EXAM 2- immunity Flashcards
6 roles of innate immunity
enhances chemotaxis
enhances phagocytosis
mediates inflammation
destroys pathogens
increases cell lysis
increases vascular permeability
igM
forms antibodies to ABO - involved in primary response to pathogen
igA
lines mucous membranes
igD
differentiates B lymphocytes
igG
secondary pathogen response - cross placenta
primary vs secondary response to pathogen
primary: igG and igM raise
secondary: igG raises drastically
3 organs of immune
BM makes lymphocytes
lymph nodes filter material
spleen filters antigens
immune cascade
- macrophade englufs virus and displays antigens on surface
- T helper cells notice and bind releasing cytokines (IL1)
- this signals tcytoxic cells and Thelper cells to proliferate
- Thelper cells release cytokines (IL2)
- B cells proliferate into plasma cells and B memory cells
- plasma cells produce antibodies and the antibody attach to antigen on virus to mark it for destruction
ALSO - Tcyto and NK cells attack cell with antigen
7,. macrophages destory pathogens
type 1 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 5 disorders
-humoral
-IgE binds to mast cells and release histamine
-yes, wheal and flare
-allergies, asthma, uticaria, angioedema, anaphylaxis
anaphylaxis
- type of rxn
-type of response
- first signs
-4 s/s of shock
-treatment - what is on metoprolol?
humoral
hypersensitivity 1
edema at site and itching
-hypotension, dilated pupils, rapid and weak pulse, dyspnea
- epi but glucagon is on BB
type 2 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 3 disorders
- tx
humoral
igM and igG binds to antigen on cell surface and complement is activated
no skin test
transfusion rxn, good pasture, graves
what to do if someone is having dypnea, weak rapid pulse, hypotension
epi or glucagon
what to do if someone has a fever, sweating, tachycardic, bloody urine
transfusion rxn so stop transfusion
type 3 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 3 disorders
- tx
humoral
igM and igG binds to free antigens
complement activated
no skin test
SLE, RA, glomerulonephritis (AI)
immunospuressants, plasmapheresis
type 4 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 3 disorders
- tx
cell mediated
t cells attack antigens
TB skin test
contact dermatitis like poison ivy
corticosteroids (bc of inflammation)
what is plasmapheresis
when is it used
3 SE and how to prevent them
replaces plasma with saline, LR, albumin
used for AI when meds dont work
albumin replacement can deplete immunoglobulin stores for weeks
hypotension- give slowly and vasalvagal
citrate toxicity
what to do if someone has hypocalcemia, dizziness, HA, parasthesia
citrate toxicity, stop plasmapheresis?
what do all hypersens. rxs need
sensitivity to antigen that results in a primary and secondary response
examples of humoral (3) and cell mediated infections(4)
h: anaphylaxis, transfusion rxn, bacterial infection
CM: TB, fungal infection, contact derm
4 ways to manage chronic allergies
med bracelet
stress reduction
limit exposure
epi
6 classes of meds plus example for allergies
- antihistamines - loratidine
- decongestants - phenylephrine
- corticosteroids- prednisone
- leukotriene antagonist- montelukast
- mast cell stabilizer - cromlyn
- antipruitic - diphen.
what does loratidine do
controls edema and itching but NOT bronchoconstriction
when to use cromlyn
NOT emergencies, reg basis
what effect does phenylephrine have
dries up runny nose
if someone has AI or taking antihistamines, what should they avoid
skin tests
epi causes
vasoconstriction and bronchodilation
how does immunotherapy work
IM or sub q - builds up igG which blocks igE from binding and releasing histamine - so blocks histamine release
4 drugs that are immunosupressants
cyclosporine
methotrexate
hydroxychloroquine
adalimumab
2 reasons to get immunotherapy
when drugs not working or allergy cannot be avoided
what is immunodef.
opposite of autoimmunity
4 interventions for immunodef patients
asepsis
neutropenic (no flowers)
remove cause
reverse isolation
4 primary immunodef. disorders
b cell def,
t cells def
x linked rec disorder
phagocytic defect
6 factors for secondary immunodef
age
stress
meds!!!
therapies
malnutrition
2 roles of immunosupressants
control symptoms
delay progression
what type of rxn is latex
type 1 and 4
when to use standard precuations 5
blood
mucous
secretions
non intact skin
body fluid
when to use transmission precuations
highly transmissable
4 interventions for HAI
hand washing
gloves
chlorohex
appropriate PPE use
airborne vs contact vs droplet
a: chicken pox, measles, TB
gloves, gown, goggles, N95 mask
d: influenza, bacterial meningitis
gloves, gown, goggles, reg mask
name 11 foods for latex food syndrome
apples
avacado
banana
celery
carrot
chestnut
kiwi
melon
papaya
potato
tomato
pathophys of HIV
HIV is an RNA virus -
it enters CD4 cell
reverse transcripterase is released
RNA becomes DNA
protease cleaves DNA
HIV virions created that have a rapid CD4 destruction
3 characteristics of an acute HIV infection
1-3 weeks
- HIGH viral load
- VERY infectious
-flu like symptoms
MOA of ART
delays progression by inhibiting viral RNA replication aka decreasing RNA viral levels
3 SE of antiretrovirals
fat redistribution, wasting
insulin resistance
high LDLs
when is preP used
to reduce risk for uninfected people getting sick
what to do if someone got a negative HIV test
come back in 3 weeks
ART drugs interactions
PPI and antacids
3 opportunistic diseases
penumococcal
hepB
influenza
what does it mean when viral load is undetectable
prevents sexual transmission
virus not gone
when do opportunistic diseases occur
Cd4 <500
fluticasone
class
use
education
***not on test
corticosteroid used for allergies
should be used before runny nose occurs
cromyln
class
proper use
**not on test
mast cell stabilizer
used on reg schedule and not for emergencies
phenylephrine
class
MOA
AE
**not on test
sympathomomimetic, decongestant
vasoconstriction
rebound congestion
loratidine
class
use
ed 2
2nd gen antihistamine
controls edema and itching in allergies
take b4 symptoms or right when they appear
does NOT cause drowsiness
diphenhydramine
class
SE
2st gen antihistamine
antipruitic - itching
diminished effect with repeated use
ibuprofen
class and MOA
4 AE
do not take when
NSAID
REVERSIBLE cox inhibition
Gi ulcer, increased BP, bleeding, renal
NOT for athritis - not an antiplatlet
cyclosporine
class
moa
use
AE
immunosupressant
inhibits calcineurin
prevents graft rejection
INC risk for infection
celecoxib
class
use
AE
nursing
NSAID
cox 2 inhibitor
protects against colon cancer
PROMOTION OF MI/STROKE
check for sulfa allergy
adalimumab
class
report
2 cautions
biologic DMARD
report fever above 100
not if active infection
NO live vaccines
methotrexate
class
moa
nursing
3 education
non biologic dmard
dec b and t cell activity
wear gloves
no preg, no vaccines, no straight razor
hydroxychloroquine
class
moa
AE
non biologic dmard
inhibits toll like receptors
retinopathy
prednisone
moa
chronic use AE 3
supresses lymphocytes
skin thinning, inc infection, HYPERGLYCEMIA
acetylsalicyclic acid
moa
contraindications
AE +s/s (5)
education
inhibits cox 1 and 2
DONt give with active bleeding
reyes syndrome - irritability, dec LOC, confusion, weakness, seizures
no alcohol
HLA is responsible for
rejection of genetically unlike
tissues. It consists of a series of linked genes that occur together on the sixth chromosome in
humans.
anergy
an immunodeficient condition characterized by lack of or diminished reaction to an
antigen or a group of antigens, is common.
4 assessments for allergies
comprehensive patient history, physical examination, diagnostic workup, and skin testing for
allergens
