Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology II > Immune System > Flashcards

Immune System Flashcards

1
Q

What are the two types of immunity?

A

Innate and Adaptive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the components of the innate immune system?

A

Chemical
Skin
Mucus membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two types of adaptive immunity?

A

Humoral and Cell mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is adaptive immunity obtained?

A

Naturally and Artificially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does the innate immune system function?

A

Recognizes a common pathogen and requires no prior exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the non cellular elements of the innate immune system?

A

Physical barriers, competent factors, acute phase and contact activation pathway proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the cellular components of the innate immune system?

A

Neutrophils, Macrophages, Monocytes and Natural killer cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where are the cells of the innate immune system located?

A

In all body tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do the cells of the innate immune system treat foreign cells?

A

They identify microbes via recognition signals from surface patterns of molecules indigenous to microorganisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are invaders destroyed by the innate immune system?

A

By release of toxic molecules or phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the two pathways that activate the complement protein cascade?

A 
Pathogen dependent (classical)
Pathogen independent (alternative)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does the complement cascade help clear microorganisms?

A

Coats the agents with protein that facilitates phagocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What results from defects in the classical pathway?

A

Predisposes to autoimmune inflammatory disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What results from deficiencies in C3 (common pathway)?

A

Usually fatal in utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What results from deficiencies in terminal complement C5-C8?

A

Associated with recurrent infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the primary organ of complement protein synthesis?

A

The liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is inflammation?

A

The means by which body defense cells and defense chemicals lave the blood and enter the tissue around the injures or infected site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What systems are involved in the inflammatory process?

A

Vascular, inhume and coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is adaptive immunity?

A

Immunity acquired by lymphocyte activation and subsequent delayed response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does the adaptive immune system display specificity?

A

Cells and antibodies are generated targeted to unique proteins found on an invading microbe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does the memory of adaptive immunity function?

A

Upon re-exposure, dormant cells are generated and mount a quick defense against invading organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are T-helper cells?

A

CD4 cells that carry T-cell receptors that respond to a single antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the function of the CD4 helper molecules that are secreted when an antigen is recognized?

A

Further enhance macrophage function and activate CD8 (cellular immunity) and B-lymphocyte (humoral immunity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the function CD8 lymphocytes?

A

Cytotoxic cells, seek out and destroy infected body cells with microbe specific to its T-cell receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the function of B-lymphocytes

A

When activated by an antigen specific to the b-cell receptor and molecules from the T-helper cells secrete antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the four cell types of T-cells?

A

Interferon
Interleukins
Pro-inflammatory
Regulatory helper cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the function of Pro inflammatory cells?

A

Chronic inflammation and autoimmune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the function of regulatory helper cells?

A

Promote tolerance, autoimmune, allergic and inflammatory responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How are foreign invaders recognized by T and B cells?

A

Antigen presenting cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the importance of antigen presenting cells?

A

They are the link between the innate and adaptive immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How do invaders hide from the immune system?

A

They have evolved proteins that interfere with the antigen presentation by major histocompatibility complex?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the often the cause of neutropenia?

A

Drug related, marrow usually recovers once the drug is withdrawn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the first step of the infection process?

A

Migration of granulocytes out of the circulation and into the bacterial invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is neutrophilia?

A

Occurs when the neutrophil count increases 2-fold within hours of onset of a severe infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

At what WBC count is a deep seated infection considered?

A

10,000-30,000mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is granulocytosis?

A

When the WBC count exceeds 50,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is granulocytosis often associated with?

A

Indicated non infectious malignant process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In what conditions does monocytosis usually occur?

A

Lupus, RA and Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is angioedema?

A

Swelling that occurs under the skin instead of on the surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the two mediators of angioedema?

A

Mast cell release and Bradykinin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What surgical procedures are triggers of angioedema?

A

Dental surgery or any surgery requiring ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What pathology is associated with defects of antibody production?

A

X-linked agammaglobinemia
Waldenstrom’s macroglobulinemia
Cold autoimmune diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What pathology is associated with defects in t-lymphocytes?

A

DiGeorge syndrome and Combined immune system defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the cause of acquired immunodeficiency syndrome?

A

A RNA virus that transcribes DNA and becomes incorporated into the host genome where it replicates freely
Infects T helper lymphocytes and destroys them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the result acquired immunodeficiency syndrome?

A

The host is more susceptible to opportunistic infections and malignancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the most common mode of transmission of acquired immunodeficiency syndrome?

A

Sexual intercourse 60-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are additional modes of transmission of acquired immunodeficiency syndrome?

A

Mother to child
Blood products and organ donation
Contaminated needles

48
Q

How is AIDS classified?

A

According to its associated clinical symptoms

49
Q

What kind of side effects are associated with AIDS drug treatment?

A

Cancer, allergic and autoimmune disorders

50
Q

How many types of immune mediated allergic reactions are there?

A

Four I, II, III, IV

51
Q

What is a type I mediated allergic response?

A

IgE mediated

52
Q

What is a type II mediated allergic response?

A

Cytotoxic reaction mediated by IgG and IgM and complement

53
Q

What is a type III mediated allergic response?

A

Reactions produce tissue damage via immune complex formation and deposition

54
Q

What is a type IV mediated allergic response?

A

Reactions are marked by T-lymphocyte mediated delayed hypersensitivity

55
Q

What is the difference between anaphylactic and anaphylactoid reactions?

A

Identical clinical picture seen as a result of the degranulation of mast cells and basophils BUT, anaphylactoid reaction are NOT mediated through IgE

56
Q

What is an example of a type II cytotoxic reaction?

A

The immune system response to antigen A and B found on RBC surfaces

57
Q

What is a transfusion reaction?

A

When A or B antigens are not present and anti A and anti agglutinogens develop in the plasma

58
Q

What reaction occurs in the body from a transfusion reaction?

A

Clumping and hemolysis occurs to form small clots which plug small blood vessels especially in the kidney

59
Q

What cell pathology is seen as a result of a transfusion reaction?

A

Hemolytic anmeia
Thrombocytopenia
Neutropenia

60
Q

What causes deposits to form in a type III mediated hypersensitivity reaction?

A

Large complexes are cleared from the circulation by macrophages but macrophages have difficulty disposing of small immune complexes

61
Q

Where are the deposits typically left in a type III mediated hypersensitivity reaction?

A

Blood vessels. joints and glomeruli and react with the complement

62
Q

Once activates, what is the role of the complement in a type III hypersensitivity reaction?

A

Complement mediates the induction of granule release from mast cells and recruitment of inflammatory cells into the tissue

63
Q

What are examples of type III hypersensitivity reactions?

A

Lupus and Glomerulonephritis

64
Q

What is the presentation of a type IV hypersensitivity reaction?

A

Cutaneous symptoms are most common and may be severe as Steven Johnson syndrome

65
Q

What is DRESS and what hypersensitivity reaction is it associated with?

A

Type IV

Drug rash with sodiniophilia and system symptoms in another sever form

66
Q

What are risk factors for anaphylaxis during anesthesia?

A 
Asthma
Longer duration of anesthesia
Female (especially for NMBA and hypnotics)
Multiple past surgeries
Presence of allergic condition
67
Q

What can be given to a patient prior to drug administration if a previous suspected reaction had been reported?

A

H1 and H2 blockers 16-24hrs before
Optimize volume status
Hydrocortisone 1g is patient is exposed to an agent with high allergic risk

68
Q

What is may be the first sign on anaphylaxis in an anesthetized patient?

A

CV collapse

69
Q

How might the provider confirm an anaphylactic reaction has occurred?

A

Elevated plasma trypase (stored in mast cells released with immune reaction) within 1-2hrs of the event

70
Q

How long does it take histamine to return to normal after an anaphylactic reaction?

A

30-60m

71
Q

What is an idiosyncratic reaction?

A

An undesirable pharmacologic response to a drug independent of the dose

72
Q

What is drug intolerance?

A

Undesirable pharmacologic effect at low doses

73
Q

What is a localized reaction?

A

Histamine release along a vein after giving a drug

74
Q

What should be done if a localized reaction occurs?

A

Stop the drug administration

75
Q

What class of drugs are responsible for 60% of drug induced allergic reactions?

A

Muscle relaxants

76
Q

What type of muscle relaxants are the most likely to cause an anaphylactoid reaction?

A

Benzyl isoquinolimum compounds (atracurium and cisatracurium)

77
Q

What drugs can be given to attenuate an anaphylactoid reaction?

A

Antihistamines and glucocorticoids

78
Q

What drug has a cross reaction with neostigmine?

A

Morphine, both contain ammonium ions

79
Q

How often do hypnotic agents cause anaphylaxis?

A

5%

80
Q

In what instance would you avoid propofol from fear of an allergic reaction?

A

The patient has a history of an egg or soy allergy

81
Q

What type of local anesthetics are people allergic to?

A

Ester type LA are more commonly allergic

82
Q

What should be done if a patient claims they are allergic to a LA?

A

They should be skin tested

83
Q

What opioids cause histamine release from mast cells and basophils?

A

Morphine, codeine and meperidine

84
Q

What type of reaction do people usually have to contrast dye?

A

Most are non-immune related and are managed with pretreatment

85
Q

What effect does protamine have on the immune system?

A

Stimulates mast cells to release histamine and activates the complement pathway leading to thromboxane production

86
Q

What types of effects does thromboxane production have on the body?

A

Bronchoconstriction, pulmonary arter HTN and systemic HoTN

87
Q

What type of patients are most likely to have a reaction from protamine?

A

Allergic to sea food
Post vasectomy
Diabetics on protamine containing insulin

88
Q

What is the second most common cause of anaphylaxis in the preoperative period?

A

Antibiotics 10-15%

89
Q

What is the most common antibiotic allergy?

A

PCN

90
Q

What class of antibiotics is said to have a cross reaction if allergic to PCN?

A

Cephalosporins 0.05%

91
Q

What is the second most common antibiotic allergy?

A

Sulfonamide drugs

92
Q

What is the leading cause of transfusion related lung injury?

A

TRALI

93
Q

What is a transfusion related lung injury?

A

Antibodies in the plasma of the donor blood react with the neutrophils on the pulmonary vascular endothelium

94
Q

When is the onset and signs of a TRALI?

A

Within 6hrs of transfusion and presents with hypoxia and pulmonary edema

95
Q

What type of hypersensitivity reactions are associated with latex allergy?

A

Type IV cell mediated delayed onset, usually contact dermatitis
Type I IgE mediated and most severe

96
Q

Who is at risk for latex allergy?

A

Healthcare workers (ICU and PACU), multiple surgeries, allergy to bananas, avocado, tropical fruit and nuts, contact dermatitis, asthma, rhinitis

97
Q

What is the onset difference between drug and latex allergies?

A

Reactions to drugs usually occur within 10min where latex can take up to 30min

98
Q

What is the route of entry for latex allergy?

A

Mucus membranes and inhalation

99
Q

What does the ASA suggest for surgical timing in patients with a latex allergy?

A

They should be the first case in the morning when the levels of latex airborne allergens are the smallest

100
Q

What is thought to trigger autoimmune disorders?

A

Infection or environmental antigens: streptococcus, e-coli, staph aureus and certain drugs

101
Q

What is the treatment for autoimmune disorders?

A

Immunosupprants

102
Q

What are three categories to consider when caring for a patient with an autoimmune disease?

A

Vulnerable organs specific to disease
Risk of accelerated atherosclerosis and associated CV compromise
The consequence of therapy used to treat disorder

103
Q

What is immunosenescence experience by the elderly?

A

The changes in the innate and adaptive immune response associated with increased age

104
Q

What effects does age have on the immune system?

A 
Increased susceptibility to infection
Malignancy
Autoimmunity
Decreased response to vaccines 
Impaired wound healing
105
Q

How do opioids affect the immune system?

A

Suppress NK, lymphocyte, neutrophil and macrophage functions

106
Q

How does morphine affect the immune system?

A

Impairs antibody formation

107
Q

How does ketamine, volatiles and thiopental affect the immune system?

A

Reduce NK cell activity and or number

108
Q

How does nitrous oxide impair immune function?

A

Impair DNA and has been observed to depress hematopoietic and mononuclear cell synthesis and neutrophil chemotaxis

109
Q

How does propofol impact the immune system?

A

Unclear but thought to inhibit neutrophil, monocyte and macrophage activity

110
Q

What effect do non opioid analgesics have on the immune system?

A

Less effect than opioids, Tramadol may actually promote NK activity
COX 2 may actually possess anti tumor and anti angiogenic properties

111
Q

What effect does regional anesthesia have on the immune system?

A

Reduces requirements for immunosuppressive drugs

May be associated with decreased cancer recurrence

112
Q

What effects do lidocaine and ropivicane have on the immune system?

A

May suppress growth of tumor cells

113
Q

What is the recommendation for surgery in patients with infectious disease?

A

No surgery except emergency or essential the nan acute infection because renal insufficiency can be caused by antimicrobial drugs

114
Q

What is the leading cause of post op morbidity in patients with an acute infectious disease?

A

Sepsis, due to decreased SVR

115
Q

What intervention has been known to radically reduce the rate of nosocomial infections?

A

Hand washing

Pathophysiology II (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions