Diseases Of The Immune System Flashcards

1
Q

What Is immunity

A

Immunity refers to protection against infections.

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2
Q

Give 2 types of immunity

A

Innate and Adaptive immunity

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3
Q

Describe innate immunity

A

Innate immunity is mediated by cells and proteins
that are always present and poised to fight against
microbes and are called into action immediately in
response to infection.

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4
Q

4 components of innate immunity

A
  1. Epithelial barriers of skin, GIT and respiratory
    tract.
  2. Phagocytic leukocytes(Neutrophils,
    macrophages)
  3. Natural killer cell
  4. Several plasma proteins
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5
Q

What is adaptive immunity

A

 Adaptive immunity( acquired or specific immunity)
is silent and responds to the presence of infectious
microbes by becoming active, expanding, and
generating potent mechanism for neutralizing and
eliminating microbes.

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6
Q

What are the components of adaptive immune system

A

Components of adaptive immune system are
lymphocytes and their products.

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7
Q

Types of adaptive immune responses

A
  1. Humoral immunity, mediated by soluble antibody
    proteins that are produced by B lymphocytes
  2. Cell mediated immunity, mediated by T
    lymphocytes
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8
Q

Describe lymphocytes

A

 Lymphocytes: are the mediators of adaptive
immunity and the only cells that produce specific
and diverse receptors for antigens

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9
Q

Describe t lymphocytes

A

T lymphocytes: express antigen receptors called T
cell receptors that recognize peptide fragments of
protein antigens that are displayed by MHC
molecules on the surface of the antigen presenting
cells.

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10
Q

Describe (Major histocompitibilty complex) molecules:

A

MHC(Major histocompitibilty complex) molecules:
the peptide display system of adaptive immunity

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11
Q

Describe B lymphocytes( Bone marrow-derived):

A

B lymphocytes( Bone marrow-derived): express
membrane bound antibodies that recognize a wide
variety of antigens. B cells are activated to become
plasma cells, which secrete antibodies.

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12
Q

Describe Natural killer cells

A

Natural killer cells: kills cells that are infected by some
microbes, or are stressed and damage beyond repair.
NK cells express inhibitory receptors that recognize
MHC molecules that are normally expressed on healthy
cells, and are thus prevented from killing normal cells.

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13
Q

Antigens presenting cells

A

Antigen- presenting cells: capture microbes and
other antigens, transport them to lymphoid organs,
and display them for recognition by lymphocytes.
The most efficient APCs are dendritic cells, which
live in epithelia and most tissue.

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14
Q

Describe the overview of normal immune responses

A

 The physiologic function of immune system is
defense against infectious microbes.
 The early reaction to microbes is mediated by the
mechanism of innate immunity, which are ready to
respond to microbes. These mechanism include
epithelial barriers, phagocytes, NK cells, and
plasma proteins, e.g. of the complement system.
The reaction of innate immunity is often manifested
as inflammation
 The defense reactions of adaptive immunity develop
slowly, but are more potent and specialized.
 Microbes and other foreign antigens are captured by
dendritic cells and transported to lymph nodes, where
the antigens are recognize by naïve lymphocytes. The
lymphocytes are activated to proliferate and
differentiate into effector and memory cells.
 Cell-mediated immunity is the reaction of Tlymphocytes,
Design to combat cell- associated microbes( e.g.
phagocytosed microbes and microbes in the
cytoplasm of infected cells)
 Humoral immunity is mediated by antibodies and is
effective against extracellular microbes( in the
circulation and mucosal lumens)
 CD4+ helper T cells help B cells to make
antibodies, activates macrophages to destroy
Microbes and block their infectivity, and promote
the phagocytosis and destruction of pathogens.
Antibodies also confer passive immunity to
neonates.

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15
Q

Describe the 4 hypersensitive reactions

A
  1. I (Immediate Hypersensitivity)
  2. II (Antibody Mediated Hypersensitivity)
  3. III (Immune-Complex Mediated Hypersensitivity)
  4. IV (Cell-Mediated Hypersensitivity)
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16
Q

Describe type 1 hypersensitivity

A

Immediate” means seconds to minutes
 “Immediate Allergic Reactions”, which may lead to
anaphylaxis, shock, edema, dyspnea death
 1) Allergen exposure
 2) IMMEDIATE phase: MAST cell
DEgranulation, vasodilatation, vascular
leakage, smooth muscle (broncho)-
spasm
 3) LATE phase (hours, days):
Eosinophil’s, PMNs, T-Cells

17
Q

Describe type 2 hypersensitivity

A

ABs attach to cell surfaces
 OPSONIZATION (basting the turkey)
 PHAGOCYTOSIS
 COMPLEMENT FIXATION (cascade of
C1q, C1r, C1s, C2, C3, C4, C5….. )
 LYSIS (destruction of cells by rupturing
or breaking of the cell membrane)

18
Q

Name type 2 diseases

A

Autoimmune Hemolytic Anemia, AHA
 Idiopathic Thrombocytopenic Purpura, ITP
 Goodpasture Syndrome (Nephritis and Lung
hemorrhage)
 Rheumatic Fever
 Myasthenia Gravis
 Graves Disease
 Pernicious Anemia, PA

19
Q

Describe type 3 hypersensitivity

A

Antigen/Antibody “Complexes”
 Where do they go?
 Kidney (Glomerular Basement Membrane)
 Blood Vessels
 Skin
 Joints (synovium)
 Common Type III Diseases- SLE (Lupus),
Poly(Peri)arteritis Nodosa, Poststreptococcal
Glomerulonephritis, Arthus reaction (hrs), Serum
sickness (days)

20
Q

Type 4 hypersensitivity

A

Tuberculin Skin Reaction
 DIRECT ANTIGENCELL CONTACT
 GRANULOMA FORMATION
 CONTACT DERMATITIS

21
Q

Describe autoimmune diseases

A

Failure of SELF RECOGNITION
 Failure of SELF TOLERANCE
TOLERANCE
 CENTRAL (Death of self reactive lymphocytes)
PERIPHERAL (anergy, suppression by T-cells,
deletion by apoptosis, sequestration (Ag masking))
 STRONG GENETIC PREDISPOSITION
 OFTEN RELATED TO OTHER AUTOIMMUNE
DISEASES
 OFTEN TRIGGERED BY INFECTIONS

22
Q

Name the classic autoimmune diseases

A

LUPUS (SLE) Systemic Lupus
Erythematosus
 RHEUMATOID ARTHRITIS
 SJÖGREN SYNDROME
 SYSTEMIC SCLEROSIS (scleroderma)
 MCD (Mixed Connective Tissue Dis.)
 Poly (Peri-) arteritis nodosa

23
Q

Give classic autoimmune diseases(local)

A

HASHIMOTO THYROIDITIS
 AUTOIMMUNE HEMOLYTIC ANEMIA
 MULTIPLE SCLEROSIS
 AUTOIMMUNE ORCHITIS
 GOODPASTURE SYNDROME
 AUTOIMMUNE THROMBOCYTOPENIA (ITP)
 “PERNICIOUS” ANEMIA
 INSULIN DEPENDENT DIABETES MELLITUS
 MYASTHENIA GRAVIS
 GRAVES DISEASE

24
Q

Lupus

A

Etiology: Antibodies (ABs) directed against the patient’s
own DNA, HISTONES, NON-histone RNA, and
NUCLEOLUS
 Pathogenesis: Progressive DEPOSITION and
INFLAMMATION to immune deposits, in skin, joints,
kidneys, vessels, heart, CNS
 Morphology: “Butterfly” rash (NOT discoid)
 , skin deposits, glomerolunephritis
 Clinical expression: Progressive renal and vascular
disease, POSITIVE A.N.A.

25
Q

SJÖGREN
SYNDROME

A

Hematologic
 Arthritis
 Skin
 Fever
 Fatigue
 Weight loss
 Renal
 Central nervous system
 Pleuritis
 Myalgia
 Pericarditis
 Gastrointestinal
 Raynaud phenomenon
 Ocular
 Peripheral neuropathy

26
Q

ImmunoDefiency S
yndromes (-IDS)

A

PRIMARY (GENETIC)
SECONDARY (A
CQUIRED) (A-IDS)

27
Q

Primary

A

CHILDREN with repeated, often severe infections, cellular
AND/OR humoral immunity problems, autoimmune defects
 BRUTON (X-linked agammaglobulinemia)
 COMMON VARIABLE
 IgA deficiency
 Hyper -IgM
 DI GEORGE (THYMIC HYPOPLASIA)
 SCID (Severe Combined Immuno Deficiency)
 COMPLEMENT DEFICIENCIES

28
Q

(A)IDS(SECONDARY IDS)

A

Etiology: HIV
Pathogenesis: Infection, Latency,
Progressive T-Cell loss
Morphology: MANY
Clinical Expressions: Infections,
Neoplasms, Progressive Immune Failure,
Death, HIV+, HIV-RNA (Viral Load)

29
Q

NATURAL HISTORY OF HIV
INFECTION

A

1) PRIMARY INFECTION
 2) LYMPHOID INFECTION
 3) ACUTE SYNDROME
 4) IMMUNE RESPONSE
 5) LATENCY
 6) AIDS

30
Q

GENERAL IMMUNE
ABNORMALITIES

A

LYMPHOPENIA
DECREASED T-CELL FUNCTION
B-CELL ACTIVATION,
POLYCLONAL
ALTERED
MONOCYTE/MACROPHAGE
FUNCTION

31
Q

Opportunistic Infection

A

Protozoal/Helminthic:
Cryptosporidium, PCP (Pneumocystis
Carinii (really Jiroveci) Pneumonia),
Toxoplasmosis
Fungal: Candida, and the usual 3
Bacterial: TB, Nocardia, Salmonella
Viral: CMV, HSV, VZ (Herpes Family)

32
Q

CANCERS of AIDS

A

KAPOSI SARCOMA
B-CELL LYMPHOMAS
CNS LYMPHOMAS
CERVIX CANCER,
SQUAMOUS CELL

33
Q

AMYLOIDOSIS

A

BUILDUP OF AMYLOID “PROTEIN”
 AL (Amyloid Light Chain)
 AA (NON-immunoglobulin protein)
 Aß (Alzheimer’s)
WHERE? BLOOD VESSEL WALLS, at first
 KIDNEY
 SPLEEN
 LIVER
 HEART

34
Q

AMYLOID ASSOCIATIONS

A

PLASMA CELL “DYSCRASIAS”, i.e.,
MULTIPLE MYELOMA
CHRONIC GRANULOMATOUS DISEASE,
e.g., TB
HEMODIALYSIS
HEREDOFAMILIAL
LOCALIZED
ENDOCRINE MEAs (Multiple Endocrine
Adenomas)
AGING