Immune System - Quiz 1 Flashcards
When does immune system start to develop?
6 weeks of age
What is the function of immune system?
Support; protection; vitalized functions; maintaine homeostasis
What are the 2 structures of the immune system?
- Non-specific or Innate; 2. Specific
Which immune system is the primary defense against bacterial bacterial invasion?
Innate
What is involved in the innate immune system? (5)
Integument; phagocytosis; Killer T cells; body’s physical response; plasma proteins
What is phagocytosis? Which immune response?
Consumtion of harmful foreign toxins - innate
What are Killer T cells? Which immune response?
Destroy many virus infected cells - innate
What is the body’s physical immune response?
Coughing, sneezing, tearing, sweating, body temp, normal flora
What is passive immunity? Which immune response?
Antibodies (activated T cells) given to provide protection (transfusion, mother’s breast milk) - innate
What is acquired/adaptive immunity?
Destruction of specific organisms and toxins by ANTIBODIES AND SPECIFIC LYMPHOCYTES
What 2 things interact to form antibodies? What is produced?
Antigens interact with B-lymphocytes—> produce Immunogobulins (Ig)
What are the 2 branches of acquired immunity?
Humoral and Cell-mediated branch
What is involved in humoral branch immunity? Origination?
B lymphocytes and Ig molecules —> bone marrow and plasma cells
What is involved in cell-mediated branch immunity? Origination and maturation location?
T lymphocytes (helper T cells and cytotoxic T cells) —> bone marrow, matures in Thymus
What part of immunity do vaccinations belong in?
Acquired/adaptive immunity
What are the 3 main granulocyte components?
Neutrophils and basophils and eosinophils
What are neutrophils involved in?
Fight bacterial and fungal infections
Which is the most abundant type of WBC?
Neutrophils
What are basophils involved in? What do they do?
Involved in hypersensitivity reactions; release histamine, leukotrines, cytokines, and prostaglandins==> can lead to bad allergic reactions. Also stimulate smooth muscle contraction
What are eosinophils? Locations (3)?
Fight against parasites -> heavy in GI tract, also in respiratory and urinary mucosa
What are the 2 main agranulocytes?
Monocytes and lymphocytes
What do monocytes do?
Phagocytosis; release cytokines (transmit signals); present pieces of pathogens to T-lymphocytes
What are the 2 types of lymphocytes?
B and T lymphocytes
What do B lymphocytes do?
Humoral immunity —> produce antibodies
What do T-lymphocytes do?
Cell-mediated immunity (no antibodies)
Is inflammation innate or acquired? What are the 5 things involved?
Innate AND acquired - 1. Localized vasodilation; 2. Increased blood flow; 3. Increased capillary permeability; 4. Extravasation of plasma proteins; chemotactic movement of leukocytes to injury
What are the 3 clinical manifestations of inflammation?
Erythema, localized edema, pain
What 2 immune cells are involved in allergic reactions?
Antibodies attaché to MAST cells and Basophils
Who many histamine receptors are there?
3
What blocks H1 receptors?
Benadryl
What blocks H2 receptors?
Pepcid and ranitidine
What do H1 receptors cause
Smooth muscle contraction (except vasculature); vasodilation; increased vascular permeability
What do H2 receptors cause?
Stimulate gastric secretion and cardiac stimulation
What are the 4 hypersensitivity groups?
Type 1 (anaphylaxis); Type 2 (cytotoxic/hemolytic anemia); Type 3 (immune complex disease/autoimmune); Type 4 (cell mediated/delayed sensitivity)
What type of sensitivity reaction is latex?
Type 1 and 4
What is required for an anaphylactic reaction (2)?
IgE mediated; requires prior exposure
What is required for an anaphylactoid reaction? What is the difference?
Non-IgE mediated; may occur with first exposure; need greater exposure than with anaphylaxis; otherwise same as anaphylaxis
What percent of adults/fetal are true drug reactions?
5% adults; 0.1% fetal
What is the most common drug reaction? Percentage?
60% - muscle relaxants - rocuronium (quarternary ammonium)
What is the second most common drug reaction? Percentage?
Latex - 15%
What is the 3rd most common drug reaction? Percentage?
Antibiotics (5-10%)
What is the 4th most common drug reaction? Percentage?
Opioids (<5%)
What symptoms of transfusion reaction are able to be observed under anesthesia
1 hemoglobinuria, hypotension, and bleeding
What symptoms of transfusion reaction are masked by anesthesia?
Fever, chills, chest pain, flank pain, nausea, flushing
What are common reactions to ABO incompatibility (3)?
DIC, renal failure, death
Who is at high risk for latex allergy?
Spina bifida, genitourinary tract defects, neural tube defects, multiple surgeries, healthcare workers
Who is at the highest risk for autoimmune diseases?
Females of child bearing and working age
What regional anesthetic technique alters immunity? What part?
Epidurals have a significant but transient alteration of lymphocytes and Killer T cell activity
Which class of medications decrease ciliary activity increasing risk of infection?
Hypnotics
What effect do pts with HIV on non-nucleoside reverse transcriptase inhibitors (NNRTIs) have regarding anesthesia?
Meds INDUCE CYP 450 system—> will metabolize drugs FASTER
What 2 cancers are associated with HIV?
Non-Hodgkin lymphoma (lesions in CNS) & Kaposi’s Sarcoma (endothelial tissue)
What is the most common opportunistic pathogen in HIV patients?
Pneumocystic carinii
What carries the highest risk of occupational HIV exposure? Percentage?
Open-bore needles (0.3%)
What is the risk of HIV exposure after mucous membrane exposure?
0.09%
What is most common presentation of SLE?
Polyarthritis and dermatitis
What is SLE?
Chronic inflammatory disease that reduces antinuclear antibodies
What is the most common cause of death of SLE patients?
Renal disease (>50% of SLE pts have this)
What are 2 common drugs in use that exacerbate SLE?
Procainamide and hydralazine
What 2 autoimmune diseases can cricoarytenoid arthritis be seen in?
SLE and RA
What possible interaction can cyclophosphamide have regarding anesthetics? Used in which 2 autoimmune diseases?
Inhibits plasma cholinesterase —> succs and ester LA can have longer effect - used in both SLE and RA
Which 2 autoimmune disease may require corticosteroid blouses because of adrenal insufficiency during anesthesia?
SLE and RA
