Immune Response Flashcards
What is self immunity
originate in your body
what is non-self immunity
come from outside the body
what are the requirements of immunocompetence
inflammation (general), antibody-mediated immunity, cell-mediated immunity
what is human leukocyte antigen
unique surface proteins present on all a persons cells - aka a persons tissue type
what do WBCs - leukocytes do
stimulate the inflammatory response
what does a WBC and differential show you
percentage of the 5 types of WBCs
what are the 5 types of WBCs
neutrophils, lymphocytes, monocytes, eosinophils, basophils
what are stem cells
immature undifferentiated cells produced in the bone marrow that are pluripotent with potential to mature into any blood cell type
what are the lab levels for leukopenia
less then 4000
what could be some causes for leukopenia
drug toxicity, autoimmune disease, bone marrow failure, overwhelming infection
what are the lab levels for leukocytosis
WBC over 10,000
what could be some causes for leukocytosis
inflammation, infection, malignancy, trauma, dehydration, stress, steroid use
what are the lab levels for neutropenia
neutrophils less then 2000
what could be some causes for neutropenia
viral infections, overwhelming bacterial infection, radiation/chemotherapy
what is neutropenic precautions
no fresh fruits or flowers, limit visitors, good hygiene
what are the normal levels of neutrophils (%)
55-70
who is the 1st WBC to respond to infection
neutrophils
what does left shift mean for neutrophils
overwhelming infection/demand from bone marrow
what do lymphocyte T cells do
initiate cell mediated immunity
what do lymphocyte B cells do
initiate antibody mediated immunity
what is innate immunity
first line of defense, not antigen specific - inflammation
what is adaptive/acquired immunity
development of immunity, antibody-mediated, b lymphocytes
what is active immunity
disease (natural), immunization (artifical)
what is passive immunity
natural or artificial (receiving COVID antibodies )
what is the purpose of inflammation
non-specific helps provide immediate protection against the effects of tissue injury and invading foreign proteins
what are the 5 cardinal symptoms of inflammation
pain, redness, heat, swelling, loss of function
how does antibody mediated immunity work
foreign antigen enters the body, b lymphocytes recognize antigen and divides into plasma cell and memory cells, antibodies are released and bind to antigen forming immune complex, other leukocytes come to destroy it- with re-exposure to the same antigen sensitized b cells (memory cells) produce large quantities of antibodies to kill it
what is immunodeficiency
immune system does not provide adequate protection of the body
what is primary immunodeficiency
impairment of phagocytosis, b cell response, t cell response, or a combo
what is secondary immunodeficiency
Immunosuppression, viruses, malnutrition, chemo/radiation, stress
what is hypersensitivity
extreme or unnecessary immune response the body has to an antigen
what is type 1 hypersensitivity
Rapid- IgE on mast cells recognize antigens like pollen, food mold and cause inflammation
what are some examples of type 1 hypersensitivity
hay fever (allergic rhinitis), allergic asthma, anaphylaxis, angioedema, latex allergy
how is anaphylaxis emergency managed
assess airway/respiratory status, remove antigen, give o2, establish IV,
what meds are used for anaphylaxis emergency
epinephrine 0.01 every 5-15mins (check pulses between doses), nebulizer albuterol to open airway, diphenhydramine, corticosteroids
what are some ss of type 1 hypersensitivity
rash, flushing, hives (urticaria), itching (puritius), edema, angioedema, wheezing, rhinitis, stomach cramps, n/v, SOB, bronchospasms, cardiac symptoms, loss of consciousness
what is type 2 hypersensitivity
IgG antibodies recognize cellular antigen and results in cell damage through phagocytosis - includes recognition of self antigens and ABO or Rh antigens on ones own RBCs
what are some examples of type 2 hypersensitivity
hemolytic transfusion reactions, autoimmune hemolytic anemia, myasthenia gravis, hemolytic disease of the newborn
what is type 3 hypersensitivity
immune complex reaction, tissue damage occurs secondary to antigen antibody complexes, IgG antibodies, complex is too small so deposit into issue or blood vessel leading to inflammation and destruction of involved tissue
what are some examples of type 3 hypersensitivity
Systemic lupus erythematosus, rheumatoid arthritis, glomerulonephritis
what is type 4 hypersensitivity
delayed hypersensitivity reaction, cell mediated immune response, sensitized t lymphocytes attack antigens or release cytokines - cytokines attract macrophages, leading to tissue damage takes 24-48 hours for response to occur
what are some examples of type 4 hypersensitivity
poison ivy, transplant rejection, positive TB skin test, contact dermatitis latex allergy
what is the treatment for chronic allergies
ID and control triggers, radioallergosorbent (RAST) test, skin testing, symptom relief, hyposensitization
what is immunotherapy
allergen stimulates immune system, desensitization over time, not all allergies can be safely treated with immunotherapy
what are some antihistamines for allergies
Diphenhydramine, Claritin (Loratadine)
what are some decongestants for allergies
Afrin (Oxymetazoline), Sudafed
what are some sympathomimetics for allergies
Epinephrine, norepinephrine
what are some antipruritics for allergies
Diphenhydramine, Topical hydrocortisone
what are some leukotriene receptor antagonist for allergies
Singulair (Montelucast)
what is autoimmunity
immune system is unable to recognize self from non self and forms an immune response to the bodys own healthy normal cells and tissues resulting in tissue damage
what is development related to for autoimmunity
genetic susceptibility, enviornmental interactions
how does rheumatic arthritis work
immune system attacks synovium aka joint deformity/erosion
what are the risk factors for rheumatic arthritis
middle aged women, family history, smoking, obesity
what are the ss of rheumatic arthritis
most commonly in the fingers/wrist, joint pain, fatigue, joint swelling and softness, symmetrical
how is rheumatic arthritis diagnosed
positive anti-CCP antibodies, increased rheumatic factor antibodies, elevated ESR or positive C-reactive protein, positive ANA titer
what is the nursing care for RA
apply hot/cold, activity with rest periods, stay healthy to avoid exacerbations, signs/symptoms to report
what meds can be given for RA
NSAIDs, corticosteroids, DMARDs
what surgery can be done for RA
plasmapheresis
how does systemic lupus erythematosus work
autoantibodies attack tissues causing type 3 hypersensitivity reaction, immune complexes deposit in tissues
what are the ss of systemic lupus erythematosus
joint pain, swelling, tenderness, butterfly rash, fatigue, fever, weight loss, alopecia, rubor, pallor, cyanosis
what are some systemic manifestations of systemic lupus erythematosus
kidney damage (lupus nephritis), pericarditis (cardiac friction rub), vasculitis
what kind of lab changes are noticed for systemic lupus erythematosus
postive antinuclear antibody titers, decreased serum complement (c3,c4), elevated ESR, elevated BUN/Creatine, urinalysis positive for protein and RBCs
what is osteoarthritis
cartilage wears down over time and affects the hands, knees, hips, and spine causing pain, stiffness, and swelling
how is osteoarthritis managed
stay active, maintain healthy weight, NSAIDs, Acetaminophen, cortisone injection, surgery
what is carpal tunnel
median nerve in wrist becm=omes depressed causing pain and numbess, seen in someone that uses repetitive stress injury
how is carpal tunnel treated
medications, immobilization, surgery
what is gout
systemic disease caused by a disruption in purine metabolism causing uric acid crystals depositied in joints and body tissues
what are the risk factors for gout
obesity, cardiovascular disease, trauma, alcohol/diuretic use, CKF
what are the ss of gout
severe joint pain, redness, swelling, warmth of joint, elevated ESR, consistent serum uric acid elevation
what are some meds used for acute gout
antigout agent (colchicine), NSAIDs, corticosteriods
what are some meds used for chronic gout
allopurinol, probenecid
what is fibromyalgia
chronic pain syndrome which manifests as pain, stiffness and tenderness at certain trigger points
what are some ss of fibromyalgia
fatigue, sleep disturbances, numbness/tingling of extremities, headaches, jaw pain, depression, visual changes, GI upset
what are some meds used for fibromyalgia
NSAIDs, Serotonin-norepinephrine reuptake inhibitors (SNRIs) - duloxetine, anticonvulsants -pregabalin (for the numbness and tingling), tricyclic antidepressants
