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DNURS 832--Principles--OTHER > Immunity > Flashcards

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

What cells are phagocytes?

A

Neutrophil

Eosinophils
Monocytes
Macrophages

Dendritic cells

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14
Q

Opsonization:

A

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

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15
Q

Mononuclear Phagocyte System (MPS):

A

-Formerly called the reticuloendothelial system
-Includes phagocytes located in reticular connective tissues (including in the lymph nodes, spleen, lungs, and liver)
-Activated when the MPS encounters a pathogen
-The MPS phagocytes secrete cytokines that promote migration of neutrophils, monocytes, eosinophils, and basophils to the infection site
-Also secrete colony-stimulating factors that stimulate production and release of additional phagocytes from the bone marrow

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16
Q

PAMPs:

A

PRRs can recognize specific pathogen-associated molecular patterns (PAMPs) found exclusively on bacteria, fungi, parasites, and viruses

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17
Q

DAMPs:

A

PRRs also recognize danger-associated molecular patterns (DAMPs) on stressed host cells in response to infection, trauma, ischemia, and tissue damage
Also called alarmins

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18
Q

NEUTROPHILS:

A

Most numerous white blood cells (WBCs)***

-Sensitive to the acidic environment of infected tissues

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19
Q

What are neutrophils responsible for?

A

-Responsible for elevated WBCs that occur with infection

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20
Q

What is the half-life of neutrophils?

A

-The half-life of 6 hours

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21
Q

What do dying neutrophils turn in to?

A

-Dying neutrophils become part of the purulent exudate at the site of infection

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22
Q

Where are Langerhans cells found?

A

in epidermis

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23
Q

Where are kupffer cells found?

A

liver
alveolar cells in the lungs microglia cells in the CNS

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24
Q

Basophils:

A

Least common blood granulocyte

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25
Q

Mast Cells:

A

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

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26
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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27
Q

where are Eosinophils concentrated?

A

GI mucosa
respiratory tract
urinary tract

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28
Q

What do eosinophils primarily defend against?

A

parasites

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29
Q

what do eosinophils release to kill microbes

A

cytokines

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30
Q

what do eosinophils play a role in?

A

allergic reactions and asthma

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31
Q

Where are dendritic cells found?

A

concentrated in:
secondary lymphoid tissue –spleen
-lymph nodes
-mucosa-associated lymphoid tissues
-skin
-mucous membranes

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32
Q

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

A

Dendritic cells

33
Q

What other cells cytokines include?

A

Interleukins

Interferons (IFNs)

Tumor necrosis factor (TNF)

Chemokines

34
Q

Tumor necrosis factor (TNF)

A

TNF-α:
Primary role is regulation of proinflammatory effects, including induction of fever

35
Q

Complement system: what does it complement?

A

the innate and adaptive immune systems

36
Q

Main function of the complement system

A

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

37
Q

What are the 2 pathways of the complement system?

A

Classic pathway

Alternative pathway

38
Q

Classic pathway:

A

C1

39
Q

Alternative pathway:

A

C3
(C3a, c3b, c4a, c5a, c5b, c6-9

40
Q

is the innate or adaptive immune system response faster?

A

innate

41
Q

What does the adaptive immune system do?

A

Produces antibodies with specificity for different pathogens

42
Q

What does the adaptive immune system do?

A

Produces antibodies with specificity for different pathogens

43
Q

does the innate or adaptive have a more aggressive response?

A

adaptive

44
Q

Types of mature lymphocytes (4)

A

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

45
Q

B cells function:

A

production of antibodies

N terminal and C terminal

46
Q

Five classes of immunoglobulin (Ig):

A

IgG

IgM

IgA

IgE

IgD

47
Q

IgG

A

– gamma chains

48
Q

IgM

A

– mu chains

49
Q

IgA

A

– alpha chains

50
Q

IgE

A

– epsilon chains

51
Q

IgD

A

– delta chains

52
Q

Where do T cells originate?

A

bone marrow

mature and differentiate in the thymus before migrating to secondary lymphoid organs

53
Q

Two types of T cells produced in the thymus:

A

T helper (Th) cells
T killer or cytotoxic (Tc) cells

54
Q

Two types of T cells produced in the thymus:

A

T helper (Th) cells
T killer or cytotoxic (Tc) cells

55
Q

Natural killer cells (NK)- do they directly attack pathogens?

A

Do NOT directly attack pathogens

56
Q

Histamine is the most important mediator of:

A

Type I hypersensitivity reactions

57
Q

Immediate Hypersensitivity occurs within:

A

15-30 minutes of exposure to the antigen

58
Q

Binding of histamine to H1 receptors triggers:

A

bronchoconstriction
increased vascular permeability
vasodilation
urticaria
pruritus
increased gut permeability increased mucus production

59
Q

Binding of histamine to H2 receptors triggers:

A

increased gastric acid secretion

decreases histamine release from mast cells and basophils

60
Q

Anaphylaxis symptoms:

A

angioedema
systemic vasodilation
hypotension
extravasation of protein and fluid
bronchospasm
dysrhythmias

61
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

62
Q

Cause of intraoperative anaphylaxis: **

A
  1. Neuromuscular blockade drugs

2.Antibiotics

3.Latex

63
Q

Symptoms of anaphylaxis in the anesthetized patient:

A

Hypotension
tachycardia bronchospasm….

followed quickly by:
hypovolemia
shock
hypoxemia

64
Q

If anaphylaxis is left untreated it will result in:

A

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

65
Q

Front-line tx for intraop anaphylaxis

A

Epinephrine (*definitive treatment)

Rapid administration of IV fluids

Arginine vasopressin

Methylene blue

Glucagon

66
Q

2nd line treatment for anaphylaxis:

A

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

67
Q

examples of type 2 reactions

A

-Type I diabetes mellitus
-Myasthenia gravis
-Drug-induced hemolytic anemia
-Granulocytopenia
-Thrombocytopenia
-Transfusion reactions
-Anemia
-Goodpasture’s nephritis

68
Q

Examples of type 3:

A

systemic lupus erythematosus (SLE),

serum sickness

rheumatoid arthritis (RA)

69
Q

example of type 5:

A

Graves’ disease

70
Q

Examples of type 4

A

Contact hypersensitivity (poison ivy)

Granulomatous sensitivity (tuberculosis and leprosy)

71
Q

6 most common autoimmune diseases

A

Graves’ disease

Hashimoto thyroiditis

Multiple sclerosis (MS)

Rheumatoid arthritis (RA)

Systemic lupus

erythematosus (SLE)

Type 1 diabetes mellitus

72
Q

The CDC defines a surgical site infection as:

A

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***

73
Q

What drug causes the greatest depression of the immune system?

A

Morphine

74
Q

Regional Anesthesia:

A

Attenuates the surgical stress response and supports the preservation of normal immune function

75
Q

weaker immune modulation drugs

A

Hydromorphone
oxycodone
tramadol
hydrocodone

76
Q

strong immune modulation drugs

A

Codeine
methadone
remifentanil
fentanyl

77
Q

ASA:

A

reduces cancer metastasis

78
Q

chronic inflammation is a sign of:

A

autoimmune disease

DNURS 832--Principles--OTHER (5 decks)

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