Chapter 18 Flashcards
1
Q
disorders of the immune system may be the result of ___ or ___
A
over-reacting, under-reacting
2
Q
Hypersensitivity
A
an over reaction of an immune respomse against a foreign antigen
3
Q
the 4 types of hypersensitivity are…
A
I-immediate,
II-cytotoxic,
III-immune-complex mediated,
IV-delayed or cell mediated
4
Q
Type I(immediate) hypersensitivity:(localized or systemic)
A
Reaction that results from the release of inflammatory molecules in response to an antigen
5
Q
Type I hypersensitivity is commonly called…
A
an allergy
6
Q
The antigens that stimulate a type I hypersensitivity are called…
A
allergens
7
Q
Mechanisms of a type I hypersensitivity reaction are
A
Antigen presenting cell, engulfs allergen, and exfposes the antigen to Th2, Th2 releases IL4 to create B cell which creates plasma cell that secretes IgE. The Fc portion of IgE bind to mast cells, basophils and eosinophils, sensitizing them to subsequent responses.
8
Q
Subsequent exposure to the same allergen, binds to IgE on the surface of mast cells, basophils and eosinophils. these cells release infammatory chemicals from granules…called ___
A
degranulation
9
Q
Degranulation releases…..
A
histamine,
kinins,
proteases,
leukotrienes, and prostaglandins
10
Q
Degranulation occurs after ___
A
cells sensitized
11
Q
Mast cells…
A
derived from stem cells i bone marrow, distributed throughout body (not WBC’s)
12
Q
Basophils…
A
least numerous wbc, (granular WBC)
13
Q
Histimine…
A
dialates blood vessels, tears, mucous, contractions ofsmooth muscle(swollen)
14
Q
Kinins…
A
inflammation
15
Q
Proteases
A
degrades proteins, activates complement
16
Q
Leukotrines…
A
inflammation, vascular permeability
17
Q
Prostglandins…
A
contract smooth muscle
18
Q
Eosinophils…
A
function primarily for parasitic worms, release leukotrines which increase vascular permeability, and muscular contraction
19
Q
Clinical signs of localized alleergic reaction:localized
A
Site of reaction depends on portal of entry, small inhaled allergens may reach lungs and cause asthma
20
Q
Asthma
A
Constriction of bronchi
21
Q
Some foods contain allergens:
A
May cause diarrhea and other gastrointestinal signs and symptoms
22
Q
Local dermatitis may produce ___ (hives)
A
urticaria
23
Q
Urticaria(hives)
A
Raised red areas of skin, itchy b/c histimine affects nerve endings in area
24
Q
Common allergens:
A
pollen, dust mites, spores
25
If lots of mast cells degranulate at once releasing large amounts of histramine or inflammatory mediator this could exceed the body's ability to adjust causing.....
Acute anaphylaxis or anaphylactic shock
26
Clinical signs of acute anaphylaxis or anaphylactic shock
Those of suffocation
27
Diagnosis of type I hypersensitivity
Based on detection of high levels of IgE against specific allergen, sample of blood is taken, and mixed with antigen to determine the IgE quantity in blood.
28
Immuno CAP specific IgE blood test...
Sample of blood is taken, and mixed with antigen to determine the IgE quantity in blood.
29
Alternative diagnoses can involve using skin tests..
Inject dilute allergen into skin of forearm, observe for any inflammation
30
Prevention of type I hypersensitivity..
Identification and avoidance of allergens
31
Food allergens are identified using an ___
elimination diet
32
Immunotherapy
"allergy shots" can help prevent allergic reactions
33
Antihistamine treatment of type I hypersensititvity
is administeration of drugs that counteract inflammatory mediators by neutralizing histamine
34
threatment of type I hypersensitivity Asthma with a ___(counteracts a inflammatory mediator) and a ___
bronchodialator
35
Epinephrine treatment of type I hypersensitivity ...
neutralizes many mechanisms of anaphylaxis
36
what epinephrine does
relaxes smooth muscle, reduces vascular permeability(used in emergencyt treatment of allergic reactions
37
Type II(cytotoxic) hypersensitivity:
Results when cells are destroyed by an immune response
38
Type II hypersensitivity....
Often the combined activities of complement and antibodies, A component of many autoimmune diseases
39
2 examples of Type II
Destruction of blood cells following an incompatible blood transfusion, destyruction of fetal red blood cells in hemalytic disease of the newborn.
40
Blood group antigens:
Surface molecules of red blood cells
41
Each person's RBC's have...
A antigen, B antigen, both antigens, or neither antigen
42
Transfusion reaction can result if an individual receives a ___
different blood type
43
Donor's blood group antigens may stimulate the prodcution of ____
antibodies in the recipient that destroy the transfused cells.
44
If recipient has preexisting antibodies to foreign blood group antigens:
immediate destruction of donated blood cells(hemolysis) can occur, hb released in blood stream, kidney damage, clotting and diarrhea
45
Recipient has no preexisting antibodies to foreign blood group antigens:
Transfused cells intitially circulate and fucntion normally, eventually recipient's immunme system mounts a primary response against the foreign antigens and destroys them
Transfused cells intitially circulate and fucntion normally, eventually recipient's immunme system mounts a primary response against the foreign antigens and destroys them
46
Rh antigen:
an antigen common to RBC's of humans and rhesus monkeys
47
About ___ of humans are Rh positive
85%
48
If Rh- woman is carrying an Rh+ fetus, the fetus may ___
be at risk of hemolytic disease
49
To prevent hemolytic disease of the newborn we ...
administer anti Rh immunoglobulin, called Rhogam
50
Whem moms blood test are done during pregnancy, if mother is Rh-, she is treated to prevent...
hemolytic disease
51
Administration of an anti-Rh immunoglobulin, called __ is performed after childbirth, abortion, or miscarrige to......
Rhogam, kill any fetal RBC's which enter mother's immune system to prevent immune response
52
Drug induced cytotoxic reactions
Some drug molecules can form haptens
53
Haptens
Spontaneously bind to blood cells or platelets(acting as an antigen) stimulating the production antibodies
54
Haptens can produce various diseases
The cells or platelets that bind with the drugs, can then be destroyed by antibodies and complement proteins causing immune Thrombocytopenic purpura
55
Thrombocytopenic purpura
can affect blood clots, WBC's, and RBC's
56
Formation of antigens bound to antibodies form ____ which initiate several immunological process in type III hypersensitivity
immune complexes
57
These immune complexes are not phagocytized, howecver circulate in blood, and .....
travel throughout body
58
Prolonged inflammation can cause ...
damage to blood vessels
59
can cause a localized reaction in type III
hypersensitivity pneumonitis, glomerulonephritis
60
Hypersensitivity pneumonotis
inhalation of antigens (spores) results in complexes that cause pneumonia in lungs
61
Glomerulonephritis
immune complexes deposit in glomerulus (vessels in kidney used for filtration) compromising kidney function
62
Can cause systemic reactions in type III
systemic lupus erhythematosus, rhematioid arthritis
63
Systemic lupus erythematosus
(lupus disease that affects multiple organs. immune system makes antibodies to multiple "self" antigens
64
Rhematioid arthritis
B-cells secrete IgM, that binds to IgG, froming complexes, These IgM-IgG complexes deposit in joints, causing inflammation, and destruction of cartilage
65
Type IV(delayed or cell-mediated) hypersensitivity
When antigens contact the skin to sensitized individuals, they provoke inflammation 12 to 24 hours after contact
66
Type IV hypersensitivity results from the interactin of
Antigens, antigen-presenting cells (APCs) and T-cells
67
The delay in types IV hpersensitivity reflects the time it takes for macrophagtes and T-cells to
Migrate to and proliferate at the site of the antigen
68
The tuberculin response in type IV hypersensitivity
Skin exposed to tuberculosis or tuberculosis vaccine reacts to an injection of tuberculin beneath the skin
69
Tuberculin response is used to
Diagnose contact with antigens of M.tuberculosis
70
There is ____ response to tuberculin when i ndividual has not been infected or vaccinated
No
71
There is a ____ that developse in individuals previously infected or immunized with TUberculin
Red hard swelling
72
Allergic contact dermatitis with type IV
Cell-mediated immune response resulting in an intesely irratating skin rash
73
The allergic contact dermatitis is triggered by
Chemically modified skin proteins that the boyd regards as foreign
74
In severe cases of allergic contact dermatitis
Acellular fluid-filled blisters develop
75
Haptens include the
Oild or poision ivy
formaldehyde
cosmetics
chemicals used to produce latex
76
Allergic contact Dermatitis can be treated with
Corticosteroids
77
Graft rejection in type IV
rejection of tissues or organs that have been transplanted
78
In graft refection a normal immune respose against
Foreign MHC proteins present on graft cells
79
Likeihood of graft rejection depends on the
Degree to which the graft is foreign to the recipient (based on the type of graft)
80
Isograft
Genetically identical (sibiling or clone)
81
Allograft
Genetically different (member of same species)
82
Xenograft
Animals
83
Graft-verus-host disease
Donated bone marrow cells regard the patient's cells as foregin
84
Donor and recipient differ in MHC class I molecules
Grafted T-cells attach recipient's tissue
85
_____ can stop graft-versus-host disease
Immunosuppressive drugs
86
Donor-recipient matching and tissue typing
MHC compativility between donor and recipient difficult due to a high degree of bariability
87
Degree of variability
the more closely the doner and recipient are relate, the smaller the difference in their MHC
88
Preferable the grafts are donated by a ___ or ___
Parent
| Sibiling
89
The actions of immunosupressive drug
imporatn to success of modern transplantation
90
Classed of immunosupressice drug
Glucocoriticoids
Cytotoxic drugs
cyclosporine
lymphocytedepleting therapies
91
Glucocorticoids
(Corticosteroids)
Steroids
supress T-cell to antigen
92
Cytotoxic drugs
Block cellular reproduction (prevents clonal expansion of B-cells and T-cells)
93
Cyclosporine
Prevents production of interleukins blocking helper T-cell responses
94
Lymphocyte-depleting therapies
Antiserum against lyphocytes
95
Autoimmune disease
May result when an indiviual begins to make autoantibodies or cytotoxic T-cells against normal body cells
96
Autoimmune diseases occur more often in
the elderly
97
Autoimmune disease are more common in
men than women
98
All autoimmune disorders are categorized into 2 major categories
Systemic autoimmune diseases, single-organ autoimmune diseases
99
Single-organ autoimmune diseases
Autoimmune hemolytic anemia, type I diabetes mellitus graves disease, multiple sclerosis, rheumatoid arthritis
100
Autoimmun hemolytic anemia
Produce antibodes against own RBCs
101
Type I diabetes mellitus
Immune attack on islets of angerhans, dont produce insulin (affects endocrine)
102
Grave disease
Autoimmune disorder on the thyroid gland (Affects endocrine)
103
Multiple sclerosis
Cell mediated response results in attack or degeneration of myelin sheaths of nervous system
104
Rheumatoid arthritis
Complexes in joints affect connective tissue
105
Conditions resulting from defective immune mechanisms (2 types)
Primar
| Acquired
106
Primary
results from some genetic or developmental defect (develops in infants and young children)
107
Example of primary conditions
Chronic granulomatous disease
Sever conbined immunodeficiency disease (SCID)
Digeorge syndrome
Brutontype agammaglobulinemia
108
Chronic granulomatous disease
Inability of phagocytes to destroy bacter susceptible to infection
109
Severe combined immunodeficiency disease (SCID)
Dont develop lymphoid stem cells, B-cells nor T-cells not produced and cannot mount an immune response
110
DiGeorge syndrome
T-cell deficiencies (thymus doesnt develop)
111
Bruton-type agammaglobulinmia
B-cell deficiencies
| cannot make immunoglobulins
112
Acquired
Develop as direct consequence of some other recognized cause (develop in later lif, number of causes)
113
Reasons we acquire immunodeficiency diseases
severe stress
malnutrition and environmental
acquired immunodeficiency syndrome
114
Severe stress
suppression of cell-mediated immunity results from an excess production of coricosteroids
115
Malnutrition and environmental facors
Inhibit production of B-cells and T-cells
116
Acquired immunodeficiency syndrome (AIDS)
Opportunistic infection
Low CD4 cells
Presence HIV
