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Nursing 120 > Exam 4 - Immune > Flashcards

Exam 4 - Immune Flashcards

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1
Q

what is innate memory?

A

non specific; immunity we were born with

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2
Q

what is adaptive memory?

A

specific; immunity that is changing through life

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3
Q

what is a hypersensitivity reaction?

A

a reaction by the immune system that is undesirable

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4
Q

what are the types of hypersensitivity reactions?

A

type 1: allergy
type 2: cytotoxic
type 3: immune complex disease
type 4: delayed type, cell mediated, antibody independent

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5
Q

what is an antibody

A

fights against invader

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6
Q

what is an antigen

A

bad guy that produces immune response

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7
Q

what is cytotoxic?

A

antibodies produced by the immune response bind to the antigens on the patients own cell surface

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8
Q

what is the immune complex disease?

A

occurs when there is accumulation of immune complexes that have not been adequately cleared by innate immune cells

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9
Q

what are the steps of an allergic reaction?

A 
allergen introduced
plasma cell creates IgE
IgE antibodies attach to mast cells
allergen is reintroduced
allergen attaches to IgE
histamine released
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10
Q

what are treatments for an allergic reaction (10)

A 
remove the allergen
administer epipen
antihistamines
corticosteroids
bronchodilator 
o2
IV fluid for BP
vasopressors
intubation
tracheostomy
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11
Q

what are the ways to administer the epinephrine

A

subcut/IM/IV

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12
Q

what are the two types of immunodeficient disorders

A

primary and secondary

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13
Q

what is a primary immunodeficient disease

A

genetic mutations; found in children and infants

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14
Q

what is a secondary immunodeficient disease

A

acquired; viral infection; toxin; med therapy

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15
Q

what is the cause of RA?

A

unknown etiology; immune related

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16
Q

what are the autoantibodies related to RA?

A

rheumatoid factors: IgG and IgM

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17
Q

what do rheumatoid factors do?

A

attack healthy tissue especially in the synovium

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18
Q

what are the other autoantibodies related to RA?

A

CD-4 T helper cells
Neutrophils
Immune complexes
B and T cell lymphocytes

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19
Q

what are the stages of RA?

A

Synvotitis
Pannus
Fibrous anklosis
Bony anklosis

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20
Q

Synvoitis

A

synovial membrane is inflamed and thickened

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21
Q

pannus

A

extensive cartilage loss/exposed

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22
Q

Fibrous anklosis

A

joint invaded by fibrous connective

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23
Q

bony anklosis

A

bones are fused

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24
Q

what are the types of deformities

A

swan neck
ulnar drift
boutinnere
nodules

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25
Q

what are the signs and symptoms of RA

A 
joint pain
tenderness
swelling
AM stiffness
fatigue, anorexia, low grade fever
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26
Q

what is the pattern to find RA

A

bilat; symmetrical

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27
Q

what are systemic issues deriving from RA

A

vasculitis
parasthesia
pleurisy/pulmonary hypertension
sjogrens

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28
Q

what is sjogrens?

A

dry eyes, mouth and vagina

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29
Q

how many tests should be abnormal to get an idea of RA?

A

3 or more

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30
Q

what tests are usually all high to determine

A

CRP
anti-nuclear
eythrocyte sedimentation

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31
Q

what other tests do they run to determine RA

A

CBC
ANTI CCP
RHEUM. FACT.

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32
Q

what is first course of treatment for RA patients?

A

NSAIDs

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33
Q

what is a DMARD

A

disease modifying anti rheumatic drugs

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34
Q

what are the DMARD I

A

methotrexate
hydroxycholeoquine (plaquenil)
sulfasalozine (azulfidine)

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35
Q

what are the DMARD II

A

Enbrel (etanercept)

remicade (infliximab)

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36
Q

what drug is

  • an immunosuppressant
  • should have no sun exposure
  • no alcohol use
  • causes bleeding, jaundice, dry cough, SOB, blood in urine and clay stool
A

methotrexate

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37
Q

what drug is

  • an antimalarial
  • causes retinal damage and psychosis
  • eyes start seeing orange
A

plaqenil (hydroxycholroquine)

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38
Q

what drug causes

  • lymphoma
  • chf and seizures
A

enbrel

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39
Q

what do DMARD II do?

A

block cytokines which cause no immune response

40
Q

what corticosteroid is taken by mouth for RA

A

prednisone

41
Q

what corticosteroid is taken through IV for Ra

A

methylprednisolone (solumedrol)

42
Q

what do corticosteroids do for RA

A

anti inflammatory, immunosupress

help while DMARD is starting to work

43
Q 
what drugs for RA 
increase risk of infection
increase risk of osteoporosis
increase blood glucose
increase gastric acid secretion and cause ulcers
cause mood disturbances
increase sodium and water
cause retention and loss of potassium
CUSHING
A

corticosteroids

44
Q

what are nursing interventions for corticosteroids

A 
give in the morning with food
monitor mood
increase insulin PRN
watch infection
give supplements (calcium and vit D)
TAPER OFF
45
Q

what happens if you don’t taper your corticosteroid?

A

adrenal insufficinecy

46
Q

what is a cytokine

A

a protein that has an effect on the interaction of cells (general)

47
Q

what is systematic erythrematosus lupus?

A

progressive inflammatory connective tissue disease

48
Q

what does SLE do?

A

immune complexes form in serum and organ tissues and cause vasculitis, depriving them of oxygen and blood

49
Q

what organs are usually effected by SLE

A

kidney lung and brain

50
Q

why do they think SLE is caused

A

over exposure to sun, autoimmune

51
Q

what is a side effect of SLE?

A

paranoid psychosis

52
Q 
butterfly rash
alopecia
osteonecrosis
polyarthritis
myotitis(muscle inflam)
pericarditis
decrease in WBC and platelets
A

systemic lupus

53
Q

what are diagnostic criteria of systemic lupus?

A 
same as RA usually
ANA
CBC
CRP
ESR
PT/PTT
urinalysis
kidney and liver function
54
Q

what are pharmacological treatments for lupus

A 
topical cortisone (rash)
hydroxycholroquine (plaquenil)
NSAIDs
corticosteroids
immunosuppressants (methotrex)
cyclosporin
psytotoxin
55
Q

alloimmunity

A

immune response to non self antigens from members of same species

56
Q

prep for blood or tissue transplant

A

typing:

  • same blood type
  • type donor and receiver
  • 3 antigen match
57
Q

what is the goal of immunosuppression

A

to calm it down and not attack everything

58
Q

common immunosuppressive drugs

A

cyclosporin
lmuran
corticosteroids

59
Q

acute rejection signs

A

fever, loss of function and clots

60
Q

what is broad spectrum

A

against gram positive and gram negative bacteria

61
Q

what is narrow spectrum

A

only against a family of bacteria

62
Q

what is an advantage to narrow spectrum antibiotics

A

less change on resistance

will not kill as many of our normal bacteria

63
Q

what are the two types of immunity

A

nonspecific

specific

64
Q

nonspecific immunity

A

initial reaction against foreign antigen

65
Q

specific immunity

A

production against a particular antigen

66
Q

what are the different WBC

A 
neutrophils
eosinphils
basophils
lymphocytes
monocytes
67
Q

neutrophil

A

innate

attach to walls and eat cells, block passage of germs

68
Q

lymphocytes

A

humoral

make antibodies

69
Q

monocytes

A

eater of dead cells

70
Q

eosinphils

A

release toxin to kill pathogens

71
Q

what is a raise in eosinophils tell you?

A

allergy

72
Q

basophils

A

dilate vessles to bring more immune cells in - contains histamine

73
Q

leukocytosis

A

increase in total number of WBC

74
Q

what are the antibiotic classifications (7)

A 
penicillins
cephalasporins 
aminoglycosides
sulfonamides 
fluoroquinolones
antiprotozoals
vancomyocin
75
Q

disrupts bac cell walls
gram positive - narrow spectrum
allergic rxn is common side effect

A

penicillin

76
Q

largest of the antibiotic class
inhibits cell wall synthesis
gram negative
each generation has a broader spectrum
1-4th gen effective against gram positive
after 4th gen can enter CSF and help brain infections

A

cephalasporins

77
Q

bacterial protein synthesis inhibitor
aerobic gram neg
narrow spectrum
measure peak and trough!

A

aminoglycoside

78
Q

inhibits bacterial growth
gram positive and negative
broad spec
high resistance

A

sulfonamides

79
Q 
disrupts bacterial DNA synthesis
gram negative
some new gen can do gram positive
broad (newer)
do not pair with anti coagulants
increase fluids for the kidneys
cipro, levofloxican
-oxican
A

fluroquinolones

80
Q 
inhibits pathogen DNA and RNA synthesis
effective against anaerobes
bacteria and parasite
give by mouth or iv
used for infection and peptic ulcer disease
A

antiprotazoals

81
Q 
serious gram positive infection
given IV
measure peak and trough for dosing
nephro and liver toxic
dilute in 100 ml at least
A

vancomyocin

82
Q

how to treat pseudomembranous colitis (c. diff)

A

vancomycin by mouth

83
Q

macrophages in the elderly

A

toxicity in tumor cells decrease

84
Q

T cells in elderly

A

function decreases

85
Q

B cells in elderly

A

fewer number and less effective

86
Q

What is an example of specificity theory

A

Nociceptor and neuropathic pain

87
Q

What is the example of gate control theory

A

Pain transmission fibers

88
Q

Neuromatrix pain is exemplified by what

A

Phantom limb pain

89
Q

What are endorphins

A

Peptides released in the CNS

90
Q

What do endorphins do?

A

Activate opioids receptors

91
Q

What other peptides have opioid like properties

A

Enkephalins and dynorphins

92
Q

amoxicillin

A

penicillin

93
Q

cephtriaxones, cephalexine

A

chephlasporin

94
Q

gentamiocin, streptomyocin

A

aminoglycosides

95
Q

ciprofloxican, levofloxican

A

fluroquinolones

96
Q

pentamide, nitazoxnide

A

antiprotazoals

Nursing 120 (21 decks)

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