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RMC Patho Exam 2 > Disorders of the Immune System > Flashcards

Disorders of the Immune System Flashcards

1
Q

The purpose of the immune system is

A

Protection

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2
Q

The immune system has three main jobs

A
  1. Protect the host against invasion by foreign substances, microorganisms, and toxins
  2. Protect against the proliferation of neoplastic cells
  3. Plays a large role in the inflammatory process and wound healing
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3
Q

When the immune system malfunctions it affects ___ and there is an overreaction to ___

A

Affects the ability to fight off infections

Overreaction to certain allergen triggers

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4
Q

The body’s immune system might also malfunctions through having an

A

Immunodeficiency disorder

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5
Q

An immunodeficiency is an abnormality in immune system that results in an

A

Increased susceptibility to disease states

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6
Q

What are the two immunodeficiency disorders?

A

Primary

Acquired

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7
Q

Primary immunodeficiency disorders are

A

Congenital or inherited

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8
Q

With primary immunodeficiency disorders, early detection is

A

Critical for treatment and decreasing risk for fatal diseases

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9
Q

If a child with a primary immunodeficiency disorder is given a vaccine with ___, it could be life threatening.

A

Live attenuated viruses (weakened form of the germ that causes the disease)

child’s body can’t fight even against the weakened form

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10
Q

The typical age that a child is referred for testing for a primary immunodeficiency disorder is

A

6 months

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11
Q

Acquired immunodeficiency disorders develop when?

A

Later in life because of other pathophysiologic states

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12
Q

Clinical manifestations and impact on the patient’s function depends on

A

The particular immunodeficiency disorder

The degree of the immune system malfunction

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13
Q

What is an example of a secondary immunodeficiency disorder?

A

HIV

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14
Q

Hypersensitivity disorder is an abnormal and

A

Excessive response of the activated immune system that causes injury and damage to host tissues

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15
Q

Normally, the immune system sends out __ when activated

A

T-cell and B-cells

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16
Q

How many types of hypersensitivity reactions are there?

A

4

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17
Q

Type 1 hypersensitivity reactions are ___ that develop ___

A

IgE-mediated reactions that develop rapidly upon exposure to an antigen

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18
Q

What is an example of a type 1 hypersensitivity reaction?

A

Peanut allergy

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19
Q

If someone has a peanut allergy, why would they have to ingest it twice to have a reaction?

A

1st time

  • Macrophage takes allergen and starts to recognize it is foreign
  • B and T cell lymphocytes establish a hyperactive immune response
  • T-cells secrete cytokine (tells B-cells to become plasma cells and secrete IgE

2nd time
- Mast cells release histamine
Basically, the first time the body interacts with the allergen, it doesn’t know what it is or that it should react. But you can bet that the next time that allergen comes into the neighborhood, the cells are going to be ready to fight.

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20
Q

IgE are

A

Antibodies produced by the immune system

These are what are released to cause an allergic reaction

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21
Q

Type 2 hypersensitivity reactions are ___ mediated

A

Antibody-mediated

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22
Q

Cytotoxic hypersensitivity is another name for

A

Type 2 hypersensitivity

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23
Q

In a type 2 hypersensitivity reaction, the first mechanism of action looks like (use blood transfusion example)

A

Blood from donor is transfused into pt

Pts body recognizes the blood cells as foreign

Destroys the foreign cells through antibodies and complement activation

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24
Q

Type 2 hypersensitivity reaction causes

A

Target cell malfunction

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25
Q

An example of a type 2 hypersensitivity reaction is

A

Hyperthyroidism

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26
Q

In type 2 hypersensitivity reaction, soluble antigens (foreign object) may

A

Enter into circulation and be deposited on the specific organ tissues

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27
Q

Within type 2 hypersensitivity, one reaction is ADCC

A

Antibody-Dependent Cell Cytotoxicity

incorporates components of both innate and adaptive immune responses

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28
Q

Type 3 hypersensitivity reaction is __ driven

A

Antibody driven

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29
Q

Examples of type 3 hypersensitivity reaction are

A

Raynaud’s disease

Lupus

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30
Q

What kind of response occurs in type 3 hypersensitivity reaction?

A

Humoral response

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31
Q

In type 3 hypersensitivity reaction, what activates immune complex deposition?

A

IgG and IgM

32
Q

In type 3 hypersensitivity reaction, ____ are formed first in the __ and then deposited ___

A

Antibody-antigen complexes

Plasma and then deposited in the tissues

33
Q

In type 3 hypersensitivity reaction, immune complexes elicit an inflammatory response by

___ are recruited to attempt to ___

A

Activating complement

Neutrophils are recruited to attempt to phagocyte the cells (unsuccessful due to large complexes)

34
Q

Lastly, in type 3 hypersensitivity reaction, ____ is released from the cell and the ___ injure tissue

A

Cellular content

Lysosomal enzymes

35
Q

Type 4 hypersensitivity reaction is ___ driven

A

T-cell-mediated

36
Q

Examples of type 4 hypersensitivity reaction are

A

Poison ivy

TB tests

37
Q

Type 4 hypersensitivity reactions can involve ___ mediated by ___ and ___

A

Tissue damage mediated by activated macrophages and cytotoxic T-Cells

38
Q

In type 4 hypersensitivity reaction, the first exposure has what kind of reaction?

What do T-cell lymphocytes do?

A

T-cell lymphocytes produce a memory for antigen or become sensitized

39
Q

In type 4 hypersensitivity reaction, the t-cell lymphocytes do what?

What about phagocytosis?

A

T-lymphocytes either

  • Attack the target cell directly
  • Recruit and activate macrophages

Phagocytosis causes damage and toxins are released into tissues

40
Q

Type 4 hypersensitivity reaction is elicited by

A

Environmental factors

41
Q

Match the four types of hypersensitivity reaction with their response

  1. Cell mediated
  2. Antibody mediated disorder
  3. Immediate allergic reactions
  4. Immune complex mediated disorder
A
  1. Type 4
  2. Type 2
  3. Type 1
  4. Type 3
42
Q

Match the four types of hypersensitivity reaction with their immune component

  1. Antibody mediated (IgE)
  2. IgG and IgM
  3. T-cell mediated
A
  1. Type 1
  2. Type 2 or 3
  3. Type 4
43
Q

Match the four types of hypersensitivity reaction with their mechanisms of action

  1. Antibodies kill cells directly or make the tissues malfunction
  2. Release of mast cell mediators (histamine)
  3. Phagocyte and lysosomal activity
  4. Cellular content is released and lysosomal enzymes injure tissue
A
  1. Type 2
  2. Type 1
  3. Type 4
  4. Type 3
44
Q

Match the four types of hypersensitivity reaction with their examples

  1. Lupus, Raynaud’s disease, Nephritis
  2. Mycobacterium, TB, Poison ivy
  3. Graves disease, blood transplant, RH pregnancy
  4. Anaphylaxis, Hay fever, Allergic rhinitis
A
  1. Type 3
  2. Type 4
  3. Type 2
  4. Type 1
45
Q

Autoimmune diseases are disorders cause by

A

A breakdown in the ability of the immune system to recognize between self and non-self antigens

46
Q

Self-tolerance refers to the ability of the immune system to

A

Recognize—and therefore not respond against—self-produced antigens.

47
Q

Self-tolerance is maintained through

A

Central and peripheral mechanisms that delete autoreactive B or T-cells

48
Q

Explain how gender plays a part in autoimmune diseases

A

Many autoimmune disorders are predominantly seen in women

  • Suggests that female hormones (estrogen) may play a role in the development of some autoimmune diseases
49
Q

How does heredity play a part in autoimmune diseases?

A

Autoimmune diseases are not inherited in the normal fashion

> People with disorders exhibit susceptibility genes that work with environmental factors to increase person’s risk

50
Q

The role of the environment in the development of autoimmune diseases is

A

Complex

some autoimmune diseases, like type 1 diabetes, have increased in recent years, suggesting environmental factors play a larger part

51
Q

Environmental factors that impact autoimmune disorders are

A

Viral infection

Decreased exposure to maternal antibodies (breast feeding)

Maternal smoking

52
Q

HIV is a ___ that selectively attacks ___

A

Retrovirus

CD4+T lymphocytes (immune cells responsible for handling the immune response to infection)

53
Q

What is the process of a virus taking over CD4+ t-cells?

A
  1. Virus attaches to receptors on the CD4 cell
  2. Virus fuses to, and enters the cell
  3. Virus incorporates its RNA into the cell’s DNA
  4. Virus uses the CD4 cell to reproduce large amounts of HIV which are released
54
Q

HIV is characterized by

A

Profound immunosuppression

55
Q

AIDS is associated with

A

Opportunistic infections
Malignancies
Wasting
CNS degeneration

56
Q

HIV can be transmitted through

A

Body or blood fluids that carry the HIV virus

57
Q

What are the ways in which HIV can be transmitted?

A

Male to male sex
Blood to blood contact
Perinatally (birth)
IV drug use (dirty needles)

58
Q

What is the primary mode of transmission of HIV?

A

Sexual contact

59
Q

What year did the US start screening all blood products for HIV?

A

1985

60
Q

How likely is someone to get HIV from occupational transmission?

A

Uncommon- not likely

61
Q

If a person has ___ the risk of getting HIV is higher

A

Another STD

62
Q

What are the three stages of HIV infection?

A

Stage 1 - Primary
Stage 2 - Latent
Stage 3 - HIV > AIDS

63
Q

Stage 1 of HIV infection occurs

A

2-4 weeks after exposure

64
Q

If someone exposed to HIV is diagnosed and treated early, what does this mean in regards to the development of the disease?

A

There are fewer CD4+ memory cells made

It is easier to control with antiretroviral therapy and their immune system

65
Q

In stage 1 of HIV infection, symptoms usually present within __ and up to ___

A

3 months and up to 6 months

66
Q

List the manifestations of HIV in stage 1

A 
Fatigue
Fever
Myalgias (muscle aches and pains)
Sore throat
Night sweats
GI issues
Lymphadenopathy (swelling of lymph nodes)
Maculopapular rash (flat or raised red bump on the skin)
Headache
67
Q

What would you expect lab values to look like for an HIV patient in stage 1?

A

High viral loads

> 1,000,000 copies/mL

Decrease in CD4+ T-cell count

68
Q

What is the time frame for HIV in stage 2?

A

10 years

69
Q

How does HIV present in stage 2?

A

Persistent generalized lymphadenopathy

No symptoms

70
Q

What would you expect lab values to look like for an HIV patient in stage 2?

A

CD4+ cells 800-1000 cells/uL (normal range) – < 200 cells/uL

or lower

71
Q

What is the time frame for a patient in stage three of HIV infection?

A

Can lead to death in 2-3 years or less

72
Q

What are manifestations of HIV in stage 3?

A

High risk of opportunistic infections and death when CD4+ cells fall under 200

73
Q

What would expect lab values to look like for an HIV patient in stage 3?

A

CD4+ cell count of < 200 cells/uL

74
Q

Opportunistic infection is caused by

A

Common organisms that don’t typically cause infections unless a person has impaired immune function

75
Q

What is the relationship between CD4+ T-cells and opportunistic infections?

A

As the number of CD4+ cells decrease, the risk of opportunistic infections increases

76
Q

How are opportunistic infection categorized?

A

By the type of organism (fungal, protozoal, bacterial and mycobacterial, viral)

77
Q

Opportunistic infections may include

A

Bacterial and mycobacterial infections (bacterial pneumonia, salmonella, TB, MAC)

Fungal infections (candidiasis, histoplasmosis, penicilliosis, pneumocystis)

Protozoal (cryptosporidiosis, toxoplasmosis)

Viral infections (CMV, herpes simplex, zoster viruses, HPC, JC virus)

Cancers (Kaposi sarcoma, NHL)

RMC Patho Exam 2 (6 decks)

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