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Pathophysiology II class notes > Ch. 16 Disorders of the Immune Response > Flashcards

Ch. 16 Disorders of the Immune Response Flashcards

1
Q

What is innate immunity?

A

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

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2
Q

What is adaptive immunity?

A

Responds to antigens

infection, tumor cells, transplanted cells

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3
Q

What does the complement system do?

A

Assists antibodies and phagocytes to destroy pathogens.

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4
Q

What are B-cells and what is their job?

A

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

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5
Q

What are T-cells and what is their job?

A

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

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6
Q

What is hypersensitivity?

A

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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7
Q

What is type I hypersensitivity?

A

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

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8
Q

What are five examples of local or atopic reactions?

A 
Rhititis (hay fever)
Food allergies
Bronchial asthma
Hives
Atopic dermatitis
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9
Q

What is anaphylaxis?

A

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

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10
Q

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

A

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

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11
Q

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

A

Acetylchonline, kinins, leukotrienes, and prostaglandins

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12
Q

What is type II hypersensitivity?

A

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

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13
Q

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

A
  1. Cell lysis
  2. Results in inflammatory process
  3. Results in cell dysfunction
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14
Q

What is opsonization?

A

Cell lysis

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15
Q

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

A

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

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16
Q

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

A

Gomerulonephritis

Transplant reaction

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17
Q

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

A

Graves disease

Myasthenia gravis

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18
Q

What is type III hypersensitivity?

A

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

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19
Q

What are four examples of type III hypersensitivity reactions?

A

Autoimmune vasculitis
Glomerulonephritis
Systemic lupus erythemoatosus (SLE)
Serum sickness

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20
Q

What is a type IV hypersensitivity response?

A

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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21
Q

What is an example of type IV hypersensitivity?

A

Some types of hepatitis

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22
Q

What is direct cell-mediated cytotoxicity?

A

Type IV hypersensitivity - Viral reactions

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23
Q

What is delayed-type hypersensitivity? (two examples)

A

Type IV hypersensitivity - tuberculin test, allergic contact dermatitis

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24
Q

What is self-tolerance?

A

The ability to differentiate self from non-self

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25
Q

What maintains self-tolerance?

A 
Central tolerance (deletes T&B cells in thymus and bone marrow)
Peripheral tolerance (deletes activated T&B)
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26
Q

What are autoimmune diseases?

A

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

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27
Q

What is “central tolerance” (what does it do)?

A

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

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28
Q

What is “peripheral tolerance” (what does it do)?

A

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

29
Q

What are primary immunodeficiency disorders?

A 
B-cell deficiencies
T-cell deficiencies
 - CD4 helper
 - CD8 cytotoxic
Combined immunodeficiencies
30
Q

What is an acquired immunodeficiency disorder?

A

AIDS

31
Q

What causes AIDS?

A

Human Immunodeficiency Virus (HIV) attacking CD4 T lymphocytes

32
Q

How does HIV attack CD4 T lymphocytes?

A

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

33
Q

What does AIDS result in? (5)

A 
Profound immunosuppression
Malignancies
Opportunistic infections
Wasting
CNS degeneration
34
Q

How is HIV transmitted?

A

Blood/body fluids

  • pre-ejaculate, semen, vaginal fluid (not saliva or urine)
  • Breast milk
  • Blood to blood contact
35
Q

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

A

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

36
Q

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

A

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

37
Q

What is seroconversion in HIV?

A

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

38
Q

What is the most contagious “window period” of HIV?

A

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

39
Q

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

A

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

40
Q

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

A

T-cell count is low

Death in 2-3 years without treatment

41
Q

What are the three stages of AIDS?

A

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

42
Q

What are opportunistic infections?

A

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

43
Q

How are opportunistic infections categorized?

A

Categorized by organism type.

44
Q

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

A

Respiratory
Gastrointestinal
Nervous system

45
Q

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

A

Bacterial pneumonia
P. Jiroveci pneumonia
Pulmonary tuberculosis

46
Q

What are P. Jiroveci and P. Carinii?

A

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

47
Q

What is the leading cause of death in HIV?

A

Tuberculosis

48
Q

What organs can be infected by tuberculosis?

A

Usually lungs

Can also be kidneys, bone marrow, etc.

49
Q

What are the manifestations of tuberculosis in an AIDS patient?

A

Fever
Night sweats
Cough
Weight loss

50
Q

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

A

Esophagitis
Aphthous ulcers (canker sores)
Gastroenteritis

51
Q

What is esophagitis caused by? (3)

A

Esophageal candidiasis, chlamydial virus, herpes simplex

52
Q

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

A

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

53
Q

What is gastroenteritis?

A

Mild to severe diarrhea.

54
Q

What does HANDS stand for?

A

HIV Associated Neurocognitive Disorders

55
Q

What is HANDS?

A

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

56
Q

What are the manifestations of HANDS?

A

Attention/concentration deficit, mental/motor slowing, apathy

57
Q

What is toxoplasmosis?

A

A parasitic infection of the nervous system.

Parasite found in cat feces and raw meat.

58
Q

What are the manifestations of toxoplasmosis?

A

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

59
Q

What is Progressive Multifocal Leukoencephalopathy?

A

Slow demyelination of white matter d/t virus

60
Q

What are the manifestations of Progressive Multifocal Leukoencephalopathy?

A

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

61
Q

What is Kaposi Sarcoma?

A

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

62
Q

What are the manifestations of Kaposi Sarcoma?

A 
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)
63
Q

What are four common malignancies found in AIDS patients?

A

Kaposi Sarcoma
Non-Hodgkin lymphoma
Cervical carcinoma
Anal carcinoma

64
Q

What is wasting syndrome?

A

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

65
Q

What causes wasting syndrome?

A

Malabsorption, endocrine dysfunction, etc.

66
Q

What are the manifestations of wasting syndrome?

A

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

67
Q

What are some metabolic disorders that accompany AIDS?

A

Insulin resistance, diabetes, hyperlipidemia, lipodystrophy, mitochondrial disorders

68
Q

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

A

Treatment regimens (side effects)

Pathophysiology II class notes (15 decks)

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