Immune System Disorders/Immunizations/Infectious Diseases Flashcards
Major histocompatibility markers
Cell markers unique to each individual - on all cells
Protective systems (4)
Skin - first line
Secretions - saliva, tears, sweat - contain chemicals that kill organisms
Stomach acid
Coughing/sneezing - eliminates organisms from body
Primary lymphoid organs
Thymus, bone marrow, liver
Secondary lymphoid organs
Spleen, lymph nodes, gut associated lymphoid tissue
Non-specific immune defenses
Redness, heat, swelling, pain
Specific immune defeses
Antibody immunity
Type I hypersensitivity reaction
Allergic or atopic reaction mediated by IgE
Type II hypersensitivity reaction
Hemolytic disease
Type III hypersensitivity reaction
Antigen-antibody reaction that affects vascular epithelium - serum sickness
Type IV hypersensitivity reaction
T-cell mediated hypersensitivity - contact dermatitis
Cell-mediated immunity develops ____
In early life
Humoral antibody immunity develops ____
At age 7-8
HIV/AIDS signs
FTT, weight loss, failure to reach developmental milestones, frequent/chronic/unusual child illnesses, chronic diarrhea, hepatomegaly, splenomegaly, lymphadenopathy
May remain asymptomatic until 3 years of age
HIV screening
Infants under 18 months require virologic assays to directly detect HIV due to persistence of maternal HIV antibodies
Recommended at 2 weeks, 4 weeks, and 4 months for infants with known exposure
HIV treatment
Prevent opportunistic infections, offer high calorie/high protein foods, only eat peeled or cooked fruits and vegetables
Severe combined immunodeficiency disorder (SCID)
Congenital primary immunodeficiency disorder usually characterized by severe defect in T and B lymphocyte systems - prone to infection
Autosomal recessive or x-linked
SCID treatment
Bone marrow transplant
Juvenile idiopathic arthritis
Autoimmune inflammatory disorder
Systemic, oligoarthritis, polyarthritis
Systemic JIA signs
High fever, painful joints, malaise, myalgia, rash, affects internal organs - pleuritis, pericarditis, adenomegaly, hepatomegaly
Oligoarthitis
Involves few joints (less than 5), typically the large ones
Three variations - type I, II, III
Polyarthritis
Involves 5 or more joints
Two variations - type I, II
Naturally acquired active immunity
Immune system makes antibodies in response to infection
Naturally acquired passive immunity
Antibodies passed on to infant through placenta or colostrum
Artificially acquired active immunity
Immune system makes antibodies in response to vaccines
Artificially acquired passive immunity
Injected antibodies - no stimulation of immune response
ID lab studies
C&S - performed on body fluids to detect organisms
Enzyme linked immunosorbent assay (ELISA) - detect viral antigens in body fluids
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) - elevated with infections
Lumbar puncture
Febrile seizures
Seizures associated with high fevers (102-104 degrees), occur in children 6 months-5 years
Signs of sepsis in neonates
Initial signs - poor sucking and feeding, weak cry, lethargy, irritability
Subsequent signs - pallor, cyanosis, mottling, decreased pain response, hypotension, tachycardia, irregular respirations, jaundice, dehydration, temperature instability, GI disturbances, seizures, hypotonia, tremors
Most common cause of sepsis
Group B streptococci
Most common causes of meningitis in neonates
E. Coli and group B streptococci
Most common causes of meningitis in children
Neisseria meningitidis and streptococcus pneumoniae
Meningitis
Bacteria enters the meninges and spreads through blood stream into CSF fluid - causes hydrocephalus, increased ICP, permanent necrosis of brain cells
Signs of meningitis in neonates
Poor feeding, irritability, high pitched cry, bulging fontanel, fever or low temperature, resistance to being held, opisthotonos (hyperextension of neck and spine, late sign)
Signs of meningitis in older children
Respiratory and GI problems, nuchal rigidity, tripod posturing, Kernig’s and Brudzinski’s sign
CSF analysis for menigitis
Establishes diagnosis and causative agent of meningitis
CSF cloudy, WBC elevated, protein elevated, glucose decreased
LP should not be done if child has increased ICP to prevent brain herniation
Meningitis treatment
Monitor I/Os - fluid intake may be lowered to prevent cerebral edema, SIADH
Steroids, antibiotics, anticonvulsants
Measles (rubeola) signs
Prodromal stage - fever, malaise, coryza (inflammation of nasal lining), cough, conjunctivitis, photophobia, Koplik spots on inside of cheek - evolve into pinpoint white papules with erythematous base
Rash appears 3-4 days later - reddened maculopapular rash on face, gradually spreads downwards
Spread through direct contact with droplets
Rubella
Rash that starts on face and rapidly spreads downward - discrete pinkish-red maculopapular rash
Spread through direct and indirect contact
Varicella
Multi-lesion rash that includes macules, papules, vesicles, pustules, and crusts - centripetal (primarily on trunk)
Is communicable 1-2 days before rash develops until all lesions are crusted over
Spread through direct contact
Erythema infectiosum (fifth disease)
Caused by parvovirus, spread through respiratory secretions and blood
3-stage rash:
1 - erythema on face, “slapped” appearance
2 - symmetrical, red, maculopapular rash appears on extremities
3 - rash subsides
Communicable before rash appears - starts with URI symptoms, then rash appears as an immune response
Exanthema subitum (roseola)
Caused by HSV, spread through respiratory and saliva contact
High fever that drops and rash appears - starts on upper back and neck, spreads down trunk and to extremities
Scarlet fever
Caused by group A beta-hemolytic streptococci, spread through direct and indirect contact, droplets
Rash intense in joint folds, skin desquamates and feels like sand paper, strawberry tongue (coated, papillae red and swollen)
Scarlet fever treatment
Penicillin, erythromycin
Diphtheria
Spread through direct contact and air
Nasal congestion, lymphadenitis, “bull neck”, tough fibrous membrane along resp. tract –> mechanical airway obstruction
Pertussis (whooping cough) treatment
Erythromycin, clarithromycin, azithromycin
Pertussis immunoglobulin
