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Patho > Immune System > Flashcards

Immune System Flashcards

1
Q

A patient has had a liver transplant. The patient is not adherent to taking their anti-rejection medications, and as a result, the liver fails. The rejection of the liver by the body is an example of:

A

Alloimmune disease

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2
Q

People with HIV are diagnosed with AIDS if they have a CD4 count of less than:

A

200 cells/mm^3

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3
Q

Healthcare workers with infection should be restricted from client care until at least 24 hours after adequate treatment for this very common bacterial infection:

A

Group A Streptococcus

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4
Q

The most common transmission of HIV in adult females is the result of:

A

Heterosexual intercourse

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5
Q

Innate Immune System

A

Non-specific
Can have a very quick response
No memory
Monocytes, neutrophils, eosinophils, basophils, mast cells, natural killer cells

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6
Q

Adaptive Immune System

A

Specific
Slow response
Memory
B and T cells, or lymphocytes

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7
Q

Combination of both systems; innate and adaptive use

A

Macrophages and dendritic cells

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8
Q

Hematopoietic Stem Cells
(Never Let Monkey x2Eat Bananas)

A

Neutrophils
Lymphocytes (B and T)
Monocytes and Macrophages
Eosinophils
Erythrocytes and Thrombocytes
Basophils and Mast cells

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9
Q

Natural Killer (NK) Cells

A

Kill cells infected with viruses, other intracellular microbe-infected cells and tumor cells
Respond by releasing cytotoxic granules and by secreting cytokines

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10
Q

Mononuclear Phagocytes and Granulocytes

A

Readily ingest pathogens and kill them to protect against infection
2 principle families: Neutrophils and monocytes
Susceptibility to infection due to decrease in absolute numbers of these cells in the blood

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11
Q

Antigen presenting cells

A

Macrophages
Dendritic cells
B cells

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12
Q

What is the first line of defense?

A

Innate immunity

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13
Q

What is the innate immunity capable of?

A

Resolving most threats
comprised of early host defense mechanisms

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14
Q

External defenses of Innate immunity

A

Physical, chemical, and mechanical barriers that provide protection against invaders;
Skin, mucus, peristalsis, coughing, sneezing, stomach acid, ear, wax, tears, saliva, pH

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15
Q

Internal defenses of Innate immunity

A

*Cells: Phagocytes + Macrophages
->NK (mast cells) ->Apoptosis (degrade + get recycled)
*Soluble factors and cellular components
*Physiologic responses
-Fever
-Fatigue and decreased appetite (causing the host to slow down and relax)

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16
Q

What is the second line of defense?

A

*Inflammatory response
Vascular response
Plasma Protein Systems
Complement System (Cytokines)

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17
Q

What is the third line of defense?

A

*The specific Immune System (Adaptive)
Adaptive Immunity
-Humoral immunity
-Cell-mediated immunity
Passive acquired immunity

18
Q

Antibody-mediated Immunity

A

*Active-you create antibodies;
-Natural -contact and infection with antigen (environmental exposure); usually permanent/may be temporary
-Artificial -inoculation of antigen (vaccination); usually permanent/may be temporary

OR

Passive-you receive antibody;
-Natural-contact with antibody transplacentally (mother to fetus) or through colostrum and breast milk; temporary
-Artificial-inoculation of antibody or antitoxin; immune SERUM globulin; temporary

19
Q

How does Adaptive immune response happen?

A

Cell mediated (T-cell immunity)
Humoral (B-cell immunity)

20
Q

Where do B-cells and T-cells Mature?

A

B-cells (Bone marrow)—>Become Plasma cells–>Antibodies->Memory->Destroy
T-cells (Thymus)—>Have memory–>Call in B-cells
Dendritic cells: stay in and hold on to antibodies and antigens =Memory

21
Q

Immunodeficiency

A

The immune response is absent or depressed as a result of a primary or secondary disorder

22
Q

What is the primary and secondary disorder of immunodeficiency?

A

*Primary reflects a defect involving T CELLS, B CELLS, or lymphoid tissue

*Secondary results from an underlying DISEASE or factor that depresses or blocks the immune response

23
Q

Primary immune deficiencies are…

A

genetically determined and are either innate host defense or adaptive immunity, which can be humoral or cellular

24
Q

What are the primary immune deficiencies consequences?

A

single gene defect, mutations that are sporadic rather than inherited;
defect occurred before birth, manifestations occur either early or late depending on the disease

25
Q

Secondary immune deficiencies are…

A

frequently encountered in people with pre-existing conditions such as malnutrition, infection, cancer, renal disease, or sarcoidosis

26
Q

Is AIDS considered a primary or secondary immunodeficency?

A

AIDS is a secondary immune deficiency

27
Q

HIV/AIDS

A

HIV: Human Immunodeficiency Virus. Progressive failure of the immune system that allows life-threatening opportunistic illnesses to thrive

Causes

AIDS: Acquired Immunodeficiency Syndrome. Immune system is severely compromised and vulnerable to opportunistic illnesses

28
Q

What is HIV known to do?

A

Capable of infecting and debilitating the immune system by selectively attacking and incapacitating the CD4 molecule of the immune system, which depletes the helper/inducer T lymphocytes (T cells)

29
Q

What are the 3 main avenues for HIV transmission?

A
  1. Percutaneous: contaminated blood (transfusions, needle sharing/stick)
  2. Sexual activity (anal, vaginal, very rarely oral)
  3. Maternal to child (pregnancy, during delivery, or breastfeeding)
30
Q

In the US, what is the most common route of HIV infection

A

Homosexual sex-most common in adult males (MSM)
AND
Injection-drug users (IDUs)

31
Q

HIV Life Cycle

A
  1. Binding
  2. Fusion
  3. Reverse transcription
  4. Integration o
  5. Replication
  6. Assembly
  7. Budding
32
Q

HIV Life Cycle in Detail

A
  1. Fusion of HIV to the host cells surface
  2. HIV RNA, reverse transcriptase, integrase, and other viral proteins enter the host cell
  3. Viral DNA is formed by reverse transcription
  4. Viral DNA is transported across the nucleus and integrates into the DNA host
  5. New viral RNA is used as genomic RNA and to make viral proteins
  6. New viral RNA and proteins move to the cell surface and a new, immature, HIV forms
  7. The virus matures by protease releasing individual HIV proteins
33
Q

Stage I : Acute HIV Infection

A

Weeks 2-4 post infection
Massive inflammatory response to initial viral exposure (develop flu-like symptoms

-Large amounts of HIV in the blood and immune system
-Body produces HIV antibodies and cytotoxic lymphocytes
-Greatest transmission risk***

34
Q

Stage II: Chronic HIV Infection

A

Clinical latency/asymptomatic infection

-HIV reproduces at low levels
-People may be asymptomatic but still able to transmit
-Without treatment, usually progresses to AIDS in ~10 years

35
Q

Final stage of HIV Infection

A

AIDS

-HIV has destroyed the immune system
-CD4<200 cells/mm^3 (normal CD4 500-1600)
-1 or more opportunistic illnesses
-Life expectancy without treatment with AIDS diagnosis = 3 years

36
Q

Transmission-based precautions

A

Education regarding sexual activity and IDU main emphasis
Routine HIV testing for all individuals between ages 13-64
Anti-retroviral Therapy (ART)-recommended for all with HIV regardless of CD4 count

37
Q

ART

A

Can’t cure HIV
Reduces morbidity and mortality
Help live longer, healthier lives
Reduce risk of transmission

38
Q

CD4 < 500

A

Thrush (oral candidiasis)
Vaginal candidiasis
Kaposi’s sarcoma (tumors caused by herpes-8)
Bacterial infections
Tuberculosis (TB)
Herpes Simplex
Herpes Zoster

39
Q

CD4 < 200

A

Pneumocystic carinii (Fungal pneumonia *#1CAUSE OF DEATH)
Toxoplasmosis
Cryptococcosis
Coccidiodomycosis
Cryptosporosis
Cytomegalovirus
Non-Hodgkin’s lymphoma

40
Q

CD4 < 50

A

Imminent Death**

Disseminated mycobacterium avium complex (MAC) infection (systemic and rapidly fatal)
Histoplasmosis
CMV retinitis
CNS lymphoma
Progressive multifocal leukoencephalopathy
HIV dementia

Patho (13 decks)

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