Ch. 16 Disorders of the Immune Response Flashcards by Rachel Wiebe

What is innate immunity?

Able to recognize self/non-self
Reacts to microbes
Leukocyes, macrophages, NKC
Complement system

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What is adaptive immunity?

Responds to antigens

infection, tumor cells, transplanted cells

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What does the complement system do?

Assists antibodies and phagocytes to destroy pathogens.

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What are B-cells and what is their job?

They are a type of WBC that is part of the adaptive immune system.
They secrete antibodies.

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What are T-cells and what is their job?

They are part of the adaptive immune system and they direct B-cell activity.

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What is hypersensitivity?

Excessive or inappropriate activation of the immune response

The body is damaged by the immune response, rather than by the antigen (often called allergen)

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What is type I hypersensitivity?

Commonly called “allergic reactions”
Systemic or anaphylactic reactions.
Local or atopic reactions

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What are five examples of local or atopic reactions?

Rhititis (hay fever)
Food allergies
Bronchial asthma
Hives
Atopic dermatitis

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What is anaphylaxis?

Systemic response to the inflammatory mediators released in type I hypersensitivity.

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What chemicals are released during an anaphylactic response that cause vasodilation?

Histamine, acetylchiline, kinins, leukotrienes, and prostaglandins (all cause vasodilation)

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What chemicals are released during an anaphylactic response that cause bronchoconstriction?

Acetylchonline, kinins, leukotrienes, and prostaglandins

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What is type II hypersensitivity?

Cytotoxic response involving IgG or IgM that attack antigens on cell surfaces.

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What are the three things that result from a type II hypersensitivity reaction?

Cell lysis
Results in inflammatory process
Results in cell dysfunction

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What is opsonization?

Cell lysis

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What are three examplse of type II hypersensitivity reactions that result in cell lysis?

Transfusion reactions
Rh disease (hemolytic disease of the newborn)
Drug reactions

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What are two examples of type II hypersensitivity reactions that result in inflammatory process?

Gomerulonephritis

Transplant reaction

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What are two examples of type II hypersensitivity reactions that result in cell dysfunction?

Graves disease

Myasthenia gravis

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What is type III hypersensitivity?

Circulating inactive antigen + antibody immune complex that deposit on the walls of blood vessels and activate complement.

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What are four examples of type III hypersensitivity reactions?

Autoimmune vasculitis
Glomerulonephritis
Systemic lupus erythemoatosus (SLE)
Serum sickness

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What is a type IV hypersensitivity response?

Cell-mediated: sensitized T cells attack antigen and cell is damaged as a result. This occurs even if the pathogen is not harming the cell.

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What is an example of type IV hypersensitivity?

Some types of hepatitis

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What is direct cell-mediated cytotoxicity?

Type IV hypersensitivity - Viral reactions

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What is delayed-type hypersensitivity? (two examples)

Type IV hypersensitivity - tuberculin test, allergic contact dermatitis

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What is self-tolerance?

The ability to differentiate self from non-self

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What maintains self-tolerance?

``` Central tolerance (deletes T&B cells in thymus and bone marrow) Peripheral tolerance (deletes activated T&B) ```

What are autoimmune diseases?

When the autoimmune system is unable to differentiate and body tissues are destroyed (impaired self-tolerance)

What is "central tolerance" (what does it do)?

Deletes T&B cells (in thymus, bone marrow)

What is "peripheral tolerance" (what does it do)?

Deletes unnecessarily activated T&B cells (stops hypersensitivity reaction)

What are primary immunodeficiency disorders?

``` B-cell deficiencies T-cell deficiencies - CD4 helper - CD8 cytotoxic Combined immunodeficiencies ```

What is an acquired immunodeficiency disorder?

AIDS

What causes AIDS?

Human Immunodeficiency Virus (HIV) attacking CD4 T lymphocytes

How does HIV attack CD4 T lymphocytes?

Attaches to CD4 T cell receptors. Enters cell. Attaches own RNA to cell's DNA. Uses cell's energy to reproduce more viruses.

What does AIDS result in? (5)

``` Profound immunosuppression Malignancies Opportunistic infections Wasting CNS degeneration ```

How is HIV transmitted?

Blood/body fluids - pre-ejaculate, semen, vaginal fluid (not saliva or urine) - Breast milk - Blood to blood contact

What are three ways HIV can be transmitted by blood to blood contact?

Contaminated needles Transfusions During pregnancy or birth (in utero or labour and delivery)

What occurs during Stage 1 of HIV infection (Primary infection phase)?

Signs of systemic infection 1-4 weeks post exposure. (Typical signs of a viral infection, lasting 7-10 days) Rapid viral replications decrease DC4 T-cell counts

What is seroconversion in HIV?

The immune system responds to the virus and antibodies against HIV appear. This takes 1-6 months.

What is the most contagious "window period" of HIV?

Primary stage, prior to seroconversion (first 1-6 months)

What occurs during Stage 2 of HIV infection (latent period)?

No signs/symptoms Virus replicates CD4 T-cell count decreases Possible lymphadenopathy

What occurs during stage 3 of HIV infection (Overt AIDS)?

T-cell count is low | Death in 2-3 years without treatment

What are the three stages of AIDS?

Stage 1: primary phase Stage 2: latent period Stage 3: overt AIDS

What are opportunistic infections?

Infections caused by organisms that would normally not cause infection in a "healthy" person (without AIDS).

How are opportunistic infections categorized?

Categorized by organism type.

What three systems are often affected by opportunistic infections in a person with AIDS?

Respiratory Gastrointestinal Nervous system

What are the three typical opportunistic respiratory infections seen in a person with AIDS?

Bacterial pneumonia P. Jiroveci pneumonia Pulmonary tuberculosis

What are P. Jiroveci and P. Carinii?

They are both common fungus in the environment. Multiply quickly in HIV infected lungs. Foamy exudate form cysts in alveoli, Manifestations: mild cough, fever, SOB, weight loss

What is the leading cause of death in HIV?

Tuberculosis

What organs can be infected by tuberculosis?

Usually lungs | Can also be kidneys, bone marrow, etc.

What are the manifestations of tuberculosis in an AIDS patient?

Fever Night sweats Cough Weight loss

What are three typical gastrointestinal infections seen in individuals with AIDS?

Esophagitis Aphthous ulcers (canker sores) Gastroenteritis

What is esophagitis caused by? (3)

Esophageal candidiasis, chlamydial virus, herpes simplex

What are the manifestations of aphthous ulcers (canker sores)?

Pain (location) Painful swallowing Retrosternal pain (when in esophagus)

What is gastroenteritis?

Mild to severe diarrhea.

What does HANDS stand for?

HIV Associated Neurocognitive Disorders

What is HANDS?

Syndrome of cognitive and motor dysfunction, with behavioural and psychosocial symptoms.

What are the manifestations of HANDS?

Attention/concentration deficit, mental/motor slowing, apathy

What is toxoplasmosis?

A parasitic infection of the nervous system. | Parasite found in cat feces and raw meat.

What are the manifestations of toxoplasmosis?

Fever, headache, confusion, lethargy, visual disturbances, seizures

What is Progressive Multifocal Leukoencephalopathy?

Slow demyelination of white matter d/t virus

What are the manifestations of Progressive Multifocal Leukoencephalopathy?

Progressive limb weakness, hemi-paresis, ataxia Sensory loss, visual disturbances Mental status changes, seizures

What is Kaposi Sarcoma?

A common malignancy in AIDS patients of endothelial lining of blood vessels.

What are the manifestations of Kaposi Sarcoma?

``` Oral & skin lesions, GI tract, lungs Violet lesions enlarge, darken Often on trunk, neck, head, tip of nose Painless at first Invade tissue (late pulmonary invasion) ```

What are four common malignancies found in AIDS patients?

Kaposi Sarcoma Non-Hodgkin lymphoma Cervical carcinoma Anal carcinoma

What is wasting syndrome?

Diagnosed in absence of opportunistic infection or malignancy. (In AIDS patients)

What causes wasting syndrome?

Malabsorption, endocrine dysfunction, etc.

What are the manifestations of wasting syndrome?

Involuntary weight loss >10% of baseline body weight Diarrhea, multiple daily stool Chronic weakness Fever

What are some metabolic disorders that accompany AIDS?

Insulin resistance, diabetes, hyperlipidemia, lipodystrophy, mitochondrial disorders

What causes metabolic disorders in AIDS patients (most often)?

Treatment regimens (side effects)