Physiology-Chapter 8

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What is Campylobacter?: Gram neg bacteria, comes from poulty (uncooked), swine
What is Vitiligous?: Looks like corpus tinea but it is versa color, white area, bleached out
Allergy: The deletrious effects of hypersensitivity to enviornmental allergens (rx to hypersensitivtiy)
When does HIV become AIDS?: When the 200 cd4 count goes below 200
What are the number 1 cause of death word wide?: In US it is CA, smallpox has been eradicated by vaccination, polio is not seen in western hemisphere
What causes Gillian Barre?: 1976 Swine Flu vaccine
What are some mechanisms of direct portal of entry?: direct contact, inhalation, ingestion, bite of animal or insect; spread is facilited if the organism can move through blood/lymph
What is IDDM?: Requires insuline, tyoe 1 is born with, secrete hormone into blood where as type 2 does not require injection of insulin, requires wt control and metabolism, have receptors for insulin
What flower carries nontoxic anthrac vaccine?: Petunias
What are the diagnosis tools to test for Type 1?: Intradermal injection or prick test, RIST (radioimminosorbent test) measures curclating IgE leles; RAST (Radioallergosobent) measures specific IgE Ab in circulation
How does GBS work?: Ab formed attack mylein but don't cross BBB, respirtory muscles weakens that a ventialtor is used, often for 6 months
What is intrinsic asthma?: hyperreactive smooth muscle in airways, do not need trigger like extrinsic.
What are type 3 hypersensitivity mechanisms?: Immune-complex mediated rxns
What virus sits in GI tract in Gillians Barre?: Campylobacter jejuni
When does Gillian Barre occur?: few days or weeks after pts symptoms usually respirtory or GI viral infection, or vaccines can trigger, most people reach greates muscle weakness at 2 weeks and after 3 week of illnuss 90% al all pts are the weakest
What is PRSP?: Penicillin resistant S. pneumoniae
What is the 6th cranial nerve Palsy?: Eye might not tract as far to one side if there is herpes zoster.
Does usually more than 1 category of the type of mechanisms occure at once?: yes
What are examples of infectious diesease against self?: Gillain Barre syndrom, rheumatic heart diease and rheumatic fever (attacks on heart valves)
What are systematic signs of anaphalaxis?: vomiting, pruritus, erythema, diarrhea, Lyarngeal edema,abdominal cramps, SOB
How does bacteria differ from human cells?: Rigid cell membrane (capsule), different ribosomes, different enzymes used for nucleic acid metabolism
What is lyarngeal edema?: Vacular collapse in anaphalatic shock will casuse death
What is the human immunodeficiecy virus?: Infects and destroyd helper Tcells, Supresses the immune response itself, Large # antigens, change constantly, Usually treated with combinations of 3 drugs, Opportunitic infections (pt. zero)
What is the cutaneous (localized) anaphylaxis?: wheal and flare. release of histamine, increase vascular permability
What is significant about the AIDS population?: Heterosexuals are increaseing dratically
What is Raynaud's Disease/Phenmenon: blood supply redcedm color change in skin- white, blue, red followed with burning and sesnation, cold and numbness. Triggered by cold, last few minutes, frequently seen in women but still in men and affects 15-40 yrs old
What does Guillian Barre syndrome other name?: Acute inflammatory demylenating polyneuropathy
What is the pathologic defense mechanisma of host resistance?: Compromised immune system means that a usually mild problem can develop into a fatal infection, some organism have learned to fight off or alter the inflammatory or immune response
What has a list of dieases caused by viral infection?: Adenovirus, herpes virus, hepititis A,B, influenza, Polio virus, Pox virus
What are mechanisms of destruction for type 2?: Complement-mediated (hemolytic diseases), antireceptor Ab (Myasthenia Gravis and graves diease)
What is myasthenia gravis?: Skeletal muscle that is weakened. The receptors of acytal choline of nicotinic receptors, the Ab takes out these respectors and the muscles will not contract b/c of less receptors
What sites are sequestered antigens?: Immunogically privilages sites are corea and testicles never come in contact with an immune response, no graft rejection. Trauma can expose these areas though
What is graves disease?: thyroid diease in metabolism "bug eyes"
What is the type 1 mechanism of hypersensitivity?: IgE mediated allergic reactions
What is the mechanism for type 2 hyperensitivity?: Tissue specific rxns
What GBS may demyelinate autonomics as well- 65% of pts?: Most often cardiac dysfunction (tachy/bradycardias, high BP, hypotension (espcially postural), arrhythmias)
What are desenziation techniques used to get rid of Type 1?: Repeated doses of increasing level of antigen, increases possibility of blocking Ab that compete with allergen for binding sites. Risk: Anaphylaxis
What are signs of GBS?: Distal to proximal weakness, loss of deep tendon reflexes, protein in CFS
What is the recovery like for Gillians Barre?: As little as a few weeks to a year, residual weakness 3 yrs. only 3% relapse of muscle weakness or tingling sensations 1mm/day, 1 wk if scar tissue
What are cutaneous eruptions?: Are unilaterl, does not cross midline, may involve more than 1 contigious dermetome but NEVER skip dermatomes
What is extrinsic asthma?: exercise induced
What is autoimmunity?: Breakdown of self tolerance 1) sequestering antigen (recoginize self and must be exposed to antigen in fetal development) 2) infectious dieasde (immune complex probles, poststrptococcal glomerilomephritis, an allergenic reaction mau not result in similar self protein being attacked (attacking self not diesase)
What are the different types of rxns?: Type 1,2,3,4
What are fungal diseases?: Mycoses- skin, hair, nails, can get serious deep infections invoved in internal organs, candida albicans normally in GI tract & mouth
What factors should be taken into account when looking at infectious dieases?: mechanism of action, infectivity, pathogenicity, virulence, immunogenicity, toxigeicity, portal of entry
Autoimmunity: Auto-immune diseases occur when immune system attacts the host tissue, distrubances in the immunologic tolerance of self antigens
What is MRSA?: Methicillin resistant S. aureus (can defeat everything, Vanco- last line of defense)
What is the Human Immunodeficiecy virus treatent drugs?: Rever transcriptase inhibitors, protease inhibitors
What drugs targets bacteria?: cell wall synthesis/ fxn: penicillins, cephalospornins, vanomycin; inhibitation of protein synthesis- streptomyocin, erthyomycin, tetracyclin, aminoglycosides; inhibition of DNA/RNA- sulfonamides, fluorquinolones (cipro)
What is the innate host resistance?: First line of defense = skin and muscus membranes, external barriers; second line of defense- inflammatory response, Third line of defense- immune system
What is fungal infection?: Thick cell walls, ifferent from bacteria, molds are aerobic, yeasts are faculative anaerobice (+/- O2), able to resist penicillins ad cephalosporins
What is VRE?: Vancomycin resistant enterococcus (diarrhea)
What is VRSA?: Vancomycin resistant staph. areus
What are problems with infectious agents?: hypersensitivity, allergic reactions, tendon damage: floroquinolones (Cipro) especially weight bearing tendons; UV sensitivity; tetracyclin; resistance (VRSA,MRSA, VRE, PRSP)
What is type 4 hpersenesitivty defination?: Does not involve Ab, sensitized cytotocic and lyphokine producing cells, activate macrphages and deayed hypersenstivity (24-72 hrs)
What is the treatment of GBS?: Supportive measures, prenisone (steroids), IV immuoglobilins (limit inflamation, decrease immune response), Plasmaphoresis (take out Ab out of plasma and return plasma), PT/OT to maintain ROM while mylein regenerates
Where is type 2 hypersensitvity found?: Destruction of target cell by Ab action against cell membrane, used for tissue specifc antigen that are expressed on the mebrance of certain cells, the type 2 diseases are limited to the tissues that have the antigen
What is Gillian Barre syndrome?: Inflammatory disorder of peripheral nerves characterized by rapid onset of weakness and paralysis of legs, arms, moving to diaphram.
Why are atopic people prone to having allergies?: a herditary disposition. It is an inherited condition, they have more IgE and Fc receptors on mast cells and have more responsive airways. 40% 1 parent, 80% if both
What are the reactions immediate or delayed in hypersensitivity?: Both, can be minutes to hours or can be most rapid and be anaphylaxis
What is SCID?: Severe combined immunodeficiencies- reticular dysgenesis, stem cell for all WBC is absent, two forms of SCID are due to autosomal recessive enzyme deficits, some are x-linked and therefore seen primarly in males, Bruton agammaglobulinemia: no b cell matuation, DiGeorge syndrome: congential thymic aplasia (thymus doesn't developed t-cell defiency)
What is Campylobacter jejuni?: Most common in diarrheak disease amoung humans, produced for 1-7 days with a fever and malaise, can cause abdominal pain, immodium is bad for it because it will stay in system,it is self limiting diease except in immunocompormised pts where it can cause infections and more likley to be irreversible
What are type 3 hypersensitivity mechanisms?: big clumpy antigen-Ab complexes that casues problems like inflammation and tisue destruction, will deposit in vessel walls (vascultis) and extra vascular tissies (arthrisits)
What do antiviral drugs do in a viral infection?: Are specific for certain virus, are generally virustatic rather than virucidal, inhibit enzymes necessary for replication, vaccinate acts by having Ab that will attack virus before it makes it into a host cells, HIV drugs are different cause retrovirsus
How does viral infection take place?: Viruses live within host cells, using metabolic machinery to live and reporduce. Take over host DNA and control cell, Do no produce toxins, immune response usually limits movement from cell to cell, may be leathal in an immunosupressed host
What are examples of type 4?: graft rejection, contact dermititis, autoimmune thyroiditis, Hashimoto disease, IDDM
What does SCID caused by lack of stem cells?: Bone marrow transplant from HLA matched donor, 75% matched transplants work, GVH disease (graft vs host) may develop 10-30 days after transplant (skin raash, heptatomegaly, diarrhea, amy lead to death from infections), gene therpy (promising still in early stages- delivery via adenovirus
What is the systemic type 3 diseases?: Serum sickness (horse) from admiistration of forgein serum (jts, kidneys, blood vesels, lyphodema, rash, pain); raynauds disease
What is residual disability for GBS ?: Clinical prognosis factors for resdual disability is if increase age not fully recovery, severity (ventialtor, rapid development, complete areflexia in acute stage (no relex), camphylobacters source, lack of treatent w. plasma ehange, lonfer time to improve over 21 days, diability present at 12 and 18 months)
Hypersensitivity: Altered immune reactivity such that a pathogenic response is to re-exposure is seen
What are examples of analphaxis?: Peanut allergies, shell fish alleregies, and bee stings
What is serum sickness?: Symptoms last 1-2 wks, indiviauls older than 15, made from horse serum (today is nonprotein drugs)
Does IgE deranualte quicker or slower when antigen is explosed?: Quicker
Why are protein levels in the CSF elevated if GBS remains in the periphery?: Elevated levels of albumin, not leukocytes are found (WBC), Elevated CSF protein may be due to leaky blood- CSF barrier due to spinal nerve root inflammation
What is the role of IgE?: B cells produce large amounts, pt is senstized, binds mast cels and in re-exposure antigens binds to it on mast cels and will degranulation; can be benificial to parasites
What is hypogammaglobulinemia?: Insufficient Ig's, Agammaglobulinemia- none
What is type 4 hypersensitivity rxns?: Cell-mediated rxns
Can treatment go from mother to infant for AIDS?: No, not if caught prenatualy, can prevent babies from being infected.
What are congenital immune deficiencies?: Hypogammaglobinemia, SCID, DiGeorge
Autoimmune Disease: The immune system of another produces an immune response against the tissues of another person (transplants)
What is replacement therapy?: B cell deficiencies can be treatment with administation of gamma globulin- IM or IV
What is the acquired immundodeficiency?: Not related to genetic defects acquired postnatally, nutritional; zinc affect both T nd B cell fucnction, vitamins needed as cofactors., Iatrogeni, Trauma, Burns, Stress, AIDS
What is multiple sclerosis?: Simialar to GBS but us has a completely different path of prognosis, no cure, Damage to CNS and brain- it sets inside the BBB
What are the three interactive processes of hypersensitivity?: Original insult upsets immunogenic homeostasis; genetic predisposition; amplification process
What has the misuse of Ab developed into?: Development of mutant strains of bacteria with resistance to previously effective antimicrobials, a number of baceria is now resistant, concern of antibotic resistanct among campylobacter isolates poultry

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