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NURS 504 : PATHO/PHYS : MODULE 2: MECHANISMS
OF SELF DEFENSE: TEST QUESTIONS AND ANSWERS
what are the first line of defense for innate immunity? -- Answer โโ Natural Barriers what is the second line of defense for innate immunity? -- Answer โโ inflammation 4 ways natural barriers prevent entry of pathogens -- Answer โโ 1. trap pathogens
- lower pH and temperature (hostile environment)
- disrupt cell membranes of pathogens
- help innate immune system to attach and attack what part of natural barriers is complex and context dependent (different depending on where in the body it is) -- Answer โโ microbiome Is innate immunity specific or non-specific? -- Answer โโ Non-specific what are the 5 cardinal signs of inflammation? -- Answer โโ 1. redness
- heat
- swelling
- pain
- loss of function
what are the 3 major plasma systems? -- Answer โโ 1. complement
- clotting
- kinin what cells typically activate the 3 major plasma systems -- Answer โโ mast cells 4 goals of inflammation -- Answer โโ 1. limit damage
- contain invading organisms
- initiate the adaptive immune response
- begin the healing process when does inflammation occur after insult/injury? -- Answer โโ immediately (within seconds) what are the 3 pathways to activate the complement cascade? -- Answer โโ 1. classical
- lectin
- alternative complement cascade products have what 4 functions? -- Answer โโ 1. anaphylatoxic activity - > mast cell degranulation
- leukocyte chemotaxis
- opsonization
- cell lysis An immune response in which the binding of antibodies to the surface of a microbe facilitates phagocytosis of the microbe by a macrophage -- Answer โโ opsonization where does the clotting cascade activate? -- Answer โโ site of inflammation
purpose of cellular infiltration in the vascular response -- Answer โโ WBC adhere to inner walls of vessels, move through large spaces between endothelial cells, into the surrounding tissue what are the 3 key changes in microcirculation during inflammation? -- Answer โโ 1. vasodilation
- increased capillary permeability
- cellular infiltration what are 4 key cellular mediators -- Answer โโ 1. mast cells
- platelets
- phagocytes (leukocytes (WBC))
- natural killer cells A molecule that binds specifically to another molecule, usually a larger one. (produced during tissue damage and binds to receptors to activate intracellular signals) -- Answer โโ ligand what are PAMPs? -- Answer โโ Pathogen-associated molecular patterns what are PRRs? -- Answer โโ pattern recognition receptors receptors that recognize pathogen-associated molecular patterns (PAMPs) -- Answer โโ Toll-like receptors (TLRs) inflammatory response is initiated when tissue injury occurs or when ________ are recognized by ________ on cells of the innate immune system -- Answer โโ PAMPS, PRRs
what are the key cellular activators of the inflammatory response -- Answer โโ mast cells where are mast cells located? -- Answer โโ close to blood vessels in skin, GI tract, and respiratory tract what is the release of granules from a mast cell -- Answer โโ degranulation what is a very potent vasodilating molecule that is a granule released by mast cells? -- Answer โโ histamine histamine receptor that is proinflammatory -- Answer โโ H1 receptors where are H1 receptors located? -- Answer โโ smooth bronchi muscle cells (induce bronchospasm) the ingestion and disposition of pathogens/foreign material -- Answer โโ phagocytosis where are H2 receptors located? -- Answer โโ stomach parietal cells (induce gastric acid secretion) histamine receptors that are anti-inflammatory -- Answer โโ H2 receptors what are the two most important phagocytes -- Answer โโ 1. neutrophils
- macrophages do neutrophils or macrophages arrive at the injury first? (6-12 hours) -- Answer โโ neutrophils
3 types of cytokines -- Answer โโ 1. interleukins
- interferons
- tumor necrosis alpha (TNF-a) what cell is the largest leukocyte (WBC) -- Answer โโ monocytes where are monocytes produced? -- Answer โโ bone marrow where do monocytes reside? -- Answer โโ blood and tissue monocytes develop into what two other cells? -- Answer โโ 1. macrophages
- dendritic cells role of monocytes -- Answer โโ alert and recruit other cells small molecules that bind to membrane receptors to help regulate both innate and adaptive immunity -- Answer โโ cytokines 3 main classes of cytokines -- Answer โโ 1. interleukins
- interferons
- tumor necrosis alpha (TNF-a) cytokines that induce chemotaxis -- Answer โโ chemokines Cell movement that occurs in response to chemical stimulus (ex. attraction of WBC to site of inflammation) -- Answer โโ chemotaxis
key initiator of primary immune response & link to adaptive immune response -- Answer โโ dendritic cells where are dendritic cells located? -- Answer โโ peripheral organs and skin what cells link innate to adaptive immune systems? -- Answer โโ dendritic cells what are 2 functions of dendritic cells -- Answer โโ 1. phagocytosis
- antigen presenting cell (APC) to stimulate naive T cells 3 systemic manifestations of inflammation -- Answer โโ 1. fever
- leukocytosis
- plasma protein synthesis main reason why we see erythema and warmth -- Answer โโ vasodilation microorganism that is highly sensitive to temperature -- Answer โโ syphilis what is a downside of fever? -- Answer โโ may enhance susceptibility to effects of endotoxins (gram negative bacteria) what causes fever? -- Answer โโ exogenous pyrogens (cytokines) main reason why we see edema -- Answer โโ increased capillary permeability main reason why we see pus -- Answer โโ cellular infiltration, phagocytosis main reason why bleeding is prevented -- Answer โโ thrombosis
what are two things to be aware of for innate immunity in neonates -- Answer โโ 1. neutrophils incapable of efficient chemotaxis
- deficient complement system what is something to be aware of for innate immunity in the elderly -- Answer โโ expression of TLR diminished cell-mediated adaptive immunity -- Answer โโ T cells humoral adaptive immunity -- Answer โโ B-cells what is the 3rd line of defense after natural barriers and innate immunity -- Answer โโ adaptive immunity is adaptive immunity specific or non-specific -- Answer โโ highly specific is adaptive immunity short or long-lasting? -- Answer โโ long lasting (slower, systemic) induction of adaptive immunity produces what two things? -- Answer โโ 1. lymphocytes (T & B cells)
- antibodies (Ig) specific response to a pathogen; subsequent exposures result in highly efficient response (long term security) -- Answer โโ memory production of naive, immunocompetent T and B cells in their respective central lymphoid organs -- Answer โโ clonal diversity
what are the primary cells of humoral immunity? -- Answer โโ B cells and circulating antibodies humoral immunity primarily protects against what two things? -- Answer โโ bacteria and viruses cellular immunity primarily protects against what two things? -- Answer โโ viruses and cancer immunocompetent T and B cells migrate from central lymphoid organs to what two secondary lymphoid organs -- Answer โโ 1. spleen
- lymph nodes What are the primary lymphoid organs? -- Answer โโ 1. thymus
- bone marrow selection, proliferation, and differentiation of individual T and B cells with receptors for a specific antigen -- Answer โโ clonal selection ability to recognize ourselves as "not foreign" -- Answer โโ tolerance molecules that react with binding sites on antibodies or receptors on B and T cells -- Answer โโ antigens antigens that induce an immune response -- Answer โโ immunogens what are 4 things that determine whether an antigen induces an immune response? -- Answer โโ 1. foreign **
- size
T Lymphocyte receptors that recognize MHC Class I molecules and develop into T cytotoxic cells (Tc) -- Answer โโ CD8+ how do T-Helper cells know which type of cell to differentiate into? -- Answer โโ what type of cytokine is released purpose of Th1 -- Answer โโ cellular immunity (activate macrophages and Tc Cells) purpose of Th2 -- Answer โโ humoral immunity (activate B cells) purpose of Th17 -- Answer โโ inflammation and epithelial cell protection purpose of Treg -- Answer โโ suppress immune response Cell receptors (BCR) on B Cells create what? -- Answer โโ plasma cells what do plasma cells produce? -- Answer โโ antibodies - immunoglobulin (Ig) most abundant Ig; transported across the placenta for 6 months of protection -- Answer โโ IgG where are 4 places you can find IgA? -- Answer โโ 1. mucus
- saliva
- tears
- breastmilk what is the largest and first antibody produced in initial antigen response? -- Answer โโ IgM
what is the antigen receptor of early B lymphocytes (basophils and mast cells) and has the lowest serum concentration? -- Answer โโ IgD when do you see IgE? -- Answer โโ 1. allergic responses
- parasites what are three direct functions of antibodies? -- Answer โโ 1. neutralization
- agglutination
- precipitation inactivates or blocks the binding of an antigen to a receptor -- Answer โโ neutralization clumps insoluble particles in suspension -- Answer โโ agglutination makes a soluble antigen into an absolute precipiate -- Answer โโ precipitation when do you see a secondary immune response? -- Answer โโ when you have subsequent exposure to the same antigen how your body develops natural active immunity -- Answer โโ Infection how your body develops artificial active immunity -- Answer โโ vaccination how your body develops natural passive immunity -- Answer โโ maternal antibodies
- uticaria
- vomiting
- diarrhea
- abdominal pain type I allergies are often to what 7 things? -- Answer โโ 1. pollen
- molds
- fungi
- foods
- animals
- smoke
- dust 3 diagnostic tests for type I hypersensitivities -- Answer โโ 1. antibody testing for IgE (general or specific)
- food challenges
- skin tests (local wheal and flare reaction) 3 treatments of type-1 hypersensitivity -- Answer โโ 1. avoidance
- antihistamines
- epinephrine what is the effect of Epinephrine as a treatment for Type I hypersensitivity -- Answer โโ binds to smooth muscle to reverse effects of histamine
- complications of type-1 hypersensitivity -- Answer โโ 1. anaphylaxis
- death from severe respiratory and vascular reaction
hypersensitivity where specific cells or tissues are attacked, primarily by IgG and IgM antibodies -- Answer โโ type II hypersensitivity 6 examples of type II hypersensitivity -- Answer โโ 1. autoimmune hemolytic anemia
- transfusion reactions
- myasthenia gravis
- Graves disease
- hemolytic disease of newborns
- drug allergies hypersensitivity where induction of inflammatory response is what causes damage (not dependent on antigen, but on WHERE these complexes deposit) -- Answer โโ Type III hypersensitivity 4 examples of type III hypersensitivity -- Answer โโ 1. SLE
- drug allergies
- celiac
- arthus reaction what type of cells mediate Type IV hypersensitivity -- Answer โโ cell-mediated (T- cells) 4 type IV hypersensitivity examples -- Answer โโ 1. acute graft rejection
- skin test
- contact allergic reaction
- some autoimmune diseases major difference between Type I and Type IV hypersensitivities -- Answer โโ delay in onset
what type of treatment would you use for a T-cell mediated graft rejection? -- Answer โโ Corticosteroids what two treatments would you use for B-cell mediated graft rejections? -- Answer โโ
- plasma exchanges
- Rituximab (targets B cells) another term for congenital immunodeficiency -- Answer โโ primary immunodeficiency how do you know immunodeficiency is caused by an issue with T-cells? -- Answer โโ recurrent infections caused by viruses, fungi or yeast how do you know immunodeficiency is caused by an issue with B-cells? -- Answer โโ recurrent infections caused by encapsulated bacteria or certain viruses how do you know immunodeficiency is caused by an issue with complement? -- Answer โโ bacteria from genus Neissera what are 4 labs for primary and secondary immunodeficiency -- Answer โโ 1. CBC with a WBC differential
- quantitative determination of immunoglobulins
- assay for total complement
- skin tests 4 treatments for immunodeficiency -- Answer โโ 1. Gamma-globulin therapy
- transplantation or transfusion
- treatment with soluble immune modulators
- gene therapy
how is gamma-globulin therapy administered? -- Answer โโ IM or IV 3 complications of immunodeficiency -- Answer โโ 1. sepsis
- SIRS
- death 4 phases of infectious disease -- Answer โโ 1. incubation
- prodromal period
- period of illness/decline "invasion"
- convalescence time between infection and appearance of symptoms -- Answer โโ incubation mild, nonspecific symptoms -- Answer โโ prodromal period phase of infectious disease where pathogens multiply rapidly, immune and inflammatory responses are triggered and symptoms are in full swing -- Answer โโ period of illness/decline "invasion" phase of infectious disease with recovery and resolution -- Answer โโ convalescence 6 steps for HIV pathophysiology -- Answer โโ 1. HIV enters the body
- HIV attacks cells
- HIV binds to CD4 receptor and fuses with cell membrane
- Reverse transcriptase converts single-stranded RNA to double-stranded DNA
- Integrase inserts HIV DNA into host DNA
- Creation of viral components
