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ANAP 520 > TEST 3 - WBC, INFL, IMMUNITY > Flashcards

TEST 3 - WBC, INFL, IMMUNITY Flashcards

1
Q

ANY substance that can elicit an immune response

A

Antigen

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2
Q

An antigen can be an exogenous substance that enters the. Body or an endogenous substance. TRUE/FALSE

A

TRUE

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3
Q

Antigen is usually a ________

A

Protein

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4
Q

Can by secreted by microorganisms and can be antigens

A

Polysaccharides
Lipids
Toxins

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5
Q

An antigen is anything whatsoever that induces an ________ in the host.

A

Immune response

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6
Q

All living cells express antigens on their cell ________; all living cells considered antigenic.

A

Membranes

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7
Q

Projections on antigen; elicit different responses from the immune system

A

Epitopes

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8
Q

Antigens are genetically determined through ________

A

Gene (DNA) inheritance

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9
Q

Antigens are cell _______ and differentiate self from ________.

A

Cell markers

Self from non-self

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10
Q

Normally ______ antigens do not activate the person’s immune system.

A

Self antigens

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11
Q

Non-self/foreign antigens that can activate the immune system in an attempt to destroy the antigen

A

Microorganisms
Rbc antigens
Transplant antigens

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12
Q

Determines a person’s ABO antigen profile or blood type

A

Genes from each parent

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13
Q

Rh stands for what

A

Rhesis

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14
Q

Rh is also inherited from parents. TRUE/FALSE

A

TRUE

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15
Q

Rh+; about _____ % of ppl have the Rh gene and express this antigen on their RBC’s

A

85%

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16
Q

Rh-; about ___% of ppl do not inherit the Rh gene and do not express the antigen on their RBCs

A

15%

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17
Q

There are naturally occurring antibodies for Rh antigen. TRUE/FALSE

A

FALSE

There are NO naturally occurring antibodies for Rh antigen

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18
Q

Antibodies for Rh antigen are only developed when Rh__ individual is exposed to Rh___; when can this happen?

A

Rh- exposed to Rh+

Pregnancy; have to do tests

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19
Q

When can fetus develop antibodies and cause an immune response?

A

If baby is Rh- and mom is Rh+??

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20
Q

Where are antigens located?

A

On the RBC

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21
Q

Where are antibodies located?

A

In the plasma

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22
Q

If have antigen A (type A), what type of antibodies to you have?

A

Anti-B antibody

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23
Q

If have antigen B (type B), what type of antibodies to you have?

A

Anti-A antibody

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24
Q

If have antigens A and B (type AB), what type of antibodies to you have?

A

Neither anti-A or anti-B

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25
Q

If have neither antigen A or B (type O), what type of antibodies to you have?

A

Anti-A and Anti-B antibodies

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26
Q

Universal recipient blood type; no antibodies against type A or B

A

Type AB

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27
Q

Universal donor; antibodies against type A and type B

A

Type O

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28
Q

Donor for O- recipient

A

O- only

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29
Q

Donors for O+ recipient

A

O-

O+

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30
Q

Donors for A- recipient

A

O-

A-

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31
Q

Donors for A+ recipient

A

O-
O+
A-
A+

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32
Q

Donors for B- recipient

A

O-

B-

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33
Q

Donors for B+ recipient

A

O-
O+
B-
B+

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34
Q

Donors for AB- recipient

A

O-
A-
B-
AB-

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35
Q

Donors for AB+ recipient

A

O-/O+
A-/A+
B-/B+
AB-/AB+

ALL OF THEM

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36
Q

Why is AB+ the universal recipient?

A

Do not have to worry about Rh and no antibodies present

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37
Q

Trauma blood

A

O-

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38
Q

Plasma donor for O recipient

A

O
A
B
AB

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39
Q

Plasma donor for A recipient

A

A

AB

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40
Q

Plasma donor for B recipient

A

B

AB

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41
Q

Plasma donor for AB recipient

A

AB

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42
Q

We have to worry about Rh antigen and antibodies when giving plasma. TRUE/FALSE

A

FALSE

Only has antibodies; no Rh antigen

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43
Q

Universal PLASMA donor

A

AB

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44
Q

Universal plasma recipient

A

Type O

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45
Q

Each person inherits __ MHCs from each parent for a total of __ MHC’s in each person

A

6 MHC’s

12 total

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46
Q

MHCs are Divided into class ___ and class____

A

I

II

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47
Q

MHCs are expressed on all _______ body cells

A

Uncleared

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48
Q

Allow immune system to differentiate self form non-self antigens

A

MHCs

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49
Q

Types of body cells MHC’s not expressed on

A

RBC

Plts

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50
Q

Class___ MHCs designated MHC- A, B, or C

A

Class I

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51
Q

Class I MHCs combine with ________ antigens to form a complex that is displayed on the cell ________

A

Intracellular antigens

Cell’s surface

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52
Q

Class I/ ______ antigen complex prompts the immune system to ______ the displaying cell

A

Foreign

Destroy

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53
Q

Class I MHCs mainly interact with what type of T cells?

A

Cytotoxic (CD8+) cells

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54
Q

Designated MHC- DB, DQ, or DR

A

Class II MHCs

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55
Q

Class I MHCs expressed on what type of cells?

A

Nucleated body cells

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56
Q

Class II MHCs expressed on antigen-presenting cells such as?

A

B cells
Macrophages
Monocytes
Dendritic cells

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57
Q

Antigen presenting cells–_________ of foreign antigens–antigens broken down and combine with class ___ MHCs– class __ MHC/antigen complex presented to other _______ cells

A

Endocytosis of foreign

Combine with class II

Class II/antigen complex

Immune cells

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58
Q

Class II MHCs mainly interact with _______ T cells

A

Helper (CD4+) T cells

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59
Q

Very large proteins; MW 150,000-900,000 daltons

A

Immunoglobulins (Ig)

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60
Q

Immunoglobulins are produced by what in response to antigens?

A

B-lymphocytes/plasma cells

B cells differentiate into plasma cells and the plasma cells produce antibodies

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61
Q

Ig’s are produced in response to _______

A

Foreign antigens

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62
Q

Each antibody is antigen ________.

A

Specific

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63
Q

Two regions of an antibody

A

Constant regions

Variable regions

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64
Q

Types of chains in antibody structure

A

Light and heavy chains

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65
Q

Region same form one antibody to the next

A

Constant region

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66
Q

Area modified in response to specific antigen on the antibody

A

Variable region

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67
Q

75% of all antibodies; activate complement system and promote phagocytosis

A

IgG antibody

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68
Q

IgG is the ____ antibody to respond to antigens

A

2nd to respond

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69
Q

Respond to bacteria, viruses, parasites, fungi and toxins

A

IgG

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70
Q

Largest size antibodies; first antibody to respond to antigens

A

IgM

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71
Q

IgM function is similar to Ig__

A

IgG

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72
Q

Antibody responsible for blood transfusion rxns

A

IgM

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73
Q

Second most abundant antibodies; present in body secretions

A

IgA

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74
Q

Major antibodies in allergic and inflammatory responses

A

IgE

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75
Q

Includes lymph, lymphatic vessels/tissue/nodules, tonsils, spleen and thymus

A

Lymphatic system

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76
Q

3 main fxns of lymphatic system

A

Fluid balance
Lipid absorption
Defense

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77
Q

What is stored in the middle of lymph nodes

A

A lot of WBC and other immune cells

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78
Q

Lymph fluid is carried out and into other lymph nodes, usually in sequence and then eventually returned to _________ veins and circulation

A

Subclavian

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79
Q

What happens to lymph nodes when chronically respond to bacteria and infection.

Examples?

A

Swell; lymphadenopathy

Chronic allergies; cancer, etc

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80
Q

Originate in terminal lymphatic spaces in interstitial spaces

A

Lymphatic vessels

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81
Q

Responsible for draining breast tissue, usually the ones that swell with breast cx/tumors

A

Infraclavicular lymph nodes

82
Q

Spleen is reservoir for WBC and RBC; where are they sequestered here?

A

WBC white pulp

RBC red pulp

83
Q

_________ response causes spleen to contract and release WBC/rbc into circulation

A

Sympathetic

84
Q

Where T lymphocytes expressed; behind sternum

A

Thymus

85
Q

Duct where lymph fluid returned back to subclavian

A

Thoracic duct

86
Q

More lymphatic drainage to RIGHT/LEFT SIDE

A

LEFT

87
Q

3 TYPES of WBC

A

Polymorphonuclear granulocytes

Lymphocytes

Monocytes

88
Q

3 types of Granulocytes

A

Neutrophils
Eosinophils
Basophils

89
Q

Types of lymphocytes

A

B-Lymphocytes

T-lymph’s

90
Q

Types of T lymphocytes

A

Helper (T4/CD4 cells)
Cytotoxic (T8/CD8)
Memory
Suppressor

91
Q

4 derivatives of WBCs

A

Macrophages
Mast cells
Natural killer cells
Plasma cells

92
Q

Majority of leukocytes (50-70%); major role is phagocytosis

A

Neutrophils

93
Q

Released by neutrophils; attracts other WBC

A

Chemotactants

94
Q

Released by neutrophils; causes fevers

A

Pyrogens

95
Q

Primary involved in allergic rxns and parasitic invasions

A

Eosinophils

96
Q

Found in the blood stream; secrete histamine and heparin

A

Basophils

97
Q

Transform in to plasma cells which secrete antibody

A

B-lymphocytes

98
Q

B-lymphocytes are responsible for ________ immunity

A

Humoral

99
Q

Stored in lymphoid tissue and respond rapidly to subsequent exposure to same antigen

A

Memory B lymphocytes

100
Q

Initially produced in bone marrow, then mature in thymus and other lymphoid tissue

A

T-lympocytes

101
Q

T-lymphocytes are responsible for ________ immunity

A

Cell mediated

102
Q

T lymphocytes secrete ________; inflammatory mediators

A

Cytokines

103
Q

T-cells that initiate b lymphocyte response

A

Helper

104
Q

T cell that destroy foreign antigens directly

A

Cytoxic

105
Q

T cells stored in lymphoid tissue and respond rapidly to subsequent exposure to the same antigen

A

Memory T cells

106
Q

T cells slow down or stop immune response

A

Suppressor T cells or

“Regulator T cells”

107
Q

Produced in the bone marrow; after leaving vascular system, transformed into tissue macrophages

A

Monocytes

108
Q

Phagocytosis of foreign microorganisms and cellular debris; antigen-presenting cells (present to T lymph’s)

A

Macrophages

109
Q

Locations for macrophage systems in the body

A

Alveoli
CNS: microglia
Sinusoids of the liver
Subcutaneous tissue

110
Q

Found in tissues surrounding blood vessels; secrete histamine and heparin

A

Mast cells

111
Q

Fxn similar to cytotoxic T cells; respond to tumor formation and virally infected cells

A

Natural killer cells

112
Q

Derived from B-lymphocytes; secrete antigen-specific antibody

A

Plasma cells

113
Q

Where B lymphocyes are processed?

A

Human bursa equivalent

Thymus

114
Q

PHSC process to granulocytes/agranulocytes

A

PHSC–
CFU-GM–
WBCs

115
Q

T-lymphocytes are processed in the fetal thymus; produce ________ of t-lymphs and laid down in lymphatic tissue

A

Clones

116
Q

Group of T-lymphs that respond to a specific antigen; in theory one for every antigen to ever come in contact with

A

Clones

117
Q

When T-lymph clones that would amount an immune response later in life against your own body cells are not destroyed, these lead to ________ diseases

A

Autoimmune

118
Q

Examples of autoimmune diseases

A

DM I
Hoshimotos thyroiditis
Lupus
RA

119
Q

Helps clones differentiate into different T lymphocyes

A

Exposure to antigen

120
Q

Biochemicla mediators that promote inflammation

A

Vasodilation
Vascular permeability
Attracting WBC
Stimulating phagocytosis

121
Q

Cellular destruction causes mast cells to produce histamine which results in what?

Purpose?

A

Local vasodilation

Increased vascular permeability

Gets more blood flow and oxygen can cross to tissue

122
Q

Results of kinins (bradykinin)

A

Local vasodilation

Increased vascular permeability

Chemotaxis

Stimulation of pain receptors in area of injury

123
Q

Stimuli that can elicit inflammatory process and release of eicosanoids

A

Physical
Chemical
Hormonal
Neuronal

124
Q

Stimulation works with this enzyme and fatty acid in cell membrane to produce arachidonic acid

A

Phospholipase A2

125
Q

Inhibits phospholipase A2; most effective class of drugs to effective treat the inflammatory process

A

Glucocorticoids

Prednisone, methylprednisone, dexamethasone, etc.

126
Q

After arachidonic acid, what are the two pathways?

A

Lipoxygenase–
Leukotrienes–

Cyclooxygenase–
PGG2/PGH2 (various prostaglandins)

127
Q

Leukotrienes are secreted from where?

A

Leukocytes
Mast cells
Plts
Lung and heart vascular tissue

128
Q

Leukotrienes lead to what?

A

Inflammation

Smooth muscle contraction

Chemotactants

Increased vascular permeability

129
Q

When are a lot of leukotrienes released?

A

Asthma attack

130
Q

Resulted of PGG2/PGH2

A

Prostaglandins
PGI2 (prostacyclin)
TxA2 (thromboxane)

131
Q

What do prostaglandins do?

A

Multiple effects; vasodilation

132
Q

What does PGI2 (prostacyclin) do?

A

Platelet anti-aggregator

133
Q

What does TxA2 (thromboxane) do?

A

Platelet aggregation/vasoconstriction

134
Q

Prostaglandins, PGI2, and TxA2 have a built in _________

A

Counterbalance

135
Q

Enhance NK cell activity

A

Interferons

136
Q

Extremely pro-inflammatory and pro-catabolic; extremely pro-sleep.

A

Tumor necrosis factor

137
Q

Promote development and differentiation of T and B lymphocytes

A

Interleukins 1,2.3.4.5.6…etc.

138
Q

Complement system is composed to ~__ proteins

A

~20

139
Q

The complement system is normally active. TRUE/FALSE.

A

FALSE

Normally INACTIVE

140
Q

Complement system that begins when antibody binds with antigen

A

Classical pathway

141
Q

Complement systemthat begins when protein C3 becomes active

A

Alternative pathway

142
Q

Classical pathway begins with _______ complex

A

Antigen-antibody complex

143
Q

Alternative pathway is activated by _______ substances and factors ____, ____, and ____

A

Foreign substances

Factors B, D, and P

144
Q

At protein ____, alternative and classical pathways become a common pathway

A

C3

145
Q

Promotes phagocytosis, inflammation, and chemotaxis; enhances/complements overall inflammatory process and immune response

A

Complement system

146
Q

How does the complement system lyse cells?

A

Complement proteins form a membrane attack complex and drill holes in the wall of foreign material so water rushes in a lyses cell

147
Q

Inflammatory response is _________ response to cell damage; may or may not involve foreign antigens

A

NONSPECIFIC

148
Q

Example of inflammatory response but foreign antigens not present

A

MI; injury and inflammation present but no foreign antigen

149
Q

Stimulates release of biochemical mediators such as histamine, kinins, eicosanoids, complement system

A

Cellular damage

150
Q

What 3 things does release of biochemical mediators do?

A

Tissue macrophages migrate to area of injury (first line defense)

Margination and diapedesis of neutrophils

Vasodilation and increased vascular permeability

151
Q

First line of defense in acute inflammatory response

A

Tissue macrophages migrate to area of injury

152
Q

What is margination?

A

Where neutrophils start to line walls of the capillaries

153
Q

What is diapedesis?

A

Neutrophils move through the spaces in capillaries and into tissue spaces

154
Q

When do neutrophils become the primary line of defense in acute inflammatory defense?

A

Margination and diapedesis

155
Q

Purpose of “walling off effect” in acute infl response

A

Localized injury; prevents spread of toxins

156
Q

The immune response is a ___________ response to exogenous or endogenous antigens

A

SPECIFIC

157
Q

The immune response involves T and B lymphocytes. TRUE/FALSE

A

True

158
Q

__-lymphocytes/antibodies respond to antigens in body fluids

A

B-lymphs

159
Q

_______- lymphocytes respond to antigens inside body cells

A

Cytotoxic T-lymph’s

160
Q

Once activated, the immune response provides __________ immunity against the specific antigen

A

Long-lasting

161
Q

Macrophage recognition, processing, and presentation to helper-T lymphocytes

A

Phagocytose foreign antigen

Breaks it down and combines with class II MHC

Presented on surface of the macrophage

Stimulates the immune response and CD4 helper T’s to respond

162
Q

Macrophages release this to help attract helper T cells

A

Interleukin-1

163
Q

Secreted by helper T cells; acts on its own cells and causes differentiation and proliferation of the helper T cells; “T cell growth factor”

A

Interleukin 2

164
Q

When a non-macrophage body cell is already infected, it is processed and combines with __________ MHC, and presented on the cell surface. This MHC and a ________ antigen Activates ______ cells.

A

Class 1

Foreign antigen

CD8 cells

165
Q

Helps CD8 cells and allows them to differentiate and proliferate.

A

Interleukin-2 secreted by helper T cells

166
Q

Cytotoxic T cells release _________ and do contact _________.

A

Cytokines

Contact killing

167
Q

B lymphocytes directly identify and process foreign antigen, presents with ________ MHC, helper T responds and interleukins _________ are released

A

Class 2 MHC

Interleukins 4,5,6

168
Q

What do interleukins 4,5,and 6 do after released from helper T cells?

A

4: differentiation of B cell
5: stimulate differentiation from B cell into plasma cell
6: promotes antibody production from the plasma cell

169
Q

Outcomes of antigen-antibody complexing

A

Inactivation of antigens

Agglutination/clumping of antigens

Activation of complement via classical pathway

Enhances inflammatory processes; esp mast cells/basophils

Enhances phagocytosis by neut’s and macrophages

170
Q

How are antigen-antibody complexes removed?

A

Phagocytosis by neutrophils and macrophages

171
Q

Explain The primary response to a specific antigen

A

Small magnitude of response

Longer response time 3-14 days

172
Q

Explain secondary response to specific antigen

A

High magnitude response

Shorter response time hours to a few days

173
Q

Innate (natural) or Aquired immunity?

Species specific; intact skin

A

Innate

174
Q

Innate (natural) or Aquired immunity?

IgA and enzymes in saliva, tears, perspiration

A

Innate

175
Q

Innate (natural) or Aquired immunity?

Requires exposure to antigen; develops SPECIFIC to each antigen

A

Aquired

176
Q

Innate (natural) or Aquired immunity?

Acid of stomach; GI tract enzymes and IgA

A

Innate

177
Q

Innate (natural) or Aquired immunity?

Memory T and B lymphocyte/antibodies

A

Aquired

178
Q

Innate (natural) or Aquired immunity?

Neutrophils and macrophages phagocytosis

A

Innate

179
Q

Innate (natural) or Aquired immunity?

Complement alternative pathway; interferons

A

Innate

180
Q

Innate (natural) or Aquired immunity?

Two types:
Passive and active

A

Aquired

181
Q

Innate (natural) or Aquired immunity?

Natural antibodies; NKCs; various cytokines

A

Innate

182
Q

Person recieves immunity but did not develop it on their own; such as mother/fetus

A

Passive immunity

183
Q

Develop this type of immunity on your own after exposure; such as exposure to elements in nature

A

Active natural immunity

184
Q

Develop this type of immunity on your own but after artificial presentation (immunizations)

A

Active artificial

185
Q

How do we halt the immune response? (4)

A

Elimination of foreign antigen

Suppressor T-lymph’s

Feedback inhibition

Idiotypes (antiidiotypes–antianti…)

186
Q

Subcomponent to antibody; body recognizes as a foreign substance and develops these to take care of it; helps to slow and stop the immune response

A

Idiotypes–antiidiotypes– antiantiidiotypes etc…

187
Q

Most frequently encountered hypersensitivity rxn during anesthesia

A

Type I (allergy)

188
Q

Type I allergy rxns are _____ mediated; what are some examples?

A

IgE mediated

Anaphylaxis, asthma

189
Q

IgG, IgM, Complement mediated; ABO incompatibility

A

Type II (cytotoxic)

190
Q

IgG, Complement, neutrophil mediated; RA, systemic lupus

A

Type III (immune complex)

191
Q

T-cell mediated; multiple sclerosis

A

Type IV (cell mediated)

192
Q

How often do allergic rxns happen during anesthetics

A

Once every 5,000-25,000 anesthetics

193
Q

Mortality % for allergic rxns

A

3.4%

194
Q

You have a ___ min time frame with allergic rxns

A

3 min

195
Q

Respiratory identification of allergic rxns

A

Wheezing

Increased peak pressures

Decreased pulm compliance

196
Q

Allergic identification cardiovascular signs

A

Hypotension
Tachycardia
Decreased SVR
Arrhythmias

197
Q

Cutaneous identification of allergic rxn

A

Urticaria

Generalized edema

198
Q

In management of allergic rxns a plan must be established when?

A

Before the event

199
Q

Primary tx of allergic rxn

A
  1. Stop administration of offending agent
  2. Maintain airway and administer 100% O2
  3. DC anesthetic agents
  4. Intravascular volume expansion
  5. Epinephrine
200
Q

Secondary treatment of allergic rxn

A

Diphehydramine
Bronchodilator
Corticosteroids

ANAP 520 (6 decks)

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