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What is self tolerance?
the immune system doesn’t attack its own cells under normal circumstances
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How does the body determine what is "self" and what is foreign
proteins on the cell membrane
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Define antigens. how many types?
- Cell surface proteins that are not self; these are capable of stimuating an immune response
- 2types:
- -complex proteins (pollen)
- -low molecular weight substances (drugs)
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TF: Cancer cells are detected as non-self by the immune system
True; the mutation of the cell into cancer causes the body to see the cell as foreign
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When does the immune system peak?
In the 20's and the 30's
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How does having a blood transfusion weaken immunity
Even with the right blood type, there are HLA-antigens on the WBCs and the immune system will recognize these as non self.
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What are the components of the immune system?
- bone marrow
- WBCs
- Lymphoid tissue
- Physical barrier (skin, membranes, cilia)
- Chemical barriers (flora, mucus, secretion, acids, tears, enzymes)
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Where are the lymphcytes stored?
spleen
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Where do the T cells mature and proliferate
Thymus gland
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What parts of the body filter out materials
- lymph nodes
- tonsils
- adenoids
Note that the spleen filters out old/injured RBCs
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The tissue in which systems are involved in anaphylaxis
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What are the three processes required for immunity
- Natural immunity:
- -inflammation
- Acquired immunity:
- -antibody mediated immunity
- -cell mediated immunity
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Distinguish between the presence of natural and acquired immunity
- Natural or innate immunity is present at birth.
- Acquired of Adaptive immunity develops after birth
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Distinguish between the responses of natural and acquired immunity
- Natural immunity has a consistent response despite repeated exposure and is responsbile for inflammation.
- Acquired immunnity has a specific, escalating response and it gets more and more marked
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TF: Natural (innate) immunity promotes the development of acquired immunnity
True
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What do the WBCs do in natural immunity?
They release cell mediators and engulf foreign bodies
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TF: the natural immune response is an immediate response
True
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What are the vascualr changes that are involved in the inflammatory response
- vasodilation
- increased capillary permeability
- increased blood flow
- local tissue congestion
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What are the cellular changes that are involved in the inflammatory response
- phagocytosis
- increased leukocytes (granulocytes & monocytes)
- chemical mediator release (mast cells and macrophages)
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The WBCs are granular and nongranular. distinguish
- Granular:
- neutrophils
- basophils
- eosinophils
- Non-granular:
- monocytes
- macrophages
- lymphocytes
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What are the three types of lymphocytes
- B-cells (antibody mediated/humoral mediated)
- T-cells (cell mediated)
- NK cells (natural killer)
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B-cell. matures where?type of? produce?
- matures in bone marrow
- type of lymphcyte<-agranulocyte<-WBC
- produce antibodies (immunoglobulins)
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T-cell. matures where?type of? it's types?
- matures in thymus
- type of lymphcyte<-agranulocyte<-WBC
- has the following types:
- -K, killer cytoxic cell
- -H, helper cells
- -R, regulatory, suppressor cells
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TF: Both B-cells and T-cells (lymphocytes) recognize antigens
True
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the b cells involved in the humoral (antibody mediated response) differentiate into what two types of cells
- plasma cells that release the antibodies
- memory cells that remember them for next time
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Discuss the escalating response when you exposed to the same antigen again
The memory cells remembers and kicks it the next time you are exposed to the same antigen
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What cells ingest the foreign material?
The granulocytes and the macrophages
Remember that the granulocytes are all the -phils.
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What cell releases the chemical mediators
eosinphils (granulocyte)
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TF: the phagocytic immune response triggers the inflammatory response
True
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What response dominates in bacterial infection
Antibody immune or humoral response
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What response dominates in fungal and viral infection
Cell mediated response
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Describe antigens and antibodies
- Antigens are cell surface proteins that are recognized by B and T cells
- Antibodies are large proteins that contain binding sites for the antigens
- This binding facilitates phagocytosis
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What is the complement activation system
actions trigered by some classes of antibodies that can remove or destroy antigens
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What are the antibodies
- IgG -activates compliment; most important in bacteria
- IgM - small amount; early
- IgA- present in most body fluids: GI, GU, respiratory
- IgE - allergies
- IgD
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stages of the immune response
- recognition
- proliferation
- response
- effector
Think: I recognize profanity and respond effectively
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TF: The antigen antibody complex causing clumping
True: makes it easier for phagocytes
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With transplants, what kind of immune response is going on
cellular
Think: not bacteria, so must be cell response that attacks directly
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What do the three types of T cells do?
- HKR:
- Helper cells: activates and secretes cytokines
- Killer cells: use cytokines and cytolytic enzymes to immobilize
- Regulator cells: regulate the degree of response
- THINK: Help Kill Regularly
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What does the complement system do that is activated by the antigen-antibody complex
- punctures bacteria cell's membrane
- assist in disposal of inflammation byproducts
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What's an example of the hypersensivity immune system?
allergies
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What's an example of the autoimmmunity immune system?
- rheumatoid arthritis
- lupus erythmatosus
- scleroderma
- gout
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Describe IgE and allergic reactions
- involves macrophages, B-cells and T-cells
- IgE binds with antigen trigger mast to release chemical mediators
- IgE producing cells are located in the respiratory and intestinal mucosa
- can be biphasic because of continuous release of mediators
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How does the low molecular weight substances type of antigen initiate antibody responses
by attaching to other proteins why
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There are two types of chemical mediators of allergic reactions. What are they. describe
- There is a primary and secondary allergic reaction.
- The primary reaction occurs immediately and involves mast cells
- The secondary reaction occurs in response to the primary mediators released by the mast cells
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Ther are four types of hypersensitivies
- Type I immediate (asthma, allergies, anaphylaxis)
- Type II cytotoxic (MG, thrombocytopenia, hemolytic anemia)
- Type III immune complex mediated (SLE, RA)
- Type IV delayed (contact dermitis, GVHD, organ rejection)
Remember: allergies, anemia, arthritis, a new organ
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What do you expect to see in anaphalyxis
- widespread blood vessel dilation
- bronchoconstriction
- decreased cardiac output
- hypotension too
- edema
- pulmonary edema
- nausea
- vomiting
- abdmominal cramping
Note: both HR and BP are decreased and this can be biphasic
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What is the most common cause of anaphylaxis
drugs
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TF: The risk of anaphylaxis is increased with urban environments
False; it is increased in rural environments
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Which route (parental or oral) contributes more to anaphylaxis
parental
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People that take what drugs and miss dosages are at an increased risk of anaphylaxis
- monoclonal antibodies
- cytokines
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What drugs are commonly involved in anaphylaxis
- antibiotics
- allopurinol (for gout)
- NSAIDs
- narcotics
- streptokinases (like TPA)
- vaccines
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What drugs do you use to treat anaphylaxis
- epinephrine
- antihistimines
- H2 antagonists
- corticosteroids
- fluids
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What happens in a cytotoxic Type II hypersensitvity reaction; examples
Examples: hemolytic anemias, hemolytic transfusion reactions, myathenia gravis
- IgG and IgM work together and the body identies something normal in the body as foreign. Develops antibodies to attack own body
- damage is mostly in kidneys and joints b/c the complexes form increase vascular permeability and cause tissue damage.
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What happens in Type III, immune complex hypersensitivity reactions
T-cells and moncytes are involved in autoimmune inflammatory response
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TF: Rheumatoid arthritis can affect the blood vessels, myocardium, kidneys, lungs
yes, because it is an inflammatory systemic disease
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what are the blood tests used to diagnose rheumatoid arthritis?
- rheumatoid factor
- ANA
- E sedimentation rate
- compliment level
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What types of meds are given for rheumatoid arthritis
- analgesics
- antipyretics
- anti-inflammaotry
- immunosuppresants
- steroids
- biologial response modifiers (etanercept, remicade)
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TF: Gout is a form of inflammatory arthritis
True
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What is the treatment of acute gout?
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What is the treatment of chronic gout?
- allopurinol
- diet: low alcohol, organ meats, red meats, sardines,
- increase fluids (be careful with diuretics)
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With chronic gout, what other illnesses present and/or develop
- tophi - deposits under skin (fingers, ears)
- renal calculi
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SLE develops from abnromall suppressor T cell production
True
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What drugs do we use to treat lupus
- corticosteroidds
- NSAIDs
- alkylating agent (chemo?)
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Scleroderma. mortality. presentation
- autoimmune disease
- higher mortality than lupus
- hard skin
- renal failure
- pulmonary hypertension
- ulcers
- esophagitis
- joint inflammation
SKIN Is like wood
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Type IV delayed hypersensitivity reactioons are mediated by which cell
T- cell reactions. antibodies nor complement are involved.
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