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STCC Immunology

Professor Rochfords Immunology Lecture

QuestionAnswer
Acquired Immunity The development of immunity, either actively or passively
Acquired Immunity: Active Results from the invasion of the body by foreign substances such as microorganisms or antigens. Natural or artificial (getting chickenpox or getting live/dead virus vaccines, for example)
Acquired Immunity: Passive Host receives antibodies to an antigen rather than synthesizing them. Natural or artificial (immuno globulins through placenta/breastmilk or injection of gamma globulin)
Auto antigens Antigens on the bodys own cells (allow the body to recognize itself)
Antigen Substance that elicits an immune response
Central Lymphoid Organs Thymus gland and bone marrow
Peripheral Lymphoid Organs Tonsils, spleen, and lymph tissue of the gut, genitals, bronchial, and skin
Thymus Gland Shrinks with age, essential for cell mediated immune response
Bone Marrow Produces RBC, WBC, lymphocytes, and platelets
Lymph Node Functions Filtration of foreign material and the circulation of lymphocytes.
Spleen Primary site for filtering foreign substances in the blood. Major site of immune responses to blood-borne antigens. Removal of the spleen = immunocomprimised.
T Lymphocytes Responsible for immunity to intracellular viruses, tumor cells, and fungi. Sensitized by exposure to antigen.
Natural Killer Cells Don't require sensitization, recognize and kill virus infected cells, tumor cells, and transplanted grafts
Mononuclear phagocyte system monocytes in the blood and macrophages in the body. Capture, process, and present antigens to lymphocytes to initiate humoral or cytotoxic response. Phagocytosis.
Antibodies Immunoglobulins produced by lymphocytes in response to antigens
Cytokines Messengers between cell types. Instruct cells to alter proliferation, differentiation, secretion, or activity
Humoral immunity In the body bluid. Antibodies produced by B-lymphocytes. Primary immune response evident 4-8 days after initial exposure.
Humoral immunity: cells involved B lymphocytes
Cellular immunity: cells involved T lymphocytes, macrophages
Humoral immunity: protects against Bacteria, EXTRACELLULAR viruses, respiratory pathogens, GI pathogens
Cellular immunity: protects against Fungus, INTRACELLULAR viruses, chronic infectious agents, tumor cells
IgG Gives newborns protection for 3-6 months. The only Ig to cross placenta and provide newborn with passive acquired immunity
IgA Found in body secretions (saliva, tears, breastmilk, colostrum)
IgM Largest of Ig's. Found in plasma. Responsible for primary immune response. Forms antibodies to ABO blood antigens.
IgD Found in plasma. Present on lymphocyte surface. Assists in differentiation of B lymphocytes.
IgE Found in plasma AND interstitial fluids. Causes s/s of allergic reaction. *Exposure to allergen increases IgE
Epinepherine for hives 1/1000 if hives are around the face or tongue to avoid airway complications
Hypersensitivity reactions: Type 1 Anaphylactic reactions. IgE. Allergy s/s with smooth muscle contractions, increased vascular permeability, vasodilation, hypotension, mucous, wheals, hives. Reversible.
Anaphylaxis Type 1 reaction. Occurs immediately in response to drug, insect bite, etc. Escalates quickly, needs early tx. Rapid/weak pulse, hypotension, dyspnea, cyanosis. Benadryl for asthma patients before tests involving contrast dye.
Rhinitis Type 1 reaction. Most common type, occurs year round or seasonally. Teach limited use of nasal sprays. Rebound reaction possible with overuse of nasal sprays, antihistamines
Asthma Type 1 reaction. Most have allergic component with hx of other allergies. Benadryl prophylaxis when getting contrast dye. Increased risk of other allergic reactions.
Asthma signs and symptoms Bronchial smooth muscle constriction, excessive secretion of mucous, dyspnea, wheezing, counging, tightness in chest
Atopic dermatitis Type 1 reaction. Chronic inherited skin d/o. Elevated IgE and positive skin test. s/s are generalized skin lesions.
Hives Type 1 reaction. pink raised itchy areas developing quickly after exposure and last minutes to hours.
Angioedema Type 1 reaction. localized, edema of eyelid, lips, tongue, larynx, hands, feet, gi, genitals. Mild to moderate may need epi 1/1000. s/s swelling, burning, stinging/itching and may last for 24 hours
Hypersensitivity reactions: Type 2 Cytotoxic/cytolytic. Target cells: RBC, platelets, leukocytes. **Transfusion reactions, RH incompatability, autoimmune/drug related hemolytic anemia, leukopenia, thrombocytopenia
Hypersensitivity reactions: Type 3 Autoimmune. Inflammitory. Cant be removed by phagocytes so deposited in tissue or blood vessels, cause inflammation and destruction. Local/systemic, immediate/delayed.
Hypersensitivity reactions: type 4 Delayed hypersensitivity reactions (cell mediated immune response). Usually protective, but tissue damage occurs in delayed reactions. Transplant rejections, contact dermatitis
Contact Dermatitis Type 4 reaction. Can be localized or involve airway if inhaled. Metal (nickel/mercury), rubber (latex allergy), poison ivy/oak, cosmetics and some dyes. Memory cells form 7-14 days. s/s burning/stinging, redness, edema, papules, etc
Microbial hypersensitivity reactions Type 4 reaction. Bodies defense against TB. Causes extensive necrosis of lungs.
Transplant Reactions Type 4 reactions. Donor doesn't perfectly match recipients HLA. Rejection in minutes/hours (hyperacute), days/months (acute), years (chronic). Pt kept immunosupressed with meds for at least a year.
Hypersensitivity reactions: Assessment Health hx including family allergies. Physical exam focusing on site of manifestations. Baseline Labs (for later comparison), RAST test, PFT's.
RAST testing Positive test shows hypersensitivity in minutes to 12 hours. If on arm and major swelling occurs, tourniquette and give epi 1/1000
Hypersensitivity reactions: teatment goals Identify and avoid triggers, reduce exposure (desensitize person through immunotherapy if needed), be prepared for emergency (epi 1/1000)
Collaborative care: Anaphylaxis **Maintain airway, precent spread with tourniquette, remove stinger/allergen. Give 02, increase if sat lower than 92%. Intubate if sats not responding to NRB. IV epi 1/10,000 (note increase) if severe. IM/IV benadryl.
Created by: omgmurse
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