Chapter 42: The Child with an Immunologic Alteration Flashcards
Why does HIV have a more rapid disease progression in infants than teenagers?
Infants have naturally decreased or immature immune systems to begin with.
Diagnosis of HIV in children uses the tests __________ and ___________.
HIV DNA PCR
HIV RNA Assay
_____________________ disorders occur when the body’s immune system can no longer differentiate its own cells from antigens.
Autoimmune
Treatment goal of Systemic Lupus Erythematosus (SLE)
prevent organ damage
____________ infants have longer immunity
Breastfed
Sneezing; tightness, tingling of mouth or face with subsequent swelling of lips and tongue; severe flushing, urticaria, and itching (especially head and upper trunk); rapid development of erythema; and a sense of impending doom are manifestations of _____________.
initial anaphylaxis
The newborn receives __________ by placental transfer, which disappears by _____________
IgG, 6-8 weeks
Classic sign of SLE
butterfly rash
The spleen reaches its full size at _________________
adulthood
___________ help build the immune system
Vaccines
When is oral ZDV given to infants
within first 6-12 hours after birth until 6 weeks old or positive HIV diagnosis
What is required for HIV to be considered negative in children?
2 negatives on 2 different occasions at 1 month and 4 months
Lymphoid tissue (increases, decreases) in males during __________ and ____________
increases, infancy, childhood
Treatment given to the mother during labor for HIV-exposed infants
IV ARV
Diagnosis for SLE involves this test
positive ANA assay
Type II hypersensitivity also known as
cytotoxic hypersensitivity
An acquired cell-mediated immunodeficiency disorder that is chronic and causes a widespread spectrum of illnesses in children
HIV
Why is CD4 direct count not monitored in children?
CD4 count can vary greatly based on age
Allergic rhinitis, acute anaphylaxis, hives, eczema, and asthma are examples of __________ hypersensitivity
Type I (immediate, anaphylactic)
Most likely method of HIV transmission in adolescents
sexual transmission or illegal drug use (due to high risk behaviors)
Type III hypersensitivity also known as
arthrus hypersensitivity (immune complex)
Other causes of anaphylaxis in children
medication, insect stings
What therapy is initiated after an infant receives a positive HIV diagnosis
antiretroviral (ARV) therapy
Children have ____________ capacity to mount an antibody response
limited
Recurrent upper respiratory infections and ear infections are common with this disorder
HIV
Immunologic alterations are usually ________________ with intervals of ___________ and ____________
chronic, wellness, relapses
This type of therapy acts as natural products of the adrenal glands and reduces systemic inflammatory symptoms
corticosteroid therapy
Preferred method of birth for HIV positive mothers
Cesarean section
Chemotherapy drug that decreases immune response and is also used for SLE
cyclophosphamide
The number of Peyer patches (increases, decreases) until __________________
increases, adolescence
Type I hypersensitivity also known as
immediate (anaphylactic) hypersensitivity
Diagnosis of SLE requires _______ or more of the manifestations to be present.
4
For treatment of anaphylactic shock, ensure an adequate ___________ and __________ if necessary. Administer _________________, _____________, ______________, and/or _____________ as ordered. Keep the child (warm, cold) and lying ______ or with feet ________________. Start an ____________.
airway, intubate
epinephrine, oxygen, corticosteroids, antihistamines
warm, flat, slightly elevated
IV line
The thymus gland is fully functional until ____________, when it begins to __________ and is ultimately replaced by _________________________
puberty, shrink, fatty tissue
Encourage to have low ________ and low ___________ diet to preserve renal function (in SLE that affects kidneys)
sodium, protein
Serum sickness and glomerulonephritis are examples of _________ hypersensitivity
Type III (arthrus, immune complex)
Long-term use of ___________________ results in adrenal suppression
corticosteroids
Treatment given to HIV-exposed infants after birth
oral ZDV
Transfusion reaction after receiving incompatible blood is an example of _________ hypersensitivity
Type II (cytotoxic)
Contact dermatitis (such as from poison ivy) is an example of ________ hypersensitivity
Type IV (delayed cell-mediated)
Why is the western blot assay inaccurate under 18 months?
Mother’s antibodies are still present
A common autoimmune disorder that results in connective tissue inflammation
Systemic Lupus Erythematosus (SLE)
What is required for a positive diagnosis of HIV in children?
2 positive tests on 2 different occasions
(Increased/Diminished) immune response allows for spread of ___________
Diminished, infection
Most common cause of anaphylaxis in children
food allergies
To be diagnosed with adrenal suppression, the patient is administered _______, and the _______________ level does not elevate as it should.
ACTH, serum cortisol
Type IV hypersensitivity also known as
delayed cell-mediated hypersensitivity
Amount of HIV virus detected in bloodstream
viral load/burden
Most likely method of HIV transmission in infants
mother to infant across placenta or during childbirth
More severe complications include osteoporosis, amenorrhea, cataracts, and pancreatitis
corticosteroid therapy
Short-term use of _____________________ can shorten the span of illness and improve patient wellbeing
corticosteroids
Instead of CD4 direct count, what levels should be monitored in children with HIV?
CD4 percentage
Manifestations include edema, GI upset, bruising, increased infection, increased appetite and weight, muscle atrophy, hypertension, and growth limitations.
corticosteroid therapy
