BLOOD AND IMMUNITY STUDY GUIDE 1. What is blood? Fluid connective tissue 2. What is blood composed of?

Plasma, red and white blood cells and platelets (formed elements) 3. What is hematocrit? The percent of blood volume the is red blood cells (42% in females and 47% in males) 4. From most dense to least dense, describe a centrifuged sample of blood: Erythrocytes at the bottom 45% leaukocytes+platelets 1% plasma 55% 5. What is blood pH? 7.35-7.45 6. What are the three main functions of blood? Distribution of oxygen and nutrients, metabolic wastes and hormones. Regulation of body temperature, pH by use of buffers and fluid volume. Protection against blood loss by clotting and infection by antibodies. 7. What is the composition of plasma? 90% water remaining 10% is made up of proteins that are mostly produced in the liver 60% albumin 36% globulins 4% fibrinogens 8. What is the importance of the plasma? It is an important blood buffer that helps determine osmotic pressure (keeps water from leaking out of blood vessels) this is mainly the job of the albumin 9. What are the only complete cells? White blood cells 10. Which cells are fragments? Platelets 11. Where do blood cells originate? Red bone marrow 12. Hematopoiesis- blood cell formation 13. What gives rise to all formed elements? Hemocytoblasts 14. Where do red blood cells die? Macrophages engulf dying RBCs in the spleen 15. Hemorrhagic Anemia- acute or chronic blood loss 16. Hemolytic Anemia- RBCs rupture prematurely 17. Aplastic Anemia- destruction of red bone marrow 18. Iron deficiency Anemia- insufficient iron or absorption 19. Pernicious Anemia- Vitamin B12 deficiency 20. Thalassemias- Abnormal hemoglobin 21. Sickle Cell Anemia- defective gene codes 22. Polycythemia- excess RBCs increases blood viscosity 23. Polycythemia Vera- bone marrow cancer 24. Leukocytosis- normal response to bacterial invasion 25. What are the granulocytic WBCs? (NEBs) neutrophils eisonophils basophils 26. What are the agranulocytic WBCs? lymphocytes and monocytes 27. Neutrophils- Lilac, very phagocytic, multi-lobed 28. Eisonophils- Red, bi-lobed, kills parasitic worms, allergy and athsma 29. Basophils- Purplish-black, bi-lobed, histamine, inflammation, heparin 30. Lymphocytes- Dark purple, spherical nucleus, mount immune response 31. Monocytes- Pale blue with dark purple U-shaped nuclei 32. What are the two types of lymphocytes? T-cells and B-cells

33. What are the differences between these cells? T-cells act against virus infected bacteria cells and tumor cells while B-cells give rise to plasma cells which produce antibodies 34. What do monocytes differentiate into? If they enter into the brain they become microglia, if the enter into the tissue they become histocytes, if they enter into the blood they become macrophages 35. What is the main function of monocytes? To perform phagocytosis 36. What do macrophages produce? Monokine or IL-1 which stimulate the immune system

Antibody Structure
Each antibody has a basic structure consisting of 4 looping polypeptide chains linked by di-sulfide bonds. The molecule is T or Y shaped and made of two heavy and two light chains. The hinge region provides flexible area. The number of antigen binding sites is the valence. FAB fragment of the antibody is the area above the hinge. FC- is the complement fixation site which is the area below the hinge. In an IgE this area is the mast cell. Most antibodies are bi-valent

IgG- 2 heavy 2 light chains

The primary antibody of the secondary immune response. Because of its small size it is the only antibody that can cross the placenta. There are 4 sub-classes based on Gamma 1-4

IgM- 10 heavy 10 light

First antibody produced by the immune system of a newborn and the main antibody of the primary immune response. Potent anti-coagulant. Since it cannot cross the placenta, the presence of IgM at birth indicates an intra-uterine infection. Overproduction of IgM indicates Waldenstroms Macroglobulina

IgA- 4 heavy 4 light connected by a IgA Dimer

Produced in all mucous secretions and provides very localized protection. Overproduction of light chains-amyloidosis. Over-production of heavy chains- Burgers Disease

IgD- 2 heavy 2 light

May function as a B-cell receptor

IgE- 2 heavy 2 light

Allergic antibody Type-1 Hypersensitivity Reaction Multiple Myeloma-bone marrow plasma cell tumor which causes over-production of H or L chains or intact anti-bodies (Light-chain myeloma is the most common) There will be presence of Benz-Jones proteins in the urine Antigens-large, complex molecules not normally found in the body. Substances that can mobilize the adaptive defenses and provoke an immune response

Complete Antigens- have immunogenicity AND reactivity; the ability to stimulate the proliferation of specific lymphocytes and antibodies AND the ability to react with products of activated lymphocytes and antibodies released (e.g.foreign proteins, polysaccharides, lipids, nucleic acids) Haptans- incomplete antigens. Only immunogenic when attached to body proteins. Cause the immune system to mount a harmful attack (e.g. poison ivy, animal dander, detergents, cosmetics) Interferons- proteins that are produced by the virus infected cells. Interferons and complement proteins are antimicrobial. They attack microorganisms directly and hinder their ability to reproduce. IFNs activate macrophages and mobilize NKs Diapedesis- the movement of leukocytes out of the circulatory system towards to site of tissue damage or infection (neutrophils flatten and squeeze out of capillaries) Agglutination- allergic reaction where cells compact together to prevent foreign materials from entering Opsonization- coating of a pathogen by complement proteins or antibodies for phagocytosis Chemotaxis- neutrophils follow the chemical trail Monokine- chemicals produced by the macrophages called IL-1 that stimulate both B and T-lymphocytes Hyperemia- an increase in the quantity of blood flow to a body part Auto grafts- transplants from one body site to another in same person Isographs- between identical twins Allograft- individuals not twins Xenografts- from another animal species Margination- neutrophils cling capillary wall Leukocytosis- neutrophils enter blood from bone marrow PRIMARY IMMUNE RESPONSE Upon first exposure to a specific antigen there is a lag period of 3-6 days. During this period B-cells specific to the antigen proliferate and differentiate into plasma cells; plasma antibody levels rise, reach peak levels in about 10 days then decline SECONDARY IMMUNE RESPONSE Upon re-exposure to the same antigen. Secondary immune responses are faster, more effective, and more prolonged because memory B-cells are already primed and on alert HYPERSENSITIVITY REACTIONS TYPE 1 Allergic/Anaphylactic Allergen enters body and stimulates IgE; this complex attracts the mast cell and combines with the FC portion of the IgE antibodies and leads to mast cell degranulation releasing vasoactive substances. (e.g. allergic asthma, uticaria, allergic rhinitis, anaphylactic shock) Treatmentsalbuterol, terbutaline TYPE 2 Cytotoxic Reaction

IgG and IgM are produced in response to stimulation to stimulation by antigens. They stimulate the immune system to produce antibodies against themselves and the antibodies destroy themselves and the tissues hosting them. (e.g. Good Pastures Syndrome, Autoimmune Hemolytic Anemia, Hashimotos Thyroiditis, Erythroblastis Fetalis) Type 3 Immune Complex Injury Antigen-antibody complexes activate the complement system which cause the release of neutrophil complement tactic C5-A which attacks the neutrophils and the neutrophils release lysosymal enzymes that cause tissue destruction. (e.g. R.A. Systemic Lupus, Arthus Reaction, Serum Sickness, Acute Glomerular Nephritis) TYPE 4 Delayed Hypersensitivity Caused by activation of sensitized T-lymphocytes which produce MCF, MIF and MAF which allow the macrophages to attack the antigen causing their destruction. (e.g. tissue graft rejection, contact dermatitis)