Defense Mechanisms/Infection Flashcards
Cell mediated responses typically occur in response to ___
viral infections
Humoral mediated responses typically respond to ___
bacterial infections
Negative effects of fever:
vasodilation causes hypotension
High temp causes increased metabolic rate which may lead to decompensation in elderly or infirmed
Type 1 Diabetes mellitus is caused by:
T-cells destroying insulin producing cells in the pancreas
Role of the inflammatory response:
Facilitate fluid shifting to clean the area, begun clotting process, promote healing, and stimulate 3rd line defense as needed
Immunodeficiencies are:
an abnormality in one or more branches of the immune system that renders a person more susceptible to disease normally prevented by the immune system
WBC count less than 5000
leukopenia
Two WBCs found in blood
Mast cells
Macrophages
Chronically inflamed tissue that is essentially scar tissue
granuloma
Qualitative defects of phagocytes
Chemotactic defect; impaired function
B-cells attack acetylcholine receptors resulting in weak muscle responses
Myasthenia Gravis
Rheumatoid arthritis (RA) typically attacks ___, and most commonly ___
collagen; synovial membranes
Functions of macrophages:
phagocytizing microbes
Definition of hypersensitivity:
when immunocytes go too far and cause harm
Immunocytes include:
T-cells and B-cells
Process in which prostaglandins and leukotrienes are created through metabolic reactions
arachidonic process
4 examples of abnormal inflammation
SIRS
Sepsis
Septic shock
Chronic inflammation
HLAs are:
human leukocyte antigens (“self” antigens)
HLAs are found:
on the membranes of most tissue cells except RBCs
SLE (lupus) is confirmed by ___ in lab tests
positive ANA
ANA (lupus) stands for:
antibody nucleic acid
Leukocytosis:
Abnormal increase in WBCs
Acute phase reactants:
CRP, circulating PGs, kinins, cytokines, complement cascade, clotting cascade
In multiple sclerosis, ___ attack the myelin sheath of ___
T-cells; brain neurons
S/S of SIRS
changes in mental status Fever > 100.4 Increased HR Increased RR Abnormal WBC count
Macrophages & neutrophils phagocytize:
dirt, debris, dying tissue, microbes
Ability to resist certain diseases due to immunocyte involvement
Acquired immunity
Exudate with WBBC and microbe involvement
purulent exudate
Disease in which the lubricating fluids of the body are dried up
Sjogren’s Syndrome
A trigger causes autoantibodies to attack RBCs
Autoimmune hemolytic anemia
Presence & multiplication of a living organism in or on a host
Infection
Invading organisms that cause infection
Pathogen
Virulence factors:
Toxins
Adhesion factors
Invasion factors
Evasion factors
Factors determining the degree/likelihood of infection
Virulence factors
Portal of entry
Immunocompetence
Protective measures used on all patients
Standard precautions
Protective measures used when potential for fluid transmission is possible via direct or indirect contact
Contact precautions
Protective measures used when potential for spread via droplets exists
Droplet precautions
Protective measures used when suspected or known infection is transmissible via airborne route
Airborne precautions
Typical stages of disease/illness progression
Incubation stage Prodrome stage Acute stage Convalescent stage Resolution
Abrupt onset of illness with little or no prodrome phase
Fulminating illness/fulminant
Factors determining “host” infection
Immunocompetence, virulence factors, portal of entry
Illness without or with less severe S/S
subacute/subclinical illness
Penicillin and it’s derivative have a molecular structure called:
beta-lactam ring
Certain microbes have developed mutations that allow them to destroy antibiotics by:
dismantling the beta lactam ring
___ developed in hospitals in the 1960’s in PTs who were on this particular abx for long periods of time
MRSA
The bacteria ___ developed resistance to methicillin
strep Aureus
___ destroys MRSA
Vancomycin
Most common microbial cause of otitis media
Strep. Pneumoniae
Normal gut flora that causes problems when it migrate to the urinary tract
enterococcus faecalis
Infection of the dermis and subcutaneous tissue by skin-dwelling microbes
cellulitis
Most common culprit of cellulitis
s. aureus
___ can sometimes follow a milder infection such as impetigo
cellulitis
Infection with clostridium botulinum
botulism
Toxins of c. botulinum effect __ by blocking ___
neuromuscular synapses; acetylcholine receptors
S/S: descending symmetric paralysis
botulism
Bacillus that lives in soil; can cause tetanus
clostridium tetanii
exotoxin released by soil dwelling microbe that blocks inhibitory neurotransmitters
tetanospasmin
jaw tightening
trismus
severe muscle cramps, twitching, or convulsions
tetany
Virus transmitted by saliva of infected host
rabies
S/S of rabies infection
anxiety, confusion, convulsions, increased salivation
Treatment for rabies should begin within:
14 days
Mosquito-vector carried illness caused by protozoa
malaria
S/S: high fever, chills, arthralgia, anemia, splenomegaly, cerebral ischemia, heart failure
Malaria
Malaria causing protozoa infects ___ causing ___
RBCs; hemolysis
Protozoa causing malaria reproduces in:
hepatocytes
Rare, deadly illness caused by infection of 1 of 5 virus strains
Ebola hemorrhagic fever
Possible routes of transmission for ebola virus
contact with blood or body fluids through skin breaks, sexual contact, or mucus membranes
TX for ebola hemorrhagic fever
no vaccine or medication currently
Spread primarily through bites from infected mosquitoes (person-mosquito-person)
Zika virus
Uncommon nervous system illness that affects a small # of Zika patients
Guillan-Barre syndrome
Zika infection during pregnancy can cause:
microcephaly & other fetal defects
Avoid these types of medications when treating Zika patients
NSAIDs & aspirin
Microbe which causes strep throat:
strep. pyrogenes
Certain strains of s. pyrogenes can cause ___
scarlet fever
S/S: red, sore throat; white patches on tonsils
Strep throat
Autoimmune diseases possible without early, thorough treatment of Strep throat with abx
rheumatic fever, rheumatic heart disease
Upper respiratory infection that causes pseudomembrane across tonsils & throat
diptheria
leading cause of vaccine-preventable death
Pertussis
Viral invasion of parotid glands that can cause infertility in males
Mumps
“Two week” measles
Rubeola
“3-day measles”
Rubella
Viral illness rarely seen in developed countries but endemic to certain underdeveloped countries
Rubeola
S/S: macropapular rash that spreads from the head down to the body, fever, cough, runny nose, conjunctivitis
Rubeola
Pregnancy complications of rubella
mental retardations, eye & hearing problems
Milder version of the Measles
rubella
S/S: fever, rash, swollen glands
rubella
“Pox” diseases are typically referred to as:
herpetic diseases
Characteristic trait of herpes virus infection:
herpes viruses never leave the body once they enter
Virus that causes vesicles which start at the trunk and spread outward in stages
varicella virus
Clusters of varicella vesicles develop in these stages:
appear
break
crust
Varicella is contagious until:
the last lesions crust over
Contagious inhaled virus that produces dense clusters of lesions that start in the face
Variola/small pox
Dormant varicella virus that sometimes reappears later in life due to age or immunocompromise
Herpes zoster “shingles”
Cell envelope proteins of Flu A
hemagglutinin, neuraminidase
Flu A cell proteins catalyze ___ and ___
viral invasion; release of viral progeny
By what mechanism does tetanospasmin operate?
Blocking inhibitory neurotransmitters causing uninterrupted nerve impulses
Infection of the dermis or subbcutaneous tissue
cellulitis
Acute viral illness of upper and lower respiratory system. S/S: high fever, chills, dry cough, myalgia, malaise, headaches
seasonal flu
Pathogen that can be resistant to vancomycin
enterococcus faecalis
Causative agent behind infectious diarrhea contracted during prolonged hospital stays
c. difficile
Protozoa transmitted by mosquitoes that reproduces and causes RBCs to rupture
Malaria
S/S of Malaria:
high fever, chills, arthralgia, anemia, splenomegaly, tissue & organ ischemia, heart failure
Number of new and existing cases within a specific time period
prevalence
What is variola?
Small pox virus
S/S of small pox (variola):
High fever, flu like symptoms, painful pustules in mouth & esophagus, hemorrhage from virulence factors
Feared bioterrorism agent
Small pox
Typical portals of entry for a pathogen
skin/mucous membranes airborne vector borne oral/fecal route blood-blood blood-open skin
Frothy, fatty, foul smelling infectious diarrhea
giardiasis
Painful, bloody, severe infectious diarrhea
dysentery
Dense maculopapular rash that starts on the head
Measles
Presence and multiplication of a living organism in or on a host
infection
The number of new cases occurring in a specific time period
incidence
Severe headache; rash; muscle pain; fever > 100.4; D/V; unexplained ABD pain, bleeding, bruising, hemorrhage
S/S of ebola hemorrhagic fever
Pink, healthy, healing tissue created by clotting factors, platelets and fibrin
granulating tissue
Hypotension occurs in septic shock due to:
high levels of systemic inflammatory mediators triggering extreme vasodilation
WBCs found in tissues instead of blood
mast cells
Primary inflammatory mediators
histamine, circulating PGs, leukotrienes
Primary inflammatory mediators are released by __ due to __
degranulation of mast cells; local cells being injured or irritated
Binding of antibodies to the toxins of bacteria, rendering them unable to bind to host tissues
Neutralization
Coating of bacteria which promotes phagocytosis by optimizing “recognizability”
opsonization
Tissue specific autoimmune diseases:
MS Graves disease Goodpasture's syndrome myasthenia gravis Diabetes melitus 1 Celiac Autoimmune hemolytic anemia
Cell-mediated immunity is developed by:
T cells
S/S of local inflammatory response
Swelling
heat
erythematosis (redness)
pain
S/S of systemic inflammatory response
malaise, aches, pains, fever
Two main groups of prostaglandins:
protective & proinflammatory
S/S of a transfusion reaction:
fever, low BP, body aches, blocked vessels in kidneys or other areas leading to ischemia
Digeorge’s syndrome is an example of:
congenital cell-mediated immunodeficiency
Target antigen in alloimmune hypersensitivity
someone else’s cells/tissue
Examples of CAUSES of acquired T and B cell immunodeficiencies:
radiation/cytotoxic drugs used for treating cancer
Immunosuppressant drugs used post-transplant
When antibodies crossover the placenta and attack the Rh+ baby due to the mother being Rh-
erythroblastosis fatalis
Causative agent/disease of most cases of hyperthyroidism
Grave’s disease
Grave’s disease functions by:
stimulating the thyroid gland to overproduce thyroid hormone
Cell-mediated acquired immunity is carried out by memory cells created by:
T cells
Humoral acquired immunity is carried out by memory cells created by:
B cells
Active acquired immunity works by:
macrophages presenting partially digested antigens to CD4 cells for destruction
Steroids work in the:
cell membrane of most cells
Steroids work by blocking the production of:
proinflammatory & protective prostaglandins, and leukotrienes
Toxic shock is an example of:
Septic shock
Septic shock usually begins when:
Bacteria invade the blood
After-effect of chemotherapy
Leukopenia
Steroids and NSAIDs suppress:
Protective and proinflammatory effects of prostaglandins
Side effects of prostaglandin suppression:
Stomach ulcers Easy bleeding Diminished Kidney function Diminished infection fighting ability Skin fragility HTN
ELISA stands for
Enzyme linked immunosorbent assay
Diagnosis of AIDS is confirmed by
CD4 count <200 and presence of opportunistic infection
Inanimate vector
Fomite
“Floppy baby syndrome” is caused by:
C. Botulinum
AKA herpes zoster
Shingles
Common causes of bacterial enteritis
E. Coli
Salmonella
Can be thought of as exaggerated “overdrive” responses to specific antigens
Hypersensitivity
Thought to be caused by antibodies or T-cells failing to “stand down” after fighting off an infectoin
Autoimmune hypersensitivity
These travel all throughout the body and get deposited in vessel lining of certain tissues causing vasculitis/inflammation
Immune complexes
SLE
Systemic lupus erythematosus
Specific diagnostic test for Lupus
ANA
ANA stands for
Antibody nuclei acid
ANA is a:
Immune complex made up of antibody and nucleic acid
One of the “great imitators” that often gets mistaken for other diseases
Lupus
The immune complex in RA consists of:
Autoantibody and collagen
In RA, inflammation Occurs anywhere there is:
Collagen
Specific test for RA
Rheumatoid factor (presence of autoantibody and collagen)
Major distinctions between OA and RA
OA occurs mostly in joints and in old age, with pain getting worse throughout the day
RA occurs anywhere there is collagen (tho typically in synovial membranes) and can occur at any age, with pain the worse in the AM and lessening throughout the day
Often known as compatibility issues
Alloimmune hypersensitivity
Types of alloimmune hypersensitivity
Histocompatibility
ABO
Rh
Histocompatibility issues typically involve
Reaction to someone else’s HLAs
3 subcategories of immunodeficiency
Humoral
Cell-mediated
Combined
When testing for AIDS, __ tests for antibodies to __; if positive, the __ is done for confirmation
ELISA, HIV antigen; western blot
Without enough __ a person is much more susceptible to opportunistic infections
CD4 cells
Examples of opportunistic infections that, if present, can help confirm an AIDS diagnosis
CMV, retinitis, thrush, pneumocystic pneumonia, Kaposi’s sarcoma
Yearly change in influenza virus is due to:
mutations of viral cell membrane proteins
self-limiting bouts of V/D
viral infectious diarrhea (“stomach flu”)
watery diarrhea, often caused by E. Coli & Salmonella
bacterial infectious diarrhea
Most common cause of bacillary dysentery
shigella
Usually due to protozoa in drinking water
amoebic dysentery
Intestinal invasion w/out invasion of the lining resulting in frothy, foul smelling, fatty diarrhea
Giardiasis
Diarrhea due to abx wiping out normal gut flora
pseudomembranous colitis
Severe, bloody, mucoid diarrhea, usually painful, due to microbial invasion of intestinal lining
Dysentery
Overcrowding of bone marrow due to over-proliferation of WBCs
leukemia
2 types of leukemia
Myelogenous & lymphocytic
4 types of leukemia
Acute myelogenous
Acute lymphocytic
Chronic myelogenous
Chronic lymphocytic
Lymph node enlargement due to local/system infections or malignancies
lymphadenopathy
Cancer in which certain lymphocytes wildly proliferate, often clumping into tumors
lymphoma
Type of lymphoma that usually begins as large, painless masses in lymph nodes of the neck
hodgkin’s lymphoma
Oversecretion of immunoglobulins by malignant plasma cells
multiple myeloma
Sequela of Multiple myeloma
increased osteoclastic activity > pathological fractures & hypercalcemia > lethargy, kidney stones
CBC findings particular to microcytic anemia
low MCV & high Hgb
CBC findings particular to normocytic anemia
low RBC & normal MCV
CBC findings particular to macrocytic anemia
MCV > 95, glossitis, neuropathies (parasthesias)
Macrocytic anemia neuropathies are usually due to
B12 deficiency from decreased apetite due to glossitis & fatigue
Enlargement of the spleen
splenomegaly
pathological Increase in splenic activity
hypersplenism
Splenomegaly caused by malignancies is caused by
large # of WBCs filtering thru the spleen, causing swelling
Physiologic splenomegaly is caused by
idiopathic etiologies, “individualistic quirk”
Hematological splenomegaly is caused by
increased hemolysis of RBCs creating more “debris” for the spleen to process
Disease process caused by erythrocytosis
polycythemia
Genetic condition of abnormal proliferation of RBCs
polycythemia vera
condition of “too few platelets”
thrombocytopenia
Autoimmune thrombocytopenia
idiopathic thrombocytopenia purpura (ITP)
Low levels of certain coagulation factors
hemophilia
Low levels of a substance released by tissue that binds platelets
von Willebrand dz
Too much clotting
thrombocytosis
Virus that travels from PNS to CNS & causes confusion, agitation, dysphagia
Rabies
protozoa that causes high fever, anemia, & splenomegaly
malaria
Strep throat with fever & rash
scarlet fever
Viral invasion of parotid glands
Mumps
AKA “Allergic hypersensitivity”
IgE mediated hypersensitivity
S/S include pulmonary hemorrhaging & glomerulonephritis
Goodpasture’s syndrome
In __ an autoantibody attacks connective tissues in pulmonary & glomerular basement membranes
Goodpasture’s syndrome
Muscle weakness & reduced sensitivity to neruomuscular impulses caused by autoantibody attacking acetylcholine receptors
Myasthenia gravis
Slow over-proliferation of bone marrow stem cells and higher than normal # of RBCs
Polycythemia vera
Polycythemia vera is treated by:
donating blood
In ___, the predominant cell that becomes cancerous is B-lymphocytes
multiple myeloma
Pathology of multiple myeloma
B-cells create overabundance of cancerous immunoglobulins that infiltrate bones and certain organs, creating multiple malignant tumors
Cancer in which certain lymphocytes wildly proliferate and begin to clump together in lymph nodes
Lymphoma