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PreClinEazy X Cardiff Medsoc IMMUNOLOGY Ba Diya LakhwaniBack to school Haemotopoeisis Layers of defence Cytokines Immunoglobulins Question 1 A Basophil What kind of cell does the image below show? Neutrophil B Macrophage C D Eosinophil E Monocyte Question 1 A Basophil What type of cell does the image below show? Neutrophil B Macrophage C D Eosinophil E Monocyte HAEMATOPOIESIS Multipontial haematopoieitic stem cell Common myeloid Common lymphoid progenitor progenitor Erythrocyte Mast cell B-lymphocytes Myeloblast Megakaryocyte Reticulocytes T-lymphocyte NK cell Plasma cell Platelets Monocyte Neutrophil Basophil Eosinophils Red blood cells BLOOD Macrophages TISSUE MYELOID - GRANULOCYTES - RED STAINING - MULTINUCLEATED - KILL PARASITES - APPEAR BLUE - PHAGOCYTOSE BACTERIA - PLAY A ROLE IN ALLERGIC - RELEASE HISTAMINE RESPONSES NEUTROPHILS EOSINOPHILS BASOPHILS MYELOID – NON-GRANULOCYTES - BICONCAVE DISC - LIVE IN TISSUES - KIDNEY SHAPED - NON-NUCLEATED - NON-PHAGOCYTIC - DESTRUCTION OF - DEEP PURPLE - TRANSPORT OF - RELEASE HISTAMINE VIRUSES. BACTERIA, - INVOLVED IN BLOOD CLOTTING RESPIRATORY GASES FUNGI & PROTOZOA - BIGGEST WBC ERYTHROCYTES MAST CELLS MONOCYTES PLATELETS LYMPHOID - PALE BLUE CYTOPLASM - IRREGULAR SHAPED - BILOBED NUCLEUS - KILL VIRALLY INFECTED CELLS - ROLE IN ADAPTIVE IMMUNE SYSTEM LYMPHOCYTES NK CELLS SUMMARY Platelet Erythrocyte Eosinophil Lymphocyte Neutrophil Basophil MonocyteLAYERS OF DEFENCE TYPES OF IMMUNITY 1. INNATE IMMUNITY - immediate bar- induced responseand physiochemical) 2. ADAPTIVE IMMUNITY SKIN & SEBUM MUCOCILIARY ESCALATOR LACRIMAL APPARATUS Sebum contains fatty acids and Goblet cells secrete mucus. Mucus is Tear production. Lysozyme causes lactic acid that provides protection degradation/lysis of bacterial cell wall (inhibit bacterial growth) moved by ciliated cells INNATE IMMUNITY SALIVA GASTRIC JUICE URINE Contains lysozyme which degrades HCL has a low pH. This destroys pathogens Flushes out pathogens bacterial cell wall SENTINEL CELLS: Macrophages INDUCED IMMUNITY Dendritic cells 2. Bacteria recognised by 3. PRR's release 1. Bacteria enter tissues inflammatory cytokines (IL- PRR on macrophage/dendritic 1, IL-6, TNFa) and the cell. PRRs recognise chemokine CXCL8/IL-8 DAMPs and PAMPs immune-response/bc.ca/biology/chaptehttps://musculoskeletalkey.com/innate-immunity-2/DENDRITIC CELLS ARE THE BRIDGE BETWEEN INNATE INDUCED IMMUNITY AND ADAPTIVE IMMUNITY 6.Phagocytosis takes 4. Release of TNFa 5. CXCL8/IL-8 will place which is optimised via makes local endothelium draw neutrophils to the site of infection via complement proteins, mast leaky, allowing chemotaxis. cells (release histamine) and neutrophils to exit blood NK cells (eliminate virally to assist with infected cells) phagocytosis 7. Dendritic cells will move through the lymph to the nearest lymph node for antigen presentation Question 2 You are the F1 doctor on call. A 5-year-old girl A DAMPs has presented to A&E with an open wound on B PAMPs her arm as a result of a fall while playing with her friends. On inspection, the wound looks C PRRs inflamed and there is some mild swelling. D RLRs Which of the following are located on E TLRs pathogens which are then detected by our immune system? Question 2 You are the F1 doctor on call. A 5-year-old girl A DAMPs has presented to A&E with an open wound on B PAMPs her arm as a result of a fall while playing with her friends. On inspection, the wound looks C PRRs inflamed and there is some mild swelling. D RLRs Which of the following are located on E TLRs pathogens which are then detected by our immune system? CHEMOTAXIS PROCESS BY WHICH NEUTROPHILS ARE RECRUITED TO SITE OF INFECTION PNEUMONIC FOR STEPS RED (Rolling adhesion) TREES (Tight binding) DANCE (Diapedesis) MONTHLY (Migration) COMPLEMENT SYSTEM THREE PATHWAYS: CLASSICAL LECTIN ALTERNATE KEY COMPLEMENT PROTEINS: 1. C3b – OPSONISATION 2. C3a/C5a - INFLAMMATION 3. C5b- CELL LYSIS MEMBRANE ATTACK COMPLEX (MAC) = C5b, C6, C7, C8, C9 https://app.biorender.com/illustrations/64fb44c2ee598ddb1c4ed8f4 Question 3 A C5 A 22-year-old female presents to her GP. She complains of bleeding in between her periods B C6 and of a thick green discharge. She is confirmed to have Neisseria Gonorrhoea and is given antibiotics accordingly. However, the C C7 infection seems to be recurrent, and her symptoms quickly return a few months later. D C8 E C9 Which complement protein deficiency is she presenting with? Question 3 A C5 A 22-year-old female presents to her GP. She complains of bleeding in between her periods B C6 and of a thick green discharge. She is confirmed to have Neisseria Gonorrhoea and is given antibiotics accordingly. However, the C C7 infection seems to be recurrent, and her symptoms quickly return a few months later. D C8 E C9 Which complement protein deficiency is she presenting with?PRO-INFLAMMATORY CYTOKINES • IL-1 • IL-6 • IL-8 (CHEMOKINE) • IL-12 • IL-4 • TNFa • IL-10 VS • IL-11 • IL-13 • TGF-B ANTI-INFLAMMATORY CYTOKINES SUMMARY Role of the innate immune system o First line of defense o Fast and immediate response to invasion o Involves recognition of PAMPs and DAMPs found on common pathogens o Non-specific response o Fixed response on repeated infection o Triggers adaptive immune responseANTIGEN PRESENTING CELLS: T CELLS MATURE IN THYMUS 1. DENDRITIC CELLS* ADAPTIVE IMMUNITY B CELLS MATURE IN BONE 2. MACROPHAGES MARROW 3. MONOCYTES B-CELLS AND T-CELLS MHC PLASMA CELL MHCII MHCI IMMUNE SYSTEM INNATE RESPONSE ADAPTIVE RESPONSE o IMMEDIATE o TAKES DAYS/WEEKS o NON-SPECIFIC o HIGHLY SPECIFIC o NO MEMORY o MEMORYIMMUNOGLOBULINS IMMUNOGLOBULIN STRUCTURE ANTIGEN ANTIGEN BINDING SITE HINGE REGION LIGHT (L) CHAIN HEAVY (H) CHAIN DISULFIDE BONDS CARBOHYDRATE EFFECTOR REGION https://www.britannica.com/science/antibody Question 5 Sam, a second-year medical student is on A IgA placement in the obstetrics department. One of B IgM this consultants asks him the following question. C IgD D IgG Which immunoglobulin can cross the placenta and reach fetal circulation? E IgE Question 5 Sam, a second-year medical student is on A IgA placement in the obstetrics department. One of B IgM this consultants asks him the following question. C IgD D IgG Which immunoglobulin can cross the placenta and reach fetal circulation? E IgE IMMUNOGLOBULINS TYPES IgA IgD IgE • Exists as a dimer • Exists as a monomer • Exists as a monomer • Present on mucosal • Involved in the • Provides immunity to membranes activation of B-cells parasites (eg. • Found in breast • Role is unknown Helminths) milk, mucus, saliva & tears • Synthesised by • Prevents pathogens from plasma cells invading mucosal • Found on surface of membranes mast cells & basophils IMMUNOGLOBULINS TYPES IgG IgM • Exists as a monomer • Exists as a pentamer • Present during a chronic infection (secondarily • Present during an acute infection produced by B-cells) • Enhances phagocytosis of (primarily produced bacteria and viruses by B-cells) • Passed through fetal circulation (placenta) IMMUNOGLOBULINS IgM IgD IgG IgA IgEPLEASE FILL OUT THE FEEDBACK FORM PLEASE TUNE IN TO OUR REMAINING SESSIONS THIS WEEK