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Pathophysiology > Exam 2: Ch 16 > Flashcards

Exam 2: Ch 16 Flashcards

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1
Q

4 types of hypersensitivity disorder

A

type 1: allergic reactions

type 2: antibody-mediated disorders

type 3: immune complex mediated disorders

type 4: cell mediated disorders

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2
Q

type 1: allergic reactions 2 subtypes

A

local (atopic) reactions

systemic (anaphylactic) reactions

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3
Q

when do type 1 allergic reactions begin

A

almost immediately after exposure to allergen

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4
Q

allergens are usually what type of molecule

A

proteins

pollen, food, animal dander, dust mites

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5
Q

immune system response to type 1: allergens

A

processed by macrophages

T helper cells (CD4) release cytokines which stimulate plasma cells to make and release IgE antibodies

IgE binds to mast cells (sensitized like memory cells)

hours later, esinophils recruited

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6
Q

mast cells that have been sensitized…

A

degranulate on subsequent exposure

release histamine, cytokines, etc

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7
Q

symptoms of type 1: allergic rxns

A

vasodilation

smooth muscle contraction

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8
Q

anaphylactic reaction (systemic)

A

can produce shock

must stabilize airway and give epi

prevent exposure, wear bracelet

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9
Q

local (atopic) allergic rxn examples

A

hives

dermatitis

hay fever

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10
Q

esinophils can also fight off _____

A

parasites

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11
Q

type 2: Ab mediated description

A

IgG or IgM mediated

directed against antigens on cell surfaces or in conn. tissue

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12
Q

3 types of type 2: Ab mediated

A

complement & Ab mediated cell destruction

complement & Ab mediated inflammation

Ab mediated cell dysfunction

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13
Q

complement & Ab mediated cell destruction

A

Ab coat abnormal cells

cells killed by complement system or phagocytosis

ex. blood transfusion rxn

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14
Q

complement & Ab mediated inflammation

A

Ab coat abnormal cells or react with extracellular proteins

complement activated –> chemotaxic factors

monocytes and neutrophils recruited

causes inflammation and tissue damage

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15
Q

examples of complement & Ab mediated inflammation

A

Goodpasture syndrome

glomerulonephritis and pulmonary hemorrhage from basement memb. inflammation

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16
Q

Ab mediated cell dysfunction

A

Ab inactivate/destroy or activate cells (receptors)

ex. Graves disease: Ab activate TSHr (hyperthyroidism)

Myasthenia Gravis: Ab inactivate AChr

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17
Q

type 3: immune complex mediated disorders

A

antigen-Ab complexes form in circulation and activate complement

inflammation and damage within blood vessels

ex. allergic rxns to drugs or food

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18
Q

type 4: cell mediated disorders

A

antigen presented to CD4 by APC

CD4 activates CD8 –> kill target cells w/ antigen

common response to intracellular parasites and part of autoimmune diseases

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19
Q

type 4 can also produce…

A

a delayed hypersensitivity rxn

CD4 secretes cytokines that recruit lymphocytes

inflammation results

ex. contact dermatitis, pneumonitis from inhaled antigens

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20
Q

HLA/MHC

A

human leukocyte antigen/major histocompatibility complex

antigens on surface of all body cells, individual specific

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21
Q

transplantation

A

taking tissue from 1 person and giving it to another

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22
Q

rejection

A

recipient’s (host) immune system sees donor HLAs as foreign and attacks the graft

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23
Q

autologous graft

A

donor & recipient are the same person

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24
Q

syngenic graft

A

donor and recipient are identical twins

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25
allogenic graft
donor and recipient differ genetically
26
allograft rejection
host immune system recognizes graft antigens on organ surface or APCs activates CD4 --> CD8 --> type 4 rxn Ab may contribute
27
3 patterns of rejection
hyper acute acute chronic
28
hyper acute rejection
almost immediate type 3 rxn results from preexisting Ab from previous blood transfusions
29
acute rejection
within months involves T cells
30
chronic rejection
may involve fibrosis cytokines takes time
31
graft vs. host disease
most common following bone marrow transplant graft attacks the host's organs host's immune system compromised and can't destroy graft produces rash, GI sloughing, organ (liver) failure
32
what is an autoimmune disease
when the immune system attacks self organ-specific or systemic
33
examples of organ-specific autoimmune diseases
thyrotoxicosis (Graves): TSH pernicious anemia Hashimoto thyroiditis Addison's disease
34
examples of systemic autoimmune diseases
lupus scleroderma rheumatoid arthritis ulcerative colitis
35
immune tolerance
immune system "tolerates" self, only attacks foreign antigen develops in fetal development
36
central tolerance
T cells reacting against self are eliminated in thymus
37
peripheral tolerance
immune cells including B cells that react against self are eliminated in the lymph organs
38
genetic susceptibility to autoimmune disease
families with specific HLAs prone not everyone with HLA type gets disease, mechanism unclear
39
environmental factors of autoimmune disease (mechanisms)
T cells active against self when co-stimulators present self-antigens that were held during development are released, prompting an immune response molecular mimicry: microbe has antigen similar to self super-antigens on microbes stim T cells w/o processing and binding to normal receptors
40
diagnosis of autoimmune disease
assay for Ab in patients with symptoms (fever, rash, inflammation)
41
treatment of autoimmune disease
steroids immunosuppressants
42
primary immunodeficiency disorders
inherited or congenital -- most recessive and x-linked some traced to cytokines/signaling pathways warning signs: multiple infections many types
43
some signs of primary immunodeficiency disorders
8+ ear infections in a year 2+ sinus infections in a year 2+ pneumonia in a year 2+ deep-seated infections 2+ months on antibiotics that doesn't help
44
b-cell immunodeficiency
most common primary immunodeficiency stem cells --> pre-B in marrow --> lymph tissue maturation mature B cells make specific Ab --> plasma cells when stim
45
transient hypogammaglobuinemia of infancy
delayed production of IgG --> multiple respiratory infections usually resolves spontaneously (infants protected by maternal IgG until 6mo of age)
46
X-linked agammaglobulinemia
recessive, more common in males bruton tyrosine kinase needed for pre-B maturation symptoms at 6-9mo, respond poorly to antibiotics Rx: IVIG (intravenous immunoglobulin)
47
common variable immunodeficiency
differentiation of B cells to plasma cells blocked (affects 1+ types) symptoms in teens to early adult
48
immunoglobulin G deficiency
respiratory infections IVIG
49
T-cell immunodeficiency
more severe than B-cell deficiency DiGeorge syndrome (thymic hypoplasia)
50
DiGeorge syndrome (thymic hypoplasia)
T-cell deficiency developmental defect of thymus and parathyroid associated w/ facial and cardiac defects extent of defect variable
51
SCID severe combined immunodeficiency disorders
most x-linked and recessive, more common in males survival rate w/o bone marrow transplantation 1 type: T, B, NK cells deficient 2nd type: T, NK, CD4 cells deficient, B cells elevated, Ab production abnomal,
52
AIDS is caused by ___ infection
HIV 34m ppl living, 1.7m died, 2.5m get it most new infections in underdeveloped countries sub-sarahan africa, racial minorities in US recognized in 1981, IDed in 1984
53
transmission of HIV
sexual contact: body fluid contact w/ mucosa or open sore blood to blood contact: shared needles perinatal transmission: in utero or during delivery occupational
54
seroconversion
when HIV Ab develop and become detectable 1-6 mo after infection
55
HIV virus structure
HIV 1 & 2 (1 most common in US & europe, 2 in africa) retrovirus (RNA)--core surrounded by lipid envelope 2 copies of RNA in core, p24 protein (target of Ab screen) and p17 protein (surrounds core) 3 enzymes: Rev. transcriptase, integrase, protease
56
enzyme order HIV
reverse transcriptase (transcribes RNA into dsDNA) integrase (dsDNA integrated into CD4 genome) (transcription, translation happens) protease (breaks polyprotein into pieces) new virus built from pieces and HIV released from cell
57
HIV infects which type of cells
CD4--binds to receptors and other surface molecules (CCR5) requires glycoproteins gp120, gp41 virus memb. fuses to CD4 so RNA and enzymes can enter cell
58
HIV replication starts at...
site of infection many CD4 cells infected by day 10 people with HIV generally asymptomatic until CD4 count falls
59
classification of HIV phases
HIV+ said to have AIDS if: CD4 count less than 200cells/microliter or have an AIDS-defining illness
60
HIV stage 1 and 2 and 3 (AIDS)
T cells greater than or equal to 500 2: T cells between 200-499 3: T cells less than 200
61
primary HIV infection
mono-like symptoms (fever, fatigue, myalgia, sore throat) viral replication rapid CD4 count falls treatment beneficial
62
latent period of HIV infection
viral load is low, but CD4 count falls over time lymphadenopathy develops
63
overt AIDS
viral load climbs CD4 count less than 200/ul or AIDS-defining illness opportunistic infections and cancer develops
64
what is the leading cause of death for AIDS
TB
65
respiratory manifestations of AIDS
pneumocystis pneumonia (fungal spores) common pneumonia like strep, pseudomonas, H flu PCP--less common since HAART mycobacterium TB: multiple drug resistant strains
66
GI manifestations of AIDS
esophageal candidiasis herpes simplex (esophageal) gastroenteritis: protozoal or bacterial (stool culture)
67
NS manifestations of AIDS
HIV-associated neurocognitive disorders (HAND) cognitive and motor impairment toxoplasmosis: parasitic brain infection antibiotics
68
Kaposi sarcoma
endothelial cell malignanacy in AIDS opportunistic cancer linked to herpes lesions on skin and in mouth, in internal organs (lungs) HAART may be effective
69
non-hodgkin lymphoma
AIDS cancer may undergo remission with HAART
70
cervical and anal carcinoma
AIDS cancer from HPV
71
wasting syndrome
AIDS weight loss, diarrhea, chronic weakness, fever Rx: appetite stimulants
72
3 metabolic disorders associated with AIDS
insulin resistance hypercholesterolemia/triglyceridemia lipohypertrophy might need to switch anti-retroviral drugs
73
insulin resistance (AIDS)
higher among those with HIV medications may contribute to development
74
hypercholesterolemia/triglyceridemia
HIV and medications contribute to development monitor lipids closely use statins with caution
75
lipohypertrophy
buffalo hump right below back of neck
76
prevention of HIV infection
condoms avoid recreational drug use, sharing needles routine screening education
77
diagnosis of HIV
HIV Ab test: ELISA + western blot if initial is ( + ) western blot is more specific (less false pos) oral swab for at home use (both ELISA and western blot) PCR: detects HIV, not Ab (used earlier)
78
HAART
combination of 2 or 3 anti-retroviral drugs reverse transcriptase inhibitors protease inhibitors entry inhibitors integrase inhibitors
79
reverse transcriptase inhibitors
block RNA --> DNA conversion block elongation of DNA by adding fake nucleotide or inhibit enzyme
80
integrase inhibitors
prevent integration of viral cDNA into cell genome
81
protease inhibitors
block cleavage of viral proteins by binding and inhibiting enzyme
82
entry inhibitors
prevent HIV from binding to or entering CD4 cells

Pathophysiology (24 decks)

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