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55 Cards in this Set
- Front
- Back
If you have an immune disorder that is CELLULAR what is your problem?
**white text |
T cells
problems with infections |
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If you have an immune disorder that is HUMORAL what is your problem?
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antibody (B cell)
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what are Primary Immunodeficiencies
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Congenital/genetic; rare
Typically manifest in childhood |
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what is Bruton X-linked agammoglobulinemia
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Lack of mature B cells
Presents in infancy Virtually absent serum Ig Normal cell mediated immunity Recurrent bacterial infections Encapsulated bacteria (e.g., Strep. pneumoniae) |
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Are T cells effected in Bruton X-linked agammoglobulinemia
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HELL NO!
damn alligator. only B cells |
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describe CVID (common variable immunodeficiency)
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Heterogeneous group of diseases; may be acquired; no uniform etiology / etiology unclear
Generally lack all Ig’s Similar presentation to Bruton’s,BUT LATER IN LIFE!!(childhood or adolescence) Prone to developing lymphoid malignancies |
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describe Isolated IgA deficiency
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Most common primary immunodeficiency
1/600 May be acquired s/p infection Almost complete lack of IgA Often asymptomatic May have recurrent sinopulmonary infections; allergic airway disease; autoimmune disease ~40% pts have IgA autoantibodies Important consideration for blood transfusions Recipient circulating anti-IgA antibodies can react with IgA in donor serum transfusion reaction |
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what is the most common primary immunodeficiency?
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Isolated IgA deficiency
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If blood was cross matched, typed, and everything seemed okay,and you saw a transfusion reaction, what might you start thinking?
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~40% pts have IgA autoantibodies
Important consideration for blood transfusions Recipient circulating anti-IgA antibodies can react with IgA in donor serum transfusion reaction |
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describe DiGeorge Syndrome
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Variable severity; typically present in infants
Failure of normal development of the 3rd or 4th pharyngeal pouches: Includes thymus, parathyroids, some cardiac structures) -->hypoplastic thymus Lack of mature T cells Increased susceptibility to fungal, viral, protozoal infections (some bacteria as well) Parathyroid hypoplasia: hypocalcemia --> tetany |
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pt. presents with hypocalcemia, cardiac anomalies, and recurrent infections
what does this patient have? |
DiGeorge Syndrome
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describe SCID (severe combined immunodeficiency)
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Group of disorders that affect both T cells and B cells
Severe, recurrent fungal, viral, protozoan, and bacterial infections |
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what is an iatrogenic immunodeficiency?
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Immune suppression in transplant patients (kidney; heart)
Cancer treatment Suppression of bone marrow with leukopenia this is when medicine suppresses your immune system |
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Systemic, chronic disease example please
Secondary (Acquired) Immunodeficiency |
E.g., malignant neoplasm
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HIV – AIDS
what is depleted? what kind of infection is this? increased risk of what? |
CD4+ T cell depletion
Opportunistic infections: agents not typically infectious in immune-competent persons increased risk of getting malignant neoplasms (B cell lymphomas; Kaposi's sarcoma) |
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Type I HS Rxn
Ab? |
: immediate-type
Antibodies targeting Ag’s already are circulating when the Ag exposure occurs IgE antibody “coating” mast cells and/or basophils binds to Ag and results in degranulation (Ag cross-links Ab “receptors”) Localized: urticaria, asthma Generalized / severe: anaphylaxsis |
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Type II HS Rxn
Ab? plz list the 2 types of effects |
IgG and IgM
Cytotoxic effects: Ab binds to cell surface antigens and irreversibly damages cells via complement-mediated pathways E.g., autoimmune hemolytic anemia; Goodpasture disease Noncytotoxic: Ab’s against cell surface receptors; no cellular destruction E.g., Graves hyperthyroidism, myasthenia gravis |
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Type III HS Rxn
ab? |
immune complex disease
IgG, IgM, IgA Ab’s complex with either circulating Ag or with Ag that is deposited in tissues Immune complexes elicit inflammation via complement activation Directed against exogenous or endogenous Ag Autoimmune diseases; serum sickness Collage-vascular diseases SLE; RA (rheumatoid arthritis); types of glomerulonephritis; types of vasculitis |
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Type IV HS Rxn
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cell-mediated; delayed type
Greatest intensity 24-48 hrs after exposure Involves immune response to complex Ag’s; Ag-presenting cells T cell-mediated tissue injury (CD4+ and CD8+) Some forms of contact dermatitis (e.g., poison ivy); some autoimmune inflammatory processes (e.g., type I DM; chronic thyroiditis; primary biliary cirrhosis) PPD rxn. In TB skin test Impaired T cell-mediated immune rxns. (e.g., as in AIDS) attenuates type IV rxns (anergy) |
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exudate
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high protein high cells
accute inflammatory Neutraphils present |
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review virchow's triad
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stasis: interrupted blood-flow, change to turbulent blood flow
endothelial injury hypercoagulability |
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people with LUPUS have what lab finding
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elevated PT and PTT
even though they have blood clots |
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say a person has none of the standard signs of blood clotting,
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genetic mutation in factor V leidien gene mutation
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Nickel contact dermatitis is what type of HS rxn?
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Type IV
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Graves disease is an example of what HS rxn (be specific)
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non-cytotoxic type II HS rxn
Ab acts like TSH to hyperstimulate the thyroid |
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The PPD rxn in the TB skin test will show what type of HS rxn?
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Type IV
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What is Anergy *** ON THE TEST!!!
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occurs when an individual lacks the appropriate T-cell component for delayed cell hypersensitivity rxn
Pt will get negative PPD test, so it will look like they don't have TB This is what happens in AIDS |
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anaphylaxis is what kind of HS?
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Type I
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Autoimmune hemolytic disease
HS type? |
type II
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Goodpasture's disease is what type of HS rxn?
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type II
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Lupus is what type of HS rxn?
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Type III
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Multiple sclerosis is what type of HS rxn?
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IV
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if sperm leave the privileged area in the testis, what can they act as?
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antigen, they will be destroyed
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if you have an imbalance of CD4/CD8 imbalance of activity what would you expect to see?
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autoimmune disease
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who are affected more readily in autoimmune diseases, Males or Females?
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Females
sorrrrryyyy |
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what is lupus in general?
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Chronic autoimmune disease affecting multiple organs / systems
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if you see someone with renal problems and a slew of others such as Skin, joint,respiratory, cardiac, CNS, serous membranes
what are you thinking? this could be on the test |
LUPUS
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if you see antibodies targeted against double-stranded DNA what would you be thinking?
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SLE
LUPUS |
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if you see a malar rash, what are you thinking
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oh shit its that old g
LUPUS! |
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what is Libman-Sacks Endocarditis ?
what is it seen in? what is the buzzword you will see with this? |
endocarditis of the mitral valve in lupus erythematosus
Buzzword: Vegetation vegetative responses |
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Sjogren Syndrome
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Chronic autoimmune disease resulting from destruction of lacrimal and salivary glands
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Patient comes in complaining of dry mouth and dry eyes
you see keratin in the conjuctiva what does this person have? |
Sjogren Syndrome
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Scerloderma
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Systemic sclerosis
Excessive systemic fibrosis: skin, GI tract, kidneys, heart, muscles, lung |
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you see a patient with fibrosis in the skin and cyanosis of the tips of fingers associated with Raynaud phenomena. What might you investigate further as a possible disease?
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Scerloderma
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if you have more localized scleroderma, what would you have?
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CREST syndrome
Calcinosis; Raynaud phenomenon; esophageal dysmotility; sclerodactyly; telangiectasia |
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what is CREST syndrome?
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Calcinosis;
Raynaud phenomenon; esophageal dysmotility; sclerodactyly; telangiectasia (small dilated blood vessels near the surface of the skin or mucous membranes) localized sclerosis |
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what type of HS rxn are seen in transplant rejection
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both Type II (humoral rejection)
and type IV (cell-mediated delayed) |
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what is hyperacute rejection?
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tissue rejection that occurs within minutes or hours
Rapid cyanosis, congestion, mottling – immediate graft failure Ag-Ab rxn at endothelial cell (type II HS rxn) Deposition of Ig, complement: fibrin-rich thrombi Action of preformed host Ab’s against donor Ag (ABO Red cell or HLA antigens) |
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a patient is in surgery getting a new kidney. The doctor removes the clamps to allow blood from the host to mix with the new kidney. The surgeon then sees rapid cyanosis, congestion, and mottling.
The surgeon says damn he is having... |
hyperacute rejection
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what is acute rejection of tissue?
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most common type of rejection to occur
happens in 7-10 days or months/yrs depending on use of immunosuppression Humoral (type II HS rxn) or cellular (type IV HS rxn), or both |
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if you have cellular acute rejection, what is the immune system targeting?
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endothelial cells
will see Endotheliitis Generally responds well to immunosuppressant tx (e.g., cyclosporine) Precursor to chronic rejection |
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the humoral response of acute rejection does what?
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Ab target donor blood vessels
Necrotizing vasculitis Responds poorly to tx |
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Chronic cellular rejection
time frame? symptoms? therapy? |
As early as 2 months post txp, but usually >1 yr
Severe organ dysfunction, with fibrosis Arteriopathy Unresponsive to therapy; graft will fail |
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what is Graft vs. Host Disease (GVHD)
what kind of transplant is this seen in ? |
Donor immune cells target host cells
seen in bone marrow transplant |
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a patient has recently had a bone marrow transplant and is now experiencing Rash, diarrhea, cramping/abd pain, liver dysfunction
what is going on? |
Graft vs. Host Disease (GVHD)
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