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34-year old male patient recently diagnosed with AIDS. Tested positive for…

- - - - Mucous membranes
      - Skin
    - - Inflammation
        
        A nonspecific response to any tissue injury. Causes include physical trauma, intense heat, irritating heat, irritating chemicals, or infection. Inflammation has several beneficial effects:
        
        it disposes of cell debris and pathogens
        
        it alerts the adaptive immune system
        
        it prevents the spread of damaging agents to nearby tissues
        
        it sets the stage for repair
        
        Four cardinal signs of acute inflammation:
        
        swelling
        
        heat
        
        redness
        
        pain
      - Natural Killer cells
        
        "police" the body in blood and lymph, are a unique group of defensive cells that can kill cancer cells, and virus-infected body cells before the adaptive immune system is activated. NK cells are part of a small group of large granular lymphocytes
      - Phagocytes
        
        Pathogens that get through the skin or mucosal into the underlying connective tissue are confronted by phagocytes (phago=eat)
        
        Neutrophils, the most abundant type of white blood cell, become phagocytic on encountering infectious material in the tissues.
        
        However, the most voracious phagocytes are macrophages ("big eaters"). Macrophages derive from white blood cells called monocytes that leave the bloodstream, enter the tissues, and develop into macrophages
        
        free macrophages wander throughout the tissue spaces in search of cellular debris or "foreign invaders
        
        fixed macrophages, such as stellate macrophages in the liver, are permanent residents of particular organs
        
        A phagocyte engulfs particulate matter much the way an amoeba ingests a food particle. Receptors on its flowing cytoplasmic extensions bind to the particle. The particle is then pulled inside, enclosed within a membrane-lined vesicle. The resulting phagosome then fuses with a lysosome to form a phagolysosome
        
        Neutrophils and macrophages generally kill ingested prey by acidifying the phagolysosome and digesting its contents with lysosomal enzymes.
        
        However, some pathogens such as the tuberculosis bacillus and certain parasites are resistant to lysosomal enzymes and can multiply within the phagolysosome. In this case, other immune cells called helper T cells release chemicals that stimulate the macrophage.
        
        This activates additional enzymes that produce a lethal respiratory burst. The respiratory burst promotes killing of pathogens by:
        
        Producing oxidizing chemicals (hydrogen peroxide and a substance identical to household bleach)
        
        Increasing the phagolysosome's pHand osmolarity, which activates other protein-digesting enzymes that digest the invader
        
        Liberating a deluge of highly destructive free radicals
      - Antimicrobial proteins
        
        A variety of antimicrobial proteins enhance our innate defenses by attacking microorganisms directly or by hindering their ability to reproduce. The most important proteins are interferons and complement proteins
        
        interferons
        
        infected cells can do little to save themselves, but some can secrete small proteins called interferons (IFNs) to help protect cells that have not yet been infected. the IFNs diffuse to nearby cells, which they stimulate to synthesize proteins that block further protein synthesis and degrade RNA
        
        the IFNs are a family of immune modulating proteins produced by a variety of body cells, each having a slightly different physiological effect. IFN alpha and beta have the anti-viral effects that we've just described and also activate NK cells.
        
        IFN gamma, or immune interferon, is secreted by lymphocytes and has widespread immune mobilizing effects, such as activating microphages. Because both macrophages and NK cells can also act directly against cancerous cells, the interferons have an indirect role in fighting cancer.
        
        complement
        
        The term complement system, or simply complement, refers to a group of at least 20 plasma proteins that normally circulate in the blood in an inactive state. These proteins include those numbered C1 through C9 plus several others that act as regulatory proteins and other factors.
        
        The lectin pathway involves lectins, water-soluble protein molecules that the innate immune system produces to recognize foreign invaders. When lectins bind specific sugars on the surface of microorganisms, they can then bind and activate complement
        
        The alternative pathway is triggered when spontaneously activated C3 and other complement factors interact on the surface of microorganisms. These microorganisms lack the complement activation inhibitors our own cells have.
        
        The classical pathway involves antibodies, water-soluble protein molecules that the adaptive immune system produces to fight off foreign invaders. When antibodies bind to pathogens, they can also bind complement components. this double binding is the first step in this complement activation pathway.
      - fever
  - - - B cells
    - - T cells
      - It involves lymphocytes called B and T lymphocytes. These lymphocytes are not involved in innate immunity.
      - It is systemic. Adaptive immunity is not restricted to the initial infection site.
      - It is specific. It recognizes and targets identified pathogens or foreign substances that initiate the immune response
      - It has "memory". After an initial exposure, it recognizes and mounts even stronger attacks on previously encountered pathogens.
  - - - site for lymphocyte activation and proliferation
      - cleanses blood and removes aged or defective red blood cells
      - stores platelets, monocytes, and iron
    - - prevent pathogens from penetrating mucous membrane
      - site for lymphocyte activation and proliferation
      - Are a set of distributed lymphoid tissues strategically located in mucous membranes throughout the body. MALT protect us from the never-ending onslaught of pathogens that seek to enter our bodies.
        
        Tonsils form a ring of lymphoid tissue around the entrance to the pharynx (throat), where they appear as swellings of the mucosa. The tonsils are named according to location
        
        Peter's patches or aggregated lymphoid nodules, are large clusters of lymphoid follicles, structurally similar to the tonsils. They are located in the wall of the distal portion of the small intestine.
        
        The appendix is a tubular offshoot of the first part of the large intestine and contains a high concentration of lymphoid follicles. Like Peyer's patches, the appendix is in an ideal position 1) to prevent bacteria (present in large numbers in the intestine) from breathing the intestinal wall, and 2) to generate many "memory" lymphocytes for long-term immunity
    - - cleanse lymph
      - site for lymphocyte activation and proliferation
      - Each node is surrounded by a dense fibrous capsule from which connective tissue strands called trabeculae extend inward to divide the node into a number of compartments. The node's internal framework, or stroma, of reticular fibers physically supports its ever-changing population of lymphocytes
        
        Cortex. The superficial part of the cortex contains densely packed follicles, many with germinal centers heavy with dividing B cells
        
        Medulla. The medulla consists of medullary cords, thin inward extensions from the cortical lymphoid tissue. Both B andT lymphocytes are found here.
    - - site for T cell maturation
      - In the thymus, T lymphocyte precursors mature to become immunocompetent lymphocytes. In other words, the thymus is where T lymphocytes become immunocompetent lymphocytes. In other words, the thymus is where T lymphocytes become able to defend us against specific pathogens in the immune response.
      - the thymus functions strictly as a maturation site for T lymphocyte precursors; The storm of the thymus consists of epithelial cells rather than reticular fibers. These epithelial cells provide the physical and chemical environment in which T lymphocytes mature.
    - - Lymphocytes are the main warriors of the immune system. There are two main varieties of lymphocytes that protect the body against antigens
        
        B cells (B lymphocytes)
        
        Activated B cells protect the body by producing plasma cells, daughter cells that secrete antibodies into the blood (or other body fluids)
        
        T cells (Lymphocytes)
        
        Activated T cells manage the immune response, and some of them directly attack and destroy infected cells.
      - Lymphoid tissue is an important component of the immune system. Lymphoid tissue, largely composed of loose connective tissue called reticular connective tissue, dominates all the lymphoid organs except the thymus.
        
        Furnishes an idea surveillance vantage point for lympocytes and macrophages
        
        Houses lymphocytes and provides a site where they can be activated and proliferate (multiply)
      - Macrophages play a crucial role in the body protection and the immune response by phagocytizing foreign substances and by helping to activate T cells. So, too, do the spiny-looking dendritic cells that capture antigens and bring them back to the lymph nodes
      - Reticular cells, fibroblast-like cells that produce the reticular fiber stroma, which is the network that supports the other cell types in lymphoid organs and tissues.
  - - - lymphocytes
        
        Accounting for 25% or more of the WBC population, are the second most numerous leukocytes in the blood. The nucleus is usually spherical but may be slightly indented, and it is surrounded by a thin rim of pale-blue cytoplasm.
        
        T lymphocytes (T cells) function in the immune response by acting directly against virus-infected cells and tumor cells
        
        B lymphocytes (B cells) give rise to plasma cells, which produce antibodies (immunoglobins) that are released to the blood
      - monocytes
        
        account for 3-8% of WBCs. With an average diameter of 18 um, they are the largest leukocytes. They have abundant pale-blue cytoplasm and a darkly staining purple nucleus, which is often U or kidney shaped. When circulating monocytes leave the bloodstream and enter the tissues, they differentiate into highly mobile macrophages with prodigious appetites
        
        macrophages are actively phagocytic, and they are crucial in the body's defense against viruses, certain intracellular bacterial parasites, and chronic infections such as tuberculosis. macrophages can also activate lymphocytes to mount an immune response
    - - Neutrophils
        
        the most numerous white blood cells, account for 50-70% of the WBC population, Neutrophils are about twice as large as erythrocytes.
      - Eosinophils
        
        account for 2-4% of all the leukocytes and are approximately the size of neutrophils. Their nucleus usually has two lobes connected by a broad band of nuclear material and so resembles earmuffs
      - Basophils
        
        are the rarest white blood cells, accounting for only 0.5-1% of the leukocyte population. Their cytoplasm contains large, coarse, histamine-containing granules that have an affinity for the basic dyes (basophil= base loving) and stain purplish-black.
        
        Histamine is an inflammatory chemical that acts as a vasodilator (makes blood vessels dilate) and attracts other white blood cells to the inflamed site; drugs called antihistamines counter this effect. The deep purple nucleus is generally U or S shaped with one or two constrictions.
  - - - bacteria are tiny microorganisms that are made up of a single cell.
      - They are very diverse, and can have a large variety shapes and structural features
      - bacteria can live in almost every conceivable environment, in or on the human body
      - only a handful of bacteria cause infections in human. These bacteria are referred to as pathogenic bacteria
      - examples: strep throat, urinary tract infection (UTI), gonorrhea, tuberculosis, lyme disease
    - - viruses are another type of tiny microorganism, although they are smaller than bacteria. Like bacteria they're very diverse, and have a variety of shapes and features
      - viruses are parasitic. That means they require living cells or tissue in which to grow.
      - viruses can invade the cells of your body, using the components of your cells to grow and multiply
      - Some viruses even kill host cells as part of their life cycle
      - examples: influenza, common cold, viral hepatitis, zika virus, west nile virus
  - - - The phage DNA becomes incorporated into the host genome
      - The cell divides, and prophage DNA is passed on to daughter cells
      - The phage infects a cell
      - Under stressful conditions , the phage DNA is excised from the bacterial chromosome and enters the lytic cycle.
    - - The phage DNA circularizes, remaining separate from the host DNA.
      - Phage DNA replicates and phage proteins are made. New phage particles are assembled.
      - The phage infects a cell
      - The cell lyses, releasing phage.
  - - - AIDS, or stage 3 HIV, develops when HIV has caused serious damage to the immune system. It is a complex condition with symptoms that vary from person to person.
      - Symptoms of stage 3 HIV are related to the infections a person may develop as a result of having a damaged immune system that can’t fight them as well. Known collectively as opportunistic infections, they include tuberculosis, pneumonia, and others.
      - AIDS (which is short for acquired immunodeficiency syndrome) is a condition. Contracting HIV can lead to the development of AIDS.
      - AIDS, on the other hand, is a condition a person acquires only after they’ve contracted HIV.
    - - A virus that can lead to immune system deterioration
      - "HIV" stands for human immunodeficiency virus
      - only humans can contract it, and it attacks the immune system
      - As a result, the immune system is unable to work as effectively as it should
      - Our immune systems can completely clear many viruses our bodies, but that’s not the case with HIV. Medications can control HIV very successfully by interrupting its viral life cycle, however.
      - Because HIV is a virus, it can be transmitted between people just like many other viruses.
- - - - It’s difficult to repair damage to the immune system at this point. Infections and other conditions, such as certain cancers, resulting from severe immune system impairment are common.
      - It should've been recommended to him that when he got tested positive for HIV, he should get treatment/medication
        
        If he got the proper treatment at the right time, it could've been possible that he would never get diagnosed with AIDS , but it was too late
- - - - A person infected with HIV may not show any symptoms for years. But untreated, the number of T-helper cells steadily drops.
        
        Eventually, the numbers fall so low that the risk of infection greatly increases, and the symptoms of AIDS appear.
  - - - This is why the patient was questioning why wasn't he diagnosed with AIDS when he got HIV over a year ago. It takes time to get AIDs, but it does hurt your immune system. Even without symptoms, HIV can still be present in the body and can still be transmitted. Receiving adequate treatment that results in viral suppression stops the progression of immune dysfunction and AIDS