Immunity Lecture

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recraig
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8278
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Immunity Lecture
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2010-02-26 22:47:39
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Questions about Class 1 immunity lecture
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  1. What is Natural Active immunity?
    You are exposed to an antigen and the body does the work of making the antibodies. You will have long term protection b/c the cells remember
  2. What is Natural Passive immunity?
    Immunity given to a baby from their mother through the placenta or boob milk
  3. What is Artificial Active immunity?
    Vaccines are given, they are not enough to make you sick but are enough to have your body make antibodies. Takes weeks to develop, only lasts a few years so need to get boosters - i.e. Tetanus get booster ever 10 years
  4. What is Artifical Passive immunity?
    Antibodies are man made and given to you by a shot - immediate and temporary since the body doesn't make a constant supply
  5. What is cell-mediated immunity(T-cells)?
    Memory cells: recognize self from non-self, remembers which cells are bad. Cytokines: chemical messengers in the body that send signals to regulate processes in the body like moderate cell growth and function. Macrophage: send chemical messages about which cells to kill during inflammation. T-cells: helper, killer, suppressor cells that keep body from over reacting, keeps homeostasis
  6. What is humoral (antibody mediated) immunity (B-cells and antibodies)?
    B-cells: sensitized and producers of antibodies and have memory. Plasma cells: secretes immunoglobins. Memory cell: remembers antigen for future. Complement system: 25 proteins circle body fluids and enhance the immune response by stimulating histamine (inflammation), increasing vascular permeability for antibodies to get out, chemotaxis, phagocytosis, and cell lysis.
  7. What is angioedema?
    Swelling of eyelids, lips, hands, etc - immediately look in the throat. Need to trach before airway gets more swollen - possible wheezing or stridor (always medical emergency) - need epi pen and lots of fluids
  8. What is Severe Combined Immunodeficiency (SCID)?
    Little to no immune response, "bubble-boy" - defect in B&T lymphocytes causing reduced or no defense for viruses, bacteria, or fungi. It's an inherited mutation in interleukin 2 receptor or lack of enzyme adenosine deaminase - no treatment just strict protective isolation forever
  9. What is autoimmunity?
    React to self - there is a defect in recognizing self form non-self. Ex. Scleroderma
  10. What is immunodeficiency?
    An under-reaction b/c of reduced T helper cells leading to reduced B cell function. Ex HIV (CD4<200)
  11. Factors affecting immunocompetence?
    Age (elderly less competent immune system), gender (women more likely to be immunocompromised b/c of estrogen), nutrition (malnourished not able to have good immune system), psychoneuro factors (the more stressed = more susceptible to immunocompetence), organ pathologies (if not all organs functioning then impaired immune system), medications, radiation (both can have immunosuppressive effects either as side effect or intended purpose - i.e. steroids w/ inflammatory response)
  12. S&Sx of immunocompetence
    fever, chills, malaise, lymphadenopathy, pharyngitis, GI disturbance (diarrhea or vomiting, Nausea)
  13. What are the lab markers for immunocompetence?
    WBC, differential, CD4 ratios, bone marrow biopsy, serum globulins, delayed hypersensitivity tests, advanced assays
  14. Neutrophil counts
    Index to infection susceptibility and system response. Higher concentration in immature cells is a "shift to the left" which signals acute infection. The bone marrow releases immature neutrophils with an acute infection. Neutropenia <1000. Normal is 3000-7000. Absolue Neutrophil Count (ANC) - percentage of neutrophils in WBC. Should be 50-70 & but need to know WBC volume b/c if WBC abnormally low can give unreliable & of neutrophil
  15. Transplant criteria for the heart
    Life expectance <1 yr, Age<65, Ejection fraction (amount of blood ejected by left ventricle - normal 50%)<25%, pulmonary vascular resistance WNL, absence of active infection, stable psychosocial status, no current alcohol/drug abuse
  16. Criteria for liver transplant
    Chronic, irreversible disease, Liver/billiary tree primary malignant tumors, primary sclerosing cholangitis, hepatic metabolic diseases, fulminant hepatic failure (toxins, hepatitis), no malignancies
  17. People not considered for Liver transplant
    Advanced sequelae of liver disease (varices, hepatorenal syndrome), systemic conditions (sepsis, CVS, DM, severe HTN), intellectual limitations/psychosocial instability, active alcoholism, advanced catabolic state, portal vein thrombosis
  18. Criteria for Kidney transplant
    End-stage renal disease, evaluation of poor efficacy of hemodialysis for maintenance, cost savings (benefit-risk: cheaper to get transplant than be on dialysis). Bad kidneys stay unless polycystic kidney disease. Put new kidneys in lower closer to bladder
  19. What is hyperacute rejection?
    Immediate, can happen within a min - usually within 12-24 hours. Not very oftemn anymore b/c check if organs compatible before hand. Due to memory of B cells, they kills the tissue b/c it doesn't recognize it - causes clotting, choking blood supply and killing organ
  20. What is acute rejection?
    Days to months after transplant. b/c of T-cells. Inflammation of walls of vessels (vasculitis)
  21. What is chronic rejection?
    Humoral attack, slowly happens overtime b/c of fibrotic scarring. Chronic inflammatory response. Vessels damaged leading to progressive ischemia
  22. What are some alterations in aging?
    Slow metabolic, decrease in sensory and mobility. Higher risks with surgery, healing, nosocomial infections, accidents, concomitant conditions and safety
  23. What is primary prevention?
    prevent antecedent conditions (factors that precede) - wear seat belts and helmets, have well-balanced meals, not smoking, no or minimal alcohol, immunizations, and maintaining ideal body weight
  24. What is secondary prevention?
    Once conditions (factors) present, prevent/manage from becoming disease/pathology - yearly PAP smears, monthly breast or testicular self-exams, mammograms, TB skin tests, tonometry tests
  25. What is tertiary prevention?
    Disease/damage to organ/body so want to prevent complications, rehab to function - cardiac rehab, rehab for CVA,head injury, arthritis pain & ADL management clinic

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