Chamberlain University
NR 507 / NR507
Bundle Weeks 1 to 4 Notes
Advanced Pathophysiology
,TABLE OFCONTENTS
/ /
Week/1/–
Immune/Response/&/Hypersensitivity/ Week/
/
2/ –
Hematologic/Disorders/&/Anemias/ Week/3/–
/
Obstructive/&/Restrictive/Lung/Diseases/ We
/
ek/4/–/Urinary/System/Pathologies/&/UTIs
, lOMoAR
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cPSD| 516
Week/1:/Immune/Response
Type/I:/Allergic/Reaction
On/initial/encounter/with/an/allergen,/the/individual/will/first/produce/IgE/antibodies./After/the/ allergen/is/cleared,/t
he/remaining/IgE/molecules/will/be/bound/by/mast/cells,/basophils,/and/ eosinophils/that/contain/receptors/for/the/
IgE/molecules./This/process/is/referred/to/as/ sensitization./On/subsequent/exposure/to/the/allergen,/the/IgE/mole
cules/located/on/the/ sensitized/cells/induces/their/immediate/degranulation./This/causes/the/release/of/inflammat
ory/ mediators/such/as/histamine,/leukotrienes,/and/prostaglandins/that/results/in/vasodilation,/ bronchial/smooth/
muscle/contraction,/and/mucus/production./Type/I/hypersensitivity/reactions/can/be/local/or/systemic./Systemic/re
actions/can/result/in/anaphylaxis,/a/potentially/life-
/ threatening/condition./Allergic/asthma/is/an/example/of/a/Type/I/hypersensitivity/reaction./On/exposure/to/certain/
allergens/(typically/inhaled),/individuals/with/allergic/asthma/experience/ inflammation/of/the/airways,/characteriz
ed/by/tissue/swelling/and/excessive/mucus/production./ This/narrowing/of/the/airways/makes/it/difficult/to/breathe.
Type/II/Hypersensitivity/Reaction
A/Type/II/hypersensitivity/reaction/is/tissue-
specific/and/usually/occurs/as/a/result/of/haptens/that/ cause/an/IgG/antibody/or/IgM/antibody/mediated/response.
/The/antibodies/are/specifically/ directed/to/the/antigen/located/on/the/cell/membrane./A/hapten/is/a/small/molecul
e/that/can/ cause/an/immune/response/when/it/attaches/to/a/protein./Macrophages/are/the/primary/effector/ cells/
of/Type/II/responses./Typical/examples/of/Type/II/reactions/are/drug/allergies,/as/well/as/allergies/against/infectiou
s/agents./The/Type/II/response/begins/with/the/antibody/binding/to/the/antigen/and/may/cause/the/following.
- The/cell/to/be/destroyed/by/the/antibody
- Cell/destruction/through/phagocytosis/by/macrophages
- Damage/to/the/cell/by/neutrophils/triggering/phagocytosis
- Natural/killer/cells/to/release/toxic/substances/that/destroy/the/target/cell
- Malfunction/of/the/cell/without/destruction
- Examples/of/type/II/reactions/include/drug/allergies,/hemolytic/anemia,/blood/transfusion/ mismatch/with/
resulting/transfusion/reaction/and/Rh/hemolytic/disease.
Type/III/Immune-Complex/Reaction
The/Type/III/hypersensitivity/reaction/is/also/an/antigen-
antibody/response./The/major/difference/between/Type/II/and/Type/III/responses/is/that/in/a/Type/II/response,/the/
antibody/binds/to/the/antigen/on/the/cell/surface,/but/in/Type/III/responses,/the/antibody/binds/to/the/antigen/in/the/
blood/or/body/fluids/and/then/circulates/to/the/tissue./Type/III/reactions/are/not/organ/specific/and/use/neutrophils/a
s/the/primary/effector/cell./In/type/III/hypersensitivity/reactions/immune-
/ complex/deposition/(ICD)/causes/autoimmune/diseases,/which/is/often/a/complication./As/the/ disease/progress
es/a/more/accumulation/of/immune-
complexes/occurs,/and/when/the/body/ becomes/overloaded/the/complexes/are/deposited/in/the/tissues/and/caus
e/inflammation/as/the/ mononuclear/phagocytes,/erythrocytes,/and/complement/system/fail/to/remove/immune/ co
mplexes/from/the/blood./One/of/the/classic/Type/III/reactions/is/serum/sickness.
Type/IV/Cell-Mediated,/Delayed/Reaction
Type/IV/hypersensitivity/reactions/are/known/as/cell-
mediated/responses/and/use/lymphocytes/and/macrophages/as/primary/mediators./Unlike/the/first/three/types/of/
responses,/which/are/ humoral/immune/functions,/a/Type/IV/response/is/mediated/by/T-
lymphocytes/and/does/not/use/antibodies./A/typical/reaction/from/a/Type/IV/cell-
mediated/response/would/be/a/localized/contact
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dermatitis./When/the/individual/comes/in/contact/with/the/antigen,/T-
cells/are/activated/and/ move/to/the/area/of/the/antigen./The/antigen/is/taken/up,/processed,/and/presented/to/ ma
crophages,/leading/to/epidermal/reactions/characterized/by/erythema,/cellular/infiltration/and/ vesicles.
Type Mechanism Example Pathology
Tissue-
specific/ destruction/or/impair
ment/ because/of:
Antibody/binding/followed/ by/l
ysis/via/complement
Antibody/binding/followed/ by/ 1-
1-ABO
Type/ macrophage/ phagocytosis incompatibility
Complement/damages/RBC/membrane/and/ cells/lys
II Antibody/binding/followed/ by/ e
5-Graves'/disease
neutrophil/destruction 5-
Autoantibodies/specific/for/thyroid/tissue/impair/ receptor/f
Antibody- or/TSH
dependent/cell/ (NK)-
mediated/ cytotoxicity,/or
Antireceptor/antibodies
Type/ Contact/dermatitis/ (e
Cytotoxic/T/cell-mediated T/cells/attack/tissue/directly/(no/antibody)
IV .g.,/poison/ivy)
Type/ Mast/cell/degranulation/results/in/an/ infla
IgE/action/on/mast/cells Hay/fever
I mmatory/response
Complex/deposited/in/small/peripheral/vessels/in/ cool/te
Type/ Antigen- Raynaud’s/ ph
mperatures/leading/to/vasoconstriction/ and/blocked/circu
III Antibody/complex/ deposited/in enomenon
lation
/tissues
Hives
Hives/(urticaria)/are/an/example/of/a:
- Type/1/hypersensitivity/reaction.
- Type/2/hypersensitivity/reaction.
- Type/3/hypersensitivity/reaction.
- Type/4/hypersensitivity/reaction.
Anaphylaxis/is/a/type/1/hypersensitivity/reaction.
Immune/System
Which/of/the/following/are/considered/the/“first/responders”/of/the/innate/immune/system?
- Eosinophils.
- IgM.
Downloaded/by/Benjamin/Luca/()
NR 507 / NR507
Bundle Weeks 1 to 4 Notes
Advanced Pathophysiology
,TABLE OFCONTENTS
/ /
Week/1/–
Immune/Response/&/Hypersensitivity/ Week/
/
2/ –
Hematologic/Disorders/&/Anemias/ Week/3/–
/
Obstructive/&/Restrictive/Lung/Diseases/ We
/
ek/4/–/Urinary/System/Pathologies/&/UTIs
, lOMoAR
48332
//
cPSD| 516
Week/1:/Immune/Response
Type/I:/Allergic/Reaction
On/initial/encounter/with/an/allergen,/the/individual/will/first/produce/IgE/antibodies./After/the/ allergen/is/cleared,/t
he/remaining/IgE/molecules/will/be/bound/by/mast/cells,/basophils,/and/ eosinophils/that/contain/receptors/for/the/
IgE/molecules./This/process/is/referred/to/as/ sensitization./On/subsequent/exposure/to/the/allergen,/the/IgE/mole
cules/located/on/the/ sensitized/cells/induces/their/immediate/degranulation./This/causes/the/release/of/inflammat
ory/ mediators/such/as/histamine,/leukotrienes,/and/prostaglandins/that/results/in/vasodilation,/ bronchial/smooth/
muscle/contraction,/and/mucus/production./Type/I/hypersensitivity/reactions/can/be/local/or/systemic./Systemic/re
actions/can/result/in/anaphylaxis,/a/potentially/life-
/ threatening/condition./Allergic/asthma/is/an/example/of/a/Type/I/hypersensitivity/reaction./On/exposure/to/certain/
allergens/(typically/inhaled),/individuals/with/allergic/asthma/experience/ inflammation/of/the/airways,/characteriz
ed/by/tissue/swelling/and/excessive/mucus/production./ This/narrowing/of/the/airways/makes/it/difficult/to/breathe.
Type/II/Hypersensitivity/Reaction
A/Type/II/hypersensitivity/reaction/is/tissue-
specific/and/usually/occurs/as/a/result/of/haptens/that/ cause/an/IgG/antibody/or/IgM/antibody/mediated/response.
/The/antibodies/are/specifically/ directed/to/the/antigen/located/on/the/cell/membrane./A/hapten/is/a/small/molecul
e/that/can/ cause/an/immune/response/when/it/attaches/to/a/protein./Macrophages/are/the/primary/effector/ cells/
of/Type/II/responses./Typical/examples/of/Type/II/reactions/are/drug/allergies,/as/well/as/allergies/against/infectiou
s/agents./The/Type/II/response/begins/with/the/antibody/binding/to/the/antigen/and/may/cause/the/following.
- The/cell/to/be/destroyed/by/the/antibody
- Cell/destruction/through/phagocytosis/by/macrophages
- Damage/to/the/cell/by/neutrophils/triggering/phagocytosis
- Natural/killer/cells/to/release/toxic/substances/that/destroy/the/target/cell
- Malfunction/of/the/cell/without/destruction
- Examples/of/type/II/reactions/include/drug/allergies,/hemolytic/anemia,/blood/transfusion/ mismatch/with/
resulting/transfusion/reaction/and/Rh/hemolytic/disease.
Type/III/Immune-Complex/Reaction
The/Type/III/hypersensitivity/reaction/is/also/an/antigen-
antibody/response./The/major/difference/between/Type/II/and/Type/III/responses/is/that/in/a/Type/II/response,/the/
antibody/binds/to/the/antigen/on/the/cell/surface,/but/in/Type/III/responses,/the/antibody/binds/to/the/antigen/in/the/
blood/or/body/fluids/and/then/circulates/to/the/tissue./Type/III/reactions/are/not/organ/specific/and/use/neutrophils/a
s/the/primary/effector/cell./In/type/III/hypersensitivity/reactions/immune-
/ complex/deposition/(ICD)/causes/autoimmune/diseases,/which/is/often/a/complication./As/the/ disease/progress
es/a/more/accumulation/of/immune-
complexes/occurs,/and/when/the/body/ becomes/overloaded/the/complexes/are/deposited/in/the/tissues/and/caus
e/inflammation/as/the/ mononuclear/phagocytes,/erythrocytes,/and/complement/system/fail/to/remove/immune/ co
mplexes/from/the/blood./One/of/the/classic/Type/III/reactions/is/serum/sickness.
Type/IV/Cell-Mediated,/Delayed/Reaction
Type/IV/hypersensitivity/reactions/are/known/as/cell-
mediated/responses/and/use/lymphocytes/and/macrophages/as/primary/mediators./Unlike/the/first/three/types/of/
responses,/which/are/ humoral/immune/functions,/a/Type/IV/response/is/mediated/by/T-
lymphocytes/and/does/not/use/antibodies./A/typical/reaction/from/a/Type/IV/cell-
mediated/response/would/be/a/localized/contact
Downloaded/by/Benjamin/Luca/()
, lOMoAR
48332
//
cPSD| 516
dermatitis./When/the/individual/comes/in/contact/with/the/antigen,/T-
cells/are/activated/and/ move/to/the/area/of/the/antigen./The/antigen/is/taken/up,/processed,/and/presented/to/ ma
crophages,/leading/to/epidermal/reactions/characterized/by/erythema,/cellular/infiltration/and/ vesicles.
Type Mechanism Example Pathology
Tissue-
specific/ destruction/or/impair
ment/ because/of:
Antibody/binding/followed/ by/l
ysis/via/complement
Antibody/binding/followed/ by/ 1-
1-ABO
Type/ macrophage/ phagocytosis incompatibility
Complement/damages/RBC/membrane/and/ cells/lys
II Antibody/binding/followed/ by/ e
5-Graves'/disease
neutrophil/destruction 5-
Autoantibodies/specific/for/thyroid/tissue/impair/ receptor/f
Antibody- or/TSH
dependent/cell/ (NK)-
mediated/ cytotoxicity,/or
Antireceptor/antibodies
Type/ Contact/dermatitis/ (e
Cytotoxic/T/cell-mediated T/cells/attack/tissue/directly/(no/antibody)
IV .g.,/poison/ivy)
Type/ Mast/cell/degranulation/results/in/an/ infla
IgE/action/on/mast/cells Hay/fever
I mmatory/response
Complex/deposited/in/small/peripheral/vessels/in/ cool/te
Type/ Antigen- Raynaud’s/ ph
mperatures/leading/to/vasoconstriction/ and/blocked/circu
III Antibody/complex/ deposited/in enomenon
lation
/tissues
Hives
Hives/(urticaria)/are/an/example/of/a:
- Type/1/hypersensitivity/reaction.
- Type/2/hypersensitivity/reaction.
- Type/3/hypersensitivity/reaction.
- Type/4/hypersensitivity/reaction.
Anaphylaxis/is/a/type/1/hypersensitivity/reaction.
Immune/System
Which/of/the/following/are/considered/the/“first/responders”/of/the/innate/immune/system?
- Eosinophils.
- IgM.
Downloaded/by/Benjamin/Luca/()
