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
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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
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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.