alterations in immune system Flashcards
what does immune system do
defend against infection and maintain equilibrium
passive immunity
short lived, maternal antibodies like placenta and breast milk, immunoglobulins like antibodies.
active immunity
bodies immune system creates its own antibodies from exposures. non specific and innate, specific and adaptive, humoral immunity involves B cells, cellular immunity involves T cells
primary organs
thymus, bone marrow. produce components of immune system
secondary organs
spleen, lymph nodes, tonsils.
IgG
greatest concentration, goes across placenta, found in body fluids, protects from bacteria, viruses and fungi
IgA
found in saliva, tears, mucus membranes, part of innate immunity, lines rr passages and gi tract
IgM
largest immunoglobulin molecule, immediate produced in immune system, cannot cross placenta
IgE
role in allergies, asthma, parasitic infection, triggers histamine release, attach to basophils and mast cells, found in lung, skin, and mucous membranes
IgD
stimulates B cell differentiation, function not clear, only small amounts.
immune system differences
decreased infla response to invading organisms, increased susceptibility to infection, has functional spleen, functional cellular immunity, short lived passive immunity, B and T cells not at adult level, trace amounts of immunoglobulins, large lymph nodes, tonsils and thymus, small spleen. thymus shrinks at puberty, peyers patches increase until 15-25yrs then decline.
factors affecting immunity
immature immune system, sx can be different compared to adults, environment in schools, hygiene cause kids dont wash hands, immunizations not complete
health hx
maternal HIV infection, frequent infections, chronic cough, low grade fever, two or more serious infections within a yr, recurrent deep skin abscesses, persistant thrush, extensive eczema, growth failure.
primary immunodeficiences
hereditary and were born with. can effect humoral or cellular or combo, and phagocytic systems. ex are hypogammaglobulinemia, wiskott aldrich syndrome, severe combined immune deficiency
tx of primary immunodeficiency
IVIG prophylactically until bone marrow transplant, hematopoietic stem cell transplant is possible cure for WAS and SCID.
secondary immunodeficiencys
caused by something else. pathogenic cause from chronic illnesses, malignancy, immunosuppressive rx, malnutrition, prematurity, HIV infection, chemo.
HIV
acquired vertically from mother or horizontally from unprotected sex or needles. shorter incubation of 17mo. shorter latency period of HIV + to AIDS, can invade CNS
sx HIV
failure to thrive, recurrent bacterial infections, opportunistic infections, chronic diarrhea, recurrent fever, development delay, prolonged candidiasis
considerations of HIV
prevent transmission, compliance with rx, promote nutrition, have financial difficulties, HIV stigmas, desire to keep confidential, many hospital visits. give IVIG and antiretrovirals right after birth and quick bath and no breast feeding.
autoimmune disorders
body makes T cells and antibodies that attack its own cells, cause may be multifactorial. factors are hereditary, hormones, self marker molecules, envirornment, viruses, drugs.
sx autoimmune disorder
fatigue, joint pain or swelling, skin problems, abd pain, gi issues, swollen glands, fever
systemic lupus erythematosus
chronic multi system disease, affects kidney and brain.
sx lupus
butterfly rash, fever, joint infla, fatigue, leukopenia, anemia, weight loss, alopecia, neuro change, nephrotic syndrome, seizure, urine color change
mx lupus
rest during flare up, dmards (methotrexate, hydrocloroquin), nsaids, ccsteroid, immunosuppressive drug, prevent infection, wear sunscreen.
juvenile idiopathic arthritis
immune system attacks joints, cartilage thins and synovial fluid accumulates, excess bone growth. sx are joint sx like large joint, pain, warm, swollen. mx is promote normal lifestyle, nsaids or dmards rx, encourage activity, pt, low impact exercise, moist heat on joint, splints,
allergies
immune mediated response, can have food or environment allergies. sx are hives, flushing, mouth itch, gi reaction, rash, rhinitis, watery eyes, salute sign, allergic shiner.
allergy dx
personal and medical hx, physical exam, skin prick test, rast, elimination diet, oral challenge test.
allergy tx
avoid triggers, antihistamine, nasal ccsteroid, allergy shots, epi pen
anaphylaxis
acute immediate severe response. within 5-10min of contact. tissue edema leads to vasodilation and circulatory collapse.
sx anaphylaxis
pruritic urticaria, coughing, lip and tnogue swell, stridor, extreme anxiety, asthma attack, loss of consciousness.
mx anaphylaxis
support airway, tx with IV epi, cc steroid, antihistamine, IM epi if not in hospital, fluids for volume expansion, monitor for 2hrs after.
