Secondary Immunodeficiencies

Question 1

4 Main Causes of Secondary Immunodeficiencies

Answer 1

• infection
• nutrition
• stress
• sleep

Question 2

Immune response requires _________

Answer 2

energy

Question 3

Infections can cause an increase in ______________ to support the upregulation of the immune system

Answer 3

resting metabolic rate (RMR)

-fever increases RMR about 7%/degree above 100

Question 4

Macronutrients provide the immune system with… (2)

Answer 4

• energy/ATP
• substrates for protein synthesis
  - synthesis of acute-phase proteins, complement, cytokines, antibodies

Question 5

sepsis can lead to a loss of up to ______% in total body protein

Answer 5

20%

Question 6

Micronutrients regulate and control metabolic processes

Answer 6

• nucleotides = folate
• RNA/DNA polymerase = zinc
• glutathione = selenium
• respiratory burst activity = iron

Question 7

What do proinflammatory cytokines do to appetite?

Answer 7

decrease it

Question 8

Immunity: Obesity

Answer 8

• increased incidence of infection
• increased inflammatory response
• dysregulation of the immune system

Question 9

________________________ w/o malnutrition appears to have beneficial effects on longevity and disease resistance.

Answer 9

moderate caloric intake

• may help by decreasing availability of dietary iron
• associated w/ increased T cell fxn

Question 10

NAIDS

Answer 10

nutritionally acquired immune deficiency Syndrome

Question 11

Malnourishment leads to (3)

Answer 11

• more severe disease episodes
• more complications
• increased longevity of illness

Question 12

once you shift/alter microbiome flora

Answer 12

PATHOGEN PARTY ZONE

Question 13

Nutritional status determines the ___________

Answer 13

impact of infection

Question 14

infections have more severe outcomes in the _______

Answer 14

malnourished

Question 15

Infections can turn mild nutritional deficiencies into __________

Answer 15

severe malnutrition

Question 16

Infection and illness can exacerbate malnutrition (4)

Answer 16

• diminished appetite
• reduced nutrient absorption
• increased nutrient losses
• alterations in metabolic rate

Question 17

Infection–> increased proinflammatory cytokines and cortisol–> insulin resistance–>

Answer 17

• muscle protein degradation
• accelerated gluconeogenesis
• increased urea cycle activity

Question 18

Infections = (3)

Answer 18

• net protein loss
• hyperglycemia
• increase in RMR and nutritional needs

Question 19

Malnutrition often presents with ___________

Answer 19

multiple nutrient deficiencies

Question 20

If specific nutrients are missing, _____________________________________

Answer 20

fundamental features of the immune system are compromised

Question 21

Supplies 35% of energy to immune cells

Answer 21

glutamine

Question 22

3 things glutamine does/helps with

Answer 22

• B cell transformation to plasma cells
• enhances phagocytic ability and killing capacity of macrophages
• regulates T cell proliferation

Question 23

Glutamine is ________________ in states of illness or injury

Answer 23

conditionally essential

Question 24

Glutamine-enriched nutrition reduces__________

Answer 24

hospital infection rates

Question 25

Iron deficiency is associated w/ ____________

Answer 25

decreased inflammatory responses -decreased respiratory burst -decreased ability of PMNs to kill bacteria/fungi -decreased lymphocyte response to antigen/mitogen - impairs NK cell activity

Question 26

Iron def. may enhance immunity to infectious diseases but untargeted supplementation is BAD

Answer 26

word

Question 27

The time to correct iron is ______________

Answer 27

NOT during an infection | - some bac like iron like malaria

Question 28

Are humans able to store zinc?

Answer 28

no

Question 29

zinc deficiency impairs (5)

Answer 29

- clonal expansion of T/B cells - NK cell cytotoxicity - phagocytosis - complement activity - wound healing

Question 30

Zinc supplements may ________

Answer 30

decrease incidence and/or duration of disease

Question 31

Zinc toxicity can occur, which can

Answer 31

reduce immune fxn

Question 32

if taken early zinc may prevent________

Answer 32

rhinovirus binding and replication

Question 33

Selenium is an essential component of glutathione peroxidase which ______________

Answer 33

helps remove hydrogen peroxide

Question 34

Selenium deficiency leads to (3)

Answer 34

- increased ROS levels which damage macrophages and PMNs - decreased lymphocyte activation - decreased cytokine production

Question 35

Vitamin A is essential for _____________

Answer 35

maintaining epidermal and mucosal integrity | -a compromised barrier may allow pathogenic organisms to cross--> invasive disease

Question 36

Vitamin A enhances recovery, but ___________

Answer 36

doesn't prevent infections

Question 37

Vitamin A deficiency results in (3)

Answer 37

- loss of cilia, microvilli, mucus - diminished number and fxn of PMNs, macrophages, and NK cells - decreased lymphocyte fxns and reduced homing to the gut

Question 38

Vitamin D may enhance ____________ but may inhibit ___________

Answer 38

- enhance innate immunity | - inhibit adaptive immunity

Question 39

Vitamin E is an _______ that increases ______

Answer 39

- antioxidant - IL-2 - increases B and NK cell fxn

Question 40

Vitamin E supplementation (2)

Answer 40

- may reverse some age-related decline in immune fxn | - increase risk of prostate

Question 41

Vitamin C provides protection against ________

Answer 41

oxidative damage | -neutralizes ROS that escape from the phagolysosome

Question 42

Vitamin C does NOT inhibit ____

Answer 42

bactericidal activity

Question 43

Vitamin C does NOT protect against _________

Answer 43

-the common cold although it may shorten the duration

Question 44

What happens to your immune system if you are chronically stressed?

Answer 44

get wrecked

Question 45

The stress response was designed for _____________

Answer 45

short-term physical crises - react then reestablish homeostasis - can be activated for psychological reasons-->stress response becomes a problem

Question 46

stress responds leads to release of

Answer 46

glucocorticoids | -cortisol-->anti-inflammatory/immunosuppressive effects

Question 47

Acute sleep deprivation (2)

Answer 47

- decrease adaptive immunity (Th1) | - decrease vaccine antibody response

Question 48

Chronic sleep deprivation (2+2)

Answer 48

- increased innate immunity/inflammation - increase IL-6, IL-1, TNF, TNFR1 - decrease adaptive immunity - decreased vaccine antibody response

Question 49

What are two drugs that can cause immunodeficiency?

Answer 49

- glucocorticoids | - calcineurin-inhibitors = inhibit IL-2 synthesis