Chamberlain University
NR 507 / NR507
Bundle Weeks 1 to 4 Notes
Advanced Pathophysiology
,TABLE OFCONTENTS
\ \
Week\1\–
Immune\Response\&\Hypersensitivity\ Week\
\
2\ –
Hematologic\Disorders\&\Anemias\ Week\3\–
\
Obstructive\&\Restrictive\Lung\Diseases\ We
\
ek\4\–\Urinary\System\Pathologies\&\UTIs
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Week\1:\Immune\Response
Type\I:\Allergic\Reaction
On\initial\encounter\with\an\allergen,\the\individual\will\first\produce\IgE\antibodies.\After\the\ allergen\is\cleared,\t
he\remaining\IgE\molecules\will\be\bound\by\mast\cells,\basophils,\and\ eosinophils\that\contain\receptors\for\the\
IgE\molecules.\This\process\is\referred\to\as\ sensitization.\On\subsequent\exposure\to\the\allergen,\the\IgE\mole
cules\located\on\the\ sensitized\cells\induces\their\immediate\degranulation.\This\causes\the\release\of\inflammat
ory\ mediators\such\as\histamine,\leukotrienes,\and\prostaglandins\that\results\in\vasodilation,\ bronchial\smooth\
muscle\contraction,\and\mucus\production.\Type\I\hypersensitivity\reactions\can\be\local\or\systemic.\Systemic\re
actions\can\result\in\anaphylaxis,\a\potentially\life-
\ threatening\condition.\Allergic\asthma\is\an\example\of\a\Type\I\hypersensitivity\reaction.\On\exposure\to\certain\
allergens\(typically\inhaled),\individuals\with\allergic\asthma\experience\ inflammation\of\the\airways,\characteriz
ed\by\tissue\swelling\and\excessive\mucus\production.\ This\narrowing\of\the\airways\makes\it\difficult\to\breathe.
Type\II\Hypersensitivity\Reaction
A\Type\II\hypersensitivity\reaction\is\tissue-
specific\and\usually\occurs\as\a\result\of\haptens\that\ cause\an\IgG\antibody\or\IgM\antibody\mediated\response.
\The\antibodies\are\specifically\ directed\to\the\antigen\located\on\the\cell\membrane.\A\hapten\is\a\small\molecul
e\that\can\ cause\an\immune\response\when\it\attaches\to\a\protein.\Macrophages\are\the\primary\effector\ cells\
of\Type\II\responses.\Typical\examples\of\Type\II\reactions\are\drug\allergies,\as\well\as\allergies\against\infectiou
s\agents.\The\Type\II\response\begins\with\the\antibody\binding\to\the\antigen\and\may\cause\the\following.
- The\cell\to\be\destroyed\by\the\antibody
- Cell\destruction\through\phagocytosis\by\macrophages
- Damage\to\the\cell\by\neutrophils\triggering\phagocytosis
- Natural\killer\cells\to\release\toxic\substances\that\destroy\the\target\cell
- Malfunction\of\the\cell\without\destruction
- Examples\of\type\II\reactions\include\drug\allergies,\hemolytic\anemia,\blood\transfusion\ mismatch\with\
resulting\transfusion\reaction\and\Rh\hemolytic\disease.
Type\III\Immune-Complex\Reaction
The\Type\III\hypersensitivity\reaction\is\also\an\antigen-
antibody\response.\The\major\difference\between\Type\II\and\Type\III\responses\is\that\in\a\Type\II\response,\the\
antibody\binds\to\the\antigen\on\the\cell\surface,\but\in\Type\III\responses,\the\antibody\binds\to\the\antigen\in\the\
blood\or\body\fluids\and\then\circulates\to\the\tissue.\Type\III\reactions\are\not\organ\specific\and\use\neutrophils\a
s\the\primary\effector\cell.\In\type\III\hypersensitivity\reactions\immune-
\ complex\deposition\(ICD)\causes\autoimmune\diseases,\which\is\often\a\complication.\As\the\ disease\progress
es\a\more\accumulation\of\immune-
complexes\occurs,\and\when\the\body\ becomes\overloaded\the\complexes\are\deposited\in\the\tissues\and\caus
e\inflammation\as\the\ mononuclear\phagocytes,\erythrocytes,\and\complement\system\fail\to\remove\immune\ co
mplexes\from\the\blood.\One\of\the\classic\Type\III\reactions\is\serum\sickness.
Type\IV\Cell-Mediated,\Delayed\Reaction
Type\IV\hypersensitivity\reactions\are\known\as\cell-
mediated\responses\and\use\lymphocytes\and\macrophages\as\primary\mediators.\Unlike\the\first\three\types\of\
responses,\which\are\ humoral\immune\functions,\a\Type\IV\response\is\mediated\by\T-
lymphocytes\and\does\not\use\antibodies.\A\typical\reaction\from\a\Type\IV\cell-
mediated\response\would\be\a\localized\contact
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dermatitis.\When\the\individual\comes\in\contact\with\the\antigen,\T-
cells\are\activated\and\ move\to\the\area\of\the\antigen.\The\antigen\is\taken\up,\processed,\and\presented\to\ ma
crophages,\leading\to\epidermal\reactions\characterized\by\erythema,\cellular\infiltration\and\ vesicles.
Type Mechanism Example Pathology
Tissue-
specific\ destruction\or\impair
ment\ because\of:
Antibody\binding\followed\ by\l
ysis\via\complement
Antibody\binding\followed\ by\ 1-
1-ABO
Type\ macrophage\ phagocytosis incompatibility
Complement\damages\RBC\membrane\and\ cells\lys
II Antibody\binding\followed\ by\ e
5-Graves'\disease
neutrophil\destruction 5-
Autoantibodies\specific\for\thyroid\tissue\impair\ receptor\f
Antibody- or\TSH
dependent\cell\ (NK)-
mediated\ cytotoxicity,\or
Antireceptor\antibodies
Type\ Contact\dermatitis\ (e
Cytotoxic\T\cell-mediated T\cells\attack\tissue\directly\(no\antibody)
IV .g.,\poison\ivy)
Type\ Mast\cell\degranulation\results\in\an\ infla
IgE\action\on\mast\cells Hay\fever
I mmatory\response
Complex\deposited\in\small\peripheral\vessels\in\ cool\te
Type\ Antigen- Raynaud’s\ ph
mperatures\leading\to\vasoconstriction\ and\blocked\circu
III Antibody\complex\ deposited\in enomenon
lation
\tissues
Hives
Hives\(urticaria)\are\an\example\of\a:
- Type\1\hypersensitivity\reaction.
- Type\2\hypersensitivity\reaction.
- Type\3\hypersensitivity\reaction.
- Type\4\hypersensitivity\reaction.
Anaphylaxis\is\a\type\1\hypersensitivity\reaction.
Immune\System
Which\of\the\following\are\considered\the\“first\responders”\of\the\innate\immune\system?
- Eosinophils.
- IgM.
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NR 507 / NR507
Bundle Weeks 1 to 4 Notes
Advanced Pathophysiology
,TABLE OFCONTENTS
\ \
Week\1\–
Immune\Response\&\Hypersensitivity\ Week\
\
2\ –
Hematologic\Disorders\&\Anemias\ Week\3\–
\
Obstructive\&\Restrictive\Lung\Diseases\ We
\
ek\4\–\Urinary\System\Pathologies\&\UTIs
, lOMoAR
48332
\\
cPSD| 516
Week\1:\Immune\Response
Type\I:\Allergic\Reaction
On\initial\encounter\with\an\allergen,\the\individual\will\first\produce\IgE\antibodies.\After\the\ allergen\is\cleared,\t
he\remaining\IgE\molecules\will\be\bound\by\mast\cells,\basophils,\and\ eosinophils\that\contain\receptors\for\the\
IgE\molecules.\This\process\is\referred\to\as\ sensitization.\On\subsequent\exposure\to\the\allergen,\the\IgE\mole
cules\located\on\the\ sensitized\cells\induces\their\immediate\degranulation.\This\causes\the\release\of\inflammat
ory\ mediators\such\as\histamine,\leukotrienes,\and\prostaglandins\that\results\in\vasodilation,\ bronchial\smooth\
muscle\contraction,\and\mucus\production.\Type\I\hypersensitivity\reactions\can\be\local\or\systemic.\Systemic\re
actions\can\result\in\anaphylaxis,\a\potentially\life-
\ threatening\condition.\Allergic\asthma\is\an\example\of\a\Type\I\hypersensitivity\reaction.\On\exposure\to\certain\
allergens\(typically\inhaled),\individuals\with\allergic\asthma\experience\ inflammation\of\the\airways,\characteriz
ed\by\tissue\swelling\and\excessive\mucus\production.\ This\narrowing\of\the\airways\makes\it\difficult\to\breathe.
Type\II\Hypersensitivity\Reaction
A\Type\II\hypersensitivity\reaction\is\tissue-
specific\and\usually\occurs\as\a\result\of\haptens\that\ cause\an\IgG\antibody\or\IgM\antibody\mediated\response.
\The\antibodies\are\specifically\ directed\to\the\antigen\located\on\the\cell\membrane.\A\hapten\is\a\small\molecul
e\that\can\ cause\an\immune\response\when\it\attaches\to\a\protein.\Macrophages\are\the\primary\effector\ cells\
of\Type\II\responses.\Typical\examples\of\Type\II\reactions\are\drug\allergies,\as\well\as\allergies\against\infectiou
s\agents.\The\Type\II\response\begins\with\the\antibody\binding\to\the\antigen\and\may\cause\the\following.
- The\cell\to\be\destroyed\by\the\antibody
- Cell\destruction\through\phagocytosis\by\macrophages
- Damage\to\the\cell\by\neutrophils\triggering\phagocytosis
- Natural\killer\cells\to\release\toxic\substances\that\destroy\the\target\cell
- Malfunction\of\the\cell\without\destruction
- Examples\of\type\II\reactions\include\drug\allergies,\hemolytic\anemia,\blood\transfusion\ mismatch\with\
resulting\transfusion\reaction\and\Rh\hemolytic\disease.
Type\III\Immune-Complex\Reaction
The\Type\III\hypersensitivity\reaction\is\also\an\antigen-
antibody\response.\The\major\difference\between\Type\II\and\Type\III\responses\is\that\in\a\Type\II\response,\the\
antibody\binds\to\the\antigen\on\the\cell\surface,\but\in\Type\III\responses,\the\antibody\binds\to\the\antigen\in\the\
blood\or\body\fluids\and\then\circulates\to\the\tissue.\Type\III\reactions\are\not\organ\specific\and\use\neutrophils\a
s\the\primary\effector\cell.\In\type\III\hypersensitivity\reactions\immune-
\ complex\deposition\(ICD)\causes\autoimmune\diseases,\which\is\often\a\complication.\As\the\ disease\progress
es\a\more\accumulation\of\immune-
complexes\occurs,\and\when\the\body\ becomes\overloaded\the\complexes\are\deposited\in\the\tissues\and\caus
e\inflammation\as\the\ mononuclear\phagocytes,\erythrocytes,\and\complement\system\fail\to\remove\immune\ co
mplexes\from\the\blood.\One\of\the\classic\Type\III\reactions\is\serum\sickness.
Type\IV\Cell-Mediated,\Delayed\Reaction
Type\IV\hypersensitivity\reactions\are\known\as\cell-
mediated\responses\and\use\lymphocytes\and\macrophages\as\primary\mediators.\Unlike\the\first\three\types\of\
responses,\which\are\ humoral\immune\functions,\a\Type\IV\response\is\mediated\by\T-
lymphocytes\and\does\not\use\antibodies.\A\typical\reaction\from\a\Type\IV\cell-
mediated\response\would\be\a\localized\contact
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dermatitis.\When\the\individual\comes\in\contact\with\the\antigen,\T-
cells\are\activated\and\ move\to\the\area\of\the\antigen.\The\antigen\is\taken\up,\processed,\and\presented\to\ ma
crophages,\leading\to\epidermal\reactions\characterized\by\erythema,\cellular\infiltration\and\ vesicles.
Type Mechanism Example Pathology
Tissue-
specific\ destruction\or\impair
ment\ because\of:
Antibody\binding\followed\ by\l
ysis\via\complement
Antibody\binding\followed\ by\ 1-
1-ABO
Type\ macrophage\ phagocytosis incompatibility
Complement\damages\RBC\membrane\and\ cells\lys
II Antibody\binding\followed\ by\ e
5-Graves'\disease
neutrophil\destruction 5-
Autoantibodies\specific\for\thyroid\tissue\impair\ receptor\f
Antibody- or\TSH
dependent\cell\ (NK)-
mediated\ cytotoxicity,\or
Antireceptor\antibodies
Type\ Contact\dermatitis\ (e
Cytotoxic\T\cell-mediated T\cells\attack\tissue\directly\(no\antibody)
IV .g.,\poison\ivy)
Type\ Mast\cell\degranulation\results\in\an\ infla
IgE\action\on\mast\cells Hay\fever
I mmatory\response
Complex\deposited\in\small\peripheral\vessels\in\ cool\te
Type\ Antigen- Raynaud’s\ ph
mperatures\leading\to\vasoconstriction\ and\blocked\circu
III Antibody\complex\ deposited\in enomenon
lation
\tissues
Hives
Hives\(urticaria)\are\an\example\of\a:
- Type\1\hypersensitivity\reaction.
- Type\2\hypersensitivity\reaction.
- Type\3\hypersensitivity\reaction.
- Type\4\hypersensitivity\reaction.
Anaphylaxis\is\a\type\1\hypersensitivity\reaction.
Immune\System
Which\of\the\following\are\considered\the\“first\responders”\of\the\innate\immune\system?
- Eosinophils.
- IgM.
Downloaded\by\Benjamin\Luca\()
