Exam 2: Immunology Flashcards
1
Q
What is immunology?
A
the study of the protection of disease by a coordinated response of the immune system cells
2
Q
What are the two types of immunology?
A
- innate
- adaptive
3
Q
This is the first line of defense that occurs early and rapid and lacks an organized attack
A
innate immunity
4
Q
T/F innate immunity recognizes self vs. nonself cells
A
true
5
Q
What physical barriers are included in innate immunity?
A
▪ Skin, mucous membranes, saliva, urine/tears, stomach acid, phagocytic leukocytes, specialized lymphocytes (NK cells)
▪Phagocytes and NK cells
just blindly rush to the
intruder
▪Some cells eat the intruder,
and PRESENT THE
ANTIGEN (antigen
presenting cells) to
the other immune cells
6
Q
This defense is secondary, specific/acquired and slower to respond but has a more effective approach. It recognizes the threat, plans, and attacks using specialized cells
A
adaptive immunity
7
Q
What are the 2 types of responses for adaptive immunity?
A
▪ Humoral- B-cells
▪ Cell-Mediated T cells
8
Q
What do humoral B cells do and where are they located?
A
create antibodies to fight the intruder (located in the blood)
9
Q
What do cell mediated T cells do and where are they located?
A
activate phagocytes or kill host cells which holds the intruder (inside cells)
10
Q
What is the complement cascade and what does it do?
A
it is a group of proteins that rid the blood of the debris from phagocytized cells and they help out by getting rid of debris (enhancing antibody response)
11
Q
What are antibodies and how do they operate in the body?
A
They are a response to a specific foreign substance in the body and are unique to that specific antigen. They bind to microbes before invasion and mark them for destruction.
12
Q
How long does antibodies last in the body?
A
forever
13
Q
What do IGM’s indicate?
A
initial exposure to an antigen (meet… you can only meet someone one time )
14
Q
What are IGGs?
A
established antibodies that continue circulating (greet… you can greet someone infinite times, but only meet someone one time)
15
Q
Which immunoglobulin indicates if someone has immunity over something (titers)?
A
IGG
16
Q
How are antibodies received in the body?
A
from Mother (IGG: these cross the placenta) or through vaccination (passive immunity)
17
Q
What type of cells do T lymphocytes recognize?
A
antigen presenting cells
18
Q
What do helper T cells do?
A
help out B cells with antibody production and phagocytes destroy their contents
19
Q
For humoral immunity:
- Where do the cells defend?
- What do B cells produce?
- How do B cells operate in the body?
- Where do antibodies connect?
A
- in the blood and mucous (humorous)
- antibodies
- they recognize the antigen, differentiate into plasma cells and then secrete specific antibodies
- antibodies connect to antigens floating in the blood or the SURFACE of cells
20
Q
How do T cells in cell mediated immunity recognize antigen presenting cells?
A
by receiving the signal from the B-cells
21
Q
Which immunity is cell mediated immunity?
A
T cell immunity
22
Q
Which immunity is humoral immunity?
A
B cell immunity
23
Q
What action does helper T cells have in the body?
A
They help regulate almost all other immune cells and release cytokines to help signal antigens for further destruction/help from other
immune system cells
24
Q
What action does cytotoxic T cells have in the body?
A
They kill the intracellular antigens by injecting enzymes into the cell where viruses/cancers/bacteria are and induce apoptosis
25
These cells are considered CD4 cells:
helper T cells
26
These cells are considered CD8 cells:
cytotoxic T cells
27
Basophils and eosinophils results in a:
fungal infection
28
Whole T cells are released into what kind of cells?
- suppressor T cells
- helper T cells
- cytotoxic T cells
29
What factors affect immune responses?
- age
- nutritional status
- stress
30
What organ produces T cells?
thymus
31
The thymus of newborns are:
fully functional and full sized at birth
32
How do newborns produce IGMs?
through environmental exposure after birth (takes about a year for them to get to adult level immune responses (IGG)
33
This population has a decreased immune function
elderly
34
Why do elderly have a decreased immune function?
due to atrophy of the thymus (decreases the amount of T cells and thus the lymphocytes become unresponsive)
35
What does malnutrition result in?
decrease in immune cells (due to chronic stress on the body)
36
This results in a chronic inflammatory response that decreases the body's response to actual intruders once they've entered the body:
obesity
37
What does stress do to the body?
suppresses the immune response (herpes/cold sores flare during stress)
38
What is hypersensitivity?
A whole group of disorders of the immune system being too responsive to a NONPATHOGENIC SUBSTANCE/ANTIGEN
39
Describe the type 1 response (immediate response) to an antigen:
○ Rapid rxn to the antigen
○ Happens within minutes
○ Range in severity from itching, hives, to anaphylaxis
40
Describe the type 4 response to an antigen (delayed response)
○ 24-72 hrs to respond
| ○ Ex: TB skin test
41
What immunoglobulin is produced for each allergen?
IGE
42
How do IGEs work?
They communicates to the MAST CELLS and the Mast Cells produce HISTAMINE. Histamine causes the allergic rxn that we know.
43
How can hypersensitivity be delayed/manifest later in life?
- Exposure can occur during a time of weakened immune system, causing the body to create antibodies
- Exposure to high enough levels to reach the threshold of an allergic response (Can accumulate enough exposure of an antigen/allergen to develop a true hypersensitivity)
- Moving to a new area (outdoor/seasonal allergies)
44
What are the 4 types of hypersensitivity?
○ Type 1 = immediate responses (IGE acts on the mast cells to release histamine)
○ Type 2 = drug allergies
○ Type 3 = Serum sickness
○ Type 4 = delayed rxn (Tend to be less serious (contact dermatitis, chronic asthma/allergies)
45
What is anaphylaxis and what is it characterized by?
○ Life threatening allergic response characterized by:
▪ Widespread edema
▪ Bronchospasms
▪ Vascular shock (vasodilation) due to Histamine release
46
What does the level of an allergic response depend on?
The level of the allergic response depends on the number of IGE antibodies produced
47
How can you be exposed to an allergen?
▪ Ingestion- food/medication
▪ Injected- bee venom/medication
▪ Absorbed- through skin or GIT
48
What are the s/sx of - anaphylaxis?
▪ Hives, itching, erythema
▪ Dyspnea
▪ Vomiting, diarrhea, cramping
▪ Edema & angioedema (swelling of the face)
▪ Airway obstruction- caused by laryngeal spasms and laryngeal edema (can impair intubation procedures)
49
What are some common antigens?
- food
- insects
- drugs
- latex
- exercise
- temperature
50
What is the most common drug allergy?
- beta lactam antibiotic (penicillin)
| - aspirin and NSAIDS
51
These are portent vasodilators that respond to the antigen within 5-30 minutes:
histamines
52
How do histamines cause reactions in the human body?
- increase capillary permeability
- smooth muscle contraction
- bronchoconstriction
53
________- block histamine release and treat the symptoms such as edema, rhinitis, hives,
antihistamines
54
What are some examples of antihistamines?
○ Diphenhydramine (Benadryl)
○ Loratadine (Claritin)
○ Cetirizine (Zyrtec)
* all cause drowsiness
55
If a patient is having a systemic response to an allergen, what do they need?
heparin (antihistamine will not work)
56
What are autoimmune disorders and how are they caused?
- when the body is unable to recognize self vs. nonself.
- causes are unknown but
○ can be genetic, and/or environmental, or caused by infectious agents (viruses). It can effect almost any type of cell or tissue
57
These disorders can cause painful/swollen joints, fever, fatigue, swollen lymph nodes
systemic autoimmune disorder
58
What are some examples of systemic autoimmune disorders?
□ Systemic lupus erythematosus (SLE)
| □ Rheumatoid arthritis
59
What are some facts about systemic lupus erythematosus (SLE)?
- Hereditary and more common in women
- Rash on the face
- Swollen lymph nodes
60
What are some examples of blood autoimmune disorder-
▪ Autoimmune hemolytic anemia (body attacks RBC and lysis them)
▪ Idiopathic thrombocytopenia purpura (body attacks platelets and leads to petechieae and bleeding)
61
This condition results in a severe atrophy of thyroid (hypothyroidism)
Hashimoto Thyroiditis
62
This condition results in destruction of the pancreatic beta cells (lack of insulin production)
Type 1 DM
63
This condition results in issue w/ innate immunity and the body can't tolerate specific forms of natural bacteria (flora) in the GIT
Crohn's Disease
64
What treatments can stop, slow down or reverse symptoms?
Corticosteroids and immunosuppressives
65
How does immunosuppressives work in the body?
Prevents DNA synthesis of WBC and prevents replication of the cells causing immune cell death (they suppress ALL types of WBC)
66
When your patient is taking immunosuppressives, what education should you provide?
Educate pt on the importance of hygiene and preventing exposure w/ sick people
67
How does steroids work in the body?
By suppressing inflammatory response for disorders like RA & lupus
68
What can occur when taking steroids?
Severe side effects depending on dosage and length of schedule:
□ Wt gain
□ Cushing's disease (buildup of cortisol = buffalo hump, moon face, etc.)
□ Osteoporosis
□ Pregnancy complications
□ Glaucoma
69
This immunodeficiency is congenital/inherited and rare:
Primary Immunodeficiency
70
What is the patho for Primary Immunodeficiency?
▪ Mutations cause a lack of development of immune system cells
▪ Mimic the symptoms of autoimmune disorders
71
Why is early detection of Primary Immunodeficiency critical?
because the primary deficiencies are FATAL in Children (condition is genetic)
72
How can you notice primary immunodeficiencys in patients?
- by recurrent, persistent, or unusual infxn (they will get the same type of infxn over and over and over. the type of infections can help diagnose the immunodeficiency)
73
This immunodeficiency is acquired and more common than primary
Secondary Immunodeficiency
74
What is secondary immunodeficiency caused by?
- a pathogen
- aging process
- malignancies
- malnutrition
- drugs
75
What is the patho for secondary immunodeficiency?
```
▪ WBC dysfunction
□ There is an overall loss
in the amount of IGG's (
making you more
susceptible to secondary
infection)
▪ Deficit in T-cell numbers and function
```
76
T/F there is no cure for secondary immunodeficiency and congenital transmission is possible?
true
77
This will leave you more vulnerable to viral & fungal infections & opportunistic infections
T-cell deficits
78
This increases bacterial susceptibility
B-cell deficits
79
How is HIV/AIDS transmitted?
○ HIV is the virus that causes AIDS
| ○ Can be transmitted through semen, blood, vaginal fluid, breastmilk
80
What is the most common transmission method for contracting HIV/AIDS
sex
81
What is the patho for HIV/AIDS?
▪ HIV is a retrovirus that kills immune cells (CD4 cells, macrophages, dendritic cells)
▪ Immune Cell Death results in decreased immune response (even if asymptomatic)
▪ Results in increased susceptibility to many secondary illnesses/infections
82
What is the stages of HIV?
1. Primary infection (can be asymptomatic or have flu-like symptoms)
2. Latency period (chronic, asymptomatic period that can last for years if managed well)
3. AIDS
83
When is AIDS diagnosed?
Diagnosed by presence of HIV, AND a CD4 Count below 200 and/or an opportunistic infxn
84
How is HIV treated and how does the medicine work?
with antiretrovirals: works to decrease the amount of the virus in the body (Goal is to get an undetectable amount of HIV (viral load) in the body and to increase CD4 Count)
85
What causes atrophy of the thyroid?
antibodies
86
HIV/AIDS can go undetected if the:
CD4 >800
87
What does each class of antiretrovirals try to interrupt?
the life cycle of the HIV at different points
88
How are antiretrovirals used in the treatment of HIV/AIDS?
by combining different types of these drugs to target the HIV replication process at multiple points (HAART (Highly Active Antiretroviral Therapy) = combination of multiple antiretrovirals)
89
What creates susceptibility to various conditions that wouldn't be pathogenic in a healthy person?
Decreased levels of the CD4 cells
90
What are some examples of opportunistic respiratory infections?
□ TB, bacterial pneumonia (there is a higher rate of TB in HIV+ populations)
91
What are some examples of opportunistic GIT infections?
□ Oral thrush (esophageal candidiasis) - yeast infxn of mouth/esophagus
□ Gastroenteritis
□ C.Diff., E.coli, etc.
92
What are some examples of opportunistic nervous system infections?
□ HANDS - HIV Associated Neurocognitive Disorders
□ Toxoplasmosis
□ PML - Progressive Multifocal Leukoencephalopathy
93
What does HANDS cause?
- Cognitive impairment w/ motor dysfunction
- Behavioral issues
- Psychosocial issues
- Hallucinations
94
This condition demyelinates white matter in the CNS
PML - Progressive Multifocal Leukoencephalopathy
95
Leuko=
| Encephalopathy =
WBC
| Brain disorder
96
Some forms of cancer (Malignancies) are more common in the HIV+ population, such as:
□ Kaposi sarcoma
| □ Non-Hodgkin's Lymphoma
97
What is wasting syndrome?
A metabolic condition resulting in involuntary loss of 10% of baseline weight (think of the stereotypical HIV+ pt that is small, skinny, frail)
98
In this metabolic condition, the body is unable to produce fat:
Lipodystrophy
99
Insulin resistance is a:
metabolic condition
