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D & D Exam 1 > Chapter 16-Disorders of the Immune Response > Flashcards

Chapter 16-Disorders of the Immune Response Flashcards

1
Q

What is the immune response?

A

Defense network that has evolved to protect against invading microorganisms

Prevents proliferation of cancer cells (natural killer cells)

Mediate the healing of damaged tissue

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2
Q

Hypersensitivity disorders

A

Excessive/inappropriate activation of immune system

Type 1 - immediate hypersensitivity disorders

Type 2 - antibody-mediated disorders

Type 3 - immune complex - mediated disorders

Type 4 - T cell mediated disorders

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3
Q

Hypersensitivity disorder Type 1

A

“Allergic reactions”

Begin rapidly

Mediators are released from mast cells

Phases
1. Initial or early response
-vasodilation (BP v)
-vascular leakage
-smooth muscle contraction
Occurs within 5-30 mins and subsides within 60 mins
  1. Secondary or late phase
    - sets in about 2-8 hours later and lasts for several days
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4
Q

What is the antigen responsible for a Type 1 reaction called?

A

allergen

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5
Q

What is a systemic Type 1 reaction called?

A

Anaphylactic shock

Widespread vasodilation (BP v = not getting to organs)

Airway constriction

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6
Q

When mast cells degranulate, histamine is released?

A

True

Histamine is one of the first chemical mediators released

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7
Q

What are mast cells?

A

Granulocytes found in connective tissue

We don’t know normal function, yet

Activated when injured

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8
Q

Anaphylaxis

A

Systemic response to inflammatory mediators released in Type 1 hypersensitivity

Histamine, acetylcholine, kinins, leukotrienes, and prostaglandins all cause vasodilation

Acetylcholine, kinins, leukotrienes and prostaglandins all can cause broncho-constriction (inability to breathe)

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9
Q

Why give epinephrine for anaphylaxis?

A

Epinephrine is a potent vasoconstrictor, which will help reverse the extreme vasodilation that caused the blood pressure to decrease and not allow blood to get to the organs.

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10
Q

Type II sensitivity

A

Antibody mediated hypersensitivity reaction

ONLY SYSTEMATIC

Mediated by IgG or IgM

Blood transfusion reactions

Newborns with incompatible ABO or Rh factors (RoGam)

sometimes in drug reactions

  • cell destruction (lysis)
  • can be fatal
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11
Q

What happened if incompatible blood is given in transfusion?

A

Hemolysis (cells blow up)

Not only are cells not able to carry oxygen but the broken up pieces of RBCs (large) go back through kidneys and can actually block kidneys and cause renal failure

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12
Q

Type III hypersensitivity

A

Immune mediated disorder

Systemic or local

Immune complexes produce inflammatory effect - damages are tissue (deposit in tissues)

Serum sickness - insoluble complexes are deposited in vessel tissue

May cause local tissue necrosis because of deposits

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13
Q

Type IV hypersensitivity

A

Cell mediated hypersensitivity disorder

Occurs when tissue damage causes cell mediated immune responses with T-lymphocytes causing cell and tissue injury

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14
Q

Allergic contact dermatitis

A

“Atopic allergic reaction”

inflammatory process of the skin

Re-exposure to an allergen - “hives”

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15
Q

Autologous graft

A

same person transplant

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16
Q

Syngenetic graft

A

from a twin

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17
Q

Allogenetic graft

A

same species

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18
Q

Self tolerance

A

Mechanism where host recognizes what cells are self (host) cells and what are non self cells (antigen)

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19
Q

Alloantigens

A

Recognized as foreign

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20
Q

Graft vs host

A

When the host attacks and rejects the transplanted organ/tissue

T cells are central to causing the rejection

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21
Q

Most autoimmune diseases are more common in women than men?

A

True

Maybe an estrogen link

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22
Q

What are local autoimmune diseases?

A

Discoid lupus

Atropic gastritis

Autoimmune adrenalitis

Temporal arteritis

23
Q

What are some systemic autoimmune diseases?

A

Systemic lupus erythmatosus

Rheumatoid arthritis

Scleroderma

Autoimmune hemolytic anemia

24
Q

Immunodeficiency disorders of B cell function

A

Impairs the ability to produce antibodies

25
Q

Immunodeficiency disorders of T cell function

A

Impairs the ability to orchestrate the immune system

Cannot protect against intracellular infection/cancer

26
Q

Immunodeficiency disorders combined B and T cell dysfunction

A

Affect all aspects of immune function

Absence of immune system
“Bubble Boy”

27
Q

Acquired immunodeficiency syndrome

A

AIDS

Caused by infection with HIV

Causes profound immunosuppression

Currently a pandemic (spreading)

HIV - if carrying disease
AIDS - infection

28
Q

Pathophysiology of HIV

A

Carries genetic material in RNA (retrovirus)

HIV 1 or HIV2

most common in US is HIV 1

Infects CD4, T helper cells, macrophages and dendritic cells

CD4 + T cells are necessary for immune functions

29
Q

What are the 8 steps to HIV replication?

A
  1. Binds to CD4+ T cell
  2. Uncoating - RNA is injected into cell
  3. DNA synthesis - uses reverse transcriptase enzyme
  4. Integration - new DNA enters nucleus (integrase)
  5. transcription - DNA makes single strand RNA
  6. translation - ribosomal RNA uses mRNA to create polyprotein
  7. cleavage - protease enzyme cuts polyprotein chain into individual proteins that will make new virus
  8. Proteins and viral RNA are assembled into new HIV viruses and releases.
30
Q

Primary phase of HIV infection

A

2-4 weeks after exposure

Last few days to 2 weeks

31
Q

Latency phase of HIV infection

A

No signs or symptoms

Median time is 10 years

Can see lymphadenopathy (swollen lymphoid tissue)

32
Q

Overt AIDS phase

A

CD4 + T cell count is less than 200 cells/microliter

Can lead to death within 2-3 years

Increases risk of opportunistic infection

33
Q

Window period

A

Time receiving infection to when it shows up positive (about 25 days)

34
Q

Symptoms of AIDS

A

Pheumocytosis Pneumonia

35
Q

Opportunistic infections of respiratory tract

A

PCP pneumocystis pneumonia

TB

36
Q

Opportunistic infections of the GI tract

A

Thrush

Herpes simplex

Esophagitis

Diarrhea (salmonella, giardia, c-difficile)

37
Q

Nervous system infections caused by HIV

A

(usually late complications)

AIDS dementia complex

Cognitive and motor dysfunction

38
Q

Opportunistic infections of the nervous system

A

Taxoplasmosis (parasite that invades CNS)

39
Q

Karposi sarcoma

A

Malignancy of endothelial cells that line small blood vessels

Most frequent malignancy associated with AIDS

Lesions can be found on skin, in mouth, GI tract, lungs

40
Q

Non Hodgkin lymphoma

A

AIDS more susceptible

Fever, night sweats, weight loss

41
Q

Cervical dysplasia

A

Progress rapidly to cervical cancer in women with HIV

42
Q

Wasting syndrome

A

AIDS defining illness

Involuntary weight loss of at least 10% of baseline body weight with the presence of diarrhea

Diagnosis made when no other cause can be identified (anorexia, metabolic abnormalities, endocrine dysfunction and malabsorption all contribute)

Cachectic - wasting away

43
Q

Cachectic

A

wasting away

44
Q

What is a nurses role in HIV/AIDS?

A

Astute infection control

Excellent respiratory assessments (lungs are usually where first infection shows up)

Hand washing

Protect not only self from infections but protect patient from opportunistic infections

45
Q

What are the diagnostic methods for HIV and AIDS?

A

ELISA test and the Western Blot

46
Q

Is there treatment for HIV or AIDS?

A

No cure

Multiple drug combinations are used to delay disease process, decrease severity of symptoms and in some cases, stop seroconversion

Can often be problems with compliance because there are so many pills to take and maybe not enough money to pay for them all or simply the patient does not want to take so many pills.

47
Q

Urticaria

A

hives

48
Q

Dermatitis

A

inflammation of the skin

49
Q

What are some examples of Type III Hypersensitivity?

A
  • “Farmer’s Lung”

- Reactive Arthritis

50
Q

Histiocompatability

A

important for organ transplants

-Is the new organ compatible with the host body?

51
Q

Discuss Autoimmune Diseases.

A
  • immune system can no longer distinguish self from non-self antigens
  • unknown etiology
  • environmental factors could contribute
  • genetic susceptibility could increase incidence and severity of autoimmune diseases
  • not uncommon for a person to end up with multiple autoimmune diseases
52
Q

Discuss Immunodeficiency Disorders.

A
  • congenital or inherited
  • renders a person susceptible to disease normally prevented by an intact immune system
  • Disorders of B cell function
  • Disorders of T cell function
  • Combined T and B cell dysfunction
53
Q

How is HIV Transmitted?

A
  1. sexual contact
  2. blood to blood contact
  3. infected mother to offspring
  4. Transfusions of blood products before 1985
  5. Needle sharing
  6. Occupational HIV infection among healthcare workers is uncommon (needle-stick)
  7. Can be transmitted even when no symptoms are present

D & D Exam 1 (5 decks)

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