NURS 5315 UTA Exam 2 With Correct Answers HIV EIA (3rd generation immunoassay) - ANSWER can use urine, saliva, or serum (most accurate), need to wait until 12 weeks post exposure to see antibodies, >99% accurate 4th generation immunoassay- "gold standard" measures P24 antigen can test 10 days post exposure Mast cell - ANSWER Cellular bags of granules located in loose connective tisssue close to blood vessels. Activation initiates inflammatory process. Histamine - ANSWER Causes vasodilation, increases vascular permeability, increases blood flow to the site of injury- causes erythema and swelling. Cytokines - ANSWER Soluble factors that contribute to the regulation of innate or adaptive resistance by affecting other neighboring cells. Can be pro-inflammatory or anti-inflammatory. Can react quickly or be more delayed. Leukotrines - ANSWER Released when mast cells degranulate, prolong the inflammatory process. Cause vasodilation, attract neutrophils, monocytes, and eosinophils.target of inhibition for singular. Prostaglandins - ANSWER Released when mast cells degranulate, are produced by the arachidonic pathway. Cause vasodilation, platelet aggregation at site of injury, pain, and fever. Chemotactic factors - ANSWER Biochemical substance that attracts leukocyte to the site of inflammation Neutrophils - ANSWER Predominant leukocyte at work during the early stages of acute inflammation Monocytes - ANSWER Become macrophages when entering the tissue, responsible for presenting antigens to the CD4 cell which triggers T-cell immunity and B-cell immunity. Releases additional cytokines IL1, IL6, TNF. Cytokine IL1 function - ANSWER Causes fever, activates phagocytes & lymphocytes and also increases the release of IL6a Cytokine IL6 function - ANSWER Stimulates production of acute phase reactants and promotes growth and stimulation of RBCs Cytokine TNF function - ANSWER Causes fever, increases synthesis of proinflammatory proteins by liver, causes muscle wasting, induces thrombosis Cytokine growth factor function - ANSWER Promotes production and maturation of neutrophils Complement - ANSWER Functions include bacterial lysis, vasodilation and increased vascular permeability, triggers mast cell degranulation, chemotaxis, and opsonization. Kinin - ANSWER Converted to bradykinin which is responsible for pain and chemotaxis, and it increases vascular permeability and vasodilation. Coagulation cascade - ANSWER Factor XII activates kinin. Function is to form fibrin mesh to stop bleeding and trap micro organisms. COX1 - ANSWER Prostaglandin of arachidonic pathway. Provides gastroprotection, platelet aggregation, fluid/electrolyte balance COX2 - ANSWER Prostaglandin of arachidonic pathway. Responsible for pain, fever, renal protection, tissue repair, reproduction development. COX2 inhibitors- clinical implications - ANSWER Protect gastric mucosa- prevent ulcers and bleeding. Removed from market r/t cardiac events except for Celebrex. Can impair renal function , monitor labs. Arachidonic pathway purpose - ANSWER Synthesis of prostaglandins Non-selective NSAIDS - ANSWER Inhibit COX1 and COX2, risk for gastric ulceration, GI bleeds, edema, renal impairment ASA - ANSWER Blocks COX1 and COX2, also inhibits Thromboxane A2 and prostaglandins Corticosteroids - ANSWER Inhibit phospholipase A2, preventing formation of prostaglandins, thromboxane A2, prostacyclin, and leukotrines Thromboxane - ANSWER Vasoconstriction, platelet aggregation Prostacyclin - ANSWER Vasodilation, platelet aggregation (most effective one) Type 1 hypersensitivity - ANSWER E. Immediate response to allergen, food, meds, pollen, asthma, allergic reactions P. IgE binds with antigen at 1st exposure. Antigen binds with this complex at 2nd exposure. Inflammatory cascade initiates. C.M. Urticaria, rhinitis, conjunctivitis, angioedema, anaphylaxis Atopic disorders - ANSWER Genetic Type 1 hypersensitivity, asthma, hay fever, eczema, urticaria Type 2 hypersensitivity - ANSWER E. Antibodies directed against fixed antigens on the plasma membrane of cells C.M. Varies depending on alloimmune or autoimmune Alloimmunity and example of hypersensitivity - ANSWER When an individuals immune system reacts against antigens on the tissues of other members of the same species Blood transfusions- causes clumping and lysis of RBC- fever, nausea, chills, low back pain, dark urine, hives, itching, SOB Rh incompatibility- hemolytic disease of newborn with jaundice, give Rhogam within 72 hours of birth (Rh- mother with Rh+ child) Autoimmunity and example of hypersensitivity - ANSWER A breakdown of tolerance in which the bodies immune system begins to recognize self-antigens as foreign. Graves Disease- autoantibodies form against thyroid cells- bind to thyroid cells and mimic action of TSH, increases secretion of thyroxine Myasthenia Gravis- autoantibodies against acetylcholine bind to the post synaptic receptors and inhibit synaptic transmission of acetylcholine. Leads to muscle weakness and paralysis (mind to ground) Guillain-Barre' syndrome- antibodies bind with myelin sheath of the peripheral nervous system, triggering the immune response. Causes demyelination of the peripheral nerves and a rapidly progressive, ascending paralysis (ground to brain) Type III hypersensitivity - ANSWER Widespread immune and inflammatory response not specified for any cell or tissue. SLE, RA Antibodies are formed against and bind to circulating antigens, antigen-antibody complex deposits in vessel walls or tissue. Causes cellular and tissue damage. IgG and IgM response, spread via circulation- not specific to a cell or tissue- widespread damage.