be able to explain all1. Vasoconstriction- triggered by damage of smooth muscle cells2. Platelet Plug formation- collagen and tissue facto contact platelets and initiate clotting (nitric oxide produced in healthy tissue prevents this from happening on a regular basis)3. Coagulation- refer to coagulation cascade diagram4. Tissue Repair5. Thrombolysis- removing clot5. What are the 3 things that platelets secrete when clotting?1. Platelet activating factor (PAF)2. Serotonin (vasoconstriction)3. ADP6. What role would aspirin play in this?Inhibits the enzyme that produces thromboxane A2. Prevents coagulation cascade- inhibits clottingII. LYMPHATIC SYSTEM AND INNATE IMMUNITY1. What are the main distinguishing factors between innate and acquired immunity?Innate: non specific, inherited, rapid, no memoryAcquired: specific, adaptive, slower, memory2. Explain the role of the spleen in the lymphatic systemwhere the blood is cleaned. Has two types of tissues1. Red pulp: has macrophages and surround sinuses2. White pulp: lymphocytes3. What are some other lymphoid tissues?1. The red bone marrow2. Gut associated lymphoid tissue (GALT)- small intestine3. Tonsils and adenoids4. Thymus gland (where T-cells mature)4. What are our innate barrier defenses?1. Skin2. Other Epithelia- nasopharynx, respiratory tract, digestive tract, urinary tract, genital tract3. Mucus (has lysozyme and IgA, cilia)4. Normal Flora5. Which immune cells are part of our innate cellular defences?Basophils and mast cells, neutrophils, eosinophils, monocytes and macrophages, dendritic cells (don’t leave tissue)6. Which immune cells are considered phagocytes?Neutrophils, eosinophils (for parasites), monocytes and macrophages7. Which immune cells are considered granulocytes?Basophils and mast cells, neutrophils, easinophils8. Name some organ specific phagocytesMicroglia in brain, Kupffer cells in liver, fixed phagocytes in spleen and lymph nodes9. Name some of the innate chemical defenses1. Lysozyme- in mucus and secretions attack bacterial walls2. IgA in mucus3. Gastrointestinal tract- gastric acid and protease, bile salts4. Urinary tract: acidic urine5. Cytokines: hormones of immune system communicate at distance6. Chemokines- type of cytokine that attract7. Interleukin 1 B- cytokine that binds to thermoregulation receptors8. Complement- complexes that let water in to kill cell- enhanced by antibodies9. Interferons (alpha,beta,gamma) slow viral replication10. What are the main mechanisms that inflammation involve?Degranulation (exocytosis of mast cells and basophils contents)1. Histamine- makes capillaries more leaky2. Heparin- anticoagulant3. Cytokines- attract phagocytes4. Leukotrienes5. ProstaglandinsMore blood to area, more oxygen, leukocytes attack bacteria, stimulate immune responseIII. ACQUIRED IMMUNITY OVERVIEW1. What exactly is it that evokes an immune response?Epitopes on an antigen2. Give a brief overview of lymphocyte function using the diagram from the slides1. B CellsEffector cells: plasma cells that secrete antibodies and act in ECFMemory cells2. Helper T cellsEffector cells: active T cells which secrete cytokinesMemory T cells3. Cytotoxic T cellsEffector cells: Active CTLs which attack and kill virus infected cells or cancerous cellsMemory CTLs3. What is the difference between B cells and T cells in binding to the antigen?B cells can directly bind to the antigen whereas T cells must be presented with antigen by other cells (Helper T: dendritic, macrophages, B cells and CTLs: targeted cell itself presents antigen)4. What are the 4 functions of antibodies?1. Complement Fixationlysis of foreign cell enhanced by presence of AB2. Opsonizationenhances phagocytosisneutralization where AB bound to surface of cell interfere with function of bacteria3. Agglutinationenhances phagocytosisantibodies polyvalent and results in clumping of bacteria4. Precipitationenhances phagocytosisAB crosslink and ppt the soluble AB making them more prone to phagocytosis5. What do cytotoxic T cells need to carry out apoptosis?Infected host cell secreted MHC class I as well as viral antigen and cytotoxic cell secretes a T cell receptorwhen they bind there is secretion of perforins and granzymes causing apoptosisIV. MECHANISMS ACQUIRED IMMUNITY1. What are the 6 classes of Immunoglobulins?1. IgG-most abundant in plasma, 4 parts, Fab,Fc, Y shape2. IgDB cell receptor with pink transmembrane region3. IgMfirst Ig secreted by B cells, large, cant leak out of capillaries, switches to IgG with same specificity4. IgGfrom IgM, leaks out of capillaries, inflammation, maternal antibody that crosses placenta, confers passive immunity5. IgE- ALLERGIESinstead of switching to IgG IgM sometimes IgE, abnormal, parasitic worm infections6. IgAmost abundant form for mucus secretions2. What is the diversity of immunoglobulin genes (numbers)Light chain: 200 different VJ combosHeavy chain: 9600 different VJD combosInaccurate recombination, somatic mutations, class switching sources of variability as well3. What is the difference between an immediate and a delayed immune response?First time exposure = normal mild reactionbecome sensitized if secretes IgE instead of IgGbind Fc receptors on surface of mast cells and basophilsIgE becomes mast cell receptornext exposure causes response in mast cell or basophil to degranulate and cause inflammation (delayed response)4. Describe the condition of anaphylaxis and how it is treatedProblem:Increase secretion from mucus membrane and broncoconstrictiondifficulty
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