Immunity

Question 1

What does infection or colonization mean ?

Answer 1

It refers to microorganisms multiplying in or on the host.

• bacteria are staking their claim and growing their settlement

Question 2

What is the microbiome?

Answer 2

This refers to all the microorganisms that live within the body. Its like the whole ecosystem of microbes living within the environment of the body.

Question 3

What benefits do bacteria of the microbiome offer?

Answer 3

They protect against pathogens by inhibiting pathogen attachment to the epithelium, competing with pathogens for food supply and have unique antibacterial properties that can limit/inhibit pathogenic colonization.
Normal flora also strengthens the body’s adaptive immune system.

Question 4

What do normal flora of the body produce?`

Answer 4

Enzymes to help with digestion, usable metabolites like vitamin K and B and antibacterial factors to prevent colonization

Question 5

Are there more microbial genes or human genes within our body.

Answer 5

There are more microbial genes- a hundred times more in fact than our own human genes.

The microbial genes react and engage and turn on/off based on what we do , while our genes turn on/off in response to what our microbes do

Question 6

Is our microbiome constant in terms of the kinds of amount of microbes that harbor and colonize?

Answer 6

No, microbiomes are always changing.
They can change in response to our diet, medications, health status, with puberty or pregnancy.
And in our early days, whether we were delivered vaginally or through Cesarean section, or whether we were breast fed or formula fed- these all make a difference in the forms and amount of bacteria that colonize.

Question 7

What effect can a prolonged use of antibiotics have on the normal flora ?

How long can this take to restore?

Answer 7

It can kill the beneficial bacteria within our biome.

It could take up to a year to restore the colonies of normal flora.

Question 8

What are interventions that can restore a depleted or weakened microbiome?

Answer 8

Probiotics encourage microbe growth

Fecal microbial transplant can introduce someone’s healthy microbe infested fecal matter into the intestine of someone’s depleted biome.

Question 9

What is the difference between innate and adaptive immunity?

Answer 9

Innate immunity (also called natural or native) are natural defenses of the body that we are born with and are always present- they do not distinguish between microbes- this includes skin, mucous membranes, stomach acidity, cilia lining the respiratory tract, sweat, coughing, vomiting.

Adaptive immunity are defenses that we develop as a result of exposure to a pathogen- this includes antibodies, memory cells and other processes that enable us immune to a certain pathogen.

Question 10

Is natural immunity specific or nonspecific?

/

Answer 10

Nonspecific. There is no targeted, specific response towards the antigen

Question 11

Is adaptive immunity specific or nonspecific?

Answer 11

Specific - there is a targeted response to the antigen (foreign agent)

Question 12

What is the first immune response to an injury?

Answer 12

The inflammatory response, which involves 2 stages: the vascular stage and the cellular stage

Question 13

What are some manifestations of the inflammatory response in a patient?

Answer 13

Redness, swelling, heat, pain and loss of function

Question 14

Vascular stage of inflammatory response involves ?

Answer 14

The vasodilation of arterioles supplying the area- this causes an increase in blood flow. Histamine is also released which increases the permeability of the vessels, allowing protein rich fluid to pour into the area of injury.

Question 15

Cellular stage of inflammatory response involves

Answer 15

Leukocytes, such as neutrophils, being delivered to the site of injury and engulfing and disposing of the microbe/foreign agent. Exudate composed of fluid, cells, and inflammatory byproducts is released from the wound. The injured area begins to regenerate and heal.

Question 16

What are the two types of adaptive immunity?

Answer 16

Cell mediated

Humoral

Question 17

Humoral adaptive immunity involves ………..

Answer 17

antibodies responding to antigens

Question 18

Cell Mediated Immunity refers to…………….

Answer 18

Immune responses in which targets are attacked directly by immune system cells- specifically Cytolytic T cells and Macrophages

Question 19

Name different types of immune system cells

Answer 19

B Cells, cytolytic T cells, helper T cells, macrophages and dendritic cells

Neutrophils and basophils and eosinophils

Question 20

B lymphocytes produce what ?

Answer 20

antibodies

Question 21

Cytolytic T cells do what ?

What are other names for these cells ?

Answer 21

Attack and kill target cells directly

Other names include cytotoxic T cells and CD8 cells

Question 22

Discuss the functions of helper T cells ?

Answer 22

Helper T Cells aid in the production of antibodies by B cells, help activate cytolytic T cells, and release factors that promote type IV sensitivity reactions (DTH delayed type hypersensitivity reactions)
These are the cells that HIV targets

Question 23

Macrophages

Answer 23

Principal role of phagocytosis. In adaptive immunity (specific acquired), they are required for the activation of helper T cells and cytolytic T cells and so macrophages are referred to as antigen presenting cells (APCs); they also phagocytize cells tagged with antibodies and are the final mediators of DTH (Delayed Type hypersensitivity reaction)

They have important roles in innate immunity, adaptive immunity and inflammation.

Question 24

Macrophages are the __________________ of the body. They are present in all _______________

Answer 24

Principal scavengers…..organs and tissues

Question 25

Dendritic Cells;

Answer 25

Antigen presenting cells

Question 26

Neutrophils

Answer 26

They phagoycytize bacteria and other foreign particles. They devour cells marked with the immunoglobulin G (IgG class). They are major contributors to inflammation and important effectors in humoral immunity.

Question 27

Mast Cells and Basophils

Answer 27

Mediate hypersensitivity reactions - they release histamine, heparin and other compounds that cause the symptoms of immediate hypersensitivity.

Question 28

Eosinophils

Answer 28

Attack and destroy foreign particles that have been coated with antibodies of the immunoglobulin E (IgE) class.

Question 29

Antibodies are also called

Answer 29

immunoglobulins and gamma globulins

Question 30

Antibodies greatest ability is …………

Answer 30

Recognizing and binding to specific antigens

Question 31

What are the five classes of antibodies ?

Answer 31

IgG, IgM, IgE, IgD, IgA

Question 32

Difference between active and passive immunity

Answer 32

Active immunity develops within the body as a result of exposure to antigens from an infection or from administration of a vaccine or toxoid. There is a production of antibodies; while this takes weeks and months to develop the effects are long lasting.

Passive immunity occurs when preformed antibodies are transferred into a person’s body, such as through breast milk. While the effect is immediate, the protection exists only as long as the antibodies remain in the body.

Question 33

What types of antibody would be elevated when in the first stages of an acute illness?

Answer 33

IgM are the first responders. Their serum levels would be elevated during the acute phase and then fall

Question 34

IgG antibody would have elevated levels when?

Answer 34

During the acute phase and even after the acute phase levels would be elevated

Question 35

Antibodies are produced upon ………….

Answer 35

exposure to an antigen

Question 36

What is an antigen?

Answer 36

A molecule that induces specific immune responses and as a result becomes the target of those response.

Question 37

What are cytokines ?

Answer 37

These are small proteins that aid cell signaling.

Question 38

Difference between active and passive immunity.

Answer 38

Active immunity- your immune system creates it own immune response. Example- contracting disease or being injected with vaccine

Passive Immunity- your immune system does not create the immune response. Example- receiving antibodies through injection or breast milk

Question 39

Difference between primary and secondary immune response…

Answer 39

Primary immune response involves the production of antibodies. It involves encountering a disease/pathogen for the first time. Plasma antibody levels respond within 1-3 weeks
Secondary immune response is much faster response and involves B memory cells that respond to a “remembered pathogen”. The plasma antibody levels respond within days

Question 40

What do booster shots do?

Answer 40

Booster shots cause a secondary immune response that raises the plasma antibody levels to prepare for an encounter with the disease.

Question 41

Antibiotics kill bacteria by targeting

Answer 41

cell wall synthesis
protein synthesis
nucleic acid synthesis
bacterial metabolism

Question 42

What is selective toxicity?

Answer 42

It is a measure of the antibiotic ability to injure target cell/microbe without injuring others. This is an important consideration to be made?

Question 43

What is crucial in effective antibiotic therapy?

Answer 43

The identification of the organism along with the susceptibility of that microbe to the antibiotic

Question 44

Amoxicillin - describe it

Answer 44

It is a beta lactam antibiotic, a penicillin. Effective against a wide range of gram positive staph, strep and pneumococcal microbes, including syphillis and Lyme disease
It works by altering the synthesis of the cell wall

Side Effects include Gi upset and diarrhea
Serious SE: Allergy with anyphalytic reactions (fever, rash, wheezing)

Question 45

What are major mechanisms of resistance that a microbe can use to resist antibiotics ?

Answer 45

They can synthesize drug metabolizing enzymes, have structural changes in one of its target sites, synthesize compounds that alters/defeats antibiotic action

Question 46

What is acquired resistance?

Answer 46

Microbes that become resistant or have decreased susceptibility to an antibiotic

Question 47

Antibiotics select for those microbes that are ……………..

Answer 47

most resistant to it. This means that those which are not susceptible to the antibiotic can colonize further and replicate.

Question 48

Truvada

Answer 48

Functional Class: Antiretroviral, nucleoside reverse transcriptase inhibitor (NRTI)
Indications: Used as part of antiretroviral therapy (ART )in HIV infection, and for prophylaxis if HIV negative (PEP and PrEP)
MOA: inhibits the activity of the HIV-1 reverse transcriptase (RT) by competing with a natural substrate and by being incorporated into nascent viral DNA which results in chain termination.
SE: Nausea, vomiting, diarrhea, headache, dizziness, trouble sleeping, back pain, or change in the color of skin on your palms or soles of the feet may occur. Fat redistribution.
Serious: Guillain-Barre Syndrome
Nursing considerations: Patients already infected with HIV should only take Truvada with other HIV meds. Patient support necessary for successful ongoing drug therapy.