Exam 4: Inflammation, immune function, and HIV (11 questions) Flashcards
Inflammation: Neutrophils
- 55% to 70% of WBC
- Function is phagocytosis
- Absolute neutrophil count (ANC)
Inflammation: Macrophages
- 4-8%
- Phagocytosis
- Repair
- Antigen presenting/processing
- Secretion of cytokines
Inflammation: Basophils
- 0-2%
- Cause the symptoms of inflammation
- Blood to collect in capillaries and arterioles
- Increases capillary permeability
Inflammation: Eosinophils
- 0-4%
- Active against parasitic larvae
- Limits inflammatory reactions
- Increases during an allergic response
Antibody mediated immunity: Cells involved
- Antibodies are produced by sensitized β -lymphocytes (β-cells)
- β-cells start as stem cells
Antibody mediated immunity: Pathology of process
- Exposure
- Antigen recognition
- Sensitization
—– Plasma cell
—– Memory cell - Antibody production and release
Circulating antibodies can be transferred to another person - Antibody-antigen binding
- Antigen-binding actions
—-Agglutination, lysis, complement fixation, precipitation, inactivation
Antibody mediated immunity: Antibody classification
- IgA
- IgD
- IgE
- IgG
- IgM
Antibody mediated immunity: Active immunity
- Body takes an active role in producing antibodies
- Natural active immunity
Antigen enters body without human assistance - Artificial active immunity
Protection developed by vaccination or immunization
Antibody mediated immunity: Passive immunity
- Transferred from another person
Short term effect - Natural passive immunity
Example: mother to baby when breast fed - Artificial passive immunity
Injecting antibodies from another person
Short term
Cell-mediated immunity: T-lymphocytes
- Helper/inducer cells
T-4 or CD4 cells, secrete lymphokines, increase bone marrow production when needed - Suppressor cells
T-8 cells, prevent hypersensitivity, secrete lymphokines, inhibit growth & activation of immune system
—–/cytolytic T-cells (Tc)
—————Destroy cells containing processed antigen’s HLA, effective against parasites, protozoa
Cell-mediated immunity: Natural Killer Cells (NK)
- CD16 , can destroy without previous sensitization
- Destroys abnormal or unhealthy cells
Cell-mediated immunity: Cytokines: small protein hormones
- Act as messengers that tell specific cells how to respond
- Control many inflammatory and immune responses
- Monokines
When produced by macrophages, neutrophils, eosinophils or monocytes - Lymphokines
When produced by T-cells
Hypersensitivity reactions: Type I: Rapid Hypersensitivity Reactions
- Examples: Allergic Rhinitis, Anaphylaxis, Latex Allergy
- Diagnosis: Allergy test: scratch test, intradermal. Antihistamines & glucocorticoids discontinued for 4 weeks prior to testing
Repeat Open Application Testing (ROAT). & blood testing - Minor reaction treatment: Antihistamines, corticosterioids
- Major reaction treatment: Epinephrine
- Also IgE
Hypersensitivity reactions: Type II: Cytotoxic Reactions
- Examples: Hemolytic anemias, Thrombocytopenic purpura, Hemolytic transfusion reactions, Goodpasture’s syndrome
- Diagnosis: Allergy test: scratch test, intradermal. Antihistamines & glucocorticoids discontinued for 4 weeks prior to testing
Repeat Open Application Testing (ROAT). & Blood testing - Minor reaction treatment: Antihistamines, corticosterioids
- Major reaction treatment: Epinephrine
-Also Type IgG
Hypersensitivity reactions: Type III: Immune Complex Reactions
- Examples: Rheumatoid arthritis, systemic lupus erythematosus, serum sickness
- Diagnosis: Allergy test: scratch test, intradermal. Antihistamines & glucocorticoids discontinued for 4 weeks prior to testing
Repeat Open Application Testing (ROAT). & blood testing - Minor reaction treatment: Antihistamines, corticosterioids
- Major reaction treatment: Epinephrine
Hypersensitivity reactions: Type IV: Delayed Hypersensitivity Reactions
- Examples: Positive purified protein derivative, Contact dermatitis, Poison ivy skin rashes, Insect stings, Tissue transplant rejection, Sarcoidosis
- Diagnosis: Allergy test: scratch test, intradermal. Antihistamines & glucocorticoids discontinued for 4 weeks prior to testing
Repeat Open Application Testing (ROAT). & blood testing - Minor reaction treatment: Antihistamines, corticosterioids
- Major reaction treatment: Epinephrine
Hypersensitivity reactions: Type V Stimulatory Reaction
Example: Graves disease
Diagnosis: Thyroid function
Treatment: Anti-thyroid medication
Sjogren’s syndrome
- Often appears with other autoimmune disorders
- Dry eyes, dry mucous membranes of nose and mouth (xerostomia), vaginal dryness
- Insufficient tears causing inflammation/ ulceration of cornea
- No cure; intensity and progression can be slowed
Goodpasture’s syndrome
- Autoantibodies made against glomerular basement membrane and neutrophils
- Lungs and kidneys
Goodpasture’s syndrome symptoms
Shortness of breath
- hemoptysis
- Decreased urine output
- weight gain
- edema
- hypertension
- tachycardia
Goodpasture’s syndrome treatment
- Treatment: high-dose corticosteroids
- May require dialysis or kidney transplant
HIV pathophysiology
- Retrovirus
- Genetic material is RNA, single stranded ribonucleic acid
- Reverse transcriptase (RT) is used to convert ss-RNA into ds-DNA
- Integrase enzyme allows the viral ds-DNA to be inserted into the ds-DNA of the host
HIV diagnostic testing
- Positive test from an HIV antibody screening test (ELISA) confirmed by a positive result from a supplemental HIV antibody test (Western blot or IFA)
HIV symptoms: Early
- Rash and sore throat
HIV symptoms: Late
- Life-threatening opportunistic infections
- death
HIV Stages: Stage 1
- Confirmed HIV infection
- CD4 T-cell count > 500 cells mm3
HIV Stages: Stage 2
- Confirmed HIV infection
- CD4 T-cell count between 200 and 499 cells mm3
- Greater than 500 is normal.
HIV stages: Stage 3
- Confirmed HIV infection
- CD4 T-cell count < 200 cells mm3 or > 200 with a documented AIDS defining illness
HIV stages: Stage 4
- Confirmed HIV infection
- No other information regarding CD4 cell counts or AIDS defining illness
- You do not know the answers to the question
HIV Patient teaching
- Avoid crowds
- Don’t share personal toilet articles
- Bathe daily
- Clean toothbrush weekly
- Wash hands
- Do not change pet litter boxes
- Take temp. once a week
- Report temp >100 F, persistent cough, pus or drainage from area, presence of boil, cloudy urine
- Take medication
- Safe sex
- Avoid Travel to poor conditions
HIV medication: Nucleoside Reverse Transcriptase inhibitors (NRTIs)
- zidovudine
- To treat HIV infection in adults and children 4 weeks of age and older.
- To prevent mother-to-child transmission of HIV
HIV medication: Non-Nucleoside Reverse Transcriptase inhibitors (NNRTIs)
- delavirdine
- prevent HIV from multiplying and can reduce the amount of HIV in the body
HIV medication: Protease Inhibitors (PIs)
- atazanavir
- prevent HIV from multiplying and can reduce the amount of HIV in the body.
HIV medication: Fusion Inhibitors
- enfuvirtide
- For people whose HIV infection is not well controlled by ongoing treatment with other HIV medicines
- block HIV from getting into and infecting certain cells of the immune system
HIV medication: Entry inhibitors
- maraviroc
- When attaches to the CCR5 coreceptor, certain strains of HIV—called R5 tropic virus—cannot attach to, enter, or infect the cell.
- should be used only in people whose strain of HIV uses the CCR5 coreceptor.
HIV medication: Integrase inhibitors
- raltegravir
- Integrase inhibitors block an HIV enzyme called integrase
