Med-Chem/Pharm 3: Immune System & Inflammation (EXAM 4)

*Eicosanoids* 1. Arachidonic acid is converted to leukotrienes (LTB₄, LTC₄, LTD₄, LTE₄) via? A. Lipooxygenase enzyme B. COX-1, COX-2 enzymes 2. Arachidonic acid is converted to prostaglandins, prostacyclin & thromboxanes resulting in inflammation via? A. Lipooxygenase enzyme B. COX-1, COX-2 enzymes

1. A 2. B

1. If COX-1 is inhibited, which of the following results? A. Altered functions B. Risk of bleeding C. Anti-thrombogenesis D. All the above 2. If COX-2 is inhibited, which of the following results? A. Ovulation B. Placentation C. Uterine contraction of labor D. All the above

1. A 2. B

1. Neutrophils accumulate during? A. Acute inflammation B. Chronic inflammation 2. Macrophages accumulate during? A. Acute inflammation B. Chronic inflammation

1. A 2. B

1. When exposed to specific antigens, B-cells differentiate into anti-body producing? A. Plasma cells B. Activated phenotype 2. When exposed to specific antigens, T-cells differentiate into? A. Plasma cells B. Activated phenotype

1. A 2. B

Adaptive immunity is generally divided into humoral immunity & cellular immunity. 1. The primary cells mediating humoral immunity are? A. B-cells B. T-cells 2. The primary cells mediating cellular immunity are? A. B-cells B. T-cells

1. A 2. B

Match the following: 1. Function as antigen presenting cells (APC) & synthesize AND secrete antibodies 2. Cytotoxic T-cells (cellular adaptive immunity; Tc) & Helper T-cells (adaptive responses; Th1, Th2) A. B-cells B. T-cells

1. A 2. B

*study guide* Match the following granulocytes to their role in tissues: 1. Anti-bacterial defense 2. Anti-parasitic defense & allergic response 3. Allergic responses (circulating) 4. Allergic responses (tissue-resident) A. Neutrophils B. Eosinophils C. Basophils D. Mast cells

1. A 2. B 3. C 4. D

Match the following drug targets/MOA to their correct agent: 1. PLA₂ inhibitors 2. Lipooxygenase inhibitors 3. Leukotriene antagonists 4. COX-1 & COX-2 inhibitors A. Corticosteroids B. Zileuton C. Montelukast & Zafirlukast D. NSAIDs

1. A 2. B 3. C 4. D

*KNOW* Match the following PGs with their major source: 1. Many tissues, macrophages & mast cells 2. Mast cells & neurons 3. Vascular smooth muscle, uterine smooth muscle 4. Endothelial cells 5. Platelets A. PGE₂ B. PGD₂ C. PGF₂α D. PGI₂ (prostacyclin) E. TXA₂ (thromboxane)

1. A 2. B 3. C 4. D 5. E

*study guide* Match the following PGs with their actions/roles: 1. Protection of gastric mucosa, vasodilation, hyperalgesia, cytoprotective (GI), acid secretion (GI), mucus formation 2. Vasodilation, inhibition of platelet activation, sleep, Alzheimer's disease 3. Vascular tone, reproductive physiology & bronchoconstriction 4. Vasodilation, inhibition of platelet activation 5. Vasoconstriction, bronchoconstriction, platelet aggregation A. PGE₂ B. PGD₂ C. PGF₂α D. PGI₂ (prostacyclin) E. TXA₂ (thromboxane)

1. A 2. B 3. C 4. D 5. E

What are the 2 major isoforms of cyclooxygenase?

COX-1 & COX-2 *COX-3 (putative functional COX) has been identified as a potential site of acetaminophen action*

*study guide* Macrophages & dendritic cells work as antigen presenting cells (APC). 1. Which one is derived from monocytes & tissue-resident cells, involved in chronic inflammation & phagocytoses cellular debris & foreign particles? 2. Which one engulfs antigens from one location, then travel & present the antigen to T-cells at a different location?

1. Macrophages 2. Dendrites *macrophages phagocytosing cellular debris & foreign particles is innate immunity & its function as APC is adaptive immunity*

*study guide* Which of the following cells are responsible for allergic response in tissues. A. Mast cells B. Eosinophils C. Basophils D. Neutrophils

A

*study guide* Which of the following cells regulate adaptive responses? A. Th cells B. Tc cells C. B cells D. Neutrophils E. MHC-I

A

*study guide* Which of the following is NOT an eicosanoid? A. Cytokine B. TXA2 C. Leukotriene D. PGE2

A

Co-stimulatory signal is ONLY present in Helper T-cells A. True B. False

A

Eicosanoids are both pro-inflammatory & anti-inflammatory. A. True B. False

A

Elevated cellular metabolism & mediators of inflammation (IL-1, IL-6 & TNF) cause? A. Fever B. Stimulation of nociceptors C. Vasodilation & ↑ blood flow D. Extravasation of fluid & ↑ permeability, release of histamine, leukotrienes, bradykinin & platelet activator factor

A

Granulocytes are the major arm of? A. The innate immune system B. The adaptive immune system

A

Inflammation is composed of a complex web of responses to tissue injury & infection. A. True B. False

A

MHC Class I is involved in? A. Activation of Cytotoxic T-cells B. Activation of Helper T-cells

A

Match the following description to either COX-1 or COX-2. -Housekeeping functions -NO induction -Expressed constitutively in gastric mucosa, kidneys, platelets, endothelial cells -Can be pharmacologically inhibited by low dose aspirin A. COX-1 B. COX-2

A

Zafirlukast and Montelukast are selective competitive antagonists for cys-LT1 receptors. Which one significantly inhibits influx of basophils & lymphocytes into the airways? A. Zafrilukast B. Montelukast

A

*study guide; KNOW* Co-stimulation is an important property of ________ on Th cells. A. CD28 B. CD21 C. CD33

A *CD28 interaction with Th cell proteins of the B7 family on APC is required for Th activation* *activated Th cell secretes IL-2*

*study guide* Which binding site is present on MHC class I protein? A. CD8 binding site B. CD4 binding site

A *MHC Class I = cytotoxic T cells = CD8 binding site*

All nucleated human cells express? A. MHC Class I proteins B. MHC Class II proteins

A *MHC Class I proteins bind with degraded fragment (antigen) in the ER (main protein present in our cells)*

Match the following LT antagonists based on the description below: -MORE bioavailable (90%) -Longer half-life (10hrs) -Increased prothrombin time with warfarin (monitoring necessary) A. Zafirlukast B. Montelukast

A *Montelukast has a 60-70% bioavailability, half-life of 3-6hrs & no interaction with warfarin*

If an APC presents both the antigen and a co-stimulatory molecule (B7), T cell proliferates and differentiates in response to the? A. Antigenic stimulus B. Co-stimulatory stimulus

A *No response of T cell in the absence of an appropriate co-stimulatory signal*

Ligand binding causes PLA₂ (Phospholipase A₂) A. Activation B. Inhibition

A *PLA₂ is associated with receptors for various ligands (IL-1, TNF-a)* *PLA2 site is where steroids work*

IL-1, TNF-α are cytokines/chemokines. A. True B. False

A *they are responsible for acute inflammatory response*

Which of the following is TRUE regarding prostaglandins? A. It shares a chemical structure called prostanoid B. It has 3 major groups (PG₁, PG₂, PG₃) C. PG₂ is the MOST prevalent D. PGH₂ serves as the precursor to all other PGs & TXA₂ E. PGs have short half-lives F. Production of a specific PG is dependent on cell-specific enzymes G. All the above

G *PGI₂ and TXA₂ are needed in platelets*

Pattern Recognition Receptors include Toll-like receptors (TLRs) & Dectin-1. 1. Which one recognizes bacterial LPS? 2. Which one recognizes fungal β-glucans?

1. Toll-like receptors (TLRs) 2. Dectin-1

*study guide* 3 differences between innate and adaptive immunity: 1. Onset of action: A. Immediate? B. Days to weeks (delayed)? 2. Mechanism of antigen recognition: A. Receptors that recognize common molecules on microbes & viruses? B. Unique antigen specific receptors (T-cell & B-cell receptors)? 3. Cell types/factors: A. Macrophages, neutrophils, mast cells, natural killer cells, complement, interferons? B. Antigen presenting cells, T-lymphocytes, B-lymphocytes?

1A. Innate 1B. Adaptive/Acquired 2A. Innate 2B. Adaptive/Acquired 3A. Innate 3B. Adaptive/Acquired

*study guide* Immune response is generally required to protect against? A. self B. non-self

B

*study guide* Which of the following mediators is derived from membranes? A. Serotonin B. Leukotrienes C. Proteases D. IL-1

B

Antigen-presenting cells (APC) stimulate the? A. The innate immune system B. The adaptive immune system

B

MHC Class II is involved in? A. Activation of Cytotoxic T-cells B. Activation of Helper T-cells

B

Match the following description to either COX-1 or COX-2. -Induced during inflammation -Expressed constitutively in brain, kidneys, endothelial cells -Undetectable in most normal tissues -Pro-inflammatory role -Pharmacologically inhibited by NSAIDs & COX-2 selective inhibitors A. COX-1 B. COX-2

B

*study guide* Which binding site is present on MHC class II protein? A. CD8 binding site B. CD4 binding site

B *MHC Class II = helper T cells = CD4 binding site*

Which of the following types of inflammation is implicated in autoimmune disease & organ transplant rejections? A. Acute inflammation B. Chronic inflammation

B *acute = innate immunity* *chronic = adaptive immunity*

Cytotoxic T-cells (Tc) express? A. T-cell receptors (TCR) B. CD8 C. Both A & B

C

Histamine is present in A. Mast cells B. Basophils C. Both A & B

C

T-helper cells (Th) express? A. T-cell receptors (TCR) B. CD4 C. Both A & B

C

Which of the following cells mediate adaptive immune responses? A. B-cells B. T-cells C. Both A & B

C

*study guide* Which of the following inflammatory processes is/are self-limited? [Select all that apply] A. Chronic B. Inflammatory bowel disease C. Acute D. Rheumatoid arthritis E. A small tissue injury

C & E

*study guide* Membrane-derived lipid mediators include: A. Prostaglandins (PG) B. Leukotrienes (LT) C. Platelet Activation Factor (PAF) D. All the above

D

Eicosanoids include: A. Prostaglandins (PG) B. Thromboxanes (TX) C. Leukotrienes D. All the above

D

Non-self can be: A. Any infectious agents B. A transplanted organ C. Endogenous tissue mistaken as something foreign D. All the above

D

Which of the following antigen presenting cells (APC) express MHC Class II proteins? A. B-cells B. Macrophages C. Dendritic cells D. All the above

D

Which of the following is TRUE regarding Adaptive immunity? A. Must be able to generate a response to any foreign antigen (non-self) B. Must be tolerant to self-antigens C. Involves major histocompatibility complex (MHC) proteins at the cell surface (MHC I and II) D. All the above

D

Which of the following is TRUE regarding the complement system? A. Its a system of serine proteases B. Its activated in response to injury (innate immunity) C. Named as "C" followed by a number & then "a" or "b" (to indicate active forms; ex: C3a, C3b) D. All the above

D

Which of the following is TRUE regarding the immune system? A. It distinguishes self from non-self B. It reacts against any non-self entity (adaptive & innate responses) C. It protects against infection D. All the above

D

*study guide* Mediators produced through degranulation include: A. Histamine B. Heparin C. Serotonin D. Proteases E. All the above

E

*study guide* Which of the following are chemical mediators of inflammation causing fever? A. IL-1 B. IL-6 C. TNF-α D. PGs E. All the above

E

Autocoids, cytokines & chemokines are released during acute inflammation. Autocoids include: A. Histamine B. Bradykinin C. Prostaglandins D. Leukotrienes E. All the above

E

Chemical mediators of inflammation include: A. Histamine B. Complement components C. Eicosanoids D. Cytokines E. All the above

E

Which of the following are important cells of Innate immune system? *hint = granulocytes* A. Neutrophils B. Eosinophils C. Basophils D. Mast cells E. All the above

E

Which of the following is TRUE regarding antigen presenting cells (APC)? A. They are important initiators of immune responses B. They process the macromolecules of invading agents into fragments C. They display the fragments to T-cells D. They provide co-stimulatory signals for T-cell activation E. All the above

E

Which of the following is TRUE regarding inflammation? A. Its the body's response to injury, pathogen invasion or necrosis B. Its meant to destroy the invader & repair damage C. It has immunological components (specific & non-specific) D. Persisting inflammation results in tissue damage E. All the above

E

Which of the following is TRUE regarding the immune system? A. It includes the cells & soluble factors (antibodies & complement proteins) B. It mediates the inflammatory response C. It eliminates the inciting inflammatory stimulus D. It initiates immunologic memory E. All the above

E

Which of the following is TRUE regarding the lipooxygenase pathway? A. Leukotrienes are synthesized from arachidonic acid by lipooxygenases B. Leukotrienes include: LTA, LTB₄, LTC₄, LTD₄, LTE₄ C. LTC₄, LTD₄, LTE₄ are cysteinyl leukotrienes which are potent bronchoconstrictors D. Cys-leukotrienes bind with cys-LT1 receptors. E. All the above

E

Which of the following is TRUE regarding the Innate immune system? A. First responders to an offending agent B. Rapid response to counteract harmful effects C. Recognize a wide range of antigens by Pattern Recognition Receptors D. Lacks memory—response will be the same upon repeated exposures E. All the above

E *Response is meant to contain the invader until the adaptive system "kicks in" = If needed*