UNMC Patho Exam 2: Questions With Accurate Answers

UNMC Patho Exam 2: Questions With Accurate Answers

Function of the immune system Right Ans - 1) to protect the body from
invasion by foreign antigens - foreign substances that trigger the immune
response
2) to identify and destroy potentially harmful cells
3) to remove cellular debris

What accomplishes the functions of the immune system? Right Ans -
lymphoid organs & specifically designed lymphocytes through the process of
antibody-mediated immune response & cell-mediated immune response.

General types of immune alterations
- immune system acts inappropriately Right Ans - 1) Exaggerated
2) Misdirected against host's own cells
3) Directed against beneficial foreign tissues
4) Deficiency / insufficient

What immune alterations are due to hypersensitivity reactions? Right Ans -
1) Exaggerated
2) Misdirected against host's own cells
3) Directed against beneficial foreign tissues

Exaggerated Right Ans - overreaction against environmental antigens
Allergic reaction = small
Anaphylactic reaction = same as allergic reaction, but bigger

Misdirected against host's own cells Right Ans - autoimmunity = sees own
cells as being foreign & destroys them.

Directed against beneficial foreign tissues Right Ans - isoimmunity = body's
immune reponse against beneficial foreign tissue - i.e. organ transplants

Hypersensitivity Right Ans - A pathologic immune response
An exaggerated AND inappropriate immune response
1) Exaggerated
2) Autoimmunity
3) Isoimmunity

,Autoimmunity Right Ans - Breakdown of that "code of recognition"
Body's immune system begins to recognize self as foreign

Autoimmunity
Etiology Right Ans - Related To:
Genetics
Exposure to antigens - thought to alter membranes and the expression of self-
DNA, and induce this autoimmunity

Isoimmunity Right Ans - Body's immune system reacts against tissues of
usually other members of the same species
i.e. organ transplant

Types of Hypersensitivity Right Ans - 1) Type I - Allergy/Anaphylaxis
2) Type II - Tissue-specific reaction
3) Type III - Immune-complex mediated reactions
4) Type IV - Cell-mediated reactions

Hypersensitivity Type I Right Ans - Allergy / Anaphylaxis
IgE-mediated allergic reactions

Hypersensitivity Type II Right Ans - Tissue specific reaction
Blood Transfusion reaction

Hypersensitivity Type III Right Ans - Immune-complex mediated reactions
Antigen-Antibody complexes form & deposit in tissues
i.e. Lupus

Hypersensitivity Type IV Right Ans - Cell-mediated reactions
Involve T cells, macrophages
i.e. Rheumatoid Arthritis

Allergy / Anaphylaxis Right Ans - A rapid, immediate hypersensitivity
reactions upon re-exposure to an antigen
*** No reaction with initial exposure

Allergy / Anaphylaxis
Pathophysiology Right Ans - Primary Exposure:
1) B cells comes in contact with Allergen

,2) IgE produced
3) IgE sits on receptor of Mast Cell
Secondary Exposure - when exposed to allergen again:
1) Mast cell degranulation
2) Release of histamine & leukotrienes

Allergy / Anaphylaxis
Manifestations Right Ans - Related to Release of histamine & leukotrienes:
Localized: local inflammation
Systemic - related to where histamine receptors are located:
* Bronchial constriction & laryngeal edema
* Skin - itching/pruritis & redness/erythema
* GI - abdominal cramping, vomiting, diarrhea
* Mucus membranes - increased secretions - nasal, eyes water
* Vasculature - increased vascular permeability & vasodilation
***Anaphylactic Shock = Life threatening, dropped BP, not perfusing

Systemic Lupus Erythematosus - SLE
aka Lupus Right Ans - chronic, autoimmune, multi-system inflammatory
disease

Lupus
Incidence Right Ans - One of the most common
Increased frequency in females
Onset age 20-40
Genetic predisposition

What level(s) of hypersensitivity is Lupus? Right Ans - Level III - mostly
Antigen-Antibody complexes form & deposit in vessel walls
Body sees self as foreign

5 components of Lupus
* happen at same time Right Ans - 1) B cells produce IgG -> attack what
thinks is DNA
2) T helper cells further stimulate B cell production of IgG
3) Macrophages recruited to further attack what is considered foreign DNA
4) IgG attacks RBC because thinks those are foreign too (in addition to DNA)
5) T-suppressor cells are NOT effective to slow down immune response
appropriately

, Lupus
Manifestations
Signs & Symptoms Right Ans - Exacerbations & Remissions
Related to the 5 components:
1) Arthritis of peripheral joints - most common
2) Vasculitis - skin rash & photosensitivity - sensitive to UV light as triggering
agent = triggers exacerbation of Lupus
3) Renal disease - due to damage to vascular walls over time & due to
destruction of RBC
4) Anemia - due to destruction of RBC
5) CardioVascular disease - pericarditis
* over time, problems with perfusion and damage to vessels

Rheumatoid Arthritis Right Ans - Autoimmune, inflammatory joint
disorder characterized by destruction of the synovial membrane of the joint

What level(s) of hypersensitivity is Rheumatoid Arthritis? Right Ans - Type
III & Type IV
* Type III - Antigen-Antibody complexes
* Type IV - Cell-mediated reactions - T cells & macrophage involved

Rheumatoid Arthritis
Pathophysiology Right Ans - 1) Rheumatoid Factor = Normal ANTIBODIES
become "autoantibodies" and attack ANTIGENS on cell membranes that it now
views as foreign = Type III
2) Vasodilation & increased permeability of vasculature surrounding synovial
space allow WBC to go into space -> WBC + more fluid = congestion
* WBC include T cells & macrophages = Type IV
3) Synovial space gets clogged up & destroyed
4) Fibrin deposits, collagen deposits, scar tissue

What is Rheumatoid Factor? Right Ans - Normal antibodies become
"autoantibodies" and attack antigens on cell membranes that it now views as
foreign

Rheumatoid Arthritis
Manifestations - EARLY Right Ans - Peripheral Joints FIRST:
1) Synovitis - inflammation of synovial membrane