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Medical Conditions 1 > Immune system pathologies > Flashcards

Immune system pathologies Flashcards

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USMLE® Step 1 flashcards
1
Q

Innate Immunity

A
  • non-specific (no memory cells)
  • no immunological memory
  • includes first and second lines of defense
  • ex: epithelial barriers, phagocytes, dendritic cells, complement cascade, Natural killer cells
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2
Q

First line of defense

A
  • part of innate immunity (non-specific)
  • skin
  • nasal hair
  • ear wax
  • reflexes
  • mucosa (digestive system, lungs, reproductive organs)
  • secretions: tears, sweat, saliva
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3
Q

Second line of defense: cellular components

A
  • internal defenses inflammation and repair
  • innate non specific immunity
  • cellular components
  • WBCs
  • monocytes
  • macrophages
  • eosinophils
  • basophils
  • platelets
  • mast cells
  • natural killer cells
  • erythrocytes
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4
Q

Second line of defense: soluble components (plasma proteins)

A
  • clotting factors
  • complement system (lysis)
  • protein factors that break down cell membranes of antigens
  • kinin system (vasodilation)
  • chemokines
  • cytokines (interferons, interleukins, tumor necrosis factor)
  • part of innate and adaptive immunity (some overlap)
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5
Q

Third line of defense

A
  • adaptive immuntiy
  • specific
  • immunological memory
    two types:
  • humoral (B-cells) antigens and antibodies
  • cell mediated (T-cells) antigens and T -lymphocytes, T helper cells CD4+ and CD8+
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6
Q

Antigen

A
  • what you are exposed to and need an adaptive response to
  • foreign substance such as bacteria, virus, parasite, foreign tissue, large protein
  • elicits immune response; acquired immunity
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7
Q

Antibodies

A
  • formed by B cells
  • polypeptide chains called globulins
  • also called immunoglobins
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8
Q

Jobs of antibodies/immunoglobulins

A
  • attack, destroy, neutralize antigens
  • activate the complement (lysis) system
  • release histamine (anaphylaxis)
  • stimulate anti-body-mediated hypersensitivity
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9
Q

Cell-mediated adaptive immunity

A
  • T-cells from thymus gland learns about antigens from other cells as they circulate through lymphatic system and spleen
  • different receptors form on cells
  • can attack intracellularly and extracellularly
  • types of T-cells: CD4+ and CD8+
  • more likely to get sick with decreased CD4+
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10
Q

function of
1. B lymphocyte

A
  1. neutralization of microbe, phagocytosis, complement activation
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11
Q

Help T cell function

A
  • activation of macrophages;
  • inflammation
  • activation of T and B cells
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12
Q

function of
5. natural killer cell

A
  1. killing of infected cells
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13
Q

Exercise effect on lymphocytes

A
  • brisk exercise increase the WBC count in proportion to the effort
  • lymphocytes increase during exercise but decrease below the normal levels for several hours after intense exercise
  • the effects of intense exercise on secondary antibody response in older adults remain unknown
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14
Q

exercise and infection

A
  • exercise during the incubation period of infection appears either to have no effect or to increase the severity of infection
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15
Q

COVID-19 testing

A

Antigen testing:
- determine presence of antigen proteins
- will be positive while virus or baceria is present

PCR: polymerase chain reaction
- detect genetic material from COVID-19

Antibody test:
- been exposed but not sure when or if infection is currently happening
- tests for presence of antibodies (IgM, IgG) produced in response to previous infection

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16
Q

Aging and the immune system: immunosenescence

A
  • aging is accompanied by immune dysregualtion as immune function declines with increasing age
  • this is described as oxidative (free radical) theory of aging
17
Q

Changes in innate immunity with age

A
  • exterior defenses are affected by thinning of skin
  • phagocytes: neutrophils and monocytes/macrophages show decreased function with aging
  • eosinophils accumulate in fewer numbers as sites of infection with age
  • basophils are characterized by reduced degranulation with aging
18
Q

Changes in acquired immunity with age

A
  • older adults have decreased response to newly encountered antigens
  • depends on naive T and B cells that decline in production with age
  • decline in antibody production that may be due or inappropriate or insufficient T-cell help
19
Q

Exercise immunology- how does moderate exercise and strenuous exercise affect the immune system

A
  • immune system is enhanced during moderate exercise
  • regular moderate physical activity can prevent the neuroendocrine and detrimental immunological effects of stress
  • strenuous or intense exercise or long-duration exercise such as marathon running may be followed by impairment of the immune system
20
Q

how does exercise effect neutrophils and macrophages

A
  • exercise triggers a rise in blood levels of neutrophils (PMNs) and stimulates the phagocytic activity of neutrophils and macrophages
  • if exercise goes beyond 30 minutes a second or delayed rise in PMNs occurs
  • this delyaed rise is probably result of cortisol
21
Q

how does exercise effect natural killer cells

A
  • number of NK cells increase
  • function or activity of NK cells increases
  • during and immediately after exercise
    NK enhancement:
  • temporary
  • surge in epinephrine (reduce inflammation and fights some infection)
  • after intense exercise of long duration, the concentration of NK cells and NK cytolytic activity declines below pre-exercise values
21
Q

Exercise and apoptosis

A
  • it is surmised that exercise-induced apoptosis is a normal regulatory process that removes certain damage cells without a pronounced inflammatory response, thereby ensuring optimal body function
21
Q

what are hypersensitivity disorders

A
  • overreaction to a substance or hypersensitivity
  • often referred to as allergic reaction
  • although the term allergy is widely used the term hypersensitivity is more appropriate
22
Q

What are the types of hypersensitivity disorders

A
  • immediate
  • late phase
  • delayed
23
Q

immediate hypersensitivity disorder

A
  • reaction occurs within minutes of exposure
  • hay fever, allergic rhinitis(nasal passage only), urticaria (hives), extrinsic asthma (exposure to something in the air) and anaphlactic shock)
  • may be a hereditary disposition
    immediate response:
  • histamine release
  • other inflammatory mediators enhance and prolong the response initiated by histamine
24
Q

late-phase hypersensitivity disorders

A
  • inflammation and symptoms persist for hours to days after allergens are removed
  • can cause cumulative damage
25
Q

delayed hypersensitivity reactions

A
  • occurs after sensitization to certain drugs or chemicals
  • can take several days to cause symptoms
  • ex: poison ivy, penicillin allergy)
26
Q

What happens if an immediate hypersensitivity becomes systemic

A
  • widespread release of histamine
  • systemic vasodilation, bronchospasm, increased muscus secretion and edema
  • referred to as anaphylaxis
27
Q

Anaphylaxis

A
  • life-threatening emergency and requires immediate intervention with injection epinephrine to restore blood pressure, strengthen the heartbeat and open airways
  • an increase in the prevalence of atopic disease (hypersensitivity) has occured in US during past 2 decades
28
Q

type 2 hypersensitivity

A
  • cytotoxic reactions to self-antigens
  • the body’s own tissue is recognized as foreign or nonself
  • autoimmune disease
29
Q

Type 3 hypersensitivity

A
  • immune complex disease
  • when antigen-antibody complexes (immune complex) circulate in the blood
  • initiates inflammation and tissue injury
  • resulting in vasculitis
30
Q

what are examples of vasculitis
1. urticaria
2. synovitis
3. nephritis
4. pleuritis
5. pericarditis

A
  1. skin: urticaria (wheals and hives
  2. joints: synovitis
  3. kidneys: nephritis
  4. pleura: pleuritis (heart or lung pleura)
  5. heart: pericarditis
31
Q

Type 4 hypersensitivity

A
  • cell-mediated immunity
  • delayed response
  • antigen is processed by macrophages, presented to T-cells
  • Sensitized t-cells release cyokines which recruit lymphocytes, monocytes, macrophages and PMNs
32
Q

what are some examples of a delayed response with type 4 hypersensitivity

A
  • contact dermatitis after exposure to an allergen
  • response to Tb test
  • graft-versus-host disease and transplant rejection
33
Q

function of cytotoxic t lymphocyte

A

killing infected cells

33
Q

function of regulatory T lymphocyte

A

suppression of immune response

Medical Conditions 1 (16 decks)

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