immunologic diseases- 27

Question 1

immunity

Answer 1

resistance to or protection from an individual’s environment

Question 2

innate immunity

Answer 2

skin and inflammatory response

Question 3

adaptive immune system

Answer 3

internal chemical system whose purpose is to enhance specific reactivity to materials that are foreign to the body

Question 4

antigen

Answer 4

material recognized as foreign by the immune system

produced within the cytoplasm of plasma cells
classified as complete or incomplete

Question 5

epitope

Answer 5

site on the antigen to which an antibody binds to

1 antigen can have several epitopes

Question 6

complete antigens

Answer 6

both induce immune responses and react with the antibodies produced by the immune response

Question 7

incomplete antigens

Answer 7

“haptens”

can react with antibodies but cannot induce an immune response unless chemically coupled to another antigen

Question 8

immunoglobilins

Answer 8

antibodies produced by plasma cells that are released into the blood where they circulate freely as part of the gamma globulin fraction of serum proteins

5 types: IgA, IgG, IgM, IgD, IgE

Question 9

B lymphocytes

Answer 9

the lymphocytes that are capable of developing into plasma cells to produce immunoglobulins
B cells

originate from lymphoid tissue of the GI tract and bone marrow

Question 10

T lymphocyte

Answer 10

production is programmed by the thymus

T helper cells
T suppressor cells
Cytotoxic T cells
NK cells

Question 11

T helper cells

Answer 11

physically deliver info about antigens to B cells to aid in the production of antibodies

Question 12

T suppressor cells

Answer 12

suppress other T cells to down regulate the immune response and suppress B cells to prevent the production of excess antibody; they also prevent the production of antibodies to the body’s own tissues

Question 13

cytotoxic T cells

Answer 13

can directly kill other cells that process foreign or altered antigens, such as neoplastic cells or cells infected with viruses

Question 14

natural killer cells (NK)

Answer 14

class of lymphocytes
destory other cells in the absence of any known antigenic stimulation, possibly by reacting with glycoproteins on the target cells’ surface
IMMUNE SURVEILLANCE

Question 15

antigen presenting cells (APC)

Answer 15

break down antigens (process) and present to T cells by macrophages, dendritic cells or other specialized cells collectively.

the antigen is cradled on the APC surface by special MHC (major histocompatibility complex) molecules

Question 16

secondary response

Answer 16

subsequent encounters with the same antigen are associated with a more rapid production of antibodies

Question 17

memory cells

Answer 17

certain lymphocytes

long lived and programmed to proliferate rapidly after a second encounter with that antigen

Question 18

IgG

Answer 18

most abundant immunoglobin
can combine with antigens such as bacterial exotoxins to neutralize their activity or it can adhere to antigen on the surface of larger foreign materials to promote their phagocytosis by leukocytes- process called OPSONIZATION

*important for infants-immature immune system

Question 19

complement

Answer 19

group f special serum proteins that often take part in antigen-antibody reactions

Question 20

IgM

Answer 20

antibodies noted for their large size, (5x IgG)
don’t readily pass into tissues or across placenta
-develop more quickly following antigenic stimulation, and are important for controlling bacteria that enter the bloodstream and in clumping of large foreign substances such as incompatible RBCs
-may also activate complement

Question 21

IgA

Answer 21

secreted into body fluids- tears, milk, saliva, bronchi, and intestinal tract where it may interact with antigens before they can enter the body’s tissues

Question 22

IgE

Answer 22

acts very specifically

• becomes attached to basophils in the bloodstrem and mast cells in tissues
• when reacts with antigen on the surface of basophils or mast cells, the cells release vasoactive substances such as histamine.
• often associated with increased numbers of eosinophils in tissue and blood- bc antigens binding IgE release chemotaxins for eosinophils

Question 23

IgD

Answer 23

serves as an antigen receptor on the surface of mature B cells (along with IgM)

Question 24

classifications of immunologic diseases

Answer 24

1: immune deficiency diseases: too little response to foreign agents

2: allergy or hypersensitivity reactions: too much response to antigens
(hypersensitivity=autoimmune- attacks own components)

Question 25

immune deficiency diseases

Answer 25

1: inherited and acquired forms 2: deficiencies of the T cell and B cell immune systems * or both

Question 26

allergy (hypersensitivity)

Answer 26

4 types divided on the basis of mechanisms

Question 27

urticaria

Answer 27

hives | type 1 allergy

Question 28

type 1 allergy

Answer 28

Type 1: anaphylactic-atopic allergy -reactions mediated by IgE antibody and involves release of vasoactive chemicals from tissue mast cells of blood basophilic leukocytes. reaction occurs in minutes. similar to initial stage of acute inflammatory reaction ex: urticaria, hay fever, environmental exposures, anaphylactic shock

Question 29

type 2 allergy

Answer 29

Type 2: cytotoxic-type hypersensitivity -involves destruction of host cells by agglutination and phagocytosis or by lysis of the membrane as a consequence of complement fixation. commonly RBCs

Question 30

type 3 allergy

Answer 30

Type 3: immune complex or arthus-type hypersensitivity - complement-mediated reaction to precipitates of antigen and antibody - complexes lodge in vessel walls, and the activation of certain inflammation-inducing components of complement results in release of vasoactive substance from mast cells and attraction of polymorphonuclear leukocytes to the site. reaction takes several hours

Question 31

type 4 allergy

Answer 31

Type 4: delayed hypersensitivity -harmful destruction of tissue by Tcells and macrophages. slow to develop, 1-2 days ex: allergic contact dermatitis

Question 32

anaphylactic shock

Answer 32

condition in which vasoactive substances are released systemically drugs and insect stings are the most common causes

Question 33

diagnosing

Answer 33

electrophoresis of serum- measures amount of gamma globulin in the blood immunodiffusion tests- measures the 5 specific immunoglobulins direct Coombs test=cytotoxic antibodies on erythrocytes indirect Coombs test=detects serum antibodies having the potential to react with erythrocytes immunofluorescence= tests deposition of antigen-antibodies and complement in tissues immunohistochemist=tests for antigens in tissue antinuclear antibody (ANA)= detects antibodies against nuclei of tissue cells that are found in the serum of patients with autoimmune disease. rheumatic factor

Question 34

immune deficiency diseases

Answer 34

acquired immune deficiency syndrome: (AIDS)

Question 35

anaphylactic-atopic allergies (type 1)

Answer 35

caused by release of chemicals=vasoactive amines (histamine)-produce most immediate reaction As a group produce the following effects: - contraction of most nonvascular smooth muscle (bronchial constriction) - vasodilation - increased vascular permeability- leads to edema - stimulation of secretory activity of some glands allergic rhinitis (hay fever) and asthma urticaria (hives) and angioedema systemic anaphylaxis

Question 36

allergic rhinitis (hay fever) and asthma

Answer 36

can be triggered by nonallergic mechanisms asthma: wheezing - bronchoconstriction - edema - increased secretion of thick mucus hay fever: seasonal/short asthma -seasonal plan pollens

Question 37

status asthmaticus

Answer 37

prolonged and unresponsive asthmatic distress labored breathing with great respiratory effort dyspnea harassing cough cyanosis

Question 38

urticaria (hives) ad angioedema

Answer 38

slightly raised, flat, well demarcated, edematous patches with a congested border (wheal and flare) - develops rapidly after exposure to allergen and associated with pruritus - may be caused by anaphylactic reaction in the skin or ingested

Question 39

systemic anaphylaxis

Answer 39

``` medical emergency seconds to minutes after exposure to allergen -itchy scalp, tongue and throat -generalized flushing and headache -can't breath -drop in BP and body temp -shock and loss of consciousness ``` tx: epinephrin (vasoconstriction)

Question 40

gastrointestinal food allergies

Answer 40

shortly after eating specific foods - diarrhea - vomiting - cramps

Question 41

cytotoxic hypersensitivities (type 2)

Answer 41

manifested by low levels of specific types of blood cells bc antibodies may form against RBC, platelets or WBCS and produce anemia, thrombocytopenia or leukopenia direct Coombs test - erthroblastosis fetalis - blood transfusion reactions - autoimmune hemolytic anemia and thrombocytopenia

Question 42

erythroblastosis fetalis

Answer 42

hemolytic disorder of the neborn caused by immunologic incompatibility between mother and child and usually involves the Rh antigen of RBCs autosomal dominant trait 1st pregnancy will be uncomplicated but now that the mother has antibodies a subsequent pregnancy will be complicated

Question 43

blood transfusion reactions

Answer 43

incompatibility will produce immediate hemolysis of the transfused RBCs resulting in fever, chills, and possible renal failure

Question 44

autoimmune hemolytic anemia and thrombocytopenia

Answer 44

mild reaction with agglutinated cells being prematurely removed by the spleen. direct coombs test

Question 45

immune complex or arthus-type hypersensitivities (type 3)

Answer 45

produce vasculitis and edema bc of the release of vasoactive substances often associated with loos of protein and RBCs in the urine and degrees of renal failure arthus reaction serum sickness glomerulonephritis polyarteritis nodosa

Question 46

arthus reaction

Answer 46

prototype of immune complex hypersensitivity reactions and is an experimental reaction and not a naturally occurring disease. local injection of soluble antigen reaction shows evidence of cell necrosis, infiltration with neutrophils and vasculitis

Question 47

serum sicknes

Answer 47

prototype of a systemic arthus-type or immune | occured after injection of horse serum- used as a source of antibodies to toxins

Question 48

glomerulonephritis

Answer 48

mediated by immune complex reactions resulting from lodging of antigen-antibody complexes in the basement membrane of glomeruli

Question 49

polyarteritis nodosa

Answer 49

severe but rare form of immune complex reaction producing widespread, multifocal, necrotizing vasculitis usually leads to organ failure and even fatal as a result of occlusion or rupture of vessels

Question 50

delayed or cell mediated hypersensitivities (type 4)

Answer 50

manifest as subacute or chronic inflammation with infiltration of the tissue and variable degrees of necrosis contact dermatitis infections graft rejection

Question 51

contact dermatitis

Answer 51

acute or chonic delayed response to allergens placed on the skin surface ``` poison ivy drugs plants cosmetics jewelry ```

Question 52

infections

Answer 52

some microorganisms tend to stimulate cell mediated immunity bacteria, fungi, viruses

Question 53

graft rejection

Answer 53

caused both by antibodies reacting against the tissue and delayed hypersensitivity reaction

Question 54

graft vs host disease

Answer 54

lymphocytes in the graft proliferate after transplant and attack the recipient (host)

Question 55

autoimmune disease

Answer 55

sensitized lymphocytes or antibodies are developed against self-antigens systemic lupus eythematosis (SLE)

Question 56

systemic lupus erythematosus (SLE)

Answer 56

may affect number of different organ systems ``` characteristic skin lesion- butterfly rash- erythematous dermatitis that coves the bridge of the nose and extends bilaterally onto the cheeks skin is generally photosensitive joints may also be involved-arthrits weakened muscles kidneys blood-anemia ``` affects young to middle aged women variable course: -renal insufficiency, bacterial endocarditis, cardiac failure, sepsis or pneumonia, neurologic problems (seizures or stroke)