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Patho Exam 3 > Immune > Flashcards

Immune Flashcards

1
Q

under function abnormality of immune

A

HIV

immunosuppression

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2
Q

over function abnormality of immune

A

autoimmune disease

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3
Q

unhelpful abnormality of immune

A

transplant

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4
Q

2 types of immunity

A

innate and acquired/adaptive

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5
Q

first line of defense

A

innate immunity

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6
Q

has external and internal defense

A

innate

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7
Q

2 types of innate immunity

A

non-specific

non-adaptive

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8
Q

same response for different pathogens (virus, fungi)

Includes inflammation phagocytes

A

non specific innate immunity

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9
Q

no memory of pathogen

A

non adaptive innate immunity

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10
Q

Specificity and Memory increase for?

A

adaptive or acquired immunity

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11
Q

Transplacental antibodies, breast milk

A

passive immunity

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12
Q

vaccine, natural infection

A

active immunity

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13
Q

first response external responses

A

physical and chemical

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14
Q

skin, mucus, cough, sneeze

A

physical/mechanical barrier

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15
Q

lysozyme (tears)

A

chemical/biochemical barrier

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16
Q

2 factors of internal defense

A

soluble

cellular

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17
Q

cytokines are what kind of internal defense

A

soluble factor

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18
Q

neutrophils, natural killer cells are what kind of internal defense

A

cellular factors

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19
Q

internal defenses create what

A

PAMPs

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20
Q

what does PAMPs stand for

A

pathogen associated molecular patterns

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21
Q

example of PAMPs

A

interferons

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22
Q

Start local reaction

 Inc vascular permeability, change blood flow, WBC migration

A

PAMPs

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23
Q

the 3 ways how our body recognizes self vs non-self

A 
MHC
class I genes
class II genes
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24
Q

Membrane proteins to present antigens to T cellsspecificity
HLA: Genes from Chromosome 6
Autoimmune diseases prevalent – RA, graft vs host disease, etc

A

MHC

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25
Q

HLA-A, HLA-B, HLA-C

On all nucleated cells; maternal + paternal genes

A

class I genes

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26
Q

HLA-DR, HLA-DP, HLA-DQ

On skin cells, dendritic cells, monocytes/macrophages, B cells, activated T cells

A

class II genes

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27
Q

any foreign substance that causes immune ponse

Bacteria, virus, transplant tissue
Must activate B cell receptors

A

antigen

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28
Q

SPECIFIC, superficial pieces of antigen that bindsto T cell receptor or antibody

A

epitope

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29
Q

made by B cells, interact with epitope

A

antibody

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30
Q

Innate immunity

Ingest ???? and kill them to prevent infection

A

pathogens

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31
Q

phagocytes Initiate immune response via release of

A

interleukin-1

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32
Q

first defense

Die after phagocytosispus

A

neutrophils

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33
Q

Filter debris after neutrophils, clean up bacteria

Macrophage takes epitope and presents it to CD4 or T4

A

monocyte

macrophages

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34
Q

allergic reaction

A

eosinophils

basophils

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35
Q 
Functions: 




Initiate immune response
Increased temperature (fever) via hypothalamusIncreased serotonin (sleep,nausea)
Lowers pain threshold via prostaglandin
A

interleukin-1 functions

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36
Q

Coat pathogens so they are targeted by phagocytes
Released by cells infected with virus to protect healthy cells Inhibit tumor growth
 Decreases the rate of infection

A

interferon

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37
Q

Function: kill infected cells, tumor cells

A

natural killer cells

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38
Q

Large, granular lymphocytes

Stored in blood and spleengo to infected tissue with inflammatory cytokines

A

natural killer cells

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39
Q

NO antigen specific receptors, USE activating or inhibitory receptors

A

natural killer cells

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40
Q

Mediated by B cell antibodies

A

humoral immunity

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41
Q

Attack free floating pathogens
 B cells made in bone marrow and then spread through lymph system
 B cell clones react to foreign antigens

Need signal from helper T cells to start to proliferate
 Plasma cells are mature B cells that produce large quantity of antibodies
Memory B cells

A

humoral immunity

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42
Q

B cells make 5 types of antibodies:

A

Ig”letter”

GMADE

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43
Q

(antiviral, antibacterial, transplacental)

2nd common antibody

A

IgG

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44
Q

primary response antibody

A

IgM

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45
Q

(mucus membrane, breast milk, respiratory, GI)

antibody

A

IgA

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46
Q

(antigen receptor

antibody

A

IgD

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47
Q

parasites, allergies

antibody

A

IgE

48
Q

Directly attack antigens, destroy/neutralize
Activate death cascade in complement systemActivate allergic response
Stimulate antibody-mediated hypersensitivity

A

immunoglobins

49
Q

Protection against intracellular “hidden” pathogens

A

cell mediated immunity

50
Q

Helper T cellslymphokines stimulate B cells, activate macrophages, help NK cellsSuppressor T cells

A

CD4 T cells

51
Q

Cytotoxic T cellsMemory T cells

A

CD8 T cells

52
Q

T cells do what to immune response?

A

amplify or reduce

53
Q

5 phases of immune response

A 
recognition
amplification
effector
termination
memory
54
Q

immune receptors bind to pathogens, antibodies bind

A

recognition phase

55
Q

soluble factors and phagocytes recruited

Proliferate T and B cells, replicate

A

amplification phase

56
Q

remove antigens via lysis, phagocytosis, cytotoxic T cells

A

effector phase

57
Q

dampen immune response when antigen is gone

A

termination phase

58
Q

T and B cells for quick response

A

memory phase

59
Q

to enhance immune function, what kind of exercise do you do?

A

moderate exercise

60
Q

what kind of exercise do you do to suppress immune function?

A

strenuous exercise

61
Q

Failure of self vs non-self
Systemic (ie. Systemic Lupus Erythematosus)Organ specific (ie. Hashimotos)
autoantibodies created

A

autoimmune disorders

62
Q 
Risk Factors:
Genetics (HLA)
Hormonal (women)Environmental
Medications
Virus
Stress
A

autoimmune disorders

63
Q 
Pathogenesis




T cells not activated
Overstimulation of organ functionCross reaction to epitopes
Autoantibodies
A

autoimmune disease

64
Q

Symptoms: most include increased inflammatory response (-itis, -algia)
Ie. Vasculitis, arthralgia

A

autoimmune disease

65
Q

Treatment:

Must balance suppression of autoimmune reaction and regular immune function

A

autoimmune diseases

66
Q

systemic and progressive disease

A

lupus

67
Q 

Types:



Discoid/cutaneous (skin)
Systemic (flare, remission)Drug-Induced
A

lupus

68
Q

unknown etiology for this disease

A

lupus

69
Q 
Risk factors:


Genetics- familial with first degree relatives
Triggers:
 Antibiotics (sulfa)
 Stress- neuroendocrine 
 UV light
 Infections
 Hormones/Pregnancy- low dose estrogen BCP

 Epstein-Barr virus

A

lupus

70
Q

Incidence: 1.8 to 7.6/100,000 per yearWomen (10:1), 15-40 yo

African Ams, Hispanics> Caucasians

A

lupus

71
Q

Comorbidities of other autoimmune dysfunction (thyroid, anemia)

A

lupus

72
Q

Cause of death: organ failure, infection or CVD (accelerated atherosclerosis)Compliance with tx difficult in child bearing women

A

lupus

73
Q

3 mechanisms for what?

Autoantibodies (generalized)
Vascular abnormalities (vasculitis) Accelerated atherosclerosis
Inflammatory mediators

A

for lupus to begin

74
Q

general lupus sx

A

fatigue
fever
weight loss

75
Q

MSK lupus sx

A

arthralgia

76
Q

skin lupus sx

A

butterfly rash

77
Q

cardiopulmonary lupus sx

A

pleuritis

myocarditis

78
Q

CNS lupus sx

A

depression

79
Q

renal lupus sx

A

kidney failure

80
Q

SLICC classification criteria

A

1 clinical or immunologic
OR
biopsy proven lupus nephritis with ANAs

81
Q 
Acute/cutaneous lupus- butterfly rash, discoid 
rash
Alopecia
Synovitis of two joints with 30 mins of AM stiffnessSerositis (pleurisy, pericardial pain)
Renal involvement
Neurologic manifestations
Hemolytic anemia
Leukopenia
Thrombocytopenia

what kind of criteria?

A

clinical criteria for lupus

82
Q

(+) ANA (antinuclear antibody)(+) DNA antibody
High ESR and CRP

what kind of criteria?

A

immunologic criteria for lupus

83
Q

lupus diagnosis

A

ANA test

84
Q

Mild cases: NSAIDs for pain and inflammation, avoid UV light, exerciseTarget symptoms:
Cardiac- corticosteroid-sparing drugs (methotrexate), anticoagulants
Skin, arthritis, renal- antimalarial drugs (Plaquenil)
Immunosuppression (Cytoxan)

treatment for?

A

lupus

85
Q

Prognosis:
Early detection prevents organ damageCVD
Lymphoma
Renal disease

A

lupus

86
Q

Prednisone, Decadron, Hydrocortisone

Blocks prostaglandins that trigger allergies, inflammation

A

corticosteroids

87
Q

corticosteroids do what?

A

help decrease inflammation for autoimmune disorders

88
Q 
Decreased WBC
Weight gain
Facial swelling (cushinoid)
Increased fat in neck/abdomen (buffalo hump)AVN –Avascular necrosis
Bruising
DM
HTN
Osteoporosis
Acne
Cataracts
Muscle atrophy
Mood swings

negative side effects for using?

A

corticosteroids

89
Q

another option besides corticosteroids to help reduce immune response

A

immunosuppressants

90
Q

Antimetabolites
Alkalating agents
Mycophenolate
Cyclosporine

A

immunosuppressants

91
Q

Side Effects:
Infection, malignancy, liver toxicity, kidney disease, easy bruising,
Pancreatitis

A

using immunosuppressants

92
Q

2 functions of immune system

A

protect self

create effector response to target invader

93
Q

Autoimmune disease of GI tract

A

IBD

94
Q

chronic, inflammatory disorder usually of the colon,ileum Affects 3 layers of bowel; exacerbations and remissions

A

crohns disease

95
Q

inflammation of the mucosa in the colon/rectum, can spread proximally

A

ulcerative colitis

96
Q

Genetics, immune system

Incidence: All age groups, both genders, between 15 to 35 yo
More common in those from eastern Europe, Jews of European decent, urban dwellers, northern climates, developed countries

A

IBD

97
Q

Higher cytokines production

Interleukin 1, IgM, IgA, and IgG levels

A

IBD

98
Q

diarrhea, abdominal pain, GI bleeding, weight loss, fever, malaise, skin rash

common sx b/w what

A

crohns disease and ulcerative colitis

99
Q

Abdominal mass (granuloma)Skip lesions
Growth retardation (peds)
Thickened bowel wall
Fissures, fistulas

sx for?

A

crohns disease

100
Q

Bloody stools
Severe diarrhea
IgG₁ (colon epithelial antibody)Cancer fairly common

signs and sx for?

A

ulcerative colitis

101
Q

Diagnosis
Biopsy: endoscopy, colonoscopy
Blood test: infection, anemia, Ig levels

A

IBD

102
Q 
Treatment
Medical followed by maintenance





Sulfa, 5 aminosalicylates (UC)
Glucocorticoids
Monoclonal antibody
Immunosuppressant
Surgery (UC cure, CD symptoms)
A

IBD

103
Q

PT Implications





Cancer risk
Low back pain, hip pain, SI joint pain DDX
Osteoporosis (dec absorption, steroid use)Hydration
Psych factors: anger, anxiety, depression

A

IBD

104
Q 
Chronic muscle pain syndrome with allodynia or hyperalgesia to pressure pain


Hypersensitive to pain stimuli
Reduced pain inhibition`
A

fibromyalgia

105
Q 
Comorbidities:



Inflammatory disease (RA, SLE)
Metabolic dysfunction (thyroid)Cancer
A

fibromyalgia

106
Q

Incidence:
Most common MSK disorder in the USWomen>men (90% women)
Childbearing ages 20-55 yo

A

fibromyalgia

107
Q 
Risk Factors: “triggers”
Prolonged psychological stress (anxiety, PTSD, bipolar)Trauma (MVA)
Steroid withdrawal
Hypothyroidism
Viral infections
A

fibromyalgia

108
Q 
Diffuse muscle pain, tender points
Fatigue, exhaustion, disordered sleep
Migraines
Irritable bowel syndrome
Psychological sx: depression, anxiety
Diaphragm not primary respiratory muscleMuscle “over activity”

signs and sx for

A

fibromyalgia

109
Q

exacerbated by stress

A

fibromyalgia

110
Q

Widespread (4 quadrant) pain above and below the waist for at least 3 mos
Subjective report of pain when pressure is applied to 11 of the 18 common tender points

2 criteria diagnosis for

A

fibromyalgia

111
Q 
CBC, thyroid levels
Spine xray for OP
Sleep studies
EMG
Psychological testing
A

diagnosis of exclusion

112
Q 
Education
Stress management
Nutrition, lifestyle modification
Cognitive behavioral strategies
Muscle tender points

Acupuncture, massage, biofeedback
Aerobic exercise, ergonomics, energy conservation

tx for?

A

fibromyalgia

113
Q 
Medications




Antidepressants, antianxiety
Muscle relaxers
Analgesics (NSAID, acetaminophen)Anticonvulsants
A

fibromyalgia

114
Q 
At least 4 of the following:
Post exertional malaise >24 hrs
Nonrestorative sleep
Impaired memory or concentrationMuscle pain
Polyarthralgia without edema
New headaches
Tender lymph nodes
Sore throat (persistent, recurring)
A

chronic fatigue syndrome

115
Q

what 2 things for CFS dont cross over to fibromyalgia?

A

tender lymph nodes

sore throat that is persistent and recurring

116
Q

Rule out: mononucleosis, Lyme disease, thyroid disorders, DM, MS, cancer, depression, bipolar disorder

dx of exclusion for?

A

CFS

117
Q 
Treatment




Lifestyle changes: dec stress, dec exertion, diet, sleep
Medications: analgesics, antidepressants, SSRI, antianxietyPsychological: cognitive behavioral therapy
PT: graded exercise
A

CFS

Patho Exam 3 (3 decks)

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