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Internal Medicine > Week 6- The Immune System (pt 2) > Flashcards

Week 6- The Immune System (pt 2) Flashcards

1
Q

Inaccurate responses to the immune system

A

-Inadequacy to protect the host (immunodeficiency)
-Overexpression to a substance or hypersensitivity reactions
-Transfusion/transplantation reactions (alloimmunity)
-Reacting to the host’s own cells (autoimmunity)

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2
Q

True or false: The immune response is absent or depressed as a result of a primary or secondary disorder

A

True

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3
Q

Reflects a defect involving T cells, B cells, or lymphoid tissues; inherited defects in the genesis of the immune system

A

Primary immunodeficiency

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4
Q

Results from an underlying disease or factor that depresses or blocks the immune response; infection, aging, malnutrition, chemotherapy, autoimmune disorders, or immunosuppression

A

Secondary immunodeficiency

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5
Q

Genetic deficiencies of components of innate immunity

A

Complement proteins
Phagocytes

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6
Q

AIDS stands for…

A

Acquired Immunodeficiency Syndrome

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7
Q

True or false: AIDS is a primary immune deficiency

A

False

(secondary immune deficiency)

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8
Q

Three main avenues for the transmission of AIDS

A

-Contaminated blood
-Sexual activity (anal, vaginal, very rarely oral)
-Maternal to child (either through pregnancy, during delivery, or breastfeeding)

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9
Q

High-risk behaviors for AIDS

A

Unprotected anal, vaginal, and oral sex, including having six or more sexual partners in the past year, sexual activity with someone known to carry HIV, or IV drug use

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10
Q

True or false: HIV is transmitted by fomites, casual household or social contact

A

False

(transmitted via fluids)

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11
Q

HIV is a _______, also known as _________

A

Ribonucleic acid (RNA) virus
Retrovirus

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12
Q

This virus is surrounded by a lipid bilayer envelope containing the glycoprotein spikes

A

HIV

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13
Q

HIV predominantly infects human _____ cells and destroy them; also infect macrophages, B cells, dendritic cells, and microglial cells

A

T4 (helper) lymphocytes (CD4)

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14
Q

______ causes the global epidemic because it is more readily transmitted than another form of HIV

A

HIV 1

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15
Q

1-6 weeks; flu-like symptoms and lymphadenopathy (swelling of lymph nodes); antibody test remains negative

A

Acute infection of AIDS

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16
Q

1-20 years; CD4 count of 500 cells/mm3 or more; positive antibody test but still no reaction

A

Asymptomatic (AIDS)

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17
Q

Refers to the emergence of HIV antibodies in the bloodstream

A

Seroconversion

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18
Q

Between 200-500 cells/mm3 or more; persistent generalized adenopathy, nonspecific symptoms (such as diarrhea, weight loss, fatigue, night sweats, and fever), or neurologic symptoms resulting from HIV encephalopathy

A

Symptomatic (AIDS)

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19
Q

200 cells/mm3 or less

A

Advanced (AIDS)

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20
Q

True or false: The stages of infection vary from acute to asymptomatic to symptomatic and correlates with the level of the CD4 (lymphocyte) counts

A

True

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21
Q

Clinical manifestations of AIDS

A

-Neurologic manifestations/peripheral neuropathies
-Neuromusculoskeletal diseases
-Rheumatologic diseases
-Cardiopulmonary diseases
-Lipodystrophy syndrome
-AIDS-related lymphoma

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22
Q

True or false: HIV medications can cure the etiologic agent

A

False

(cannot cure)

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23
Q

True or false: HIV treatment can promote healthier lives and prolong the lives of people with HIV

A

True

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24
Q

True or false: Combinations of medicine are taken to prevent HIV from advancing to AIDS

A

True

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25
Q

True or false: The medicines used for HIV increase the risk of transmissibility to other people

A

False

(reduce)

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26
Q

Indicates that this illness is not a single disease but the result of a combination of factors

A

Chronic fatigue syndrome

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27
Q

Unexplained fatigue of greater than or equal to 6 months’ duration

A

Chronic fatigue

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28
Q

Etiologic factors and pathogenesis of Chronic fatigue and Immune dysfunction syndrome

A

Viral infections, immune dysfunction, neuroendocrine responses, dysfunction of the CNS, muscle structure, exercise capacity, sleep patterns, genetic constitution, personality, and (neuro)psychologic processes

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29
Q

Immune system
Endogenous normal flora
Gastrointestinal system
Genitourinary system
Respiratory system
Mucous membrane function
Skin breakdown

A

Altered defense mechanism

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30
Q

Exogenous and bacteria, fungi, viruses

Opportunistic agents: tuberculosis, pneumocystis, carinii pneumonia, cytomegalovirus, candida albicans

A

Infectious agents

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31
Q

The client

Invasive devices: tubing, catheters, needles

Reusable equipment

A

Reservoirs

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32
Q

Direct: hands, broken skin

Indirect: tubes, needles, dressings, catheters, equipment

Droplet: cough, sneeze

Vehicle: blood

A

Modes of transmission

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33
Q

Hand washing
Standard precautions
Clear/sterile techniques
Masks for respiratory diseases
Sterilize/disinfect equipment
Maintain skin integrity

A

Infection control strategies

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34
Q

4 types of hypersensitivity disorders

A

Type I- Ige-mediated/immediate type
Type II- tissue specific
Type III- immune complex mediated
Type IV- cell mediated

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35
Q

These compete with histamine for histamine receptors on cell membranes

A

Antihistamines

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36
Q

Two of the most common applications of antihistamines are…

A

-Treatment of respiratory symptoms caused by viral infections (ex: common cold)
-Respiratory allergic response to seasonal allergies and other allergens

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37
Q

Antihistamines are drugs that specifically block the ____ subtype of histamine receptors

A

H1

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38
Q

True or false: Newer “second-generation” antihistamines readily cross the blood-brain barrier and enter the brain, causing CNS-related side effects such as sedation and psychomotor slowing

A

False

(“First generation”)

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39
Q

Newer antihistamines, or second generation antihistamines, seem to be more ______ for the ____ receptor subtype and produce fewer side effects related to other histamine receptors and receptors for other neurotransmitters

A

Selective
H1

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40
Q

Which type?

-IgE-mediated reaction
-Immediate rate of development
-IgE involved
-Mast cells involved
-No complement participation
-Seasonal allergic rhinitis

A

Type I

41
Q

Which type?

-Tissue-specific reaction
-Immediate rate of development
-IgG/IgM involved
-Macrophages in tissues involved
-Frequent complement participation
-Autoimmune thrombocytopenic purpura, Graves disease, autoimmune hemolytic anemia

A

Type II

42
Q

Which type?

-Immune complex mediated reaction
-Immediate rate of development
-IgG/IgM involved
-Neutrophils involved
-No complement participation
-Systemic lupus erythematosus

A

Type III

43
Q

Which type?

-Cell mediated reaction
-Delayed rate of development
-No antibody involved
-Lymphocytes and macrophages involved
-No complement participation
-Contact sensitivity to poison ivy and metals (jewelry)

A

Type IV

44
Q

Type for these clinical manifestations:

-Varies according to allergies present
-Classic symptoms: wheezing, hypotension, swelling, urticaria,
rhinorrhea
-Anaphylaxis

A

Type I

45
Q

Formed from a CD4+ Th2 (T helper 2) cell-dependent mechanism that binds with receptors on mast cells and basophils

A

IgE-mediated antibody (on B cells)

46
Q

True or false: To activate the mast cell, the antigen crosslinks to more than one IgE antibody molecule

A

True

47
Q

Mast cells release ________ that induces constriction of vascular and nonvascular smooth muscles, causing ___________ and increasing venule permeability (bronchoconstriction; wheal and flare in the skin)

A

Histamine
Vasodilation

48
Q

IgG and IgM antibodies are involved in this hypersensitivity

A

Type II

49
Q

The symptoms and reactions in type II hypersensitivity depend on what _______ expresses the particular antigen

A

Organ/tissue

50
Q

Examples of antibody-mediated diseases

A

-Myasthenia gravis
-Graves disease (hyperthyroidism)
-Insulin-resistant diabetes

51
Q

2 mechanisms of type II hypersensitivity (only need to know #1 and #2 out of the 5)

A

-ABO incompatibility transfusion reactions; receive wrong type of blood during blood transfusion
-Antibody may cause destruction of the cell via phagocytosis by macrophage

52
Q

Involves interaction of antibody and complement, which may attract the polymorphonuclear cells or neutrophils

A

Type III hypersensitivity

53
Q

Antibodies involved in type III hypersensitivity

A

IgG, IgM, and occasionally IgA

54
Q

Most common tissues affected for type III hypersensitivity

A

Kidneys
Joints
Skin
Blood vessels

55
Q

Example of immune-complex mediated diseases

A

Systemic lupus erythematosus

56
Q

The presence of T lymphocyte–mediated reactions (no antibodies are involved)

A

Type IV hypersensitivity

57
Q

True or false: Type IV hypersensitivity has an immediate type hypersensitivity reaction

A

False

(delayed)

58
Q

True or false: There is a graft rejection or allergic reaction after receiving transplantation for type IV hypersensitivity

A

True

59
Q

T-Cell mediated diseases

A

Rheumatoid arthritis
Multiple sclerosis
Type I diabetes mellitus
Hashimoto thyroiditis

60
Q

Immune mechanisms directed against self-antigens

A

Autoimmune diseases

61
Q

True or false: Autoimmune diseases occur when the body fails to distinguish self from non-self, causing the immune system to direct immune responses against normal (self) tissue and become self-destructive

A

True

62
Q

More than ____ autoimmune diseases have been identified

A

56

63
Q

Example for localized tissue damage occurs, resulting from the presence of specific autoantibodies

A

Hashimoto disease

64
Q

Example for the lesion tends to be localized in one organ, but the antibodies are not organ specific

A

Primary biliary cirrhosis

65
Q

Example for non-organ specific diseases in which lesions and antibodies are widespread throughout the body and not limited to one target organ

A

SLE

66
Q

Disease in which the immune mechanisms are directed against self-antigens

A

Autoimmune diseases

67
Q

True or false: When one has an autoimmune disease, their body fails to distinguish self from non-self, causing the immune system to direct immune responses against normal (self) tissue and become self-destructive

A

True

68
Q

True or false: Less than 56 autoimmune diseases have been identified

A

False

(more)

69
Q

True or false: The causes of autoimmune diseases are often determined

A

False

(not often determined)

70
Q

Factors of autoimmune disease

A

-Genetic
-Hormonal
-Environmental influences
-Other factors (ex: viruses, stress, cross-reactive antibodies)

71
Q

True or false: Although no single gene has been identified as responsible for autoimmune diseases, clusters of genes seem to increase susceptibility

A

True

72
Q

The unresponsiveness of certain antigens induced by their exposure to lymphocytes

A

Immunologic tolerance

73
Q

Lack of recognition and responsiveness to one’s own tissue antigens

A

Self-tolerance

74
Q

Autoimmunity indicates loss of __________

A

Self-tolerance

75
Q

Immature lymphocytes that recognize self-antigens during their maturation in central (generative) lymphoid organs

A

Central tolerance

76
Q

Immature lymphocytes are killed by _________ in _________ tolerance

A

Apoptosis
Central

77
Q

Mature lymphocytes that recognize self-antigens become either anergic (i.e., functionally inactive) or suppressed by regulatory T cells or undergo apoptosis

A

Peripheral tolerance

78
Q

True or false: The mechanisms of autoimmunity can be associated with gene susceptibilities and epigenetic changes in tissue

A

True

79
Q

True or false: Gene-mapping studies have demonstrated that allergy and autoimmunity only involve the recognition of antigen by T cells

A

False

(that and immunoregulatory effects of cytokines, inhibitory receptors, and survival factors)

80
Q

Linkage analysis of human genome has revealed candidate locations for susceptibility to…

A

MS, type I diabetes, SLE, Crohn disease

81
Q

True or false: Bacteria, mycoplasmas, and viruses do not trigger autoimmunity

A

False

82
Q

True or false: In the concept of molecular mimicry, viruses and microbes share cross-reacting epitopes with self-antigens where microbial antigens tend to attack self-tissues

A

True

83
Q

Two forms of lupus erythematosus (lupus)

A

DLE

SLE

84
Q

Lupus that affects only the skin (usually the face, neck, and scalp)

A

Discoid lupus erythematosus

85
Q

Lupus that can affect any organ or system of the body

A

System lupus erythematosus

86
Q

True or false: DLE is more severe than SLE

A

False

(SLE is more severe)

87
Q

True or false: No two people with SLE will have identical symptoms

A

True

88
Q

True or false: SLE is primarily a disease in young women

A

True

89
Q

True or false: Evidence does not point to interrelated immunologic, environmental, hormonal, and genetic factors that affect SLE

A

False

(it does)

90
Q

True or false: It is known SLE represents a single pathologic entity with variable expression and a group of related conditions remains unknown

A

False

(unknown)

91
Q

A higher incidence of SLE exacerbation occurs among women taking even low-dose ____________.

A

Estrogen contraceptives

92
Q

True or false: SLE may also be triggered or aggravated by treatment with certain drugs, which could modify both cellular responsiveness and immunogenicity of self-antigens

A

True

93
Q

Three main mechanisms implicated in the development of lupus…

A

Autoantibodies
Vascular abnormalities
Inflammatory mediators

94
Q

One significant feature of SLE is the ability to produce antibodies against many different tissue components such as…

A

-Red blood cells
-Neutrophils
-Platelets
-Lymphocytes
-Almost any organ/tissue in the body

95
Q

Clinical manifestation of lupus

A

-Musculoskeletal
-Cutaneous and membranous lesions
-Cardiopulmonary system
-Central nervous system
-Renal system
-Other systems

96
Q

True or false: Transplantation of almost any tissue is feasible, but the clinical use of transplantation to remedy disease is still limited for many organ systems because of the rejection reaction

A

True

97
Q

In all cases of graft rejection, the cause is __________ of cell surface antigens

A

Incompatibility

98
Q

True or false: A recipient’s immune system does not recognize that the surface HLA proteins of the donor’s tissue are different from the recipient’s

A

False

(it does)

99
Q

True or false: HLA matching of donor and recipient can enhance the probability of graft acceptance

A

True

Internal Medicine (25 decks)

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