4/20 Flashcards
Identify the disorder where the immune system attacks itself
A. gammopathy
B. autoimmune
C. hypersensitivity
D. secondary
Answer: B
Rationale: gammopathy - abnormal protein synthesis
Autoimmune - attacks itself
HIV/AIDS is classified as what type of immunodeficiency?
A. primary
B. inherited
C. secondary
D. selective
Answer: C
Rationale: AIDS - acquired immunodeficiency syndrome - since acquired is secondary
Primary - born with as part genetic make-up - in genes and part of them
Can be born with HIV/AIDS but not part genetic make-up - acquired in utero from mother - acquired via exposure = secondary
Organ transplant rejection that occurs one week to three months after transplantation and sporadically after that as a result of two mechanisms is known as what type of rejection?
A. hyperacute
B. chronic
C. complex
D. acute
Answer: D
Rationale: acute transplant rejection
Imp distinguish hyperacute, acute, chronic transplant rejections
Hyperacute
Acute
Chronic
All Decrease blood flow to tissue - Reduce O2 and result in death
Within mins to hours of receiving transplant - notice SOB, BP decreasing, HR increasing, urine output not existent (if got kidney transplant)
Result of ABO mismatch or other antibody not matching
Same type reaction - cell thrombosis and occlusion
Not get blood flow so transplant dies
Do with patient: support medically but need go back to OR because body actively fighting newly transplanted organ - kill it and clots forming and need support medically: steroids, platelets or blood transfusion, pressor, fluid
Quick after new organ transplanted
Might be ok if check quick enough
Heart transplant - cannot readily do that - may do mechanical support - cont attack any assitance will not help
Organs more than 1 of hope for best; just 1 of and rely on not good
Organs incompatible quickly
Hyperacute
WBCs attacking organ
T-cell mediated
Starts occurring within weeks to months after transplantation - can go longer
Body attacking transplanted organ but slower
Sending leukocytes into attack new organ
New organ - cannot do job effectively because constantly under attack
Results: clots that block blood flow: no blood flow = no O2 = ischemia
Might have more time to identify it
Sx with kidney failure: hematuria, oliguria, anuria, trouble breathing, - no urine output - fluid volume overload - backs up to lungs; exhibit signs of fluid volume overload - signs when original organ starts fail; whatever type failure occurred initially
Assess: vitals, labs, ask patient: taking meds
WBCs attacking the organ
Acute
Reduce blood flow
Cause scar tissue
Kill organ
Over period of years
Organ making cells that attack body
Chronic
Anaphylactic shock is categorized as which of the following hypersensitivity disorders?
A. type I
B. type II
C. type III
D. type IV
Answer: A
Rationale: different types!
Anaphylaxis
Type II
Type III
Type IV
Hives
Airway obstruction caused by angioedema and airway restriction = swollen
Priority: airway - breathing - circulation
Treatments: epi; steroids; antihistamine; pepcid (H2 blocker) - not hit anaphylaxis - steroids, antihistamine, pepcid; anaphylaxis bad - epi
IgE mediated response
Known allergy might encounter - keep epipen - at least 2
After use epipen - go to hospital - depending amount substance exposed to possibility go to rebound anaphylaxis
How use epipen and teach pt and fam members
Anaphylaxis
Cell specific
Classic: blood transfusion rxn - ABO incompatibility
Type II
Cell mediated
EX: autoimmune: lupus, RA
Type III
Delayed
Localized hypersensitivity rxn
EX: TB skin test; contact dermatitis; poison ivy
Type IV
Which of the following is a risk factor associated with HIV infection?
A. abstinence
B. sharing needles
C. condom usage
D. donating blood
Answer: B
Rationale: blood-blood transfer
Condom usage way prevent
Donating blood - not risk factor for donor
HIV transmission - rare - thoroughly tested with each unit
Abstinence - help reduce risks of HIV transmission
A - Abstinence
B - being faithful
C - condoms/barrier method
HIV staging
CD4 counts: normal: 500-1200
Stage 1: 400 or less
Stage 2: 200 or less - move to AIDS
Stage 3: less than 100 - watching for opportunistic infection; AIDS - die because not able to fight off the infection
HIV staging
ART
Often more than 1 at time
Switched often because rapidly mutating virus
Changing frequently want stay ahead of mutations
Access with insurance to help provide medications
Not give blood: homosexual men not allowed give blood regardless HIV status
Already HIV+
For committed partner: Truvada - before PrEP; first get HIV test; if - get PrEP medications; starting meds - ton labwork - renal and liver func examined
Intense GI AE - profuse diarrhea when starting
Still use barrier method
Committed relationship and known HIV+
