Pathophys Exam 2

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Rx2013
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46167
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Pathophys Exam 2
Updated:
2010-10-30 20:51:23
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Introduction Immunology
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Principles of Infectious Disease
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  1. Organs of the immune system
    • bone marrow
    • thymus
    • spleen
    • lymph nodes
  2. Cells of the immune system
    • Tcells
    • Natural Killer Cells
    • B Cells
    • Granulocytes
    • Macrophages
    • Dendritic cells
  3. Two types of T-cells and location
    • CD4 and CD8
    • liver
    • blood intestinal and reproductive tracts
  4. Helper T Cells
    • CD4
    • coordinators of immune regulation
    • potentiate immune response
  5. Killer T cells
    • CD8
    • important for directly killing tumor cells, viral infected cells and parasites
    • down regulation of immune response
  6. Natural Killer Cells
    • directly kill certain tumors and viral infected cells.
    • Stimulated by T-cells
  7. B-cells
    • responsible for production of antibodies
    • adaptive response
    • occurs under direction of CD4 cells
  8. Granulocytes
    • Neutrophils, Eosinophils & Basophils
    • Removal of bacteria and parasites from the body.
  9. Macrophages
    • Antigen Presenting Cells
    • Present to T and B cells
  10. Dendritic Cells
    • originate in bone marrow
    • Antigen presenting cells (more efficient)
    • Presents antigens to lymphoid organs
  11. Innate Immune Response Components
    • Physical barriers
    • Biochemical messengers
    • Cellular components
  12. Duties of the innate immune response
    • distinguish self from not-self
    • Bind pathogens to PRRs on leukocytes to initiate signaling
  13. Pattern recongnition receptors (PRRs)
    host pathogen sensors that recognize structural patterns.
  14. PAMPs
    Pathogen associated molecular patterns
  15. Toll-like receptors (TLRs)
    • expressed on immune system cells responsible for innate response
    • binding triggers recruitment of soluble mediators
  16. Soluble mediators of innate immunity
    • opsonins
    • inflammatory cytokines
    • acute-phase proteins
  17. Opsonins
    Tag pathogens for removal by phagocytosis
  18. Inflammatory Cytokines
    • stimulate recruitment of WBC
    • stimulate acute-phase protein production
    • inhibit viral replication
    • affect development of innate and adaptive cells
    • short half life
  19. Cytokines that mediate innate immunity
    • Type I interferons
    • Tumor necrosis factor-A
    • chemokines
  20. Cytokines that mediate adaptive immunity
    • interferon g (type II)
    • lymphotoxin-a (TNF-B)
  21. Acute phase proteins
    • produced by the liver in response to cytokines
    • inhibit microbial growth
    • promote inflammatory response
    • C-reactive protein
  22. Complement system
    • inactive precursor proteins that are present in circulation
    • activated by pathogens, cytokines or antibodies
  23. Three step reaction of the complement system
    • Activation
    • Amplification
    • Membrane attack response
  24. Complement protein mechanism
    • complement binds antibodies on the pathogen
    • attach to pathogen membrane forming a membrane attack complex
    • MAC forms a pore in the membrane leading to cell lysis
  25. Adaptive Immune System
    • mobilized by cues from innate response
    • discriminates between foreign and self
    • responds to previously encountered antigens
    • humoral and cell mediated immunity
  26. CD4 and CD8 Cells recognize...
    peptide complexes provided by antigen presenting cells
  27. CD8 and CD4 cells secrete IL-4 and IL-5 which result in
    B-cell proliferation
  28. have not previously encountered an antigenfunction is antigen recognition
    Naive lymphocytes
  29. capable of performing the functions required to eliminate microbes. secrete cytokines.
    • effector lymphocytes
    • B lymphocytes
  30. long-lived functionally silent cells which mount rapid responses to antigen challenge
    memory lymphocytes
  31. activates complement and binds to macrophages
    IgG
  32. primary defense against local infections in mucosal tissues
    IgA
  33. activates complement
    IgM
  34. Needed for maturation of B cells
    IgD
  35. Binds to mast cells and basophils
    IgE
  36. Two ways T cell receptors may recognize antigens
    • presentation by MHC
    • direct recognition of peptide fragments
  37. MHCII goes with
    CD4
  38. MHCI goes with
    CD8
  39. MHC Class I produced in
    the cytosol by the proteosome
  40. MHC Class II expressed on
    • specialized antigen presenting cells
    • bacterial
  41. stabilize interaction between t cells and MHC
    adhesion molecules
  42. When interaction between T cells and MHC then....
    • a second signal is produced
    • lack of production of the second signal results in apoptosis
  43. 3 major variables determining outcome of MHC/T-cell interaction
    • duration and affinity of interaction
    • maturity of T-cell
    • nature of APC
  44. T-cell differentiation and effector function driven primarily by
    • IL-2
    • niave to effector
  45. Abilities of effector T cells
    • lower activation threshold
    • no costimulation required
    • scan tissues that lack APCs
    • gain access to peripheral tissues
  46. Effector tcells _____ antigen bearing cells and activate _____.
    • lyse
    • phagocytosis
  47. Memory B cells distribution in peripheral tissues is an example of
    humoral immunity
  48. Cells that hold immune system memory
    • memory T cells and B cells
    • low antigen stiumlation threashold
  49. White blood cell count
    increased number = infection
  50. Mature neutrophils normal range (segs)
    50-70%
  51. immature neutrophils (bands) normal range
    3-5%
  52. Absoulte Neutrophil Count
    WBC (%segs + %bands) divided by 100
  53. ANC <1800
    neutropenia
  54. ANC<500
    infection high risk
  55. bacterial infections show
    increased neutrophils (left shift)
  56. viral infections show
    increased lymphocytes
  57. allergic reactions or protozoal infections show
    increased eosinophils
  58. Stress may cause
    • delayed production of antibodies
    • suppressed T cell activity

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