Endocrine and Immune Systems - NCLEX-PN

The pituitary is located just below the hypothalamus. The pituitary and the hypothalamus are connected by nerves and maintain an important working relationship with one another. Both are located near the base of the brain.

IgA, primarily in its secretory form (sIgA), is the most abundant immunoglobulin in the lining of the gastrointestinal tract and in the mucus membranes of the respiratory tract. It is also present in the urogenital tract, in tears, in saliva, and in breast milk. All of the other immunoglobulins may be present in mucus membranes, depending on the presence of active infection or allergy, but none is as abundant in secretions as IgA. IgE is primarily involved in binding allergens and inducing the allergic response via release of histamine. IgM is expressed on the surface of B cells and is the first immunoglobulin to fight pathogens at the site of infection/injury. IgG are the most abundant antibody throughout the body and play the largest role in fighting pathogens. IgG can cross the placenta and thus confer passive immunity to the fetus.

The presence of CMV IgM would suggest an active cytomegalovirus infection, as IgM is the immunoglobulin released during the initial, active infection with a pathogen. The presence of IgG would suggest a past infection, where IgG specific to the virus would be present as part of adaptive immunity (ready to respond to the virus should the host ever be re-exposed). IgE is not formed when an individual contracts CMV, as IgE is produced in response to allergens rather than pathogens (except parasites). The function of IgD is thought to be related to the allergic response by regulating basophils and mast cells.

The only immunoglobulin that has been shown to be able to cross the placenta is IgG. This is important in that it confers short term immunity to the fetus that continues into the first few months of the infant's life. Note that it is common to give Rh-negative anti-Rh IgG injections at about 28 weeks gestation; a booster may also be given at about 34 weeks gestation.

Lymphoid progenitor cells are produced in all of the following tissues: the liver, the bone marrow, spleen, and gut associated lymphoid tissue (mainly found in the liver and intestines). However, note that the vast majority of all blood cells are produced in the red bone marrow of long bones by hematopoietic stem cells.

Mast cells are rich in granules that contain high concentrations of heparin, histamine, and trypsin, among other preformed proteases. These granules also contain serotonin and various eicosanoids. The function of mast cells is primarily to regulate immune (inflammatory) responses to allergens.

While all of the cells listed may have some indirect involvement in the overall response to a parasitic infection, eosinophils are the only immune cells that are specialized to respond to multicellular parasites, especially helminths such as hookworms and pinworms.

Macrophages, the main blood cells responsible for phagocytosis of debris, bacteria, and virally infected cells, are part of the nonspecific immune response. While they are able to recognize self versus non-self proteins, they are not uniquely sensitive to any particular non-self protein type. Rathe, they phagocytose foreign matter as well as cellular debris. Plasma cells, memory cells, and CD8 T cells are all lymphocytes, and as such they are all part of the adaptive or "specific" immune system, meaning that they are uniquely sensitive to particular pathogenic proteins.

While all of the enzymes listed are present in saliva, lysozyme is the only enzyme listed that has antibacterial properties. This enzyme, present not only in saliva but also in tears, sweat, and breast milk, damages bacterial cell walls, making it an important part of the innate immune system. Amylase breaks down carbohydrates, lipase breaks down lipids, and kallikrein breaks down proteins.

Antibodies are only produced by B cells, specifically by a type of specialized B cell called a plasma cell. B cells belong to a broader category of leukocytes known as lymphocytes, which are agranulocytes.

T lymphocytes are so titled because they mature in the thymus, unlike B lymphocytes, which mature in the bone marrow. The thymus is located in the anterior superior mediastinum, ventral to the heart and dorsal to the sternum. It is most active in the neonatal and pre-adolescent periods, afterwards, it degenerates and is replaced with adipose tissue.

Lysozymes are a group of defense enzymes found in tears, saliva, mucus, and breast milk. It is considered part of our innate immune systems, as its presence in tears prevents infectious conjunctivitis. Cathelicidin, Defensin-5, and DEFA1 are found in the lysosomes of polymorphonuclear leukocytes (PMN's) and macrophages.

Interleukins (IL) are cytokines that play a role in signaling the immune cells. IL-8 is produced mainly by macrophage and dendritic cells and plays a major role in inflammation as a chemoattractant for neutrophils. IL-1 and IL-6 both induce acute phase proteins. TNF-alpha is involved in the acute phase reaction. It is an endogenous pyrogen (meaning it induces fever) and is also involved in apoptosis and tumor inhibition.

Major histocompatibility complex 1 in a membrane protein that binds to peptide fragments from pathogens such as viruses and bacteria and then displays them on the cell surface in order to alert other immune cells of the presence and nature of infection.

All cells with nuclei express MHC-1. Red blood cells do not have nuclei, and do not express MHC-1 on membranes.

The correct answer is "CD4 T-cells."

In AIDS, which is the most progressed stage of HIV, the cell type that is most significantly diminished is CD4 T-cells. Often times, the degree of disease progress of HIV and AIDS is established by monitoring the patient's CD4 T-cell count across the course of the illness. The CD4 count guides differential diagnoses when patients with HIV or AIDS present with various complaints, and also guides what prophylactic measures (e.g. antibiotics, antifungals) are administered to these patients.

While CD8 T-cell, monocyte, platelet, and neutrophil counts may each be decreased for various reasons in patients with HIV and AIDS, the most substantial association between diminished cell count and HIV/AIDS is that of CD4 T-cells.

The pituitary is located just below the hypothalamus. The pituitary and the hypothalamus are connected by nerves and maintain an important working relationship with one another. Both are located near the base of the brain.

Insulin is produced by beta cells of the pancreatic islets. Insulin's action is to decrease blood glucose, facilitating its uptake into cells. Alpha cells produce glucagon, which has the opposite effect as insulin. Delta cells produce somatostatin, which inhibits many digestive processes. and gamma cells produce pancreatic polypeptide, which regulate pancreatic secretion.

Lysozymes are a group of defense enzymes found in tears, saliva, mucus, and breast milk. It is considered part of our innate immune systems, as its presence in tears prevents infectious conjunctivitis. Cathelicidin, Defensin-5, and DEFA1 are found in the lysosomes of polymorphonuclear leukocytes (PMN's) and macrophages.

Interleukins (IL) are cytokines that play a role in signaling the immune cells. IL-8 is produced mainly by macrophage and dendritic cells and plays a major role in inflammation as a chemoattractant for neutrophils. IL-1 and IL-6 both induce acute phase proteins. TNF-alpha is involved in the acute phase reaction. It is an endogenous pyrogen (meaning it induces fever) and is also involved in apoptosis and tumor inhibition.