Immunity Flashcards

1
Q

What are the two subcategories of the immune system?

A

Innate (natural) immunity:
First line of defense
Activated when a pathogen is first encountered
Initial response: Sneezing, tearing, coughing, sweating

Adaptive (acquired) immunity:
Becomes prominent as it develops antigen-specific antibodies in response to activation by the innate system

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2
Q

What is the key characteristic of the immune system?

A

The ability to distinguish between self and nonself

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3
Q

What is the Humoral response mediated by?

A

B lymphocyte antibodies circulating in the lymph or blood

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4
Q

Cell Mediated Response

A

Produced by phagocytes, T lymphocytes, and cytokines
Directed primarily at microbes that survive in host cells
Plays a major role in transplanted organ rejection

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5
Q

Does the innate immune response require prior pathogen exposure for activation?

A

nope!

Response is always the same regardless of prior exposure to the same pathogen

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6
Q

What is the most numerous of all the white blood cells?

A

Neutrophils

Responsible for elevated WBCs that occur with infection

Half-life 6 hours

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7
Q

Basophil and Mast Cells:

A

Express cell surface high affinity receptors for immunoglobulin E (IgE)

Key initiators of immediate hypersensitivity reactions through the release of histamine, leukotrienes, cytokines, and prostaglandins

Stimulate smooth muscle contraction

Play a major role in atopic allergies (hay fever, asthma, eczema)

Respond directly to bacterial pathogens

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8
Q

What acts as messengers in the immune system and modulate the response to pathogenic microbes, tumor cells, and apoptotic cells?

A

cytokines

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9
Q

What are the most potent antigen-presenting cells (APCs)

A

Dendritic Cells (DCs)

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10
Q

What “Complements” the innate and adaptive immune systems?

A

Compliment system

Main function: Mark pathogens for permanent destruction and recruit other immune cells to destroy the pathogens

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11
Q

Key points about the adaptive immune system

A

Produces antibodies with specificity for different pathogens

Slower response than the innate system but develops immunological memory that allows for a more aggressive response with repeated exposure to a pathogen

Adaptive immune system cells develop from hematopoietic stem cells that differentiate into a common lymphoid progenitor

The common lymphoid progenitor further differentiates into four types of mature lymphocytes:

B lymphocytes (B cells)
T lymphocytes (T cells)
Natural killer cells (NK)
Natural killer T cells (NKT)

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12
Q

What cells produce antibodies?

A

B Cells

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13
Q

What cells originate in bone marrow, mature and differentiate in the thymus before migrating to secondary lymphoid organs?

A

T Cells

Some T cells become memory T cells – quicker response with repeat exposure to an antigen

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14
Q

Do Natural Killer Cells (NK) directly attack pathogens?

A

nope!

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15
Q

What is active immunity?

A

Active immunity is achieved when a pathogen is administered for the purpose of stimulating the immune system to produce antibodies specific for the antigen
With repeat exposure to the antigen, the adaptive immune system provides a quicker and more efficient response

Vaccines:

Live, attenuated vaccines:
Long lasting protection immunity, but concerns regarding mutation and reversion to the live pathogen that will cause disease

Inactivated bacterial toxins: Used for bacterial diseases that are caused by a toxin produced by the bacterium (not the bacterium itself)
Example: tetanus vaccine
Shorter length of protection than live vaccines and require boosters for long term immunity

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16
Q

What is passive immunity?

A

Passive Immunity:
Occurs when an individual receives another person’s antibodies to help prevent or fight infectious diseases
Protection is immediate but short-lived (lasting only a few weeks or months)

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17
Q

Vaccine type

18
Q

What are Monoclonal Antibodies (MABs)?

A

Lab engineered molecules that mimic natural antibodies

Attach to abnormal cells and mark them for identification and destruction by the immune system (immunotherapy)

Surrounding healthy cells are not affected by MABs

19
Q

What is the most important mediator of Type I hypersensitivity reactions?

20
Q

Treatment of Type I Hypersensitivity reaction?

A

Antihistamines – to prevent systemic effects of histamine

Cromolyn sodium – to prevent mast cell degranulation

Bronchodilators – to treat bronchospasm

21
Q

What are the causes of Cause of intraoperative anaphylaxis?

A
  1. Neuromuscular blockade drugs
  2. Antibiotics
  3. Latex
22
Q

What are the symptoms of anaphylaxis in the anesthetized patient?

A

Hypotension, tachycardia and bronchospasm…. followed quickly by hypovolemia, shock, and hypoxemia

Left untreated, rapid progression to pulseless electrical activity (PEA) and cardiac arrest

23
Q

How do you treat intraoperative anaphylaxis?

A

Front-line Treatments:
Epinephrine (*definitive treatment)

Rapid administration of IV fluids
Necessary to counteract the loss of intravascular volume into the extravascular space

Arginine vasopressin
Indicated for hypotension unresponsive to epinephrine

Methylene blue
A selective inhibitor of guanylate cyclase, prevents nitric oxide (NO) mediated vascular smooth muscle relaxation

Glucagon
Directly activates adenyl cyclase and is indicated for continuing hypotension and bronchospasm in patients on β blockers

24
Q

What are the second line treatments for anaphylaxis?

A

Antihistamines
H₁ antagonists
H₂ antagonists
Bronchodilators
β₂ agonists
Albuterol
Terbutaline
Ipatropium bromide (Atrovent)
Corticosteroids – for airway edema

25
What is Type II Hypersensitivity?
Cytotoxic Hypersensitivity Type I diabetes mellitus Myasthenia gravis Drug-induced hemolytic anemia Granulocytopenia Thrombocytopenia Transfusion reactions Anemia Goodpasture’s nephritis
26
What are type III reactions?
Immune Complex Hypersensitivity Examples: systemic lupus erythematosus (SLE), serum sickness, and rheumatoid arthritis (RA)
27
Type V Hypersensitivity
graves
28
What is Alloimmunity/Isoimmunity?
transplact, transfusion reactions, neonatal allimmune thrombocytopenia
29
What is the is the classic sign of autoimmune disease?
Chronic inflammation
30
What are the six most common autoimmune diseases?
Graves’ disease Hashimoto thyroiditis Multiple sclerosis (MS) Rheumatoid arthritis (RA) Systemic lupus erythematosus (SLE) Type 1 diabetes mellitus
31
What is the most common cause of hyperthyroidism?
Graves’ Disease Thyroid enlargement (goiter) Weight Loss Exopthalmus
32
What is the most common thyroid disorder in the United States?
Hashimoto Thyroiditis
33
What is the most prevalent demyelinating disorder of the CNS?
Multiple Sclerosis Females effected 2X more than males
34
An inflammatory autoimmune disease characterized by synovial inflammation and hyperplasia, cartilage and bone destruction, and systemic features, including cardiovascular, pulmonary, *****psychological, and skeletal disorders
Rheumatoid Arthritis
35
What is the most common primary immunodeficiency disorder?
Selective IgA Deficiency
36
The CDC defines a surgical site infection as:
one that occurs at or near the surgical incision within 30 days of the procedure or within 1 year of the implantation of a prosthetic device
37
What is the most vulnerable time for metastasis of tumor cells?
The postoperative period This can be attributed to the surgical suppression of cell-mediated immunity
38
True/false: Blood transfusion is: associated with immune system depression, increased incidence of surgical site infection, and earlier recurrence of cancer
True
39
Perioperative Hypothermia facts
Defined as a core body temperature below 36° C Suppresses innate and adaptive immunity Associated with: Increased incidence of surgical site infections Increased blood loss Impaired wound healing Decreased immune function
40
What opioid is associated with the greatest depression of the immune system?
Morphine
41
Least common WBC?
Basophils