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Med Surg > Immunity > Flashcards

Immunity Flashcards

1
Q

What is the correct sequence for donning PPE?

A

Gown
Mask or respirator
Googles or face shield
Gloves

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2
Q

What is the correct sequence for doffing PPE?

A

Gloves
Face shield
Gown
Mask

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3
Q

What are 3 illnesses that would require airborne precautions?

A

Tuberculosis
Measles (rubeola)
Chicken pox (varicella)

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4
Q

How many air changes per hour in airborne precautions?

A

6-12

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5
Q

Which 6 illnesses would require contact precautions?

A 
MRSA
VRE
C-Diff
E.Coli
Hep A
Rotavirus
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6
Q

What are 8 illnesses that would require droplet precautions?

A 
Diphtheria
Strep
Pneumonia
Influenza
Pertussis
Meningitis
Mumps
Rubella
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7
Q

What would the neutrophil count have to be for reverse isolation?

A

Less than 500

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8
Q

What is a left shift?

A

When bands of immature neutrophils increase it indicates that there is an infection that has used up all the segmented neutrophils.

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9
Q

What is the normal ESR?

A

Less than or equal to 20

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10
Q

What does an increased ESR mean?

A

Inflammation or infection

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11
Q

What is the normal count of neutrophils segs? Bands?

A

55-70%

5%

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12
Q

What is the function of neutrophils and macrophages?

A

Phagocytosis

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13
Q

What is the normal count for basophils?

A

1%

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14
Q

What is the function of basophils?

A

Release histamine and heparin in areas of tissue damage

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15
Q

What is the normal count for eosinophils?

A

1-2%

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16
Q

What is the function of eosinophils?

A

Release vasoactive amines histamine during allergic reactions to limit these reactions.

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17
Q

What is the function of tissue mast cells?

A

Maintain and prolong the inflammatory and hypersensitivity reactions.

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18
Q

What is the normal count of monocytes?

A

3%

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19
Q

What is the function of monocytes?

A

Destruction of bacteria and cellular debris. Mature into macrophages

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20
Q

What is the function of B-lymphocytes?

A

Become sensitized to foreign cells and proteins

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21
Q

Why is the function of plasma cells?

A

Secrete immunoglobulin in response to the presence of specific antigens

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22
Q

What is the function of memory cells?

A

Remains sensitized to a specific antigen and can secrete increased amounts if immunoglobulins specific to the antigen in re-exposure

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23
Q

What is the function of helper T cells?

A

Enhances immune activity through secretions of various factors, cytokines, and lymphokines.

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24
Q

What is the function of cytotoxic/cytolytic T-cells?

A

Selectively attacks and destroys non-self cells including vitally infected cells, grafts, and transplanted organs.

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25
Q

What is the function of natural killer cells?

A

Nonselectively attacks nonself cells that have undergone mutation and become malignant; also attacks grafts and transplant organs

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26
Q

IgA

A

Secretory antibody that is present in high concentrations in the secretions of mucous membranes and in intestinal mucosa.
Most responsible for preventing infection in the upper and lower respiratory tracts, GI tract, and GU tract.
15%

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27
Q

IgD

A

<1% activates immature B cells

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28
Q

IgE

A

<1% degranulates basophils and mast cells during inflammatory responses.

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29
Q

IgG

A

75% activates compliment, neutralizes toxins, enhances phagocytosis, and provides sustained immunity

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30
Q

IgM

A

10%
Activates complement , clears antigens through precipitation, mediated autoimmune reactions and ABO incompatibility reactions

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31
Q

CD4+

A

Helper/inducer T-cells that are the army callers

32
Q

CD8+

A

Suppressor T-cells that prevent hypersensitivity

33
Q

CD16+

A

NK cells

34
Q

Hyperacute rejection

A

Immediate antibody-mediated response that is non-reversible

35
Q

Acute rejection

A

Within 1 week to 3 months after transplant and can be stopped with drug therapy

36
Q

Chronic rejection

A

Similar to chronic inflammation and scarring and the patient will need another transplant

37
Q

Calcineurin inhibitor

A

For tissue transplant rejections
Cyclosporine
Tacrolimus

38
Q

Corticosteroids for tissue transplant rejections

A

Prednisone

Can cause moon face, weight gain, slower wound healing, increased blood glucose, psychosis

39
Q

Antiproliferative agent

A

Azathioprine
Mycophenolate
Sirolimus
Everolimus

40
Q

What are the two short term therapies for rescue therapy in tissue transplant rejection?

A

Monoclonal rejection

Polyclonal rejection

41
Q

What should you assess with systemic lupus erythematosus?

A

Urine

42
Q

What is the main drug to treat Lupus?

A

Hydroxychloroquine (Plaquenil)

43
Q

For scleroderma, what does CREST syndrome mean?

A 
Calcinosis
Raynaud's phenomenon 
Esophageal dysmotility 
Sclerodactyly
Telamgiectasia
44
Q

What are some drugs to treat Gout?

A

Colchicine
Allopurinol
Decrease purine in the diet

45
Q

What are some treatments for psoriatic arthritis?

A 
Methotrexaste
Sulfasalazine 
1% hydrocortisone cream
Etanercept
Golimumab
46
Q

Treatment for fibromyalgia

A

Lyrica
Antidepressants
Regular exercise

47
Q

What is the normal value for CD4+

A

600-1200

48
Q

How high does the viral load have to be to receive meds for HIV?

A

55,000

49
Q

How long once a person becomes infected with HIV does it take to show up in the blood?

A

2-6 months

50
Q

Stage one HIV

A

CD4 count 500 or greater with no AIDS

51
Q

Stage 2 HIV

A

CD4 count 200-499 with no AIDS

52
Q

Stage 3 HIV

A

CD4 count less than 200 and documented AIDS

53
Q

Stage 4 or unknown HIV

A

No information

54
Q

What is the main OI for HIV?

A

Pneumocystitis jiroveci pneumonia or PCP

55
Q

AIDS wasting

A

Loss of more than 10% of body weight and more than 30 days of diarrhea

56
Q

What is a normal CD 8 count?

A

300-600

57
Q

When do you start drug therapy to prevent pneumocystis?

A

CD4 count less than 200

58
Q

When do you start drug therapy to prevent toxoplasmosis and crypticoccosis?

A

CD 4 less than 100

59
Q

When do you start drug therapy to prevent mycobacterium about complex

A

CD 4 less than 75

60
Q

Nucleoside Analog RT

A

Reverse teanscriptsse and inhibit viral DNA synthesis and replication; Retrovir and AZT

61
Q

Non-nucleoside Analog RT inhibitors

A

Suppress viral replication but does not kill the virus

62
Q

Protease inhibitors

A

Block the HIV protease enzyme, inhibiting viral replication and release of viral particles

63
Q

Fusion inhibitors

A

Block the fusion of HIV with a host cell by blocking the ability of gp41 to fuse with the host cell therefore it cannot infect other cells

64
Q

Entry inhibitors

A

Prevent infection by blocking CCR5 receptor on CD4 cells

65
Q

Integrase inhibitors

A

Inhibits the enzyme integrase which is needed to transfer viral DNA into the host

66
Q

What is the daily dose for AZT?

A

500-600mg daily

67
Q

What are 5 main side effects of AZT?

A 
Headaches
High blood pressure 
General ill feeling 
NV
Fatigue
68
Q

How does AZT work?

A

Slows down the destruction of T4 cells

69
Q

What are the three most serious side effects of AZT?

A

Anemia
Granulocytopenia
Myopathy

70
Q

Bruton’s agammaglobulinemia

A

Congenital or primary immunodeficiency that begins in infancy; unable to produce antibodies

71
Q

What is the treatment for Bruton’s agammaglomulinemia

A

Immune serum IV every 3-4 weeks

72
Q

Type 1 hypersensitivity reaction

A

Increased production of IgE. Atopic allergy
Hay fever
Allergic asthma
Anaphylaxis

73
Q

Type 2 hypersensitivity reaction

A

Reaction of IgG with host cell membrane or antigen.
Autoimmune hemolytic anemia
Goodpastures syndrome
Myasthenia gravis

74
Q

Hypersensitivity type 3 reaction

A

Immune complex mediated
Form immune complexes that deposit in walls of blood vessels and result in complement release of inflammation.
SLE
RA

75
Q

Hypersensitivity reaction 4

A 
Delayed 
Release lymphokines which activate macrophages and induce inflammation. 
Poison ivy
Graft rejection 
TB skin tests
76
Q

Sjogren’s Syndrome

A

Dry mucous membranes with no cure however immune suppression can slow

77
Q

Goodpasture’s syndrome

A

Autoantibodies are made against the glomerular basement membrane and neutrophils, primarily effecting the kidneys and lungs.
SOB, hemoptysis, decreased output, weight gain, edema, HTN, tachycardia
High dose corticosteroids

Med Surg (6 decks)

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