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STCC Immunology
Professor Rochfords Immunology Lecture
| Question | Answer |
|---|---|
| Acquired Immunity | The development of immunity, either actively or passively |
| Acquired Immunity: Active | Results from the invasion of the body by foreign substances such as microorganisms or antigens. Natural or artificial (getting chickenpox or getting live/dead virus vaccines, for example) |
| Acquired Immunity: Passive | Host receives antibodies to an antigen rather than synthesizing them. Natural or artificial (immuno globulins through placenta/breastmilk or injection of gamma globulin) |
| Auto antigens | Antigens on the bodys own cells (allow the body to recognize itself) |
| Antigen | Substance that elicits an immune response |
| Central Lymphoid Organs | Thymus gland and bone marrow |
| Peripheral Lymphoid Organs | Tonsils, spleen, and lymph tissue of the gut, genitals, bronchial, and skin |
| Thymus Gland | Shrinks with age, essential for cell mediated immune response |
| Bone Marrow | Produces RBC, WBC, lymphocytes, and platelets |
| Lymph Node Functions | Filtration of foreign material and the circulation of lymphocytes. |
| Spleen | Primary site for filtering foreign substances in the blood. Major site of immune responses to blood-borne antigens. Removal of the spleen = immunocomprimised. |
| T Lymphocytes | Responsible for immunity to intracellular viruses, tumor cells, and fungi. Sensitized by exposure to antigen. |
| Natural Killer Cells | Don't require sensitization, recognize and kill virus infected cells, tumor cells, and transplanted grafts |
| Mononuclear phagocyte system | monocytes in the blood and macrophages in the body. Capture, process, and present antigens to lymphocytes to initiate humoral or cytotoxic response. Phagocytosis. |
| Antibodies | Immunoglobulins produced by lymphocytes in response to antigens |
| Cytokines | Messengers between cell types. Instruct cells to alter proliferation, differentiation, secretion, or activity |
| Humoral immunity | In the body bluid. Antibodies produced by B-lymphocytes. Primary immune response evident 4-8 days after initial exposure. |
| Humoral immunity: cells involved | B lymphocytes |
| Cellular immunity: cells involved | T lymphocytes, macrophages |
| Humoral immunity: protects against | Bacteria, EXTRACELLULAR viruses, respiratory pathogens, GI pathogens |
| Cellular immunity: protects against | Fungus, INTRACELLULAR viruses, chronic infectious agents, tumor cells |
| IgG | Gives newborns protection for 3-6 months. The only Ig to cross placenta and provide newborn with passive acquired immunity |
| IgA | Found in body secretions (saliva, tears, breastmilk, colostrum) |
| IgM | Largest of Ig's. Found in plasma. Responsible for primary immune response. Forms antibodies to ABO blood antigens. |
| IgD | Found in plasma. Present on lymphocyte surface. Assists in differentiation of B lymphocytes. |
| IgE | Found in plasma AND interstitial fluids. Causes s/s of allergic reaction. *Exposure to allergen increases IgE |
| Epinepherine for hives | 1/1000 if hives are around the face or tongue to avoid airway complications |
| Hypersensitivity reactions: Type 1 | Anaphylactic reactions. IgE. Allergy s/s with smooth muscle contractions, increased vascular permeability, vasodilation, hypotension, mucous, wheals, hives. Reversible. |
| Anaphylaxis | Type 1 reaction. Occurs immediately in response to drug, insect bite, etc. Escalates quickly, needs early tx. Rapid/weak pulse, hypotension, dyspnea, cyanosis. Benadryl for asthma patients before tests involving contrast dye. |
| Rhinitis | Type 1 reaction. Most common type, occurs year round or seasonally. Teach limited use of nasal sprays. Rebound reaction possible with overuse of nasal sprays, antihistamines |
| Asthma | Type 1 reaction. Most have allergic component with hx of other allergies. Benadryl prophylaxis when getting contrast dye. Increased risk of other allergic reactions. |
| Asthma signs and symptoms | Bronchial smooth muscle constriction, excessive secretion of mucous, dyspnea, wheezing, counging, tightness in chest |
| Atopic dermatitis | Type 1 reaction. Chronic inherited skin d/o. Elevated IgE and positive skin test. s/s are generalized skin lesions. |
| Hives | Type 1 reaction. pink raised itchy areas developing quickly after exposure and last minutes to hours. |
| Angioedema | Type 1 reaction. localized, edema of eyelid, lips, tongue, larynx, hands, feet, gi, genitals. Mild to moderate may need epi 1/1000. s/s swelling, burning, stinging/itching and may last for 24 hours |
| Hypersensitivity reactions: Type 2 | Cytotoxic/cytolytic. Target cells: RBC, platelets, leukocytes. **Transfusion reactions, RH incompatability, autoimmune/drug related hemolytic anemia, leukopenia, thrombocytopenia |
| Hypersensitivity reactions: Type 3 | Autoimmune. Inflammitory. Cant be removed by phagocytes so deposited in tissue or blood vessels, cause inflammation and destruction. Local/systemic, immediate/delayed. |
| Hypersensitivity reactions: type 4 | Delayed hypersensitivity reactions (cell mediated immune response). Usually protective, but tissue damage occurs in delayed reactions. Transplant rejections, contact dermatitis |
| Contact Dermatitis | Type 4 reaction. Can be localized or involve airway if inhaled. Metal (nickel/mercury), rubber (latex allergy), poison ivy/oak, cosmetics and some dyes. Memory cells form 7-14 days. s/s burning/stinging, redness, edema, papules, etc |
| Microbial hypersensitivity reactions | Type 4 reaction. Bodies defense against TB. Causes extensive necrosis of lungs. |
| Transplant Reactions | Type 4 reactions. Donor doesn't perfectly match recipients HLA. Rejection in minutes/hours (hyperacute), days/months (acute), years (chronic). Pt kept immunosupressed with meds for at least a year. |
| Hypersensitivity reactions: Assessment | Health hx including family allergies. Physical exam focusing on site of manifestations. Baseline Labs (for later comparison), RAST test, PFT's. |
| RAST testing | Positive test shows hypersensitivity in minutes to 12 hours. If on arm and major swelling occurs, tourniquette and give epi 1/1000 |
| Hypersensitivity reactions: teatment goals | Identify and avoid triggers, reduce exposure (desensitize person through immunotherapy if needed), be prepared for emergency (epi 1/1000) |
| Collaborative care: Anaphylaxis | **Maintain airway, precent spread with tourniquette, remove stinger/allergen. Give 02, increase if sat lower than 92%. Intubate if sats not responding to NRB. IV epi 1/10,000 (note increase) if severe. IM/IV benadryl. |
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