Module 5-1 - Immune System Flashcards

1
Q

Types of Blood Cell

A

Monocytes/Macrophages

Lymphocytes (B and T Cells)

Granulocytes (Polymorphonuclear leukocytes: Neutrophils, Eosinophils, Basophils, Mast Cells)

RBC

Platelet

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2
Q

Granulocytes

A

blood cells with granules like heparin and histamine in the cytoplasm

Neutrophils (bacteria), Eosinophils (parasites and algae), Basophils (become mast cells)

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3
Q

In what situation does Neutrophilia and Microcytosis occur?

A

Infection

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4
Q

In what situation does Eosinophilia occur?

A

Allergies

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5
Q

In what situation does Lymphocytosis occur?

A

Viral Infection

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6
Q

Hematopoietic Stem Cell

A

an undifferentiated cell that can go down a progenitor line to make a very differentiated cell

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7
Q

What are the Host Defense Systems?

A
  1. Physical and Chemical Barriers to Infection
  2. Inflammatory Response (Non Specific)
  3. Immune Response (Specific)
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8
Q

Physical and Chemical Barriers to Infection

A

Skin

Mucous Membranes and Secretions

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9
Q

Inflammatory Response

A

Non specific response

occurs after tissue injury or infection

causes fever and inflammation

phagocytic WBCs, antimicrobial substances, and natural killer cells accumulate

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10
Q

Immune Response

A

Specific Response

Identifies self from non self (host v foreign)

Recognizes and eliminates altered host cells

Antigen-Antibody response

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11
Q

What induces fever?

A

Prostaglandins

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12
Q

Classic Infection Signs

A

Redness
Swelling
Pain
Warmth

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13
Q

What sort of trauma can cause an inflammatory response

A

Mechanical
Thermal
Chemical

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14
Q

Antigen

A

Immunogen

A molecule that can stimulate and immune response

It is usually a protein or large CHO (NOT LIPIDS OR NUCLEIC ACIDS)

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15
Q

Epitope / Antigenic Determinant

A

Discrete immunologically active sites on antigens

A single antigen has several antigenic determinants on it

Each can stimulate a distinct clone of lymphocytes

Antibodies attach here

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16
Q

Hapten and Hapten Carrier complex

A

Low molecular weight compound - Basically Hapten is a small compound

Can combine with carrier protein molecules to act like an antigen

Ex: Penicillin cannot cause a reaction alone so by carrying it on a carrier protein it is then large enough to cause an immune response

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17
Q

Protein structure?

A

Long chains of amino acids

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18
Q

Partial or Incomplete Antigen

A

The situation in which hapten can only induce antibodies if bound to another carrier protein or molecule

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19
Q

How many epitopes are on an antigen?

A

Multiple

They stick out all over

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20
Q

Why is each epitope different on an antigen?

A

They have different amino acid patterns so the antibody must be specific

The amino acids have a variable and constant portion and each site has a different shape so antibodies need to be specific to just that site

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21
Q

Names of Immune Cell Lymphocytes are based on…

A

their location of maturation

T Cell = Thymus

B Cell = Bone

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22
Q

Regulatory Lymphocytes

A

Assist in the immune response

These are Helper T cells

They activate other immune cells

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23
Q

Effector Lymphocytes

A

Final stage cells of the immune response

These are killer T cells

They ensure removal of foreign invaders

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24
Q

B Lymphocytes

A

10-20%

Mature in bone marrow

Used in Humoral or Antibody Mediated Immunity

Secrete Antibodies

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25
T Lymphocytes
60-70% (Predominant) Mature in Thymus Used in Cell Mediated Immunity Do not involve antibody production - they do cell-to-cell killing
26
T4 Lymphocytes
The "Quarterback" Helper T Cells Secrete chemical messages that amplify or stimulate other things to happen, such as recruiting and activating cells to do things such as killing Send Orders Have CD4 Markers Speed up or slow down the immune response, but do not do the direct killing
27
T8 Lymphocytes
Effector Cells Natural Killer T Cells Carry out the T4's orders The final immune response stage There are a variety of them, but they all wait to seek and destroy until the T4 orders them to do so
28
Major Histocompatibility Complex (MHC)
These are the markers on the cells surface also known as Human Leukocyte Antigens (HLA) They are four closely linked groups of genes (loci) on Chromosome 6 that code for specific cell surface molecules
29
MHC 1
HLA-A, HLA-B, HLA-C On all NUCLEATED cells in the body and on platelets Tells the immune system you are you Present the processed antigen to cytotoxic T cells to tell which cells are "you"
30
MHC 2
Mostly on antigen presenting cells like B Cells, Macrophages, and APCs Present processed antigen to helper T Cells to give orders (so it can get antibodies made and tell cytotoxic T cells what to attack and what not to attack) The antibody will then go onto the antigens on cells that need to be destroyed and "lock up" so a macrophage can come get it
31
Types of Immunity
Cell mediated immunity Humoral or Immunoglobulin mediated immunity
32
Which type of immunity involves the production of antibodies?`
Humoral or Immunoglobulin mediated immunity
33
T8 Suppressor Cell
tells when the immune response it over and no longer needed Reduces the humoral response
34
Memory T Cell
Does not forget the antigen and response to the specific antigen in cell mediated immunity - since there are no antibodies made, this cell remembers and can launch an attack faster if the same invader enters the body Remains dormant until second exposure
35
Cell Mediated Immunity
T Cells respond directly to antigens (helper, killer, suppressor, memory) Involves destruction of target cells through secretion of lymphokines rather than antibodies
36
Humoral or Immunoglobulin Mediated Immunity
B cells mature into plasma cells and produce specific antibodies that mark things for destruction Provides for elimination of bacteria, neutralization of bacterial toxins, and prevention of viral infection
37
Which type of immunity is fastest? Slowest?
Fast - Cell Mediated Slow - Humoral (can take months to make antibodies)
38
Why is specific immune response special?
the antigens can allow responses from infected cells and viral cells (inside) - unlike just neutrophil response - and T cells can do surveillance for cancer cells and mutated cells
39
Do cell mediated and humoral responses occur at the same time?
Often they do
40
What sort of immune response is launched regarding a transplanted organ?
Cell Mediated Response It is recognized as non self and is attacked
41
What do T lymphocytes function in?
Activating other T cells and B cells Controlling viral infections Rejecting foreign tissue graft Delayed hypersensitivity reactions (ex: poison ivy) Regulating and amplifying T and B cell response
42
High Lymphocyte count indicates what?
A viral infection
43
Cytotoxic (CD8+) T Lymphocytes
T8 Killer Cells They bind to the surface of an invading cell, disrupt the membrane, and release toxic chemicals They have the CD8+ markers
44
Helper (CD4+) T Lymphocytes
Helper T4 Cells - Quarterback Have CD4+ marker Secrete cytokines to direct cells Facilitate cell mediated response Stimulates B cells to proliferate and mature into plasma cells for humoral response
45
Natural Killer (NK) Cells
Large granular lymphocytes with CD16 and CD56 markers Non specific effector cells that kill tumor cells and virus infected cells Its programmed killing is inhibited by contact with MHC I (Self Molecules) It pokes holes in cells so cytotoxic enzymes can destroy it
46
What determines the activity of NK cells? What enhances NK cell activity?
Determined by: Perforins Enzymes Toxic Cytokines Enhanced By: IL-2 (from T4 helper)
47
What are the main communicators between WBCs?
Interleukins
48
Macrophages
Phagocytic Effector cells in both humoral and cell mediated responses Do not have surface receptors for specific antigens, but can ingest an antigen to put on its surface to present to a T4 cell to activate the T Lymphocyte Response They do have the Fc region antigens and for the constant complement portion of an antibody tough Non specific response role in bacterial infection secretes Cytokines
49
Variable versus Constant Portion
Variable Portion is the unique portion of an antigen while the constant is the same on every antigen Macrophages can only read the constant portion, and activation of this portion by antibodies gets them to come over and eat it
50
Antigen Presenting Cells
APCs B Cells Macrophages
51
Cytokines
small hormone like polypeptides "Interleukins" Act on immune cells to regulate inflammatory responses including movement, proliferation and differentiation of leukocytes and other cells (the T4's messages) They end up enhancing the production and maturation of B Lymphocytes into Plasma Cells Usually have multiple jobs or mult kinds can do one job
52
How are Cytokines named?
For the cell type that makes them (ex: Lymphokines) International nomenclature - ex: interleukin 1 through 17 the biologic property first ascribed to them - ex: interferon
53
ILs
Interleukins Cytokine Involved in fever, inflammation, and regulation of immune cell response
54
IF
Interferons Cytokine Augments natural killer cell activity and exerts antiviral activity to boost immune system response (when given as an IV)
55
TNF
Tumor Necrosis Factor Cytokine Destroys things by directing cytotoxins toward tumors
56
CSF
Colony Stimulating Factor Cytokine Stimulates different colonies of WBC to be produced
57
Reticuloendothelial System
RES Tissue Macrophages - localized to different regions and tissues and given different names based on their area Wherever the macrophages are migrating to with the system they may stay their entire life
58
Alveolar Macrophages
Lung Macrophage
59
Kupffer's Cells
Liver macrophage
60
Peyer's Patches
Intestine Macrophage
61
Microglial Cells
CNS Macrophage
62
Langerhan's Cells
Skin macrophage
63
Histiocytes
Connective tissue macrophage
64
Where are macrophages most abundant?
Lymph fluid and lymph nodes
65
If the macrophage count is high...
you probably have an infection
66
Lymph Nodes
Distributed along lymphatic vessels an immune system structure Filters lymph fluid and removes bacteria and toxins from circulation Crucial in the proliferation of immune cells
67
Thymus
Located in the mediastinum Produces T lymphocytes
68
Spleen
Largest lymph organ reservoir for blood macrophages clear cellular debris and process hemoglobin here
69
Tonsils
produce lymphocytes guards against airborne and ingested pathogens immune system structure very important, especially in those <2 y/o
70
Thoracic Duct drains...
the left side of the body while the right lymphatic duct drains the top right quarter
71
What is not in lymph that is in plasma
RBC
72
Lymph flows back to the ___
heart
73
Afferent Lymph Vessels
carries lymph into nodes
74
What does a warm, tender, enlarged, and maybe red lymph node indicate?
That the lymph is working at phagocytizing foreign particles because that is inflammation
75
What does a non painful, enlarged, fixed lymph node mean?
Indicates cancer Especially if you cannot feel the edges of it
76
If a node is enlarged than where is the infection occurring?
Distal to the lymph node this is because lymph nodes drain from distal areas back toward the heart
77
B Lymphocytes
Basis of humoral immunity When an antigen binds with a receptor it will differentiate into a plasma cell and secrete immunoglobulins/antibodies
78
What is an action B lymphocytes can do other than make antibodies once they differentiate into plasma cells?
They can act as Antigen Presenting Cells (APCs) by ingesting and depositing an antigen onto its own surface to activate T lymphocytes (T4) to secrete cytokines and initiate a response
79
What regulates B lymphocyte activity?
T Lymphocytes (T4) and Cytokines
80
Memory B Cells
B lymphocytes that circulate indefinitely and become active and remember how to make a specific antibody if there is a repeat exposure They can be induced to make the antibody when told by cytokines from T cells
81
Structure of an Antibody
1. Fc (Constant Fragment) 2. Fab (Antigen Binding Fragment) Heavy Chain and Light Chain
82
Fc
Constant fragment / Heavy chain of an antigen It is a non specific activator site for inflammation It is identical for all antibodies of a single class (IgE, IgG, etc)
83
Fab
Antigen Binding Fragment / Light Chain of an antigen Is specific for each individual antibody Contains a specific antigen binding site An antigen binds to this site and which activates the constant portion to attract macrophages
84
Binding to the Fab portion --> ?
Binding to Fab --> Activates Fc portion --> Destruction of microorganism
85
What are the major class of Immunoglobulins (antibodies)?
IgG IgM IgA IgD IgE
86
IgG
Most abundant antibody in the blood (75%) Appears in all body fluids and can cross placenta Major antibacterial and antiviral antibody 2nd Antibody produced during an immune response; greater on second exposure or with booster shots
87
IgM
10% of immunoglobulins in blood 1st immunoglobulin produced during an immune response Too large to cross membranes, only in vascular system Activates complements and is responsible for natural immunity in species M = Mostly in blood
88
IgA
15% of all immunoglobulins Mostly in body secretions like saliva, tears, mucus, bile, etc Defends against pathogens on body surfaces, especially respiratory and GI tracts - acts locally in GI tract but can act systemic
89
IgD
<1% of all immunoglobulins Present in plasma and is easily broken down Rare Predominant antibody on the surface of B cells and is mainly and antigen receptor Needed for the maturation of B Lymphocytes
90
IgE
<1% of all immunoglobulins Antibody involved in immediate hypersensitivity reactions or allergic reactions occurring in minutes of exposure to an antigen Binds to mast cells and basophils Stimulates release of mast cell granules (histamine and heparin) Also involved in parasitic infection
91
What immunoglobulin is the reason we do not normally get zoonoses?
IgM
92
Which is the largest type / structure of immunoglobulins?
IgM
93
Which immunoglobulin has a booster effect where it increases dramatically upon second exposure?
IgG
94
Types of Immunity
Natural Active Passive
95
Natural Immunity
Innate Resistance Factors: heredity, age, health, species, sex Occurs due to IgM
96
Active Immunity
Acquired through immunization (all or part of a microorganism) OR from actually having the disease
97
Passive Immunity
Immunity transferred from another source Sources: breast milk, anti serum, pooled gamma globulin, immune serum Short Term Protection is offered
98
Inactivated Vaccines
Killed viruses providing active immunity not capable of replicating in the host - present little risk to recipient Maintenance of lifelong immunity requires multiple doses
99
Live Vaccines (Attenuated)
Mostly involves use of live virus with altered virulence Does not require use of multiple doses Give active immunity
100
Active Immunization
Use of a modified product of an organism such as a toxoid is given gives active immunity Maintenance of protective titers requires periodic boosters
101
Examples of Active Immunity Vaccinations
Hepatitis B vaccine Diphtheria Pertussis & Tetanus (DPT) Haemophilus influenzae B vaccine Poliovirus vaccine Rotavirus vaccine Measles, Mumps, and Rubella vaccine (MMR) Varicella virus vaccine Influenza virus vaccine Pneumococcal polysaccharide vaccine
102
Why is active immunity not guaranteed by a vaccine?
You have to make the antibodies in response
103
Titer
a test to check for antibodies or if we are making antibodies Often used with immunizations
104
Booster
A booster immunization to make sure you can continue to have a strong immune response with antibodies
105
How does passive immunity occur?
When antibodies from a human or animal are given to people who do not have immunity to the organism Can either be naturally through placenta and breast feeding or by injection of gamma globulins
106
What are the components of a passive immunity vaccination?
1. Immunizing Agent - active component 2. Suspending Fluid - sterile water, saline, complex tissue culture fluid 3. Preservatives - stabilizers or antibiotics to prevent bacterial overgrowth 4. Adjuvants - aluminum based compound to enhance immunogenicity and prolong stimulatory effects
107
What kind of immunity does a Rabies Vaccine offer?
Passive Immunity because you need immediate protection - not the time to make your own antibodies Same applies to snake antivenom
108
Examples of Passive Immunity Globulins
Hepatitis B immune globulin Diphtheria antitoxin Tetanus immune globulin Varicella zoster immune globulin Rabies immune globulin
109
Humoral Immunity depends on ...
maturation of B cells into plasma cells and secretion of antibodies
110
What are the effector responses of humoral immunity?
Precipitation of antigen antibody complexes Agglutination or clumping of cells Neutralization of bacterial toxins and viruses Lysis and destruction of pathogens or cells Adherence of antigen to immune cells Facilitation of phagocytosis Activation of complement There is a primary and secondary response in humoral immunity
111
Serum Sickness
Immune response (like an allergic reaction) occurs when falsely identifying a protein in medicine or antiserum Causes hives, itching, joint, pain, swollen lymph nodes, pain Can occur up to 25 days after exposure to the drug the first time and only 3 the next time
112
What are the stages that occur in a humoral response?
Antigen invades --> attaches to something (MCII) --> Macrophage engulfs and presents the antigen on its surface -->T4 cells then are stimulate from the presence of that MCII antigen --> T4 then activates B cells and differentiation into plasma cells to make antigens/immunoglobulins --> attach to invaders and allows destruction and an attack Proliferation of B and T then occurs allowing Memory cell creation
113
How does HIV prevent the humoral response?
HIV destroys the CD4 marker on the T4 cells which means it can no longer direct destruction
114
How do IgG and IgM levels differ between induced immunity through a primary vaccination and a booster dose?
In the primary vaccination the IgM level will be the first main responder with a slow and slight increase in IgG over time In the booster dose, the IgM level raises the same immediately like in the first dose, but the IgG has been raising since the first dose and immediately grows higher and higher (way above IgM) IgM was metabolized after the first dose, but IgG remained
115
Cell Mediated Immunity
Protection against viruses and cancer cells Action of T Lymphocytes and Macrophages predominate this response Macrophages processes the antigen and presents it to T Cells No antibodies, but protects against viruses and cancer
116
What type of immunity allows for constant cancer screening?
Cell Mediated Immunity
117
What are the stages of a cell-mediated immune response?
Antigen --> Macrophage engulfs antigen --> Antigen MHC II expression --> Release of cytokines by T4 to stimulate T8 --> T8 Production of cytotoxic cells
118
Complement and the Complement Cascade
Consists of 20 proteins circulating as functionally inactive molecules that cause inflammation in response to an invader They "complement" the immune system by helping make an inflammatory response to draw WBC in to the area to phagocytize foreign bodies and lyse it
119
What is usually required for the complement cascade to work?
The antigen-antibody (IgG or IgM) reaction to activate the complement system
120
Chemotaxis
Draws WBC to foreign bodies
121
Potential Pathways for Complement Cascade
Classic Pathway Alternative (Properdin) Pathway
122
Classic Pathway of Complement Cascade
initial step with activation of C1 (complement 1 protein) Fc portion (constant) of IgG and IgM antibody is turned on after the antigen binds to the Fab portion
123
Alternative (Properdin Pathway) of Complement Cascade
Initial step with activation of C3 Activation is done by pieces of bacterial or fungal cell walls being released during phagocytosis Does NOT involve antibodies Debris activates complements for its destruction
124
What do Complement Proteins 1 through 5 do?
Stimulates mast cell degranulation, WBC chemotaxis, and opsonization of bacteria
125
What do Complement Proteins 6 through 20 do?
Bacterial cell lysis by making cell wall "leaky" Pokes holes for enzyme injection
126
Complement Mediated Immune Responses
Cytolysis Adherence of Immune Cells Chemotaxis Anaphylaxis Opsonization
127
Cytolysis
Destruction of cell membranes (body cells or pathogens)
128
Adherence of Immune Cells
Adhesion of Ag-Ab complexes to surfaces of cells or tissues (phagocytes)
129
Chemotaxis
Chemical attraction of phagocytic cells to foreign agents
130
Anaphylaxis
Degranulation of mast cells with release of histamine and other chemical mediators
131
Opsonization
Targeting of antigen so it can be easily engulfed and digested by macrophages Not marked by antibodies, another molecule
132
What are the main things complements do?
They launch an inflammatory response and mark a virus for a macrophage to find This is a non specific response
133
Types of Immune Disorders
Hypersensitivity Disorders Autoimmune Disorders Immunodeficiency Disorders
134
Type I Hypersensitivity Disorders
IgE Mediated allergic reaction (basically allergic mast cell reaction) Anaphylactic - immediate, mediated by IgE IgE antibodies bind with antigens on the surface of Mast cells --> release of allergic mediators that cause vasodilation, increased capillary permeability, smooth muscle contraction, and eosinophilia ex: anaphylaxis, allergy, hay fever, asthma, rhinitis, anaphylaxis, insect reactions
135
Type II Hypersensitivity Disorders
Cytotoxic reaction (cytolytic, complement-dependent) IgG or IgM antibodies bind to cellular or exogenous antigens causing activation of the complement cascade --> this causes phagocytosis or cytolysis ex: Blood transfusion reaction, Goodpasture's syndrome, erythroblastosis fetalis, autoimmune anemia
136
Type III Hypersensitivity Disorders
Immune complex reactions / antigen and antibodies keep grouping together (d/t PMNs) and clump together and are deposited somewhere causing inflammation reaction ex: Post streptococcal, serum sickness, autoimmune vasculitis
137
Type IV Hypersensitivity Disorders
Cell mediated reactions (immediately activates T4 cascade) Delayed reaction APC presents antigen to T cells in association with MHC --> T cells release lymphokines that stim macrophages (NO ANTIBODIES) --> Lysozymes released and damage surrounding tissue (an inflammation reaction causing damage) ex: Contact dermatitis, Tb test, transplant rejection, poison ivy, allograft rejection, HVGD and GVHD
138
Which Hypersensitivity Disorder types are humoral/antibody mediated and which are cell mediated?
Humoral/Antibody - I II III Cell Mediated - IV
139
Autoimmune Disorders
Immune response against self / T celsl get hyperactive and destroy healthy "you" cells ex: rheumatoid arthritis and SLE, can cause Diabetes type I or Pernicious Anemia
140
Anaphylactic Shock
A systemic response from a type I hypersensitivity reaction
141
Anaphylaxis
Systemic response to the inflammatory mediators released in type I hypersensitivity ex: Histamine, acetylcholine, kinins,, leukotrienes, and prostaglandins all cause VASODILATION (less circulating volume, could lead to shock) ex: acetylcholine, kinins, leukotrienes, and prostaglandins all can cause BRONCHOCONSTRICTION
142
Goodpasture's Syndrome
Type II Hypersens. Rxn Inflammation in glomerulus from exposure to an antigen similar to the lining of the glomerulus
143
Erythroblastosis Fetalis
Hemolytic Disease of the Newborn Type II Hypersens. Rxn If the mom is rH negative and dad is rH positive and the baby is rH positive, during delivery the babies blood, if exposed to the mom, can cause the mom to develop antibodies in response to rH antigens Nothing occurs in the first pregnancy, but in the second if the baby is rH+ then the IgG will cross the placenta (not IgM since its too big) and bind to rH and kill fetal RBC --> leads to anemia and cyanosis This is why we give Rhogam twice during pregnancy
144
Agglutination
Blood clumping that occurs if the opposite antibody hits the antigen on an opposite blood type ex: If you give B blood transfusion to an A blood person, the anti A antibodies in the donor B blood will connect with the A antigen on the recipients normal blood and destroy it, while the recipients anti b antibodies will hook to the b antigen and destroy those cells
145
Hemolytic Anemia
Type II reaction This is the agglutination when the donor blood antibodies kill an opposite recipient blood type if given to the wrong person
146
What antigen and antibodies are present in A, B, O, and AB Blood?
A - Antigen A; Anti B Antibody B - Antigen B; Anti A Antibody O - No Antigens; Anti A and Anti B Antibodies AB - A and B Antigens; No Antibodies
147
What is the mechanism of a type III hypersensitivity reaction?
Immune complexes deposit on the walls of blood vessels and activate complements Blood vessels are then damaged Inflammatory response at the vessel level causes damage in type III
148
HVGD
Host v Graft Disease Type IV Hypersens Rxn Tissue Transplant Rejection If the MHC I are not similar enough (still need autoimmune drugs even if they are) the autoimmune system activates in a delayed reaction to the new organ
149
GVHD
Graft v Host Disease Type IV Hypersens Rxn Organ transplanted attacks the host We can suppress the T cells in the person, but T cells in the organ will attack the person and are not suppressed
150
How is Tb testing a Type IV Hypersen Rxn?
Tb is a huge bacteria so we dont have antibodies or a titer for it If we put an antigen under the skin and look for a cell mediated response indicating Tb exposure