ALU 301 Exam Guide – Immunology, Rheumatoid Arthritis, Infectious Diseases, Chronic Illness

Description: This document contains verified exam questions and solutions for ALU 301, focusing on immunology, autoimmune diseases, infectious diseases, and chronic health conditions. Topics include the immune system, inflammatory bowel disease, rheumatoid arthritis, virology, parasitology, and geriatric health issues. The content is updated and complete for exam preparation. Mediators - answerImmune cells release proteins that mediate inflammation and in the destruction of agents foreign to the host (interferons, interleukins, and immunoglobulins) Two main parts of the immune system - answer1) Innate Immune System 2) The Adaptive Immune System White blood cells of the innate immune system - answer1) Monocytes 2) Granulocytes (Neutrophils, Eosinophils, Basophils) 3) Natural Killer (NK) Cells Two types of T-lymphocytes - answer1) Cytotoxic T-cells 2) Helper T-cells What are the roles of the cytotoxic T-lymphocytes? - answer1) Destroy or remove the infectious microorganism 2) Recognize altered host cells that have become malignant Polyclonal Gammopathy - answerA broad-based spike would be seen on serum protein electrophoresis (SPEP) testing.More than one clone of lymphocytes has been stimulated to produce different antibodies Monoclonal Gammopathy - answerSPEP results with narrow peak known as a spike. Corresponds to an elevated level of a single antibody Agammaglobulinemia - answerA disorder that can result from a number of abnormal genes Monocytes - answerThey circulate in the blood and are one part of the WBC differential in a CBC. When the leave the blood circulation, they migrate into tissues and mature into macrophages Granulocytes - answerThe most abundant WBC in the blood count differential. They circulate in the blood and concentrate at a site of infection when signaled by macrophages Natural Killer (NK) Cells - answerCan act on its own with receptors that recognize damaged cells. They are important for surveillance of cancerous and pre-cancerous cells. Cells of the adaptive immune system - answerLymphocytes 5 Classes of Immunoglobulins - answerIgG, IgA, IgM, IgE, IgD The first antibody to be produced during an infection - answerIgM Type of immune cell that differentiates in the bone marrow - answerB-lymphocyte Which immune cell produces antibodies? - answerB-lymphocytes Three components of the innate immunity - answer1) Physical Barriers 2) White Blood Cells 3) Natural Killers Granulocytes - answer1) Neutrophils, 2) Eosinophils, 3) Basophils The Complement System - answerA group of about 30 blood proteins that may amplify the inflammatory response, enhance phagocytosis, or directly lyse extracellular pathogens. Cytokines - answerEnhance activation of immune cells Two types of Inflammatory Bowel Diseases - answer1) Ulcerative Colitis 2) Crohn's Disease Three etiologies of Inflammatory Bowel Disease - answer1) Genetic Predisposition 2) Unidentified Environmental Factors 3) Abnormality of the mucosal immune system Where does Ulcerative Colitis manifest? - answerOnly in the colon and only in the mucosa (inner lining) What is the most common presenting symptom of UC? - answerRectal bleeding in the form of bloody diarrhea How is disease severity determined in UC? - answerClinical Symptoms and Endoscopy Where does Crohn's Disease manifest? - answerAll parts of the GI tract can be involved, from mouth to anus What is the most common presenting symptom of Crohn's Disease? - answerAbdominal Pain Serologic markers that can help with diagnosis of IBD - answerPerinuclear Antineutrophil cytoplasmic antibodies (pANCA) -or- anti-Saccharomyees Cerevisiae Antibodies The most common extraintestinal manifestation of IBD - answerArthritis Ocular manifestations of IBD - answerAnterior Uveitis Episcleritis Most life-threatening complication of IBD - answerToxic Megacolon The premalignant lesion in IBD - answerA flat dysplastic tissue that is visually normal in appearance Cure for Ulcerative Colitis - answerTotal Proctocolectomy The mainstay of acute treatment for mild to moderate IBD - answer5-aminosalicylate-based compounds. Sulfasalazine and Mesalamine Treatment for moderate to severe IBD when the 5-aminosalicylate baseed compounds are inadequate - answerCorticosteroids (Prednisone) The drug prescribed to individuals who cannot taper or discontinue corticosteroids without a flare are prescribed what? - answerImmunomodulating Drugs (Azathioprine, 6 Mercaptopurine, and Methotrexate) Drug of choice for maintenance therapy in Crohn's Disease - answerImmunomodulating Drugs (Azathioprine, 6-Mercaptopurine, and Methotrexate) 1. Genetic 2. Environmental 3. Immunologic - answerPrimary etiologies of Rheumatoid Arthritis Symptoms of Rheumatoid Arthritis - answerPain, Stiffness, and Swelling of the diarthrodial joints Most commonly affected joints in Rheumatoid Arthritis - answer1) Proximal Interphalangeal (PIP) and Metacarpophalangeal (MCP) Joints of the hands 2) Metatarsophalangeal (MTP) Joints of the feet 3) Wrists and Elbows 4) Shoulders 5) Ankles and Knees What score is needed on the ACR-EULAR 2010 criteria to diagnose RA? - answer6 Palindromic Rheumatism - answerA pattern in which joint pain worsens for a few hours to days the rapidly remits Morning Stiffness in RA - answerNot uncommon in other arthropathies, persistence for at least one hour is unusual, except in RA Initial Assessment of RA shoud include: - answerComplete Examination, Blood Chemistries, CBC, RF, anti-CCP, ANA, CRP, ESR, UA, XRays, baseline CXR, and Hepatitis Serologies Measures to quantify and serially measure disease activity and response to therapy (Rheumatoid Arthritis) - answerDisease Activity Score (DAS) and Clinical Disease Activity index (CDAI) Laboratory Testing in RA - answerRF and anti-CCP (ACPA) for diagnosis and CRP for monitoring Acute Phase Reactants (APR) - answerC-Reactive Protein and Erythrocyte Sedimentation Rate (ESR) The leading cause of death in RA - answerCoronary Artery Disease Felty's Syndrome - answerA triad of seropositive rheumatoid arthritis, splenomegaly, neutropenia Hallmark of current therapy in RA - answerDisease Modifying anti-rheumatic drugs (DMARDS). Examples include Methotrexate, Hydroxychloroquine, and Sulfasalazine Gold Standard for the treatment of moderate to severe RA - answerMethotrexate Biologics - answerGenetically engineered immunosuppressives that are highly effective DMARDs that target specific factors involved in the inflammatory process Medications that target anti-TNF - answerEtanercept (Enbrel), Infliximab (Remicade), Adalimumab (Humira), Certolizumab Pegol (Cimzia), and Golimumab (Simponi) How does Systemic Onset JIA manifest? - answerManifests with intermittent rash, fever, and arthritis Unlike adult RA, systemic onset JIA can present with arthralgias where? - answerHip 5 Subgroups of Juvenile Idiopathic Arthritis (JIA) - answer1) Oligoarticular (Persistent or Extended) 2) Polyarticular (RF-negative or RF-positive) 3) Systemic (sJIA) 4) Psoriatic Arthritis 5) Enthesitis-related arthritis The most common subset of JIA - answerOligoarticular Onset JIA Reservoir - answerThe native habitat, in which the infective agent lives and multiplies Four types of reservoirs - answer1) Symptomatic Indiviuals 2) Carriers 3) Animals 4) Water, Food, Soil, Air, Fomites (i.e., inanimate objects that carry disease-causing microbes) Laboratory Diagnosis of Infection - answer1) Direct Detection Methods 2) Culture and