Week 6- The Immune System (pt 2) Flashcards by Amber Zimmer

Inaccurate responses to the immune system

-Inadequacy to protect the host (immunodeficiency)
-Overexpression to a substance or hypersensitivity reactions
-Transfusion/transplantation reactions (alloimmunity)
-Reacting to the host’s own cells (autoimmunity)

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True or false: The immune response is absent or depressed as a result of a primary or secondary disorder

True

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Reflects a defect involving T cells, B cells, or lymphoid tissues; inherited defects in the genesis of the immune system

Primary immunodeficiency

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Results from an underlying disease or factor that depresses or blocks the immune response; infection, aging, malnutrition, chemotherapy, autoimmune disorders, or immunosuppression

Secondary immunodeficiency

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Genetic deficiencies of components of innate immunity

Complement proteins
Phagocytes

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AIDS stands for…

Acquired Immunodeficiency Syndrome

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True or false: AIDS is a primary immune deficiency

False

(secondary immune deficiency)

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Three main avenues for the transmission of AIDS

-Contaminated blood
-Sexual activity (anal, vaginal, very rarely oral)
-Maternal to child (either through pregnancy, during delivery, or breastfeeding)

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High-risk behaviors for AIDS

Unprotected anal, vaginal, and oral sex, including having six or more sexual partners in the past year, sexual activity with someone known to carry HIV, or IV drug use

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True or false: HIV is transmitted by fomites, casual household or social contact

False

(transmitted via fluids)

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HIV is a _______, also known as _________

Ribonucleic acid (RNA) virus
Retrovirus

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This virus is surrounded by a lipid bilayer envelope containing the glycoprotein spikes

HIV

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HIV predominantly infects human _____ cells and destroy them; also infect macrophages, B cells, dendritic cells, and microglial cells

T4 (helper) lymphocytes (CD4)

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______ causes the global epidemic because it is more readily transmitted than another form of HIV

HIV 1

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1-6 weeks; flu-like symptoms and lymphadenopathy (swelling of lymph nodes); antibody test remains negative

Acute infection of AIDS

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1-20 years; CD4 count of 500 cells/mm3 or more; positive antibody test but still no reaction

Asymptomatic (AIDS)

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Refers to the emergence of HIV antibodies in the bloodstream

Seroconversion

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Between 200-500 cells/mm3 or more; persistent generalized adenopathy, nonspecific symptoms (such as diarrhea, weight loss, fatigue, night sweats, and fever), or neurologic symptoms resulting from HIV encephalopathy

Symptomatic (AIDS)

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200 cells/mm3 or less

Advanced (AIDS)

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True or false: The stages of infection vary from acute to asymptomatic to symptomatic and correlates with the level of the CD4 (lymphocyte) counts

True

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Clinical manifestations of AIDS

-Neurologic manifestations/peripheral neuropathies
-Neuromusculoskeletal diseases
-Rheumatologic diseases
-Cardiopulmonary diseases
-Lipodystrophy syndrome
-AIDS-related lymphoma

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True or false: HIV medications can cure the etiologic agent

False

(cannot cure)

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True or false: HIV treatment can promote healthier lives and prolong the lives of people with HIV

True

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True or false: Combinations of medicine are taken to prevent HIV from advancing to AIDS

True

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True or false: The medicines used for HIV increase the risk of transmissibility to other people

False (reduce)

Indicates that this illness is not a single disease but the result of a combination of factors

Chronic fatigue syndrome

Unexplained fatigue of greater than or equal to 6 months' duration

Chronic fatigue

Etiologic factors and pathogenesis of Chronic fatigue and Immune dysfunction syndrome

Viral infections, immune dysfunction, neuroendocrine responses, dysfunction of the CNS, muscle structure, exercise capacity, sleep patterns, genetic constitution, personality, and (neuro)psychologic processes

Immune system Endogenous normal flora Gastrointestinal system Genitourinary system Respiratory system Mucous membrane function Skin breakdown

Altered defense mechanism

Exogenous and bacteria, fungi, viruses Opportunistic agents: tuberculosis, pneumocystis, carinii pneumonia, cytomegalovirus, candida albicans

Infectious agents

The client Invasive devices: tubing, catheters, needles Reusable equipment

Reservoirs

Direct: hands, broken skin Indirect: tubes, needles, dressings, catheters, equipment Droplet: cough, sneeze Vehicle: blood

Modes of transmission

Hand washing Standard precautions Clear/sterile techniques Masks for respiratory diseases Sterilize/disinfect equipment Maintain skin integrity

Infection control strategies

4 types of hypersensitivity disorders

Type I- Ige-mediated/immediate type Type II- tissue specific Type III- immune complex mediated Type IV- cell mediated

These compete with histamine for histamine receptors on cell membranes

Antihistamines

Two of the most common applications of antihistamines are...

-Treatment of respiratory symptoms caused by viral infections (ex: common cold) -Respiratory allergic response to seasonal allergies and other allergens

Antihistamines are drugs that specifically block the ____ subtype of histamine receptors

True or false: Newer "second-generation" antihistamines readily cross the blood-brain barrier and enter the brain, causing CNS-related side effects such as sedation and psychomotor slowing

False ("First generation")

Newer antihistamines, or second generation antihistamines, seem to be more ______ for the ____ receptor subtype and produce fewer side effects related to other histamine receptors and receptors for other neurotransmitters

Selective H1

Which type? -IgE-mediated reaction -Immediate rate of development -IgE involved -Mast cells involved -No complement participation -Seasonal allergic rhinitis

Type I

Which type? -Tissue-specific reaction -Immediate rate of development -IgG/IgM involved -Macrophages in tissues involved -Frequent complement participation -Autoimmune thrombocytopenic purpura, Graves disease, autoimmune hemolytic anemia

Type II

Which type? -Immune complex mediated reaction -Immediate rate of development -IgG/IgM involved -Neutrophils involved -No complement participation -Systemic lupus erythematosus

Type III

Which type? -Cell mediated reaction -Delayed rate of development -No antibody involved -Lymphocytes and macrophages involved -No complement participation -Contact sensitivity to poison ivy and metals (jewelry)

Type IV

Type for these clinical manifestations: -Varies according to allergies present -Classic symptoms: wheezing, hypotension, swelling, urticaria, rhinorrhea -Anaphylaxis

Type I

Formed from a CD4+ Th2 (T helper 2) cell-dependent mechanism that binds with receptors on mast cells and basophils

IgE-mediated antibody (on B cells)

True or false: To activate the mast cell, the antigen crosslinks to more than one IgE antibody molecule

True

Mast cells release ________ that induces constriction of vascular and nonvascular smooth muscles, causing ___________ and increasing venule permeability (bronchoconstriction; wheal and flare in the skin)

Histamine Vasodilation

IgG and IgM antibodies are involved in this hypersensitivity

Type II

The symptoms and reactions in type II hypersensitivity depend on what _______ expresses the particular antigen

Organ/tissue

Examples of antibody-mediated diseases

-Myasthenia gravis -Graves disease (hyperthyroidism) -Insulin-resistant diabetes

2 mechanisms of type II hypersensitivity (only need to know #1 and #2 out of the 5)

-ABO incompatibility transfusion reactions; receive wrong type of blood during blood transfusion -Antibody may cause destruction of the cell via phagocytosis by macrophage

Involves interaction of antibody and complement, which may attract the polymorphonuclear cells or neutrophils

Type III hypersensitivity

Antibodies involved in type III hypersensitivity

IgG, IgM, and occasionally IgA

Most common tissues affected for type III hypersensitivity

Kidneys Joints Skin Blood vessels

Example of immune-complex mediated diseases

Systemic lupus erythematosus

The presence of T lymphocyte–mediated reactions (no antibodies are involved)

Type IV hypersensitivity

True or false: Type IV hypersensitivity has an immediate type hypersensitivity reaction

False (delayed)

True or false: There is a graft rejection or allergic reaction after receiving transplantation for type IV hypersensitivity

True

T-Cell mediated diseases

Rheumatoid arthritis Multiple sclerosis Type I diabetes mellitus Hashimoto thyroiditis

Immune mechanisms directed against self-antigens

Autoimmune diseases

True or false: Autoimmune diseases occur when the body fails to distinguish self from non-self, causing the immune system to direct immune responses against normal (self) tissue and become self-destructive

True

More than ____ autoimmune diseases have been identified

Example for localized tissue damage occurs, resulting from the presence of specific autoantibodies

Hashimoto disease

Example for the lesion tends to be localized in one organ, but the antibodies are not organ specific

Primary biliary cirrhosis

Example for non-organ specific diseases in which lesions and antibodies are widespread throughout the body and not limited to one target organ

SLE

Disease in which the immune mechanisms are directed against self-antigens

Autoimmune diseases

True or false: When one has an autoimmune disease, their body fails to distinguish self from non-self, causing the immune system to direct immune responses against normal (self) tissue and become self-destructive

True

True or false: Less than 56 autoimmune diseases have been identified

False (more)

True or false: The causes of autoimmune diseases are often determined

False (not often determined)

Factors of autoimmune disease

-Genetic -Hormonal -Environmental influences -Other factors (ex: viruses, stress, cross-reactive antibodies)

True or false: Although no single gene has been identified as responsible for autoimmune diseases, clusters of genes seem to increase susceptibility

True

The unresponsiveness of certain antigens induced by their exposure to lymphocytes

Immunologic tolerance

Lack of recognition and responsiveness to one’s own tissue antigens

Self-tolerance

Autoimmunity indicates loss of __________

Self-tolerance

Immature lymphocytes that recognize self-antigens during their maturation in central (generative) lymphoid organs

Central tolerance

Immature lymphocytes are killed by _________ in _________ tolerance

Apoptosis Central

Mature lymphocytes that recognize self-antigens become either anergic (i.e., functionally inactive) or suppressed by regulatory T cells or undergo apoptosis

Peripheral tolerance

True or false: The mechanisms of autoimmunity can be associated with gene susceptibilities and epigenetic changes in tissue

True

True or false: Gene-mapping studies have demonstrated that allergy and autoimmunity only involve the recognition of antigen by T cells

False (that and immunoregulatory effects of cytokines, inhibitory receptors, and survival factors)

Linkage analysis of human genome has revealed candidate locations for susceptibility to...

MS, type I diabetes, SLE, Crohn disease

True or false: Bacteria, mycoplasmas, and viruses do not trigger autoimmunity

False

True or false: In the concept of molecular mimicry, viruses and microbes share cross-reacting epitopes with self-antigens where microbial antigens tend to attack self-tissues

True

Two forms of lupus erythematosus (lupus)

DLE SLE

Lupus that affects only the skin (usually the face, neck, and scalp)

Discoid lupus erythematosus

Lupus that can affect any organ or system of the body

System lupus erythematosus

True or false: DLE is more severe than SLE

False (SLE is more severe)

True or false: No two people with SLE will have identical symptoms

True

True or false: SLE is primarily a disease in young women

True

True or false: Evidence does not point to interrelated immunologic, environmental, hormonal, and genetic factors that affect SLE

False (it does)

True or false: It is known SLE represents a single pathologic entity with variable expression and a group of related conditions remains unknown

False (unknown)

A higher incidence of SLE exacerbation occurs among women taking even low-dose ____________.

Estrogen contraceptives

True or false: SLE may also be triggered or aggravated by treatment with certain drugs, which could modify both cellular responsiveness and immunogenicity of self-antigens

True

Three main mechanisms implicated in the development of lupus...

Autoantibodies Vascular abnormalities Inflammatory mediators

One significant feature of SLE is the ability to produce antibodies against many different tissue components such as...

-Red blood cells -Neutrophils -Platelets -Lymphocytes -Almost any organ/tissue in the body

Clinical manifestation of lupus

-Musculoskeletal -Cutaneous and membranous lesions -Cardiopulmonary system -Central nervous system -Renal system -Other systems

True or false: Transplantation of almost any tissue is feasible, but the clinical use of transplantation to remedy disease is still limited for many organ systems because of the rejection reaction

True

In all cases of graft rejection, the cause is __________ of cell surface antigens

Incompatibility

True or false: A recipient's immune system does not recognize that the surface HLA proteins of the donor's tissue are different from the recipient's

False (it does)

True or false: HLA matching of donor and recipient can enhance the probability of graft acceptance

True

Week 6- The Immune System (pt 2) Flashcards

(99 cards)