Immune system Flashcards
what is most common opportunistic infection in HIV patients
pneumocystic carini
what is most common adverse reaction to a blood transfusion
a febrile reaction
the appearance of hives on a person getting a blood transfusion indicates what
an allergic reaction
what are the signs of a hemolytic reaction in the anesthetized patient
1) first sign is HGB in urine
2) bleeding in surgical field
3) unexplained tachycardia and hypotension
4) rise in temperature
what are the signs of a hemolytic transfusion reaction in awake patient
fever chills chest and flank pain, nausea
what immunoglobulin are latex allergies mediated by
- some might be contact dermatitis (type IV)
- serious reactions to latex are type I mediated IgE reactions to polypeptides in latex
name 2 common protocols used for latex allergies
1) schedule for first case of the day to prevent exposure of latex particles in the air from other cases in room
2) removal of rubber stoppers from drug vials
what 3 factors are associated with risk for developing a latex allergy
1) spinal bifida
2) multiple procedures on urogenital tract
3) spinal cord injury
what food allergies are associated with latex allergies
tropical fruit allergies such as bananas, mangoes, peaches, avocados kiwi, passion fruit, celery, buckwheat, papa, and chestnuts
how long after exposure to latex will a latex sensitive person develop an allergic reaction
onset of symptoms to latex allergy do not genuine until after 30 minutes of exposure compared to 5-10 minutes with other allergies
what family of viruses are HIV a part of
retroviruses
what type of lymphocyte does HIV destroy
T helper cells (CD4 cells)
what are odds of seroconversion after exposure from open bore needle infected with HIV
0.3-0.4%
what are respiratory complications from pneumocystis carinii pneumonia
breathlessness, nigh sweats, bacterial lung abscesses, tuberculosis, fungal infections, pneumothorax, pulmonary kaposi’s sarcoma, and respirator failure. pulmonary adenopathy can be so severe that it results in tracheobroncial and pulmonary vessel compression. Kaposis sarcoma in lungs can cause massive hemoptysis. HIV can also lead to emphysematous destruction to alveolar tissue
How does CXR in a patient with HIV infected with pneumocystis carinii appear
often normal, or with a ground glass appearance and pneumothoracies
what does a positive acid fast bacilli test indicate in a patient with HIV
tuberculosis
what are potential cardiac complications in a person with HIV/AIDS
- abnormal echo in 50% of patients
- pericardial effusions
- myocarditis with ventricular dilation resulting from infection with cryptococcus, coxsackie B virus, CMV, toxoplasmosis, and aspergillus
what does the HAART acronym stand for
Highly active antiretroviral therapy -prevents advancement of HIV infection to AIDS
An HIV patient takes non-nucleoside reverse transcriptase inhibitor-how might this effect your anesthetic plan
prolong the half life and effects of drugs such as diazepam, midazolam, fentanyl, and meperidine
what are the five major classes of antiretroviral dugs used in treatment of HIV
-nucleoside analogue reverse transcriptase inhibitors, non nucleoside reverse transcriptase inhibitors, protease inhibitors, entry inhibitors, and integrate inhibitors
what is zidovudine and what is its principle side effect
nucleoside analogue reverse transcriptase inhibitor use to that HIV, side effect is bone marrow suppression
what is underlying pathology of joints in patients with rheumatoid arthritis
cellular hyperplasia occurs in the synovium with progressive infiltration by lymphocytes, plasma cells, and fibroblasts, which destroy articular cartilage
name symptoms of RA
- symmetric polyarthropathy effecting weight bearing joints and proximal interphalangeal and metacarpophalangeal joints
- symptoms worse in the AM
- every joint may be effected except lumbar and sacral spine
what are treatment options for RA
palliative medial therapy such as corticosteroids(surpression of inflammatory symptoms)
- anticytokine agents such as etanercept, adimumab, and infiximab interfere with cytokine growth known as tumor necrosis factor (slow progression of the disease)
- methotrexate(reduces symptoms)
- immunosuppressive drugs (cyclophosphamide and cyclosporine)