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Self-Defense: Immune
Nursing School: Patho-Pharm Immune System Self-Defense Mechanisms
| Question? | Answer? |
|---|---|
| What is a complex network of specialized cells and organs that has evolved to defend the body against attacks by “foreign invaders (viruses, bacteria, microorganisms)? | Immune System |
| Normal Functions of an Immune System? | it fights off infections by agents such as bacteria, viruses, fungi, and parasites |
| What is part of the immune system that are barriers that block harmful materials from entering the body | Innate Immunity |
| List the 3 Lines of Defense for Innate Immunity | 1 = Mechanical and Chemical Barriers 2 = Inflammation 3 = Immunity |
| The bodies immune system attempts to do what 2 main things? | 1. Bar their entry (1st line of defense), or failing that, will lead to body… 2. Seek out and destroy them (2nd and 3rd line of defense going into action) |
| The human blood is made up of? | + Red blood cells (erythrocytes) that transport oxygen + Platelets (thrombocytes) that trigger clotting, and + White blood cells (Leukocytes), which are an important element of the immune system that defend the body against attack from pathogens |
| • An overall term for White blood cells (WBCs) • Principal cells involved in the immune response; protect body from infection and maintain normal immune system. | Leukocytes |
| Leukocyte Normal Value and it originated where and from what? | • Normal Value: 4,000-10,000 per cubic mm of blood count • Originate in bone marrow from hemocytoblasts (stem cells) that give rise to other cells. |
| 3 types of Leukocytes? | 1) Granulocytes (Contain large granules) a) Neutrophils b) Eosinophils c) Basophils d) Agranulocytes (Without granules) 2) Monocytes and Macrophages 3) Lymphocytes e) T cells f) B cells |
| Class of leukocytes, contains granules & Largest class Composes 60-80 % of the total # of normal leukocytes Short life span (only living hours to days) Key defenders in acute inflammation and infection Chemotaxis occurs? | Granulocytes |
| List the 3 main types of Granulocytes? | Neutrophils, Basophils, & Eosinophils |
| o Type of granulocyte that is phagocytic o First line of defense o First cells to arrive within exudate in the early hours of inflammation (within 90 min.) o Phagocytes ingest and kill foreign microorganisms With half-life is 6 hours, life span | Neutrophils |
| o Type of granulocyte, phagocytic o Respond to certain unique chemotactic stimuli generated in the course of an allergic reaction, they detoxify and ingest antigen-antibody complexes before they can harm the body. | Eosinophils |
| o Type of granulocyte o These leukocytes come from bone marrow but are similar to mast cells (connective tissue) o Granules contain a variety of enzymes, heparin and histamine – | Basophils |
| do not have granules. AKA “immature” eating dead & defective cell Largest of WBC’s: 3-8% of total blood leukocytes is the? | Agranulocytes and Monocytes are the largest of the WBC's |
| Arrive within 5 hours, and by 48 hours these are prominent. They stay around a long time. Considered the body’s Second line of defense ↑ in bacterial and viral infections | Monocytes |
| Released from the bone marrow while still immature As monocytes enter infected tissue, the perform their phagocytic function and form into? Known as? | mature into Macrophages (mature)“Big Eaters” |
| Agranulocyte that is a type of leukocytes Provide 2 types of immune protection 1. Humoral response – B cells 2. Cell mediated –T cells | Lymphocytes |
| - Perhaps the most frequently ordered lab test - WBC – generally the first result on the lab report | CBC |
| This number represents the WBC Amount of white cells present in one cubic mm of blood To interpret it, you must examine the differential o Breaks the white cells down into their types | WBC Count |
| - Breaks down into: Neutrophils - Gran o Segmented o Band Eosinophils - Gran Basophils - Gran Lymphocytes – Agran, T and B cells Monocytes – Agran - Macrophages | WBC Differential Test |
| Mature Neutrophils and Immature Neutrophils known as? | Segs and Bands |
| the part of the WBC to pay most attention to! If it falls below normal the pt. is susceptible to bacterial infections – Normal is 1.8-7.7 If it falls to low any infection can be life-threatening | Neutrophil Count |
| less than 500 total or absolute lack of or drop in total WBC (eos, neutros & basos) | Agranulocytes |
| decrease in total number of neutrophils; less than 2000 | Neutropenia |
| - The immune system protects the body from potentially harmful substances by recognizing and responding to so-called? are anything that is non-self? | Antigens |
| - The babies don’t have time to develop immune system; when this happens we have recognition and memory. - Ex: Antigen comes in body – Body says I have memory of this and I built up immunity to it and next time it came back I would have time to fight | Acquired Immune Response: Adaptive |
| What contains o General/specific o Natural/Adaptive (Innate/Acquired) o Cell mediated/Humoral o Active/Passive o Primary/Secondary - The most important of these is? | Self/Non-Self Recognition Most Important is Self/Non-Self |
| Virtually every cell carries distinctive molecules that identify it as | SELF |
| Any substance capable of triggering an immune response is called an | Antigen or Non-Self |
| Examples of? Toxins Chemicals Drugs Foreign particles o Splinter | Non-Living Agents |
| Bacterium Fungus Parasite Transplanted tissue | Living Agents |
| An antigen announces its foreignness by means of intricate and characteristic shapes called? & what occurs | Epitopes which protrude from its surface – bacterial cell has things on them that say oh! Look at me! – Antibody connect into epitopes |
| What 3rd Line of Defense ⇨ Occurs when an antigen is introduced – body starts to develop antibodies against antigen, takes about 10 days to develop | Primary |
| What 3rd Line of Defense• Occurs with subsequent exposure to antigen – 2nd time will not take as long to get the antibodies produced: may get sick but not for a long time. | Secondary: Memory Response |
| The anatomy of the immune system are generally referred to as? because they are concerned with the growth, development, and deployment of lymphocytes (leukocytes). | Lymphoid Organs |
| The Lymphoid Organs Include? | the bone marrow and the thymus, as well as lymph nodes, spleen, tonsils, adenoids, and the appendix |
| • The primary site for filtering foreign substances • It is the major site of immune responses to blood-borne antigens – Largest organ lymphatic system and only one able to filter blood | Spleen |
| • Produced in the bone marrow and eventually migrate to the peripheral lymph organs • Constantly circulate in a homing pattern = Always return to lymphoid tissue: where they originated. | Lymphocytes |
| What interact with B and T lymphocytes and macrophages in the lymph nodes ? | Antigens |
| 2 most important functions of Lymphnodes? | • Filtration of antigens brought to the site • Circulation of lymphocytes |
| Primary fnct of Lymphocyte and - On the CBC, differential, the lymphocyte count represents both B and T cells & It is not divided | to fight the infection |
| What are small white blood cells that bear the major responsibility for carrying out the activities of the immune system; they number about one trillion. | Lymphocytes |
| 3 types of Lymphocytes are? | 1) T lymphocytes (T cells) 2) B lymphocytes (B cells) 3) Natural killer cells (NK cells) |
| What circulates in the blood and lymph channels to lyse cancer cells and virus infected body cells. | NK: Natural Killer Cells |
| Recognize and destroy specific antigens (anything _______) • Both recognize specific antigen targets for one antigen type. With different exposures, you have different B and T cells formed for each specific antigen. Once exposed, both have? | B and T cells anything Non-Self Memory Cells |
| What work chiefly by secreting soluble substances called antibodies into the body’s fluids? Each is programmed to make? | B Cells One specific Antibody |
| When a B cell encounters its triggering antigen, it gives rise to many large plasma cells. o Every plasma cell is essentially a ____ for producing ___? | Factory producing Antibodies |
| A given antibody interlocks with the antigen and thereby marks it for destruction o Antibodies belong to a family of large molecules known as? Which have how many types? | Immunoglobulins 9 types |
| What originate in the bone marrow and mature into plasma cells that produce antibodies (immunoglobulin molecules that interact with a specific antigen)? | B Cells |
| Cells that migrate from the bone marrow to the thymus differentiate into? | T Cells: T Lymphocytes or Thymocytes |
| What distinguishes B from T cells? | interact directly with their targets by attacking body cells that have been commandeered by viruses or warped by malignancy – this is why they are diff than B cells |
| Every mature T cell carries a? (molecules on cell surface that makes them recognizable) o Specific examples: • What also carry a T4 (CD4) marker • What also carry a T8 marker | Marker Helper T Cells Suppressor & Cytotoxic T Cells |
| T cells contribute to the immune defenses in two major ways? | 1. Regulatory T Cells 2. Effector/Cytotoxic T Cells |
| Regulatory T cell are vital to and contain what 2 types of cells? | Vital to orchestrating the elaborate system Helper T Cell Suppressor T Cells |
| What Directly attack body cells that are infected or malignant Responsible for ridding the body of cells that have been infected by viruses or transformed by cancer, rejection of tissue or organ transplants | Effector or Cytotoxic T Cells |
| There are 9 distinct classes of Ig: Immunoglobulins - 4 kinds of 2 kinds of Ig_ Ig__ Ig__ | 4 IgG 2 IgA IgM IgE IgD |
| What Ig most abundant immunoglobulin located serums and tissues, crosses placenta, and is responsible for protection of newborn | 4 kinds of IgG |
| What Ig protect mucous membranes and found in saliva and nasal secretions – protects against Sinus and Respiratory Infections. | 2 kinds of IgA |
| What Ig forms blood antibodies; the first to appear in response to infection, second only to IgG in abundance. | IgM |
| What Ig is involved in immediate hypersensitivity reactions or allergic reactions developing within minutes of exposure to an antigen. IgE stimulates histamine and heparin release | IgE |
| What Ig is needed for B cell Maturation? | IgD |
| In cell communication what are the chemical messengers? | Cytokines |
| 〉 The immune response is dependent on the complex interactions of T cells, B cells, monocytes and neutrophils. These interactions are dependent on? | Cytokines |
| Cytokines - basically _____ hormones; referred to as “____ of the ____ _____”. 〉 Work to modify the body’s response thru messages sent in the tissue fluids | Polypeptide Hormone "Hormones of the Immune System" |
| 〉 Cytokines are secreted by _____ and many other cells in the body – telling ____ _____to make antibodies 〉 They act at low concentrations, are short lived and may act either locally or systemically | WBC's B Cells |
| What • Encourage cell growth • Promote cell activation • Direct cellular traffic • Destroy target cells • Incite macrophages? It is secreted by what type of cells? | Lymphokines T Cells |
| Known as the B Cell Response? | Humoral Immune Response |
| • Also known as immunoglobulin-mediated immunity bc B Cells secrete immunoglobulins? | Antibody Mediated Immunity |
| What is... - Secreted antibodies produced in the B cells, in order to get going need T helper cells. - Secreted antibodies bind to antigens on the surfaces of invading microbes | Humoral Immunity is mediated by |
| Humoral Immunity activates what type of cells? | Activation primarily on T Cells |
| • The Primary Immune Response is evident ____days after the initial exposure. o What is the first antibody formed, followed by ___? o Subsequent exposure to the antigen causes a secondary antibody response in ____ days | 4-8 Days IgM, IgG 1-3 Days |
| What accounts for the memory of the first exposure? • What is the primary antibody formed in ______ Immune Response | Memory Cells IgG Secondary |
| What is also known as T Cell Response? Does not involve what? | Cell-Mediated Immunity Antibodies |
| Cell Mediated Immune Response + Antigens such as viral infected cells, cancer cells, and foreign tissue, activate what cells which are the primary agents of what? | T Cells Cellular Response |
| T Cells work primarily by secreting? | Lymphokines |
| What MUST occur in order to have an immune response? | o The success of immune response depends on the interaction of humoral o Cell-mediated responses because they share components and processes |
| What is a vascular reaction whose net result is the delivery of fluid, dissolved substances, and cells from circulating blood into the interstitial tissues in an area of injury or necrosis? | Inflammation |
| The goal of Inflammation is to form? Which is what? | exudates – beneficial to the body • It is a defensive phenomenon – actually beneficial to the body |
| Exudates do 2 things: | 1. Defends body from infection 2. Facilitate tissue repair and healing |
| Main PURPOSE of inflammation is to? | To bring fluid, proteins, and cells from the blood into the damaged tissues and form exudate |
| Inflammatory Response – Mechanisms of Action: (How does it work? How is exudate formed?) | • Vasodilation – vascular space will vasodilate • Increased vascular permeability • Cellular infiltration • Activation of cells of the immune system – the macrophages, neutrophils, basophils, … |
| The degree to which these inflammations occur is going to be proportional to the? | Based on the severity of the Illness |
| 3 Phases of Inflammation are: | 1 - Temporary Vasoconstriction 2 - Two-Pronged Response 3 - Resolution or Reconstruction & Maturation |
| What has both a vascular phase and a cellular phase? | Two-Pronged Response to an injury |
| vasodilation and immediate increase in blood flow and capillary permeability to the damaged area? | Vascular Phase |
| specialized white blood cells move out of the circulatory system to clean up and deactivate? Containing what 2 responses? | Cellular Phase 1 - Acute Cellular Responses 2 - Chronic Cellular Responses |
| What Occurs with sufficient tissue damage or if infection has occurred and takes place over several hours – when exudate is formed? o The appearance of leukocytes, particularly neutrophils in the tissues. • This movement of leukocytes r/t _____ | Acute Cellular Responses Chemotaxis |
| What Occurs over the next few days if damage is severe enough. • Mononuclear cell infiltrates of macrophages and lymphocytes appear • Aid in microbial killing and clearing up cellular tissue debris. | Chronic Cellular Responses |
| 4 main gross features of acute inflammation are | 1 - redness 2 - warmth 3 - Pain 4 - Swelling |
| Tissue damage causes injured Mast Cells to degranulate and release? Like what 2 types? | Cell-Derived Mediators of Inflammation 1 - Histamines 2 - Serotonin |
| Histamine & Serotonin are both performed and stored in the? | Intracellular Granules |
| What are Cellular bags of granules in the loose connective tissue found close to blood vessels – close to vessels d/t needing perfusion. + Large amounts of Histamines are stored within these granules | Mast Cells |
| Mast cells activate the inflammatory response by what 2 things? | o Degranulation – release of contents o Synthesis of cells-derived mediators |
| 3 types of mast cell derived mediators of inflammation: | 1 - Histamine 2 - Serotonin 3 - Arachidonic Acid Metabolite Synthesize Prostaglandins |
| • When released → increases blood flow into microcirculation o Causes dilation of local blood vessels • Causes constriction of bronchioles and increased mucus production: | Histamines |
| What is found in platelets | Serotonin |
| What is Released from injured cells and converted by COX enzyme into Leukotriene’s and Prostaglandins | Arachidonic Acid Metabolites |
| What complement histamine, but are produced more slowly | Leukotrienes |
| Who's 4 major actions are: o ↑ vasodilation and capillary permeability o ↑ sensitivity of nerve endings, causing Pain o ↑ platelet aggregation, facilitates Clotting o ↑ Chemotaxis, attracts WBC’s (neutrophils) to the site of injury | Prostaglandin's |
| What contains Kinins and Bradykinin? | Plasma-Derived Mediators of Inflammation |
| What are products of the coagulation/fibrinolysis system | Kinins |
| What are plasma PRO that is formed when an injury releases clotting factors (XII to XIIa) • Dilates blood vessels causing increased capillary permeability and pain? | Bradykinin |
| REVIEW of 3 main chemical mediators of inflammation: ? Inc bl flow, cap perm through vasodilation ? Made by, causing further vasodilation & pain ? Effect clotting factors and cause pain. | Histamine Prostaglandins Kinins |
| 3 Prominent Systemic Manifestations in Acute Phase are: | 1 - Alterations in WBC count = Leukocytosis 2 - Fever 3 - Sepsis/Septic Shock |
| Only when you have an inflammatory process, there will be what type of phase? | Reconstructing Phase |
| Designation of the Inflammatory Process is through what 4 phase: | 1 - Acute (Resolution) 2 - Chronic (Reconstruction & Maturation) 3 - Reconstruction Phase 4 - Maturation Phase |
| 2 types of wound healing: 1 - healing by first intention - incisions brought together? 2 - healing by second intention or by granulation - open wound or scab & scars occur? | Primary Healing Secondary Healing |
| Treatment of Inflammation through what 5 agents? | 1 - Anti-Histamines 2 - ASA 3 - NSAIDS 4 - Glucocorticoids 5 - Others: Gold cmpds, Anti-Malarial agents, or immunodilating agents |
| What Prevents the actions of histamine at receptor sites. Does not block histamine? | Anti-Histamines |
| What Works by decreasing prostaglandin synthesis at the site of inflammation & will decrease pain - If you decrease inflammation, you decrease the pain associated with tissue injury - Suppresses platelet aggregation ? | ASA: Aspirin |
| Inhibit formation of prostaglandins by inhibiting the COX enzyme 1 & 2? | NSAIDS |
| What enzyme is + 1 present anywhere + Is present in all tissues, performs “housekeeping chores”, protects gastric mucosa, increases blood flow to kidneys, and promotes platelet aggregation inhibition – harmful effects. | COX 1 |
| What enzyme is + 2 present only at the site of injury. + Present at the sites of injury mediates fever, pain, inflammation, and inhibition – beneficial effects | COX 2 |
| If on an NSAID, may need to be placed on what? to protect what? | put on prophylactic proton pump inhibitor or protonix to protect their gastric mucosa + increase stress from being in hospital. Major Cox 2 inhibitors are Celebrex. |
| What are used to suppress inflammatory process from increased cap permeability through decreasing cap perm, reducing leukocytes and mast cells, stabilize lysosomal memb, block immune responses? | Glucocorticoids |
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ehward
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