Unit 4 Serology, Immunity, And Immune Disorders

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1st and 2nd lines of defense

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Nonspecific

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3rd line of defense

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Specific, results in long term immunity. Ex: T-cells, B-cells, and antibodies.

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Antigen

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Chemical substances usually a non-self invader.

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Body recognizes

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antigenic surface determinants.

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Origin of immune system

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Fetus 2 months after conception. Stem cells develop in the bone marrow with a variety of stem cells. 2 Ex. Erythropoietic- RBC's
Lymphopoietic- Lymph node sites.

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Dual system of immunity

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1. CMI- Cellular Mediated Immunity- Involves T-cells, Lymphokines, and interlukins.

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T-cells

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have an advanced life span, make up more than half of the circulating lymphocytes.

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Lymphokines

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Protein produced by lymphoblasts. Also r/t 2nd level, and they increase efficiency of phagocytosis.

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Interlukins

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Produced by WBC's influences activitay of other WBC's.

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Cellular mediated immunity (CMI)

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Found in 4 classes of T-cells.
Helper T-cells, Suppressor T-cells, Cytotoxic /T-cells, delayed hypersensitivity T-cells.

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Helper T-cells

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Signal to produce more T-cells.

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Suppressor T-cells

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Reduce production of T-cells.

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Cytotoxic T-cells

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killer T-cells. Destroys antigens

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Delayed hypersensitivity T-cells

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Destroys future reappearing non-self foreign antigens, resulting in long term immunity.

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Helper T-cells and Suppressor T-cells aid in

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B-cells production and reduction.

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B-cells

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remain in lymphoid tissue, called plasma cells. Go through many adaptions end result in this is production of antibodies.

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Humoral Immunity

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Rises from our B-cells.

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Antibody

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Globulin groups of protein.

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Immunoglobulins

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another name for antibodies.

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5 groups of immunoglobulins

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1. IgG
2. IgM
3. IgA
4. IgD
5. IgE

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IgG

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Monomer, single subunit. Generally everywhere crosses walls of vessels and placenta. Principle component in secondary response.

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IgM

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Pentamer, 5 put together, too large to fit through tissue (a monster). Principle component of primary response also important in secondary response.

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IgA

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Dimer, contained in tears, saliva, and breastmilk.

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IgD

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Monomer, don't really know what it does, part of the immune response system.

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IgE

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Monomer, great role with allergic response.

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Surface determinants

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Pathogens can have several antigenic surface determinants, its a chemical communication. The body memorizes these determinants and has seen them before.

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2 types of immunity

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Innate and acquired

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Innate

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Is the immunity that you are born with. Your genetic makeup.

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Acquired

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acquired after birth, usually not inherited.

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People that didn't have innate immunity

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Native Americans to small pox.
Polynesians to measles.

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2 groups of acquired immunity

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long term and short term.

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long term immunity

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naturally acquired active immunity. Direct exposure to disease. Ex. Mumps and measles.

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Artificial acquired active immunity

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Immunity received through vaccinations, (1st generation vaccinations)

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3 groups of whole cell

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whole cell, whole virus, whole toxin.

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Whole cell

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killed, inactivated, safer but, could be less effective. Many side effects. Ex. typhoid fever

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whole virus

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Ex. Rabies, Pasteur 1885

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Whole toxin

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tetanus

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Attenuated vaccination

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Not killed, its alive, but weakened. Antibody created quickly with more quantity. Ex. Polio virus (1954) Sabin- Oral polio vaccine (created 1-2 yrs later)

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Short term immunity (essay)

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Naturally acquired passive immunity can occur from mother to child via placenta transfer, and after birth via breast milk.

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Artificial acquired passive immunity (essay)

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Injected into the body due to exposure of the disease.

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Gamma globulin

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Several types available. Hep A and Hep B must have vaccinations for both.

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Hepatitis A

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Foodborne

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Hepatitis B

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bloodborne

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ISG

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Immune serum globulin, used to treat Hep A is collected from the pooled blood of 1,000 donors.

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SIG

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Specific immune globulin, pooled human serum from convalescing diseased serum. Was used to treat Hep A, but is now used to treat Hep B.

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Timeframe for Hep A and Hep B

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Hepatitis A you can have for 3 months, hepatitis B you can have for a lifetime.

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Vaccine

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Suspension of microorganisms that will induce immunity when introduced into the patient. Provides specific immunity defense and resistance. They are a preventative maintenance. Not a cure.

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Sub-unit vaccinations

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Genetically engineered antigenic proteins from the MO cell not the whole cell.

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Acellular vaccinations

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The whole cell is not used, just antigenic fragments of the cell.

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Anti-idiotypic vaccinations

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antigen from the microorganism that mimics the antibody is used.

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Serology

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branch of immunity that deals with in vitro testing.

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In vitro

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Removal of blood into a test tube for diagnostic testing. Antibody/Antigen properties, if there's surface determinants, you have been exposed. Tests can determine what has invaded you and how to treat it.

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5 types of serological testing

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1.Agglutination tests
2.Precipitation tests
3.Complement fixation test
4.Immunoflourescence
5.Immunoassays

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Agglutination tests

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Will show visible clumping. used to
1. Measure antibody level.
2.looking for highest dilution that gives body reaction, looking for high titer levels. Titer tests can tell if you've ever had disease or vaccine.

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Precipitation tests

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Will show bands. Soft agar gel is used.

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Complement fixation

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looking for lysine. Will lyse certain cells.

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Immunofluorescence

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Antibody will be tagged with fluorescent dyes. Uses flurochrome.

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Immunoassays

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2 groups RIA and ELISA

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RIA

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Radioimmunoassay, radioactive labeling.

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ELISA

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Enzyme Linked Immunosorbent assay. Uses enzymes and dyes to detect antibody/antigen complex.

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Immunopathology

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Study of disease associated with excesses of deficiencies with the immune response.

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2 major groups of antigens

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Exogenous and Endogenous

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Exogenous

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Originates outside the body. Ex. Bee pollen

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Endogenous

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arises from inside the body, autoimmune disorders.

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Gell and Coombs classification of hypersensitivity

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Classification of allergic responses.

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Allergies

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Exaggerated immune response to an allergen (substance that promotes or provokes an allergic response.)

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Type 1 Immediate

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After 2nd contact with the antigen, Specific B-cells react within 30 minutes or less with the allergen. Invades IgE and histamine. 2 variations local and chronic Ex. Hayfever. Anaphylaxis; systemic, acute, explosive. Ex. Anaphylactic shock; airway obstruction, epinephrine, as well as anthihistamine will need to be administered.

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Type 2 Antibody mediated

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After 2nd contact with specific antigen, B- lymphocytes will react within hours-days. Involves IgM, IgG, and complement. Ex: mismatched blood transfusion. Ex hemolytic disease of newborn. Mom Rh (-) fetus Rh(+), body will produce antibodies to the fetus. Rhogam is the gamma globulin that will be administered must be given with 1st pregnancy at 28 weeks gestation, and at birth.

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Type 3 Immune contact

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After 2nd contact with antigen, specific B-lymphocytes react within hrs- days. Involves IgM, IgG, IgA, and complement. Immune complex is trapped and causes chronic inflammation.
2 types of syndromes: arthus reaction and serum sickness.
Autoimmunities- autoantigen is unrecognized self tissues, body would form T-cells that are synthesized to autoantibodies. Antibodies are produced to unrecognized autoantigens. Ex. SLE systemic lupus erythematosus. and RA rheumatoid arthritis.

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Type 4 T-cell mediated

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After 2nd contact with antigen, cytotoxic T-cells react in 1-many days, response to self tissues or transplanted tissue.
Self tissue- delayed allergic response
Transplanted tissue- Host would reject the transplant.

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Graft

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within 2 weeks body would reject the graft.

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Graft vs Host Disease

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Usually occurs with bone marrow transplants. Can occur as early as 3 months or as late as 10 months.

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Tissue Typing

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Major histocompatibility complex (MHC) aka Human leukocyte antigen complex (HLA)- Identify patient tissue and type the tissues.

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Transplantation grafts

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There are privileged tissue and privileged sites.

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Privileged tissue

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Tissue safe from rejection. Ex: pig valves

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Privileged sites

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Sites where antibodies do not circulate. Ex Cornea and brain.

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4 basic types of grafts

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1. Autograft
2. Isograft
3. Allograft
4. Xenograft

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Autograft

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Burn victims (face, ears) skin is removed from same patient from a large surface area. some MHC.

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Isograft

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balanced; from identical twins, Will not tissue type if very young, MHC can change as twins grow older.

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Allograft

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Most common type of grafting between individuals of same species. Will be tissue typed. Will need immunosuppressive, Cyclosporin A as well as the steroid Prednisone.

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xenograft

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Graft from 2 different species. Ex organs from animals, can be temporary.

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Immunodeficiency diseases

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Primary and secondary

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Primary

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Disease that a person is born with. B-cell deficit, patient lacks the ability to produce antibodies. Ex: agammaglobulinanemia-deficit of B-cells.
Ex: DiGeorge syndrome- individual without a thymus or defective thymus. Deficit in T-cells.
Ex: B and T-cell deficit- no immunity at all. SCID severe combined immunodeficiency disease, must receive bone marrow transplant or, live in a special facility.

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Secondary

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Acquired after one is born, damage to immune system. Ex: AIDs acquired immune deficiency syndrome. T-cells are the main target resulting in opportunistic infections and cancer.

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Tumor

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A new growth of abnormal cells, caused by mytosis gone wild.

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Benign

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Local tumor

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Malignant tumor

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cancerous

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mestastisized

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goes systemic

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Neoplasm

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another name for cancer

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Oncology

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Medical specialty regarding the study of cancer.

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Oncogene

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cancer gene

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Anti-oncogene

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tumor suppressing gene it regulates tumor suppression and the proto-oncogene.

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Proto-oncogene

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Regulates start of mytosis

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Genetic disruption

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oncogene takes control, overriding the stop of mytosis resulting in immortalization. Non stop cell division will occur. Non stop development of a tumor, it will go systemic.

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Some viruses can cause cancer

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They may be DNA or RNA NOT both.

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RNA

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Retrovirus is a RNA virus, some retroviruses contain the enzyme revers transcriptase, it uses this enzyme to synthesize nucleic acid in the host. Ex T-Cell leukemia.

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DNA

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Human papilloma virus, may cause cervical cancer.

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Immune surveillance

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patrolling cells for particular abnormal cells. After locating them they will begin to destroy abnormal cells unless antigen modulation is present.

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3 types of patrolling cells

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Cytotoxic T-cells, natural killers (NK) and Lymphokine activated killer cells (LAK)

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Tumor shells

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Can sometimes shed their antigenic surface determinants.