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Foundations 2 GW > Immune System > Flashcards

Immune System Flashcards

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1
Q

Characteristics of the Innate Immune System:

A

First line of defense (skin)
Inherited
Rapid response
Prior exposure not needed to act

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2
Q

Components of the Innate Immune System

A 
Granulocytes
-neutrophils
-eosinophils
-basophils
Agranulocytes
-monocytes
-macrophages
Dendritic cells (DCs)
Cytokines
Complement system
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3
Q

What Components of the Innate Immune System are Phagocytes?

A 
Neutrophils
Eosinophils
Monocytes
Macrophages
DCs
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4
Q

Neutrophils have the ____ response time to a pathogen.

A

Fastest

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5
Q

Neutrophils

A

(Granulocyte)
Most numerous of WBCs
Release of cytotoxic cytokines
Dead neutrophils become purulent puss at site of infection

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6
Q

Eosinophils

A 
(Granulocyte)
Heavily concentrated in GI mucosa 
Primary defense against parasites
Release cytokines
Responsible for degrading mast-cell inflammatory response
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7
Q

Basophils and Mast Cells

A

(Granulocyte)
IgE
Release histamine, leukotrienes, cytokines, prostaglandins.
Smooth muscle contraction (bronchospasm).
Basophils least common granulocyte.
Mast cells found in peripheral connective tissue close to blood vessels.
Key initiators of immediate hypersensitivity reactions.
Hay fever, asthma, eczema (atopic allergies)

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8
Q

Monocytes and Macrophages

A

(Agranulocyte)
The largest blood cells
Late inflammatory response

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9
Q

Dendritic Cells are mostly located in the…

A

Spleen
Lymph nodes
Skin
Mucous membranes

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10
Q

Dendritic Cells

A

Most potent antigen presenting cells (identifies pathogen and presents to the adaptive immune system)
Contributes to B cell memory
Also can destroy antigen by phagocytosis

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11
Q

Cytokines

A

Small proteins
Interleukins (regulates inflammatory response)
Interferons (destruction of viral antigens)

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12
Q

Complement System

A

Compliments both innate and adaptive systems

Marks pathogens for destruction and recruitment

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13
Q

What are the components of the Adaptive Immune System?

A

B Cells
T Cells
Natural Killer Cells
Natural Killer T Cells

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14
Q

B Cells

A

Production of antibodies (IgG, IgM, IgA, IgD, IgE)

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15
Q

T Cells

A

Originate in bone marrow then mature in thymus.

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16
Q

Destruction of helper CD4T cells is seen with…

A

Human Papilloma Virus (HPV)

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17
Q

A loss of functional CD4 T cells leads to…

A

HIV and AIDS

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18
Q

Natural Killer Cells

A

Secretion of cytokines to destroy virus infected self cells, tumor cells, and other abnormal cells missing the MHC markers required for identification by other T and B cells.

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19
Q

Natural Killer T Cells

A

Can destroy both bacterial and viral pathogens

They can promote or inhibit the development of autoimmune diseases like diabetes type 1.

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20
Q

Active Immunity is to ________ as Passive immunity is to ________.

A

Vaccines, breast feeding (mother to baby) or transfusions.

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21
Q

Type I Hypersensitivity

A

Immediate 15-30 mins (anaphylactic).
IgE binds to mast cells and basophils which release reactive substances (histamine).
Drug allergy, hay fever, asthma.

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22
Q

Type II Hypersensitivity

A

Cytotoxic
IgG, IgM, compliment
Antigen-antibody complex activates complement and destroys target cells.
Blood transfusion, acute autoimmune hemolytic anemia, transplant rejection, myasthenia gravis, type I DM

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23
Q

Type III Hypersensitivity

A

Immune complex
IgG, IgM, neutrophils, compliment
Antigen-antibody complex deposited in tissue stimulates inflammation.
SLE, RA, glomerulonephritis

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24
Q

Type IV Hypersensitivity

Study These Flashcards
A

Delayed (24 hrs-14 days)
T cells, monocytes, macrophages, cytokines
Antigen activates Tc that kills target tissue.
Poison ivy, transplant rejection, contact dermatitis, graft rejection

25
Type V Hypersensitivity
Stimulatory Humoral antibodies Grave’s disease (> secretion of thyroid hormones)
26
What is the classic sign of an autoimmune disease?
Chronic Inflammation
27
What groups of people are at an > risk for an autoimmune disease?
Females (especially African and Native americans, hispanic females, and females of childbearing age).
28
What are the 6 most common autoimmune diseases?
``` Grave’s disease Hashimoto Thyroiditis Multiple Sclerosis Rheumatoid Arthritis Systemic Lupus Erythematosus Type 1 DM ```
29
B-Lymphocytes do or do not produce antibodies?
Do
30
T-Lymphocytes do or do not produce antibodies?
Do not
31
H1 receptors main actions
- Contraction of most smooth muscle other than of blood vessels. - Vasodilation - Increased vascular permeability
32
H2 receptors main actions
Gastric secretion | Cardiac stimulation
33
Difference between anaphylaxis vs anaphylactoid reaction
Anaphylaxis is IgE mediated while anaphylactoid is not IgE mediated. (But response is the same)
34
Most common culprits for anaphylactic reactions:
- NMB (60%)(Rocc) we give it the most (Quaternary Ammonium)(Cosmetics) - Latex (15%) - Antibiotics (5-10%) - Opioids (<5%)
35
Non-life threatening treatment
Epi - Adults: 100-500mcg sub-q or IM q 15 mins - children: 10mcg/kg (500mcg max) q 15mons x2 then q 4 hours Diphenhydramine -1-2 mg/kg or 25-50 mg IV
36
Life threatening (Anaphylaxis) Tx
Stop administration of antigen Airway 100% O2 Epi 50-100mcg (or more) IV - >cAMP (restores norm cap permeability) and (relaxes smooth muscle) - may get poor response if on BB. (Glucagon can reverse BBs) H1 and H2
37
Latex Allergy
> risk w/ HC workers, neural tube defects, multiple surgeries, spina bifida, genitourinary tract defects. Tropical fruit Type IV (dermatitis) or Type I (anaphylaxis)
38
Anesthesia can ________ the immune system
Depress
39
_______ can alter lymphocyte and killer T activity.
Epidurals
40
With HIV/AIDS, ________ invades cell-mediated branch of the immune system.
Retrovirus
41
Pts with HIV/AID are usually on Non-nucleoside reverse transcriptase inhibitors (NNRTIs) which > the _________ system. This can do what with other drugs?
CYP450. Metabolize other drugs faster.
42
Patients with HIV/AIDS have a abnormal _____ in 50% and _______ _____ in 25% of patients.
EKG, Pericardial Effusions.
43
Some common comorbidities in pts with HIV/AIDS.
Wasting syndrome Dementia, neuropathies Platelet function impairment Non-Hodgkin’s and Kaposi’s Sarcoma.
44
Two major concerns in pts with HIV/AIDS
Infection of patient infection of staff Do not recap needles PPE Highest risk with open bore needles Make sure everyone is aware.
45
What is the most common opportunistic pathogen with HIV/AIDS
Pneumocystic carinii | Pneumonia responsible for most deaths
46
Risk and what to do if exposed to HIV/AIDS
0. 3% after percutaneous exposure 0. 09% after mucous exposure 0. 0% non-intack skin to fluid other than blood. Wash and clean area Get immediate baseline test (you and pt) Empirical tx with 2 or more antiretrovirals within 1-2 hours / 1-2 weeks Periodic testing for 6 months
47
SLE presentation
Chronic inflammatory disease - polyarthritis and dermatitis - malar rash in 1/3 of pts - renal disease in >50% (most common cause of death) 10-20% require dialysis
48
What are some > risks in pts with SLE?
Seizure, stroke, dementia, neuropathy, psychosis Pericardial effusion in >50% of pts
49
Tx for SLE
Corticosteroids Antimalarial Immunosuppressants
50
What exacerbates SLE?
Infection Pregnancy Surgical stress Drugs (over 80) procainamide, hydralazine, captopril....
51
Anesthesia Implications with SLE
Prone to PE, pneumonitis, alveolar hemorrhage, pulmonary HTN, restrictive disease 1/3 of pts exhibit cricoarytendoid arthritis and RLN palsy May need corticosteroids Pts are on cyclophosphamide which inhibit plasma cholinesterase (my > lasting effect of ester LAs and Succ)
52
Scleroderma progression
1 injury to vascular endothelium 2 vascular obliteration and leakage of proteins into interstitial space. 3 tissue edema and lymphatic obstruction due to protein leakage 4 tissue fibrosis
53
Scleroderma Impact | SLIDE 46
Multiple complications | SLIDE 46
54
Anesthetic implications with Scleroderma
``` May require fiberoptic intubation DIFFICULT INTUBATION Bleeding with airway manipulation Chronic HTN GERD Corneal Abrasion Pulmonary HTN (avoid acidosis and hypoxemia) Regional Anesthesia ```
55
RA
Infiltration of lymphocytes, plasma cells,and fibroblasts in synovium. Articular cartilage is eventually completely destroyed.
56
RA Tx
Corticosteroids Methotrexate Immunosuppressants NSAIDs
57
Anesthetic considerations with RA
AIRWAY cervical joints restricted Fiberoptic? No neck extension (restricted) Steriod supplement Cyclophosphamide (plasma cholinesterase inhibitor) NSAIDS and platelet function
58
Most important infection prevention
Hand hygiene - frequent - effective ``` 5 moment for HH Before pt contact Before aseptic task After body exposure After pt contact After pt contact with surroundings ```

Foundations 2 GW (2 decks)

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