Exam 2 Immunity

Question 1

Skin Defense and Failures

Answer 1

Defense - Epidermal Barrier

Failures - Punctures, burns, ulcers, penetration

Question 2

GI Tract Defense and Failures

Answer 2

Defense - Normal flora, Epithelial barrier, Acidic secretions, bile, pancreatic enzymes
Failures - proliferation of microbes, uptake through M cells, Acid production problems, Broad spectrum abx use

Question 3

Respiratory Tract Defense and Failures

Answer 3

Defense - Mucociliary clearance, alveolar macrophages

Failures - Ciliary paralysis, lack of mucous production, microbe proliferation

Question 4

Urogenital tract Defense and Failures

Answer 4

Defense - Urination, normal vaginal flora, epidermal/epithelial barrier
Failures - Abx use, Urinary obstruction, infection/invasion, trauma, microbe proliferation

Question 5

Cytokines are _____ proteins, which regulate innate and acquired _____, _____, _____, _____ and ______ though ______ signaling.

They function in a predominantly ______ fashion

Answer 5

Signaling, Immunity, hematopoiesis, inflammation, repair and proliferation, extracellular, paracrine.

Question 6

Innate immunity 1_____, 2_____, 3_____

Answer 6

1) Rapid response to pathogens (seconds to minutes)
2) Chemical complement and physical cell types quickly attack the pathogen
3) Reguires no previous exposure to respond to antigen

Question 7

Acquired immunity: 1 _______ 2 ______ 3 ______

Answer 7

1) Slower activation and can last a lifetime
2) Example vaccinations
3) T cells (cytotoxic killer) and B cells (Antibodies so secondary exposures illicit a more prolific response)

Question 8

The role of arachidonic acid metabolites in inflammation response
1 ____ 2___ 3___ 4____ 5____ 6____

Answer 8

1) Arachidonic acid is secreted upon damage to the host cells from pathogen
2) Mast cells release histamine, and chemo toxins released by damaged cells
3) Vasodilation and increased blood flow is caused (leading to warmth)
4) Increased permeability due to widening endothelial cell connections (Edema)
5) Neutrophils and macrophages rush to the area to chemically and physically attack pathogen
6) After pathogen/infection is killed inflammation should resolve

INFLAMMATION PROMPTS INNATE AND ADAPTIVE IMMUNE SYSTEM

Question 9

Macrophages (monocytes)

Cell surface covered with _____, produce ____, present ____ to __ and __ cells

Answer 9

Receptors, cytokines, antigens, B, T

Question 10

Dendritic Cells

Made in ____, _____ presenting cells, Produces _____ : type 1 _____ for ____ infections

Answer 10

Bone marrow, antigen, cytokines, interferon, viral

Question 11

Cytokines are the way that

Answer 11

Cells are told what to do

Question 12

MHC (major Histocompatibility Complex) AKA HLA (Human Leukocyte Antigen) role in cell mediated immunity

Answer 12

Marks body cells as “self”

These complexes are PROTEINS THAT PRESENT ANTIGENS ON CELL SURFACE

Question 13

3 Classes of MHC

Answer 13

Type 1: Intracellular presentation, cytotoxic cells recognize antigens on MHC class 1
Type 2: Helper antigen presenting cells, cause T helper cells to recognize antigens on MHC class 2

Question 14

HIV transmission

Answer 14

Blood, semen, contaminated needles, contaminated blood transfusions, artificial insemination, in utero to developing fetuses of infected mothers

Question 15

Significance of CD4 count with HIV

Answer 15

CD4 count less than 200/L indicates HIV is now AIDS, immune competence is significantly reduced and there is a high risk of opportunistic infections

Question 16

HIV common infections

Answer 16

P Jiroveci PNA, viruses (cytomegalovirus), fungi (Candida), bacteria (Mycobacterium tuberculosis/Adium and staphylococcus), Cryptosporidium (a protozoan) causes diarrhea

Question 17

Most reliable test for HIV

Answer 17

ELISA (once patients had enough time to seroconvert)

Question 18

Complement: ____ plasma proteins synthesized by ___, ___, and ____

Answer 18

20, liver, macrophages, neutrophils

Question 19

Complement Functions 1) ____ 2) ____ 3) _____ 4) _____

Answer 19

1) Enhance inflammation
2) Chemotaxis (movement of cell/organism in a direction to a gradient of increasing or decreasing concentration of a particular substance)
3) Lysis of target cells
4) Opsonization (immune process where particles such as bacteria are targeted for destruction by an immune cell known as a phagocyte. The process of opsonization is a means of identifying the invading particle to the phagocyte)

Question 20

Cytokines and Chemokines (cytokines that function as chemotactic factors) 1 _____ 2____ 3____

Answer 20

1) Signaling molecules that affect the functioning of other cells
2) Complex intracellular communication
3) Enhance and coordinate innate and specific immune defenses

Question 21

Potential mechanisms where erroneous reaction immune system with “self” tissue leads to autoimmune diseases

Answer 21

T lymphocytes - (capable with reacting with self tissue) are destroyed or permanently inactivated during development in thymus [Positive selection selects for only those TH or TC cells that can recognize self MHC I or MHC II, become MHC-restricted, MHC-restricted TH or TC cells then exposed to all self antigens, negative selection - self-antigen recognizing cells are destroyed in thymus]

Clonal Deletion - Lymphocytes come in contact with all self antigens during development, those that bind to self antigens are deleted (killed)

B lymphocytes capable of reacting with self antigens are eliminated in bone marrow

Question 22

Autoimmunity

Answer 22

Immune system recognizes it’s own cells as foreign and mounts an immune response that injures self tissues

Question 23

Self tolerance breaks down into _______ , _______

Answer 23

Central tolerance, peripheral tolerance

Question 24

Failure of self tolerance due to

Answer 24

Susceptibility genes that disrupt tolerance pathways, persistent microbial infections, antigen mimicry, release of sequestered antigens, decreased tree cells

Question 25

Treatment of autoimmunity 1_____ 2____

Answer 25

1) immunosuppressive drugs: corticosteroids, TNF inhibitors

2) Cytotoxins: kill actively proliferating lymphocytes

Question 26

High mutation rate (2)

Answer 26

HIV -> AIDS

Influenza Virus -> Influenza

Question 27

Genetic Reassortment (2)

Answer 27

Influenza Virus -> Influenza

Rotavirus -> Diarrhea

Question 28

Genetic Rearrangement (3)

Answer 28

Borellia Burgdoferi -> Lymes Disease
Neiserria Gonorrhea -> Gonorrhea
Plasmodium sp. -> Malaria

Question 29

Diverse serotypes (3)

Answer 29

Rhinovirus -> colds
Streptococcus -> PNA
Pneumoniae -> Meningitis

Question 30

Hypersensitivity

Answer 30

Normal immune response that is either inappropriately triggered, excessive or produces undesirable effects on body (usually doesn’t occur on first exposure)

Question 31

Hypersensitivity types I, II, III mediated by antibodies produced by

Answer 31

B lymphocytes

Question 32

Hypersensitivity type IV mediated by

Answer 32

T cells

Question 33

Type I Hypersensitivity

Immediate Hypersensitivity, occurs ____ min after exposure to antigen/allergen, Ig_ mediated, ___ cells and ___ effector cells

Early Phase _____
Late Phase ______
Manifestations ______
Treatment ______

Answer 33

15-30, E, mast, principal

Vascular smooth muscle reactions

Inflammation

Hives, eczema, rhinitis - throat constriction, tachycardia - Anaphylaxis

Antihistamines, Beta agonists (bronchodilator), corticosteroids (Anti-inflammatory), anticholinergics (block PNS), Epi

Question 34

Type II Hypersensitivity

Tissue specific, cytotoxic, cytolytic hypersensitivity

Reaction often ____ but sometimes ____, Ig_, antibodies attack antigens on surface of specific cells or tissues causing _____

Examples ____, ____, ____, ____, _____

Answer 34

Immediate, over time, G, lysis,

Transfusion reaction

Hemolytic Disease of newborns: mothers RH+ antibodies attack fetus RBC’s. Give RhoGAM to Rh- mothers

Myasthenia Gravis: Ab against ACHR in motor end plates of skeletal muscle, degrades muscle cell membrane. Tx anti-inflammatories, anti-cholinesterase meds

Graves’ disease: Hyperthyroid, TSH receptor, goiter too much T3/4

Graft Rejection: Tissue antigen from donor and recipient has Ab’s