Med-Surg: Chapter 18: Promoting Health in Patients with Immune disorders

Question 1

Immunity

Answer 1

body’s ability to resist infection and disease

Question 2

Innate Immunity

Answer 2

-provides first and second lines of defense

>when the first line of defense is breached, the second line of defense is initiated

Question 3

First line of Defense

Answer 3

-physical, biochemical, and mechanical barriers

>offer surface protection to prevent the invasion of microbes

Question 4

Second line of Defense

Answer 4

the inflammatory response

-initiated to prevent and/or limit infection, clean out the debris of dead cells, and initiate tissue healing

Question 5

Adaptive (acquired) Immunity

Answer 5

Third line of defense

• natural exposure (which will make antibodies in the body)
• infection
• transfer of maternal antibodies

> artificial exposure

• vaccines
• infusion of immune serum globulin

> is specific
protects by cellular-mediated (T cell) and humoral-mediated (B-cell antibodies) mechanisms

Question 6

The Immune System When Competent

Answer 6

immune system wards off the penetration of foreign microbes and the proliferation of abnormal or malignant cells

Question 7

The Immune System when Incompetent

Answer 7

the failure can lead to allergies, infection, cancer, and autoimmune and immunodeficiency disorders

Question 8

Lymphatic System

Answer 8

-network of vessels that transports excess interstitial fluid that has not been reabsorbed (lymph fluid) back to the bloodstream, helping to maintain fluid balance
>system contains thousands of lymph nodes located superficially and deep within the tissues near the lymphatic vessels

Question 9

Lymphatic System: Lymph Nodes

Answer 9

small glandular structures that house macrophages, lymphocytes, and monocytes that filter and phagocytize microorganisms and other invading particles from circulating lymphatic fluid
>this filtering prevents unwanted substances from reentering the bloodstream

Question 10

Thymus

Answer 10

soft organ located within the chest cavity near the heart

• large in children
• decreases in size into adulthood
• central lymphoid organ that produces thymosin (hormone that stimulates T-cell production) and is where T-cell development takes place

Question 11

Bone Marrow

Answer 11

within the cavities of bone

• consists of red (active) marrow and yellow (inactive) marrow
• where B and T lymphocyte formation and differentiation of B and T cells occur
• B cells stay within the bone marrow to mature
• T cells migrate to the thymus to mature and become active as regulatory T cells (suppressor T cells) or effector T cells (helper T cells and cytotoxic T cells)

Question 12

Spleen

Answer 12

-size of a fist, located in the LUQ of abdominal cavity
-blood filter
>red pulp= filtering site for old or damaged red blood cells; can also store blood
>white pulp= houses lymphocytes and macrophages, filtering unwanted debris
-if it is removed, patient may become immunocompromised; requiring lifelong antibiotics

Question 13

Tonsils

Answer 13

function as traps to protect against bacteria and viruses that are inhaled

Question 14

Adenoids

Answer 14

located at nasopharyngeal border

-defend against inhaled bacteria and viruses

Question 15

Peyer’s Patches

Answer 15

lymphoid follicles located on the mucosa of the small intestine
-known as intestinal immune sensors and defend against pathogens that gain entry to the intestinal tract

Question 16

Leukocytes

Answer 16

White Blood Cells

• formed in the bone marrow and lymph tissue
• mature in thymus or bone marrow
• found in blood, lymphatic system, spleen, and other body tissues
• mobile units traveling through the bloodstream to defend the body against infection

Question 17

5 Types of Leukocytes

Answer 17

-Neutrophils
-Monocytes
-Eosinophils
-Basophils
-Lymphocytes (B and T cells)
>further classified into granulocytes or agranulocytes

Question 18

Granulocytes

Answer 18

have granules in the cytoplasm and release histamine and other substances to defend the body against foreign materials by increasing capillary permeability through vasodilatory effects and mediating the inflammatory response
>Neutrophils, basophils, and eosinophils are all phagocytic (cells that engulf bacteria and debris) granulocytes

Question 19

Neutrophils

Answer 19

phagocytes of early inflammation that destroy bacteria

Question 20

Basophils

Answer 20

release heparin as an anticoagulant and histamine during the early inflammatory response

Question 21

Eosinophils

Answer 21

phagocytes that destroy allergens and combat parasitic infections

Question 22

Agranulocytes

Answer 22

without granules in the cytoplasm

-monocytes and lymphocytes

Question 23

Monocytes

Answer 23

agranulocyte

• presents pathogens to T cells for destruction
• develop into macrophages

Question 24

Macrophages

Answer 24

phagocytes and initiators of the inflammatory response that digest and destroy, or phagocytize, microorganisms and other debris
-activate helper T cells by secreting signaling proteins (Cytokines), and presenting processed antigens for destruction by the T cell

Question 25

Lymphocytes

Answer 25

active in both humoral and cell-mediated immune responses -formed in the bone marrow -found in lymph nodes, spleen, and thymus -enter bloodstream through lymphatic system >B Lymphocytes >T Lymphocytes >Immunoglobulins

Question 26

B Lymphocytes

Answer 26

-involved in humoral immune responses -mature in bone marrow -produce antibodies, or immunoglobulins >once B cells are exposed to a specific antigen for the first time, they proliferate and differentiate into plasma cells and memory cells -B cells can function independently but typically require the help of T lymphocytes

Question 27

Antibodies

Answer 27

bind with specific antigens, marking them for destruction by other components of the immune system, or directly neutralize the antigen by inhibiting an essential function necessary for its survival

Question 28

Plasma Cells

Answer 28

secrete antibodies after the first exposure to the antigen

Question 29

Memory Cells

Answer 29

re-stimulated by the same antigen, mount a specific antigen-antibody response, sometimes long after the initial exposure

Question 30

Immunoglobulins (IgG)

Answer 30

or antibodies - B cells produce - 5 Classes: IgA, IgD, IgE, IgG, or IgM

Question 31

Immunoglobulin: IgA

Answer 31

found in exocrine-gland secretions such as breast milk and tears >dominant in secretory-gland secretions such as breast milk, sweat, saliva, mucus, and tears

Question 32

Immunoglobulin: IgD

Answer 32

plays a role in B-cell activation | -located on surface of developing B lymphocytes

Question 33

Immunoglobulin: IgE

Answer 33

allergic reactions and parasitic infections | -least concentrated

Question 34

Immunoglobulin: IgG

Answer 34

effective against bacteria, viruses, and other toxins - most abundant - transported across placenta

Question 35

Immunoglobulin: IgM

Answer 35

initial antibody produced after an infection - largest - first antibody produced during the primary response to an antigen - expressed by competent B cells

Question 36

T Lymphocytes

Answer 36

-cellular-mediated immune response -T-cell activation occurs when macrophages present the T-cell with a phagocytized antigen >function: elimination of cells infected by pathogens, continued activation of the inflammatory response against persistent infections, and regulation of innate and adaptive immune responses >Cytotoxic T cells (destroy the cell) >Suppressor T cells >Helper T cells -T cells are needed by B cells in order to activate the B cell

Question 37

Cytotoxic T Cells

Answer 37

respond to foreign cells, including tumors, non-self cells, and virus-laden cells

Question 38

Helper T Cells

Answer 38

- augment the effectiveness of the innate immune response by activating macrophages - augment both humoral and cellular immunity through the activation of B cells to produce antibodies - activate cytotoxic T cells and natural killer cells

Question 39

Suppressor T cells

Answer 39

activated by helper T cells when the immune response is no longer needed

Question 40

Natural Killer (NK) cells

Answer 40

another form of T cell - targets virus-infected and tumor cells - number increases as we age; helps control infections in elderly and important for successful aging

Question 41

Cytokines

Answer 41

-interleukins (ILs) -interferon (IFN) -tumor necrosis factor alpha (TNFa) >small proteins that act to regulate immune responses

Question 42

Cytokines: Interleukins (ILs)

Answer 42

production occurs by macrophages and lymphocytes in response to the initiation of the inflammatory response -responsible for the general enhancement or suppression of inflammation and the stimulation of leukocyte production and maturation

Question 43

Cytokines: Interferons

Answer 43

proteins that protect against viral infections and tumor growth -do not destroy viruses directly; they prevent the virus from infecting the surrounding healthy cells and interfere with its ability to replicate

Question 44

Cytokines: Tumor Necrosis Factor Alpha

Answer 44

-produced by macrophages -enhances inflammation -involved in the regulation and production of immune cells >Interleukins and Interferons rely on TNFa to mount an effective inflammatory response

Question 45

Complement

Answer 45

complex system of proteins - provides cell-killing effects for innate and acquired immunity - activates pathogens and inflammatory response - initiation of the complement can activate every component of the Inflammatory response - "complement" the antibacterial function of antibodies - complement proteins are synthesized in the liver and circulate in the bloodstream in an inactive form until activated by bacteria, viruses, fungi, tumor cells, antigen-antibody complexes, or endotoxins

Question 46

Active Immunity

Answer 46

antibodies or T cells are produced either after natural exposure to an antigen during illness or infection or after immunization

Question 47

Passive Immunity

Answer 47

happens when preformed antibodies or T lymphocytes are transferred from one individual to another ex: a newborn acquires immunity from his/her mother through the placenta ex: acquire immunity through transfusion of antibody-laden blood products

Question 48

Humoral Medicated Immunity

Answer 48

- antibody mediated - cell type: B lymphocytes - defense modality: circulating antibodies - defends against extracellular microorganisms; bacteria, viruses

Question 49

Cellular-Mediated Immunity

Answer 49

- cellular mediated - Cell type: T lymphocytes - defense modality: cell-to-cell contact - defends against intracellular microorganisms: fungi, viruses, bacteria, tumor and transplant antigens

Question 50

Changes in The Aging Immune Response

Answer 50

- decline in T-cell function and antibody production when exposed to specific antigen challenges - have increased circulating antibody levels; leading to autoimmune disorders