Immune System Flashcards
How many line of defense does the body have and what are they?
3
-Physical and chemical (innate)
-nonspecific (innate)
-specific (acquired)
What is the innate immunity?
provides broad defense against infection.
Physical
chemical
What are physical barriers?
skin
mucous membranes
nose hair
what are chemical carriers?
lysozyme (enzymes in tears that acts like an antibiotic)
Gastric juices in stomach to destry bacteria
What is nonspecific resistance ?
Phagocytic cells (ingest and destroy)
inflammation (brings more WBC to the party)
fever (inhibits bacterial growth and increases rate of tissue repair)
What is acquired adaptive immunity
What is Specific resistance?
Antigens!
-specific substances (proteins) found in foreign microbes.
these produce an immune response
What are the steps in the immune response (during specific acquired immunity)
1) antigen is detected by a macrophage
2) T-cells (fire and police) they are the first responders
3) T-cells secrete interleukin 2
…..need to add (slide 8)
ImmWhat are the 3 major T cells?
1) cytotoxic (poke holes)
2) helper T cells (sound the alarm)
3) Memory (remain dormant, and allow a faster response if antigen is detected again)
What are antibodies also called?
Immunoglobulins (Ig’s)
What do immunizations do
Use portions of pathogens to stimulate T & B cells response.
Live
Inactivated
Toxoid
What is a live vaccines
Used for Viruses
-contain a weakened version of pathogens
-similar immune response to natural infection
-examples: MMR & Vericella
what is a inactivated vaccines
Used for Viruses
Use a “killed” version of the pathogen
Example: polio
what is toxoid vaccines
Used for Bacteria
Use the toxins produced by bacteria to stimulate the immune response
Example: Diphtheria and tetanus of the DTap
What is subunit vaccine
Used for both viruses and bacteria
contains parts of the pathogen
Example: DTap
What is Conjugate vaccine
Used for bacteria
Used with bacteria that have protective polysaccharide coatings
Example: H-Flu
What is mRNA Vaccines
Uses messenger RNA (mRNA)
0immune cells use the mRNA as a “blueprint” to build similar protein
stimulate adaptive immune response
person is NOT exposed to pathogen
vaccine has not effect on DNA
Vaccine History
Vacca = cow
Started by Edward Jenner 1796
Cow-pox (taken from cow-pox pustule)
What are allergies?
Immune reaction to foreign substances
The immune system overreacts by producing antibodies (IgE) to travel around and release chemicals causing reaction
Anaphylaxis
Histamines causes the blood vessels to expand
-Dangerous drop in blood pressure
-fluid can leak into the lungs, causing swelling and pulmonary edema
What is allergy testing?
Can be completed using a blood test (but can be less accurate)
Typically done with skin test
What are the 3 major types of skin cancer?
1) Bastal Cell Carcinoma
2) Squamous Cell Carcinoma
3) Malignant Melanoma (big bad one)
What are risk factors for developing skin cancer?
-sun exposure
-Predisposition (genetics
-Skin tone
-exposure to toxic chemicals
-frequent sunburns as a child
Describe Basal cell carcinoma
“pearly” glossy, shiny, waxy appearance
-raised edges w/ depressed center
-slow growing, waxy to manage, rarely metastasizes
Describe Squamous cell carcinoma
-“crusty” hard-covering, scaly, pink or reddish and raised lesion
-faster growing than BBC and can metastasize
How do we assess for skin cancer?
ABCDE
A - asymmetry
B - Boarders
C - color
D - diameter
E - Evolving shape/size/color
describe malignant melanoma
*most deadly form of skin cancer
-not asymmetrical
-not well defined boarders
-multiple colors
-large (greater than 5cm)
-evolve and grows
What are skin cancer treatments
Cryosurgery (freezing)
excisional biopsy
radiation
Chemo
MOHS surgery
When would you use MOHS Surgery?
Used for cancers that have a high risk of returning
goal is to remove all cancer one later at a time
Nursing intervention for skin cancer
routine wound care
Pt education for prevention of skin cancer
-Avoid direct skin exposure (between 10-4)
-wear long sleeves, sunglasses, hats
-use sunscreen15 or higher
-avoid tanning beds and toxic chemical burns
What is HIV
Human immunodeficiency virus
-Enters CD4+ T cells and replicates killing T-cells
What are clinical manifestations of HIV
What are complications from HIV
Opportunistic infections
Resp failure
Cachexia and wasting
How do we diagnose HIV
CBC
Serum antibody test
Western blot test
viral load testing
CD4+T cell count
other testing
What medications are used for HIV
-Antiretrovirals
-meds to opportunistic infections
-antidepressant
-nutrition therapy
Prevention for HIV
-Safe sex
-Know sex partners
-blood and blood components
What should we be assessing in a person with HIV?
-nutritional status
-skin integrity
-respt status
-neurologic status
fluid and electrolyte balance
-knowledge level
Rheumatoid Arthritis
-Autoimmune disease
-diffuse connective tissue disease
-degenerative
Causes for RA
Genetics
infection
female hormones
environmental factors
occupational exposures
What are manifestations of RA
-joint pain
-swelling
-warmth
-erythema
-lack of function
-deformities
-RA nodules
What are complications that can come from RA?
-bone marrow suppression
-anemia
-GI disturbances
How do we diagnose RA
-ANA (Antinuclear antibody)
-RF (rheumatoid factor)
Everything else is extra
-CRP, CBC, ESR, Ig, IgM, IgG
xray of joints
radionuclide scans
direct arthroscopy
synovial/fluid aspirate
synovial membrane biopsy
Medical management for RA
-balance of rest and exercise
-biologic response modifiers
-therapy
(occupational therapy is usually for hands)
-nutrition
Medications for RA
NSAID
COX-2 (Celebrex)
Methotrexate
analgesics
immunosuppressants
antidepressants
steroids
Nursing interventions for RA
-Relieve pain
-reduce fatigue
-increase mobility
-facilitate self care
-improving body image
-monitor for complications
What is Lupus?
autoimmune condition that causes inflammation to organs, joints, and tissues
Chronic condition with periods of flair ups
Risk factors for Lupis
genetics
sun exposure
infection
hormones
S/S of lupus
butterfly rash
photosensitivity
mouth ulcers
GI issues
joints and muscles
mental issues (fog, seizures, fever)
heart failure
labs used to determine Lupus
ANA
ESR
CRP
CBC
Medical management for Lupus
steroids
NSAIDS
Hydrochloroquine
Immunosuppressants
Biologics
Pt education for Lupus
-teach to determine triggers for flare ups (sun, stress, skickness)
What is Gout
Excess Serum uric acid build up
can lead to joint damage
Uric acid can build up due to what kind of foods?
Foods high in purine?
-internal organ meats (liver, kidneys, sweetbrads)
-other red meats
-alcohol (especially beer)
-seafood (anchovies, sardines, scallops)
What are manifestations of Gout
-joint pain and inflammation
-mostly seen in big tow
-can increase risk for kidney stones
What meds can increase Gout
aspirin
cyclosporin
loop and thiazide diuretics
What meds help gout
-Allopurinol
-Colchicine (ONLY FOR FLAR UPS)
-NSAIDS
-corticosteroids
What is fibromyalgia
Chronic disorder that causes pain and tenderness throughout the body
-causes fatiuge and trouble sleeping
Manifestations / symptoms of fibromyalgia
-pain and stiffness (all over)
-fatigue and tiredness
-depression and anxiety
-sleep problems
-cognitive (thinking, memory, concentration, headaches)
-tingling or numbness
Risk factors for Fibromyalgia
-Age (usually after 40, but can affect anyone)
-gender (women)
-stressful events, PTSD
-repetitive injuries
-illness
-family history
-obesity
Diagnostics for Fibromyalgia
labs: ANA, CRP. ESR, CBS
Xrays
history
Medical management for fibromyalgia
-SSRI/SNRI
-Muscle relaxant
-gabapentin
-Lyrica (pregabalin)
-PT
What is Psoriasis?
Autoimmune disorder where there is hyperproliferation of the epidermis and inflammation.
this leads to scaly patches on the skin
Risk factors for Psoriasis
-genetics
-stress
-smoking and alcohol
-infections
-obesity
-cold, dry air
Types of Psoriasis
-Erythrodermc - very red and rashlike (lesions, rate, temperature variations, dysregulation)
-Guttate - pink / red spot (activated by upper respt infection
-Inverse - located in armpits, groin, skin folds
-Plaque (most common) patches that are thick, red, white sclaes
-Pustular - pus filled blisters and red skin (activated by chemicals, medication and infections
How do we manage psoriasis?
MOISTURIZE!
-emollients
-Salicylic acid
-corticosteroids
-antifungal
meds to suppress immune system
-methotrexate
-biological therapy (last option)
UV phototherapy
What is Eczema? (Atopic Dermatitis)
Chronic inflammatory skin disease, more common in children (5 and under), but can affect adults
***many times goes hand and hand with asthma, allergic rhinitis, and conjunctivitis
manifestations of Eczema
dry
scaly
itchy
red
rash
Medical management for Eczema?
MOISTURIZE
corticosteroid creams
biologics
avoid triggers
