IMMUNE DISORDER Flashcards
Exam 2
Innate and adaptive immune responses provide 3 lines of defense against unwanted antigens
What are they?
- Innate (natural) immunity
- Inflammatory response
- Acquired (adaptive) immunity
What is included in the inflammatory response?
Interferon (IFN)
Complement
Phagocytosis
IMMUNE FUNCTION PHYSIOLOGY:
Innate immune response (1st line defense)
Physical and mechanical barriers
Biochemical barriers
IMMUNE FUNCTION PHYSIOLOGY:
Inflammatory response (2nd line defense)
Acute cellular injury
Active Immunity
Antibodies or T-Cells produced after natural exposure (illness) or vaccination
IMMUNE FUNCTION PHYSIOLOGY:
Adaptive Immunity (3rd line of defense)
Two types of immunity
- Active Immunity
- Passive Immunity
IMMUNE FUNCTION PHYSIOLOGY
Initiation of the inflammatory response
includes;
Vasodilation with increased capillary permeability
Increases blood flow and leukocyte movement
IMMUNE FUNCTION PHYSIOLOGY:
Adaptive Immunity (3rd line of defense)
includes what?
Cellular response (T-Lymphocytes)
Humoral response (B-Lymphocytes)
Passive Immunity
Preformed T Lymphocytes or antibodies are transferred from one individual to another (e.g. newborn from mother)
Components of the Immune System include:
Lymphatic System
Primary Lymphoid Organs
Secondary Lymphoid Organs
Cells & Proteins
What is included in the lymphatic system
Lymphatic vessels and collecting ducts
Primary Lymphoid Organs
Bone Marrow
Thymus
Secondary Lymphoid Organs
Spleen
Lymph nodes
Tonsils
Adenoids
Peyer’s patches
ASSESSMENT OF THE IMMUNE SYSTEM includes:
History
Physical examination
Inspection
Auscultation
Palpation and percussion
Diagnostic studies to evaluate state of an individual’s immune competence?
Blood tests
Skin tests
Bone marrow aspiration and biopsy
Radiological imaging
Immune deficiencies- 2 types
- Primary
- Secondary
AGE-RELATED CHANGES-The aging immune system
Decreased immunological function; less efficient immune responses
Increased production of autoantibodies
Decline in immune response; malignant cells not destroyed as quickly
Decreased immunological function; less efficient immune responses
leads to what?
Increased infections especially secondary infections
Increased production of autoantibodies
Increased autoimmune disorders
Decline in immune response; malignant cells not destroyed as quickly
Increased cancer incidence
What is the most common form of arthritis
OSTEOARTHRITIS
Osteoarthritis- affects how many people
Affecting almost 27 million people
What is the leading cause of chronic disability?
OSTEOARTHRITIS
OSTEOARTHRITIS- pathophysiology
Affects joint as a whole
OSTEOARTHRITIS- affects what kind of joints?
Usually affect weight bearing joints, knees, hips joints, hand, shoulders
OSTEOARTHRITIS- who is most at risk?
Risk- anyone over 50;
usually females more;
individuals obese;
any occupation that causes repetitive movements (occupational hazards)
OSTEOARTHRITIS : What are symptoms?
the joints will be very tender
might be swelling
decreased range of motion
might be a deformity present
OSTEOARTHRITIS : Management
Diagnosis
Laboratory testing not necessary to confirm diagnosis
Radiographical evidence
OSTEOARTHRITIS: What would lab testing be used for?
To rule out other forms of arthritis
OSTEOARTHRITIS : Management
Treatment
Pharmacological and nonpharmacological therapies
Osteoarthritis:
Before giving medications, what must be done?
You must check liver and kidney function
Osteoarthritis:
What are the pharmacological drugs used?
Pain medication
Glucocorticoids
Steriods
Osteoarthritis:
What are the nonpharmacological drugs used?
physical activity
rest
weight loss
walker/cane
aerobic activity
OSTEOARTHRITIS : Management
Complications
Chronic pain, less function, and toxic effects of medications
RHEUMATOID ARTHRITIS
Epidemiology- affects what percent of the population?
Affects approximately 1% of the population
RHEUMATOID ARTHRITIS
Epidemiology-how does it affect women compared to men?
Affects females 2.5 times more than males
RHEUMATOID ARTHRITIS
Epidemiology-What group of people is it prevalent in?
Prevalent in Pima and Chippewa Indians
RHEUMATOID ARTHRITIS: Pathophysiology?
Chronic, systemic, autoimmune inflammatory disease
RHEUMATOID ARTHRITIS: Management
Diagnosis?
Combining signs, symptoms, laboratory values, and radiographs or ultrasound
Radiographs are used to assess for bony erosions and joint space narrowing
RHEUMATOID ARTHRITIS: Management
Treatment
Pharmacological and nonpharmacological therapy
RHEUMATOID ARTHRITIS- COmmon joint deformities
Swan-neck deformity
Boutonnière deformity
Ulnar deviation
What is the most common RA joint deformity?
Swan-neck deformity
SCLERODERMA- How many cases a year?
9 to 19 cases/million per year
SCLERODERMA- what is the age of onset?
Age of onset is 30 to 50 years
SCLERODERMA- who does it affect more women or men? What race?
Women exceed men 3 to 5:1
Affects all races, but African Americans at a higher rate than Caucasians
SCLERODERMA: Pathophysiology
Exact etiology is unknown
SCLERODERMA: Management
Diagnosis
Presence of clinical manifestations and serum antibodies
SCLERODERMA:
Clinical Manifestations include:
Patchy or thickening skin
Itching and pulmonary involvement (nonproductive cough or pulm fibrosis)
increases risk of lung cancer
Heart burn, bloating, constipation and diarrhea
SCLERODERMA:
Clinical Manifestations: itching and pulm. involvement or pulmonary fibrosis increases the risk of what?
Itching and pulmonary involvement (nonproductive cough or pulm fibrosis)
increases risk of lung cancer
Scleroderma: What kind of assessment should always be done?
A pulmonary assessment
Lung capacity and compliance
SCLERODERMA: Management
Treatment
No single treatment
Systemic steroids
SCLERODERMA: Management
Complications
Infection, renal and heart failure, pulmonary fibrosis, and death
LUPUS- Epidemiology
Affects how many people?
Affects fewer than 25 people per 100,000 in North America, South America, Europe, and Asia
LUPUS- Epidemiology
Who does it affect more women or men?
Female to male ratio is 3:1
LUPUS-Pathophysiology
Chronic inflammatory disease affecting organ systems
Unknown etiology
LUPUS
Management- Diagnosis
4 of 11 criteria must present
Presence of ANAs does not confirm diagnosis
LUPUS
Management-Treatment
Avoid prolonged sun exposure
Well-balanced diet
Antimalarial medications
Gout Epidemiology: How many people does it affect in the US?
Affects approximately 2% of people in U.S.
Gout Epidemiology: What men and women does it affect?
Men aged 40 to 60 years
Women aged 55 to 70 years
Gout pathophysiology
What gets deposited into the bone?
Monosodium urate crystals deposited in joints, bone, and soft tissues with inflammation
Gout pathophysiology
What must be present prior to gout?
Hyperuricemia must be present prior evolution of gout
What are the three phases to gout?
- Acute gout
- Intercritical gout
- chronic tophaceous gout
Management of gout:
Splinting
Medication depends upon the stage
Complications of gout:
Tophi
What can be a direct complication of gout?
Kidney stones
Fibromyalgia- Epidemiology
How many people does it effect in the US?
Who is it a greater prevalence in?
Affects approximately 4% of the U.S.
Greater prevalence in women
What is the most common cause of chronic musculoskeletal pain in women between ages of 20 and 55
Fibromyalgia
Fibromyalgia: Pathophysiology
Etiology and pathophysiology are unclear
Fibromyalgia: clinical manifestations
Widespread pain
Insomnia, fatigue, stiffness, and cognitive dysfunction
Fibromyalgia: Management
Diagnosis
History and physical assessment
Experience pain at 11 or more of 18 specified locations
Treatment for Fibromyalgia
Nonpharmacological therapy
Pharmacological therapy
How many pain sites are there?
18 pain sites
