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546 Body Systems > Immune System > Flashcards

Immune System Flashcards

1
Q

Antigen

A

foreign molecule that triggers an immune response

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2
Q

T Cells

A

cell mediated immunity, directly destroy infected cells or cancer cells

Helper T cells = coordinate the immune response by activating cytotoxic T cells and B cells

Cytotoxic T cells = directly kill infected cells by releasing cytotoxic substances

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3
Q

B cells

A

humoral immunity, produce antibodies that bind to pathogens and neutralize them, mark them for destruction by other immune cells
- produced by bone marrow

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4
Q

Cytokines

A

proteins that trigger inflammation that fights invaders

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5
Q

Immune system function: thymus

A

glandular organ near the heart where T cells learn their jobs

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6
Q

Immune system function: bone marrow

A

blood producing tissue located inside certain bones, blood stem cells give rise to all of the different types of blood cells

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7
Q

Immune system function: spleen

A

serves as a filter for the blood, removes old and damaged RBCs, removes. infectious agents and uses them to activate cells called lymphocytes, participates in antibody production

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8
Q

Immune system function: lymph nodes

A

small organs that filter out dead cells, antigens, and other stuff present to lymphocytes

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9
Q

Immune system function: lymphatic vessels

A

collect fluid (lymph) that has “leaked” out from the blood into the tissues and returns it to circulation

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10
Q

Immune system function: tonsils

A

help filter out germs that enter through the nose and mouth, produce WBC and antibodies

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11
Q

Immune system function: GI tract

A

gut microbiome stimulates the immune system, protects the body from ingested pathogens, regulates the immune system to allow it to response appropriately

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12
Q

Passive immunity

A

acquisition of immunity from an outside source (maternal from womb, vaccines)

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13
Q

Active immunity

A

immune system’s response to an antigen (natural from past illness, vaccines)

INNATE = first line of defense, defends the body the same way all the time (skin, saliva, natural bacteria, cells)

ADAPTIVE = specific lymphocytes, cytokines, immunoglobulins to produce a specific response against invaders (antigens)

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14
Q

Immune system: Specificity

A

triggering mechanism to a particular pathogen, immunogen, antigen

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15
Q

Immune system: Heterogeneity

A

signifies the production of millions of different effectors or the immune response against millions of intruders

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16
Q

Immune system: Memory

A

ability to recognize a pathogen on its second contact and generate a faster and stronger response

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17
Q

Abnormal immune system

A

primary immune deficiency = something you are born with

acquired immune deficiency = from a disease that weakens your immune system

hyperactivity = response to an allergic reaction

autoimmune = immune system turns on itself

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18
Q

HIV

A

human immunodeficiency virus, spread by mucous membrane contact with body fluids (blood, semen, breast milk, vaginal fluids) or directly injected into the blood stream (needles)

no cure, will lead to AIDS, patient will die from opportunistic infection

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18
Q

What is the most common mode of transmission for HIV?

A

anal/vaginal sex, sharing needles

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19
Q

What does HIV do to the body?

A

infects CD4 T cells and makes copies inside those cells, killing those cells, the immune system tries to make more CD4 T cells but the body can’t keep up which leads to an increase in the amount of virus in the body

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20
Q

HIV: stage I

A

acute, 2-4 weeks after initial infection
- flu like symptoms (night sweats, fatigue, chills, muscle aches, mouth sores, sore throat, swollen lymph nodes)
- sometimes asymptomatic
- can last a few days to several weeks

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21
Q

HIV: stage II

A

clinical latency, can stay 10-15 years with treatment
- will test positive but often asymptomatic
- can get to undetectable viral load where no transmission will happen

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22
Q

HIV: stage III

A

AIDS
- rapid weight loss, recurring fever, night sweats, extreme fatigue, prolonged swelling of lymph nodes, chronic diarrhea, mouth sores, opportunistic infections

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23
Q

PT for HIV

A
  • patients live longer with antiretroviral therapy, but tend to have comorbidities
  • multisystem involvement leads to compromised immune system so patients spend more time in the hospital –> effects of prolonged bed rest
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24
Fibromyalgia syndrome
systemic problem involving biochemical, neuroendocrine, and physiologic abnormalities leading to a disorder of pain processing and perception widespread pain, muscle ache, fatigue, sleep problems, emotional distress WITHOUT evidence of inflammation or tissue damage *diagnosis of exclusion: widespread tender spots over 3 months
25
Fibromyalgia syndrome: risk factors
- middle aged - diagnosed with lupus or RA - female - stressful/traumatic event - repetitive stress injuries - viral infections - obesity - family history
26
Fibromyalgia syndrome: clinical presentation
- pain and stiffness all over the body (multiple tender points) - fatigue - memory/concentration problems - headaches - GI issues - pain in face/jaw/TMJ - muscle spasms or nodules - morning stiffness - increased sensitivity to noise, light, cold, heat, odors, pressure - tingling hands/feet
27
Fibromyalgia syndrome: diagnostic criteria
- generalized pain in 4-5 regions - symptoms for 3+ months - widespread pain index >7 - symptom severity scale >5 * diagnosis of exclusion
28
Fibromyalgia syndrome: treatment
- stress management - nutrition (anti inflammatory food) - sleep - light aerobic and resistance training - gentle joint mobs, STM, AROM - aquatic therapy * anti depressants, anti convulsants, weak opioids, NSAIDs have been found not to be useful
29
What are the differential diagnosis for fibromyalgia syndrome?
there are a TON from endocrine disorders, illness, infections, inflammation, and other random diseases
30
Rheumatoid arthritis
a chronic, systemic inflammatory disorder that affects multiple organs - a disease of the synovium that leads to adhesions, fibrosis, and ankylosing of the joint
31
Rheumatoid arthritis: risk factors
- age (60+ older) - females > males (2-3x higher) - genetics (HLA) - smoking - women who have not given birth - rheumatoid factor (RF) antibody
32
Rheumatoid arthritis: symptoms
- malaise - fatigue - stiffness out of bed or prolonged sitting that lasts >1hr - diffuse joint pain - MTP and MCP joint pain - low grade fever - depression - weight loss - joint erosion in x ray within 2 years of diagnosis
33
Rheumatoid arthritis: symptoms (SERIOUS)
S = swelling in 1 or more joints E = early morning stiffness R = recurring pain/tenderness in joints I = inability to move a joint normally O = obvious tenderness and warmth U = unexplained fever, weight loss, weakness S = symptoms lasting > 2 weeks
34
Rheumatoid arthritis: class I
completely able to perform usual activities of daily living (self care, vocational, avocational)
35
Rheumatoid arthritis: class II
able to perform usual self care and vocational activities, but limited in avocational activities
36
Rheumatoid arthritis: class III
able to perform usual self care activities, but limited in vocational and avocational activities
37
Rheumatoid arthritis: class IV
limited in ability to perform usual self care, vocational, and avocational activities
38
Polymyalgia rheumatica
widespread aching and stiffness with symptoms that come on quickly over days/night that has symmetrical involvement - does not usually cause swollen joints so it may be hard to recognize - lab tests may show very high erythrocyte sedimentation rate (ESR) and c-reactive protein * intermittent lasting 2-3 years then resolves
39
Rheumatoid arthritis: clinical presentation
- severe aching - stiffness - pain more severe in the morning or long periods of inactivity - limits sleep quality - pain with overhead activities - fatigue - fever - poor appetite - weight loss
39
Rheumatoid arthritis: treatment
low dose of corticosteroids to relieve stiffness/pain - therapy based on symptoms * no evidence that PT helps
40
Rheumatoid arthritis: differential diagnosis
- rotator cuff diseases/adhesive capsulitis - DDD - fibromyalgia - endocrinopathies (thyroid problems, infections, viruses/bacteria) - parkinsonism - hypovitaminosis D - drug induced myopathy (statins)
41
Systemic Lupus Erythematosus
a chronic, systemic, inflammatory disease that affects multiple systems - two types 1. discoid 2. systemic
42
Systemic Lupus Erythematosus: discoid
disease is confined to skin and coin shaped lesions are present but it does not progress to systemic lupus erythematosus (SLE)
43
Systemic Lupus Erythematosus: systemic
disease affects almost every organ/system, but varies person to person
44
Systemic Lupus Erythematosus: risk factors
- genetics - infections (ebstein-barr) - UV light exposure, pollutants - smoking - hormonal disturbances - extreme physical or emotional stress - medications (hydrochloride, penicillin, chlorpromazine, phenytoin, etc) - pregnancy - women - more severe in men - peak onset 20s-40s
45
Systemic Lupus Erythematosus: symptoms
** vary depending on system involved - integumentary: (butterfly rash, photosensitivity, hair loss) - musculoskeletal: (bilateral arthritis in small joints) - neuro: (peripheral neuropathy, decreased DTR, abnormal sensation) - pulmonary: (pleurisy, chest pain, difficulty breathing, cough) - N/T tongue and inside mouth - mouth sores - low grade fever - fatigue - raynaud's - kidney problems
46
Systemic Lupus Erythematosus: treatment
- NSAIDs, antimalarials, steroids, cytotoxic drugs - decrease stress - improve sleep - diet (no alfalfa sprouts or echinacea) - increase vit. D - stop smoking - aerobic exercise (30-50 min at 60% VO2 max or 75-80% HR max) - energy conservation techniques - gentle ROM, PREs - photoprotection
47
Scleroderma: localized
primarily affects the skin and NOT major organs
48
Scleroderma: systemic
affects the skin and major body systems (there are subtypes: limited, diffuse, sine) - skin thickening - chronic joint pain - inflammation of joints/muscles - raynaud's
49
Scleroderma: risk factors
- any age - more in women - localized types before age 40 - systemic types between 30-50 yrs
50
Scleroderma: systemic - limited
seen on head and distal extremities
51
Scleroderma: systemic - diffuse
seen all over the body with an emphasis of skin changes on trunk/torso - affects GI, lungs, kidneys, heart - renal disease is the most common - commonly have flexion contractures - may have cardiomyopathy, pericarditis, arrhythmias
52
Scleroderma: systemic - sine
organ involvement without skin involvement
53
Scleroderma: symptoms (CREST)
C = calcinosis (calcium deposits on skin) R = raynaud's E = esophageal dysfunction (acid reflux and decreased motility of esophagus) S = sclerodactyly (thickening and tightening of skin on fingers/hands) T = telangiectasis (dilation of capillaries causing red marks on skin)
54
Scleroderma: treatment
NO CURE - anti inflammatories, immune suppressants, NSAIDs, creams - pain management - increase strength and aerobic capacity - ROM to prevent contractures - ADL maintenance
55
Reactive arthritis
painful inflammatory arthritis occurring from a reaction to a bacterial infection - formally known as "reiter's syndrome" (arthritis, conjunctivitis, urethritis) - linked to chlamydia and HLA-B27 gene
56
Reactive arthritis: risk factors
- males 20-50 yrs old - HLA-B27 gene carrier - weakened immune systems
57
Reactive arthritis: treatment
- NSAIDs in early stage - RA (joint inflammation) meds in late stage
58
Reactive arthritis: symptoms
- pain/swelling of joints - heel pain/plantar fasciitis - swelling of toes/fingers - lesions on toes, nails, soles of feet that look like psoriasis - LBP that's worse at night or morning - (B) eye irritation - burning w/ urination - low grade fever - may be preceded by diarrhea, nausea, vomiting
59
Psoriatic arthritis
autoimmune disease of the skin where raised red patches of skin covered with scaly white patches develop (immune system going into overdrive) - can affect any joint in the body - persistent inflammation can lead to joint damage *no known cause
60
Psoriatic arthritis: risk factors
- 30-50 yrs old - already having psoriasis
61
Psoriatic arthritis: symptoms
- painful, stiff, swollen joints - can be in single or multiple joints, bilateral or unilateral - dactylitis (swollen fingers/toes "sausage") - spondylitis in spine - anemia - fatigue
62
Gout
too much uric acid builds up and creates uric acid crystals in the joint - a form of inflammatory arthritis - can last from weeks to years NO CURE
63
Gout: risk factors
- males - obese - CHF, HTN, metabolic syndrome, diabetes - protein rich diet - alcohol - high fructose foods
64
Gout: "flares"
when a single joint becomes painful, swollen, red, and hot
65
Common patterns of immune system problems
most auto immune/arthritis disorders involve some of these - soft tissue/joint pain - stiffness - swelling - weakness - raynaud's - sleep disturbances - fatigue ** stiffness will be in a cyclic pattern - after awakening, prolonged sitting, at night, etc
66
Bouchard's nodes
spongy synovial thickening/bony hypertrophic changes that are seen in RA and hand deformities
67
What is important to asses when it comes to swelling as a PT?
whether swelling is intermittent, persistent, symmetric, or asymmetric, whether swelling changes throughout the day
68
When is immediate medical attention needed?
- S/S of shock, hoarse voice, difficulty breathing, chest discomfort/tightness - new onset joint pain with recent surgery/infection - dusky blue color - very tender joint
69
When is a referral to a physician needed?
- new onset joint pain within 6 wks of surgery especially with rash/skin lesion - symmetric swelling - progressive neruo symptoms 1-3 wks of infection or vaccination - spinal cord compression with cervical RA - incontinence with ankylosing spondylitis
70
Key points!
- pain in knee, hands, wrists, elbows may indicate autoimmune disorder - true arthritis will be painful/inflamed during BOTH active and passive ROM - take caution with RA and AS patients due to increase risk of subluxation/FX - persistent widespread and diffuse tender points in body should not be dismissed

546 Body Systems (6 decks)

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