Disorders of immune response Flashcards

1
Q

Innate vs Adaptive Immunity

A
  1. Innate (born with) e.g. skin, mucous membranes
    Able to recognize self/non-self
    Reacts to microbes
    Leukocytes, macrophages, NKC
    Complement system:
    - Assist antibodies and phagocytes to destroy pathogens
2. Adaptive
Responds to antigens
-Infection
-Tumor cells
-Transplanted cells

B-cells (type of wbc) secretes antibodies
Cytotoxic T-cells act directly on infected cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Type I Hypersensitivity

A
  • Commonly called “allergic reactions”
  • Systemic or anaphylactic reactions
  • Local or atopic reactions
    examples:
    -Rhinitis (hay fever)
    -Food allergies
    -Bronchial asthma
    -Hives
    -Atopic dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anaphylaxis

A
  • Systemic response to the inflammatory mediators released in type I hypersensitivity
  • Histamine, acetylcholine, kinins, leukotrienes, and prostaglandins all cause vasodilation

-Acetylcholine, kinins, leukotrienes, and prostaglandins all can cause bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type II Hypersensitivity

A
  • Cytotoxic
  • IgG or IgM attack antigens on cell surfaces
    1. Results in cell lysis (opsonization)
  • Transfusion reactions
  • Rh disease (hemolytic disease of the newborn)
  • Drug reactions
    2. Results in inflammatory process
  • glomerulonephritis, transplant rejection
    3. Results in cell dysfunction
  • Graves disease (TSH stimulated = hyperthyroidism)
  • Myasthenia Gravis (acetylcholine or receptors blocked)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Type III Hypersensitivity

A

-Circulating inactive antigen + antibody immune complex
-Immune complexes deposit on walls of blood vessels and activate complement
-Blood vessels are damaged
Eg:
-Autoimmune vasculitis
-Glomerulonephritis
-Systemic lupus erythemoatosus (SLE)
-Serum sickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type IV Hypersensitivity

A
1. Cell-mediated: sensitized TH1 cells attack antigen and cell damaged as a result
Occurs even if pathogen not harming cell
E.g. some types of hepatitis
2. Direct cell-mediated cytotoxicity
- Viral reactions
3. Delayed-type hypersensitivity
-Tuberculin test
-Allergic contact dermatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Autoimmune Diseases: Self tolerance, Central tolerance, Peripheral tolerance

A

Self-tolerance is ability to differentiate self from non-self
Maintained by
-Central tolerance which deletes T&B cells (in thymus; in bone marrow)
-Peripheral tolerance which deletes activated T&B cells.
If immune system is unable to differentiate, body tissues are destroyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Immunodeficiency Disorders: Primary and aquired

A
  1. Primary (congenital or inherited)
    -B-cell deficiencies
    -T-cell deficiencies
    CD4 helper
    CD8 cytotoxic
    -Combined immunodeficiencies
  2. Acquired (more common)
    AIDS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acquired Immunodeficiency Syndrome (AIDS)

A
  • Caused by Human Immunodeficiency Virus (HIV) attacking CD4 T lymphocytes
  • Attaches to CD4 T cell receptors
  • Enters cell
  • Attaches own RNA to cell’s DNA
  • Uses cells energy to reproduce more viruses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does AIDS result in?

A

Results in:

  • Profound immunosuppression
  • Malignancies
  • Opportunistic infections
  • Wasting
  • CNS degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Human Immunodeficiency Virus (HIV) Transmission

A

-Transmitted by blood/body fluids
-Pre-ejaculate, semen, vaginal fluid (not saliva or urine)
-Breast milk (30-40% of cases)
-Blood to blood contact
-Contaminated needles
-Transfusions
-During pregnancy or birth
-In-utero (15-20%)
-During labor and delivery (45-50%)
Occupational exposure uncommon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Stage 1 of HIV infection

A

Stage 1: Primary infection phase

  • Signs of systemic infection 1-4 weeks post exposure
  • fever, fatgue, myalgia, sore throat, night sweats, GI issues, lymphadenopathy, maculopapular rash, h/a
  • Last 7-10 days
  • Rapid viral replication decreases CD4 t-cell count
  • Most contagious during “window period” for 1-6 months prior to seroconversion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stage 2 of HIV infection

A

Stage 2: Latent period (approx. 10 years)

  • No signs and symptoms
  • Virus replicates
  • CD4 T-cell count decreases
  • Possible lymphadonopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stage 3 of HIV infection

A

Stage 3: Overt AIDS

  • T-cell count low
  • Death in 2-3 years without treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AIDS-Associated Illnesses

A

-Opportunistic infections
-Infections caused by organisms that would normally not
-Categorized by organism type
Respiratory
Gastrointestinal
Nervous system

17
Q

Respiratory Infections

A

Bacterial pneumonia,
P. jiroveci pneumonia
pulmonary tuberculosis

18
Q

P. Jiroveci (PCP)

A
  • Common in fungus in environment
  • Multiplies quickly in HIV infected lungs
  • Foamy exudate forms cysts in alveoli
  • Mild cough, fever, SOB, weight loss
19
Q

Tuberculosis

A
  • leading cause of death with HIV
  • Usually in lung but also kidneys, bone marrow, etc.
  • Fever, night sweats, cough, weight loss.
20
Q

GI Infections

A
  1. Esophagitis
    Esophageal candidiasis, chlamydial virus, herpes simplex
  2. Aphthous ulcers
    Cause painful swallowing, retrosternal pain
  3. Gastroenteritis
    Mild to severe diarrhea
21
Q

Nervous System Disorders: HANDS

A
  • (HIV associated Neurocognitive Disorders)
  • Syndrome of cognitive & motor dysfunction, with behavioral and psychosocial symptoms
  • Attention/concentration deficit, mental/motor slowing, apathy.
22
Q

Nervous System Disorders: Toxoplasmosis

A

(parasitic)
Cat feces, raw meat
Fever, h/a, confusion, lethargy, visual disturbances, seizures

23
Q

Nervous System Disorders: Progressive Multifocal Leukoencephalopathy

A

Slow demyelination of white matter d/t virus
Progressive limb weakness, hemi-paresis, ataxia
Sensory loss, visual disturbances
Mental status changes, seizures

24
Q

Malignancies: Kaposi Sarcoma (KS)

A
  • Common
  • Endothelial lining of small blood vessels
  • 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)
25
Q

Malignancies: Non-Hodgkin lymphoma

A

Fever, night sweats, weight loss
-Cervical carcinoma
Human papilloma virus (HPV)
-Anal carcinoma

26
Q

Wasting Syndrome

A

Diagnosed in absence of opportunistic infection or malignancy (other than aids)
Causes:
malabsorption, endocrine dysfunction, etc.
Manifesations:
Involuntary weight loss > 10% of baseline body weight
Diarrhea, multiple daily stool
Chronic weakness
fever

27
Q

Metabolic Disorders

A

Insulin resistance, diabetes, hyperlipidemia, lipodystrophy, mitochondrial disorders
Often d/t treatment regimens