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Questions and Answers

What initiates the activation of the fibrinolytic cascade?

  • Injury to blood vessels
  • Activation of thrombin
  • Washout of coagulation factors (correct)
  • Platelet contraction

Which of the following statements correctly describes the function of plasmin?

  • It enhances platelet aggregation.
  • It digests fibrin and cleans up clots. (correct)
  • It initiates the coagulation cascade.
  • It converts fibrinogen to fibrin.

Which factor is primarily involved in vitamin K deficiency?

  • Factor II (correct)
  • Factor VIII
  • Factor IX
  • Factor X

What is the common cause of thrombocytopenia?

<p>Hypersplenism (C)</p> Signup and view all the answers

What does the International Normalized Ratio (INR) indicate?

<p>The risk of excessive bleeding. (A)</p> Signup and view all the answers

Which of the following best describes disseminated intravascular coagulation (DIC)?

<p>Widespread coagulation in small blood vessels. (D)</p> Signup and view all the answers

What triggers the release of heparin by basophils and mast cells?

<p>IgE binding (B)</p> Signup and view all the answers

Which component is responsible for shielding tissues from pro-coagulant signals?

<p>Endothelial cells (B)</p> Signup and view all the answers

What is the life span of circulating granulocytes?

<p>4-8 hours (C)</p> Signup and view all the answers

What is the primary function of thrombomodulin?

<p>Competing with thrombin to inhibit coagulation (D)</p> Signup and view all the answers

What is the function of dendritic cells in the immune system?

<p>Link the innate and adaptive immune responses (A)</p> Signup and view all the answers

Which of the following accurately describes the relationship between MHC proteins and T cells?

<p>MHC-I proteins are presented to cytotoxic T cells by any cell (B)</p> Signup and view all the answers

What triggers the clonal expansion of lymphocytes?

<p>Contact with its specific antigen (D)</p> Signup and view all the answers

Which component of the immune system is primarily responsible for the release of histamine during an allergic reaction?

<p>Mast cells activated by IgE (B)</p> Signup and view all the answers

What is a primary outcome of immunological memory in the adaptive immune response?

<p>More efficient recognition of previously encountered antigens (C)</p> Signup and view all the answers

Which statement about B cells is correct?

<p>They can both serve as antigen receptors and secrete antibodies (B)</p> Signup and view all the answers

What is the role of the complement system in immune response?

<p>It can amplify the immune response through a cascading series of proteins (B)</p> Signup and view all the answers

What mechanism is employed by natural killer (NK) cells to eliminate target cells?

<p>Induce infected cells to undergo apoptosis (D)</p> Signup and view all the answers

What are epitopes in the context of adaptive immunity?

<p>Unique structures on antigens recognized by immune cells (A)</p> Signup and view all the answers

What role do antigen-presenting cells (APCs) play in the activation of T cells?

<p>They present antigens in conjunction with MHC-II molecules to helper T cells (C)</p> Signup and view all the answers

What role do basophils and mast cells play in the immune response?

<p>They release histamine and other chemicals during an allergic reaction. (B)</p> Signup and view all the answers

What is a characteristic of leukopenia?

<p>Low white blood cell count resulting from bone marrow failure. (D)</p> Signup and view all the answers

Which immune response is primarily activated by the presence of PAMPs on pathogens?

<p>Both innate and adaptive immune responses. (C)</p> Signup and view all the answers

What is the primary function of reactive oxygen species (ROS) in phagocytes?

<p>To kill pathogens through oxidative damage. (A)</p> Signup and view all the answers

How do neutrophils respond when encountering pathogens too large to ingest?

<p>They eject chromatin to form a neutrophil extracellular trap (NET). (C)</p> Signup and view all the answers

Which component of the complement system acts as an opsonin?

<p>C3b (B)</p> Signup and view all the answers

What triggers the activation of the complement system?

<p>The binding of antibodies to their specific antigens. (D)</p> Signup and view all the answers

What is the primary significance of interferon-alpha and -beta in viral infections?

<p>They promote apoptosis in infected cells. (C)</p> Signup and view all the answers

Which cells are described as typically being the first responders to infection?

<p>Neutrophils. (D)</p> Signup and view all the answers

What is the primary role of defensins in the immune system?

<p>They disrupt the membranes of pathogens. (D)</p> Signup and view all the answers

Which phase of gastric secretion is primarily initiated by the sight or smell of food?

<p>Cephalic phase (D)</p> Signup and view all the answers

What mechanism is primarily responsible for the secretion of HCl by gastric parietal cells?

<p>H/K pump transporting H ions out (D)</p> Signup and view all the answers

What type of muscle contractions are seen in the large intestine during the mixing of feces?

<p>Segmental contractions (A)</p> Signup and view all the answers

Which of the following factors decreases gastric emptying?

<p>Increased pylorus tone (C)</p> Signup and view all the answers

Which type of action potential is characterized by variable amplitude and happens at fixed frequency in GI smooth muscle?

<p>Slow waves (C)</p> Signup and view all the answers

What is the primary function of the gastrocolic reflex?

<p>To stimulate colon motility after eating (A)</p> Signup and view all the answers

In which phase of swallowing does the action become involuntary?

<p>Pharyngeal phase (A)</p> Signup and view all the answers

What triggers enterogastric reflex to lower gastric emptying?

<p>Presence of fat, acid, or protein in the intestine (B)</p> Signup and view all the answers

Which type of cells in the pancreas produce secretin?

<p>S cells (B)</p> Signup and view all the answers

What is the effect of acetylcholine on gastrointestinal smooth muscle?

<p>Stimulates contractions (C)</p> Signup and view all the answers

What is the major gastric secretion that activates pepsinogen into pepsin?

<p>Hydrochloric acid (C)</p> Signup and view all the answers

What does the term 'antral pump' refer to in gastric motility?

<p>The contraction of the caudad area mixing food with gastric juices (D)</p> Signup and view all the answers

What causes the mass movements in the colon?

<p>Propulsive contractions in response to luminal distension (D)</p> Signup and view all the answers

Which white blood cell type primarily functions as the first responder to an infection?

<p>Neutrophils (C)</p> Signup and view all the answers

What is the role of dendritic cells in the immune response?

<p>Bridge innate and adaptive immunity (A)</p> Signup and view all the answers

What does the Major Histocompatibility Complex (MHC) II primarily do?

<p>Presents antigens to T-helper cells (D)</p> Signup and view all the answers

Which factor is primarily responsible for regulating erythrocyte production?

<p>Erythropoietin (C)</p> Signup and view all the answers

What type of anemia is characterized by the inability to absorb vitamin B12?

<p>Pernicious anemia (B)</p> Signup and view all the answers

Which of the following factors contribute to the phenomenon of increased cardiac output in anemia?

<p>Increased heart rate (D)</p> Signup and view all the answers

What is the final step in the clotting process during secondary hemostasis?

<p>Conversion of fibrinogen to fibrin (B)</p> Signup and view all the answers

Which pathway initiates blood coagulation in response to tissue injury?

<p>Extrinsic pathway (D)</p> Signup and view all the answers

What happens to red blood cells after they reach the end of their lifecycle in approximately 120 days?

<p>They are recycled in the spleen or liver. (C)</p> Signup and view all the answers

What is the primary function of basophils in the immune system?

<p>Histamine release during allergic reactions (A)</p> Signup and view all the answers

What might cause an increase in erythropoietin production?

<p>Chronic hypoxia (D)</p> Signup and view all the answers

Which component primarily mediates vascular constriction during hemostasis?

<p>Thromboxane A2 (A)</p> Signup and view all the answers

What is a characteristic of polycythemia vera?

<p>Increased blood viscosity and hypercoagulopathy (B)</p> Signup and view all the answers

What indicates that a substance is not filtered or is filtered and reabsorbed when comparing its clearance to inulin clearance?

<p>Clearance ratio lower than 1 (D)</p> Signup and view all the answers

Which factor primarily influences the regulation of GFR through net filtration pressure?

<p>Colloid osmotic pressure in capillaries (C)</p> Signup and view all the answers

Which mechanism promotes vasoconstriction in response to increased renal blood flow?

<p>Macula densa feedback (A)</p> Signup and view all the answers

What is the primary role of aldosterone in the renal system?

<p>Promote sodium and water reabsorption (B)</p> Signup and view all the answers

What happens to GFR when there is increased hydrostatic pressure in Bowman's capsule?

<p>GFR decreases (D)</p> Signup and view all the answers

Which substance is known to be freely filtered and serves as an accurate marker for GFR measurement?

<p>Inulin (D)</p> Signup and view all the answers

What physiological effect does atrial natriuretic peptide (ANP) have on renal blood flow?

<p>Increases renal blood flow and GFR (C)</p> Signup and view all the answers

What defines the 'transport maximum' in the context of renal physiology?

<p>The threshold at which a substance begins to be excreted (B)</p> Signup and view all the answers

What mechanism allows secondary active transport of glucose and amino acids within the nephron?

<p>Coupling with sodium transport (C)</p> Signup and view all the answers

The concentrating ability of the renal medulla relies on which gradient?

<p>Corticopapillary osmotic gradient (D)</p> Signup and view all the answers

What is the effect of angiotensin II on renal function at low levels?

<p>Increased GFR and decreased RBF (A)</p> Signup and view all the answers

In situations of low blood pressure, which mechanism does the body utilize to maintain renal function?

<p>Renal neurohormonal regulation (C)</p> Signup and view all the answers

Which cells in the collecting ducts are involved in acid-base regulation?

<p>Intercalated cells (C)</p> Signup and view all the answers

How does nitric oxide affect renal blood flow?

<p>Opposes constriction caused by catecholamines (B)</p> Signup and view all the answers

Flashcards

What is the role of plasminogen in the fibrinolytic system?

Plasminogen is a protein that is converted to plasmin, an enzyme that breaks down fibrin clots. This process helps to dissolve blood clots and prevent them from growing too large.

What are the antithrombotic properties of the endothelium?

The endothelium, the inner lining of blood vessels, actively prevents blood clots by shielding collagen, releasing nitric oxide, degrading ADP, altering thrombin, shielding tissue factor, competing with thrombomodulin, producing heparin and antithrombin III, and activating fibrinolysis by producing tissue plasminogen activator (tPA).

What causes Vitamin K deficiency?

Vitamin K deficiency can be caused by a lack of bacteria in the intestine, which are responsible for producing Vitamin K. It can also be caused by an inability to absorb Vitamin K, which can occur with conditions like bile duct obstruction.

What is hemophilia?

Hemophilia is a genetic disorder that impairs blood clotting due to a deficiency in certain clotting factors. The most common type, Hemophilia A, is due to a lack of factor VIII. Hemophilia B is due to a lack of factor IX.

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What is thrombocytopenia?

Thrombocytopenia is a condition characterized by a low platelet count in the blood, making it difficult for the blood to clot properly.

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What is a pulmonary embolism?

A pulmonary embolism occurs when a blood clot (embolus) from a deep vein in the leg travels to the lungs and blocks an artery, potentially leading to serious respiratory complications.

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What is disseminated intravascular coagulation (DIC)?

DIC is a life-threatening condition where widespread clotting occurs within small blood vessels. It often arises due to underlying infections, trauma, or cancer, and leads to a deficiency of clotting factors, which paradoxically leads to excessive bleeding.

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What is the prothrombin time (PT) test?

The prothrombin time test measures the time it takes for blood plasma to clot after adding calcium and tissue factor. It assesses the function of the extrinsic and common pathways of the coagulation cascade.

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What is INR?

INR stands for International Normalized Ratio. It is a standardized way to measure the prothrombin time, allowing for consistent results across different laboratories. A normal INR value typically falls between 1.0 and 2.0. Higher INR indicates increased bleeding risk.

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What are the three main types of white blood cells (WBCs)?

The three main types of WBCs are granulocytes, monocytes, and lymphocytes. Granulocytes include neutrophils, eosinophils, and basophils. Monocytes develop into macrophages. Lymphocytes include T cells and B cells.

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Natural Killer Cells (NK Cells)

Part of the innate immune system that directly kills infected or cancerous cells without prior sensitization. They recognize cells with low or abnormal MHC-1 expression, suggesting viral infection or malignancy.

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How NK cells recognize their targets

NK cells detect the absence or decrease of MHC-1 molecules on the surface of target cells, indicating potential infection or transformation. They also recognize stress-induced molecules expressed by infected or cancerous cells.

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Dendritic Cells (DCs)

Antigen-presenting cells (APCs) that link the innate and adaptive immune systems. They engulf pathogens, process their antigens, and present them to T cells in lymph nodes.

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Adaptive Immunity

A highly specific and long-lasting immune response that involves lymphocytes (B cells and T cells) and antibodies. It targets specific pathogens and remembers them for future encounters.

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Antigens

Substances that elicit an immune response, specifically by binding to antibodies or T cell receptors.

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Clonal Selection

The mechanism by which adaptive immune cells (lymphocytes) are selected and activated based on their specific antigen-binding receptors. When a lymphocyte encounters its specific antigen, it proliferates and differentiates, generating many copies of itself and effector cells.

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Immunological Memory

The ability of the adaptive immune system to remember past encounters with specific pathogens. This allows for a faster and stronger response upon re-exposure to the same pathogen.

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B Cells and Antibodies

B cells are a type of lymphocyte that produce antibodies. Antibodies are proteins that bind to specific antigens and neutralize pathogens, recruit other immune cells, and trigger complement activation.

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T Cells

Type of lymphocytes that require antigen presentation by APCs (like dendritic cells) for activation. They act in a short range and have different types, including cytotoxic T cells and helper T cells.

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MHC Proteins

Major Histocompatibility Complex proteins are markers on cells that identify them as 'self. They play a critical role in antigen presentation to T cells.

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IgE's role in histamine release

IgE antibodies bind to mast cells and basophils. When an allergen binds to IgE, it triggers the release of histamine and other inflammatory mediators.

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Mast Cells and Basophils

These immune cells are responsible for releasing histamine and other inflammatory mediators during allergic reactions.

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Leukopenia

A condition where the body has a low white blood cell count, making it more susceptible to infections.

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Leukemia

A type of cancer where abnormal white blood cells are produced in the bone marrow. These cells can't fight infections effectively.

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Innate Immunity

The body's first line of defense against infection, including physical barriers, antimicrobial substances, and phagocytes.

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PAMPs

Pathogen-associated molecular patterns (PAMPs) are molecules found on pathogens that are recognized by the immune system.

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PRRs

Pattern recognition receptors (PRRs) are receptors on immune cells that detect PAMPs, initiating an immune response.

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Phagocytosis

The process by which immune cells engulf and destroy pathogens.

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Complement System

A complex system of proteins that assists in the immune response by tagging pathogens for destruction, activating inflammation, and directly killing invaders.

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What is Clearance (Cx)?

The volume of plasma cleared of a substance per unit time. It represents the removal rate of a substance from the body.

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How is Clearance Measured?

It can be calculated by dividing the excretion rate of a substance by its arterial plasma concentration.

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What is the Glomerular Filtration Rate (GFR)?

The volume of fluid filtered from the blood into Bowman's capsule per unit time. It's a measure of kidney function.

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What is Inulin?

A substance used to measure GFR because it is freely filtered, not reabsorbed or secreted by the kidneys.

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What is the Filtration Coefficient (Kf)?

A measure of the glomerular wall's permeability and surface area to water. It reflects how easily fluid can pass through the filter.

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What is Net Filtration Pressure?

The difference between the hydrostatic pressure in glomerular capillaries and Bowman's capsule, and the colloid osmotic pressure in the capillaries.

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How does Increased Bowman's Capsule Hydrostatic Pressure affect GFR?

It decreases GFR because it increases the pressure opposing filtration.

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How does Increased Glomerular Capillary Colloid Osmotic Pressure affect GFR?

It decreases GFR because it increases the pressure opposing filtration.

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What is Renal Blood Flow (RBF)?

The volume of blood flowing through the kidneys per unit time.

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What is Autoregulation of RBF and GFR?

The ability of the kidneys to maintain a steady RBF and GFR despite changes in systemic blood pressure.

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What is Myogenic Autoregulation?

The constriction of blood vessels in response to increased blood pressure, which helps maintain a steady RBF.

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What is Tubuloglomerular Feedback?

A mechanism where the macula densa cells monitor the concentration of sodium in the filtrate and adjust the GFR.

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What is Sympathetic Nerve Activity's effect on GFR/RBF?

It constricts both afferent and efferent arterioles, lowering GFR and RBF.

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What is Angiotensin II's effect on GFR/RBF?

Low levels primarily constrict efferent arterioles (raising GFR, lowering RBF), while high levels constrict both (lowering GFR and RBF).

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What are slow waves in GI smooth muscle?

Slow waves are rhythmic fluctuations in membrane potential that occur at a fixed frequency but variable amplitude. They are not true action potentials and are generated by specialized pacemaker cells in the gut wall.

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What are spike potentials in GI smooth muscle?

Spike potentials are true action potentials triggered when slow waves reach threshold. They are caused by the opening of voltage-dependent calcium channels.

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What is the relationship between electrical and mechanical activity in GI smooth muscle?

Electrical activity (slow waves and spike potentials) slightly precedes mechanical activity (muscle contraction).

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What are the phases of swallowing?

Swallowing involves three phases: oral (voluntary), pharyngeal (involuntary), and esophageal (involuntary).

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What is the role of the upper esophageal sphincter (UES) during swallowing?

The UES opens to allow food into the esophagus and closes to prevent food from going back up into the pharynx.

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What is the role of the lower esophageal sphincter (LES) during swallowing?

The LES opens to allow food into the stomach and closes to prevent stomach contents from refluxing back into the esophagus.

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What is receptive relaxation of the stomach?

Receptive relaxation is the relaxation of the orad (upper) part of the stomach to accommodate incoming food.

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What are the functions of the caudad (lower) part of the stomach?

The caudad part of the stomach mixes food with gastric juice (propulsion/retropulsion) and propels chyme into the duodenum (antral pump).

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What factors increase gastric emptying?

Factors that increase gastric emptying include: higher tone of the orad region, stronger peristaltic contractions, lower pylorus tone, and absence of segmental contractions in the intestine.

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What factors decrease gastric emptying?

Factors that decrease gastric emptying are the opposite of those that increase it. These are triggered by receptors in the intestinal mucosa when food enters the small intestine.

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What are enterogastric reflexes?

Enterogastric reflexes are neural and hormonal signals that originate in the small intestine and inhibit gastric emptying. This is triggered by receptors in the intestinal mucosa that are activated by osmolarity, acid, fat, or protein.

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What is the role of cholecystokinin (CCK) in gastric emptying?

CCK is a hormone released by the small intestine in response to fat and proteins. It slows gastric emptying by inhibiting the antral pump and promoting relaxation of the orad region.

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What is the main function of the small intestine in terms of motility?

The small intestine mixes chyme with enzymes and other digestive secretions, circulates it to expose it to the mucosa, and propels it forward.

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What are haustral contractions?

Haustral contractions are segmental contractions of the large intestine that occur in the haustra (pouches) of the colon. They serve to mix and propel fecal matter.

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What is the gastrocolic reflex?

The gastrocolic reflex is a reflex that increases colonic motility (mass movements) in response to distension of the stomach by food.

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Neutrophils

The most abundant type of white blood cell, specializing in quickly attacking and killing bacteria.

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Macrophages

Larger phagocytes that engulf pathogens, debris, and old cells, playing a crucial role in wound healing and immune response.

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Basophils

White blood cells involved in allergic reactions, releasing histamine to trigger inflammation.

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Eosinophils

White blood cells that target parasites and modulate allergic reactions.

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Innate Immune Response

The body's first line of defense against pathogens, involving physical barriers, antimicrobial substances, and phagocytes.

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Adaptive Immune Response

The body's targeted and long-lasting immune response that specifically targets pathogens and remembers them for future encounters.

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T-Helper Cells

A type of T cell that orchestrates the immune response, activating other immune cells to fight specific pathogens.

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MHC-II

A protein complex on the surface of antigen-presenting cells (APCs) that presents antigen fragments to T-helper cells.

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Common Pathway

The final stage of the coagulation cascade where the extrinsic and intrinsic pathways converge to activate thrombin.

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Erythrocytes (RBCs)

Red blood cells responsible for oxygen transport throughout the body.

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Hemoglobin

The protein in red blood cells that binds to oxygen, giving blood its red color.

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Hemostasis

The process of stopping bleeding by forming a clot to seal the damaged blood vessel.

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Study Notes

Blood and Immunity

  • Neutrophils are the main phagocytes, basophils are involved in allergic reactions, and eosinophils play a role in defense against parasites.
  • Differences in size and function exist between neutrophils and macrophages.
  • The innate immune response is the first line of defense. If it is not effective, it stimulates the adaptive response.
  • Pathogens have molecular patterns (PAMPs); cells (macrophages) have pattern recognition receptors (PRRs). The interaction leads to phagocytosis (engulfing and destruction of pathogens).
  • Microbe remnants are presented on MHC-II molecules to T-helper cells, which activate cells to eliminate the microbes.
  • Dendritic cells bridge the innate and adaptive immune systems.
  • All nucleated cells have MHC-I, and dendritic cells, macrophages, and B lymphocytes have MHC-II.
  • The complement system, including extrinsic and intrinsic pathways, is part of the immune response.

Blood Cell Types

  • Blood is composed of various blood cell types originating from the bone marrow.
  • Granulocytes include neutrophils, basophils, and eosinophils.
  • Monocytes and lymphocytes (B and T cells, NK cells) are also white blood cells (WBCs).
  • Erythrocytes (red blood cells, RBCs) are responsible for oxygen transport.

RBCs

  • No organelles, destroyed by macrophages after 120 days.
  • Shape and size allow RBCs to move through capillaries.
  • Hold hemoglobin and carbonic anhydrase.
  • At 100% saturation, men hold 20mlO2, and women 19ml.
  • RBC production regulated by erythropoietin (EPO), produced by the kidneys.
  • Low oxygen levels stimulate EPO production.
  • Nutritional needs include vitamin B12/folic acid for maturation and DNA synthesis.
  • Pernicious anemia results from a lack of intrinsic factor, needed to absorb vitamin B12.
  • Defective iron metabolism causes microcytic-hypochromic anemia.
  • Macrocytic anemia relates to larger RBCs and normal coloring.

Hemostasis

  • Hemostasis is the process of stopping blood loss, including vascular constriction, plateletaggregation and coagulation.
  • Damaged tissue activates the coagulation cascade.
  • Extrinsic and intrinsic pathways meet at the common pathway which activates prothrombin to thrombin, converting fibrinogen to fibrin.
  • Thrombin initiates clot retraction and fibrinolysis with plasminogen activation.
  • Endothelial factors regulate clot formation and dissolution..
  • Disorders include hemophilia, thrombocytopenia and DIC.

Innate and Adaptive Immunity

  • The body has mechanisms, including innate and adaptive mechanisms (immune responses, to combat pathogens).
  • Pathogens and damaged cells trigger a cascade of events to initiate an inflammatory response.
  • Leukocytes (white blood cells, WBCs) are important in the immune response.
  • Cytokines and chemokines, prostaglandins and leukotrienes mediate a variety of inflammatory and immune responses.
  • Phagocytosis, including macrophages and neutrophils help destroy pathogens,
  • Complement system- A complex system of proteins that enhances the inflammatory response and directly attacks pathogens.

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