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Co-Exisiting Disease 2 > Immune System Dysfunction > Flashcards

Immune System Dysfunction Flashcards

1
Q

Molecule capable of inducing an immune response in host organism

A

Antigen

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2
Q

Existing from brith immune system; evolutionarily conserved system acting as a first line defense against invading microbial pathogens and other potential threats to host; mechanism include physical barriers (skin, chemicals in blood, cells that attack foreign cells in body)

A

Innate immune system

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3
Q

Come into play immediately or within hours of antigen’s appearance in body

A

Innate immune system

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4
Q

Antigen specific immunize response; triggered when pathogen evades innate immune system; mor complex

A

Adaptive immunity

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5
Q

Requires days to active with unfamiliar antigen; develops memory that make future response quicker and more effective

A

Adaptive immunity

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6
Q

Major functions of acquired immune system

A

Recognition of specific “non self” antigens in the presence of “self”, during process of antigen presentation

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7
Q

Immune system that enhances ability of antibodies and phagocytic cells to clear microbes and damages cells, promote inflammation, and attach pathogens plasma membrane

A

Complement system

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8
Q

Proteins that act to inhibit the complement system (C1-inhibitor) and can lead to what kind of response, causing hereditary angioedema

A

Overactive

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9
Q

Proteins that act to activate the complement system (C3) that can lead to what response, causing greater susceptibility to infections

A

Under active

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10
Q

Measure of number of neutrophil granulocytes

A

Absolute neutrophil count (ANC)

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11
Q

Abnormal ANC

A

> 7,700 cells/cubic mm

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12
Q

Excessive innate response leads to what?

A

Higher neutrophilia count

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13
Q

Angioedema can be treated with what? (3)

A

C1inhibitor (25U/kg) or FFP (2-4units)

  1. Cinryze
  2. Ruconest
  3. Berinert
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14
Q

What is NOT useful for angioedema (4)

A
  1. Androgens
  2. Catecholamines
  3. Antihistamines
  4. Anti fibrolytics
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15
Q

Defects of antibody production and how is it treated?

A

X-linked treated with IV immunoglobulin /3-4 months

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16
Q

Defects in T lymphocytes

A

DiGeorge syndrome (characteristics facies, congenital heart disease, hypocalcemia)

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17
Q

Combined immunodeficiency (SCID), unable to fight off most types of infections, including bacterial, viral and fungal infections

A

Adenosine deaminase (ADA) deficiency

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18
Q

Excessive adaptive immunity with allergic reaction types?

A

1, 2, 3, 4

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19
Q

Life threatening antigen antibody reaction, occurs within 5-10min, up to 50% IV fluid leaks out through capillaries

A

Antiphylaxis, type 1

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20
Q

Most common intraop drug allergies?

A

Muscle relaxant

21
Q

Intraop drug allergies (4)

A
  1. Muscle relaxant
  2. Latex
  3. Antibiotics
  4. Hypnotics, opioids, X-ray contrast, protamine
22
Q

What are the least cause of anaphylaxis with drug allergies (2)

A
  1. Ketamine

2. Benzodiazepines

23
Q

What is a good consideration with anaphylaxis?

A

Abrupt drop in BP

24
Q

What can anaphylaxis mimic (4)

A

PE, acute MI, aspiration, vasovagal

25
Q

Treatment with anaphylaxis? (4)

A
  1. Epi 10-100mcg every 1-2min
  2. Benadryl
  3. Albuterol inhaler
  4. Corticosteroids
26
Q

Misdirected adaptive immunity

A

Autoimmune disease

27
Q

Who gets autoimmune disease? (4)

A
  1. Women of childbearing age
  2. Family history (lupus and MS)
  3. Environment triggers (sunlight, solvents, viral and bacteria)
  4. Race or ethnicity (DM1=whites, lupus=African&hispanic)
28
Q

Enlargement of thyroid due to lymphocytic infiltration and fibrosis rather than tissue hypertrophy; hypothyroidism with bouts of hyperthyroidism, leading to muscle failure and HF

A

Hashimoto’s thyroiditis

29
Q

Anesthesia and Hashimoto’s thyroiditis? (5)

A

Airway compromise (edema and deviation), hypothermia, anemia, hypoglycemia, hyponatremia

30
Q

Leading cause of hyperthyroidism?

A

Graves’ disease

31
Q

Treatment of Graves’ disease

A

Propylthiouracil (PTU) or methimazole

32
Q

Anesthesia and Graves’ disease (2)

A
  1. Use anything that DOES NOT simulate SNS

2. Run DEEP

33
Q

How to handle thyroid storm (5)

A
  1. Cooling pt
  2. IV fluids
  3. Control BP and HR (propranolol, esmolol, labetalol, NTG)
  4. Decadron (2mg/6hr) or cortisol (100-200mg/8hr)
  5. PTU (200-400/8hr)
34
Q

Destruction of gastric parietal cells decreases absorption of Vit B12 leading to anemia

A

Pernicious (Addison’s) anemia

35
Q

Treatment of pernicious (addison’s) anemia

A

B12 supplements

36
Q

Immune system begins to attack liver cells leading to cirrhosis and even liver failure

A

Autoimmune hepatitis

37
Q

Treatment for autoimmune hepatitis?

A

Corticosteroids (if not treated can lead to DM, HTN, psychosis, infxn, osteoporosis)

38
Q

Hyperglycemia (>250), hyperosmolar, dehydration, ketosis, acidosis (<7.25), low K Na Mg PO4

A

Diabetic ketoacidosis (DKA)

39
Q

Fluid bolus for DKA

A

Peds: 10ml/kg
Adult: 1L
Add K if below 5.3

40
Q

Insulin bolus for DKA

A

Lower glucose to 250-300mg/dL slowly
.1unit/kg/hr or .1 unit/kg bolus
No bicarb unless pH below 7.0

41
Q

What is used for cerebral edema for DKA (2)

A 
Mannitol 
Hypertonic saline (3%)
42
Q

Chronic disease resulting form inability of pancreas to maintain production of insulin necessary to regulate blood sugar levels leading to DKA, HTN, CAD, PVD, CHF, MI, CVA, CRF, infxn, neuropathy

A

Type 1 DM

43
Q

Stress of surgery can lead to what in DM1?

A

Hyperglycemia, ketoacidosis, insulin resistance

44
Q

Gluten intolerance, consumption of gluten products and some other proteins in foods like wheat or rye cause damage to small intestines lining

A

Celiac disease

45
Q

Progressive disease that affects CNS; causes damage to nerves, slowing down or completely disrupting nerve impulses

A

Multiple sclerosis

46
Q

MS and anesthesia (5)

A
  1. Spinal exacerbate symptoms
  2. Caudal, epidural doesn’t
  3. Sux may increase k+
  4. NDMR may prolong or resistant
  5. Steroids
47
Q

Causes hair loss anywhere on body but is most common on scalp

A

Alopecia areata

48
Q

Characterized by inflammation of GI tract; can afflict any part of GI tract right from the mouth to anus

A

Crohn’s disease

49
Q

What should you be careful with for pt on Crohn’s disease

A

OG

Co-Exisiting Disease 2 (11 decks)

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