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Pathophysiology - year 3 > The Immune Response > Flashcards

The Immune Response Flashcards

1
Q

first line of defence?

A

intrinsic barriers

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2
Q

second line of defence?

A

innate immunity

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3
Q

third line of defence?

A

adaptive immunity

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4
Q

confers protection against a broad spectrum of pathogens through use of surface receptors on phagocytic cells that recognize evolutionary conversed patterns unique to pathogens

A

the innate immune system (2nd line of defence)

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5
Q

do not phagocytose pathogens, rather they secrete toxic chemicals or induce apoptosis in target cells

A

natural killer cells

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6
Q

a localized response to infection involving vasodilation, increased vascular permeability and mobilization of phagocytes involving: leukocytosis, margination, diapedesis and chemotaxis

A

inflammation

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7
Q

It is initiated by release of pyrogens (pyro= fire) which include bacterial toxins and/or components, antigen-antibody complexes or substances released by phagocyte

A

a fever

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8
Q

The goal is to eliminate pathogens that may have circumvented or overwhelmed the first 2 lines of defence and to confer protection from new and emergent strains of pathogens

A

the adaptive immune response (3rd line of defence)

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9
Q

what are the hallmarks of the adaptive immune response?

A
  • specificity (self vs non-self)

- memory

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10
Q

is the ability to mount a response to a particular pathogen or foreign substance while being able to discriminate between self vs non-self antigens

A

Specificity

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11
Q

represents the ability to recall past exposures to specific pathogens and provides the adaptive immune system with the ability to mount an even stronger response to a pathogen upon repeat exposure

A

Memory

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12
Q
  • broad specificity
  • limited repertoire
  • lacks memory
A

innate immune system

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13
Q
  • narrow specificity
  • slow response
  • memory
A

adaptive immune system

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14
Q

represents a loose aggregation of lymphoid tissue that is in a unique position to eliminate pathogens at mucosal surfaces before they spread to the underlying tissues

A

MALT (mucosal associated lymphoid tissue)

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15
Q

____ can only recognize antigens that have first been processed by specialized immune cells known as antigen presenting cells or APCs

A

T-cells

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16
Q

___ are capable of recognizing unprocessed (or native) antigens

A

B-cell receptors

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17
Q

DNA segments in T-cell and B-cell receptor genes are randomly combined to create a vast array of permutations

A

Somatic recombination

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18
Q

progressive neurodegenerative disorder involving demyelination of CNS axons

A

MS

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19
Q

an endocrine disorder resulting in hyperglycemia due to insulin insufficiency

A

T1DM

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20
Q

a neuromuscular disease resulting in progressive weakening or paralysis of skeletal muscle

A

Myasthenia Gravis (MG)

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21
Q

a thyroid disorder resulting in overproduction of thyroid hormone (thyroxine) leading to diffuse goitre and exophthalmos

A

Grave’s Disease

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22
Q

Auto-antibodies bind IgG, forming immune complexes in synovial joints resulting in synovitis with destruction of articular cartilage and bone

A

Rheumatoid Arthritis (RA)

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23
Q

impairment of renal function due to inflammation of glomerular basement membrane

A

Glomerulonephritis

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24
Q

Characterized by inflammation involving multiple body systems

A

Systemic Lupus Erythematosus (SLE)

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25
Q

___ are more prone to developing SLE

A

females

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26
Q

Inhibit the early events of antigen processing and cytokine production by macrophages, thereby reducing lymphocyte activation and subsequent autoantibody production

A

Anti-malarials

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27
Q

are a broad class of therapies that employ a wide variety of products from humans, animals, and microorganisms

A

Biologics

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28
Q

inhibits a cell survival factor called BLyS (or B-lymphocyte stimulator), which is necessary for B-cell survival.

A

One specific biologic (a monoclonal antibody preparation called belimumab)

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29
Q

is a cytokine that promotes the survival of regulatory T-helper cells

A

IL-2

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30
Q

T-cell development begins with a process known as ____

A

positive selection or MHC restriction

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31
Q

specialized thymic epithelial cells present self-antigens to developing T-cells in the context of MHC.

A

negative selection or clonal detection

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32
Q

both positive and negative selection occur within the ____

A

thymus

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33
Q

___ appears to be the main mechanism responsible for preventing B-cell mediated autoimmune responses should autoreactive B-cells make their way out of the bone marrow.

A

angery

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34
Q

For T-cells and B-cells to become fully activated antigen presenting cells must supply them with ___

A

additional co-stimulatory molecules

35
Q

function to inhibit or suppress the activities of autoreactive lymphocytes, thereby contributing to peripheral tolerance and ensuring that autoimmune diseases do not arise.

A

Regulatory T-cells produced during thymic education

36
Q

may result if self-antigens that were not present during T-cell and B-cell development suddenly become accessible

A

autoimmunity

37
Q

Cytotoxic T-cells are responsible for mediating cellular immunity

A

CD8+

38
Q

Helper T-cells aid in the induction of cellular and humoral responses by providing essential signals that drive T-cell and B-cell differentiation and clonal expansion

A

CD4+

39
Q

largely secrete a chemical signal called interleukin-2 (IL-2) which helps to fully activate cytotoxic T-cells.

A

Th1 cells

40
Q

largely secrete IL-4 which provides the co-stimulatory signal necessary to fully activate B-cells that have come into contact with foreign antigens

A

Th2 cells

41
Q

cells secrete IL-17 which activates neutrophils and plays a major role in fighting fungal infections

A

Th17 cells

42
Q

Their main function is to suppress adaptive immune responses

A

Regulatory T-cells

43
Q

are largely found in the secondary lymphoid tissues

A

B-cells

44
Q

when antibodies bind toxins, they often inactivate it through direct or allosteric inhibition of the toxin’s active site

A

Neutralization

45
Q

each antibody possesses at least two antigen binding sites, hence they are capable of binding more than one antigen, resulting in clumping

A

agglutination

46
Q

process of tagging antigens with antibodies to help improve phagocytosis

A

opsonization

47
Q

__ on the surface of mast cells, basophils, and eosinophils are capable of binding the stem region of antibodies, which then act as a surface receptor

A

Fc-receptors

48
Q

1st antibody produced during an adaptive response

A

IgM

49
Q
  • Activate compliment
  • Enhance agglutination
  • Neutralize toxins, bacteria and viruses
A

IgM Functions

50
Q
  • most abundant serum antibody (80-85%)

- Longest lasting antibody

A

IgG

51
Q
  • complement activation
  • opsonization of pathogens
  • neutralization of toxin, bacteria and viruses
A

IgG functions

52
Q

found in mucosal secretions (milk, tears)

A

IgA

53
Q
  • confers protection to GI, resp, urinary, and reproductive tracts
  • agglutination
  • neutralization of pathogens
A

IgA functions

54
Q

implicated in host response to parasites and involved in allergic reactions

A

IgE

55
Q
  • expressed on surface of B-cells (B-cell receptor)

- thought to participate in B-cell differentiation

A

IgD

56
Q

largely reside in the skin and mucus membranes where they are most likely to encounter pathogens

A

dendritic cells

57
Q

are considered professional since they are capable of processing extracellular antigens

A

antigen-presenting cells

58
Q

are found on virtually all nucleated cells of the body

A

class I MHC molecules

59
Q

only found on professional APCs

A

class II MHC molecules

60
Q

involves processing of endogenous, cytoplasmic proteins which are then loaded onto MHC I within the endoplasmic reticulum

A

the MHC I pathway

61
Q

Essentially, exogenous antigens are taken up by the cell through phagocytosis and processed by combining the resultant phagosome with a lysosome to create phagolysosome

A

MHC II pathway

62
Q

Infected- and this is the key here - infected dendritic cells will present antigen via MHC I to cytotoxic T-cells

A

Step 1- antigen presentation

Cellular immunity

63
Q
  • involves helper T-cell differentiation

- For a helper T-cell to become activated, the dendritic cell must present antigen in the context of MHC II.

A

Step 2- involves helper T-cell differentiation

Cellular immunity

64
Q
  • requires both the coupling of MHC I with the T-cell receptor and IL-2 from activated helper T-cells
  • Once activated, cytotoxic T-cells will proliferate to form identical clones that will either become memory T-cells or more cytotoxic T-cells
A

Step 3- involves clonal expansion of cytotoxic T-cells

Cellular immunity

65
Q

As clonal expansion proceeds, many of the replicating cytotoxic T-cells will begin to secrete their own IL-2, thereby obviating any need for further dendritic or helper T-cell support

A

Step 4- involves self-stimulation

Cellular immunity

66
Q

This response is initiated by cross-linking of more than one B-cell receptor by repeating epitopes contained on evolutionarily-conserved structures such as the capsule of the influenza virus, lipopolysaccharide expressed in the outer cell wall of gram-negative bacteria (as shown here), bacterial flagella, and other viral capsids

A

T-cell independent humoral activation

67
Q
  • the type of antibody produced will change

- involves an alteration in the stem or Fc region of an antibody

A

class switching

68
Q

The hallmark of adaptive immunity is ___

A

immunologic memory

69
Q

○ Sensitization to antigen (allergen) resulting in production of IgE which primes mast cells, basophils, and eosinophils
○ Subsequent binding of allergen to IgE-receptors of mast cells, basophils and eosinophils induces degranulation with release of histamine
○ Disorders- seasonal allergic rhinitis, conjunctivitis, asthma, acute anaphylaxis (shock)

A

Type I hypersensitivity reaction

70
Q

○ Antibodies bind cells and fix complement resulting in cell lysis
○ Disorders- transfusion reaction, hemolytic disease of newborn, drug-induced cytotoxicity

A

Type II hypersensitivity reaction

71
Q

○ Deposition of antigen-antibody complexes in joints, tissues, and vessel walls
○ Complement activation and inflammation damage tissues
○ Disorders- systemic lupus erythematosus, serum sickness, rheumatoid arthritis, glomerulonephritis, hypersensitivity pneumonitis

A

Type III hypersensitivity reaction

72
Q

○ Host cells destroyed by cytotoxic T-cells
○ Delay reflects time required to initiate cellular response
○ Disorders- contact dermatitis, tuberculin response, graft rejection

A

Type IV hypersensitivity reaction

73
Q

is largely due to increased vascular permeability in the mucus membranes of the lower airways

A

airway swelling

74
Q

is a direct result of histamine-evoked airway smooth muscle contraction

A

bronchospasm

75
Q

is characterized by system wide vasodilation and increased vascular permeability owing to massive combined release of histamine from tissue resident mast cells and basophils present in circulation

A

Anaphylactic shock

76
Q

is a blood-borne pathogen that is also present in other bodily fluids including vaginal secretions, semen, and breast milk

A

HIV

77
Q

HIV occurs in __ phases

A

3

78
Q

usually occurs 1-3 months following infection and is characterized by detectable levels of anti-HIV antibodies

A

seroconversion

79
Q

CD4+ T-cell counts gradually decline as the rate of T-cell death overcomes production

A

latency period

80
Q

inhibit elongation of viral DNA by preventing addition of nucleosides

A

Nucleoside/nucleotide analogs (NRTI/NtRTI)

81
Q

Bind RT active site to prevent transcription of viral RNA into DNA

A

Reverse Transcriptase inhibitors (NNRTIs)

82
Q

Prevent cleavage of viral polypeptides necessary for viral assembly (virus rendered non-infectious)

A

Protease inhibitors

83
Q

Block HIV fusion with CD4

Block CCR5 receptors

A

Entry inhibitors

84
Q

Prevent viral DNA integration into host genome

A

Integrase inhibitors

Pathophysiology - year 3 (8 decks)

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