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Immunology II > acquired immunodeficiency > Flashcards

acquired immunodeficiency Flashcards

1
Q

etiology of acquire immunodeficiency

A
  1. Disorder of biochemical homeostatic imbalances: diabetes, dialysis, uremia and cirrhosis
  2. Protein loss (nephrotic, enteropathies, dialysis, dermatitis)
  3. Trauma
  4. Burn
  5. Infection (parasites)
  6. Stress and Pregnancy
  7. Splenectomy/hyposplenism
  8. Environmental exposures
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2
Q

acquire immunodeficiency

A

not genetic acquisitions of immunodeficiencies

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3
Q

diabetes

A
  • loss of peripheral vasculature- can cause decreased neurological sensations and when lesions occur they do not heal
  • candidiasis problematic
  • decreased neutrophils - directly related to hyperglycemia
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4
Q

two types of dialysis

A
  1. hemodialysis- decrease T cells, neutrophils, and Ig (=protein loss), and dendritic function
  2. Chronic Ambulatory Peritoneal Dialysis (CAPD)- peritoneal catheter
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5
Q

cirrhosis

A

liver failure
increased risk of sepsis and peritonitis
- cause is higher endogenous glucocorticoids and low complement

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6
Q

etiologies of protein loss

A
  • nephrological (kidney and urine)
  • enteropathies (GI/stool)
  • dermatitis (skin)
  • dialysis
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7
Q

symptoms of protein loss

A
  • decreased innate immune system
  • decreased epithelium
  • decreased Ig
  • hypoglammaglobulinemia (decreased IgG and A and sometime M)
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8
Q

nephrotic syndrome

A
  • kidney disease with significant protein loss
  • low Ig
  • increased risk of infection by encapsulated bacteria
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9
Q

treatment for nephrotic syndrome

A

immunosuppressive drugs that can lead to further immune disorders

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10
Q

____ is problematic in patients requiring immunosuppressant drugs

A

varicella - chickenpox

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11
Q

trauma

A

release of inflammatory cytokine

can impact the immune system depending on how long they are in the hospital secondary infections

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12
Q

burn

A
  • greater impact on the immune system compared to trauma because first line of defense (skin) is impacted
  • loss of fluids and proteins
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13
Q

two types of environmental exposures

A
  1. Ionizing radiation

2. UV radiation

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14
Q

ionizing radiation

A
  • damages DNA –> decreased cell proliferation –> decreased immune system cells
  • B cells are greatly affected and then T cells
    therefore it takes longer for B cells to get back to normal numbers
  • primary antibody response is diminished
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15
Q

UV radiation

A
  • due to the sun

- destroys epithelium resident immune system cells

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16
Q

splenectomy and hyposplenism etiologies

A
  • congenital
  • trauma
  • atrophy/non-functional due to sickle cell anemia, IBS, graft versus host disease
17
Q

symptoms of splenectomy and hyposplenism

A
  • increased risk of sepsis and encapsulated bacteria

- can be fatal

18
Q

treatments of splenectomy and hyposplenism

A
  • vaccination before splenectomy

- prophylactic antibiotics

19
Q

two types fo normal life stages/events that can lead to acquired immunodeficiencies

A
  1. stress

2. pregnancy

20
Q

stress

A
  • diminished cellular immune functions in PSTD
  • reduced natural killer cell activity and depressed lymphocyte mitogen response
  • higher risk of RTI
21
Q

pregnancy

A
  • decreased immune response- so does not attack baby

- incidence of infection is increased

22
Q

Infections that can lead to acquired immunodeficiencies

A
  1. HIV
  2. measles
  3. herpesviruses
  4. parasitic infections
  5. bacterial infections
23
Q

measles

A
  • T cell lymphopenia (decreased T cells)

- decreased antibodies

24
Q

herpesviruses

A
  • transient depression of cell mediated immunity

- cytomeglovirus

25
Q

parasites

A
  • protozoan - more pronounced immune suppression than any other microbe
  • malaria- decreased cell mediated immunity
26
Q

bacteria infections arenot as well known to cause secondary immune suppression but one exception is

A

superantigens (staph and trep)

27
Q

superantigens (staph and strep)

A
  • lead to significant immune stimulation but T cells eventually decrease in number and activity
  • neutrophil function is decreased
28
Q

In disorders of protein loss such as nephrotic syndrome, the immune deficiency is due to:
A. Loss or inactivation of B cells
B. Loss of pro-inflammatory cytokines in urine
C. Loss of immunoglobulin (IgG) in urine
D. Enhanced cytotoxic T cell activity in the damaged kidney

A

C. Loss of immunoglobulin (IgG) in urine

29
Q

Acquired immune defect associated with measles virus infection:

A. Is due to increased protein loss leading to low levels of IgG
B. Is associated with direct infection of T cells by measles virus
C. Is associated with higher rates of IgG production
D. Results in superinfection with opportunistic pathogens such as Pneumocystis.
A

B. Is associated with direct infection of T cells by measles virus

Immunology II (11 decks)

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