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A1 > Immune system lecture > Flashcards

Immune system lecture Flashcards

1
Q

When does the rudimentary immune system begin?

A

6 weeks old

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2
Q

2 different types of immunity and their definitions

A

Non specific/ innate- defense against many pathogens
Specific/ adaptive/ acquired- bodys ability to protect itself from damaging organisms and toxins

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3
Q

Time line for different types of immunity

A

Innate- 0-12 hours
Adaptive- 12h to 5 days

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4
Q

Innate immunity processes (5)

A

Skin
Phagocytosis
Killer T cells virus infected cells
Responses of sneezing, temperature, flora
Passive immunity via antibodies from activated T cells

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5
Q

Which cells conduct phagocytosis

A

Neutrophils, eosiniphils, monocytes, macrophages, dendritic cells

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6
Q

Acquired immunity processes

A

Antibodies and specific lymphocytes (B) and immunoglobulins
Humoral branch- b lymphocytes
Cell mediated branch- t lymphocytes
Vaccinations
Granulocytes
Agranulocytes

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7
Q

Granulocytes cells

A

Neutrophils- most numerous WBC, fastest, 6hr half life, fight bacteria
Basophils- least common, cause bronchospasm
Eosiniphils- heavy in GI, respiratory

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8
Q

Agranulocyte cells

A

Monocytes- phagocytosis, release cytokines
Lymphocytes- B (humoral)
and T (cell mediated)

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9
Q

Where do lymphocytes originate and mature

A

Humoral B cells- bone marrow/ bone marrow
Cell mediated T cells- bone marrow/ thymus

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10
Q

4 types of hypersensitivity

A

Type 1- anaphylaxis
2- antibody antigen reaction
3- immune complex disease
4-delayed hypersensitivity

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11
Q

Anaphylaxis vs anaphylactoid

A

Anaphyalxis- IGE mediated, mast cells, basophils, rapid <30 min, hotn, bronchospasm,
Anaphylactoid- NO IGE, mast cells and basophils, generally greater amounts of drug than anahylaxis, may occur first exposure, but presentation is identical

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12
Q

Tx of anaphylaxis non life threatening

A

Epi 100mcg-500mcg subq or IM q10min
Children- 10mcg/kg-500mcg q 15 min x2 q4h
Benadryl 1-2mg/kg or 25-50mg IV
Steroids are questionable

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13
Q

Tx of anaphylaxis life threatening

A

1.0 fio2
EPI IV 50-100 mcg to increase CAMP for permeability and relaxes bronchioles
BB can cause poor response
BB- fluids and glucagon
Bronchodilators
Steroids

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14
Q

Awake pt latex reactions

A

Itchy eyes
SOB
Impending doom
NV
General itchy

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15
Q

Anesthetized latex reaction

A

Tachy
HTN
Wheeze/ bronchospasm
Laryngeal edema
Itchy
Flushing

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16
Q

How do epidurals affect immunity

A

Alteration of lymphocyte and killer t activity

17
Q

How do volatile anesthetics impact immunity

A

Suppress nk cells
Induce apoptosis
Suppress apoptosis of cancer cells

17
Q

Which opioids has the greatest depression of immunity

A

Morphine
Fentanyl

18
Q

Which anesthetic is recommended for hiv pt

A

None
But meds can induce p450 system (NNRTIs)

19
Q

Treatment of SLE exacerbation

A

Corticosteroids
Antimalarial
ImmunosuppressantsWha

20
Q

What can exacerbate SLE

A

Pregnancy
Infection
Surgical stress
Drugs

21
Q

SLE anesthetic implications, what are they prone to

A

1/3 exhibit cricoaryetnoid arthritis and RLN palsy
Prone to PE, pneumonitis, alveolar hemorrhage

22
Q

Tx of RA

A

Corticosteroids
Methotrexate
Immunosuppressants
NSAIDS

23
Q

RA anesthetic considerations

A

Neck restrictions, AO subluxation
TMJ restriction/ small mouth opening
Laryngeal edema

24
Q

H1 receptor effect after anaphylaxis. anaphylactoid

A

vasodilation
increased vascular permeability
smooth muscle contraction

25
Q

H2 receptor effect after anaphylaxis/ anaphylactoid

A

tachycardia
gastric acid secretion

26
Q

Best lab to test for a type 1 allergic reaction

A

Tryptase,
Examples: anaphylaxis, extrinsic asthma

27
Q

Type 2 reactions are mediated by, examples

A

(antibody mediated)
IgG and IgM, complement cascade
Examples: abo incompatibility, HIT

28
Q

Type 3 reaction

A

An immune complex is formed and deposited into the patients tissue- complement cascade
Example: snake venom

29
Q

type 4 hypersensitivity reaction

A

12 hours later
Examples: contact dermatitis, graft vs host, tissue rejection

30
Q

Treatment for intraoperative anaphylaxis

A

DC offending agent
1.0 fio2
epinephrine 5-10 mcg for hotn, 1mg for CV collapse
10-25ml/kg
1mg/kg benadryl
albuterol
vasopressin drip

31
Q

What fruits put you at risk for latex allergy

A

kiwi banana papaya pineapple tomato mango

32
Q

neutrophils

A

fight bacteria and fungus
60% of all wbc

33
Q

eosiniphils

A

fight parasites

34
Q

basophils

A

important for allergic reaction

35
Q

monocytes

A

fight bacteria, virus, and fungus
release cytokines
present pathogens to t lymphocytes

36
Q

Lymphocytes

A

b- humoral (produce antibodies)
t- cell mediated- doesnt produce antibodies
NK- limits spread of tumor, and opioids decrease function

37
Q

anaphylaxis causes degranulation of __ and __, but can be prevented with ___

A

mast cells
basophils
can be prevented with epoi

38
Q
A

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