Immune system Flashcards
Sepsis
What
* A systemic inflammatory reaction to an infection
Pathophysiology
* Infection spreads to the bloodstream
* Increased capillary membrane permeability
○ Fluid leaks out of the blood vessels
○ Low blood volume
○ Hypotension
* Massive vasodilation
○ Hypotension
* The blood pressure is not high enough to bring blood to the tissues
* The tissues don’t get oxygen
* Shock!
Assessment
* Elevated lactic acid
○ Indicates body has switched to anaerobic metabolism
○ Tissues are not getting sufficient oxygen
* Metabolic acidosis
* Leukocytosis
* Hypotension
* Tachypnea
* Tachycardia
* Febrile
Treatment
* Blood cultures first
* Broad spectrum IV abx within one hour
* IV fluids
* Vasopressors
Systemic Lupus Erythematosus (SLE)
What
○ Immune system attacks the joints, skin, brain, lungs, kidneys and blood vessels
Causes
○ widespread inflammation and tissue damage
○ Fatigue
○ Rashes
○ Fever
○ Pain and swelling in joints
○ ‘Flare ups’ and remissions
○ No cure
Symptom Management
○ Immunosuppressants
○ Steroids
Hydroxychloroquine
Multiple Sclerosis
What
* Autoimmune disorder
* CNS inflammation
* Damages and degrades the myelin sheath surrounding neurons
Demyelination
Myasthenia Gravis
What
* Autoimmune disorder
* Communication between nerves and muscles destroyed
Diagnosis
Tensilon Test
Guillain-Barré
What
* Antibody and cell mediated immunologic reaction precipitated by a viral or bacterial illness
* Immune system switches to attacking the nerves and demyelinates peripheral nerves
* Causes ascending weakness and paralysis
If ascends to the diaphragm can cause respiratory arrest
Rheumatoid Arthritis
What
* Chronic systemic inflammatory disease
* Leads to destruction of connective tissue and synovial membrane within the
joints
* Weakens the joint, leading to dislocation and deformity of the joint
* Pannus forms at the junction of synovial tissue and articular cartilage and
projects into the joint space which causes necrosis
* RA exacerbations or “flares” occur during periods of fatigue and stress
(emotional or physical)
Psoriasis
What
○ Chronic autoimmune T-cell mediated inflammatory skin disease
○ Periods of exacerbations and remissions
○ Thickening of epidermis and dermis
○ Scaly, erythematous, pruritic plaques
Interventions
○ Light therapy
○ Systemic therapy
○ Methotrexate
○ Folic acid
○ Systemic retinoids
○ Infliximab
Graves Disease
What
○ Autoimmune disease with antibodies attacking the thyroid
○ The body has too much thyroid hormone!
○ Decreased levels of TSH
○ Anterior pituitary sees low TSH and signals to the Thyroid gland to secrete more T3 and T4
○ T3 and T4 continue to be secreted despite being high
○ The negative feedback loop is broken
○ High T4 / Low TSH
Type I Diabetes Mellitus (TIDM)
What
* Autoimmune disease
* Body has destroyed the beta cells of the pancreas that produce
insulin
* There is little or no insulin in the body
* Very high levels of glucose in the bloodstream
* No glucose can get to the cells for fuel
Contact Precautions
Infections requiring contact precautions
* MRSA
* VRE
* Noroviruses
* Rotavirus
* Conjunctivitis
* Diphtheria (cutaneous)
* Herpes Simplex virus
* Human Metapneumovirus
* Respiratory Syncytial Virus
* Pediculosis (lice)
* Scabies
* Poliomyelitis
* Staphylococcus aureus
PPE
* Hand hygiene
* Gown
* Gloves
* Dedicated disposable equipment
* Private room or cohort with same infections
Contact Enteric
Infections
* C.diff
* Noroviruses
* Rotavirus
PPE
* Contact precautions PPE
* Hand hygiene with soap and water
Droplet Precautions
Infections requiring droplet precautions:
* Influenza
* Pertussis
* Mumps
* Rhinovirus
* Adenovirus
* Meningitis
* Streptococcus Aureus
* Rubella
* Haemophilus influenzae type B
○ Epiglottitis
* Diphtheria (pharyngeal)
PPE
* Hand hygiene
* Mask
* Private room or cohort with same infections
Airborne Precautions
Infections requiring airborne precautions:
* Tuberculosis
* Rubeola virus (Measles)
* Varicella virus (Chickenpox)
* Varicella zoster
* SARS
* Smallpox
PPE
* Hand hygiene
* N-95
* Private, negative pressure room with closed door
* Gown
* gloves
