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Patho 2 > 3 - Immune Disease > Flashcards

3 - Immune Disease Flashcards

1
Q

Virulence refers to:

A

the capacity of a virus to cause severe disease

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2
Q

Endemic refers to:

A

disease with relatively high but constant rates of infection in a particular population

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3
Q

Epidemic refers to:

A

the number of new infections in a particular population greatly exceeds the number usually observed

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4
Q

Define the following:

Direct Transmission

Vertical Transmission

Indirect Transmission

A

Direct: human to human via contact

Vertical: mother to child in utero

Indirect: via vector

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5
Q

What are the four stages of infection?

A

Incubation

Prodromal

Invasion

Convalescence

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6
Q

Bacteria are prokaryotes, meaning:

A

They are unicellular organisms

They have no nuclei, mitochondria or other membrane bound organelles

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7
Q

Gram negative bacteria (do/do not) retain violet dye in a gram stain

A

Do not

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8
Q

Gram ______ bacteria contain a lipopolysaccharide coat that is also known as _____

A

Negative

Endotoxin

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9
Q

What’s the difference between endotoxin and exotoxin?

A

Exotoxins are produced during bacterial proliferation

Endotoxins are contained in the cell walls of GRAM NEGATIVE bacteria and are released during lysis or destruction of the bacteria

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10
Q

Bacteria that produce endotoxins are called _______

A

pyrogenic bacteria

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11
Q

What are some of the potential actions of endotoxins?

A
  1. diffuse vasodilation with hypotension
  2. activation of the coagulation cascade, leading to DIC
  3. release of TNF-A, resulting in wide spread inflammation
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12
Q

Most bacteria secrete a variety of proteases. Why?

A

Defend the pathogen from the immune system by digesting components of plasma systems (including clotting, complement, fibrinolysis)

Weaken surrounding connective tissue, allowing invasion

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13
Q

Infection with a fungus is called:

A

mycosis

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14
Q

Some viruses have a protective envelope over their capsid. Where does this envelope come from?

A

The plasma membrane from the previously infected cell!

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15
Q

Which types of bacteria have a phospholipid bilayer outer membrane?

A

Gram negative ONLY

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16
Q

The primary surface receptor on HIV is the envelope glycoprotein _____, which binds to _____ molecules found mostly on the surface of _____ cells

A

gp120

CD4

T-helper

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17
Q

The major immunologic finding in AIDS is the a striking decrease in the number of ______ cells

A

CD4+ Th cells

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18
Q

Children with HIV are at increased risk of _______

A

coronary artery disease

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19
Q

What is infectious mononucleosis?

A

an acute viral infection of B cells

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20
Q

What is the incubation period of IM?

A

30-50 days!

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21
Q

What is the classic triad of mono symptoms?

A

fever

pharyngitis

lymphadenopathy of cervical lymph nodes

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22
Q

The common feature of all forms of leukemia is:

A

uncontrolled proliferation of leukocytes, causing overcrowded bone marrow and a decrease in functional normal hematopoietic cells

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23
Q

Leukemia is a _____ and _____ disorder

A

accumulation

proliferation

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24
Q

What is the difference between precursor and peripheral lymphocytes?

A

precursor = immature

peripheral = mature

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25
Q

What is the most common form of leukemia in children?

A

Acute Lymphocytic Leukemia (ALL)

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26
Q

What are the most common types of leukemia in adults?

A

chronic lymphocitic leukemia (CLL)

Acute myelogenous leukemia (AML)

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27
Q

90% of lymphoid neoplasms originate from _____

A

B cell progenitor disorder

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28
Q

In a patient with ALL, you would expect an increase in which kinds of white blood cells?

A

lymphoblasts

(T-cell, B-cell)

29
Q

In a patient with AML, you would expect an increase in which white blood cells?

A

Non-lymphoblast

(everything but T and B cell)

30
Q

Why does treatment for one cancer often lead to AML?

A

Drugs that cause bone marrow depression predispose individuals to leukemia

31
Q

Why is CNS involvement common in leukemia?

A

Either from leukemic infiltration or cerebral bleeding

32
Q

What is the 5-year survival rate for adult leukemia?

A

38%

33
Q

What is the most common adult cancer?

A

Chronic Lymphocytic Leukemia

34
Q

The _____ chromosome is present in ____% of CLL patients

A

Philadelphia

95

35
Q

CLL involves malignant transformation and progressive accumulation of _____

A

monoclonal B cells

(rarely t cells)

36
Q

What is it about CLL that makes it chronic, and not acute?

A

the cells that accumulate in the marrow don’t interfere with normal blood cell production that much

37
Q

The major pathophysiologic deficit in CLL is:

A

the failure of B cells to mature into plasma cells that synthesize immunoglobulins

38
Q

The most significant effect of CLL is

A

suppression of humoral immunity and increased infection with encapsulated bacteria

39
Q

Lymphadenopathy is caused by four kinds of disease:

A
  1. Neoplastic
  2. Immune/Inflammatory
  3. Endocrine
  4. Lipid storage
40
Q

There are two types of lymphoma:

A

Hodgkins

Non-Hodgkins

41
Q

There are three types of non-Hodgkin lymphoma:

A

B-cell neoplasms

T-cell neoplasms

NK neoplasms

42
Q

Hodgkin Lymphoma is indicated by the presence of which cells?

A

Reed-Sternberg B cells

43
Q

Discovery of an ______ is often the initial sign of HL

A

asymptomatic mediastinal mass

44
Q

What causes the symptoms associated with Hodkins?

A

the Reed-Sternberg cells secrete cytokines and growth factors that induce infiltration and proliferation of inflammatory cells

45
Q

What is the cure rate for Hodgkins?

A

75%

46
Q

What age range is associated with Hodkins?

Non-Hodgkins?

A

Early 20s and 60s

Middle Age

47
Q

What is Burkitt Lymphoma?

A

B-cell non-Hodgkin lymphoma

fastest growing human tumor

48
Q

Which virus is associated with almost all cases of Burkitt Lymphoma?

A

EBV

49
Q

Lymphoblastic lymphomas are _____ lymphomas arising from _____ cells

A

NHL

T cells

50
Q

It’s easy to mistake a disease process for a lymphoma. When differentiating, an important distinction is:

A

lymphomas usually involve localized lymphadenopathy

51
Q

What has to happen for a plasma cell to be made?

A

A B cell has to be presented with an antigen and stimulated with cytokines from T helper cells

undergoes proliferation and differentiation into an antibody-producing plasma cell

52
Q

When do plasma cells become malignant?

A

During development, plasma cells are designed to secrete IgM, or are rearranged to irreversibly switch to IgG, IgA or IgE

This rearrangement is when some cells may become malignant

53
Q

A common characteristic of plasma cell tumors is:

A

secretion of complete or partial immunoglobulin molecules

54
Q

What is multiple myeloma?

A

clonal plasma cell cancer causing tumor cell masses in the bone marrow

55
Q

Multiple Myeloma causes malignant plasma cells that:

A

produce abnormal amounts of one class of immunoglobulin

USUALLY IgG!

56
Q

Why does Multiple Myeloma cause bone lesions?

A

Malignant plasma cells return to the bone marrow and adhere

they result in osteoclast activation, and osteoclasts begin reabsorbing bone

57
Q

Multiple myeloma results in ____ and _____

A

bone lesions

hypercalcemia

58
Q

What is amyloidosis?

A

When antibody proteins stick together and deposit in peripheral nerves and organs

59
Q

Why does multiple myeloma cause renal failure?

A

Produces an intense amount of abnormal protein in the blood, which puts strain on the kidneys and causes increased viscosity

60
Q

What is the leading cause of death from MM?

A

Infection

61
Q

How does the pathogenesis of Waldenstrom macroglobulinemia differ from MM?

A

WM arises from plasma cells that have undergone rearrangement, but NOT class switch. So they still primarily secrete IgM

62
Q

What is hypersplenism?

A

When splenomegaly leads to overactivity of the spleen

63
Q

Splenic rupture is a complication associated with which disease?

A

Mono

64
Q

Beta Thalassemia results in both hypochromic-microcytic anemia and iron overload. How?

A

Reduced beta globin synthesis leads to abnormal erythroblasts, most of which die in the bone marrow

the ones that do survive are released into the blood stream and don’t live very long, lysing and releasing iron

The body can sense that Hgb levels are low, so it starts absorbing more iron, but the marrow isn’t producing enough cells to use that iron, so it builds up in the body

65
Q

Why is B thalassemia more common?

A

Depending on which trait is inherited, alpha thalassemia is usually either extremely mild or lethal enough to cause stillbirth

66
Q

What is usually the cause of death for people with B thalassemia?

A

Hemochromatosis

67
Q

There are two reasons kids with leukemia may run a fever:

A
  1. Infection
  2. Hypermetabolism from rapid growth and destruction of leukemic cells
68
Q

What is the most common cause of non-hodgkins lymphoma in children?

A

Burkitt’s

Patho 2 (24 decks)

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