Immune System - Quiz 1

Question 1

When does immune system start to develop?

Answer 1

6 weeks of age

Question 2

What is the function of immune system?

Answer 2

Support; protection; vitalized functions; maintaine homeostasis

Question 3

What are the 2 structures of the immune system?

Answer 3

1. Non-specific or Innate; 2. Specific

Question 4

Which immune system is the primary defense against bacterial bacterial invasion?

Answer 4

Innate

Question 5

What is involved in the innate immune system? (5)

Answer 5

Integument; phagocytosis; Killer T cells; body’s physical response; plasma proteins

Question 6

What is phagocytosis? Which immune response?

Answer 6

Consumtion of harmful foreign toxins - innate

Question 7

What are Killer T cells? Which immune response?

Answer 7

Destroy many virus infected cells - innate

Question 8

What is the body’s physical immune response?

Answer 8

Coughing, sneezing, tearing, sweating, body temp, normal flora

Question 9

What is passive immunity? Which immune response?

Answer 9

Antibodies (activated T cells) given to provide protection (transfusion, mother’s breast milk) - innate

Question 10

What is acquired/adaptive immunity?

Answer 10

Destruction of specific organisms and toxins by ANTIBODIES AND SPECIFIC LYMPHOCYTES

Question 11

What 2 things interact to form antibodies? What is produced?

Answer 11

Antigens interact with B-lymphocytes—> produce Immunogobulins (Ig)

Question 12

What are the 2 branches of acquired immunity?

Answer 12

Humoral and Cell-mediated branch

Question 13

What is involved in humoral branch immunity? Origination?

Answer 13

B lymphocytes and Ig molecules —> bone marrow and plasma cells

Question 14

What is involved in cell-mediated branch immunity? Origination and maturation location?

Answer 14

T lymphocytes (helper T cells and cytotoxic T cells) —> bone marrow, matures in Thymus

Question 15

What part of immunity do vaccinations belong in?

Answer 15

Acquired/adaptive immunity

Question 16

What are the 3 main granulocyte components?

Answer 16

Neutrophils and basophils and eosinophils

Question 17

What are neutrophils involved in?

Answer 17

Fight bacterial and fungal infections

Question 18

Which is the most abundant type of WBC?

Answer 18

Neutrophils

Question 19

What are basophils involved in? What do they do?

Answer 19

Involved in hypersensitivity reactions; release histamine, leukotrines, cytokines, and prostaglandins==> can lead to bad allergic reactions. Also stimulate smooth muscle contraction

Question 20

What are eosinophils? Locations (3)?

Answer 20

Fight against parasites -> heavy in GI tract, also in respiratory and urinary mucosa

Question 21

What are the 2 main agranulocytes?

Answer 21

Monocytes and lymphocytes

Question 22

What do monocytes do?

Answer 22

Phagocytosis; release cytokines (transmit signals); present pieces of pathogens to T-lymphocytes

Question 23

What are the 2 types of lymphocytes?

Answer 23

B and T lymphocytes

Question 24

What do B lymphocytes do?

Answer 24

Humoral immunity —> produce antibodies

Question 25

What do T-lymphocytes do?

Answer 25

Cell-mediated immunity (no antibodies)

Question 26

Is inflammation innate or acquired? What are the 5 things involved?

Answer 26

Innate AND acquired - 1. Localized vasodilation; 2. Increased blood flow; 3. Increased capillary permeability; 4. Extravasation of plasma proteins; chemotactic movement of leukocytes to injury

Question 27

What are the 3 clinical manifestations of inflammation?

Answer 27

Erythema, localized edema, pain

Question 28

What 2 immune cells are involved in allergic reactions?

Answer 28

Antibodies attaché to MAST cells and Basophils

Question 29

Who many histamine receptors are there?

Answer 29

3

Question 30

What blocks H1 receptors?

Answer 30

Benadryl

Question 31

What blocks H2 receptors?

Answer 31

Pepcid and ranitidine

Question 32

What do H1 receptors cause

Answer 32

Smooth muscle contraction (except vasculature); vasodilation; increased vascular permeability

Question 33

What do H2 receptors cause?

Answer 33

Stimulate gastric secretion and cardiac stimulation

Question 34

What are the 4 hypersensitivity groups?

Answer 34

Type 1 (anaphylaxis); Type 2 (cytotoxic/hemolytic anemia); Type 3 (immune complex disease/autoimmune); Type 4 (cell mediated/delayed sensitivity)

Question 35

What type of sensitivity reaction is latex?

Answer 35

Type 1 and 4

Question 36

What is required for an anaphylactic reaction (2)?

Answer 36

IgE mediated; requires prior exposure

Question 37

What is required for an anaphylactoid reaction? What is the difference?

Answer 37

Non-IgE mediated; may occur with first exposure; need greater exposure than with anaphylaxis; otherwise same as anaphylaxis

Question 38

What percent of adults/fetal are true drug reactions?

Answer 38

5% adults; 0.1% fetal

Question 39

What is the most common drug reaction? Percentage?

Answer 39

60% - muscle relaxants - rocuronium (quarternary ammonium)

Question 40

What is the second most common drug reaction? Percentage?

Answer 40

Latex - 15%

Question 41

What is the 3rd most common drug reaction? Percentage?

Answer 41

Antibiotics (5-10%)

Question 42

What is the 4th most common drug reaction? Percentage?

Answer 42

Opioids (<5%)

Question 43

What symptoms of transfusion reaction are able to be observed under anesthesia

Answer 43

#1 hemoglobinuria, hypotension, and bleeding

Question 44

What symptoms of transfusion reaction are masked by anesthesia?

Answer 44

Fever, chills, chest pain, flank pain, nausea, flushing

Question 45

What are common reactions to ABO incompatibility (3)?

Answer 45

DIC, renal failure, death

Question 46

Who is at high risk for latex allergy?

Answer 46

Spina bifida, genitourinary tract defects, neural tube defects, multiple surgeries, healthcare workers

Question 47

Who is at the highest risk for autoimmune diseases?

Answer 47

Females of child bearing and working age

Question 48

What regional anesthetic technique alters immunity? What part?

Answer 48

Epidurals have a significant but transient alteration of lymphocytes and Killer T cell activity

Question 49

Which class of medications decrease ciliary activity increasing risk of infection?

Answer 49

Hypnotics

Question 50

What effect do pts with HIV on non-nucleoside reverse transcriptase inhibitors (NNRTIs) have regarding anesthesia?

Answer 50

Meds INDUCE CYP 450 system—> will metabolize drugs FASTER

Question 51

What 2 cancers are associated with HIV?

Answer 51

Non-Hodgkin lymphoma (lesions in CNS) & Kaposi’s Sarcoma (endothelial tissue)

Question 52

What is the most common opportunistic pathogen in HIV patients?

Answer 52

Pneumocystic carinii

Question 53

What carries the highest risk of occupational HIV exposure? Percentage?

Answer 53

Open-bore needles (0.3%)

Question 54

What is the risk of HIV exposure after mucous membrane exposure?

Answer 54

0.09%

Question 55

What is most common presentation of SLE?

Answer 55

Polyarthritis and dermatitis

Question 56

What is SLE?

Answer 56

Chronic inflammatory disease that reduces antinuclear antibodies

Question 57

What is the most common cause of death of SLE patients?

Answer 57

Renal disease (>50% of SLE pts have this)

Question 58

What are 2 common drugs in use that exacerbate SLE?

Answer 58

Procainamide and hydralazine

Question 59

What 2 autoimmune diseases can cricoarytenoid arthritis be seen in?

Answer 59

SLE and RA

Question 60

What possible interaction can cyclophosphamide have regarding anesthetics? Used in which 2 autoimmune diseases?

Answer 60

Inhibits plasma cholinesterase —> succs and ester LA can have longer effect - used in both SLE and RA

Question 61

Which 2 autoimmune disease may require corticosteroid blouses because of adrenal insufficiency during anesthesia?

Answer 61

SLE and RA