Guided Lecture Notes
Chapter 15: Alterations in the Immune Response
Learning Objective 1. Describe the immune mechanisms involved in type I, type II,
type III, and type IV hypersensitivity reactions (refer to Table 15-1).

Define hypersensitivity reaction (refer to PowerPoint Slide 2).

Using examples, explain the mechanisms involved in the type I (refer to
PowerPoint Slide 4 and Fig. 15-1), type II (refer to PowerPoint Slide 11 and
Fig. 15-2), type III (refer to PowerPoint Slide 16 and Fig. 15-3), and type IV
(refer to PowerPoint Slide 20 and Fig. 15-4) hypersensitivity reactions.
Learning Objective 2. Describe the pathogenesis of allergic rhinitis, food allergy, serum
sickness, Arthus reaction, contact dermatitis, and hypersensitivity pneumonitis.

Differentiate between systemic and local allergic reactions.

Describe the causes, signs and symptoms, diagnosis and treatment of allergic
dermatitis and food allergies (refer to PowerPoint Slide 3).

Differentiate between local and systemic immune complex disorders.

Describe the causes, signs and symptoms, diagnosis and treatment of serum
sickness (refer to PowerPoint Slide 15).

Explain what an Arthus reaction is (refer to PowerPoint Slide 15).

Describe the causes, signs and symptoms, diagnosis and treatment of delayed
hypersensitivity disorders, such as contact dermatitis and hypersensitivity
pneumonitis (refer to PowerPoint Slide 19).
Learning Objective 3. Relate the mechanisms of self-tolerance to the possible
explanations for development of autoimmune disease.

Define self-tolerance, and explain how it leads to autoimmune disease (refer to
PowerPoint Slide 21).
Learning Objective 4. Name four or more diseases attributed to autoimmunity.

Identify several autoimmune diseases (refer to Chart 15-1).
Learning Objective 5. Describe three or more postulated mechanisms underlying
autoimmune disease.

Explain how genetic susceptibility and various environmental factors may play a
role in autoimmune disease.
Learning Objective 6. State the criteria for establishing an autoimmune basis for a
disease.

Discuss diagnosis and treatment for autoimmune diseases.
Learning Objective 7. Describe the rationale for matching of human leukocyte antigen
(HLA) in organ transplantation.

Define allogeneic, syngeneic, autologous, and heterologous as they relate to organ
transplantation.

Explain why it is necessary to match MCH and HLA types when transplanting
tissue.
Learning Objective 8. Compare the immune mechanisms involved in host-versus-graft
and graft-versus-host disease (refer to Fig. 15-5).

Explain the terms hyperacute reaction, acute rejection, and chronic rejection as
they relate to HVGD (refer to PowerPoint Slide 22).

Differentiate between the immune mechanisms at work and the clinical
manifestations associated with HVGD and GVHD.

Identify the factors necessary for GVHD to occur (refer to PowerPoint Slide 23).
Learning Objective 9. State the difference between primary and secondary
immunodeficiency states.

Using examples, differentiate between primary and secondary immunodeficiency
(refer to PowerPoint Slide 26).

Discuss the factors that determine the severity and symptomatology of the various
disorders associated with primary and secondary immune disorders.
Learning Objective 10. Compare and contrast immunodeficiency disorders caused by
B-cell and T-cell disorders.

Differentiate between humoral (B-cell) and cellular (T-cell) immunodeficiency
disorders (refer to Fig. 15-6).
Learning Objective 11. Briefly trace the history of the AIDS epidemic.

Define pandemic, and discuss the morbidity and mortality of AIDS both globally
and in the U.S.
Learning Objective 12. State the virus responsible for AIDS and explain how it differs
from other viruses.

Explain what makes the HIV virus unique, and why it is difficult to treat.
Learning Objective 13. Describe the mechanisms of HIV transmission and relate them
to the need for public awareness and concern regarding the spread of AIDS.

List the ways in which HIV is spread, and discuss preventative measures (refer to
PowerPoint Slide 27).

Discuss the importance of public education as a deterrent to the spread of AIDS.
Learning Objective 14. Describe the eight steps of HIV replication.

Explain the eight steps necessary in order for HIV to reproduce inside the host
cell (refer to PowerPoint Slides 28–29 and Fig. 15-8).
Learning Objective 15. Describe the CDC HIV/AIDS classification system.

Explain the CDC HIV classification system using clinical conditions and CD4+
T-cell counts (refer to PowerPoint Slide 32, Chart 15-2, and Fig. 15-9).
Learning Objective 16. Discuss respiratory tract infections, gastrointestinal infections,
and nervous system infections, and their connection to the term opportunistic infection
(refer to PowerPoint Slide 33).

Define opportunistic infection.

Using examples, explain why immunocompromised patients are at risk for these
types of infections.

Identify signs and symptoms of HIV infection (refer to Chart 15-3).
Learning Objective 17. Discuss methods of diagnosis of HIV infection.

Using examples, discuss the usefulness of the HIV antibody test and polymerase
chain reaction (PCR) as diagnostic tools for HIV.
Learning Objective 18. Discuss HAART as it relates to the treatment of HIV infection.

Explain the goal of HAART, and list the types of anti-HIV drugs that are
currently on the market.
Learning Objective 19. Discuss the vertical transmission of HIV infection from mother
to child and recommended prevention measures.

Explain how HIV may be transmitted from mother to infant.

List factors that increase the likelihood of transmission.

Discuss measures and medications used to prevent the transmission of HIV from
mother to infant.
Learning Objective 20. Cite problems with the diagnosis of HIV infection in the infant.

Explain why the presence of maternal HIV antibody makes diagnosis of HIV in
infants more difficult.
Learning Objective 21. Compare the progress of HIV infection in infants and children
with that of HIV infection in adults.

Differentiate the onset of PCP in adults and children, and explain how this affects
morbidity and mortality.