Chapter 14 (Nonspecific Defenses) Superset

Pattern Recognition Receptors (PRRs)

"feelers" for sensing pathogens; kinases, lectins, and mannose-type molecules.

plasma= 55% cellular elements 45%

% blood component

Select all of the correct statements concerning SLE to test your understanding of the pathogenesis of autoimmune diseases.

- Autoantibodies bind self antigens forming immune complexes that accumulate in basement membranes of various organs. - Autoantibodies include those against white and red blood cells, and platelets.

Select all statements that apply to hemolytic disease of the newborn to test your understanding of this disorder.

- Fetal RBC leakage sensitizes the mother to make anti-Rh antibodies. - Anti-Rh antibodies that are IgG can cross the placenta and induce complement-mediated lysis of fetal RBCs. - Hemolytic disease is a Type II hypersensitivity reaction.

Select all of the correct statements concerning SCIDs to test your understanding of severe combined immunodeficiency disease.

- Most serious and lethal of the primary immunodeficiency diseases, caused by genetic defects - Involves loss or dysfunction of both humoral and cell-mediated immunity - Requires vigorous adherence to aseptic techniques to prevent infection

Type 4

- T-cell mediated - delayed hypersensitivity - contact dermatitis, graft rejection

Type 1 Hypersensitivity

- immediate - IgE-mediated, involving mast cells and basophils - anaphylaxis, allergies, asthma

Type 3

- immune complex mediated - IgG complexes in basement membranes - SLE, rheumatoid arthritis, serum sickness

Type 2

- involves IgG & IgM - blood group incompatibility

Basophils

0.5% of white blood cells; primary function is active in allergies and inflammation; contains histamines and prostaglandins; (nonspecific). Have mast cells.

Eosinophils

1%-3% of white blood cells; primary function is destruction of parasites; mainly found in spleen and bone marrow. (nonspecific); contain peroxidase and lysozomes. Attack and destroy eukaryotic pathogens.

Primary functions of the Immune System

1. Surveillance of organs, tissues, and other compartments. 2. Recognition and differentiation of normal components of the body and foreign material such as pathogens. 3. Attack and destruction of foreign invaders.

Major functions of Lymphatic system

1. To provide an auxiliary rout for the return of extracellular fluid to the circulatory system proper. 2. To act as a "drain off" system for the inflammatory respon. 3. To render surveillance, recognition, and protection against foreign materials through a system of lymphocytes, phagocytes, and antibodies.

Functions of phagocytosis

1. survey tissue compartments to discover microbes 2. to ingest and eliminated these materials 3. to extract immunogenic information (anitgens)

The most extensive body compartments that participate in immune functions

1. the reticuloendothelial system (RES) 2. The spaces surrounding tissue cells that contain extracellular fluid (ECF) 3. The bloodstream 4. The lymphatic system RES and ECF --> blood steam --> lymphatic system

Chief functions of inflammation

1. to mobilize and attract immune components 2. to set in motion mechanisms to repair the tissue and clear away harmful substances 3. to detsroy and bloc microbes from further invation

Percentage of population prone to atopic allergy

10-30

Generally, it is not possible to have an allergic reaction the ____ time a person is exposed to an antigen.

1st

injury--> vasoconstriction--> release of chemical mediator

1st event in inflammation

resident microbiota

1st line defense block access of pathogen to epithelial surface provide microbial antagonism creates unfavorable environment for pathogens

mucous membrane

1st line defense digestive, urinary and respiratory tract moist and permeable provides barrier protection without keratnized layer mucous coat impedes the entry and attachment of bacteria

Skin

1st line defense epithelial cells compacted together containing keratin highly impervious and waterproof few pathogens can penetrate this broken layer

Respiratory tract

1st line defense nasal hair traps larger particles copious flow of mucous and fluid during allergies and cold exert a flushing action ciliated epithelium moves foreign particles trapped in mucous toward the pharynx for removal

Genitourinary tract

1st line defense protection through the continuous trickle of urine through ureter and flushing of bladder emptying vaginal secretion provide cleansing of the lower reproductive tract in females

Lymphocytes

20%-35% of white blood cells; Specific (acquired) immunity; two types: B lymphocytes and T lymphocytes

Skin lesions due to hypersensitivity appear

24 hours after second exposure to antigen

vasodilation--> increase blood flow--> increase vascular permeability--> leakage of fluid from blood vessel into tissue

2nd event in inflammation

Monocytes

3%-7% of white blood cells; differentiation of macrophages and dendritic cells; secrete several chemicals that moderate immune system functions. Bone marrow -> blood steam.

edema--> infiltration of site by neurophiles and accumulation of puss

3rd event in inflammation

Macrophage and lymphocyte--> repair either by complete resolution and return of tissue to normal state or by formation of scar tissue

4th event in inflammation

Percentage of hospitalized patients experiencing drug allergy reactions

5-10

Neutrophils

55%-95% of white blood cells; primary function is general phagocytosis; average life span is 2 days. (nonspecific)

Percentage of allergic patients that benefit from desensitization therapy

70

Percentage of humans expressing Rh antigen on RBCs

85

Plasma

92% water, contains hundreds of different chemicals, contains the proteins albumin, globulins, and antibodies. Support the functions of nutrition, homeostasis, etc.

Which of the following antigens are present on the patient's red blood cells?

A antigen

Which of the following is an example of GALT? A. Appendix B. Lymph nodes C. Spleen D. Tonsils E. Thymus gland

A. Appendix

Which structures are found along lymphatic vessels but are heavily clustered in the armpit, groin, and neck? A. Lymph nodes B. Thymus C. spleen D. GALT E. Tonsils

A. Lymph nodes

29. Elimination and destruction systems present in the phagolysosome include all the following, except A. bromine. B. hydroxyl free radical. C. nitric oxide. D. lactic acid. E. lysozyme.

A. bromine.

Due to the way the lymph drains from lymph nodes, cell and products of immunity continually A. enter the regular circulatory system. B. enter the liver. C. enter the gastrointestinal tract. D. enter the gall bladder. E. enter the thymus gland.

A. enter the regular circulatory system.

All the following are events of early inflammation, except A. macrophages appear first and begin phagocytosis. B. chemical mediators and cytokines are released. C. brief vasoconstriction is followed by vasodilation. D. exudate and pus can accumulate. E. capillaries become more permeable resulting in edema.

A. macrophages appear first and begin phagocytosis.

The key phagocytic cells of the body are the A. neutrophils and macrophages. B. basophils and neutrophils. C. eosinophils and macrophages. D. macrophages and monocytes. E. natural killer cells.

A. neutrophils and macrophages.

All of the following pertain to platelets, except A. they contain hemoglobin to transport oxygen and carbon dioxide. B. they are also called thrombocytes. C. they originate from giant multinucleate cells called megakaryocytes. D. they function in blood clotting and inflammation. E. they are not whole cells but are pieces of cells.

A. they contain hemoglobin to transport oxygen and carbon dioxide.

26. Histamine, serotonin, and bradykinin are all A. vasoactive mediators. B. mediators of B cell activity. C. mediators of T cell activity. D. mediators that increase chemotaxis. E. fever inducers.

A. vasoactive mediators.

Third line of defense

Acquired, specific; T lymphocytes, B lymphocytes, and antibodies. Responses directed toward each different microbe produce unique protective substances and memory cells that can come into play id that microbe is encountered again.

The mother has a second child who has Rh negative blood. What is the most appropriate action during her third pregnancy?

Administration of RhoGAM between 28 and 32 weeks of pregnancy and immediately after delivery

Choose the statement that does not describe the anaphylactic response to test your understanding of anaphylaxis.

Allergen route of entry is always due to inhalation.

Eosinophils

Attracted to site of parasitic infection

_____ lymphocytes function in humoral immunity, while _____ lymphocytes function in cellmediated immunity.

B, T

When macrophages migrate to the skin and remain there, they are called _____ cells. A. alveolar B. Langerhans C. GALT D. Kupffer

B. Langerhans

Which is incorrect about complement? A. Composed of at least 26 blood proteins B. Only appear in the blood during a response to a pathogen C. Act in a cascade reaction D. Involves a classical pathway E. Involves an alternate pathway

B. Only appear in the blood during a response to a pathogen

45. During what process is hypochlorite & hydrogen peroxide produced to destroy bacteria and inhibit viral replication? A. Inflammation B. Phagocytosis C. Interferon production D. Complement production

B. Phagocytosis

Which is incorrect about inflammation? A. It can last hours to years. B. Pyrogens cause vasodilation and increased capillary permeability. C. Serotonin causes smooth muscle contraction. D. Fever could be beneficial to inhibiting the pathogen. E. Basophils and mast cells release histamine.

B. Pyrogens cause vasodilation and increased capillary permeability.

Eosinophils

Bilob nuclei present in the bone marrow and spleen attack and destroy large eukaryotic pathogens

Plasma red blood cells white blood cells platelets stem cells

Blood Composition

28. All of the following can be recognized by toll-like receptors, except A. single-stranded viral RNA. B. flagellin. C. host cell membrane proteins. D. lipoteichoic acid. E. lipopolysaccharide.

C. host cell membrane proteins.

The chemical found in tears and saliva that hydrolyzes the peptidoglycan in certain bacterial cell walls is A. lactic acid. B. hydrochloric acid. C. lysozyme. D. histamine. E. bile.

C. lysozyme.

The most numerous WBCs, that have multilobed nuclei and are very phagocytic are A. basophils. B. eosinophils. C. neutrophils. D. monocytes. E. lymphocytes.

C. neutrophils.

Hemopoiesis is the A. loss of blood due to hemorrhaging. B. production of only red blood cells. C. production of white blood cells, red blood cells, and platelets. D. plugging of broken vessels to stop bleeding. E. migration of white blood cells from the blood out to the tissues

C. production of white blood cells, red blood cells, and platelets.

Which of the following lymphoid organs has the immunological function of filtering pathogens from the blood? A. Lymph nodes B. Thymus C. spleen D. GALT E. Tonsils

C. spleen

Basophils

Constricted nuclei 0.5% of circulating White blood cells similar to eosinophil localized mast cell

The _____ region of a lymph node has germinal centers packed with T and B lymphocytes.

Cortex

Juan has influenza and has aches, pains, and a fever. His mother, a physician, tells him to take an antipyretic. What is she telling him to take? A. An antibiotic, like erythromycin B. An antiviral drug, like Tamiflu C. An antihistamine D. Acetaminophen, like Tylenol E. Herbal tea with honey

D. Acetaminophen, like Tylenol

21. The lymphoid tissues of the intestinal tract are collectively referred to as A. lymph nodes. B. thymus. C. spleen. D. GALT. E. tonsils.

D. GALT.

44. Which of the following nonspecific mediators inhibits virus replication and cellular division while increasing some lymphocyte action? A. TNF B. IL-1 C. IL-6 D. IFN E. Chemokines

D. IFN

Which cell type is phagocytic and can migrate out into body tissues to differentiate into macrophages? A. Basophils B. Eosinophils C. Neutrophils D. Monocytes E. Lymphocytes

D. Monocytes

Specificity and memory are associated with which body defense mechanism? A. Inflammatory response B. Phagocytosis by macrophages and neutrophils C. Interferon D. T cell and B cell responses E. Anatomical barriers in the body

D. T cell and B cell responses

The clearance of pus, cellular debris, dead neutrophils, and damaged tissue after inflammation is performed by A. basophils. B. eosinophils. C. neutrophils. D. macrophages. E. complement.

D. macrophages.

Plasma cells A. function in cell-mediated immunity. B. are derived from T-lymphocytes. C. function in blood clotting. D. produce and secrete antibodies. E. All of the choices are correct.

D. produce and secrete antibodies.

Intestine

Digestive juices, Bile, defense

Following delivery, the mother is educated regarding future pregnancies. Which of the following is the most appropriate statement by the RN?

Due to the risk of hemolytic disease of the newborn, you will require treatment during future pregnancies.

The reticuloendothelial system A. is a support network of connective tissue fibers. B. originates in the cellular basal lamina. C. provides a passageway within and between tissues and organs. D. is heavily populated with macrophages. E. All of the choices are correct.

E. All of the choices are correct

Nonspecific chemical defenses include A. lysozyme. B. lactic acid and electrolytes of sweat. C. skin's acidic pH and fatty acids. D. stomach hydrochloric acid. E. All of the choices are correct.

E. All of the choices are correct.

Plasma A. is the liquid portion of blood in which blood cells are suspended. B. is mostly water. C. contains albumin and globulins. D. contains fibrinogen. E. All of the choices are correct.

E. All of the choices are correct.

All of the following are types of agranulocytes because they do not have prominent granules in their cytoplasm when stained, except A. T cells. B. B cells. C. monocytes. D. lymphocytes. E. basophils.

E. basophils.

22. The four classic signs and symptoms of inflammation include all the following, except A. redness. B. warmth. C. swelling. D. pain. E. chills.

E. chills.

All of the following are correct about lymph, except A. its composition is similar to plasma. B. it travels in vessels similar to blood vessels. C. it is made mostly of water. D. it transports numerous white blood cells. E. it is transported through the body by the same pump as blood, i.e., the heart.

E. it is transported through the body by the same pump as blood, i.e., the heart.

Diapedesis is the A. loss of blood due to hemorrhaging. B. production of only red blood cells. C. production of white blood cells, red blood cells, and platelets. D. plugging of broken vessels to stop bleeding. E. migration of white blood cells from the blood out to the tissues.

E. migration of white blood cells from the blood out to the tissues.

Hematopoeitic stem cell (pluripotent) in red marrow of bone

Erythrocyte, Leukocyte, and platelets all develop from

Red blood cells

Erythrocytes transport oxygen

True or False: Complement proteins are produced by the spleen.

FALSE

True or False: During phagocytosis, intracellular digestion begins as soon as the phagosome is formed.

FALSE

True or False: Inflammatory responses are orchestrated by the immune system and are part of the body's third line of defense.

FALSE

True or false: B lymphocytes and T lymphocytes mature in the thymus gland.

FALSE

True or false: Plasma is also called lymph

FALSE

Mitochondria contain hydrolytic enzymes.

False

Most intermediate size antigen-antibody complexes are removed by phagocytosi

False

The complement system is part of the specific immune response.

False

The antibody involved in Type I hypersensitivity is _____.

IgE

Which of these describes Type I hypersensitivity?

IgE-mediated and involves mast cells, helper T-cells, and histamine

The basic mechanism in Type II hypersensitivities involves:

IgG and IgM triggering cell destruction by complement and other mechanisms.

The first class of antibody synthesized in the host's first encounter with antigen is ________.

IgM

Surveillance recognition destruction

Immune system is responsible for

________ defenses are present at birth and provide mostly nonspecific resistance to infection, whereas ________ defenses are specific defenses that must be acquired.

Innate; adaptive

virus-binds to host cell a signal is sent to the nucleus to synthesize (transcription/Translation) It is secreted binding to other host cells

Interferon activity happens when:

Select all of the statements that apply to both Type II and Type III hypersensitivity reactions.

Involve IgG antibodies Involve IgM antibodies Involve the activation of complement

Autograft

Involve the activation of complement

B-cell: plasma cell and produce antibodies T-cell: helper T-cell Natural killer cell: cytotoxic t-cell

Lymphocytes contain

_________ are the precursors to macrophages.

Monocytes

Diapedesis

Movement of white blood cells from bloodstream to tissues WBC are actively motile and able to change shape receptors on endothelial cells capture WBC and participate in their transport

Upon delivery, blood type testing is done on the newborn. The newborn is found to have an AB positive blood type. Which of the following reactions may be expected?

No immune response in newborn or mother

People with this blood type are known as "universal donors."

O

Toll-like receptors (TLRs)

PRRs that reside withing the membrane of early responders such as phagocytes; can immediately recognize and interact with molecules on the surface of many pathogens

material antibodies b cell t cel Humoral response cell-mediated response

Passive defense contains:

Chemotaxis adhesion of bacteria engulfment into phagocytic vacuoles form a phagosome formation of phagolysosome killing digestion of the microbe release of debris

Phases in phagocytosis

Innate Immunity

Present before any exposure to pathogen present at birth not specific no memory

Biconcave disc= 7um shape allows the cell to distort and access capillary vesicles

RBC Shape and why it is that shape

White blood cells leukocytes

Recognize self markers on host cell recognize non self markers on invading microbe

Dendritic cells

Reside throughout tissue and RES responsible for processing foreign matter and present to lymphocyte

Immunology Specific and non specific defense White blood cells markers

Second line defense contains

dsRNA

Some viruses can encode protein that bind to

T-cell

Specific cellular immune response assisting B-cell and killing foreign cells (cell-mediated)

Platelets

Sticky cell fragment no nucleus fragment of cytoplasm derived from megakaryocytes entering circulation involved in blood clotting

Red blood cells Whit blood cells

Suspended cells in plasma

Which of the following autoimmune diseases is the most likely diagnosis based upon the patient's presentation?

Systemic lupus erythematosus

MHC class II receptors are found on all of the following EXCEPT

T-Cells

True or False: Certain complement components stimulate inflammation and phagocytosis

TRUE

True or False: Endotoxin is an exogenous pyrogen.

TRUE

True or false: Dermacidin is an antimicrobic peptide secreted by skin cells, which breaks down bacterial membranes and causes them to lyse.

TRUE

True or false: Genetic differences among species, and within a species, can convey genetic immunity to certain diseases.

TRUE

True or false: PAMPs are molecules shared by many microorganisms but not present in mammals.

TRUE

Xenograft

Tissue transplant between individuals of different species

Isograft

Tissue transplant from an identical twin

Complement factor C3b coats a bacterium and binds to C3b receptors on phagocytes, making the bacterium more susceptible to being phagocytized.

True

Inborn, nonspecific defenses include physical, chemical, and genetic barriers that impede the entry of not only microbes but any foreign agent.

True

Phagocytosis is part of the body's nonspecific defenses.

True

When the lysosome fuses with the phagosome to form a phagolysosome, granules containing antimicrobial chemicals are released in the phagolysosome causing the death of the microbe.

True

What type of hypersensitivity do the patient's symptoms demonstrate?

Type III: Immune complex-mediated hypersensitivity

signaling, production, and the blocking of the function of the IFN-induced protein

Viruses find away around the IFN response is through the inhibition of interferon

What type of hypersensitivity, mediated by IgE, do the patient's symptoms demonstrate?

What type of hypersensitivity, mediated by IgE, do the patient's symptoms demonstrate?

second line defenses

a cellular and chemical system that comes immediately into play if infectious agents make it past the surface defenses

Chemokins

a chemotactic factor that affects white blood cells

Dermicidin

a defensin that helps eliminate bacteria

Phagosome

a phagocyte that has enclosed bacteria/foreign stubstance

Lymph

a plasmalike liquid carried by the lymphatic system; formed when certain blood components move out of the blood vessels into the extracellular space; it transports white blood cells (mostly leukocytes), and cellular debris, etc.

Cytokins

a protein or polypeptide produced by WBC's that regulates host defenses

Interferon

a small protein produced naturally by certain white blood and tissue cells. Used against certain viral infections and cancer; produced in response to viruses, RNA, immune products, and various antigens; they bind to surfaces and induce changes in genetic expression; can inhibit cancer genes and have tumor suppressor eggects

first line defense

a surface protection composed of anatomical and physiological barriers that keep microbes from penetrating sterile body compartments

edematous exudate

accumulation of liquid that contains varying amounts of clotting protein fibrinogen, blood cells, and cellular debris - called serous. Dilutes toxic substances and clotting traps microbes and prevents them from spreading.

Intermediate size complexes

activate complement

Classical

activated by the presence of antibody bound to microbes

Monocyte

are transformed into macrophages after emigrating out of the bloodstream into the tissue due to chemical stimuli increase in size enhance developing of lysosomes and other organelle

long-lived inflammatory reaction

attract monocytes, lymphocytes and macrophages macrophages clear pus, cellular debris, dead neutrophils damaged tissue B-lymphocytes T-lymphocytes tissue is completely repaired or replaced by a scar

Extracellular fluid (ECF)

bathes all cells and is an important site of exchange for nutrients and gases, carried by reticuloendothelial system.

On first exposure to antigen, T helper cells

become activated and increase in number.

inhibits microbe and viral multiplication impedes the nutrition of bacterium by reducing the availability of iron increase metabolism and stimulates immune reaction and naturally protective physiological process

benefits to a fever

Complement

biochemical cascade that consist of over 30 protein that work together to destroy bacteria and viruses sequential physiological process first substance in a chemical series activates the next substance

monocytes

blood phagocytes that rapidly leave the circulation and mature into macrophages

vascular change

early inflammation changes controlled by chemical mediator and cytokines that are released by blood cells, tissue and platelets

Phagocytosis

eating cell process, actively attack and dismantle foreign cells with a wide array of antimicrobial substances.

influx of fluid to dilutes toxic substance fibrin clot trap microbes and prevent further spread neutrophils actively phagocytosis and destroy bacteria, dead tissue and particulate matter

edema and chemotaxis benefits

Mucosal-associated lymphoid tissue - MALT

embedded throughout systems with mucous membranes are discrete bundles of lymphocytes and other whire blood cells (Tonsils, lactating women).

Phagocytes are attracted by all of the following EXCEPT

enzymes released by lysosomes.

neutrophil

essential blood phagocytes active engulfed and killer of bacteria

Allograft

exchange between genetically different individuals belonging to the same species

Paneth cells

in the intestine, secrete defensins that act on se3veral types of infectious agents.

Third line of defense

includes specific host defense that must be developed uniquely for each microbe through the action of specialized white blood cells

Vasoilation

increase the flow of blood into the area, which facilitates the influx of immune components and also causes redess and warmth

pyrogens

induces fever reset hypothalamic thermostat vasoconstriction

cause fever, simulate lymphoctes, prevent virus spread, cause allergic symptoms

inflammation mediator

Dendritic cells

ingestion of bacteria and viruses stimulate them to move to the lymph nodes and spleen mature into highly effective processor and presenter of foreign protein

Allergens that enter by the nose are called ________.

inhalants

Heoglobin

located within read blood cells

siderophores

low molecular weight iron-chelating protein capable of scavenging iron from iron binding protein bind iron binding protein more tightly

loose connective tissue containing aggregated lymphocytes

lymphoid organ and tissue

A ______ contains hydrolytic enzymes to digest foreign bacteria.

lysosome

formation of phagolysosome

lysosomes fuse with the phagosome granules with antimicrobial chemicals are released into _________ that destroy ingested material kills bacteria within 30 min

Phagolysosome

lysosomes fused with phagosome; antimicrobial chemicals are released inside forming a potent brew that poisons and dismantles the ingested material.

When monocytes migrate from the blood out to the tissues, they are transformed by inflammatory mediators to develop into _____.

macrophages

monocytes

macrophages Dentritic cells

Secondary lymphoid organs

spleen, lymph nodes, MALT, SALT, GALT, BALT; circulatory based locations where encounters with microbes and immune responses often take place.

Initiation amplification and cascade polymerization membrane attack

stages of complement

Reactive oxygen intermediates (ROI)

strong (myeloperoxidase in granulocytes), hydrogen peroxide, activated single oxygen, hydroxyl free radical. These are necessary in phagolysosomes with kill aerobic pathogen such as fungi and bacteria.

Whole blood

substance that courses through the arteries, veins, and capillaries (a liquid connective tissue), consisting of blood cells (formed elements) suspended in plasma (clotting pro).

Please select all the primary functions of the immune system.

surveillance of the body recognition of self and foreign material such as pathogens attack and destruction of foreign invaders

Phagocytes

survey tissue compartment and discover microbes particulates matter and injured or dead cells ingest and eliminate materials recognize immunologic inflammation (antigens)

Redness warmth swelling pain loss of function

symptoms/signs of inflammation

Diapedesis (transmigration)

the adherence of WBCs to the inner walls of the smaller blood vessels such as capillaries and venules, then marginate at the endothelial cells, and crawl into the extracellular spaces. (WBCs leaving blood vessels and entering the tissue)

Gut-associated lymphoid tissue - GALT

the appendix and Peyer's patches; compact aggregations of lymphocytes in the ileum of the SI; provides immune functions against intestinal pathogens and is a significant source of antibodies.

Classical pathway

the most specific, activated mainly by the presence of antibody bound to a microbe.

Membrane attack complex MAC

the primary destructive force of the complement system. It effectively perforates and lyses the membranes of gram-negative bacteria, fungi, parasitic protozoans, and enveloped viruses.

Classical lectin alternative

types of biochemical pathways that activate the complement system

Physical barriers Chemical barriers genetic components

types of first line defenses

phagocytosis inflammation interferon complement Iron-binding protein antimicrobial peptide

types of non specific immunity

Phagocytosis inflammation fever antimicrobial protein

types of second line defenses

monocytes neutrophil basophils eosophils lymphocytes

types of white blood cells

The physician orders allergy skin testing to be performed on this patient. Following the antigenic challenge, what observation would indicate a positive atopic sensitivity to the given allergen?

wheel of 15mm

plasma protein

which influence blood pH, Osmotic Pressure and viscosity

for enzyme and metabolism to function properly

why is iron required by human and bacteria

killing digestion of the microbe

with the action of digestive enzyme and reactive oxygen product

The patient's initial treatment plan involves all of the following, except:

albuterol inhaler

The RN may anticipate which of the following medications to be initiated for this patient?

all of these

Which of the following organs may be affected in the patient's disease?

all of these

Injectant

allergens such as drugs or venoms that pierce the skin

Ingestant

allergens that enter by mouth

Contactant

allergens that enter through the skin

No Hypersensitivity Reaction Occurs

an An rH positive mother is carrying her first rH positive fetus

Seminal plasmin

an antimicrobial chemical in semen

Lysozome

an enzyme that hydrolyzes the peptidoglycan in the cell wall of bacteria

An allergy is best described as ____.

an exaggerated immune response

Hypersensitivity or allergy is:

an excessive immune response that damages tissues.

Respiratory burst

an oxidative burst elaborated products of oxygen metabolism called reactive oxygen intermediates (ROI)

Two key parts of the mechanisms responsible for transfusion reactions are:

antibodies and complement.

Humoral immune response

antibody-mediated immunity involves activation and colonial selection of B cell producing of secreted antibodies

The term _____ is given to any foreign substance that stimulates a specific immune system response.

antigen

Which of the following stimulates cell-bound IgE molecules, resulting in degranulation of mast cells?

antigen

Immune complexes consist of

antigen plus antibody.

Allergens are:

antigens that do not affect some people but trigger extreme reactions in others.

sebaceous secretion

antimicrobial effect low pH making skin inhospitable to most breakdown of the fatty acid contained in lipid leads to toxic by-product that inhibits growth

Defensins

are peptides produced by various cells and tissues that damage cell membranes and lyse bacteria and fungi.

proteins

are produced by liver hepatocytes, lymphocytes and monocytes

adaptive immunites

are specific and must be acquired

inflammation

is a reaction to any traumatic event in the tissues that restores homeostasis; characterized by rubor, calor, tumor, dolor: redness caused by increased blood circulation, warmth from the increased blood flow, swelling from increased extracellular fluid, and pain caused by nerve stimulation.

Pus

is composed of white blood cells, microbes, and debris from phagocytosis

Serum

is essentially the same as plasma - except it is a clear fluid from clotted blood so it lacks the clotting proteins; often used in immune testing and therapy.

Alternative pathway

is initiated by complement proteins binding to certain surface molecules of microbes; non-specific.

The reticuloendothelial system (RES)

is intrinsic to immune function because it provides a passageway within and between tissues and organs. Heavily endowed with mononuclear phagocyte system. Serves an additional role in carrying extracellular fluid though network.

Immunology

is the study of all features of the body's second and third lines of defense - is central to the study of fields as diverse as cancer and allergy.

Mononuclear phagocyte system

is waiting to attack passing foreign intruders as they arrive in the skin, lungs, liver, lymph nodes, spleen, and bone marrow.

T- lymphocytes

kill intruders directly

Agranulocyte

lack cytoplasmic granules unlobed and round nucleus

macrophages

larges phagocyte that ingest and kill foreign cells, strategic participant in certain immune reaction

White Blood cells

leukocytes defense by phagocytizing bacteria and debris or producing antibodies

endogenous pyrogens

liberated by monocytes, neutrophils, and are a natural part of the immune response' interleukin-1 (IL-1) and tumor necrosis factor (TNF).

edema

local swelling and firmness due to accumulation and leakage of exudate

IgE molecules attach to ____.

mast cells via their constant region

B lymphocytes (B cells)

mature in bone marrow; responsible for humoral immunity (protective molecules carried in the fluids of the body). Activated B cells form specialized plasma cells that produce antibodies

T lymphocytes (T cells)

mature in the thymus; responsible for cell-mediated immunity. Activated T cells modulate immune functions and kill foreign cells

Adhesion of bacteria

mediated by surface receptors on macrophages

vasoactive

mediators that affect white blood cells

Markers

molecules on the surface of the cell composed of protein and/or sugar evaluated by cell of the immune system

Pathogen-associated molecular patterns (PAMPs)

molecules shared by many microbes that act like"red flags" for the white blood cells involved in innate immunity; on pathogens and are detected by PRRs and TLRs - it provides an early alert of invasion and triggers reactions that help to control pathogens before they can invade further. Ex: peptidoglycans, lipoteichoic acid, lipopolysaccharides. Nonspecific innate immunity.

Types of Agranulocytes

monocytes and lymphocytes

interferon

small protein produced naturally by certain WBC and tissue cells used in therapy against certain viral infection and caner defense against other microbes and in immune regulation and intercommunication not virus specific

Genetic Defenses

some host are genetically immune to disease because they do not have the receptor for specific microorganisms.

Genetic variation

some host are unaffected by infectious disease some pathogens have specificity

Histiocytes

specialized macrophages that migrate to a certain tissue and remain there during their life span

mast cell

specialized tissue cells similar to basophils that trigger local inflammatory reaction and are responsible for many allergic symptoms

Macrophages

specific and non specific killing cellular house keeping- phagocytosis created by inflammation and infection processing foreign material and taking it to lymphocyte secreting biological active compounds- assist mediate attract and inhibit immune cells

Lymphoctes

specific immunity: T-cell, B-cell Natural killer cells

Pluripotential stem cells

the primary precursor of new blood cells is undifferentiated stem cells, maintains in the bone marrow

Hematopoiesis

the production of blood cells

desquamated

the shedding of follicle cells

Chemotaxis

the tendency of cells to migrate in response to a specific chemical stimulus released at a site of injury or infection - cells swarm to a cite of infection.

What role do cytokines play in this allergic reaction?

they stimulate b cells to proliferate

acquired on an individual basis as each foreign substance is encountered by white blood cells called lymphocytes

third line of defense

Primary lymphoid organs

thymus and bone marrow; they are the source of immune cells and the nursery for developing white blood cells; site of origin and maturation of lymphocytes.

Dendritic cells

trap pathogens; when bacteria has been digested the cells migrate to lymph nodes and the spleen to participate in reactions with lymphocytes.

After complement activation, basophils may degranulate causing vasodilation.

true

Thymus

two lobes in the pharyngeal that fuse together in the thoracic cavity; T lymphocytes mature here.

Toll-like receptors

type of PRR recognize PAMP set in motion a cascade of event inside the cell that amplifies and orchestrates a defense response to the pathogen

Active Passive

type of third line defense

Granulocyte

cytoplasmic granules lobed nucleus neutrophils basophils- mast cell eosinophils

In IgE-mediated hypersensitivity, all of the following are needed EXCEPT:

cytotoxic T cells

Select all of the conditions that result from IgE- and mast-cell-mediated allergic reactions.

hay fever allergic asthma food allergy reactions drug allergy reactions eczema

Histamine released by mast cells leads to all of the following symptoms except:

high fever

Stomach

hydrocholoric acid defense

Please choose the answer that best completes the blanks of this sentence in the correct order. Immunopathology is the study of disease states or immune dysfunctions, which are divided into two categories: ___________ diseases (i.e., allergy) or diseases associated with __________ (i.e., AIDS).

hypersensitivity; immunodeficiency

inorganic salt

in forms of dissolved ions

Benefits of fever

inhibits multiplication of fever sensitive microbes, impedes the nutrition of bacteria, and increases metabolism and stimulates immune reactions.

Second line of defense

innate, mostly nonspecific; phagocytosis, inflammation, fever, interferon, and complement. System of protective cells and fluids - its acts rapidly at local and systemic levels.

First line of defense

innate, nonspecific; physical barriers - skin, tears, coughing. Chemical barriers - low pH, lysozyme, digestive enzyme. Genetic barriers - resistance inherent in genetic makeup of host (pathogen cannot invade). Includes any barrier that blocks invasion at the portal of entry - not considered a true immune response.

Platelets

involve in clotting and inflammation

cell-mediated immune response

involves activation and colonial selection of cytotoxic T cell

internalized system of protective cells and chemicals, which includes inflammation and phagocytosis

second line of defense

This body region is protected by fatty acids, acidic pH, lactic acid, and a tough cell barrier with its own normal flora A. skin. B. respiratory tract. C. digestive tract. D. urinary tract. E. eyes.

A. skin.

Inhalant

airborne environmental allergen such as pollen

C1 component

classical pathway begins with______ _____ binding to antibodies

The _____ system of blood proteins act to lyse foreign cells.

complement

Spleen

serves as a filter for blood , primary function is to remove worn-out red blood cells from circulation, its most important function is filtering of pathogens from the blood and their subsequent phagocytosis by resident macrophages.

pathogen-associated molecular pattern

serves as a signal molecules on the surface of microbes not present in mammals recognized by phagocytes and defensive cell

plasma

several kinds of cells suspended in a liquid mix

Maria was scratched on her arm by her cat and the site is experiencing rubor. This means A. redness. B. pain. C. loss of function. D. warmth. E. swelling.

A. redness.

Antimicrobial peptide

short protein (positively charged) capable of inserting themselves to bacterial membrane (negatively charged and disrupt bacterial membrane

lymph node

small encapsulated bean shaped organs stationed in clusters along lymphatic channel and large blood vessels ideal for filtering out material that have entered lymph

1. Components of the first line of defense include all the following, except A. the tough cell sheet of the upper epidermis of the skin. B. nasal hairs. C. flushing action of tears and blinking. D. flushing action of urine. E. phagocytic white blood cells.

E. phagocytic white blood cells.

Lymph nodes

small encapsulated, bean-shaped organs; specialized for filtering out materials that have entered the lymph and providing appropriate cell and niches for immune reactions.

Joan's inflamed and painful joints are likely due to which of the following chemicals? A. Gamma interferon B. Interleukin 5 C. Prostaglandins D. Histamine E. Platelet-activating factor

C. Prostaglandins

Which gland shrinks in size during adulthood, and has hormones that function in maturation of Tlymphocytes? A. Lymph nodes B. Thymus C. spleen D. GALT E. Tonsils

B. Thymus

The blood cells that particularly target parasitic worms and fungi are A. basophils. B. eosinophils. C. neutrophils. D. monocytes. E. lymphocytes.

B. eosinophils.

27. These white blood cells are particularly attracted to sites of parasitic infections. They are known as A. monocytes. B. eosinphils. C. basophils. D. neutrophils. E. lymphocytes.

B. eosinphils.

The contribution of B cells is mainly in A. inflammation. B. humoral immunity. C. complement activity. D. cell mediated immunity. E. phagocytosis.

B. humoral immunity.

All of the following are types of granulocytes because they have prominent cytoplasmic granules when stained, except A. eosinophils. B. monocytes. C. neutrophils. D. basophils. E. They are all granulocytes.

B. monocytes.

Joe cut his finger on a sharp twig and now is experiencing dolor. This means A. redness. B. pain. C. loss of function. D. warmth. E. swelling.

B. pain

The body region where a ciliary escalator helps to sweep microbes trapped in mucus away from that body site is the A. skin. B. respiratory tract. C. digestive tract. D. urinary tract. E. eyes.

B. respiratory tract.

first line defense

Barrier that blocks invasion at portal of entry does not involve recognition of foreign substance general action

32. The membrane attack stage of the complement cascade involves A. initiation of the cascade. B. production of inflammatory cytokines. C. a ring-shaped protein digests holes in bacterial cell membranes and virus envelopes. D. cleaving of C3 to yield C3a and C3b. E. C1q binds to surface receptors on a membrane.

C. a ring-shaped protein digests holes in bacterial cell membranes and virus envelopes.

Which is incorrect regarding fever? A. It is present in all vertebrates. B. It increases the rate of antibody synthesis. C. It is a symptom of a few diseases. D. When rising, a person feels cold. E. It inhibits the multiplication of temperature-sensitive microorganisms.

C. It is a symptom of a few diseases.

25. Which is mismatched? A. interferon alpha and beta - inhibits viral replication B. interleukin-2 - stimulate T cell mitosis and B cell antibody production C. serotonin - causes smooth muscle contraction D. prostaglandins - activate eosinophils and B cells E. tumor necrosis factor - increases chemotaxis and phagocytosis

D. prostaglandins - activate eosinophils and B cells

30. The circulating substances that affect the hypothalamus and initiate fever are A. complement. B. interferons. C. leukotrienes. D. pyrogens. E. lysozymes.

D. pyrogens.

third line defense

acquired on an infividual basis on each unique foreign substance is encountered by lymhocytes reaction with each microbe produces unique protective substances and cells that provide long-term immunity and have memory

Alternative

activated by bacterial or fungal cell wall, viruses pr parasite surface

Lectin

activated when a host serum protein binds a sugar (mannan) in the wall of fungi and other microbes

cell-killing membrane attack complex

activation cascade is massive amplification of the response and activation of the

infection

active defense is...

Eosinophil

active in worm and fungi infection allergy and inflammation

vasoactive

affect endothelial cells and smooth muscle cells of blood vessel

Complement

consists of at least 30 blood proteins that work in concert to destroy a wide variety of bacteria, viruses, and parasites. The sources of these factors comes from liver hepatocytes, lymphocytes. and monocytes. A positive feedback loop; creates wholes in the microbe membrane.

Ciliary Escalator

conveys foreign particles entrapped in mucous toward the pharynx to be removed

In providing education for this patient, the nurse describes the physiology of an allergic response. What is primarily responsible for her allergy symptoms?

cytokines

Exudate

blood-borne component that escape into extracellular space

red blood cells

carry oxygen and carbon dioxide

All of the following are probable causes for the patient's new-onset of allergies, except:

cat dander

Inflammation

cause tissue injury due to physical or chemical agent

A person will typically experience the sensation of _____ when fever is starting to occur in the body.

chills

macrophages

circulating phagocyte ingest invading material mature to tissue

In the presence of activated complement, neutrophils

degranulate and release enzymes that cause tissue damage

Acquired immunity

develop after exposure to agents, specific have memory slower response to specific microbes

Erythrocytes

develop from stem cells in the bone marrow and lose nucleus, the are now red blood cells. Sacs of hemoglobin that transport oxygen and carbon dioxide to and from tissues; they can be the target of immune reactions.

immunology

development of resistance to infectious agents by the body, central study to cancer and allergy

B-cell

differentiate into plasma cell and form antibodies (humoral)

In phagocytosis, the digested contents are eliminated by

exocytosis

A hapten is an antigen that is capable of causing antibody production on its own.

false

Delayed hypersensitivity is due to the effects of the humoral part of the immune system.

false

True or False: Hemolytic transfusion reactions occur due to underreaction or loss of the immune system.

false

True or False: LPS is responsible for the destruction of red blood cells in this reaction.

false

Spleen

filter for blood instead of lymph worn out red blood cells from circulation filter pathogens from the blood for phagocytosis by macrophages

includes any barrier that blocks invasion at the portal of entry

first line of defense

Nonself

foreign matter that are not your cells

Platelets

formed elements in circulating blood that are not whole cells; function primarily in hemostasis (plugging broken blood vessels to stop bleeding) and in releasing chemicals that act in blood clotting and inflammation.

transferrin

found in blood and tissue fluids

ferritin

found in every cell type

Lactoferrin

found in milk, blood, tears and saliva

lysozomes

found in tears and saliva hydrolyze peptidoglycan in the cell wall lactic acid and electrolyte concentration skin's acidic pH

The antigens that trigger Type II hypersensitivity are typically:

found on cell surfaces.

pattern recognition receptor

found on the surface of phagocytes, dentritic, endothelial recognize and bind PAMP found on the surface at all times

Basophil

function in inflammatory event and allergies

lipid transport immunity blood clotting

function of Plasma protein

an auxiliary route for return of extracellular fluid to circulatory system

function of the lymphatic system

Phagocytizes bacteria

granules are digestive enzymes

Neutrophils, eosinophils, and basophils are called _____ because they have prominent cytoplasmic granules that, in a stained blood smear, appear with identifying, characteristic colors.

granulocytes

White blood cells (leukocytes)

have the innate capacity to recognize and differentiate any foreign material in the body; the ability to differentiate nonself and thus spare self from attack is central to the effectiveness of the immune system.

Lymphatic vessels

moves in one direction extremities to heart only transported through contraction

Which of the following statements by the patient demonstrates an understanding of autoimmune disease?

my body has formed antibodies against itself

Innate immunities

natural defenses present at birth that provide nonspecific resistance to infection

three main phagocytes

neutrophiles (react early in the inflammatory response) monocytes (transformed into -->), and macrophages.

Which cell type is capable of phagocytosis?

neutrophils and macrophages

types of Granulocytes

neutrophils, eosinophils, and basophils.

Lectin pathway

non-specific, a host serum protein or lectin binds to a sugar called mannan present in the walls of fungi and other microbes.

Second line defense

nonspecific internalized system to protective cells come immediately into play if infectious agents make it past the first line of defense

Self

normal cells found in the human body

endogenous pyrogen

originating inside the body release by monocytes, neutrophils, macrophages during the process of phagocytosis Intereukin and tumor necrosis factor

Exogenous pyrogen

originating outside the body product of infectious agent

Lymphatic capillaries

permeate all parts of the body except the central nervous system and certain organs/bone; returns lymph back to the circulatory system; lymph is moved through the contraction of skeletal muscles that surround the lymphatic ducts.

Chemotaxis

phagocytes are attracted to the area of invasion by chemical product of the microorganism phospholipid released by injured cells

Which type of cells produce antibodies?

plasma cells

lymph

plasma like fluid water dissolved salt 2%-5% protein transport numerous white blood cells, fat, cellular debris and infectious agent that have gained across to tissue space

Neurophils

polumorphic nuclei 55-90% circulating leukocytes Phagocytizes bacteria first during immune response (inflammation)

Stem cell

precursor to blood cells undifferentiated in red marrow differentiate to rise of different cell lines that become specialized until mature enough to release into circulation

lymphocyte

primary cell involved is specific immune reaction

Interferon gamma

produced by T cells; an immune regulator of macrophages and T and B cells; inhibits cancer cells, stimulates B lymphocytes, and enhances the effectiveness of phagocytosis.

Interferon beta

produced by fibroblast and epithelial cells; stimulates phagocytes; plays a role in the maturation of B and T lymphocytes and inflammation.

Interferon alpha

produced by lymphocytes and macrophages; stimulates phagocytes.; activate natural killer cells.

hematopiesis

production of blood cells

exogenous pyrogens

products of infectious agents such as bacteria or viruses.

Antibodies

protein molecules that interlock with foreign cells or molecules and participate in their destruction.

Antibodies are composed of _____.

proteins

pyogenic

pus-forming bacteria (streptococci, staphylococci, gonocci)

Iron-binding protein

rate-limiting factor in the growth of bacteria that have invaded a host keeps it bound tightly so it is not available for microbial use

Neutrophils

react early in inflammation response primary component of pus sign of bacterial infection is a high neutrophil count

B-lymphocytes

react with foreign molecules and produce antibodies

Lymphatic system

recognition and protection against foreign materials lymphocyte, phagocytes, antibodies drain off for inflammatory response transport in only one direction circulatory and lymphatic comes into contact near the heart.

Natural killer cell

relative to T-cell display no antigen specificity active against cancerous an viraly infected cells

When T helper cells are exposed for the second time to hapten-peptide on antigen-presenting cells, they

release cytokines which attract more macrophages.

pyrogen

resets the hypothalamic thermostat to a higher setting which causes a fever.

Macrophages

responsible for phagocytic and killing functions ("house keepers of the cell"), presents foreign substances to lymphocytes, and secretes biologically active compounds that assist, mediates, attract, and inhibit immune cells and reactions.

Nonspecific defenses

sebaceous secretions, lysozomes, acidic pH, digestive enzymes and juices (chemical)