Week 7 (exam 2) Flashcards

1
Q

Describe Innate Immune System

A

immediate onset

1st and 2nd line of defense
- (physical barriers)
- (chemical barriers)

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2
Q

Describe Adaptive Immune System

A

humoral

cell-mediated

third line of defense
- active immunity
- passive immunity

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3
Q

What happens in an autoimmune disease

A

when the body mistakenly makes antibodies against itself

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4
Q

What are the main types of antibodies

A

immunoglobin A
immunoglobin G
immunoglobin M
immunoglobin E
immunoglobin D

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5
Q

Describe the immunoglobins

A

IgA: found in the lining of the respiratory tract, digestive system, spit, tears, and breast milk

IgG: most common antibody, long term, and found shortly after a primary response

IgM: first antibody found in New infection or primary response

IgE: high with allergens or parasitic infections

IgD: least understood antibody

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6
Q

When do we order immunoglobins tests?

A

history of recurrent infections

rare infections in newborns

certain types of cancers

test efficacy of certain immunizations

allergy testing

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7
Q

When do we suspect an immunoglobin deficiency

A

multiple unexplained infections
- see in kids first
- weird infections

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8
Q

Immunoglobins and associated condition

A

IgA high: rheumatoid arthritis, lupus (SLE)
IgA low: congenital deficiencies

IgG high: long term chronic infections
IgG low: often congenital deficiencies

IgE high: allergies and parasitic infections
IgE low: congential deficiencies

IgD high: unknown
IgD low: unknown

IgM high: acute infections
IgM low: congenital deficiencies

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9
Q

Define immunization titer testing

A

tests that measure the antibodies in your blood to determine if you have immunity to a disease

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10
Q

if positive IgG and not vaccinated…

A

still MORE likely to get a bad infection than those without a vaccine

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11
Q

What is RAST Testing and what is it indicated for

A

allergy testing

identify specific allergens
elevated IgE levels

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12
Q

Define leukemia

A

cancer of bone marrow stem cells

begins in the BONE MARROW

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13
Q

What are the diagnostic tools for leukemia

A

CBC: total WBC count always ELEVATED

peripheral smear

flow cytometry (of bone marrow - usually hip)

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14
Q

What are the cells involved, WBC results, and demographics for:
1. acute lymphocytic leukemia
2. chronic lymphocytic leukemia
3. acute myelogenous leukemia
4. chronic myeloid leukemia

A
  1. immature B or T cells, >30% lymphoblasts, children
  2. peripheral B or T cell (lymph nodes), lymphocytosis, MC leukemia in adults
  3. myeloblasts, monoblasts, auer rods, >30% myeloblasts, older adults
  4. elevated eosinophils and basophils, WBC >50,000 some blasts including eosinophils and basophils, ages 20-50 and rare in children
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15
Q

What are the indications for ordering a platelet count

A

signs of petechiae, spontaneous bleeding, increasingly heavy menses

pts with thrombocytopenia

to monitor course or therapy of thrombocytopenia or bone marrow failure

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16
Q

define thrombocytosis

A

increased levels of platelets

major complication = vascular thrombosis
- leads to tissue/organ infarction (decreased blood flow d/t excessive clumping/clotting causing obstruction)

17
Q

Causes of thrombocytosis

A

most common cause: infections

18
Q

How do you evaluate thrombocytosis

A

CBC with peripheral smear
- high platelets –> call heme

PTT/PT/INR

19
Q

define thrombocytopenia

A

decreased levels of platelets

major complication = spontaneous hemorrhage

20
Q

Causes of thrombocytopenia

A

hypersplenism, hemorrhage, immune thrombocytopenia (antibodies destroy platelets), thrombotic thrombocytopenia (HELLP syndrome)

21
Q

What is the initial evaluation of thrombocytopenia

A

CBC with peripheral smear
- low platelets –> call heme

PTT/PT/INR

Bone marrow aspiration
- check if there are issues with production

VWF antigen

22
Q

What is primary hemostasis and secondary hemostasis

A

primary: platelet aggregation

secondary: clotting cascade

23
Q

What is the goal of the clotting cascade

A

to create a fibrin clot from two separate paths

24
Q

What is prothrombin time

A

test used to evaluate the adequacy of the extrinsic system and common pathway in the clotting mechanism

25
What does prothrombin measure the clotting ability of
factor 1 (fibrinogen) factor 2 (prothrombin) factor 5 factor 7 factor 10 (extrinsic system and final common pathway)
26
When the above clotting factors (factors 1, 2, 5, 7, and 10) are deficient in quantities
prothrombin time gets prolonged
27
Live produces clotting factors
1, 2, 5, 7, 9, and 10
28
Which factors depend on vitamin K
2, 7, 9, 10 no vitamin K absorption --> no factor synthesis
29
What is the impact of warfarin on vitamin k dependent clotting factors
interfere with production of vitamin k dependent clotting factors = prolonged PT
30
What are the interfering factors for prothrombin time
alcohol ingestion - prolongs PT time high fat and leafy vegetables diet - shortens PT time diarrhea/malabsorption syndromes - prolongs PT time certain drugs/medications - warfarin
31
Relationship between PT and INR
INR too low = pt is fast/high INR too high = pt is slow/low
32
What is INR used for
used to measure effectiveness and adequacy of anticoagulation therapy with warfarin
33
What is the partial thromboplastin time
test used to evaluate the intrinsic system and the clotting pathway of clot formation also used to monitor heparin therapy
34
What does partial thromboplastin time (PTT) measure the clotting ability of
factor 1 (fibrinogen), factor 2 (prothrombin), factor 5, factor 8, factor 9, factor 10 (extrinsic and common pathway), factor 11, and factor 12 * when the above clotting factors exist in deficient quantities, the PTT gets prolonged
35
What does heparin inactivate
prothrombin (factor 2) - prevents the formation of thromboplastin --> prolongs the intrinsic clotting pathway
36
What deficiencies are seen in hemophilia A, B, C and Von Willebrand Disease
A: 8 B: 9 C: 11 Von Willebrand disease: vwf
37
Why is only the PTT prolonged and not the PT/INR in hemophilia
only factors 8, 9, and 11 are involved in hemophilia PT is factors 1, 2, 5, 7, and 10
38
What are the key points in blood typing
when transfusing, make sure that recipient does not have antibodies to donor blood RBC's crossmatch: mixing of recipient's serum with donor RBC's in saline with Coombs serum