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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
An example of a type 2 hypersensitivity reaction is
Hyperthyroidism
26
In type 2 hypersensitivity reaction, soluble antigens (foreign object) may
Enter into circulation and be deposited on the specific organ tissues
27
Within type 2 hypersensitivity, one reaction is ADCC
Antibody-Dependent Cell Cytotoxicity **incorporates components of both innate and adaptive immune responses**
28
Type 3 hypersensitivity reaction is __ driven
Antibody driven
29
Examples of type 3 hypersensitivity reaction are
Raynaud's disease | Lupus
30
What kind of response occurs in type 3 hypersensitivity reaction?
Humoral response
31
In type 3 hypersensitivity reaction, what activates immune complex deposition?
IgG and IgM
32
In type 3 hypersensitivity reaction, ____ are formed first in the __ and then deposited ___
Antibody-antigen complexes Plasma and then deposited in the tissues
33
In type 3 hypersensitivity reaction, immune complexes elicit an inflammatory response by ___ are recruited to attempt to ___
Activating complement Neutrophils are recruited to attempt to phagocyte the cells (unsuccessful due to large complexes)
34
Lastly, in type 3 hypersensitivity reaction, ____ is released from the cell and the ___ injure tissue
Cellular content | Lysosomal enzymes
35
Type 4 hypersensitivity reaction is ___ driven
T-cell-mediated
36
Examples of type 4 hypersensitivity reaction are
Poison ivy | TB tests
37
Type 4 hypersensitivity reactions can involve ___ mediated by ___ and ___
Tissue damage mediated by activated macrophages and cytotoxic T-Cells
38
In type 4 hypersensitivity reaction, the first exposure has what kind of reaction? What do T-cell lymphocytes do?
No reaction - T-cell lymphocytes produce a memory for antigen or become sensitized
39
In type 4 hypersensitivity reaction, the t-cell lymphocytes do what? What about phagocytosis?
T-lymphocytes either - Attack the target cell directly - Recruit and activate macrophages Phagocytosis causes damage and toxins are released into tissues
40
Type 4 hypersensitivity reaction is elicited by
Environmental factors
41
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
1. Type 4 2. Type 2 3. Type 1 4. Type 3
42
Match the four types of hypersensitivity reaction with their immune component 1. Antibody mediated (IgE) 2. IgG and IgM 3. T-cell mediated
1. Type 1 2. Type 2 or 3 3. Type 4
43
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
1. Type 2 2. Type 1 3. Type 4 4. Type 3
44
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
1. Type 3 2. Type 4 3. Type 2 4. Type 1
45
Autoimmune diseases are disorders cause by
A breakdown in the ability of the immune system to recognize between self and non-self antigens
46
Self-tolerance refers to the ability of the immune system to
Recognize—and therefore not respond against—self-produced antigens.
47
Self-tolerance is maintained through
Central and peripheral mechanisms that delete autoreactive B or T-cells
48
Explain how gender plays a part in autoimmune diseases
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
How does heredity play a part in autoimmune diseases?
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
The role of the environment in the development of autoimmune diseases is
Complex **some autoimmune diseases, like type 1 diabetes, have increased in recent years, suggesting environmental factors play a larger part**
51
Environmental factors that impact autoimmune disorders are
Viral infection Decreased exposure to maternal antibodies (breast feeding) Maternal smoking
52
HIV is a ___ that selectively attacks ___
Retrovirus CD4+T lymphocytes (immune cells responsible for handling the immune response to infection)
53
What is the process of a virus taking over CD4+ t-cells?
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
HIV is characterized by
Profound immunosuppression
55
AIDS is associated with
Opportunistic infections Malignancies Wasting CNS degeneration
56
HIV can be transmitted through
Body or blood fluids that carry the HIV virus
57
What are the ways in which HIV can be transmitted?
Male to male sex Blood to blood contact Perinatally (birth) IV drug use (dirty needles)
58
What is the primary mode of transmission of HIV?
Sexual contact
59
What year did the US start screening all blood products for HIV?
1985
60
How likely is someone to get HIV from occupational transmission?
Uncommon- not likely
61
If a person has ___ the risk of getting HIV is higher
Another STD
62
What are the three stages of HIV infection?
Stage 1 - Primary Stage 2 - Latent Stage 3 - HIV > AIDS
63
Stage 1 of HIV infection occurs
2-4 weeks after exposure
64
If someone exposed to HIV is diagnosed and treated early, what does this mean in regards to the development of the disease?
There are fewer CD4+ memory cells made It is easier to control with antiretroviral therapy and their immune system
65
In stage 1 of HIV infection, symptoms usually present within __ and up to ___
3 months and up to 6 months
66
List the manifestations of HIV in stage 1
``` 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
What would you expect lab values to look like for an HIV patient in stage 1?
High viral loads >1,000,000 copies/mL Decrease in CD4+ T-cell count
68
What is the time frame for HIV in stage 2?
10 years
69
How does HIV present in stage 2?
Persistent generalized lymphadenopathy | No symptoms
70
What would you expect lab values to look like for an HIV patient in stage 2?
CD4+ cells 800-1000 cells/uL (normal range) -- < 200 cells/uL *or lower*
71
What is the time frame for a patient in stage three of HIV infection?
Can lead to death in 2-3 years or less
72
What are manifestations of HIV in stage 3?
High risk of opportunistic infections and death when CD4+ cells fall under 200
73
What would expect lab values to look like for an HIV patient in stage 3?
CD4+ cell count of < 200 cells/uL
74
Opportunistic infection is caused by
Common organisms that don't typically cause infections unless a person has impaired immune function
75
What is the relationship between CD4+ T-cells and opportunistic infections?
As the number of CD4+ cells decrease, the risk of opportunistic infections increases
76
How are opportunistic infection categorized?
By the type of organism (fungal, protozoal, bacterial and mycobacterial, viral)
77
Opportunistic infections may include
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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