Immune System

Question 1

Erythropoietin (EPO)

Answer 1

• Controls erythropoiesis (formation of blood cells)
• Made by kidneys
• Increase in RBC #’s in 5 days

Question 2

Normal hematocrit in men and women

Answer 2

Men - 45%
Women - 40%

(blood = hematocrit + plasma)

Question 3

How are red blood cells recycled?

Answer 3

Lifespan = 120 days
Digested in spleen by macrophages
Hemoglobin excreted as bilirubin

Question 4

Jaundice

Answer 4

Indicates liver failure

Or if infants producing excess RBCs & hemoglobin

Question 5

Anemia - levels at which it effects you

Answer 5

Deficiency of hemoglobin

• decrease by 30% –> symptoms, tiredness
• Elevated cardiac output, decreased vascular resistance

Question 6

Polycythemia

Answer 6

Increased RBC production

Increases viscosity –> increases cardiac work

Question 7

5 types of Leukocytes

Answer 7

• Granulocytes (Neutrophils, Eosinophils, Basophils)
• Monocytes (AKA macrophages)
• Lymphocytes

Question 8

Eosinophils

Answer 8

2% of WBCs

• Phagocytic, immunomodulary, decrease inflammation
• PARASITES, skin diseases, chronic infections

Question 9

Basophils

Answer 9

0.5% of WBCs
Release histamine (allergic reactions)

Question 10

3 mechanisms of innate immunity

Answer 10

Innate immunity = non specific processes to destroy foreign organisms

1. Phagocytosis of bacteria
2. GI tract- acid secretions destroy organisms
3. Skin - resists invasion

Question 11

2 types of cell responsible for phagocytosis

Answer 11

1. Neutrophils

2. Macrophages (aka monocytes when inactive in blood)

Question 12

4 steps of inflammation process

Answer 12

Inflammation = part of innate immune response!

1. Tissue damage
2. Vasodilation, increased permeability of blood vessels
3. Phagocytes migrate to area, kill bacteria
4. Tissue repair

Question 13

Neutrophilia

Answer 13

Increased level of neutrophils in blood

Red flag for a serious infection

Question 14

Diapedesis

Answer 14

Process by which white blood cells exit capillaries into tissue

Question 15

2 types of Leukemia

Answer 15

Lymphocytic (lymphoid)
Myelogenous (bone marrow)
- Designated Acute or Chronic (speed of progression, amt undifferentiated cells)

Question 16

2 categories of adaptive (acquired) immunity

Answer 16

• Humoral-mediated - B cells, antibodies

- Cell-mediated (T cells)

Question 17

Humoral immunity

Answer 17

B cells in lymph activated by antigen

Clone selves to form plasma cells (travel in blood) and Memory B cells

Question 18

2 mechanisms of antibody action

Answer 18

1. Direct attack on invader (Abs bind, neutralize, lyse)

2. Activate complement system

Question 19

Complement system

Answer 19

Part of humoral immunity
Several enzymes in blood, series of reactions activated by antibodies
- Leads to lysis of invaders

Question 20

Cell-mediated immunity

Answer 20

T cells in lymph - respond to antigens ONLY displayed on MHC complex on antigen-presenting cell

Question 21

Antigen presenting cells (3)

Answer 21

Macrophages, B cells, dendritic cells

- Bind fragments of antigens to MHC complex to activate T cells

Question 22

CD4 cells

Answer 22

Helper T cells

secrete lymphokines & interleukins to mediate immune action

Question 23

Cytotoxic T cells

Answer 23

i.e. CD8 cells
Killer T cells
Insert perforins to kill attacked cells

Question 24

Hemostasis

Answer 24

Prevention of blood loss by the process of clotting

Question 25

What are blood clots made of?

Answer 25

Fibrin (and platelets, and dead cells)

Question 26

Intrinsic, extrinsic, and common pathways of blood clotting

Answer 26

- Intrinsic = skin damage pathway, many clotting factors involved - Extrinsic - tissue/organ damage - Both lead to common pathway, which eventually converts fibrinogen to fibrin to form clots

Question 27

3 reasons for coagulation problems

Answer 27

1. Liver failure (clotting factors made there) 2. Vitamin C deficiency (elderly, alcoholics lack stable collagen) 3. Vitamin K deficiency (needed for clotting factors)

Question 28

Vasculitis

Answer 28

Inflammation of small vessels, can leave lesions on skin in rheumatoid arthritis

Question 29

C-reactive protein

Answer 29

Commonly measured indicator of indication (

Question 30

RF (Rheumatoid Factor)

Answer 30

Auto-antibody produced by individuals with rheumatoid arthritis

Question 31

ANA's (Antinuclear Antibodies)

Answer 31

Specific auto-antibodies for lupus

Question 32

Symptoms of Rheumatoid Arthritis

Answer 32

- Subcutaneous nodules - small, firm, painless - Painful swelling of small joints in hands and feet - bone erosion, joint deformity

Question 33

Rheumatoid arthritis pathogenesis

Answer 33

Progressive autoimmune disesase - Attacks synovium of joints - Chronic inflammatory disorder - Overactive immune response to self erodes bone & synovium rather than repairing it

Question 34

RA vs. OA differences

Answer 34

- RA affects synovium vs wear & tear on cartilage - RA early morning pain lasts >45 min (OA lasts ~20 min) - RA symmetrical & affects whole body - RA affects more women than men, OA affects sexes equally - OA generally affects people over age 40, RA can onset any age

Question 35

Pannus

Answer 35

Hardening of joint from dead cells, becomes fibrotic

Question 36

Most common RA treatments

Answer 36

- Glucocorticoids - DMARDS (anti rheumatic drugs) - Combinations, trial and error

Question 37

Hemoglobin A1C | - Blood levels & significance

Answer 37

% glycated hemoglobin, reflects the blood glucose levels over the past 2-3 months - HbA1C > 6.5 % is diagnostic of diabetes (if measured repeatedly)