Patho Exam 2

Adaptive immunity is ____, has memory, provides ____-____ protection, has a slower response, and is composed of ____ cells that eliminate ____ or prevent their growth.

systemic, long-term, specialized, pathogens

B cells are a type of ____ and are responsible for ____ immunity mediated by circulating ____ (immunoglobulins)

lymphocyte, humoral, antibodies

_ cells are responsible for cell mediated immunity, kills targets directly or ____ the activity of other ____.

T cells, stimulates, leukocytes

_____ is directed against beneficial foreign tissues (ex. ____, ____).

Also called isoimmunity.

alloimmunity, transfusions, transplants

Humoral immunity produces ____-____ antibodies, causes direct ____ of a microorganism or the activation of ____ ____.

antigen-specific, inactivation, inflammatory mediators

B cells mature in the ____ ____ or ____ ____.

bone marrow or lymph node

Maturation of T cells involves the development of the T cell ____ and the expression of ____ molecules.

T cells are released into the blood and take up residence in the ____ ____ ____ (spleen, lymph nodes, etc) to await ____.

receptors, surface

secondary lymph organs, antigens

____-_____ immunity differentiates T cells (helper T cells; CD4 and cytotoxic/ ____ T cells; CD8) and primarily protects against viruses and ____.

cell-mediated immunity, killer T cells, cancer

Helper T cells (____) are responsible for proper function of the rest of immune cells including __ ____ and ____.

CD4, B lymphocytes and CD8 (cytotoxic/ killer T cells)

____ / ____ T cells (CD8) kill by directly invading a pathogen.

cytotoxic/ killer T cells (CD8)

Antigens are mostly ____ but can be other molecules as well.

protein

____ antigen is an antigen that can trigger an immune response.

immunogenic

The recipient of a ____ can mount a immune response against foreign ___ molecules.

transplantation, MHC molecules (major histocompatibility complex)

The more similar two individuals (of a transplant) are in ___ tissue type, the more likely for a successful transplant.

HLA (human leukocyte antigen)

_____ are also called immunoglobulins and are produced by _____ cells.

antibodies, plasma

____ is the most prevalent immunoglobulin and is administered for most autoimmune diseases.

IgG

____ is found mostly in secretions. Deficiency causes recurrent _____ tract infections and chronic yeast infections of the __ tract.

IgA, respiratory, GI

____ is rarest immunoglobulin. Deficiency due to ____ infection.

IgE, parasitic

____ immunoglobulin has an unknown function.

IgD

____ immunoglobulin is the first to respond to an antigen and are characterized by antigenic, structural, and functional differences.

IgM

When an antibody recognizes a pathogen, it attaches to it to completely coat it, called _____. Antibodies mark the pathogen for _____ by other immune cells.

opsonization, destruction

Active immunity is a type of _____ immunity that is developed after being exposed to an _____ or from getting a _____.

acquired, infection, vaccine

_____ active immunity is where antibodies are made after exposure to an infection.

natural

_____ active immunity is where antibodies are made after receiving a vaccination.

artificial

_____ immunity is immunity you acquire from someone or something else.

passive

_____ passive immunity is where antibodies are transferred from mom to baby (ex: via _____)

natural, breastmilk

Active acquired immunity: antibodies are produced after either a _____ _____ to an antigen or after _____, and is long lived.

natural exposure, immunization

Immunodeficiency is an _____ response to protect the host.

insufficient

Allergy, autoimmunity, alloimmunity are collectively referred to as _____ _____.

hypersensitivity reactions

_____ is the most immediate hypersensitivity reaction, occurs within minutes of re-exposure to the antigen and can lead to _____ _____.

Common offenders: beestings, peanuts, and fish.

anaphylaxis, cardiovascular shock

Clinical manifestations of anaphylaxis are _____, _____, swelling, _____, and dyspnea.

itching, pain, swelling, redness, and dyspnea

Type I (___ mediated) hypersensitivity causes the release of _____ and other inflammatory substances. Histamine release leads to _____.

IgE mediated, histamines, edema

Type __ (tissue specific) hypersensitivity reactions are caused by five possible mechanisms: _____ mediated lysis, _____ & phagocytosis, _____ mediated tissue damage, antibody dependent mediated cytotoxicity, _____ of cellular function.

II, complement, opsonization, neutrophil, modulation

Type III (_____ _____ _____ reactions) caused by the formation of immune complexes deposited in target tissues where they activate the complement cascade generating _____ fragments that attract _____ into the inflammatory response.

Neutrophils release _____ enzymes resulting in tissue damage.

immune complex mediated, chemotactic, neutrophils, lysosomal

Type IV (cell mediated) caused by either _____ T lymphs or _____ producing Th1 cells.

cytotoxic, lymphokine

Two major carbohydrate antigens are __ and __ co-dominant.

A and B co-dominant

_ blood type is a universal donor.

O

__ blood type is the universal recipient.

AB

Rh_ expresses the _ antigen on the RhD protein.

Rh+, D

Rh_ does not express the D antigen.

Rh-

Graft rejection is an _____ reaction.

alloimmune

Matching the ____- DR locus is most critical for _____ acceptance.

HLA- DR locus, graft

_____ (congenital) deficiency is a genetic defect that disrupts _____ development.

primary, lymphocyte

Secondary (_____) deficiency is _____ to disease or other physiologic alteration.

acquired, secondary

_____: recurrent, severe infections, often with _____ organisms.

hallmark, opportunistic

Gonorrhea suggests _____ deficiency.

complement

_____ infections suggest T cell deficiency.

viral

Microorganisms requiring _____ suggest B cell and _____ deficiencies.

opsonization, phagocyte

_____ syndrome (congenital thymic aplasia or _____) characterized by a complete or partial lack of the _____ (resulting in depressed T cell immunity), parathyroid glands (resulting in _____), and the presence of _____ _____.

DiGeorge syndrome, hypoplasia, thymus, hypocalcemia, cardiac anomalies

What happens if an A- patient receives O+ blood?

lysis and clumping of RBCs occurs

When there is a parasitic infection, you will see which types of cells?

eosinophils

Human normal flora prevents ____ and ____ of microorganisms.

colonization and multiplication

With clonal selection, ____ recognize and react to a specific ____.

lymphocytes, antigen

Septicemia is a ____ infection of the ____.

bacterial, blood

Which microorganism causes UTIs?

E. coli

Portal of entry is an ____ ____ such as the ____ inhaling microorganisms.

entry point, nose

Viruses require a permissive ____ to replicate.

host

Fungi have ____ ____ and cause ____.

thick walls, disease

A child stung by a bee may suffer from _____ reaction.

anaphylaxis

Systemic lupus erythematosus (SLE) is an _____ disease.

autoimmune

Maternal immune system can become _____ against fetal antigens, causing an _____ reaction.

sensitized, alloimmune

_____ immunity creates antibodies and is developed by B cells.

humoral immunity

____ immunoglobulin may be given to patient with an autoimmune disease to protect against ____.

IgG, infection

___ immunoglobulin deficiency leads to susceptibility to parasitic infection.

IgE

The severity of an infection or virus depends on ____.

cytokines

Immune reaction for poison ivy is ______ cell mediated.

Type IV

You will see a decreased ___ cell count in patients with AIDS.

CD4

Recurrent respiratory infections and yeast in GI tract are due to ___ immunoglobulin deficiency.

IgA

A patient who has resistance due to primary exposure was ____ ____.

actively acquired

Virulence means it causes

disease

Cytokines that are responsible for inducing a response are ____

TNF alpha

_____ protect themselves by forming capsules.

bacteria

Immunoglobulins pass the placenta and cause ____ immunity.

passive

_____ is dyspnea when a person is lying down.

orthopnea

Paroxysmal nocturnal dyspnea (PND) is when

you are awaken at night gasping for air

Hemoptysis is

coughing up blood

Hyperpnea is ____ and ____ breathing.

rapid and deep

_____ leads to respiratory acidosis.

hypoventilation

Hypercapnia is ____ breathing (excessive CO2) and occurs with _____.

shallow, hypoventilation

Hyperventilation is ____ or deep breathing, causes ____ ____, and causes _____ (low CO2).

rapid, respiratory alkalosis, hypocapnia

_____ is mainly seen in those with chronic obstructive pulmonary diseases.

clubbing

Hypercapnia, hypoxemia, and acute respiratory failure are conditions caused by _____ disease or ____.

pulmonary, injury

____ is a lack of oxygen in the blood and causes ventilation- perfusion abnormalities.

hypoxemia

Hypoxia is a lack of oxygen in the ____.

tissues

A patient has bulbous enlargement of the distal segments of the fingers. Which disease is associated with this condition?

a. cystic fibrosis

b. acute pneumonia

c. sickle cell disease

d. acute myocardial infarction

a. cystic fibrosis

Rationale: this condition describes clubbing, in which there is an enlargement of the distal segment of the finger. It is associated with condition of decreased oxygenation such as bronchiectasis, cystic fibrosis, pulmonary fibrosis, lung abscess, and congenital heart disease.

Which of the following is true regarding acute respiratory distress syndrome (ARDS)?

a. it is caused by injury to the bronchioles

b. it can cause severe pulmonary edema

c. it is most commonly caused by exposure to inhaled irritants

d. macrophages are not involved in response

b. it can cause severe pulmonary edema

Rationale: Acute respiratory distress syndrome (ARDS) is characterized by damage that is done to the alveolar capillary membrane and causes severe pulmonary edema. The most common cause of ARDS is either sepsis or multiple trauma. Macrophages, neutrophils, complement, and endotoxins are all important mediators.

Which of the following is TRUE regarding the pathophysiology of asthma?
a. IgA is the major factor.
b. There is decreased vascular permeability.
c. Inflammation results in hyperresponsiveness.
d. The inflammatory process is caused by the loss of bronchial smooth muscle spasm.

c. inflammation results in hyperresponsiveness

Rationale: Asthma is caused by increased bronchial smooth muscle
spasm and increased vascular permeability. IgE is the major factor. There is increased capillary permeability. Inflammatory mediators cause vasodilation, increased capillary permeability, mucosal edema, bronchial smooth muscle contraction (bronchospasm), and mucus secretion from mucosal goblet cells with narrowing of the airways and obstruction to airflow.

A patient has right ventricular enlargement secondary to pulmonary hypertension. Which of the following would be the most likely diagnosis?

a. Cor pulmonale
b. acute bronchitis
c. pulmonary embolism
d. pulmonary thromboembolism

a. cor pulmonale

Rationale: cor pulmonale consists of right ventricular enlargement and failure. Acute bronchitis is an acute infection or inflammation of the airways. Pulmonary embolism is occlusion of a portion of the pulmonary vascular bed by
an embolus. Pulmonary thromboembolism is obstruction of a pulmonary vessel by a thrombus.

_____ is a condition where air enters the chest causing lung collapse. Usually d/t ____ ____ ____. A chest tube is inserted to ____ the lungs.

pneumothorax, blunt force trauma, reinflate

_____ pneumothorax occurs when air accumulates between the chest wall and lungs. Increased ____ in the chest reduces blood flow to the ____.

tension pneumothorax, pressure, heart

Patient with a tension pneumothorax presents with hypotension, ____, ____ ____, and ____ vein distention.

hypotension, hypoxemia, tracheal deviation, jugular vein distention

_____ is a collection of blood in the pleural space.

Seen after motor vehicle accidents.

Decreased ____ ____ because of puncture wounds.

hemothorax, breath sounds

Surfactant is a _____ that helps keep _____ open.

Low surfactant = _____ _____ _____

lipoprotein, alveoli

decreased lung function

_____ _____ is excess water in the lungs. Is usually seen in someone with CHF.

pulmonary edema

Manifestations of acute respiratory disease syndrome (ARDS) include dyspnea and ____, ____ and respiratory ____, hypercapnia and respiratory ____.

hypoxemia, hyperventilation, alkalosis, acidosis

Obstructive lung diseases cause a ____ of airways resulting in airway ____ that is worse with _____.

Causes ____ and wheezing.

narrowing, airway restriction, expiration

dyspnea and wheezing

____ is chronic inflammation of the airways. It causes bronchial hyperesponsiveness, ____ of airways, and reversible airflow ____.

It is associated with immunglobulin ___.

asthma, constriction, obstruction

IgE

Symptoms of asthma include _____ _____ (d/t bronchial constriction), _____, and _____.

expiratory wheezing, dyspnea, tachypnea

Beta 2 _____ agonist (albuterol medication inhaler) causes ______.

When a patient is having exacerbation of asthma (____ ____), there is a decrease in diameter of bronchi and ____, increasing airway ____.

adrenergic, bronchodilation

asthma attack, bronchioles, resistance

COPD is a combination of ____ and ____, is usually progressive, and is the most common chronic lung disease in the world.

Risk factors include ____ ____, occupational dusts and chemicals, ___ pollution, and any factor affecting ____ ____ during ____ and childhood.

bronchitis, emphazema

tobacco smoke, air pollution, lung growth, gestation