Pathophys Test 2

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Author:
cgordon05
ID:
12116
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Pathophys Test 2
Updated:
2010-03-27 16:43:30
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Immune
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Immune
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  1. Explain innate immunity.
    What types of cells would mediate innate immunity? (p.1)
    • Present at birth
    • Activates in same manner every time
    • Not antigen specific
    • Primarily mediated by cells involved in inflammatory process:
    • - polymorphonuclear leukocytes - basophils, neutrophils, eosinophils
    • - macrophages
    • - platelets
    • Also involves complement cascade
  2. Explain adaptive immunity.
    What types of cells would mediate adaptive immunity? (p.1)
    • Acquired after birth
    • Occurs after sensitizing exposure to foreign agent (antigen)
    • Involves cellular and humoral immunity - T and B lymphocytes
    • - B = humoral immunity --> antibodies
    • - T = cellular immunity
  3. Monocytes
    (non-granular leukocytes) (p.2-3)
    • 4-8% of WBCs
    • Not activated as monocytes.
    • Migrate to tissue
    • Activated as macrophages once in area of injury
    • Important APCs - antigen-presenting cells
  4. Polymorphonuclear Leukocytes
    (PMNLs)
    • Found primarily in vascular system
    • Constitute majority of circulating leukocytes
  5. Macrophages
    • Have receptors for antigens, for complement components, and for FC receptors on antibodies
    • Effective in stimulating immune system
    • Also function as APCs
    • Ingest foreign antigens, partially digest with lysosomal enzymes, then return portion of antigen to cell membrane so other immune cells can see it and further attack
    • Generate superoxide free radicals and hydrogen peroxide
    • Primary functions:
    • - Phagocytosis
    • - Antigen-presenting to T-helper cells
    • - Cytokine production (IL-1, IL-6, IL-8, and several others)
  6. Neutrophils
    • First to arrive at site of injury; Usually first seen with acute infection
    • Main function = phagocytize microorganisms
    • Granules contain enzymes that digest biologic materials and generate free radicals
    • Destroy bacterial cell membranes
    • Categorized based on maturity:
    • - Segs = mature
    • - Bands = immature
    • Normal neutrophil count = 1500-7700 /uL
  7. Eosinophils
    • Contain cytosolic granules of toxic enzymes – acid phosphatase and peroxidase
    • Contain type of protein particularly effective against parasites
  8. Eosinophilia
    • Increased eosinophils
    • Hallmark of allergic reactions
    • Seen with asthma, hay fever, eczema,allergic dermatitis, drug reactions, and parasitic infections
  9. Basophils
    • Function – antigen interacts with IgE on basophil receptor (mast cells) --> cell’s granules --> histamine release --> bronchoconstriction, mucus production, pruritus, vasopermeability, vasodilation
    • Allergic reaction, type I hypersensitivity
  10. What about T lymphocytes?
    • Produced in bone marrow and mature in the thymus gland
    • Acquire histocompatibility during maturation
    • Must see foreign antigen, understand it, then replicate it (cellular immunity)
    • Responsible for initiating cellular immunity
    • T-cell precursors in bone marrow --> thymus gland --> cell division and maturation – acquire Histocompatibility molecules --> secondary lymph organs (appendix, tonsils, adenoids, Peyer’s patches in small intestines) --> react with antigens
    • Increase in viral infections
  11. What are the 3 pools of neutrophils?
    • Marginal – 1-4 days
    • Circulating – 3-6 days
    • Bone marrow – 9 days
  12. What is meant by bands versus segs in terms of the maturation of neutrophils? (p.3)
    • Stages of neutrophil maturation – myeloblasts, promyeloblasts, myelocytes, metamyelocytes, bands, segmented neutrophils (segs)
    • Bands = less mature than segs
    • Degree of immaturity = different pathologies
    • More immature the neutrophil = sicker the patient (i.e., chronic leukemia)
  13. What does a left shift indicate?
    • Increased metamyelocyte / bands = typical left shift seen with bacterial infections
    • Higher # of extremely immature neutrophils = larger left shift = sicker patient
  14. Review cell-mediated and humoral immunity. (p.1)
    • Humoral immunity – B lymphocytes
    • - Prevention*
    • - Relies on production of antibodies by B-cells and plasma cells
    • Cell-mediated immunity – T lymphocytes
    • - Recovery*
    • - Involves interaction of helper T cells and cytotoxic T cells with various target cells
  15. What immune cells are involved with each type of immunity?
    • B-cell immunity – B lymphocytes
    • - Produced and mature in bone marrow
    • - Travel to lymphoid tissue
    • - Once exposed to antigen, B lymphocytes turn into plasma cells that secrete specific antibodies.
    • - Antigens are exposed to B cells once they are attached on T helper cells
    • T helper cells are subsets of CD4 T-lymphocyte cells
    • Without T cells, B cells cannot recognize antigen as foreign.

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