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Immunity Flashcards

1
Q

key characteristic about immune system:

A

The ability to distinguish between self and nonself

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2
Q

What are the 2 subcategories of the immune system?

A

Innate (natural) immunity
Adaptive (acquired) immunity

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3
Q

What is innate (natural) immunity

A

-First line of defense
-Activated when a pathogen is first encountered
-Initial response: Sneezing, tearing, coughing, sweating

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4
Q

What is adaptive (acquired) immunity

A

Produces antibodies with specificity for different pathogens

Becomes prominent as it develops antigen specific antibodies in response to activation by the innate system

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5
Q

Immune response of innate and adaptive immunity:

A

Humoral response
Cell mediated response

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6
Q

Humoral response:

A

Mediated by B lymphocyte antibodies circulating in the lymph or blood

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7
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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8
Q

Innate immune system

A

-Inherited
-First line of defense

-Rapid response but lacks immunological memory

-Does not require prior pathogen exposure for activation

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

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9
Q

Major cellular components of the innate immune system

A

Granulocytes

Agranulocytes

Dendritic cells (DCs)

Cytokines

Complement system

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10
Q

What cells are granulocytes?

A

Neutrophils
Eosinophils
Basophils

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11
Q

what cells are Agranulocytes?

A

Monocytes
Macrophages

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12
Q

What is phagocytosis?

A

The process of ingesting pathogens (bacteria, viruses, fungi, parasites, tumor cells, and apoptotic cells)
Exposes the pathogen to intracellular chemical pathways that destroy it

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13
Q

Opsonization:

A

Antibodies and complements (opsonins) bind to the pathogen and mark it for destruction by the phagocytes

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14
Q

NEUTROPHILS:

A

Most numerous white blood cells (WBCs)***

-Sensitive to the acidic environment of infected tissues

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15
Q

What are neutrophils responsible for?

A

-Responsible for elevated WBCs that occur with infection

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16
Q

What is the half-life of neutrophils?

A

-The half-life of 6 hours

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17
Q

What do dying neutrophils turn in to?

A

purulent exudate at the site of infection

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18
Q

Where are Langerhans cells found?

A

in epidermis

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19
Q

Where are kupffer cells found?

A

liver
alveolar cells in the lungs
microglia cells in the CNS

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20
Q

Basophils:

A

Least common blood granulocyte

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21
Q

Mast Cells:

A

Reside in peripheral tissues, especially connective tissue close to blood vessels

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22
Q

What do basophils and mast cells do?

A

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

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

Respond directly to bacterial pathogens

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23
Q

where are Eosinophils concentrated?

A

GI mucosa
respiratory tract
urinary tract

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24
Q

what do eosinophils play a role in?

A

allergic reactions and asthma

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25
Where are dendritic cells found?
concentrated in: -spleen -lymph nodes -mucosa-associated lymphoid tissues -skin -mucous membranes
26
What are the Most potent antigen-presenting cells (APCs)
Dendritic cells
27
What other cells do cytokines include?
Interleukins Interferons (IFNs) Tumor necrosis factor (TNF) Chemokines
28
Tumor necrosis factor (TNF)
TNF-α: Primary role is regulation of proinflammatory effects, including induction of fever
29
Complement system: what does it complement?
the innate and adaptive immune systems
30
Main function of the complement system
Main function: Mark pathogens for permanent destruction and recruit other immune cells to destroy the pathogens
31
What are the 2 pathways of the complement system?
Classic pathway Alternative pathway
32
Classic pathway:
C1
33
Alternative pathway:
C3 (C3a, c3b, c4a, c5a, c5b, c6-9
34
is the innate or adaptive immune system response faster?
innate
35
What does the adaptive immune system do?
Produces antibodies with specificity for different pathogens
36
What does the adaptive immune system do?
Produces antibodies with specificity for different pathogens
37
does the innate or adaptive have a more aggressive response?
adaptive
38
Types of mature lymphocytes (4)
B lymphocytes (B cells) T lymphocytes (T cells) Natural killer cells (NK) Natural killer T cells (NKT)
39
B cells function:
production of antibodies N terminal and C terminal
40
Five classes of immunoglobulin (Ig):
IgG IgM IgA IgE IgD
41
Where do T cells originate?
bone marrow mature and differentiate in the thymus before migrating to secondary lymphoid organs
42
Two types of T cells produced in the thymus:
T helper (Th) cells T killer or cytotoxic (Tc) cells
43
Natural killer cells (NK)- do they directly attack pathogens?
Do NOT directly attack pathogens
44
Histamine is the most important mediator of:
Type I hypersensitivity reactions
45
Immediate Hypersensitivity occurs within:
15-30 minutes of exposure to the antigen
46
Binding of histamine to H1 receptors triggers:
bronchoconstriction increased vascular permeability vasodilation urticaria pruritus increased gut permeability increased mucus production
47
Binding of histamine to H2 receptors triggers:
increased gastric acid secretion decreases histamine release from mast cells and basophils
48
Anaphylaxis symptoms:
angioedema systemic vasodilation hypotension extravasation of protein and fluid bronchospasm dysrhythmias
49
Treatment of Type I Hypersensitivity reaction:
-Antihistamines – to prevent systemic effects of histamine -Cromolyn sodium – to prevent mast cell degranulation -Bronchodilators – to treat bronchospasm
50
Cause of intraoperative anaphylaxis: ****
1. Neuromuscular blockade drugs 2.Antibiotics 3.Latex
51
Symptoms of anaphylaxis in the anesthetized patient:
Hypotension tachycardia bronchospasm…. followed quickly by: hypovolemia shock hypoxemia
52
If anaphylaxis is left untreated it will result in:
rapid progression to pulseless electrical activity (PEA) and cardiac arrest
53
Front-line tx for intraop anaphylaxis
Epinephrine (*definitive treatment) Rapid administration of IV fluids Arginine vasopressin Methylene blue Glucagon
54
2nd line treatment for anaphylaxis:
Antihistamines H₁ antagonists H₂ antagonists Bronchodilators β₂ agonists Albuterol Terbutaline Ipatropium bromide (Atrovent) Corticosteroids – for airway edema
55
examples of type 2 reactions
-Type I diabetes mellitus -Myasthenia gravis -Drug-induced hemolytic anemia -Granulocytopenia -Thrombocytopenia -Transfusion reactions -Anemia -Goodpasture’s nephritis
56
Examples of type 3:
systemic lupus erythematosus (SLE), serum sickness rheumatoid arthritis (RA)
57
example of type 5:
Graves’ disease
58
Examples of type 4
Contact hypersensitivity (poison ivy) Granulomatous sensitivity (tuberculosis and leprosy)
59
6 most common autoimmune diseases
Graves’ disease Hashimoto thyroiditis Multiple sclerosis (MS) Rheumatoid arthritis (RA) Systemic lupus erythematosus (SLE) Type 1 diabetes mellitus
60
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***
61
What drug causes the greatest depression of the immune system?
Morphine
62
Regional Anesthesia:
Attenuates the surgical stress response and supports the preservation of normal immune function
63
weaker immune modulation drugs
Hydromorphone oxycodone tramadol hydrocodone
64
strong immune modulation drugs
Codeine methadone remifentanil fentanyl
65
ASA:
reduces cancer metastasis
66
chronic inflammation is a sign of:
autoimmune disease
67
What do eosinophils play a role in?
allergic reactions and asthma
68
Persistent presence at sites of chronic infection
Monocytes and Macrophages:
69
Live attenuated vaccines
MMR VARICELLA INFLUENZA ROTAVIRUS ZOSTER YELLOW FEVER
70
Laparoscopic surgery is associated with:
decreased immune suppression and attenuates the cytokine cascade
71
Blood transfusion is associated with
-immune system depression -increased incidence of surgical site infection -earlier recurrence of cancer -Higher allograft survival rates -An increased risk of postoperative infections -Increased risk of tumor recurrence after excision -Activation of latent viral infections -Improvement in autoimmune disease
72
A patient experiences an anaphylactic reaction to an antibiotic while under anesthesia. The patient remains hypotensive despite epinephrine and hydration. The next appropriate step would be to administer A. phenylephrine B. albumin 5% C. ephedrine D. arginine vasopressin
D. arginine vasopressin
73
Which demographic is most likely to experience a type I hypersensitivity reaction under anesthesia? A. Adult female B. Adult male C. Adolescent female D. Adolescent male
A. Adult female
74
The humoral immune response is directed by A. phagocytes B. B lymphocytes C. T lymphocytes D. cytokines
C. T lymphocytes
75
What is the definitive treatment for anaphylaxis? A. Diphenhydramine B. Albuterol C. Epinephrine D. Lidocaine
C. Epinephrine
76
Seventy percent of anesthesia-related allergic reactions are A. IgA-mediated type I reactions B. IgE-mediated type I reactions C. IgM-mediated delayed-onset reactions D. IgG-mediated globulin reactions
B. IgE-mediated type I reactions

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