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ALU 301 Exam Questions And Complete Solutions Graded A+ Mediators Immune cells release proteins that mediate inflammation and in the destruction of agents foreign to the host (interferons, interleukins, and immunoglobulins) Two main parts of the immune system 1) Innate Immune System 2) The...

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ALU 301 Exam Questions And Complete
Solutions Graded A+
Mediators
Immune cells release proteins that mediate inflammation and in the destruction of agents foreign to
the host (interferons, interleukins, and immunoglobulins)


Two main parts of the immune system
1) Innate Immune System
2) The Adaptive Immune System


White blood cells of the innate immune system
1) Monocytes
2) Granulocytes (Neutrophils, Eosinophils, Basophils)
3) Natural Killer (NK) Cells


Two types of T-lymphocytes
1) Cytotoxic T-cells
2) Helper T-cells


What are the roles of the cytotoxic T-lymphocytes?
1) Destroy or remove the infectious microorganism
2) Recognize altered host cells that have become malignant


Polyclonal Gammopathy
A broad-based spike would be seen on serum protein electrophoresis (SPEP) testing.More than one
clone of lymphocytes has been stimulated to produce different antibodies


Monoclonal Gammopathy
SPEP results with narrow peak known as a spike. Corresponds to an elevated level of a single antibody


Agammaglobulinemia
A disorder that can result from a number of abnormal genes


Monocytes
They circulate in the blood and are one part of the WBC differential in a CBC. When the leave the
blood circulation, they migrate into tissues and mature into macrophages


Granulocytes
The most abundant WBC in the blood count differential. They circulate in the blood and concentrate
at a site of infection when signaled by macrophages


Natural Killer (NK) Cells
Can act on its own with receptors that recognize damaged cells. They are important for surveillance of
cancerous and pre-cancerous cells.

,Cells of the adaptive immune system
Lymphocytes


5 Classes of Immunoglobulins
IgG, IgA, IgM, IgE, IgD


The first antibody to be produced during an infection
IgM


Type of immune cell that differentiates in the bone marrow
B-lymphocyte


Which immune cell produces antibodies?
B-lymphocytes


Three components of the innate immunity
1) Physical Barriers
2) White Blood Cells
3) Natural Killers


Granulocytes
1) Neutrophils,
2) Eosinophils,
3) Basophils


The Complement System
A group of about 30 blood proteins that may amplify the inflammatory response, enhance
phagocytosis, or directly lyse extracellular pathogens.


Cytokines
Enhance activation of immune cells


Two types of Inflammatory Bowel Diseases
1) Ulcerative Colitis
2) Crohn's Disease


Three etiologies of Inflammatory Bowel Disease
1) Genetic Predisposition
2) Unidentified Environmental Factors
3) Abnormality of the mucosal immune system


Where does Ulcerative Colitis manifest?
Only in the colon and only in the mucosa (inner lining)


What is the most common presenting symptom of UC?

,Rectal bleeding in the form of bloody diarrhea


How is disease severity determined in UC?
Clinical Symptoms and Endoscopy


Where does Crohn's Disease manifest?
All parts of the GI tract can be involved, from mouth to anus


What is the most common presenting symptom of Crohn's Disease?
Abdominal Pain


Serologic markers that can help with diagnosis of IBD
Perinuclear Antineutrophil cytoplasmic antibodies (pANCA)
-or-
anti-Saccharomyees Cerevisiae Antibodies


The most common extraintestinal manifestation of IBD
Arthritis


Ocular manifestations of IBD
Anterior Uveitis
Episcleritis


Most life-threatening complication of IBD
Toxic Megacolon


The premalignant lesion in IBD
A flat dysplastic tissue that is visually normal in appearance


Cure for Ulcerative Colitis
Total Proctocolectomy


The mainstay of acute treatment for mild to moderate IBD
5-aminosalicylate-based compounds. Sulfasalazine and Mesalamine


Treatment for moderate to severe IBD when the 5-aminosalicylate-baseed compounds are
inadequate
Corticosteroids (Prednisone)


The drug prescribed to individuals who cannot taper or discontinue corticosteroids without a flare are
prescribed what?
Immunomodulating Drugs (Azathioprine, 6-Mercaptopurine, and Methotrexate)


Drug of choice for maintenance therapy in Crohn's Disease

, Immunomodulating Drugs (Azathioprine, 6-Mercaptopurine, and Methotrexate)


1. Genetic
2. Environmental
3. Immunologic
Primary etiologies of Rheumatoid Arthritis


Symptoms of Rheumatoid Arthritis
Pain, Stiffness, and Swelling of the diarthrodial joints


Most commonly affected joints in Rheumatoid Arthritis
1) Proximal Interphalangeal (PIP) and Metacarpophalangeal (MCP) Joints of the hands
2) Metatarsophalangeal (MTP) Joints of the feet
3) Wrists and Elbows
4) Shoulders
5) Ankles and Knees


What score is needed on the ACR-EULAR 2010 criteria to diagnose RA?
>6


Palindromic Rheumatism
A pattern in which joint pain worsens for a few hours to days the rapidly remits


Morning Stiffness in RA
Not uncommon in other arthropathies, persistence for at least one hour is unusual, except in RA


Initial Assessment of RA shoud include:
Complete Examination, Blood Chemistries, CBC, RF, anti-CCP, ANA, CRP, ESR, UA, XRays, baseline CXR,
and Hepatitis Serologies


Measures to quantify and serially measure disease activity and response to therapy (Rheumatoid
Arthritis)
Disease Activity Score (DAS) and Clinical Disease Activity index (CDAI)


Laboratory Testing in RA
RF and anti-CCP (ACPA) for diagnosis and CRP for monitoring


Acute Phase Reactants (APR)
C-Reactive Protein and Erythrocyte Sedimentation Rate (ESR)


The leading cause of death in RA
Coronary Artery Disease


Felty's Syndrome
A triad of seropositive rheumatoid arthritis, splenomegaly, neutropenia

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