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immunity
pathophysiology NUR 304
| Question | Answer |
|---|---|
| What are the two parts of the immune system? | innate and adaptive immmunity |
| Define immunodeficiency | failure of the immune system |
| Define autoimmunity | when the body attacks its own cells |
| Define hypersensitivity | an overreaction of the immune system |
| Define innate immunity | 1st line of defense. nonspecific immunity. has physical & chemical barriers like skin, pH of Gi tract, enzymes in tears, and monocytes (macrophages) |
| What are monocytes (macrophages) | they ingest and destroy invaders (phagocytosis), & release cytokines, & antigen presentation |
| What are cytokines? | chemical signals produced by WBCs that regulate/coordinate the immune system & provide inflammation regulation |
| Define natural killer cells (NK cells) | granular lymphocytes that destroy tumor cells & virus infected cells that the body has not be presented with previously. |
| Define adaptive immunity | acquired immunity that responds to a specific antigen rapidly & has a memory response after the 2nd exposure to the particular antigen. consists of t cells & b cells. recognizes self vs. nonself |
| What is self vs non-self | since our bodies have the ability to detect the difference between our own body cells and foreign material. if our body has trouble doing this, it manifests itself as an autoimmune disorder like lupus or RA |
| What do t cells do for our adaptive immunity? | aka cell mediated. 1st response; the defenders that mature in the thymus gland. the degenerate as we age |
| What do b cells do for our adaptive immunity? | they mature in the bone arrow, spleen, and lymph nose; responsible for ANTIBODY-MEDIATED immunity. they are storage & memory |
| What is another name for antibody-mediated immunity (b cells)? | humoral immunity |
| What helps the body recognize self vs non-self | the major histocompatibility complex & human leukocyte antigen |
| Define the major histocompatibility complex (MHC) | group of genes that code for proteins found on the surface of cells that help the immune system recognize foreign substances |
| Define the human leukocyte antigen (HLA) | molecule found on all nucleated cells in the body that help the immune system to recognize whether or not a cell is foreign to the body |
| Explain B cell activation | antigens activate a B cell, the cell becomes a plasma cell, that plasma cell produces antibodies (immunoglobulins), the activated B cell forms a new memory cell, which has a quicker and stronger response |
| What are immunoglobulins (antibodies) produced by? | B cells |
| What are the five subtypes of immunoglobulins? | IgM, IgG, IgA, IgE, and IgD |
| What is the primary response of immunoglobulins? | 1st exposure to the antigen, lag time before Ig levels increase, IgM is the FIRST ANTIBODY |
| What is the first antibody produced? | IgM |
| What is the secondary response of immunoglobulins? | any exposure after the first, IgG levels are increasing rapidly (memory cell response), the antigen is neutralized before disease S/S are present |
| What are IgA antibodies? | mainly found in secretions like tears, saliva, respiratory secretions, GI fluid, and breast milk |
| What are IgE antibodies? | usually present in very low concentrations in the blood. the elevated during allergic reactions like pollen or dust. |
| What are IgD antibodies? | hypersensitivity reactions like itchy eyes, runny nose. they comprise only 1% of immunoglobulins, they bind to mast cells and B cells, and they are known the lease about |
| What is active acquired adaptive immunity? | exposure to an antigen through an illness or vaccination. the immune system is activated and memory cells are produced |
| What is passive acquired adaptive immunity? | they recieve pre-made antibodies against an antigen; the body does not do anything for immunity, it is immediate and short term. like antibodies being transferred through breast milk |
| Define vaccines | specific for formulation that contains a weakened, non-disease producing pathogen & exposes the body to a specific antigen which stimulates an immune response & produces memory cells without disease contraction |
| What is the difference between a viral and a bacterial vaccination? | with viral vaccines, they are inactivated, the antigens are there, but a person does not get sick & they wear off overtime. bacterial vaccines are made from killed microorganisms or extracted from antigens or toxins like tetanus shots. |
| What are the five types of vaccines? | DNA and RNA, live attenuated, inactivated, subunit, or viral vectors |
| Explain booster vaccines | an additional dose of a vaccine to stimulate the immune system's antigenic memory |
| Explain toxoid vaccines | a vaccine produced against toxin-producing bacteria; like a tetanus toxoid |
| Define anergy panels | a test of immunocompetence. you want the patient to have a positive reaction because we know that their immune system reacts to it. lacking in response can indicate immunodeficiency |
| How does an anergy panel work? | it injects a common antigen; mumps candida intradermally |
| What are antibody titers? | antibody screening test indicating presence and level of antibodies. can be used to indicate immunity. measures IgM. looks at the blood for presence of exposure |
| What can antibody presence in a titer indicate? | exposure to a disease |
| What is allergy testing? | a skin test to measure reactions to allergen by scratching or injecting small amounts of the antigens into the skin |
| What is serology testing? | measures IgE levels in response to antigens |
| Define overreaction immune disorders | hypersensitivity reactions and autoimmune disorders |
| Define under-reaction immune disorders | causes immunodeficiency disorders (primary: present at birth and secondary: develops to an infection) |
| How many types of hypersensitivity are there? | four |
| Explain type 1 immediate hypersensitivity | known as allergies or atopic disorder. rapid developing, IgEs bind to mast cells causing degranulation: release of chemicals from mast cells: histamine inducing S/S |
| What is a common treatment of immediate hypersensitivity reactions? | antihistamines like benadryl |
| What is the process of type 1 immediate hypersensitivity reactions? | antigen (allergen) interacts with the antigen presenting cell (APC), B cells are activated & produce IgEs, the IgEs bind to mast cells that release histamine, degradulation or the release of chemicals from the mast cells, the chemicals induce allergy S/S |
| What are some CM of type 1 immediate hypersensitivity? | urticaria (hives), nasal discharge, bronchial asthma, allergic gastroenteritis, mucus hypersecretion, bronchial constriction, pale nasal mucosa, watery eyes, and sneezing |
| What are some common allergens? | pollen, dust, nuts, chocolate, animal hair, shellfish, and penicillin |
| Explain anaphylaxis | severe , life threatening, allergic response that can result in death within minutes. a major medical emergency |
| What are some CM of anaphylaxis? | urticaria, bronchoconstriction, laryngeal edema, and angioedema |
| What is a treatment for anaphylaxis? | an epinephrine injection is used to counteract the response until medical help can be obtained |
| Explain type 2 hypersensitivity cytotoxic hypersensitivity | when immunoglobulins attack antigens on cell surface, the antibody mediated cell lysis results, like when you give a patient the wrong type of blood during a transfusion, it causes destruction of their blood cells |
| Explain type 3 immune complex hypersensitivity | antigen-antibody complex deposited in tissues; the organ becomes dysfunctional and the body begins to attack itself and tissue damage results. can be systemic (lupus) or localized (RA). |
| Explain type 4 delayed hypersensitivity | T cell mediated. previous exposure primes the T cells. the T cell attack does not occur until days after the initial exposure |
| What are some examples of type 4 delayed hypersensitivity reactions? | poison ivy, transplant rejection, TB skin test |
| Explain autoimmune disorders | an attack of "self" cells. T cell or Ig-mediated (autoantibodies). organ specific or systemic (type 1 diabetes). unknown underlying etiology. molecular mimicry |
| Define molecular minicry | a close resemblance between foreign antigen and self antigen |
| What is an example of molecular mimicry? | anti-streptococcal antibodies attack heart cells if strep throat goes untreated |
| Define asthma | a chronic inflammatory disorder of the airways characterized by recurrent episodes of reversible airway obstruction and hyperactive (exaggerated response to stimulus airways ) |
| What are some risk factors for asthma? | genetic factors, hx of RSV, males before puberty, females after adolescence, obesity, exposure to allergens, exposure to irritants, tobacco exposure |
| What is the etiology of asthma? | genetic predisposition with a trigger. more common in those with allergies. classified as allergic (triggered by factors that cause an allergic response) or non-allergic (triggered by factors that don't cause an allergic response) |
| What are some triggers for asthma? | allergens, occupational stimuli, infection, exercise, meds (aspirin and NSAIDs), air pollution, and strong emotions like crying, laughing, or anxiety |
| What is the pathophysiology of asthma? | an exposure to a trigger, stimulation of the production of antibodies & mast cells, release of inflammatory mediators, that increases vascular permeability, fluid accumulation, bronchoconstriction, & mucus section in the airways, possible scarring |
| What are some CM of asthma? | recurrent chest tightness, SOB, wheezing, a cough that may be worse at night or early morning, production of thick "stringy" sputum, and in severe cases, tachypnea, tachycardia, and retractions |
| How can we diagnose asthma? | medical hx, physical exam, pulmonary function tests, elevated sedimentation rate, confirmatory challenge test, and peak flow maneuver |
| What is the confirmatory challenge test? | a test for the diagnosis of asthma. breaths dilute amounts of an irritating substance to provoke airway obstruction and asthma |
| What is the peak flow maneuver? | a test for the diagnosis of asthma. measure maximum airflow through large airways when an individual exhales very strong after a maximal inhalation |
| How is asthma treated? | prevention (environmental control), meds: inhaled short and long acting bronchodilators, inhaled corticosteroids, leukotriene receptor agonists, antihistamines, theophyllines, mast cell stabilizers, and anti-IgE therapy to suppress inflammation |
Created by:
keiondraharden
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