Immunity Flashcards
What is the correct sequence for donning PPE?
Gown
Mask or respirator
Googles or face shield
Gloves
What is the correct sequence for doffing PPE?
Gloves
Face shield
Gown
Mask
What are 3 illnesses that would require airborne precautions?
Tuberculosis
Measles (rubeola)
Chicken pox (varicella)
How many air changes per hour in airborne precautions?
6-12
Which 6 illnesses would require contact precautions?
MRSA VRE C-Diff E.Coli Hep A Rotavirus
What are 8 illnesses that would require droplet precautions?
Diphtheria Strep Pneumonia Influenza Pertussis Meningitis Mumps Rubella
What would the neutrophil count have to be for reverse isolation?
Less than 500
What is a left shift?
When bands of immature neutrophils increase it indicates that there is an infection that has used up all the segmented neutrophils.
What is the normal ESR?
Less than or equal to 20
What does an increased ESR mean?
Inflammation or infection
What is the normal count of neutrophils segs? Bands?
55-70%
5%
What is the function of neutrophils and macrophages?
Phagocytosis
What is the normal count for basophils?
1%
What is the function of basophils?
Release histamine and heparin in areas of tissue damage
What is the normal count for eosinophils?
1-2%
What is the function of eosinophils?
Release vasoactive amines histamine during allergic reactions to limit these reactions.
What is the function of tissue mast cells?
Maintain and prolong the inflammatory and hypersensitivity reactions.
What is the normal count of monocytes?
3%
What is the function of monocytes?
Destruction of bacteria and cellular debris. Mature into macrophages
What is the function of B-lymphocytes?
Become sensitized to foreign cells and proteins
Why is the function of plasma cells?
Secrete immunoglobulin in response to the presence of specific antigens
What is the function of memory cells?
Remains sensitized to a specific antigen and can secrete increased amounts if immunoglobulins specific to the antigen in re-exposure
What is the function of helper T cells?
Enhances immune activity through secretions of various factors, cytokines, and lymphokines.
What is the function of cytotoxic/cytolytic T-cells?
Selectively attacks and destroys non-self cells including vitally infected cells, grafts, and transplanted organs.
What is the function of natural killer cells?
Nonselectively attacks nonself cells that have undergone mutation and become malignant; also attacks grafts and transplant organs
IgA
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%
IgD
<1% activates immature B cells
IgE
<1% degranulates basophils and mast cells during inflammatory responses.
IgG
75% activates compliment, neutralizes toxins, enhances phagocytosis, and provides sustained immunity
IgM
10%
Activates complement , clears antigens through precipitation, mediated autoimmune reactions and ABO incompatibility reactions
CD4+
Helper/inducer T-cells that are the army callers
CD8+
Suppressor T-cells that prevent hypersensitivity
CD16+
NK cells
Hyperacute rejection
Immediate antibody-mediated response that is non-reversible
Acute rejection
Within 1 week to 3 months after transplant and can be stopped with drug therapy
Chronic rejection
Similar to chronic inflammation and scarring and the patient will need another transplant
Calcineurin inhibitor
For tissue transplant rejections
Cyclosporine
Tacrolimus
Corticosteroids for tissue transplant rejections
Prednisone
Can cause moon face, weight gain, slower wound healing, increased blood glucose, psychosis
Antiproliferative agent
Azathioprine
Mycophenolate
Sirolimus
Everolimus
What are the two short term therapies for rescue therapy in tissue transplant rejection?
Monoclonal rejection
Polyclonal rejection
What should you assess with systemic lupus erythematosus?
Urine
What is the main drug to treat Lupus?
Hydroxychloroquine (Plaquenil)
For scleroderma, what does CREST syndrome mean?
Calcinosis Raynaud's phenomenon Esophageal dysmotility Sclerodactyly Telamgiectasia
What are some drugs to treat Gout?
Colchicine
Allopurinol
Decrease purine in the diet
What are some treatments for psoriatic arthritis?
Methotrexaste Sulfasalazine 1% hydrocortisone cream Etanercept Golimumab
Treatment for fibromyalgia
Lyrica
Antidepressants
Regular exercise
What is the normal value for CD4+
600-1200
How high does the viral load have to be to receive meds for HIV?
55,000
How long once a person becomes infected with HIV does it take to show up in the blood?
2-6 months
Stage one HIV
CD4 count 500 or greater with no AIDS
Stage 2 HIV
CD4 count 200-499 with no AIDS
Stage 3 HIV
CD4 count less than 200 and documented AIDS
Stage 4 or unknown HIV
No information
What is the main OI for HIV?
Pneumocystitis jiroveci pneumonia or PCP
AIDS wasting
Loss of more than 10% of body weight and more than 30 days of diarrhea
What is a normal CD 8 count?
300-600
When do you start drug therapy to prevent pneumocystis?
CD4 count less than 200
When do you start drug therapy to prevent toxoplasmosis and crypticoccosis?
CD 4 less than 100
When do you start drug therapy to prevent mycobacterium about complex
CD 4 less than 75
Nucleoside Analog RT
Reverse teanscriptsse and inhibit viral DNA synthesis and replication; Retrovir and AZT
Non-nucleoside Analog RT inhibitors
Suppress viral replication but does not kill the virus
Protease inhibitors
Block the HIV protease enzyme, inhibiting viral replication and release of viral particles
Fusion inhibitors
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
Entry inhibitors
Prevent infection by blocking CCR5 receptor on CD4 cells
Integrase inhibitors
Inhibits the enzyme integrase which is needed to transfer viral DNA into the host
What is the daily dose for AZT?
500-600mg daily
What are 5 main side effects of AZT?
Headaches High blood pressure General ill feeling NV Fatigue
How does AZT work?
Slows down the destruction of T4 cells
What are the three most serious side effects of AZT?
Anemia
Granulocytopenia
Myopathy
Bruton’s agammaglobulinemia
Congenital or primary immunodeficiency that begins in infancy; unable to produce antibodies
What is the treatment for Bruton’s agammaglomulinemia
Immune serum IV every 3-4 weeks
Type 1 hypersensitivity reaction
Increased production of IgE. Atopic allergy
Hay fever
Allergic asthma
Anaphylaxis
Type 2 hypersensitivity reaction
Reaction of IgG with host cell membrane or antigen.
Autoimmune hemolytic anemia
Goodpastures syndrome
Myasthenia gravis
Hypersensitivity type 3 reaction
Immune complex mediated
Form immune complexes that deposit in walls of blood vessels and result in complement release of inflammation.
SLE
RA
Hypersensitivity reaction 4
Delayed Release lymphokines which activate macrophages and induce inflammation. Poison ivy Graft rejection TB skin tests
Sjogren’s Syndrome
Dry mucous membranes with no cure however immune suppression can slow
Goodpasture’s syndrome
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