Immunology Flashcards

1
Q

The majority of fluid distributed in the body is where?

A

Intracellularly

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2
Q

Where is plasma contained?

A

Cardiovascular system

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3
Q

What is the most common plasma protein?

A

Albumins

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4
Q

Where are the plasma proteins synthesized?

A

In the Liver

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5
Q

Binding to plasma proteins helps what with hormones?

A

prevents inappropriate metabolism and/or excretion

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6
Q

Plasma albumin binds mainly to?

A

acidic drugs

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7
Q

The general functions of plasma include what?

A

transport of nutrients for energy, growth and repair, removal of wastes; transport of hormones and regulation of body temperature

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8
Q

Plasma is what percentage of blood volume?

A

55%

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9
Q

Plasma is ___ percent water

A

91%

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10
Q

What is the lifespan of Erythrocytes?

A

100-120 days

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11
Q

what is the duration of development of Erythrocytes?

A

5-7 days

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12
Q

How many Erythrocytes are in a microliter of blood?

A

4-6 million

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13
Q

what is the function of Erythrocytes?

A

Transport oxygen and carbon dioxide

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14
Q

How many Neutrophils are in a microliter of blood?

A

3000-7000

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15
Q

How many Eosinophils are in one microliter of blood?

A

100-400

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16
Q

How many Basophils are in one microliter of blood?

A

20-50

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17
Q

How many lymphocytes are in one microliter of blood?

A

1500-3000

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18
Q

How many monocytes are in one microliter of blood?

A

100-700

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19
Q

How many platelets are in one microliter of blood?

A

150,000-500,000

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20
Q

What is the Duration of development for Neutrophils?

A

6-9 days

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21
Q

What is the duration of development for Eosinophils?

A

6-9 days

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22
Q

What is the duration of development for Basophils?

A

3-7 days

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23
Q

What is the duration of development for Lymphocytes?

A

days to weeks

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24
Q

what is the duration of development for monocytes?

A

2-3 days

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25
Q

what is the duration of development for platelets?

A

4-5 days

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26
Q

what is the life span of neutrophils?

A

6 hours to a few days

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27
Q

How many Leukocytes are in one microliter of blood?

A

4800-11,000

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28
Q

What is the lifespan of eosinophils?

A

8-12 days

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29
Q

what is the lifespan of Basophils?

A

a few hours to a few days

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30
Q

what is the lifespan of lymphocytes?

A

hours to years

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31
Q

what is the lifespan of platelets?

A

5-10 days

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32
Q

what is the function of neutrophils?

A

destroy bacteria by phagocytosis

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33
Q

what is the function of Eosinophils?

A

turn off allergic responses and kill parasites

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34
Q

what is the function of Basophils?

A

Release histamine and other mediators of inflammation

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35
Q

what is the function of lymphocytes?

A

mount immune response by direct cell attack (T-cells) or via antibodies (B-cells)

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36
Q

what is the function of monocytes?

A

Phagocytosis; develop into macrophages in tissues

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37
Q

what is the function of platelets?

A

Seal small tears in blood vessels; instrumental in blood clotting

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38
Q

Hemoglobin (Hb) is a _____ protein

A

heterotetrameric

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39
Q

Do mature RBC’s have a nucleus?

A

no, they cannot divide

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40
Q

Do mature RBC’s have any mitochondria or endoplasmic reticulums?

A

No, they only produce energy through glycolysis

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41
Q

what state is the iron in when used by hemoglobin?

A

Ferrous (Fe 2+)

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42
Q

Where are RBC’s produced after twenty years of age?

A

membranous bones such as the vertebrae, sternum, and ribs.

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43
Q

In the embryo primitive nucleated RBC’s are produced in the ___ ___

A

yolk sac

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44
Q

By the middle of the last trimester production of RBC’s has moved exclusively to the ___ ____ in the ____ and ____

A

bone marrow in the femur and tibia

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45
Q

All blood cells originate from ____ _____ stem cells

A

pluripotential hematopoietic

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46
Q

By the _____ stage the ____ and ____ have either been absorbed or ejected from the immature RBC.

A

reticulocyte stage; nucleus and ER

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47
Q

Reticulocytes leave the bone marrow and enter the circulation to complete the maturation process which lasts how long?

A

one to two days

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48
Q

Lack of oxygen stimulates what?

A

Erythropoietin which causes an increase in production of RBC’s but only can be worked with a little because it thickens the blood

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49
Q

What is hypoxia?

A

lack of oxygen delivery to tissues

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50
Q

What produces Erythropoietin?

A

The kidneys

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51
Q

What is anemia?

A

a decrease in the ability of the blood to carry oxygen

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52
Q

what vitamins are important for RBC’s?

A

Iron, B12 and folate

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53
Q

How is hemoglobin formed?

A

Succinyl-CoA combines with glycine to form pyrrole and four of these compose to make protoporphyrin IX which binds to ferrous to make heme. Lastly heme is joined to the polypeptide globin.

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54
Q

fetal Hb has a ____ ____ to oxygen than the mother

A

higher affinity

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55
Q

The iron in each heme group binds how many oxygen molecules?

A

one

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56
Q

Each hemoglobin molecule can bind to how many oxygen molecules

A

four (100% saturated)

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57
Q

Where does the body transfer the iron from?

A

GI tract

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58
Q

Where do RBC’s self-destruct in the body?

A

in the spleen as they squeeze through the “red pulp” reticular mesh

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59
Q

Pernicious anemia results from

A

lack of absorption of B12

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60
Q

Sprue results from

A

lack of absorption of Folic acid

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61
Q

Sickle cell anemia is due to what?

A

a single amino acid change in a specific position in the globin polypeptide chain of Hb

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62
Q

What is Erythroblastosis fetalis?

A

when a Rh- mother has a child with Rh + and the mother’s immune system produces antibodies to attack the baby (will have severe anemia)

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63
Q

What is polycythemia vera?

A

when too many RBC’s are produced: causes the blood to be difficult to pump

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64
Q

what is hemostasis?

A

the prevention of blood loss when a vessel is severed or ruptured.

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65
Q

To limit blood loss what does a vessel do?

A

vascular constriction, formation of a platelet plug, formation of a blood clot, clot retraction, and finally removal of the clot, (dissolved), after repair.

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66
Q

What is the synthesis of TXA2?

A

PLA2 to Arachidonic acid to COX then to TXA2

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67
Q

what is the most important factor to cause vasoconstriction?

A

Thromboxane A2 (TXA2)

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68
Q

When activated platelets become ____

A

sticky

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69
Q

platelets are formed from

A

megakaryocytes in the bone marrow or blood from cell fragmentation

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70
Q

Platelets contain remnants of the ____ and ____ ____ in order to produce enzymes and store calcium.

A

ER and Golgi apparatus

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71
Q

fibroblasts are necessary for the platelets to do what?

A

multiply and grow

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72
Q

fibrin-stabilizing factor is necessary for platelets to do what?

A

repair

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73
Q

what prevents platelets from adhering to the undamaged vessel walls?

A

glycoproteins

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74
Q

platelets contain high concentrations of ____ that are involved in blood clotting.

A

phospholipids

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75
Q

platelets are removed by what?

A

macrophages in the spleen

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76
Q

What strengthens the clot?

A

fibrin fibers

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77
Q

A blood clot starts to form after ______ if trauma is significant and after ____ if minor

A

15-20 seconds if significant and 1-2 minutes if minor

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78
Q

after ____ most reasonable holes are plugged

A

3-6 minutes

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79
Q

after _____ the clot retracts due to platelets and closes the hole even tighter.

A

20-60 minutes

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80
Q

Once a clot has formed it can do what two things?

A

be invaded by fibroblasts or be dissolved

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81
Q

If invaded by fibroblasts the repair is usually _____ after 1-2 weeks

A

complete

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82
Q

Synonym for fibrinogen

A

factor I

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83
Q

synonym for prothrombin

A

factor II

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84
Q

synonym for tissue factor

A

factor III

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85
Q

synonym for calcium

A

factor IV

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86
Q

synonym for factor V

A

Proaccelerin

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87
Q

synonym for factor VII

A

serum prothrombin conversion accelerator (spca)

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88
Q

synonym for factor VIII

A

antihemophilic factor (AHF)

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89
Q

synonym for factor IX

A

plasma thromboplastin component (PTC)

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90
Q

synonym for factor X

A

stuart factor

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91
Q

synonym for factor XI

A

plasma thromboplastin antecedent (PTA)

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92
Q

synonym for factor XII

A

Hageman factor

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93
Q

synonym for factor XIII

A

fibrin stabilizing factor

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94
Q

synonym for prekallikrein

A

fletcher factor

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95
Q

synonym for high-molecular-weight kininogen

A

fitzgerald factor

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96
Q

What is the rate of turnover of RBC’s?

A

10 to the 11th power

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97
Q

What kind of fats make vessels rougher?

A

saturated fats

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98
Q

what two factors are inhibited by activated protein C?

A

factor V and factor VIII

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99
Q

what is the most important in preventing inappropriate clotting?

A

endothelial surface factors

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100
Q

What inactivates or removes thrombin?

A

fibrin fibers and alpha-globulin a.k.a antithrombin III

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101
Q

What factors does heparin block?

A

Factors 2, 9, 10, 11, 12

102
Q

Heparin combines with what to block clotting factors?

A

antithrombin III; this increases its activity a lot

103
Q

What inactivates heparin?

A

heparinase (about 1.5-4 hours)

104
Q

Warfarin decreases plasma levels of ____ and factors (3 different ones), by competing with ____?

A

decreases levels of prothrombin II and factors 7, 9, and 10 by competing with vitamin K

105
Q

What is special about Rivaroxaban being specifically a factor Xa inhibitor?

A

I acts further “upstream” of the clotting factor cascade thus having a wider therapeutic window and less monitoring needed.

106
Q

What three conditions are notorious for causing excessive bleeding?

A

vitamin K deficiency, hemophila, and thrombocytopenia

107
Q

Vitamin K is necessary for the synthesis of what four important clotting factors?

A

Prothrombin II and factors 7, 9, and 10 also to note is that protein C is affected (anti-coagulant)

108
Q

vitamin K is normally synthesized by ____ ____

A

gut flora

109
Q

Hemophilia primarily effects males because…

A

it is a genetic disease that is sex-linked

110
Q

Thrombocytopenia can be noticed by what?

A

purpura; which is purplish blotches on the skin from loss of clot retraction by platelets

111
Q

what two things kill virtually all pathogens entering the GI tract?

A

HCl secretion and the protease pepsin

112
Q

What does mother’s milk contain that is antimicrobial to help protect the baby?

A

the enzyme lactoperoxidase

113
Q

Defecation and vomiting caused by some microbial toxins acting on the smooth muscle of the GI tract work via _____ areas to expel toxins

A

chemosensitive

114
Q

Where are Leukocytes produced?

A

bone marrow

115
Q

What is the function of Neutrophils?

A

Phagocytosis, releases chemicals involved in inflammation

116
Q

what is the function of Basophils?

A

release histamine and other chemicals involved in inflammation

117
Q

what is the function of Eosinophils?

A

Destroy multicellular parasites, participate in immediate hypersensitivity reactions

118
Q

what is the function of monocytes?

A

carry out functions in blood similar to those of macrophages in tissues, enter tissues and transform into macrophages

119
Q

what is the function of macrophages?

A

phagocytosis, extracellular killing via secretion of toxic chemicals, process and present antigens to helper T cells, secretion of cytokines involved in inflammation, activation and differentiation of helper T cells, and systemic responses to infection or injury

120
Q

Where is IL-1, tumor necrosis factor, and IL-6 located?

A

Antigen-presenting cells (e.g. macrophages)

121
Q

What is the target cell of IL-1, tumor necrosis factor, and IL-6?

A

Helper T cells; certain brain cells; numerous systemic cells

122
Q

what is the major function of IL-1, tumor necrosis factor, and IL-6?

A

stimulate IL-2 secretion and IL-2 receptor expression; induce fever; stimulate systemic responses to inflammation, infection, and injury

123
Q

what is the source of IL-2?

A

Most immune cells

124
Q

what is the target cell of IL-2

A

Helper T cells; cytotoxic T cells; NK cells; B cells

125
Q

What are the major functions of IL-2?

A

stimulate proliferation, promote conversion to plasma cells

126
Q

What is the source of Interferons?

A

Most cell types

127
Q

what are the target cells of interferons?

A

most cell types

128
Q

what is the major function of interferons?

A

stimulate cells to produce antiviral proteins (nonspecific response)

129
Q

what is the source of interferon-gamma?

A

NK cells and activated helper T cells

130
Q

what are the target cells of interferon-gamma?

A

NK cells and macrophages

131
Q

what are the major functions of interferon-gamma?

A

stimulate proliferation and secretion of cytotoxic compounds

132
Q

what is the source of Chemokines?

A

damaged cells, including endothelial cells

133
Q

what are the target cells of chemokines?

A

neutrophils and other leukocytes

134
Q

what are the major functions of chemokines?

A

facilitate accumulation of leukocytes at sites of injury and inflammation

135
Q

what is the source of Colony-stimulating factors?

A

Macrophages

136
Q

what are the target cells of colony-stimulating factors?

A

bone marrow

137
Q

what are the major functions of colony-stimulating factors?

A

Stimulate proliferation of neutrophils and monocytes

138
Q

What is diapedesis?

A

mobile cells pass through gaps in the capillary endothelium to enter the tissues and can follow chemical trails

139
Q

What two mechanisms are innate and help direct WBC’s to pathogens?

A

they have rough surfaces and most pathogens lack the repellant protective coats that our cells posses

140
Q

What is the alternate complement pathway?

A

where the complement system is activated without the involvement of antibodies during inflammation to tag bacterial pathogens

141
Q

What is opsonization?

A

The relatively non-specific binding of the complement system factor C3b to cell surface/cell wall carbs of bacteria which allows more effective phagocytosis

142
Q

What does the MAC do?

A

perforate bacterial membranes which makes them leaky and kills the bacteria

143
Q

What is a phagosome?

A

Where a pathogen that is enveloped by the cell

144
Q

what is a phagolysosome?

A

the pathogen when enveloped fuses with lysosomes

145
Q

about how many bacteria can a neutrophil phagocytize?

A

20-Mar

146
Q

Macrophages can typically ingest how many bacteria?

A

around 100

147
Q

some tissues/organs have their own subclass of macrophages such as ____

A

Kupffer cells in liver and Dendritic cells of the skin

148
Q

Anything not phagocytized must be removed via the ____ as it cannot cross the endothelium and enter the blood.

A

lymph

149
Q

If an invading organism enters the blood it can be removed by what?

A

the spleen and bone marrow by macrophages

150
Q

What is the first stage of attraction for a Leukocyte?

A

chemokine expression

151
Q

what occurs after chemokine expression in the attraction of leukocytes?

A

the change in integrin receptors to facilitate diapedesis (increases affinity)

152
Q

What can interferons do within a cell?

A

they are cytokines that inhibit viral replication inside host cells with the secretion of antiviral proteins.

153
Q

When are eosinophils produced in higher concentrations?

A

in response to parasitic infections when they are attracted by chemotaxis

154
Q

What are the primary cells involved in an increased response of Eosinophils?

A

Mast cells and basophils

155
Q

What is the Eosinophil Chemotactic Factor?

A

the substance released by mast cells and basophils that attract eosinophils which may then detoxify certain substances involved in inflammation.

156
Q

What antibody is released during an allergic response?

A

IgE

157
Q

What chemicals are released during an allergic response by basophils?

A

histamine, bradykinin, serotonin, heparin, setc.

158
Q

what is leukopenia?

A

bone marrow condition where it starts to produce very few WBC’s

159
Q

What can cause leukopenia?

A

radiation, chemicals

160
Q

What is Leukemia?

A

cancerous mutations of WBC precursor cells where an uncontrolled production of WBC’s occurs

161
Q

where does myelogenous leukemia originate?

A

bone marrow

162
Q

where does leukemia spread?

A

throughout the body especially to lymph nodes, spleen, and liver…cells are often undifferentiated with bizarre shapes.

163
Q

what is the primary result of leukemia?

A

the production of non-functional/partially functional WBC’s in inappropriate areas of the body resulting in infection, severe anemia, and a tendency to bleed due to thrombocytopenia

164
Q

Why does leukemia cause thrombocytopenia and a tendency to bleed?

A

it is caused by the physical displacement of normally functioning bone marrow by the cancerous cells

165
Q

what is the most significant effect on the patient by leukemia?

A

a very high metabolic demand placed on the body by these rapidly dividing cells; other tissues can be starved and forced to rely on protein catabolism

166
Q

B-lymphocytes produce a humoral response by synthesizing ____ ____ that target the invader for destruction .

A

circulating antibodies

167
Q

T-lymphocytes produce activated ____ ____ that directly destroy the invaders.

A

Killer Cells

168
Q

antigens are recognized specifically by _______

A

immunoglobulins

169
Q

What do T-lymphocytes require to activate?

A

APC’s (Antigen-Presenting Cells)

170
Q

When molecules are identified as foreign what is produced?

A

antigens

171
Q

what is the function of lymphocytes?

A

recognition cells

172
Q

What is the function of B cells?

A

initiate antibody mediated immune responses by binding antigens to the B cell’s plasma membrane receptors

173
Q

What happens to B cells once activated?

A

They transform into plasma cells and present antigen to helper T cells

174
Q

what is the function of cytotoxic T cells?

A

bind to antigens on plasma membrane of target cells and directly destroy the cells

175
Q

what is the function of helper T cells?

A

secrete cytokines that help to activate B cells, cytotoxic T cells, NK cells, and macrophages

176
Q

what is the function of NK cells?

A

Bind directly and nonspecifically to virus-infected cells and cancer cells and kill them…they also function as killer cells in antibody-dependent cellular cytotoxicity (ADCC)

177
Q

what is the function of plasma cells?

A

they secrete antibodies

178
Q

Potential T-lymphocytes first migrate to the ___ for processing.

A

thymus

179
Q

potential B-lymphocytes first migrate to the ___ ___ for processing.

A

liver prior to birth but afterwards the Bone Marrow

180
Q

each T-lymphocyte develops specific reactivity to how many antigens?

A

one

181
Q

What three cells principally can present antigens to T-cells?

A

Macrophages, B-lymphocytes, and Dendritic cells

182
Q

Macrophages secrete what to promote reproduction and growth of lymphocyte clones?

A

IL-1

183
Q

What three events are required for activation of helper T-lymphocytes?

A

Presentation of an antigen bound to MHC II, Binding of matching non-antigenic proteins, secretion by APC or B-cell of cytokines including IL-1 and TNF which act on the helper lymphocyte

184
Q

T-lymphocytes only respond when the ____ is ____ to special surface molecules called what?

A

antigen is bound to the special surface molecules call major histocompatibility complexes (MHC’s)

185
Q

What proteins are vital to present to and activate Helper T-cells?

A

MHC II proteins

186
Q

MHC 1’s present to what cells?

A

Cytotoxic T-lymphocytes

187
Q

MHC 2’s present to what cells?

A

Helper T-cells

188
Q

To activate the T-cell after the MHC binding what must occur?

A

a second “handshake” between the T-Helpers and APC’s by binding of matching, non-antigenic proteins

189
Q

Lastly the secretion by the APC of ____ fully activates the T-Helper cells.

A

Cytokines (especially IL-1 and TNF)

190
Q

Helper T-cells secrete ____ after activation which enhances the activation of processed ____.

A

lymphokines; B-lymphocytes

191
Q

What do memory cells help with?

A

when presented to the same antigen they can produce a far more rapid and effective response

192
Q

Antibodies are gamma globulins called what?

A

immunoglobulins

193
Q

The specificity of the antigen biding sites is due to what?

A

appropriate amino acids forming a highly specific binding site analogous to a drug receptor or enzyme active site

194
Q

what are the five different antibodies?

A

IgM, IgG, IgA, IgD, and IgE

195
Q

what is the most commonly found antibody in the body?

A

IgG

196
Q

IgM is produced during the ____ response and is effective due to what?

A

the primary response and is effective due to having ten binding sites

197
Q

what is agglutination?

A

when large invaders become bound together via antibodies into a clump

198
Q

what is precipitation?

A

when the linked molecules become so large that they become insoluble (such as toxins)

199
Q

what is neutralization?

A

when binding antibodies cover and inactivate toxic sites on the invader

200
Q

what is Lysis?

A

some antibodies can rupture the cell membranes of invading organisms, however are not sufficient enough on their own.

201
Q

Antibodies are also used for what?

A

pharmacological tools and treatments

202
Q

What are the four different types of T-lymphocytes?

A

Helper, cytotoxic, suppressor, and natural killer (NK)

203
Q

what are Helper T-lymphocytes?

A

most numerous and they help the immune system function effectively and are involved in regulating virtually all immune functions

204
Q

What are suppressor T-lymphocytes?

A

decrease function of cytotoxic and helper T-cells to suppress autoimmune responses

205
Q

what are cytotoxic T-lymphocytes?

A

kill invading organisms by punching a hole through their membranes via perforins

206
Q

What are NK cells?

A

they target virus-infected and cancerous cells. They kill their target after binding to them…not much is known on how

207
Q

Infection in the body leads the Brain to do what?

A

fever, decreased appetite, decrease food intake, sleepiness, fatigue

208
Q

Infection in the body leads the Liver to do what?

A

Retain Fe, Zn, secrete acute phase proteins

209
Q

Infection in the body leads the Bone Marrow to do what?

A

Increase production and release of leukocytes

210
Q

Infection in the body leads the Adipose tissue to do what?

A

increase lipolysis

211
Q

Infection in the body leads the Muscle to do what?

A

increase protein breakdown and amino acid release

212
Q

Infection in the body leads the Hypothalamus to do what?

A

increase ACTH secretion

213
Q

A rise in ACTH secretion due to infection in the body leads the Adrenal cortex to do what?

A

increase cortisol secretion

214
Q

Immunization eliminates what to speed up response time?

A

eliminates the time lag required for specific recognition

215
Q

What is anaphylaxis?

A

An extreme response triggered in tissues surrounding small blood vessels due to Mast cells and eosinophils that rapidly spread throughout the circulation

216
Q

What is Urticaria?

A

triggered by antigens entering the skin and releasing histamine (hives)

217
Q

What is Hay fever?

A

the allergen-regain reaction occurs in nasal passages with released histamine, also causes sneezing as the body tries to eject the causative agent

218
Q

What is Asthma?

A

the allergen-regain reaction in the bronchioles

219
Q

What is type I hypersensitivity?

A

immediate hypersensitivity from a release of mast cell mediators, IgE

220
Q

what is Type II hypersensitivity?

A

antibody mediated, IgM, IgG antibodies

221
Q

What is type III hypersensitivity?

A

immune complex mediated, formation of immune complexes, activates inflammatory cells

222
Q

What is type IV hypersensitivity?

A

CD4+Tcells (delayed), macrophage activation of cytokine-mediated inflammation

223
Q

What is the additional sugar residue on Group B blood?

A

Galactose

224
Q

what is the additional sugar residue on Group A blood?

A

N acetyl-galactosamine

225
Q

What antigen is on blood group A?

A

A

226
Q

what antigen is on blood group B?

A

B

227
Q

what antigen is on blood group AB?

A

A and B

228
Q

what antigen is on blood group O?

A

neither A or B

229
Q

what antibody is found on blood group A?

A

Anti-B

230
Q

what antibody is found on blood group B?

A

Anti-A

231
Q

what antibody is found on blood group AB?

A

neither A or B

232
Q

what antibody is found on blood group O?

A

Anti-A and Anti-B

233
Q

Which blood groups can have a homozygous and heterozygous form?

A

group A and group B (AA or AO) (BB or BO)

234
Q

which blood group does not have a homozygous form?

A

AB

235
Q

which blood grouping does not have a heterozygous form?

A

O

236
Q

Which blood type is the universal donor?

A

O

237
Q

which blood type is the universal acceptor?

A

AB

238
Q

Where are the antibodies to the non-expressed antigen found?

A

in the plasma

239
Q

Blood antibodies are mostly which immunoglobulins?

A

IgG and IgM

240
Q

Antibody production is stimulated by what for A-B-O grouping?

A

certain bacteria and food

241
Q

Which blood groups will A not interact with?

A

O and A

242
Q

Which blood groups will B not interact with?

A

O and B

243
Q

Which blood groups will O not interact with?

A

O

244
Q

Which blood groups will AB not interact with?

A

AB, O, B, A

245
Q

Unlike the O-A-B system rhesus antigens are not normally produced until when?

A

exposure to the antigens from an exogenous source

246
Q

What are the common types of Rh antigens?

A

C,D,E, c, d, e

247
Q

Which Rh antigen is most widely expressed in the population?

A

D

248
Q

What is Erythroblastosis fetalis?

A

when the Rh- mother’s antibodies attack her Rh+ baby’s blood cells

249
Q

Isograft is between what?

A

identical twins

250
Q

Autograft is between what?

A

within an individual

251
Q

Allograft is between what?

A

beings of the same species

252
Q

Xenograft is between what?

A

beings of different species