NURS 505
Terms
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- Humoral immunity is a function of what?
- B lymphocytes
- When B lymphocytes encounter an antigen they do what?
- Differentiate into plasma cells that secrete antibodies (immunoglobulins)
- Where are immunoglobulins found?
- Circulating everywhere in all the bodily fluids
- What is the function of cytotoxic T cells and they are involved in what type of immunity?
- They are involved in direct cell-cell contact and killing, they are involved in cell mediated immunity
- What do cytotoxic T cells produce that kill the infected cell?
- Perforins
- What do immunoglobulins do?
- Recognize antigens and bind to them, also bind to phagocytes
- When immunoglobulins bind to a phagocyte via their Fc portion this is an example of what?
- Opsonization
- Antigen-antibody complexes activate what and what does this do?
- Complement and it is a chemoattractant to phagocytes (helps to kill)
- What is the most commonly found antibody?
- IgG
- What types of properities does IgG have?
- Antiviral, antitoxin, and antibacterial
- What is the only antibody that crosses the placenta and why is this important?
- IgG and this gives the newborn some protection against the environment when it is born, it lasts about 6 months after birth.
- IgG acts as an opsonin how?
- By binidng to the phagocytes via the Fc receptor
- What is gammaglobulin?
- A mixture of all the different IgG antibodies found in the blood.
- What can gammaglobulin be used for?
- It can be injected to impart immunity to an immunodeficient patient.
- What is the first antibody present in the plasma in response to an antigen?
- IgM
- What antibody is responsible for the ABO blood incompatibilities?
- IgM
- IgM bound to an antigen activates what?
- Complement
- What is the first antibody produced by the newborn?
- IgM
- What antibody is found primarily in bodily secretions? (Saliva, nasal and respiratory secretions, breast milk)
- IgA
- What antibody is found on most epithelial surfaces in the GI and GU tract?
- IgA
- Which antibody is a major component of the barrier that prevents bacterial invasion?
- IgA
- What antibody binds to mast cells?
- IgE
- What antibody is involved in parasitic infections, allergies, and hypersensitivity reactions?
- IgE
- Where is IgD found and what is its purpose?
- On the cell membrane of B lymphocytes, and it serves as a receptor.
- What is IgD required for?
- The maturation of B lymphocytes
- What is the function of the thymus?
- During fetal development and through early childhood it provides immunocompetent T lymphocytes for all other lymphoid tissues
- What is red pulp?
- Erytrocyte storage and disposal.
- What is white pulp?
- Large collection of lymphoid tissue (B and T cells, and macrophages)
- What removes the antigen-antibody complexes?
- Spleen and liver
- Lymph nodes contain what?
- B and T cells, as well as macrophages and plasma cells.
- Where are B lymphocytes "programmed"?
- Lymph nodes
- What is the function of the lymph nodes?
- To filter lymph (interstial fluid filtered out of the blood)
- Where is humoral immunity usually initiated?
- Lymph nodes
- Lymphadenopathy is what and is an indication of what?
- Swollen lymph nodes and it is the first indication of the immune response.
- What is the purpose of the MALT system?
- To secrete antibodies onto the mucosal surface to participate in the barrier against bacterial invasion.
- Innate or nonspecific immunity
- Your natural resistance to disease, dependent on heredity, age, overall health, species, race and sex.
- Acquired or specific immunity
- used to describe the protection gained through exposure to an antigen or through the transfer of protective antibodies. (injection of immunoglobulins, or IgA in breast milk)
- Immunization
- The administration of an antigen through vaccinatino with the purpose of achieveing a specific immunity.
- Active immunity is acquired from where?
- Immunization or actually having the disease
- Passive immunity is acquired from where?
- Gammaglobulins injections, IgA in breast milk, IgG crossing the placenta
- With humoral immunity with initial exposure to the antigen how long does it take for immunoglobulins to appear in the serum?
- Few days to weeks.
- Why does it take time for immunoglobulins to appear in the serum?
- Time is required for activation of B lymphocytes, activation of helper T cells, proliferation of activated B lymphocytes, and differentiation into sufficient numbers to plasma cells that secrete a specific class of antibody.
- How long does it take for cell mediated immunity to ward off an invader?
- Up to 10 days.
- What fails in transient hypogammaglobulinemia?
- The B lymphocytes do not differentiate into plasma cells because help from the helper T cells is deficient so there is no cytokine production.
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True or False...
The number of B and T cells are normal is transient hypogammaglobulinemia - True, the numbers are normal but the functioning of the T cells is deficient meaning the number of plasma cells is low.
- What do patients with transient hypogammablobulinemia normally present with?
- About 6 months of age they start to present with repeated bouts of upper respiratory and middle ear infections.
- In transient hypogammablobulinemia the germinal centers in lymph tissue are what?
- Reduced or absent
- When does transient hypogammaglobulinemia normally resolve and why?
- 2-4 years of age, and the reason is unknown
- Are viral infections a problem in children with transient hypogammaglobulinemia?
- No which indicates that there are some functions helper T cells.
- X-Linked agammaglobulinemia is primarily a deficiency of what?
- B cells.
- X-linked agammaglobulinemia is what kind of trait and found in who?
- Recessive and only in males
- What are the serum levels in X-linked agammaglobulinemia?
- Undetectable
- Patients with agammaglobulinemia are susceptible to what types of infections?
- Bacterial (Meningitis, recurrent ear, sinus and pulmonary infections)
- X-linked ammaglobulinemia prevents the development of what?
- Mature B lymphocytes and plasma cells
-
True or false...
In X-linked agammablobulinemia T lymphocytes are present in normal numbers but they do not function correctly - False... they are present in normal numbers and they function properly.
- In agammaglobulinemia the germinal centers in lymphoid tissue are ____
- Absent
- In agammaglobulinemia patient's are able to clear viral and protozoal infections why?
- Because the cytotoxic, and helper T cell function is normal.
- What therapy is avaliable for patients with agammaglobulinemia?
- Administration of gammaglobulin and appropriate antibotics
- What disorder is present in common variable immunodeficiency?
- B cells fail to differentiate into plasma cells.
- What is the numbers of antibodies in common variable immunodeficiency?
- Marked reduction but still present
- What is the number of B cells in common variable immunodeficiency? (High, Normal, Low)
- Normal
- When is the onset of common variable immunodeficiency and who is it seen in?
- 15-35 years of age, and both males and females
- What is the treatment for common variable immunodeficiency?
- Same as agammaglbulinemia, administration of gammaglobulin and antibiotics.
- Why are T-cell immunodeficiencies much rarer than B-cell immunodeficiencies?
- Because they are much more severe and the patients usually do not survive very long.
- What does DiGeorge syndrome normally result from?
- Partial or total lack of development of the thymus during fetal development
- What does DiGeorge syndrome result in?
- Lack of immunocompotent T lymphocytes.
- IgG levels are low in DiGeorge Syndrome because?
- Lack of helper T cells
- The lack of T lymphocytes in DiGeorge syndrome results in a deficient immune response in which type?
- Cell-mediated
- What types of infection are patients with DiGeorge Syndrome at risk for.
- All types of infections
- Number of B cells is normal in DiGeorge Syndrome but the number of plasma cells is low, why?
- Because there are no helper T cells with cytokines.
- For children that survive the neonatal period in DiGeorge Syndrome what are some treatment options?
- Thymus transplantation, or a bone marrow transplant.
- What is a secondary T cell immunodeficiency and what is an example?
- Depletion of the T cell population because of an acute viral infection. Classic example is HIV
- What do most primary disorders of the complement system involve?
- One or more of the distinct complement proteins.
- What is the defincieny in Primary complement deficiencies?
- Formation of the proper component or the compononent is defective
- In primary complement deficiencies symptomes may be mild to severe why?
- It depends on which complement is deficient to how the symptoms are going to be manifested.
- What types of infections does primary complement deficiencies make patients susceptible to?
- Bacterial infections, the inflammatory response is surpressed
- What is the secondary complement deficiency normally due to?
- Severe liver disease/illness
- Where are complement proteins made?
- the liver
- With acute infections what happens to the serum level of complement and why?
- It is depleted or used up because it happens faster than the liver can make complement
- Patients with disorders of phagocytosis are prone to what types of infections?
- Bacterial and fungal
- List three secondary disorders of phagocytosis and how they effect it.
-
Lack of opsonins- either a complement deficiency, or an immunoglobulin deficiency
Corticosteroid and cyclosporine administration- inhibit inflammation and thus phagocytosis
Diabetes- due to altered chemotaxis - What is Chediak-Higashi a type of?
- Primary disorder of Phagocytosis
- How is Chediak-Higashi passed?
- Inherited as an autosomal recessive trait
- In chediak-higashi what happens with the phagocytes?
- They internalize the pathogen but can't digest them and phagocytes exhibt poor mobility.
- What infections are children with chediak-higashi susceptible for?
- Repeated cutaneous and respiratory infections
- Chediak-Higashi syndrome, and DiGeorge Syndrome can sometimes be treated with what?
- Stem cell transplantation from an unaffected donor
- Where can stem cells be collected from?
- Whole blood, bone marrow, and umbilical cord blood
- Hypersensitivity disorders
- An immune response to antigens that produce inflammation that can cause unwanted tissue injury.
- Hypersensitivity reactions can come from ________ ________, or in reaction to _________ _________
- autoimmune diseases, foregin antigens
- Type I hypersensitivity
- Allergy, including anaphylaxis
- Type II hypersensitivity
- cytotoxic hypersensitiy, antibody mediated mechanisms
- Type III hypersensitivity
- Immune complex disease (Anitgen-antibody complexes)
- Type IV Hypersensitivity
- Cell mediated
- What is the most common and immediate of the hypersensitivity reactions?
- Type I- Allergy
- How long does it take the immune system to response in a Type I hypersensitivity reaction?
- Within minutes
- Where does Type I hypersensitivity occur?
- Organs exposed to the enviornment, GI, skin, and respiratory systems.
- List two antigens that can be responsible for a Type I hypersensitivity reaction
- Pollen, food, animal dander, insect bites/stings
- Sensitization
- The process by which IgE binds to a mast cell and becomes a receptor for the mast cell.
- In a type I hypersensitivity what happens with reexposure to the antigen?
- It combines with the IgE bound on the mast cell and the mast cell release secretory vesicles including histamine
- In type I hypersensitivity what do the potent inflammatory mediators do?
- Increase mucus secretion, vasodilation, increased vascular permeability, edema, and contraction of the airway smooth muscle
- What are two examples of type I hypersensitivity
- Asthma, anaphylaxis, hay fever, and allergic dermatitis.
- What distinguishes anaphylaxis from hay fever is the mechanism is the same?
- Anaphylaxis is systemic where hay fever is localized.
- What is an example of Type II cytotoxic hypersensitivity?
- Blood transfusion reactions.
- What antibody is involved in blood transfusion reactions?
- IgM
- In type II hypersensitivity what happens when a drugs binds to an erytrocyte?
- An antibody binds to the cells and the cell is destructed.
- The destruction of red blood cells in Type II hypersensitivity results in a form of what anemia?
- hemolytic anemia
- What is the name of a disease that can cause a Type II hypersensitivity reaction?
- Goodpasture's disease, myasthenia gravis, and Grave's disease
- Autoimmunity
- the immune system recognizes self antigens as foreign
- Who is genetically predisposed to autoimmune diseases?
- Females more than males and the elderly.
- What may alter our own antigens to make our body recognize them as foreign?
- Viruses, or other environmental stimuli