Bio Final Review

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immunopathology

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study of disease states associated with overactivity or under reactivity of immune response

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hyposensitivity disease

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immune function is incompletely developed, suppressed or destroyed

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allergy

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an exaggerated immune response that is manifested by inflammation

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allergen

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antigens that do not noticeably affect non allergic individuals

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atopy

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chronic local allergy such as hay fever or asthma

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anaphylaxis

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a systematic, sometimes fatal reaction that involves airway obstruction

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antigens that elect hypersensitivity reactions are

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exogenous: microbes, pollens, grains

endogenous: arising from self

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chemical mediators

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act alone or in combination

account for the tremendous scope of allergies

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what do chemical mediators target

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skin, upper respiratory tract, GI tract

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asthma

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episodes of impaired breathing

airways of asthmatics are responsive to minute amounts of inhalant allergens, foods, or infectious disease

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eczema

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sensitization occurs through ingestion, inhalation, skin contact

dry scaly thickened skin

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systemic anaphylaxis

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sudden respiratory an circulatory disruption, can be fatal in a few minutes

allergen and route are variable

-bee venom

-injections of antibiotics or serum

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skin testing: in vivo

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method that detects precise atopic or anaphylactic sensitivities

-skin is injected, scratched, or pricked with small amount of pure allergen

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drugs that block allergy: antihistamines

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interfere with histamine activity by binding to histamine receptors on target organs

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drugs that block allergy: epinephrine(adrenaline)

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individuals prone to anaphylactic attacks

reverses constriction of airways

buys individual time to get to a hospital

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allergy vaccines: desensitization or hyposensitization

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prevents reactions between allergen, IgE, and mast cells

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creation of the IgG blocking antibodies

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remove the allergen from the system before it can bind to IgE and trigger mast cell degranulation

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blood types were first demonstrated by

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Karl Landsteiner in 1906

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Karl found that the serum of one person could ___ the red blood cells of another

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clump

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ABO antigen markers

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genetically determined

composed of glycoproteins

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the RBC's of type O have ___ but not A and B antigens

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antigens

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Rh factor

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D antigen

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Rh type results from a combination of two alleles

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Rh+: dominant

Rh- : recessive

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a person inheriting at least one Rh gene will be

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Rh+

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serum sickness and the arthus reaction depend on

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IgG, IgM, or IgA

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serum sickness and arthus require

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large doses of antigen

(compared to anaphylaxis which requires minisclue doses)

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differences between arthus and serum sickness

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arthus reaction is a localized dermal injury

serum sickness is a systemic injury

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type IV hypersensitivties primarily involves

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T Cells

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type IV diseases result when T cells respond to antigens displayed in ___ ___ or ___ ___

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self tissues

transplanted tissues

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infectious allergy:

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when a person sensitized by tuberculosis infection is injected with an extract of mycobacterium tuberculosis

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tuberculin reaction

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inflammation at the injection site with 24-48 hours

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contact dermatitis caused by

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exposure to: resins in poison ivy or poison oak

haptens in household item (jewelry, cosmetics,)

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contact dermatitis requires a

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sensitization and provocative dose

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autograft

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tissue transplanted from one site on a individuals body to another site on his or her body

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isograft

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tissue from an identical twin is used

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allografts

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exchanged between genetically different individuals belonging to the same species

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xenograft

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tissues exchanged between individuals of different species

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autoimmune disease

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individual develops hypersensitivity to him or herself

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autoantibodies

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T cells, both amount an abnormal attack against self antigens

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systemic autoimmunity

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involve several major organs

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organ specific autoimmunity

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involves only one organ or tissue

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sequestered antigens

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some antigens become exposed through infection, trauma or deterioration

when finally encounter immune cells, they are recognized as foreign trigger a reaction to self antigens

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forbidden clones

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immune system of a fetus develops tolerating by eradicting all self reacting lymphocytes

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bystander effect

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T cell activation may incorrectly "turn on" B cells that react with self antigens

Chemicalcompounds such as heavy metals may stimulate autoreactive T-cell populations

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molecular mimicry

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leads immune system to misidentify antigens

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molecular mimicry: type I diabetes and MS

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triggered by viral infection

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molecular mimicry: Rheumatic fever and psoriasis

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result of bacterial infection

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primary immunodeficiency disease

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present at birth

stem from genetic errors

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secondary immunodeficiency disease

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acquired after birth

caused by natural or artificial agents

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severe combined immunodeficiencies (SCIDS)

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most serious and potentially lethal forms of immunodeficiency

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SCIDS causes

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dysfunction in both lymphocyte systems

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secondary immunologic diseases

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AIDS

T helper, monocytes, macrophages, and APCs are infected with HIV

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depletion of T helper cells and functional impairment of immune system responses account for ___ and opportunistic infections associated with ___

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cancer

AIDS

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bone marrow or lymphoid organ cancers can cause malfunction of

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humoral and cellular immunity

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leukemia

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cancer cells displace normal cells of the bone marrow and blood

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integument

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skin

hair

nails

sweat and oil glands

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epidermis: stratum corneum

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packed with keratin gives cells ability to withstand damage and abrasion

lipids are packed between cells to water repel

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epidermis is replaced every

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25-45 days

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impetigo

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superficial bacterial infection causes skin to flake or peel off

-caused by staph aureus or staph pyogenes or mixture of two

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who are the primary victims of impetigo

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children

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staphylococcal scalded skin syndrome (SSSS) caused by

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dermolytic condition caused by staph aureus

systemic form of impetigo

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bullous lesions caused by and appearance

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caused by exfoliative toxins A and B

appearance of wrinkled tissue paper

patients are left vulnerable to secondary bacterial infections

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chickenox

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mild disease

some experience secondary infections

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shingles reside in

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reactivavted form of chickenpox

virus resides in cranial and sensory neurons

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two forms of smallpox

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variola major

variola minor

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variola major

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highly virulent, leading to toxemia, shock, and intravascular coagulation

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variola minor

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rash less dense patient experiences weaker symptoms

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squeal of measles

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laryngitis, bronchopneumonia, and bacterial secondary infections

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subacute sclerosing panencephalitis

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1 in 1 million cases develop this

progressive neurological degeneration of the cerebral cortex

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rubella

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causes minor rash

damage occur when fetus is exposed in womb

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congenital rubella

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infection in the first trimester: indices miscarriage

causes multipul permanent defects in new born

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congenital defects caused by rubella

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deafness

cardiac abnormalities

ocular lesions

mental and physical retardation

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cutaneous anthrax caused by

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most common and least dangerous infection caused by bacillus anthracis

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what does cutaneous anthrax form

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a black eschar when endospores enter skin and germinate there

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11 cases of cutaneous anthrax occurred following

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bioterrorism attacks in the fall of 2001

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blood brain barrier

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cells that make up the walls of blood vessels around the brain allow very few molecules to pass through

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blood brain barrier prohibits most

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microorganisms from passing into the CNS

(drugs and antibiotics are difficult to introduce into the CNS when needed)

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rabies

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zoonotic disease characterized by fatal encephalitis

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furious rabies

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agitation, disorientation, seizures, twitching

hydrophobia

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dumb rabies

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patient is paralyzed, disoriented, stuporous

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rabies reservoirs

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wild mammals: canines, skunks, raccoons, bats, cats

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tetanus: clostridium tetani(resident of)

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soil and GI tract of animals

gram pos

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tetanospasmin binds to

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target antigens on peripheral motor neurons

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tetanospasmin blocks inhibitions of

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muscle contaction and causes muscles to contract uncontrollably resultsing in spastic paralysis

death results from paralysis of respiratory muscles and respiratory arrest

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anthrax: bacillus anthracis

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zoonotic disease of herbivores

gram pos

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bacillus anthracis forms (tripartite toxins):

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edema factor

protective antigen

lethal factor

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human immunodeficiency virus (HIV) causes

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retrovirus

causes acquired immune deficiency syndrome (AIDS)

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symptoms of HIV

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pneumonia

kaposi's sarcoma

sudden weight loss

swollen lymph nodes

general loss of immune function

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signs and symptoms of HIV

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initial symptoms: fatigue, diarrhea, weight loss, neurological changes

oppurtunistic infections

poor nutrient absorption

night sweats, fever, sore throat

lesions on brain, spinal column

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HIV transmission

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any form of intimate contact involving transfer of blood can be potential source

(not considered sources of infection: urine, sweat, tears, saliva)

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epidemiology of HIV

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beginning of epidemic: 1980's

60 million have become infected, 30 million have died of HIV related causes

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diphtheria: corynebacterium diphtheriae

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gram pos

produces sore throat, lack of appetite and low grade fever

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diphtheria

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produce an exotoxin that inhibits protein synthesis and irresponsible for pathogenesis

-resistant to drying

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diphtheria transmission

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airborne transmission by nasopharyngeal secretions

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whooping cough: catarrhal phase

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bacteria in the respiratory tract cause cold symptoms

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whooping cough: paroxysmal phase

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uncontrollable coughing accompanied by a "whoop" sound

can result in broken blood vessels in the eyes, vomitting, even hemorrhages in the brain

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whooping cough: convalescent phase

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bacteria are decreasing, but ciliated epithelia have been damaged, requiring weeks to months of recovery

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filamentous hemagglutinin

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essential for attachment

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pertussis toxin

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causes massive mucus production

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tracheal cytotoxin

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causes direct destruction of ciliated cells

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pertussis vaccine does not provide

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lifelong protection

organism may be evolving

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influenza sighs and symptoms

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headache, chills, dry cough, body aches, fever, stuffy nose, sore throat

H1N1 swine flu: not all patients had fever, patients had GI distress or multigrain system failure

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influenza: hemagglutinin

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agglutinating action on red blood cells

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influenza: neuraminidase

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breaks down protective mucous coating of respiratory tract

keeps viruses from sticking together

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antigenic drift

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gradual changing of amino acid composition of influenza antigens

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antigenic shift

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swapping out one of the strands of viral DNA with a gene or strand from another virus

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tuberculosis

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bacteria grow inside alveolar macrophages

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tubercles

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granulomas containing a core of TB bacteria and enlarged macrophages surrounded by an outer wall made of fibroblasts, lymphocytes, and macrophages

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secondary tuberculosis (reactivation)

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bacteria remain dormant in lungs

become reactivated when immune system wanes

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symptoms of secondary TB

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violent coughing, greenish or bloody sputum, low grade fever, anorexia

untreated has 60% mortality rate

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tuberculosis: extrapulmonary TB (organs primarily involved)

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lymph nodes

intestines

kidneys

long bones

brain

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transmission of TB

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droplets of respiratory mucus in the air

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Tb is an infection of poverty:

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inadequate nutrition

debilitation of immune system

poor access to medical care

lung damage

genetics

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TB diagnosis

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mantoux test: shows evidence of delayed hypersensitivity after initial injection

(purified protein derivative is injected under the skin and observed for evidence)

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treatment of active TB

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first 2 months: rifampin, isoniazid, ethambutol

4-7 months: rifampin, isoniazid

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treatment of latent TB

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isoniazid, rifampin, rifapentine

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mycibacterium avian complex (MAC)

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causes a dissminated tuberculoosis infection in patients with AIDS

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MAC is a frequent inhabitant of

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showerheads

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campylobacter

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most common cause of bacteria diarrhea in US

symptoms may last longer than 2 weeks (watery stool, fever, etc)

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vibrio cholerae symptoms

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vomitting, copious watery feces, large fluid loss 1 liter per hour

loss of BV, hypotension(low BP), tachycardia(rapid heart rate)

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vibrio cholerae: transmission

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warm, monsoon, alkaline, and saline condition favor growth

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treatment of vibrio cholerae

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oral rehydration therapy

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hepatitis

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inflammatory disease of the liver

interferes with excretion of bile pigments causes bilirubin to accumulate in blood and tissues causing jaundice

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hepatitis A virus

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non- enveloped single stranded RNA virus

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hepatitis A virus: signs and symptoms

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flulike symptoms

jaundice in 10% of cases

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hepatitis A transmission

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fecal-oral route, associated with deficient personal hygiene nd lack of public health measures

immunizations available

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hepatitis B

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enveloped DNA virus

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hepatitis B signs and symptoms

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fever, chills, abdominal discomfort

rashes and arthritis

causes heatocellular carcinoma

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hepatitus B transmitted

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by minute amount of blood

effective vaccine available

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hepatitis C

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silent epidemic

similar to hepatitis B

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hepatitis C transmission

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blood transfusion, needle sharing

no vaccine available

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what drugs inhibit hepatitis C

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pegylated interferon, ribavirin, protease, and polymerase

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normal biota of male genitalia tract

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lactobacillus, and streptococcus

microbiota shifts when sexual activity begins

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microbes associated with STI's can

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take up residence in genital tract

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vaginal, oral, and anal, intercourse can harbor

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bacteria that produce vaginosis in females

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normal biota of the female genital tract

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uterus and organs above it are sterile

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vaginal canal colonized by a diverse array of microorganisms

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lactobacillus (lowers pH of vagina)

carndida albicans (prsent at low levels in healthy female reproductive tract)

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microbial make up can shift dramatically during

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menstruation cycle and pregnancy

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gonorrhea: signs and symptoms (male)

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urethritis, painful urination, yellowish discharge, many cases asymptomatic

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gonorrhea: signs and symptoms (female)

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bloody discharge, painful urination

salpingitis: inflammation of the fallopian tubes

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children born to gonococcus carriers

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can be infected as they pass through the birth canal

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neisseria gonorrhoeae

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use fimbriae to attach to mucosal epithelial cells

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neisseria gonorrhoeae: tranmission

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all forms of sexual contact

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infection of neisseria gonoorrhoeae increases ones risk of

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HIV infection

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chlamydia

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most common reported infectious disease

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chlamydia signs and symptoms: male

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discharge and painful urination

most are asymptomatic

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chlamydia signs and symptoms: female

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cervictis, discharge, salpingitis, PID

most are asymptomatic

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lymphogranuloma venereum

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invasion of lymphatic tissues

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chlamydia trachomatis

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cell wall prevents phagosome-lysosome fusion

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chlamydia trachoma's treatment

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doxycycline or azithromycin

(confection with gonorrhea is common)

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primary syphilis

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chancre: small, red, hard bump that appears at the site of entry of pathogen

appear on internal and external genitalia, lips, oral cavity, nipples, fingers, anus

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secondary syphilis

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red or brown rash on palms and soles of feet

accompanied by hair loss

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latent and territory syphilis

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damage to small arteries and aortic wall

gummas develop in liver, skin, and bone

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congenital syphilis

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inhibits fetal growth and disrupts critical periods of development

causes fetal abnormalities

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treponema pallidum

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binds to epithelial cells by its hooked tip

outer membrane lipoproteins stimulate a strong inflammatory response that can cause damage to host

barrier condoms provide protection