White Blood Cells and Immunity Quiz
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Questions and Answers

What is the primary role of TH1 helper T cells in Type IV hypersensitivity reactions?

  • They inhibit other immune cells.
  • They produce antibodies.
  • They recruit phagocytes to tissues. (correct)
  • They directly destroy pathogens.
  • Which type of immune deficiency is characterized by inborn genetic defects and presents early in life?

  • Cytokine deficiency
  • Primary immune deficiency (correct)
  • Secondary immune deficiency
  • Acquired immune deficiency
  • What distinguishes severe combined immunodeficiency (SCID) from other primary immune deficiencies?

  • No B-cell function
  • Total lack of T-cell function (correct)
  • Presence of antibodies
  • Partial T-cell function
  • What is the most common primary immune deficiency?

    <p>IgA deficiency</p> Signup and view all the answers

    Which of the following best describes allergic contact dermatitis?

    <p>A delayed reaction to an irritant.</p> Signup and view all the answers

    What is the primary function of phagocytosis in the immune response?

    <p>To directly attack and destroy pathogens</p> Signup and view all the answers

    Which immunoglobulin is primarily involved in type I hypersensitivity reactions?

    <p>IgE</p> Signup and view all the answers

    What is the first line of defense in the immune response?

    <p>Physical and chemical barriers</p> Signup and view all the answers

    Which T cell type is crucial for cell-mediated immunity?

    <p>Cytotoxic T cells</p> Signup and view all the answers

    How does healing occur in the context of wound healing?

    <p>Wound healing builds up layers of tissue before skin heals</p> Signup and view all the answers

    Which type of hypersensitivity reaction is often immediate and can lead to anaphylactic shock?

    <p>Type I hypersensitivity</p> Signup and view all the answers

    What characteristic differentiates gram-positive bacteria from gram-negative bacteria?

    <p>Thickness of peptidoglycan layer</p> Signup and view all the answers

    What is a common consequence of a type I hypersensitivity reaction?

    <p>Vasodilation and decreased blood pressure</p> Signup and view all the answers

    What is the primary role of neutrophils in the immune response?

    <p>First responders to bacterial infections</p> Signup and view all the answers

    What distinguishes humoral immunity from cell-mediated immunity?

    <p>Involves production of antibodies by B cells</p> Signup and view all the answers

    Which of the following is NOT a component of the first line of defense?

    <p>Phagocytosis by macrophages</p> Signup and view all the answers

    What is a key characteristic of cell-mediated immunity?

    <p>Activation of cytotoxic T lymphocytes</p> Signup and view all the answers

    Which statement about passive immunity is correct?

    <p>It involves direct transfer of antibodies from another source.</p> Signup and view all the answers

    Which type of wound healing involves edges that can be pulled together?

    <p>Primary intention</p> Signup and view all the answers

    What role do mast cells play in the immune response?

    <p>Link innate and adaptive immunity</p> Signup and view all the answers

    Which is a component of the body's second line of defense?

    <p>Inflammatory response</p> Signup and view all the answers

    Which immune cells perform phagocytosis in tissues after differentiating from monocytes?

    <p>Macrophages</p> Signup and view all the answers

    What is a characteristic of wounds healing by secondary intention?

    <p>Do not have edges that can be pulled together</p> Signup and view all the answers

    What causes the exaggerated immune response during a Type IV hypersensitivity reaction upon second exposure?

    <p>Activation of memory T cells</p> Signup and view all the answers

    Which of the following best describes primary immune deficiencies?

    <p>Genetically linked inborn defects present early in life</p> Signup and view all the answers

    Which condition is characterized by a significant lack of both T-cell and B-cell function?

    <p>Severe combined immunodeficiency (SCID)</p> Signup and view all the answers

    What typical feature is associated with allergic contact dermatitis?

    <p>Delayed reaction occurring after initial contact</p> Signup and view all the answers

    Which of the following best describes secondary immune deficiencies?

    <p>Acquired due to diseases, infections, or nutritional deficiencies</p> Signup and view all the answers

    What type of hypersensitivity reaction is primarily mediated by IgE?

    <p>Type I hypersensitivity</p> Signup and view all the answers

    Which type of infection is associated with opportunistic pathogens like candida albicans?

    <p>Yeast infection</p> Signup and view all the answers

    Which event occurs following the degranulation of mast cells during an anaphylactic reaction?

    <p>Swelling and redness</p> Signup and view all the answers

    What defines a gram-positive bacterium?

    <p>Presence of a thick peptidoglycan layer</p> Signup and view all the answers

    What type of viral infection is commonly associated with antibiotic use and immunocompromised individuals?

    <p>Viral infection</p> Signup and view all the answers

    The recruitment of eosinophils during a Type I hypersensitivity reaction leads to which response?

    <p>Epithelial damage and inflammation</p> Signup and view all the answers

    What is the initial response time for an immediate reaction in a Type I hypersensitivity event?

    <p>5-30 minutes</p> Signup and view all the answers

    Which component primarily contributes to the inflammatory response during a Type I hypersensitivity reaction?

    <p>Histamine</p> Signup and view all the answers

    What is a characteristic of Type II hypersensitivity reactions?

    <p>They target specific cells or tissues.</p> Signup and view all the answers

    Which condition is associated with antibodies attacking the basement membrane of cells?

    <p>Goodpasture's syndrome</p> Signup and view all the answers

    What results from a hemolytic transfusion reaction?

    <p>Destruction of donor red blood cells</p> Signup and view all the answers

    What triggers muscle weakness in Myasthenia Gravis?

    <p>Blockage of acetylcholine receptors</p> Signup and view all the answers

    What characterizes Type III hypersensitivity reactions?

    <p>Formation of immune complexes deposited in tissues</p> Signup and view all the answers

    What initiates the immune response in systemic lupus erythematosus?

    <p>Autoantibodies and self-antigen immune complexes</p> Signup and view all the answers

    Raynaud's disease is characterized as what type of condition?

    <p>A primary disease or secondary syndrome</p> Signup and view all the answers

    Which factor is NOT a common risk associated with Goodpasture's syndrome?

    <p>Increased production of antibodies against red blood cells</p> Signup and view all the answers

    Which of the following immune cells is primarily involved in fighting parasites and allergic reactions?

    <p>Eosinophils</p> Signup and view all the answers

    What is the main function of B cells in humoral immunity?

    <p>Production of antibodies</p> Signup and view all the answers

    In which line of defense does the inflammatory response occur?

    <p>Second line of defense</p> Signup and view all the answers

    What differentiates primary intention from secondary intention in wound healing?

    <p>Primary intention facilitates sutures or glue</p> Signup and view all the answers

    Which of the following describes passive immunity?

    <p>It is received from another source, like breast milk</p> Signup and view all the answers

    Which cell type is involved in both innate and adaptive immunity due to its role in linking the two?

    <p>Mast cells</p> Signup and view all the answers

    What key role do cytokines play in the immune response?

    <p>They facilitate communication between immune cells</p> Signup and view all the answers

    Which of the following is a characteristic of cell-mediated immunity?

    <p>Utilizes antigen-specific cytotoxic T lymphocytes</p> Signup and view all the answers

    What component of innate immunity serves as the first physical barrier to pathogens?

    <p>Mucous membranes</p> Signup and view all the answers

    Which immune cell type is most abundant and acts as the first responder to bacterial infections?

    <p>Neutrophils</p> Signup and view all the answers

    What is a hallmark symptom of pleural effusion?

    <p>Pain on inspiration</p> Signup and view all the answers

    Which type of pleural effusion is characterized by cloudy fluid with high protein content?

    <p>Exudative</p> Signup and view all the answers

    What can cause a transudative pleural effusion?

    <p>Congestive heart failure</p> Signup and view all the answers

    Which step does a blood clot typically take on its way to becoming a pulmonary embolism?

    <p>Moves from the inferior vena cava to the right atrium</p> Signup and view all the answers

    What is a common symptom associated with both pleural effusion and pulmonary embolism?

    <p>Cough</p> Signup and view all the answers

    What is a hallmark symptom of tension pneumothorax?

    <p>Heart and trachea shift towards the undamaged side</p> Signup and view all the answers

    Which risk factor is not associated with spontaneous pneumothorax?

    <p>Obesity</p> Signup and view all the answers

    What is a primary cause of cardiogenic pulmonary edema?

    <p>High pulmonary venous pressure</p> Signup and view all the answers

    Which condition is associated with the collapse of lung tissue due to plugged alveoli?

    <p>Atelectasis</p> Signup and view all the answers

    Which symptom is considered the hallmark of pulmonary edema?

    <p>Feeling of suffocating, drowning</p> Signup and view all the answers

    What occurs during flail chest due to multiple rib fractures?

    <p>Paradoxical movement of the chest wall</p> Signup and view all the answers

    What is the main consequence of trapped air in the thoracic cavity during a tension pneumothorax?

    <p>Compression of the lungs</p> Signup and view all the answers

    Which symptom is commonly associated with both pneumothorax and atelectasis?

    <p>Cyanosis</p> Signup and view all the answers

    Which factor contributes to non-cardiogenic pulmonary edema?

    <p>Injury or inflammation of lung tissue</p> Signup and view all the answers

    What is the main consequence of lymph blockage concerning fluid dynamics in the lungs?

    <p>Prevention of reabsorption of net filtration</p> Signup and view all the answers

    Which of the following risk factors is NOT associated with pneumonia?

    <p>Living in high-rate areas</p> Signup and view all the answers

    What is the hallmark symptom of pneumonia?

    <p>Productive cough</p> Signup and view all the answers

    Which feature of tuberculosis makes it particularly difficult to treat?

    <p>Resistance to most anti-bacterial medications</p> Signup and view all the answers

    What type of pneumonia affects patches throughout both lungs?

    <p>Bronchial pneumonia</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with tuberculosis?

    <p>Productive cough</p> Signup and view all the answers

    Which phase of Acute Respiratory Distress involves the resolution of pulmonary edema?

    <p>Proliferative phase</p> Signup and view all the answers

    What is a common characteristic of chronic bronchitis?

    <p>Chronic productive cough for over 3 years</p> Signup and view all the answers

    What is a primary trigger for asthma episodes?

    <p>Air pollution</p> Signup and view all the answers

    What underlying change leads to the symptoms of emphysema?

    <p>Loss of lung elasticity</p> Signup and view all the answers

    Which of the following is a symptom of pulmonary artery hypertension?

    <p>Severe right to left shunting</p> Signup and view all the answers

    Which characteristic best describes asthma's pathophysiology?

    <p>Impaired mucociliary function</p> Signup and view all the answers

    What is a common risk factor for chronic obstructive pulmonary disorder (COPD)?

    <p>Genetic abnormalities</p> Signup and view all the answers

    Which symptom is most associated with the exudative phase of Acute Respiratory Distress?

    <p>Pulmonary edema</p> Signup and view all the answers

    What pathophysiological process occurs in acute respiratory distress syndrome (ARDS)?

    <p>Membrane integrity loss</p> Signup and view all the answers

    Which factor does NOT contribute to pulmonary artery hypertension?

    <p>Decreased airway resistance</p> Signup and view all the answers

    What primarily causes non-cardiogenic pulmonary edema?

    <p>Increased capillary permeability</p> Signup and view all the answers

    Which of the following is considered a hallmark symptom of pulmonary edema?

    <p>Feeling of suffocating or drowning</p> Signup and view all the answers

    What occurs during flail chest when the fractured section of the rib cage moves abnormally?

    <p>It collapses inward during inspiration</p> Signup and view all the answers

    What is a common cause of pneumothorax?

    <p>Trauma causing disruption of the pleura</p> Signup and view all the answers

    Which symptom might a patient experience if they have pulmonary edema?

    <p>Dyspnea on exertion</p> Signup and view all the answers

    What is a hallmark symptom of pleural effusion?

    <p>Pain on inspiration</p> Signup and view all the answers

    What type of pleural effusion is characterized by cloudy fluid and high protein content?

    <p>Exudative</p> Signup and view all the answers

    What causes transudative pleural effusion?

    <p>Congestive heart failure</p> Signup and view all the answers

    Which condition involves a collection of pus in the pleural space?

    <p>Empyema</p> Signup and view all the answers

    What is the definition of an embolism in the context of pulmonary circulation?

    <p>A freed blood clot that lodges in pulmonary vasculature</p> Signup and view all the answers

    What is a hallmark symptom of tension pneumothorax?

    <p>Tracheal deviation towards the undamaged side</p> Signup and view all the answers

    Which of the following conditions is classified as a secondary spontaneous pneumothorax?

    <p>COPD</p> Signup and view all the answers

    What is a common risk factor for developing a traumatic pneumothorax?

    <p>Central line insertion</p> Signup and view all the answers

    What occurs when air becomes trapped in the thoracic cavity due to tension pneumothorax?

    <p>Reduction of lung volume</p> Signup and view all the answers

    What is the primary cause of atelectasis?

    <p>Obstructed airway or lung tissue disease</p> Signup and view all the answers

    What is the hallmark symptom of pneumonia?

    <p>Productive cough</p> Signup and view all the answers

    Which risk factor significantly increases the likelihood of developing pneumonia?

    <p>Age over 65</p> Signup and view all the answers

    What is a common characteristic of tuberculosis?

    <p>It leads to tubercle formation in the lungs.</p> Signup and view all the answers

    Which type of pneumonia affects one or more whole sections of the lungs?

    <p>Lobar pneumonia</p> Signup and view all the answers

    What is a major risk factor for tuberculosis?

    <p>IV drug use</p> Signup and view all the answers

    What is the primary feature of the exudative phase of acute respiratory distress?

    <p>Increased capillary membrane permeability</p> Signup and view all the answers

    Which condition is characterized by chronic productive cough and increased sputum production for over 3 years?

    <p>Chronic bronchitis</p> Signup and view all the answers

    Which of the following triggers is NOT associated with asthma?

    <p>Breathing in toxins</p> Signup and view all the answers

    What is a common symptom of emphysema?

    <p>Pursed lip breathing</p> Signup and view all the answers

    What is indicated by refractory hypoxemia in acute respiratory distress?

    <p>Ventilation-perfusion mismatch</p> Signup and view all the answers

    What is the consequence of bronchial hyperresponsiveness in asthma?

    <p>Airway obstruction</p> Signup and view all the answers

    What physiological change occurs during the fibrotic phase of acute respiratory distress?

    <p>Alveolar destruction</p> Signup and view all the answers

    Which risk factor is commonly associated with chronic obstructive pulmonary disorder (COPD)?

    <p>Severe childhood respiratory infection</p> Signup and view all the answers

    What is the function of IL-4 and IL-5 in asthma pathophysiology?

    <p>Stimulation of IgE production</p> Signup and view all the answers

    What effect does decreased pulmonary vasodilators have on pulmonary artery hypertension?

    <p>Increased pulmonary artery pressure</p> Signup and view all the answers

    Study Notes

    White Blood Cells and Immunity

    • Neutrophils are the most abundant immune cells, acting as first responders to bacterial infections. They engulf and destroy bacteria through phagocytosis.
    • Lymphocytes include T cells (including cytotoxic T cells and helper T cells), B cells, and natural killer cells.
      • T cells play a crucial role in cell-mediated immunity, directly attacking infected cells.
      • B cells produce antibodies, which are essential for humoral immunity.
      • Natural killer cells are part of the innate immune system and kill cancerous cells and virus-infected cells.
    • Monocytes circulate in the blood and differentiate into macrophages in tissues, where they also perform phagocytosis.
    • Eosinophils have granules containing enzymes that target parasites and bacteria, also playing a role in allergic reactions.
    • Mast cells reside in connective tissues and mucous membranes. They are involved in wound healing and microbial defense, but also contribute to allergic reactions. They contain granules with histamine and heparin, which are released during allergic reactions.

    Lines of Defense in Immunity

    • First line of defense acts as a barrier to prevent pathogens from entering the body.
      • Physical and mechanical barriers include mucous membranes, skin, and mechanical actions like coughing, sneezing, and vomiting.
      • Biochemical barriers: include natural flora, secretions (sweat, saliva, tears, and blood), and substances like sebum, lactic acid, and fatty acids.
    • Second line of defense is the inflammatory response to tissue injury or infection. It involves various white blood cells and factors to fight infection and repair damaged tissue.
    • Third line of defense is the adaptive immune response, which involves the generation of specific antibodies and T cells to target specific pathogens encountered in past infections.

    Humoral and Cell-Mediated Immunity

    • Humoral Immunity is antibody-mediated, meaning it relies on the production of antibodies by B cells to fight pathogens.
    • Cell-mediated immunity does not involve antibodies directly. Instead, it relies on T cells, especially cytotoxic T cells, to directly kill infected cells.

    Passive Immunity

    • Passive immunity is when an individual receives antibodies from an external source, such as through breast milk from a mother to her infant. The individual does not produce the antibodies themselves.

    Wound Healing

    • Primary intention healing occurs when wounds have clean edges that can be closed, allowing for quick healing with minimal scarring.
    • Secondary intention healing occurs when wounds have edges that cannot be brought together. These wounds heal from the bottom up, leading to more scarring and a longer healing time.

    Types of Infections

    • Bacterial infections can be gram-positive or gram-negative based on their cell wall structure. Examples include tuberculosis, pneumonia, and bubonic plague.
    • Fungal infections (mold and yeast) include ringworm, athlete's foot, and aspergillosis. These infections can be opportunistic, meaning they thrive in weakened immune systems.
    • Viral infections are caused by viruses and can lead to various diseases.
      • HIV, the human immunodeficiency virus, targets CD4+ T cells, which are crucial for both humoral and cell-mediated immunity. HIV depletes the body's immune system, leaving it vulnerable to opportunistic infections.

    Types of Hypersensitivity Reactions

    • Hypersensitivity reactions are exaggerated immune responses to substances that are typically harmless.
    • Type I hypersensitivity (anaphylactic) is mediated by IgE antibodies. It is a rapid and severe reaction that involves mast cell degranulation.
      • Immediate response: (5-30 mins)
        • Release of Histamine and IgE: mast cells release histamine, causing vasodilation, increased heart rate, and inflammation.
      • Delayed response: (2-8 hours)
        • Infiltration and Damage: leukocyte infiltration (increased white blood cells), edema, mucus secretion, and epithelial damage.
      • Prostaglandins: are released, contributing to inflammation.
    • Type IV hypersensitivity (cell-mediated) is mediated by T cells.
      • Delayed Response: (days to weeks)
        • Cytotoxic T cells (CD8+): kill healthy tissue.
        • Helper T cells (TH1): recruit phagocytes to the site of inflammation.
        • Allergic contact dermatitis: a common example of Type IV hypersensitivity. The reaction takes time to develop upon repeated exposures.

    Immune Deficiencies

    • Primary immune deficiencies are caused by genetic defects in the immune system. They are usually present at birth.
      • Severe Combined Immunodeficiency (SCID): most severe primary immune deficiency, leading to a lack of T cell function and often a lack of B cell function.
      • DiGeorge Syndrome: a T cell deficiency
      • Bruton's agammaglobulinemia: an antibody deficiency.
    • Secondary immune deficiencies are acquired due to factors like infections (e.g., HIV), cancer, or malnutrition. They are more common than primary immunodeficiency.

    White Blood Cells and Cells in Immunity

    • Neutrophils are the most abundant immune cells. They are first responders to bacterial infections and are involved in phagocytosis.
    • Lymphocytes include T cells, B cells, and natural killer cells.
    • Monocytes circulate in the blood and differentiate into macrophages in tissues; they perform phagocytosis.
    • Eosinophils have granules containing enzymes active against parasites and bacterial infections, and are involved in allergic reactions.
    • Mast cells reside in connective tissues and mucous membranes. They have a role in wound healing and microbial defense, are involved in serious allergic reactions, and contain granules containing histamine and heparin. They help bridge innate and adaptive immunity to fight pathogens.

    Lines of Defense

    • First line of defense barriers prevent entry:
      • Physical and mechanical barriers: Secretions, excretions, and skin as a barrier
      • Biochemical barriers: Microbiome, sweat, saliva, tears, sputum, earwax, blood, sebaceous glands, cathelicidins, and defensins
    • Second line of defense is an inflammatory response to tissue injury or infection.
    • Third line of defense is adaptive immunity: The body's immune system responds to a foreign substance or microorganism such as a virus or bacteria to develop immunity.

    Humoral Immunity

    • Humoral immunity is antibody-mediated: B cells produce antibodies to neutralize pathogens.
    • B cells are found in lymphoid progenitor cells (lymph tissue). They produce antibodies and present antigens via MHC class I and II to T cells for destruction.

    Cell-mediated Immunity

    • Cell-mediated immunity does not involve antibodies, but involves the activation of phagocytes, antigen-specific cytotoxic T lymphocytes, and the release of various cytokines in response to an antigen.

    Passive Immunity

    • Passive immunity is when an individual does not produce their own antibodies but receives them from another source, such as a mother to an infant through breast milk.

    Types of Healing

    • Primary intention healing occurs in wounds with clean edges that can be pulled together to promote healing, allowing for sutures or glue. These wounds heal from the top down with minimal scarring.
    • Secondary intention healing occurs in wounds lacking edges that can be pulled together. They heal from the bottom up and build up layers of tissue first before the skin heals, increasing the likelihood of scarring and infection.

    Types of Infections

    • Bacterial infections can be gram-positive or gram-negative. Examples include TB, pneumonia, and bubonic plague.
      • Gram-positive bacteria have peptidoglycan in their cell wall.
    • Mold infections such as ringworm and athlete's foot are transmitted from person to person. They are opportunistic infections and include aspergillosis.
    • Yeast infections are typically opportunistic infections common with antibiotic use and in the immunocompromised; an example is Candida albicans.
    • Viral infections are caused by tiny organisms that may cause many diseases. They are often opportunistic and common with antibiotic use.
      • HIV (human immunodeficiency virus) is incredibly difficult to treat and cure. It binds to CD4 T helper cells for cell-mediated and Th2 for humoral cells, wiping out CD4 cells.

    Types of Hypersensitivity Reactions

    • Hypersensitivity reactions are exaggerated immune responses that can cause tissue damage.
    • Type I hypersensitivity (anaphylactic) is mediated by IgE.
      • Pathophysiology: An allergen antigen causes mast cells or eosinophils to "de-granulate" leading to an immediate response within 5-30 minutes and a delayed response in 2-8 hours after exposure.
      • Results: Decreased blood pressure from vasodilation, increased heart rate, swelling, redness, itching, bronchospasms, and upper airway swelling.
    • Type II hypersensitivity (tissue-specific reaction) targets a specific cell or tissue.
      • Pathophysiology: Antibodies bind to antigens in the tissue, ending in cellular dysfunction or destruction.
      • Examples:
        • Hemolytic transfusion reaction: mismatched blood products undergo complement-mediated lysis.
        • Goodpasture's syndrome: anti-GBM antibodies attack collagen within the basement membrane of cells in the kidney and lungs.
        • Myasthenia Gravis: antibodies block acetylcholine receptors on muscles, causing muscle weakness.
    • Type III hypersensitivity (immune complex reaction) involves the formation of antigen-antibody complexes in circulation.
      • Pathophysiology: Complexes deposit in vessel walls or extravascular tissues, stimulating an inflammatory response.
      • Examples:
        • Systemic lupus erythematosus (SLE): immune complexes of autoantibodies and self-antigens are deposited in tissues.
        • Raynaud's disease: antibodies form complexes that cause peripheral arteries to narrow in response to cold or stress.
    • Type IV hypersensitivity (cell-mediated reaction) involves T cells.
      • Pathophysiology:
        • Cytotoxic T cells (CD8+) directly kill healthy tissue.
        • TH1 helper T cells (CD4+) recruit phagocytes to tissues.
      • Examples:
        • Allergic contact dermatitis: a delayed response to an allergen or irritant that comes into contact with skin.

    Immune Deficiencies

    • Primary immune deficiency is genetically linked, present early in life, and can be mild or severe.
      • Examples:
        • SCID (severe combined immunodeficiency): a total lack of T-cell function with partial or total lack of B-cell function.
        • DiGeorge: a T-cell deficiency.
        • Bruton's agammaglobulinemia: an antibody deficiency.
        • IgA deficiency: the most common primary deficiency.
    • Secondary immune deficiency is acquired (e.g., from disease, infection, or nutritional deficiencies). It is more common than primary deficiencies.
      • Examples:
        • Cancer, HIV, malnutrition (e.g., zinc deficiency).

    Acute Respiratory Distress

    • Acute inflammation causing alveoli epithelial lining disruption
    • Capillary endothelial lining damage leads to fluid leaking
    • Cells lose membrane integrity
    • Refractory hypoxemia due to a ventilation/perfusion mismatch
    • Three phases: exudative, proliferative, fibrotic

    Asthma

    • A chronic inflammatory airway disease of the bronchi mucosa with recurrent episodes of wheezing and breathlessness
    • Triggers include indoor allergens, secondhand smoke, etc.
    • Risk factors include family history, low birth weight, etc.
    • Allergen exposure causes immune activation leading to bronchospasm, congestion, and airway obstruction
    • Symptoms include wheezing, dyspnea, anxiety, coughing, etc.

    Chronic Obstructive Pulmonary Disorder (COPD)

    • A progressive lung disease encompassing emphysema and chronic bronchitis
    • Risk factors include smoking, breathing in toxins, and genetic abnormalities, etc.
    • Emphysema is characterized by damaged and enlarged alveoli
    • Chronic bronchitis presents with chronic productive cough and sputum for over 3 years with mucus secretion and airway obstruction

    Pulmonary Artery Hypertension

    • Increased pulmonary vasoconstrictors and decreased vasodilators lead to increased pulmonary artery pressure
    • Worsened by hypoxemia, respiratory and metabolic acidosis

    Edema

    • Cardiogenic edema arises from high pulmonary capillary hydrostatic pressure due to high pulmonary venous pressure
    • Non-cardiogenic edema arises from increased filtration due to increased capillary permeability
    • Lymph blockage prevents reabsorption of net filtration
    • Symptoms of pulmonary edema include dyspnea, orthopnea, wheezing, etc.

    Flail Chest

    • Occurs due to the rib cage breaking from the chest wall
    • Life-threatening emergency
    • Symptoms include paradoxical breathing, pain, dyspnea, etc.

    Pneumothorax

    • Collapsed lung caused by a vacuum created when the pleura is disrupted
    • Can be spontaneous or traumatic
    • Tension pneumothorax is life-threatening due to trapped air, compressing the lungs and reducing blood flow to the heart.
    • Hallmark symptom: heart, blood vessels, and trachea shifted towards the undamaged side

    Atelectasis

    • A collapse of lung tissue due to reduced alveolar ventilation or absorption of air inside a plugged alveolus
    • Can lead to hypoxia, pneumonia, and respiratory failure
    • Symptoms include dyspnea, tachycardia, cough, etc.

    Pleural Effusion

    • Excess fluid in the pleural space
    • Symptoms include dyspnea, cough, pain on inspiration, etc.
    • Hallmark symptom: pain on inspiration
    • Two types: transudative and exudative
    • Empyema is a collection of pus in the pleuritic space

    Pulmonary Embolism

    • Blood clot forming in a vein, that travels to the pulmonary vasculature
    • Risk factors include hypercoagulable state, vascular wall injury, circulatory stasis
    • Can lodge at any point in the pulmonary artery, causing venous destruction

    Pneumonia

    • Infection of the lungs in alveoli, impairing gas exchange
    • Causes purulent fluid buildup in alveoli
    • Types include lobar and bronchial pneumonia
    • Symptoms include cyanosis, fever, sweating, chills, etc.
    • Hallmark symptom: productive cough

    Tuberculosis

    • Transmitted via droplets, caused by Mycobacterium tuberculosis bacteria
    • Granulomatous inflammation forms tubercles filled with caseous necrosis
    • Resistant to many antibacterial medications
    • Symptoms include progressive fatigue, malaise, anorexia, etc.
    • Risk factors include recent exposure, living in high-rate areas, etc.

    Acute Respiratory Distress

    • Inflammation of alveoli epithelium and capillary endothelium leads to fluid leakage.
    • Cells lose membrane integrity resulting in refractory hypoxemia due to ventilation-perfusion mismatch.
    • Exudative Phase (within 72 hours): Alveolocapillary membrane damage, increased capillary permeability leading to pulmonary edema, and surfactant inactivation.
    • Proliferative Phase (4-21 days): Pulmonary edema resolves with type II pneumocytes, fibroblasts, and myofibroblasts proliferation. Hyaline membranes form and hypoxemia persists.
    • Fibrotic Phase (14-21 days): Remodeling and fibrosis, alveolar destruction, and severe right-to-left shunting causing acute respiratory failure.

    Asthma

    • Chronic inflammatory airway disease of bronchi mucosa with recurrent wheezing and breathlessness episodes.
    • Triggers: Indoor allergens, secondhand smoke, dust mites, animals, cockroaches, cold weather, stress.
    • Risk Factors: Family history, low birth weight, respiratory complications in infancy, smoking, obesity, allergies, occupation.
    • Pathophysiology: Allergen exposure activates immune system (IL-4, IL-5, IgE production) leading to mast cell degranulation, causing vasodilation, increased capillary permeability, bronchospasm, congestion, thickening of airway walls, impaired mucociliary function, mucus secretion, epithelial desquamation, fibrosis, bronchial hyperresponsiveness, and airway obstruction.
    • Signs and Symptoms: Wheezing, dyspnea, anxiety, coughing, chest tightness, decreased FEV1 that can be reversed with bronchodilators.

    Chronic Obstructive Pulmonary Disorder (COPD)

    • Umbrella term for progressive lung disease consisting of emphysema and chronic bronchitis.
    • Risk Factors: Smoking, breathing in toxins, exposure to smoke, infection, air pollution, genetic abnormalities, asthma, severe childhood respiratory infections in childhood.
    • Emphysema: Alveoli are damaged and enlarged, leading to loss of lung elasticity, reduced lung tissue recoil, and air trapping.
    • Emphysema Signs and Symptoms: Hyperinflation of lungs, barrel chest, increased CO2 in lungs, purse-lip breathing, dyspnea, use of accessory muscles to breathe.
    • Chronic Bronchitis: Chronic productive cough with sputum production for over 3 years, characterized by mucus secretion and airway obstruction.
    • Chronic Bronchitis Signs and Symptoms: Cyanosis from hypoxia, airway flow problems, increased sputum, increased respiratory rate, digital clubbing, increased hemoglobin.

    Pulmonary Artery Hypertension

    • Elevated pulmonary vasoconstrictors and decreased vasodilators lead to increased pulmonary artery pressure.
    • Aggravated by hypoxemia, respiratory and metabolic acidosis.

    Flail Chest

    • Segment of rib cage detaches from the chest wall due to 3 or more ribs broken in 2 or more places.
    • Caused by trauma to the chest.
    • Signs and Symptoms: Paradoxical breathing, pain, bruising, dyspnea.
    • The fractured section of the chest wall does not resist lung inward pull: During inspiration, the broken section collapses; during expiration, the vacuum created by the collapsed portion pulls air towards itself, causing chest flailing.

    Pneumothorax

    • Collapsed lung caused by pleural disruption and air entering the pleural space.
    • Classified as: Traumatic, Spontaneous (primary and secondary), and Tension.
    • Spontaneous: Risk factors include young, thin male smokers, sudden changes in atmospheric pressure.
    • Secondary: Associated with lung tissue disease like COPD, cancer, asthma, cystic fibrosis, interstitial and inflammatory lung disease.
    • Tension: Trapped air in the thoracic cavity cannot escape, causing increased pressure, lung compression, and decreased blood flow to the heart. Creates mediastinal shift (heart, blood vessels, and trachea shift towards the undamaged side).
    • Tension Signs and Symptoms: Heart, blood vessels, and trachea shift towards the undamaged side due to increased pressure on the pneumothorax side.
    • Signs and Symptoms: Dyspnea, chest aches, chest tightness, cyanosis, tachycardia, absent breath sounds on affected side, JVD.
    • Risk Factors: Trauma, medical procedures like central line insertion, gunshot or stabbing.

    Atelectasis

    • Collapse of lung tissue due to reduced alveolar ventilation or air absorption from a plugged alveolus.
    • Risk Factors: Confinement to bed, infections, disease, foreign body.
    • Can lead to hypoxia, pneumonia, and respiratory failure.
    • Signs and Symptoms: Dyspnea, tachycardia, cough, pain, cyanosis, wheezing.

    Pleural Effusion

    • Hallmark Symptom: Pain on inspiration.
    • Excess fluid in the pleural space.
    • Risk Factors: Infection, trauma.
    • Signs and Symptoms: Dyspnea, cough, pain on inspiration, fever, difficulty taking deep breaths.
    • Diagnosis: Thoracentesis.
    • Types: Transudative and Exudative.
    • Transudative: Clear, low protein, no cells, non-inflammatory, caused by salt and fluid retention, increased venous pressure, RAAS activation. Caused by: congestive heart failure, cirrhosis, nephrotic syndrome, peritoneal dialysis.
    • Exudative: Cloudy, thick, high protein, cells present, inflammatory, blood, bacteria, WBC may be present. Caused by: Infections, malignancy, connective tissue disease, inflammatory disease, movement of fluid from the abdomen to the pleural space, coronary artery bypass surgery, pulmonary embolism.
    • Empyema: Collection of pus in the pleural space due to infection.

    Pulmonary Embolism

    • Thrombus: Blood clot attached to the original vein where it forms.
    • Embolism: Freed blood clot that lodges in the pulmonary vasculature.
    • Travels from inferior vena cava to the right side of the heart, right atrium, right ventricle, and then to the pulmonary artery. Emboli lodge in the pulmonary vasculature causing venous destruction.
    • Risk Factors: Hypercoagulable state, vascular wall injury, circulatory stasis.

    Pneumonia

    • Infection of the lungs in the alveoli, impairing gas exchange.
    • Viral, bacterial, fungal.
    • Causes purulent fluid buildup in alveoli.
    • Risk Factors: Over 65 years old, existing lung disease, smoking, unvaccinated, hospital-acquired, community-acquired.
    • Signs and Symptoms: Cyanosis, fever, sweating, chills, fatigue, tachypnea, dyspnea, tachycardia, chest pain.
    • Hallmark Symptom: Productive cough.
    • Can occur as: Lobar (one or more whole sections of lungs), Bronchial (patches throughout both lungs).

    Tuberculosis

    • Transmitted via droplets, caused by Mycobacterium tuberculosis bacteria.
    • Tubercle Formation: Granulomatous inflammation filled with caseous necrosis isolates bacteria, leading to cavities within lung tissue.
    • Resistant to most antibacterial medications, requiring multiple types of medication and long-term therapy.
    • Risk Factors: Recent exposure, living in high-rate areas, immune deficiency, housing insecurity, IV drug use, post-organ transplant, healthcare workers, diseases that lower immune function.
    • Signs and Symptoms: Progressive fatigue, malaise, anorexia, weight loss.

    Edema: Cardiogenic and Non-Cardiogenic

    • Fluid in the lungs.
    • Cardiogenic: High pulmonary capillary hydrostatic pressure secondary to high pulmonary venous pressure. Fluid accumulates in the interstitium and alveoli. Caused by heart failure, fluid overload.
    • Non-Cardiogenic: Increased filtration due to increased capillary permeability, caused by injury, inflammation, obstruction, high altitude, cancer, toxins, neurogenic trauma, lung re-expansion. Protein leaves capillaries, increasing interstitial oncotic pressure, bringing water or direct hemorrhage.
    • Lymph Blockage: Prevents reabsorption of net filtration.
    • Signs and Symptoms of Pulmonary Edema: Dyspnea on exertion, orthopnea, wheezing, anxiety, wet cough, chest pain, fatigue, frothy sputum, sweating, clammy feeling.
    • Hallmark Symptom: Feeling of suffocating or drowning.

    Fluid Movement

    • This section appears to be a general reference to fluid movement, which is addressed in greater detail in other sections and modules. For more specific information, review those sections and modules.

    Hemoglobin Dissociation

    • This section appears to be a general reference to hemoglobin dissociation, which is addressed in greater detail in other sections and modules. For more specific information, review those sections and modules.

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    Test your knowledge about the various types of white blood cells and their roles in the immune system. This quiz covers neutrophils, lymphocytes, monocytes, eosinophils, and mast cells, highlighting their functions in immunity. Assess your understanding of how these cells defend against infections and diseases.

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