Midterm Review 3

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Questions and Answers

What is the primary purpose of the inflammatory response?

To promote adaptive immune responses

To stimulate vascular growth

To contain damage and eliminate pathogens (correct)

To initiate systemic infection

Which of the following is NOT a characteristic of acute inflammation?

Pain and loss of function

Vascular dilation

Tissue necrosis (correct)

Redness and swelling

Which type of cytokines amplifies the inflammatory response?

TGF-β

TNF-α (correct)

IL-10

Interferon-γ

What cellular events occur during the inflammatory response?

Leukocyte recruitment and phagocytosis Signup and view all the answers

What is a potential outcome of chronic inflammation?

Granuloma formation and fibrosis Signup and view all the answers

Which cells are primarily responsible for engulfing pathogens during inflammation?

Neutrophils and macrophages Signup and view all the answers

What defines chronic inflammation?

Persistent inflammation and tissue destruction Signup and view all the answers

How do anti-inflammatory cytokines function in the inflammatory response?

They dampen the inflammatory response Signup and view all the answers

What is a common cause of urinary tract infections?

Escherichia coli Signup and view all the answers

Which symptom is indicative of cystitis rather than pyelonephritis?

Dysuria Signup and view all the answers

In which part of the body does pyelonephritis primarily cause inflammation?

Renal pelvis and calyces Signup and view all the answers

What characterizes the energy imbalance in cachexia?

Energy input does not meet the body's needs Signup and view all the answers

Which cytokines are primarily involved in the inflammation associated with cachexia?

TNF-α and IL-1 Signup and view all the answers

What condition can lead to acute glomerulonephritis?

Group A beta-hemolytic streptococci infection Signup and view all the answers

What component of HIV enables it to bind to CD4 T cells?

gp120 Signup and view all the answers

What is a possible consequence of the inflammatory response in cystitis?

Necrosis of bladder wall Signup and view all the answers

How does HIV establish dormancy in the host genome?

By incorporating its DNA into the host genome Signup and view all the answers

What characterizes primary glomerulonephritis?

It develops independently in the glomeruli. Signup and view all the answers

What distinguishes chronic glomerulonephritis from acute glomerulonephritis?

It is often linked to systemic diseases. Signup and view all the answers

What occurs during the initial infection with HIV before the immune system responds?

Significant elevation of plasma viral load Signup and view all the answers

What is the pathophysiological trigger for glomerulonephritis?

Immune responses damaging the filtration membrane Signup and view all the answers

What is the relationship between HIV reactivation and CD4 T cell count?

Reactivation results in a drastic decline in CD4 T cells Signup and view all the answers

What defines AIDS in relation to CD4 T cells?

Drastic reduction in CD4 T helper cells Signup and view all the answers

Which fluids are known to transmit HIV?

Blood, vaginal fluid, semen, and breast milk Signup and view all the answers

What happens during diastole in the cardiac cycle?

Filling of blood into a chamber of the heart Signup and view all the answers

What does preload refer to in the context of cardiac function?

The volume and pressure inside the ventricle at the end of diastole Signup and view all the answers

Which of the following best defines afterload?

The resistance the ventricle must overcome to eject blood Signup and view all the answers

How does increased contractility affect cardiac output?

It increases the force of contraction for a given preload Signup and view all the answers

Which risk factor is primarily associated with damage to blood vessels?

Smoking Signup and view all the answers

What effect does hypertension have on the arteries?

It puts stress on artery walls, making them susceptible to damage Signup and view all the answers

What is the role of macrophages in the progression of atherosclerosis?

They release inflammatory cytokines that worsen inflammation Signup and view all the answers

Which of the following dietary components can contribute to high LDL cholesterol levels?

Saturated and trans fats Signup and view all the answers

What is the primary consequence of a mutated CFTR gene in cystic fibrosis?

Impaired chloride and water transport Signup and view all the answers

Which characteristic is NOT commonly associated with cystic fibrosis?

Weight loss Signup and view all the answers

What is the most likely causative microorganism for pneumonia?

Streptococcus pneumoniae Signup and view all the answers

Which of the following is primarily responsible for the initial recognition of pathogens in pneumonia?

Alveolar macrophages Signup and view all the answers

What role do neutrophils play in the lungs of cystic fibrosis patients?

Releasing inflammatory mediators Signup and view all the answers

What is the primary function of the CFTR protein?

Regulating chloride channels in epithelial cells Signup and view all the answers

Which of the following statements about cystic fibrosis mucus is true?

It contains excess bacteria and neutrophil by-products. Signup and view all the answers

Which of these options is a method by which microorganisms contribute to chronic infection in cystic fibrosis?

Destruction of immunoglobulin G (IgG) Signup and view all the answers

What is the primary result of the persistently elevated pulmonary artery pressure in cor pulmonale?

Right ventricular hypertrophy Signup and view all the answers

Which hormone acts as a potent vasoconstrictor and is involved in the RAAS system?

Angiotensin II Signup and view all the answers

Which receptor type does angiotensin II bind to that has opposing effects, including vasodilation?

AT2 receptor Signup and view all the answers

What is the role of aldosterone in the regulation of blood pressure?

Promotes sodium and water retention Signup and view all the answers

Which component of the RAAS is secreted by the kidneys in response to low blood pressure?

Renin Signup and view all the answers

How does the body regulate the RAAS to prevent excessive activation?

With negative feedback mechanisms Signup and view all the answers

What effect does angiotensin II have on the sympathetic nervous system?

Enhances sympathetic activity Signup and view all the answers

What is the initial change in the heart due to cor pulmonale?

Right ventricular hypertrophy Signup and view all the answers

What is the primary role of mast cells in the inflammatory response?

They immediately release histamine and attract other immune cells. Signup and view all the answers

Which cells serve as antigen-presenting cells that link innate and adaptive immunity?

Dendritic cells Signup and view all the answers

What type of response does the innate immune system provide?

Immediate and non-specific Signup and view all the answers

In what way can reactive oxygen species (ROS) released by neutrophils be detrimental?

They can contribute to tissue damage during inflammation. Signup and view all the answers

Which cytokine is specifically known for promoting systemic effects like fever during inflammation?

TNF-α Signup and view all the answers

What function do eosinophils primarily serve in the context of inflammation?

Regulate vascular mediators and defend against parasites. Signup and view all the answers

Which phenomenon related to neutrophils can exacerbate inflammation and tissue damage?

Formation of neutrophil extracellular traps (NETs) Signup and view all the answers

What is the effect of pro-inflammatory cytokines in the context of inflammation?

They amplify inflammation and promote leukocyte recruitment. Signup and view all the answers

Which of the following diseases is most commonly associated with Staphylococcus aureus infections?

Cellulitis Signup and view all the answers

What role do fibroblasts play in the dermis?

Producing connective tissue matrix and collagen Signup and view all the answers

Which condition is characterized by superficial skin lesions that develop a honey-coloured crust?

Impetigo Signup and view all the answers

In the immune response of the skin, which cell type is primarily responsible for releasing inflammatory mediators?

Mast cells Signup and view all the answers

Which of the following conditions does NOT typically manifest with defined borders?

Cellulitis Signup and view all the answers

What mechanism does the Frank-Starling Law exemplify in the cardiovascular system?

Increased stroke volume due to myocardial fiber stretching Signup and view all the answers

What is the primary function of macrophages in the dermis?

Engulfing and digesting cellular debris and pathogens Signup and view all the answers

Which factor is NOT considered a primary risk factor for atherosclerosis?

Increased fluid intake Signup and view all the answers

Which skin structure contains hair follicles, sebaceous glands, and blood vessels?

Dermis Signup and view all the answers

Which of the following is a significant risk factor for cellulitis?

Diabetes Signup and view all the answers

How does afterload impact the ejection of blood from the ventricle during systole?

Higher afterload creates more resistance for blood ejection Signup and view all the answers

What is the primary role of macrophages in the pathology of atherosclerosis?

To cause endothelial cell inflammation and plaque formation Signup and view all the answers

Which statement about preload is accurate within the context of the cardiac cycle?

It is the volume and pressure at the end of diastole Signup and view all the answers

What occurs when endothelial cells become inflamed during atherosclerosis?

Formation of adhesion molecules attracting inflammatory cells Signup and view all the answers

What is the expected consequence of increased contractility in cardiac function?

Greater force of contraction for a given preload Signup and view all the answers

Which of the following factors is most likely to negatively impact endothelial health?

Chronic high blood sugar levels Signup and view all the answers

Which cytokines are predominantly secreted by Th2 cells during the immune response in asthma?

IL-4, IL-5, IL-8, and IL-13 Signup and view all the answers

What immediate effect does mast cell degranulation have during the early phase of inflammation in asthma?

Release of histamine causing bronchoconstriction Signup and view all the answers

Which of the following best describes a result of prolonged airway obstruction in asthma?

Decreased perfusion to alveoli Signup and view all the answers

What is a notable change in the structure of the airways due to chronic inflammation in asthma?

Epithelial cell hyperplasia Signup and view all the answers

Which symptom is indicative of airway obstruction in asthma?

Prolonged expiration and dyspnea Signup and view all the answers

Cystic fibrosis is characterized by dysfunction in which type of cells?

Epithelial cells producing mucus and other secretions Signup and view all the answers

What long-term consequence can arise from untreated asthma exacerbations?

Airway remodeling and structural changes Signup and view all the answers

Which of the following describes a symptom of hyperventilation due to asthma?

Feeling of breathlessness Signup and view all the answers

What is the most common type of urinary stone formed in the body?

Calcium oxalate and calcium phosphate stones Signup and view all the answers

Which factor is NOT a common cause of lower urinary tract obstruction?

Diabetes mellitus Signup and view all the answers

What physiological change occurs in the unaffected kidney when one kidney is obstructed?

Compensatory hypertrophy and hyperfunction Signup and view all the answers

Urinary incontinence associated with involuntary loss of urine due to bladder overdistention is categorized as:

Overflow incontinence Signup and view all the answers

Which type of urinary incontinence is often triggered by sudden increases in intra-abdominal pressure?

Stress incontinence Signup and view all the answers

What is the primary mechanism leading to urinary tract infections (UTIs)?

Bacterial movement from the gut to the urinary tract Signup and view all the answers

What complication may arise from post-obstructive diuresis if not managed properly?

Dehydration Signup and view all the answers

Lesions in which location are primarily associated with neurogenic bladder dysfunction?

Spinal cord Signup and view all the answers

What is a key clinical manifestation of nephrotic syndrome?

Massive proteinuria Signup and view all the answers

Which of the following is a common cause of prerenal acute kidney injury (AKI)?

Severe dehydration Signup and view all the answers

Which symptom is characteristic of nephritic syndrome?

Hematuria with red blood cell casts Signup and view all the answers

What is a potential consequence of damage to the glomerular filtration barrier?

Hypoalbuminemia Signup and view all the answers

How does acute kidney injury (AKI) lead to oliguria?

Decreased glomerular filtration rate Signup and view all the answers

In which condition is edema most prominently observed?

Nephrotic syndrome Signup and view all the answers

Which of the following conditions is associated with acute interstitial nephritis?

Use of nephrotoxic medications Signup and view all the answers

What is the result of fluid retention due to glomerular damage?

Hypertension Signup and view all the answers

Study Notes

Inflammatory Response

Inflammation is a crucial component of the innate immune system, triggered by tissue injury.
It's a rapid, non-specific process that aims to contain damage, eliminate pathogens, and initiate healing.
Key features include activation (seconds after injury), vascular changes (vasodilation, increased permeability), cellular events (leukocyte recruitment), and cytokine signaling.

Characteristics of Acute Inflammation

Characterized by redness, swelling, heat, pain, and loss of function.
A protective physiological response to injury.
Initial, transient response lasting days.
Carried out by cells of the innate immune system via cytokines and chemokines.

Chronic Inflammation

Result from unresolved acute inflammation or persistent triggers.
Characterized by infiltration of lymphocytes and macrophages, fibroblast proliferation, connective tissue formation, and potential scarring or polyp formation.
Granulomatous inflammation occurs when macrophages and eosinophils wall off foreign bodies or infected areas.

Cells Involved in Acute Inflammation

Mast cells: release histamine, causing vasodilation, and cytokines (TNF-α, IL-4, IL-5, IL-6, and IL-13).
Macrophages: engulf pathogens and cellular debris, release pro-inflammatory cytokines (TNF-α, IL-1, IL-6), and present antigens to T helper cells.
Neutrophils: rapid recruitment, highly effective phagocytes, release enzymes and toxic reactive oxygen species.
Dendritic cells: capture antigen, migrate to lymph nodes, present antigens to T cells.
Eosinophils: primarily involved in defense against parasites.

Hypersensitivity Reactions

Three major types: Allergy (environmental antigens), Autoimmunity (self-antigens), Alloimmunity (tissue from another individual like in transfusions or pregnancy).
Four major mechanisms: Type 1 (immediate/humoral), Type 2 (tissue-specific), Type 3 (immune complex-mediated), and Type 4 (delayed/cell-mediated).
Type 1 involves IgE antibodies, Type 2 involves IgG or IgM antibodies, Type 4 involves T cells.

Antibody-Dependent Cellular Cytotoxicity (ADCC)

Antibodies (IgG) bind to target cells, marking them for destruction by immune cells (NK cells, macrophages, or neutrophils).

Immune Complex-Mediated Hypersensitivity (Type III)

Results from antigen-antibody complex formation.
Complexes deposit in tissues, activating complement and causing neutrophil-mediated tissue damage.

Cell-Mediated Hypersensitivity (Type IV)

Mediated by T cells, not antibodies.
Delayed response (24 to 72 hours).
Activated macrophages release enzymes and toxic oxygen species, causing tissue damage.

Cachexia

A complex metabolic disorder characterized by muscle wasting and atrophy.
Often accompanied by weakness and fatigue.
Characterized by an imbalance in energy balance.

HIV/AIDS

HIV is a retrovirus that primarily infects and destroys CD4+ T helper cells of the adaptive immune system.
Can also infect macrophages, dendritic cells, NK cells and cytotoxic T cells.

Infection Concepts

Factors influencing a microorganism's ability to cause infection include communicability, immunogenicity, infectivity, mechanism of action, pathogenicity, portal of entry, toxigenicity, and virulence.

Epidermis

The outermost layer of skin, acting as a protective barrier.
Predominantly made up of keratinocytes, producing keratin for strength and resilience.
Keratinocytes undergo keratinization (cornification) as they move from the basal layer to the surface.
Melanocytes produce melanin to protect against UV light.
Other cells include Langerhans cells (dendritic cells) and Merkel cells.

Viral Skin Infections

Caused by viruses including herpes simplex virus, varicella-zoster virus, human papillomavirus, measles, and rubella.

Fungal Skin Infections

Dermatophytes (trichophyton, microsporum) are a group of fungi causing superficial skin infections.
Mycoses (e.g., tinea infections), are fungal disorders that utilize keratin.
Candidiasis results from infection by the yeast-like fungus Candida albicans.

Skin Cancer

Caused by UV radiation damage to DNA in skin cells.
Types include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma (melanocytes).

Atherosclerosis

Buildup of lipid-laden macrophages (foam cells) in artery walls, resulting in plaque formation.
Risk factors include smoking, hypertension, diabetes, high cholesterol, obesity, and unhealthy diet.

Acute Coronary Syndrome

Includes unstable angina and myocardial infarction (MI).
Caused by thrombus formation over a ruptured atherosclerotic plaque.

Hypertension

Consistently high blood pressure (≥140/90 mmHg).

Deep Vein Thrombosis (DVT)

Characterized by blood clot formation in a deep vein, usually in the legs.
Risk factors include venous stasis, venous endothelial damage, and hypercoagulable states.

Heart Failure

Systolic and diastolic heart failure.
Factors such as reduced contractility, increased preload, and afterload contribute to HF.

Primary and Secondary Glomerulonephritis

Primary inflammation originates in the glomeruli.
Secondary inflammation is linked to other systemic diseases.

Urinary Tract Obstructions

Kidney stones (calculi) are the most common cause of upper urinary tract obstructions.

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Description

Explore the intricacies of the inflammatory response, including what initiates inflammation and its significance in the immune system. Understand the characteristics of both acute and chronic inflammation, from the rapid response mechanisms to the consequences of prolonged inflammation.