Immunity Flashcards
What are the different types of leukocytes and their functions
neutrophils - inflammatory response
eosinophils and basophils - allergic reactions and stress reactions
What are the different kinds of non-granular lymphocytes and their functions?
macrophages - phagocytosis
null lymphocytes - antibody-dependent, cell-mediated cytotoxicity
natural killer cells - secrete macrophage activating cytokines
What is the function of B-cells?
B-cells produce antibodies that are specific to a specific antigen tag them for T-cells.
What is the function of CD4 cells?
Helper T cells summon other lymphocytes during infection
What is the function of CD8 cells?
Killer T-cells bind to antigens and attack the cells.
How do antibodies provide defense against antigens?
Agglutination - clumping of antigens
Opsonization - facilitate phagocytosis
stimulates release of histamines and cytokines
What are the 5 signs of inflammation
- redness
- warmth
- swelling
- pain
- loss of function
What is autoimmunity and some examples?
Attack against self cells.
Rheumatoid arthritis, SLE
What is alloimmunity and examples?
Rejection of foreign tissue.
Graft/transplant rejection. Blood transfusion reaction.
What are some examples of natural or innate immunity, and their characteristics?
Physical barriers, chemical barriers, mechanical responses.
Characteristics: non-specific, first-line defense, rapid & generalized response
How do macrophages respond to initial infection?
Macrophages perform phagocytosis, release cytokines, and stimulate inflammation.
How does humoral immunity work?
Antibody mediated: B-lymphocytes differentiate into plasma cells that produce antibodies to protect against pathogens. Memory B-cells allow for greater and faster response in subsequent infections.
How does cell-mediated immunity work?
CD8 bind to antigen-presenting pathogens and induces apoptosis. CD4 cells secrete cytokines to attract other immune cells. Suppressor T-cells suppress immune response, while memory T-cells prepare for future infections.
What molecules are responsible for allergic reactions?
IgE antibodies trigger mast cells/basophils
Histamine S/Sx
- erythema
- localized edema
- decreased BP
- increased HR
- increased secretion of gastric/mucosal cells
- increased vascular permeability
- increased smooth muscle contraction
H1 antagonists
diphenhydramine (Benadryl), loratadine (Claritin)
H2 antagonists
Cimetidine (Tagamet), Ranitidine (Zantac)
What are the treatment steps for anaphylaxis?
- remove allergen
- provide O2 or CPR
- call RRT
- Trendelenburg position
- medications per orders
What are the medications used in case of anaphylaxis?
- epinephrine SQ 1:1000
- IV fluids
- albuterol
- diphenhydramine
- corticosteroids
What type of reaction is an anaphylactic reaction?
Type I Hypersensitivity Reaction
What type of reaction is a transfusion reaction?
Type II Cytotoxic reaction or alloimmune reaction.
What type of reaction is a transplant rejection?
Type IV Delayed hypersensitivity reaction or alloimmune reaction.
What type of reaction is Sjogren’s Syndrome?
Type II Cytotoxic reaction or autoimmune reaction
What type of reaction is Rheumatoid Arthritis?
Type III Immune complex reaction or autoimmune reaction
What type of reaction is SLE?
Type III Immune Complex reaction or autoimmune reaction
What type of reaction is a skin TB test?
Type IV Delayed Hypersensitivity reaction
What is a Type I Hypersensitivity reaction
It is an overreaction of the immune system and igE overproduction due to an antigen or allergen
What is a Type II Cytotoxic Reaction
A special reaction in which the immune system attacks self cells because antibodies attach to self-cells
What is a Type III Immune Complex Reaction?
Excessive antigen response resulting in acute or chronic inflammation
What is a Type IV Delayed Hypersensitivity reaction?
A delayed reaction after exposure to an antigen
What is the pathophysiology of rheumatoid arthritis
Inflammatory responses break down collagen in synovial tissues, resulting in edema, nerve compression, pain, and nerve cell breakdown.
What is the pathophysiology of SLE?
Immune responses recognize cellular components of self cells as foreign, causing chronic activation of B and T cells.
What is the pathophysiology of Goodpasture’s Syndrome?
immune response against glomerular basement membranes and neutrophils, commonly in lungs and kidneys
What is the pathophysiology of Sjogren’s Syndrome?
Autoimmune response to mucosa and glands, usually lacrimal, salivary, and vaginal.
Rituximab
monoclonal antibody Tx for Sjogren’s Syndrome
methotrexate
Rheumatrex
DMARD treatment for RA and SLE
immunosuppressant
medications for RA
methotrexate
prednisone
NSAIDs
cyclosporine
medications for SLE
monoclonal antibody
corticosteroids
methotrexate
NSAIDs
S/Sx SLE
skin: butterfly rash, photosensitivity, oral ulcers
cardiac: pleural effusion, HTN, dysrhythmias, CVD
hematologic: anemia
musculoskeletal: joint pain
renal: nephritis, renal failure
neurological: psychosis, cognitive impairment, seizure, neuropathy, stroke
S/Sx Rheumatoid Arthritis
symmetrical joint pain, swelling, warmth, erythema, loss of function
spongy or boggy tissue
fluid-filled joints or nodules
anemia
lymph node enlargement
Raynaud’s syndrome
neuropathy
splenomegaly
pericarditis
Sjogren’s syndrome
Diagnostic tests for immune function
CBC w/ differential
serum IgE, ANA, cDNA, anti-CCP, CRP levels
skin test
S/Sx Anaphylaxis
flushing
urticaria
angioedema
hypotension
tachycardia
bronchoconstriction
N/V
diarrhea
pain
wet eyes/stuffy nose
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Determine the isolation precautions for the following diseases.
C. diff
HiB
Pertussis
Measles
TB
Mumps
Rubella
MRSA
VRSA
Pneumonia
Varicella
Herpes
C. diff - contact
HiB - droplet
Pertussis - droplet
Measles - airborne
TB - airborne
Mumps - droplet
Rubella - droplet
MRSA - contact
VRSA - contact
Pneumonia - droplet
Varicella - airborne
Herpes - contact
What is the pathophysiology of Raynaud phenomenon?
Type III hypersensitivity response causes acute inflammation and increased clotting factors, which causes swelling, decreased blood flow, and increase blood viscosity.
What are the signs and symptoms of AIDS?
opportunistic infections
recurrent pneumonia
wasting syndrome
Kaposi’s sarcoma (purple lesions)
candidiasis
herpes simplex > 1 month
lymphoma
What are the classifications of HIV
Stage 1: CD4 = >500 cells/mm, >29%
Stage 2: CD4 = 200-499 cells/mm, 14-28%
Stage 3 (AIDS) : CD4 < 200 cell/mm, <14%
- other signs and symptoms
What are signs and symptoms of HIV
chills, rash, nausea, weight loss, fatigue, weakness, sore throat, night sweats
anemia, thrombocytopenia (<150,000), leukopenia
What are the diagnostic tests for HIV infection?
ELISA and Western blot or IFA antibody tests.
HIV RNA viral load test
What are the diagnostic tests for HIV infection?
ELISA and Western blot or IFA antibody tests.
HIV RNA viral load test
