3200 Pathology

  1. What is natural immunity?
    Hard-wired protective devices that don't depend on previous exposure to antigens (AGs)
  2. 3 forms of natural immunity
    • Mechanical barriers
    • Phagocytic cells
    • Protective proteins (ex/ lysozyme)
  3. What is an AG (antigen)?
    a substance we recognize as foreign to our selves and elicits an immune response
  4. What is aquired immunity?
    • specific responses to antigens
    • (note: this is all he had, so I assume all that is required, but it is very very generalized)
  5. What are cells of the immune system called?
  6. Two types of Lymphocytes?
    T-lymphocytes and B-lymphocytes
  7. Cells derived from the thymus
  8. Immune cells derived from the bone marrow
  9. Lymphocytes in gastrointestinal and bronchial mucosa
    mucosa-associated lymphoid tissue (MALT)
  10. 2 ways to differentiate between or identify lymphocytes
    Specific stains and surface markers
  11. two types of T-lymphocytes
    T helper and T suppressor/cytotoxic cells
  12. help B cells produce immunoglobulin
    T-helper cells
  13. suppress unwanted antibody production and mediate killing of virus-infected cells or tumor cells
    T suppressor/cytotoxic cells
  14. ______ percent of circulating lymphocytes are "T"
  15. All T cells have surface _________ which is attached to a membrane protein __________, making these two unique markers for T cells.
    T-cell receptor (TCR) and CD3
  16. The 15% of peripheral lymphocytes that have TCR but no CD3
    NK cells
  17. T/F: NK cells can kill virus infected cells, tumor cells and foreign cells WITHOUT previous sensitization
  18. T-helper cells express _____ on their surfaces while T-suppressor/cytotoxic cells express ______
    • CD4 for T-helpers
    • CD8 for T-suppressors/cytotoxic
  19. Normal ratio of T-helpers to T-suppressor/cytotoxic
    2(Th):1 (Tc)
  20. T helper to T suppressor/cytotoxic ratio in a person with HIV (ratio of CD4 to CD8)
    less than 1.0
  21. Two subsets of CD4 cells and what they produce
    • T-helper 1: produce interleukin-2 and interferon
    • T-helper 2: prdouce IL 4,5, and 13
  22. These cells differentiate into immunoglobulin producing cells that develop RER and eventually become plasma cells
    B lymphocytes
  23. 3 characteristics of plasma cells
    • eccentric nucleus, a prominent Golgi apparatus and stain Pyrinophilic because of the marked numbers of concentric arranged
    • RER.
  24. 5 classes of immunoglobin (IG)
    IgG, IgA, IgM, IgD, IgE
  25. Each IG molecule is made up of two ______ and two _______.
    heavy chains and light chains
  26. The end of the molecule that attaches to the antigen has two portions. What are they?
    variable and invariable
  27. 5 molecules linked together (IG)
  28. First class produced (IG)
  29. Good compliment binder (IG)
  30. Secretory, in GI,tears and respiratory tract (IG)
  31. secreted into lumen (IG)
  32. 1/1000 people deficient (IG)
  33. most common IG
  34. IG that passes via placenta into baby
  35. IG in very small amounts in body
  36. IG attached to mast cells
  37. IG important in allegies and anaphylaxis reactions
  38. IG that is a precursor, found on B cells
  39. This complex, often called human leukocyte antigens is what identifies us as ourselves.
    major histocompatibility complex (MHC)
  40. MHC's are responsible for _____________as well as ____________ to responsible cells for immunological reactions
    • transplantation reactions
    • presentation of antigens
  41. What are the two groups of MHCs?
    type I and type II
  42. 2 characteristics of type I MHCs
    • receptors for CD8
    • link macrophages to cytotoxic/suppressor lymphocytes
  43. 2 characteristics of type II MHCs
    • receptors for CD4
    • interact with B helper cells presentation of Ag
  44. When antigens (Ag) and antibodies (aby) come together, they form an _______________.
    immune complex
  45. Depending on __________, immune complexes may be soluble or insoluble.
    ratio of Ag to aby
  46. If an aby attaches to a RBC (no complement), the cell will
    destroyed in the spleen (delayed reaction)
  47. If an aby plus complement attaches to a RBC what happens?
    the RBC will lyse and be immediately destroyed
  48. RBCs lysing from aby + complement reactions is commonly seen in ___________ and leads to _________.
    • incompatible blood transfusions
    • shock-like state and death
  49. Type I hypersensitivity reaction
    • An IgE mediated event. IgE molecule binds to a mast cell with the
    • Fab fragment outward. When the antigen and the Fab fragment come together, the
    • mast cell ruptures releasing histamine and other mediators of inflammation.
    • Examples are hay fever, atopic dermatitis, bronchial asthma and anaphylactic
    • shock.
  50. Type II hypersensitivity reaction
    • When ABy or complement are attached to a cell,
    • this can serve as a signal that causes cells such as neutrophils,monocytes and
    • NK cells to attach to either the ABY or complement and destroy the cell. This
    • is called antibody-dependent cellular cytotoxic reaction (ADCC). Other
    • examples of Type II hypersensitivity include ABY to TSH receptors on thyroid
    • cells and ABY against the receptor of acetylcholine in Myasthenia gravis.
  51. Type III hypersensitivity reaction
    • These are diseases where AG/ABy complexes
    • produce an inflammatory effect often mediated by complement. When there is AB-ABy equilibrium or mild ABY
    • excess the immune complexes are small and precipitate throughout the body. Complement is activated and tissue damage
    • occurs. When there is ABy excess large
    • insoluble complexes occur that are easily broken down and phagocytosed with
    • little tissue damage. Again when the AG/ABY complexes are small and precipitate in small vessels
    • producing a lot of inflammation. These
    • mechanisms are important in:
      1. Systemic
      2. lupus erythematosus (SLW)

    • Poststreptococcal
    • glomerulonephritis

    • Polyarteritis
    • nodosa
  • Type IV hypersensitivity reaction
      1. Called
      2. cell mediated – A cellular reaction when T-Lymphocytes that are previously sensitized
      3. are exposed to the sensitizing antigen to release a series of small molecular
      4. weight compounds called cytokines. IFN-gamma
      5. acts to stimulate macrophages to release other products phagocytose invading
      6. organisms and fuse together to form granulomas.
      7. This is the basis of the TB skin test, where TB antigen is injected, if
      8. there are sensitized lymphocytes, they
      9. stimulate macrophages that enter
      10. the area. This is manifested by cell
      11. infiltration and firmness or induration of the skin. Contact dermatitis such as
      12. poison ivy is another example of this type of reaction. This is why poison ivy
      13. stays around for such a long time
  • 4 types of transplantation
    • 1. Autografts – within one person – hair transplants, veins, skin grafts
    • 2. Isografts – genitically identical individuals of same species
    • 3. Homografts or allografts – not genetically
    • related individuials
    • 4.Xenografts – between different
    • species – UMMC developed Pig that we will accept
  • Rejection of a transplantation can be___________,__________, or ___________.
    hyperacute, acute, or chronic
  • Graft vs Host reaction
    • A serious complication when donor lymphocytes
    • attack recipient cells.
  • Many new drugs have been developed to depress the _________ ___________ so that transplants can occur.
    immune system
  • Is a blood transfusion a form of a transplantation?
  • Blood transfusion – This is form of
      1. There
      2. are ABO RBC membrane antigens, which are encoded by three genes. There are 6 genotypes: AA, AB, AO, BO, BB and OO. The A and B gene
      3. are dominant over the O gene so there are only 4 blood groups A which can be
      4. (AA or AO) , B (BB or BO), AB and O. O
      5. is the universal donor and AB is the universal recipient. If a person is type A, then there will have
      6. naturally occurring B antibodies. If a
      7. person is type B, then they will have natural occurring anti-A.

    • All
    • blood is typed to prevent incompatibilities.

    • Another group of RBC antigens are called Rh factors
    • blood group. These are strong antigens
    • and if incompatible can elicit a strong immunologic reaction resulting in the
    • death of the RBC. When an Rh- mother has
    • an Rh+ baby the fetal RBC's (Rh+)can leak into the circulation of the mother
    • and she will form Rh+ antibodies. These antibodies in subsequent pregnancies
    • can destroy the fetal RBC's. This disease can be prevented by giving the mother
    • a drug called RhoGAM, which can destroy these fetal cells in her circulation
    • before they induce an immunological response. RhoGAM is an antibody against RBC's that are
    • Rh+.
  • What is an autoimmune disease?
    • These are a category of diseases where the
    • immunological system has an immune response against its own antigens. There may
    • involve Type II,III or IV reactions
  • Which gender has a higher prevalence of autoimmune diseases?
  • Autoimmune brain disease?
    multiple sclerosis
  • autoimmune thyroid disease
    Hashimoto's disease
  • autoimmune blood disorder
    autoimmune hemolytic anema
  • autoimmune kidney disease
  • autoimmune skin disorder
    pemphigus vulgaris
  • autoimmune muscle disorder
    myasthenia gravis
  • Systemic Lupus Erythematosus
      1. These
      2. individuals produced antibodies to many intrinsic antigens, such as

    • DNA, RNA (anti-nuclear antibodies) as well as
    • some organ specific antibodies

    • The form immune complexes composed of AG-ABy that are deposited in tissue, activate
    • complement and causes inflammation and attraction of inflammatory cells. This
    • can produce joint disease.

    • These complexes are sometimes deposited within the glomeruli of kidneys causes renal
    • disease

    • Treatment is immunosupression.
  • Transient immunodeficiency
    infants of about 6 months run out of maternal aby and are slow to produce their own
  • HIV virus
    • 1.
    • The HIV virus (a retrovirus) has infinity for CD4 helper lymphocytes and
    • destroys them creating a host that is susceptible to certain infectious
    • disease. Currently we can identify the viral load and by doing a CD4/CD8 ratio
    • determine the state of health of the
    • infected individual. When the CD4 cells falls below 200, the crisis phase beg
    • 2. There may be a significant latent time
    • for symptoms to occur and there are examples of infected people who have no
    • evidence of disease.

    • 3. Like many viruses many systems can be infected including CNS, Lungs,
    • Intestine New tumor formation (Lymphoma or Kaposi's sarcoma)

    4. .HIV research has developed a large number of effective anti-viral
  • Amyloidosis

    1. Diseases caused by the infiltration of organs with amyloid (a fine fibrillar material)

    2. Associated with production of light chains from malignant antibody producing cells

      • Can be produced by chronic disease states in
      • particular liver disease where the amyloid is derived from a serum protein

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    3200 Pathology
    Definitions and Questions from Chapter 3