NR 283 Exam 2 Concept Review / NR283 Pathophysiology Exam 2 Study Guide (Latest):
Pathophysiology: Chamberlain
NR 283 Concept Review Exam 2
Summer 2016 Session B
**Please be sure to study etiology, clinical manifestations and complications, pathophysiology of the
following topics:
Immunology : The Immune system seeks out invaders that attack our bodies constantly
The Immune system must be able to
Recognize
Respond and
Remember the invader.
Immunity means you have protection, but before that you must have been attack by the virus to be
immune to it. E.g chicken pox, when someone is exposed to chicken pox virus for the first time, after a
couple of days the signs will appear (rash on skin) while the immune system is busy fighting it off. After
the person gets better the virus the immune system has the ability to create the memory cells which
carries the memory of the chicken pox virus forever. That’s why people that previously had chicken pox
rarely get it for the second time. Another example is through vaccination, when we get vaccinated our
immune system thinks we already have the virus and builds a line of defense through the memory cells.
Memory cells allow Instant recognition to invaders and immediate response to those threats.
Transfer factors are memory molecule which educates our immune system the ability to respond
immediately because it recognize threats through those memory cells which act like “wanted posters”
3 specific lines of defense
Innate immunity (also known as natural or native immunity) is the first line of defense in the
body. It is in place at birth to prevent damages from things in the environment. Innate immunity
is comprised of physical and chemical barriers
, Physical barriers include your skin and the cells that you have lining your GI tract and
esophagus
Chemical barriers include things like mucus, tears, saliva, and the normal flora that lives in
our gut and colon
If the natural barriers are breached, the second line of defense is the
Inflammatory response which will cause a rapid activation of many chemical
and cellular mechanisms. Inflammation is usually the first response to any type
of injury. The inflammatory response will protect the body from further injury,
prevent infection of the injured tissue, and promote healing.
Microscopic changes occur within seconds of the injury and include:
Vasodilation
Increased vascular permeability
Adherence of WBC’s to the site of injury
Manifestations of the inflammatory response include:
Redness
Heat
Swelling
Pain
Loss of function
The third line of defense is adaptive immunity (acquired or specific immunity). This defense
is typically slower and targets specific microorganisms for destruction. Adaptive immunity
also has a memory, so that the next time the body is attacked by the same microorganism, the
response will be more rapid.
This is where antigens and antibodies come into play
Antigens are either foreign substances or they can be normally found on the surface of human cells.
Their main job is to activate the immune system to produce matching antibodies
Antibodies are specific proteins that are produced in response to bind with an antigen
,Antibodies are also known as Immunoglobulins, of which there are 5 different types
The most common antibody that forms in the blood is IgG
Antibodies bind to the antigen and destroy it
B Cells and T Cells An important difference between T-cells and B-cells is that B-cells can connect to
antigens right on the surface of the invading virus or bacteria. This is different from T-cells, which can
only connect to virus antigens on the outside of infected cells.
Titer- checking for immunity
Lab Values for Immune System
Hypersentivities-is an altered or inappropriate immunologic response to an antigen that results in disease
or damage to the individual (this is the actual response to the immune deficiency)
3 types of Hypersentivity
An allergy – which is a hypersensitivity to an environmental antigen, such as medicines, natural
products (pollen, bee stings, mold), or infectious agents
An Autoimmunity – which is a problem with the body’s ability to tolerate or recognize its own
antigens (or self-antigens). Autoimmune diseases occur when the body reacts to the self-antigens
causing the autoantibodies to damage tissue
Alloimmunity – occurs when the immune system of one person produces an immunologic
reaction against tissues of another person. This can be seen in reactions from transplanted tissue
or in the fetus during pregnancy
4 specific mechanism of Hypersentivity
Type 1: is IgE mediated, these are most commonly related to reactions against environmental antigens
and are therefore allergic
Most type 1 reactions are referred to as allergies
, The key with Type 1 reactions is the release of histamine, which causes bronchial constriction,
vasodilation, and edema
Manifestations include itching, urticaria or hives, rhinitis, hypotension, dysrhythmias, and GI
cramps (if the allergen is food related)
Type 2 is Tissue Specific- is cytotoxic ( E.G blood transfusion, grave disease)These are reactions
against a specific cell or tissue
o The circulating antibodies react to the antigen on the tissue and cause the cells to be
destroyed
o This would be seen if you give the wrong blood to someone (for example, you give B-
blood to someone who is A+. The person with a blood has anti-B antibodies in their
blood. So if you mismatch them and give them B blood instead, their body will sense
that and destroy those B type blood cells)
Type 3 is Immune complex mediated: In this type, the antigen forms with the antibody forming a
complex, which then gets deposited in the tissue or blood vessel walls
This process leads to inflammation and tissue destruction
Diseases associated with this include rheumatoid arthritis or Raynaud’s, Lupus
Type 4 is Cell mediated: This response is not related to antibodies but is a delayed response by a
specific type of lymphocyte to an antigen causing the release of enzymes and the destruction of tissue
o This is seen with graft rejections or contact allergen reactions such as the PPD-Tb skin
test or poison ivy (contact dermatitis)
Inflammatory: We have many cells and chemicals in our body that are associated with the second line
of defense, our inflammatory response
Pathophysiology: Chamberlain
NR 283 Concept Review Exam 2
Summer 2016 Session B
**Please be sure to study etiology, clinical manifestations and complications, pathophysiology of the
following topics:
Immunology : The Immune system seeks out invaders that attack our bodies constantly
The Immune system must be able to
Recognize
Respond and
Remember the invader.
Immunity means you have protection, but before that you must have been attack by the virus to be
immune to it. E.g chicken pox, when someone is exposed to chicken pox virus for the first time, after a
couple of days the signs will appear (rash on skin) while the immune system is busy fighting it off. After
the person gets better the virus the immune system has the ability to create the memory cells which
carries the memory of the chicken pox virus forever. That’s why people that previously had chicken pox
rarely get it for the second time. Another example is through vaccination, when we get vaccinated our
immune system thinks we already have the virus and builds a line of defense through the memory cells.
Memory cells allow Instant recognition to invaders and immediate response to those threats.
Transfer factors are memory molecule which educates our immune system the ability to respond
immediately because it recognize threats through those memory cells which act like “wanted posters”
3 specific lines of defense
Innate immunity (also known as natural or native immunity) is the first line of defense in the
body. It is in place at birth to prevent damages from things in the environment. Innate immunity
is comprised of physical and chemical barriers
, Physical barriers include your skin and the cells that you have lining your GI tract and
esophagus
Chemical barriers include things like mucus, tears, saliva, and the normal flora that lives in
our gut and colon
If the natural barriers are breached, the second line of defense is the
Inflammatory response which will cause a rapid activation of many chemical
and cellular mechanisms. Inflammation is usually the first response to any type
of injury. The inflammatory response will protect the body from further injury,
prevent infection of the injured tissue, and promote healing.
Microscopic changes occur within seconds of the injury and include:
Vasodilation
Increased vascular permeability
Adherence of WBC’s to the site of injury
Manifestations of the inflammatory response include:
Redness
Heat
Swelling
Pain
Loss of function
The third line of defense is adaptive immunity (acquired or specific immunity). This defense
is typically slower and targets specific microorganisms for destruction. Adaptive immunity
also has a memory, so that the next time the body is attacked by the same microorganism, the
response will be more rapid.
This is where antigens and antibodies come into play
Antigens are either foreign substances or they can be normally found on the surface of human cells.
Their main job is to activate the immune system to produce matching antibodies
Antibodies are specific proteins that are produced in response to bind with an antigen
,Antibodies are also known as Immunoglobulins, of which there are 5 different types
The most common antibody that forms in the blood is IgG
Antibodies bind to the antigen and destroy it
B Cells and T Cells An important difference between T-cells and B-cells is that B-cells can connect to
antigens right on the surface of the invading virus or bacteria. This is different from T-cells, which can
only connect to virus antigens on the outside of infected cells.
Titer- checking for immunity
Lab Values for Immune System
Hypersentivities-is an altered or inappropriate immunologic response to an antigen that results in disease
or damage to the individual (this is the actual response to the immune deficiency)
3 types of Hypersentivity
An allergy – which is a hypersensitivity to an environmental antigen, such as medicines, natural
products (pollen, bee stings, mold), or infectious agents
An Autoimmunity – which is a problem with the body’s ability to tolerate or recognize its own
antigens (or self-antigens). Autoimmune diseases occur when the body reacts to the self-antigens
causing the autoantibodies to damage tissue
Alloimmunity – occurs when the immune system of one person produces an immunologic
reaction against tissues of another person. This can be seen in reactions from transplanted tissue
or in the fetus during pregnancy
4 specific mechanism of Hypersentivity
Type 1: is IgE mediated, these are most commonly related to reactions against environmental antigens
and are therefore allergic
Most type 1 reactions are referred to as allergies
, The key with Type 1 reactions is the release of histamine, which causes bronchial constriction,
vasodilation, and edema
Manifestations include itching, urticaria or hives, rhinitis, hypotension, dysrhythmias, and GI
cramps (if the allergen is food related)
Type 2 is Tissue Specific- is cytotoxic ( E.G blood transfusion, grave disease)These are reactions
against a specific cell or tissue
o The circulating antibodies react to the antigen on the tissue and cause the cells to be
destroyed
o This would be seen if you give the wrong blood to someone (for example, you give B-
blood to someone who is A+. The person with a blood has anti-B antibodies in their
blood. So if you mismatch them and give them B blood instead, their body will sense
that and destroy those B type blood cells)
Type 3 is Immune complex mediated: In this type, the antigen forms with the antibody forming a
complex, which then gets deposited in the tissue or blood vessel walls
This process leads to inflammation and tissue destruction
Diseases associated with this include rheumatoid arthritis or Raynaud’s, Lupus
Type 4 is Cell mediated: This response is not related to antibodies but is a delayed response by a
specific type of lymphocyte to an antigen causing the release of enzymes and the destruction of tissue
o This is seen with graft rejections or contact allergen reactions such as the PPD-Tb skin
test or poison ivy (contact dermatitis)
Inflammatory: We have many cells and chemicals in our body that are associated with the second line
of defense, our inflammatory response
