Immune System - Quiz 1 Flashcards
What are the body’s primary defenses gainst bacterial invasion?
- Skin
- Phagocytosis - kills foreign toxins
- Killer T Cells - kills virus infected cells
- Responses - sneeze, cough, sweat…
What is Passive Immunity?
Receiving Antibodies / Activated T-Cells for protection via transfusion
Immediate Protection, but Short Lived
What is the Complement Cascade?
Immune response that marks pathogens for destruction & makes holes in its cell membrane
What is Adaptive / Acquired Immunity?
Immune system that is activated after exposure to pathogens and uses specific antigens for attack.
Which cells are a part of the Humoral Branch?
B-Lymphocytes - comes from bone marrow & plasma cells
Which cells are part of the Cell Mediated Branch?
T-Lymphocytes - comes from bone marrow & matures in the Thymus
How is Resistance to Pathogens developed?
Antigens interact w/ B-Lymphocytes to form Antibodies, AKA, Immunoglobulins
Antibodies have memory
What is the difference b/t Humoral Immunity & Cell Mediated Immunity?
Humoral: uses antibodies from plasma cells
Cell Mediated: uses Killer T-Cells
What is the difference of Response Time b/t Innate Immunity & Adaptive Immunity?
Innate: minutes/hours
Adaptive: days
Which type of immunity is Highly Specific?
Adaptive Immunity - can tell difference b/t pathogen vs. non-pathogen structures
What are the major cell types involved in Innate Immunity?
Macrophages
Neutrophils
Natural Killer Cells
Dendritic Cells
Basophils
Eosinophils
What are the major cell types in Adaptive Immunity?
T-Cells
B-Cells
Antigen presenting cells
What are the key components of Innate Immunity?
Antimicrobial Peptides & Proteins
What are the key components of Adaptive Immunity?
Antibodies
How effective is Innate & Adaptive Immunity at discerning Self vs. Nonself?
Innate: Perfect
Adaptive: Not as good, but still good. May cause autoimmune diseases
Which type of Immunity has memory?
Adaptive Imunity
Which type of Immunity is Highly Diverse?
Adaptive Immunity - customizable
Vaccines are an example of _______ Immunity
Vaccines are an example of Active Immunity
Antibodies passed from the mother to fetus is an example of ______ Immunity
Antibodies passed from the mother to fetus is an example of Passive Immunity
What do Mononuclear cells do?
Ingest & Destroy bacteria, neoplastic, and damaged cells
What do Eosinophils do?
Phagocytosis
Defends GI (Parasites) , Respiratory, and Urinary Mucosa
What do Neutrophils do?
Most Numerous WBC & First to Arrive
Releases Cytokine & Hydrolytic Enzymes
Fight Bacteria & Fungal Infection
What do Basophils & Mast Cells do?
- Least common
- Release histamine, leukotriens, cytokines, & prostaglandins
- ↑Vascular Permeability
- ↑Inflammation
- ↑Smooth Muscle Contraction (Bronchspasm)
What do Natural Killer Cells do?
Respond to cytokine and kills tumor and virus infected cells
What is Opsonization?
Process of coating cell w/ protein that helps w/ phagocytosis
What happens during Inflammation?
Vasodilation
↑Blood Flow
↑Capillary Permeability
Plasma Protein Extravasation
Leukocytes move to site of Injury
How do Antibodies protect the Body?
Direct Attack
&
Activate Complement System
Which class of Antibodies make up 75% of all antibodies in the normal person?
IgG
Bivalent Antibody
Which class constitutes a small percentage of Antibodies and are especially involved in Allergy?
IgE
Which class of Antibodies are formed during the primary response and have 10 binding sites?
IgM
What happens during an Allergic Reaction?
Antibodies attach to Mast Cells & Basophils which then release histamines and leads to abnormal response
What are the 4 Types of Hypersensitivity?
ACID
- Type I: A llergic/Anaphytlactic/Atopic (Hay Fever, Hives, Asthma)
- Type II:C ytotoxic (Hemolytic Anemia)
- Type III:I mmune Complex (Lupus, RA)
- Type IV: D elayed Sensitivity (Contact Dermatitis, Graft Rejection)
What is the difference b/t Anaphylaxis & Anaphylactoid?
Anaphylactoid is NON IgE mediated
Needs more exposure
Can happen w/ 1st exposure
What are some symptoms of an Anaphylaxis reaction?
Hypotension
Dysrrhythmias
Dyspnea
Dizziness
Diaphoresis
Itching/Tingling
Edema
What is the most common medication that causes Drug Reactions?
Rocuronium > Latex > Abx > Opioids
What is the treatment for Non Life Threatening Anaphylaxis?
Epinephrine
Diphenhydramine
Maybe Steroids
What is the treatment for Life Threatening Anaphylaxis?
Maintain Airway
100% O2 & Stop Gases
Epinephrine IV
Pressors &Fluids
Bronchodilators
Antihistamine
Steroid
What are the risk factors for Latex Allergy?
Healthcare Workers
Neural Tube Defects
Spina Bifida
GU Defects
Multiple Surgeries
Fruit Allergies
What are symptoms of Latex Allergy in the Awake pt?
Itch
SOB
Doom
N/V
Diarrhea/Cramping
Wheezing
What are symptoms of Latex Allergy in the Anesthetized pt?
Tachycardia
HTN
Wheezing
Bronchospams
Facial Flush & Edema
Hives
What is the classic sign of Autimmune Disease?
Chronic Inflammation
Which population has the most risk for Autoimmune Disease?
Black, Native American, and Hispanic females in child bearing years
How does anesthesia affect the immune system?
Depresses Immune System
Other than anesthesia, what are some causes Immune system depression?
Surgery (Tissue Damage/Blood Loss)
(Laparascopic Procedures are better)
Blood Transfusion
Hyperglycemia
Hypothermia
How does HIV work?
Retrovirus invades cell-mediated branch of immune system
Transmitted thru blood & body fluids
What anesthetic considerations should be taken for patients w/ HIV?
Patient might be on NNRTIs, which induce CYP450
What are the common Comobidities of HIV?
Abnormal EKG
Pericardial Effusion
Wasting Syndrome
Dementia, Neuropathy
Platelet Impairment
Cancer
What are some of the major concerns when caring for an HIV patient in the OR?
Infection of patient & staff
What is the most common opportunistic pathogen in regards to HIV patients?
Pneumocystic Carinii Pneumonia
What are symptoms of Lupus?
Chronic Inflammation
Antinuclear Antibodies
Polyarthritis & Dermatitis
Malar Rash
Renal Disease
How is Lupus treated?
Steroids
Antimalarial
Immunosuppressants
What conditions are pts w/ Lupus at higher risk for?
Seizure
Stroke
Dementia
Neuropathy
Psychosis
Pericardial Effusion
What factors might exacerbate symptoms of Lupus?
Infection
Pregnancy
Surgical Stress
Drugs
What are the Anesthesia implications for Lupus Patients?
Pulm. HTN
Pneumonitis
Cricoarytenoid Arthritis
RLN Palsy
Cyclophosphamides that inhibit cholinesterase
What happens in Rheumatoid Arthritis?
Destruction of articular cartilage by lymphocytes, plasma cells, and fibroblasts
What is the treatment for Rheumatoid Arthritis?
Steroids
Methotrexate
Immunosuppressants
NSAIDs
What are some anesthetic considerations for RA patients?
Decreased Neck & Mouth Mobility
Swelling
Use Glidoscope or Fiberoptic
What is Scleroderma?
Collegen Vascular Disease - hard skin & vessels, inflammation
How does Scleroderma progress?
- Vascular Endothelium Injury
- Vascular Destruction & Protein Leaks out
- Tissue Edema & Lymphatic Obstruction
- Tissue Fibrosis
What are anesthetic considerations for patients w/ Scleroderma?
HTN
GERD
Corneal Abrasion
Pulm. HTN
Bleeding Intubation - may need fiberoptic
