Module 6

Question 1

What are the first lines of defense for the immune system?

Answer 1

Skin, mucous, tears, normal flora and urine flow

Question 2

How does mucous prevent infections?

Answer 2

Nasal hairs, cough, and sneeze reflexes protect the respiratory tract

Question 3

How do tears prevent infections?

Answer 3

Contain antibodies and enzymes that destroy bacteria

Question 4

How does urine flow prevent infections?

Answer 4

Acidic urine, and immunoglobulin work together to impede bacterial growth

Question 5

what occurs when the “first line of defense” fails?

Answer 5

Immune-mediated inflammatory reaction

Question 6

What are some features of the innate immune system?

Answer 6

Response is non-specific
Exposure leads to immediate maximal response
Cell-mediated and humoral components
No immunological memory

Question 7

What does “innate” mean?

Answer 7

Occurs naturally

Question 8

What does “adaptive” mean?

Answer 8

Acquired

Question 9

What are some features of the adaptive immune system?

Answer 9

Pathogen and antigen specific response
Delay between exposure and maximal response
Cell-mediated and humoral components
Exposure leads to immunological memory

Question 10

What are the second and third line of defence ?

Answer 10

Innate (inflammatory) and acquired (immune) response

Question 11

When the immune system is triggered what occurs?

Answer 11

Phagocytic granulocytes (usually neutrophils) to the site of tissue injury (second line of defence. This is followed (up to 48 hours later) with an influx of cells consising of macrophages and T-cells (third line of defence)

Question 12

What is involved in the initial inflammatory reaction?

Answer 12

Dilation and increased permeability of small blood vessles designed o trap and destory harmful molecules

Question 13

What is the third line of defense?

Answer 13

Acquired immunity

Question 14

How does acquired immunity happen?

Answer 14

through prior exposure or vaccines

Question 15

What are the 2 components of the immune response?

Answer 15

Recognition of the presence of foreign substances

Taking action to destroy foreign substances

Question 16

What does SIRS stand for?

Answer 16

Systemic inflammatory response syndrome

Question 17

What is occurring in SIRS?

Answer 17

Its the uncontrolled inflammatory reactions that result from system mediator release.
These mediators are secreted by immune cells that are responding to infection, trauma, pancreatitis, burns or surgery

Question 18

What are some cell mediators released in the immune response?

Answer 18

histamine, cytokins, and endotoxins, signal immune cells, such as T-cells and macrophages, to travel to the site of infection.

Question 19

What is an infection?

Answer 19

A host response to the presence of microorganisms or tissue invasion by microorganisms

Question 20

What is bacteremia?

Answer 20

The presence of viable bacteria in circulating blood

Question 21

What are the 4 conditions that are associated with SIRS?

Answer 21

Temperature >38 or <36
Heart rate >90 BPM
Resp rate >20 breaths per min or PaCO2 <32mm hg
WBC > 12 pr <4, or >10% immature (band) forms

Question 22

What is sepsis

Answer 22

The systemic inflammatory response to infection, IN association with infection
Clinical manifestations of sepsis are the same as SIRS

Question 23

What is multi-organ dysfunction syndrome

Answer 23

Presence of altered organ function in acutely ill patients where homoeostasis cannot be maintained without intervention

Question 24

What is severe sepsis?

Answer 24

Sepsis associated with organ dysfunction, hypoperfusion or hypotension. Hypoperfusion and perfusion abnormalities may
include but are not limited to lactic acidosis, oliguria or an acute alteration in mental status. Hypotension is defined as a
systolic blood pressure 90 mmHg or a decrease in 40 mmHg from baseline in the absence of other causes.

Question 25

What is septic shock?

Answer 25

Sepsis with hypotension despite adequate fluid resuscitation, plus perfusion abnormalities as severe sepsis. Patients who are on inotropic support may not be hypotensive when the perfusion abnormalities are measured

Question 26

What type of response is inflammation?

Answer 26

non-specific

Question 27

How much blood are the kidneys perfused with every mintue and what percen of cardaic output does this repersent?

Answer 27

1200ml | 20-25% of CO

Question 28

What are the three main functions of the kidneys?

Answer 28

Maintenance of body composition Excretion of metabolic end products and foreign substances Production and secretion of enzymes and hormones

Question 29

How do the kidneys help with maintenance of body composition?

Answer 29

The body's principal method of regulating body fluid volume, osmolarity, electrolyte concentration, and pH balance, electrolytes regulated by changes in urinary excretion include sodium, potassium, chloride, calcium, magnesium, and phosphate.

Question 30

How do the kidneys help with excretion of metabolic end products and foreign substances?

Answer 30

The kidneys excrete many of the end products of metabolism, most notably urea. The kidneys also excrete many toxins and drugs from the body.

Question 31

How do the kidneys help with production and secretion of enzyme and hormones?

Answer 31

The kidneys are responsible for the production and excretion of three major enzymes and hormones. These are: renin, which is important in the regulation of blood pressure; erythropoietin, which stimulates maturation of erythrocytes in the bone marrow; and vitamin D3, which is important in regulation of calcium and phosphate balance.

Question 32

What is acute renal failure?

Answer 32

The abrupt decline in renal function resulting in the inability to excrete metabolic wastes and maintain proper fluid and electrolyte balance

Question 33

What is the action and what part of the kidney does anti-diuretic hormone work on?

Answer 33

Makes the tubule impermeable to water, causing the body to retain water Acts on the distal tubule of the kidney and collecting ducts

Question 34

What is the action and what part of the kidney does aldosterone work on?

Answer 34

Regulates sodium retention and potassium secretion | Acts on the kidney tubules

Question 35

What is the action and what part of the kidney does atrial natriurectic peptide (ANP)

Answer 35

Produced by heart in response to over-stretching the atrial walls or fluid overload. Promotes loss of sodium and water Acts on the kidney tubules