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2 SEPSIS > Immunology > Flashcards

Immunology Flashcards

1
Q

what are the cells of the innate immune system

A

phagocytes

Nk cells

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2
Q

what are the cells of the acquitted/adaptive immune system

A

B cells

T cells

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3
Q

what immune cells target bacteria

A

phagocytes
antibodies and b lymphocytes
complement

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4
Q

what immune cells target viruses

A

t lymphocytes

antibodies and b lymphocytes

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5
Q

what immune cells target fungi

A

phagocytes
t lymphocytes
eosinophils

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6
Q

what immune cells target protozoa

A

eosinophils

t lymphocytes

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7
Q

what immune cells target worms

A

eosinophils

mast cells

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8
Q

what are the physical barrier to infection

A

skin

  • antimicrobial secretions from keratinocytes
  • sebaceous/sweat glands
  • antigen presenting cells in skin

mucosa

  • antimicrobial substances. eg. lysozyme
  • IgA
  • Gastric acid
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9
Q

what are some risk factors to impaired barrier function in skin

A 
eczema 
psoriasis 
erythoderma 
tine pedis (athletes foot)/ cracking of skin 
ulcers/pressure sores
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10
Q

risk factors to impaired barrier function in the lungs

A

cystic fibrosis
COPD
poor swallow

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11
Q

risk factors to impaired barrier function GI

A

Impaired bladder function

urinary stasis

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12
Q

what do phagocytes do

A

ingest organisms following opsonisation

kill via oxygen killing or independent mechanisms

control bacteria and fungi

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13
Q

what conditions cause phagocytes deficiency

A

haematological malignancy

cytotoxic chemotherapy

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14
Q

hat are the 2 types of helper T cells

A

helper T cells

cytotoxic T cells

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15
Q

what causes T cell deficiencies

A

HIV pneumonia
Lymphoma
Primary immunodeficiency syndromes

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16
Q

what do B cells do

A

mature into plasma cells and produce immunoglobulins

17
Q

what do immunoglobulins protect against

A

recognised antigens also

opsonise microbes for ingestion by phagocytes

18
Q

what is the firs immunoglobulin to be produces

A

IgM- Has a weak affinity so does not bind very strongly to pathogen

19
Q

what is the most abundant immunoglobulin

A

IgG - produced after IgM - much stronger affinity

20
Q

where are B cell deficiencies seen

A

myeloma
primary immune deficiency syndromes
certain immune suppressants

21
Q

what cells are infected by HIV

A

CD4+ T lymphocytes

22
Q

what does HIV cause a high risk of

A

invasive pneumococcal disease irrespective of CD4 count

23
Q

what is hyposplenism

A

decreased spleen function

24
Q

what causes hyposplenism

A 
splenectomy 
functional hyposplenism (sickle cell anaemia, cirrhosis, coeliac disease)
25
Q

what does reduced spleen function cause susceptibility to

A

encapsulated organisms

strep pneumoniae
haemophilus influenzae
neisseria meningitidis

26
Q

what is the aim of immunosuppression

A

to reduce the damage caused to the body by the immune system

27
Q

when are immunosuppressive drugs used

A

autoimmune conditions
transplants
cancers

28
Q

what are the side effects of immune suppression

A
  • blunted response to stimulus
  • do not have normal symptoms and signs of infection
  • often lower threshold for treatment
29
Q

what do steroids increase the risk of

A

a wide range of infections particularly fungal infections

30
Q

what does anti-TNFa therapy increase the risk of

A

mycobacterium tuberculosis

fungal infections

31
Q

what do purine analogues increase the risks of

A

viral infections

pneumoncystitis jirovecci

32
Q

when are prophylaxis given in immunosuppression

A

HIV - cotrimoxazole

Bone marrow transplant

33
Q

describe the immune response in sepsis

A

disordered immune response to inflammation

cause inappropriate immune activation and inflammatory cascade

unchecked inflammation leads to organ dysfunction

34
Q

what causes cardiovascular dysfunction in sepsis

A

hypotension due to wide spread vasodilation leading to fall in peripheral resistance

needs fluid resuscitation

35
Q

what causes pulmonary dysfunction in sepsis

A

endothelial injury with lung tissue/capillar leak

diffuse alveolar oedema

respiratory failure, needing supplemental oxygen

36
Q

what causes renal dysfunction in sepsis

A

acute kidney injury, a rise in urea/creatine due to hypoperfusion

37
Q

what causes CNS dysfunction in sepsis

A

delirium/acute confusion due to cerebral hypoperfusion

drowsy, decreased conscious level

38
Q

what causes lactic acidosis in sepsis

A

diffuse tissue hypoperfusion leads to anaerobic metabolism and lactic acid production causing acidosis

2 SEPSIS (5 decks)

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