Acquired Immune Deficiency Flashcards
acquired immune deficiency definition
- defects in immune system not from genetic abnormalities
acquired immune deficiency’s come from
- infections
- nutritional deficiencies
- other medical conditions or treatments
- external stimuli
disorders of biochemical homeostasis definition
- disorders that lead to chronic imbalance in hormones, nutrients, and toxic metabolic waste products in body fluids
disorders of biochemical homeostasis examples
- diabetes mellitus
- dialysis and uremia
- cirrhosis
diabetes mellitus disorders of biochemical homeostasis
- decreased neutrophil function
- poor peripheral circulation
diabetes mellitus decreased neutrophil function related to
- level of hyperglycemia
diabetes mellitus poor peripheral circulation results in
- risk of skin ulcers
- decreased delivery of neutrophils to sites
diabetes mellitus usually infectious complications caused by
- disseminated candidiasis/yeast and other fungi
hemodialysis results in
- reduced T cell function
- reduced Ig production
- compromised neutrophil and dendritic function
peritoneal dialysis defects
- changes in peritoneum
- peritoneal neutrophil function decreased
why is peritoneal neutrophil function decreased
- removal of Ig and complement (opsonization factors) with the dialysate
- protein loss
dialysis presence of catheter causes
- increased risk of infection
cirrhosis liver dysfunction causes an increased risk of
- bacterial sepsis
- peritonitis
etiology of cirrhosis immune problems
- higher endogenous glucocorticoids
- low complement levels (complement made in liver)
disorders of protein loss
- nephrotic syndrome
- protein losing enteropathies
- severe dermatitis
- peritoneal dialysis
nephrotic syndrome loss of protein due to
- loss through kidneys
- in urine
protein losing enteropathies due to
- loss through GI tract
- stool
severe dermatitis loss of protein due to
- loss through skin
- ooze through skin
any disease process with increased protein loss can lead to
- hypogammaglobulinemia
hypogammaglobuliemia presents with what antibody levels
- low IgG and IgA
- normal IgM
why normal IgM
- too big of a molecule
how to determine if IgG levels are low due to protein los vs B cells?
- urinalysis
- give IvIg and measure Ig in their blood per week
nephrotic syndrome
- kidney disease with significant protein loss
result of nephrotic syndrome
- low immunoglobulin
- depressed cellular immunity due to loss of vitamin D
treatment of nephrotic syndrome with immunosuppressive drugs
- further increases risk of infection
infectious complications of nephrotic syndrome
- recurrent respiratory tract infections
- urinary tract infections
- peritonitis
- sepsis
- WITH ENCAPSULATED BACTERIA
examples of protein-losing enteropathies?
- IBD
- celiac
- intestinal lymphangiectasia
trauma mechanism initiating cascade of immune effects
- massive release of inflammatory cytokines (L-1, TNF) due to activation of monocytes and macrophages by products of cellular necrosis
burn trauma versus mechanical trauma
- greater immune suppression than mechanical trauma
burns disrupt a large area of
- nonspecific defense (the skin)
disruption of nonspecific defense (the skin) results in
- increased loss of fluids/proteins
- increased risk of infection
environmental exposures
- ionizing radiation
- UV radiation
- toxic chemicals
examples of ionizing radiation
- x rays
- gamma rays
problem with ionization radiation
- damages DNA and impaired cell division
impaired cell division leads to
- impaired immune function
proteins that regulate cell division that may be impaired by somatic mutations
- p53
- leads to malignant growth
which cells most affected in ionizing radiation
- B cells>T cells
- primary antibody response diminished
tissues affected in ionizing radiation
- nodes, spleen
which cells recover more rapidly in ionizing radiation
- T cell numbers
most functions of mature, long-lived phagocytic cells and ionizing radiation
- radiation-resistant
radiation and damaged local barriers
- increased susceptibility to infection
- ares with high rates of cellular division
major determinant of risk for skin cancer
- UVB radiation
chronic sun exposure leads to
- diminished function of all skin resident immune cells
numerous toxic chemicals incriminated in causing harm to immune system gives rise to
- discipline of immunotoxicology
toxic effects more pronounced in
- younger individuals
etiology of splenectomy/hyposplenism
- congenital asplenia
- trauma or status post splenectomy
- atrophy/non-functional spleen
atrophy of spleen due to
- sickle cell disease
splectomy/hyposplenism leads to increased infection by
- encapsulated organisms
why greater risk of encapsulated organisms with splectomy/hyposplenism
- macrophages in spleen best at taking out bacteria that are encapsulated
what vaccines do you make sure the person has prior to removal of the spleen?
- meningococcal and pneumococcal
- the encapsulated ones
pregnancy immunosuppression leads to
- higher incidence of certain infections depending on cellular immunity
depressed cellular immunity during pregnancy benefit
- reduce likelihood of maternal rejection of fetus
infections due to major life stressed
- higher rates of respiratory tract infections
- reactivation of herpesvirus
- increased incidence of cancer
diminished function described in post-traumatic stress disorder
- diminished cellular immune function
cell depletions in stressed individuals
- reduced NK cell activity
- depressed lymphocytqes mitogen responses
morbidity and mortality of measles due to
- signifiant immune suppression which leads to superinfection
superinfection with measles common with
- respiratory viruses
- staph aureus
- strep pneumo
immune alterations induced by measles
- T cell lymphopenia
- diminished T cell proliferation
- diminished antibody production
T cell lymphopenia
- deletion of T dependent areas of lymph nodes and spleen
diminished in vitro proliferation with
- mitogens
- alloantigens
immune alternations of measles caused by
- direct infection of T cells and dendritic cells by measles
herpesvirus infections on immunity
- transient depression of cell-mediated immunity
example of herpesvirus that causes immune depression
- CMV
immune suppression from protozoan infection versus any other class of microbe
- much more pronounced
immune suppression from protozoan infection affects which part of immunity?
- decreased cell-mediated immunity
exception of bacterial infections that causes secondary immune suppression
- superantigens
result of superantigen
- significant immune stimulation
- but T cells eventually decrease
- decreased neutrophil function
