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MS_Primers for Exam 3 Content > Immunity, Anaphylaxis, Allergy Primer > Flashcards

Immunity, Anaphylaxis, Allergy Primer Flashcards

1
Q

Name several factors that can affect the body’s immune response.

A
  • CNS integrity
  • General physical condition
  • Emotional status
  • Medications
  • Dietary factors
  • Illness, trauma, or surgery
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2
Q

“Immunity” is the responsiveness to…

A

The invasion of foreign substances

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3
Q

What are the 3 functions of our immune system?

A
  • Defence: protection against micro-organisms
  • Homeostasis: damaged cellular substances digested and removed
  • Surveillance: mutations recognized and removed
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4
Q

What are the 2 “types” of immunity?

A
  • Innate: born with
  • Acquired: acquired after birth
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5
Q

What are the 2 types of acquired immunity?

A
  • Active:
    • Immunity developed due to exposure to disease/inoculation
  • Passive:
    • Acquired by receiving antibodies rather than synthesizing them
    • Can xfer across the placenta
    • Short lived due to lack of memory for the antigen
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6
Q

Describe the “innate” immune system.

A
  • Present at birth
  • First line of defense that responds w/in minutes without prior exposure as it is not cell specific
  • Neutrophils and monocytes are the primary WBCs for this response
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7
Q

Describe the “acquired” immune system.

A
  • Invasion of foreign substances and subsequent development of antibodies and sensitized lymphocytes
  • With each reinvasion the body responds more rapidly
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8
Q

Humoral response relates to the body ____ response, with antibodies produced by ____ cells.

A

Fluid, plasma

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9
Q

In regards to a humoral response, when an individual is exposed to an antigen for a second time the response is ___ and lasts _____.

A

Faster (1 to 3 days), longer

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10
Q

A main product of secondary humoral response is ___ rather than ___.

A

IgG, IgM

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11
Q

Memory cells account for more rapid production of___.

A

IgG

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12
Q

Cell-mediated immune responses are initiated through…

A

Specific antigen recognition by T cells

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13
Q

What are three cell types involved in the cell-mediated immunity response?

A
  • T lymphocytes
  • Macrophages
  • Natural Killer cells
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14
Q

Cell mediated responses are particularly important for immunity against pathogens _____ the cells including…

A
  • Inside
  • viruses and some bacteria, fungal infections, rejection of transplanted tissues, contact hypersensitivity, tumor immunity
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15
Q

What are some effects of ageing on the immune system?

A
  • Greater susceptibility to pathogens (ex. influenza pneumonia)
  • Higher incidence of malignancies
  • Bone marrow relatively unaffected
  • Immunoglobulin levels decrease
  • Decreased numbers of T cells
  • Ability to develop new antibodies decreased
  • Delayed hypersensitivity reaction
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16
Q

Decreased immunoglobulin levels lead to a…

A

Suppressed immune response.

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17
Q

An antigen is…

A

A substance that elicits an immune response

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18
Q

What are the key factors to remember regarding Tumor Necrosis Factor (TNF)?

A
  • Activates macrophages and granulocytes
  • Promotes the immune and inflammatory responses
  • Kills tumor cells
  • Responsible for extensive weight loss
  • Associated with chronic inflammation and cancer
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19
Q

What are some signs of recognizing anaphylactic shock?

A

Edema and itching at the site of exposure, possible angioedema, followed by shock symptoms: rapid weak pulse, hypotension, dilated pupils, dyspnea, bronchial edema.

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20
Q

What happens if anaphylactic shock isn’t treated immediately?

A

If not treated immediately will lead to death.

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21
Q

What are the cardinal principles of treating anaphylaxis?

A
  • Recognition of the signs and symptoms
  • Maintenance of patient’s airway (high flow O2)
  • Prevention of spread by using a tourniquet (remove stinger if present/applicable)
  • Administration of the appropriate drugs (establish IV access)
  • Treatment of shock (fluids and ongoing monitoring)
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22
Q

What is the drug regimen for anaphylaxis?

A
  • Epinephrine (1:1000) every 5-15 mins until desired result achieved
  • Nebulized albuterol (Proventil)
  • Diphenhydramine (Benadryl) IM or IV
  • Corticosteroids (methylprednisolone, hydrocortisone)
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23
Q

Why would the administration of epinephrine for anaphylaxis be of concern for someone on beta blockers?

A

Beta blockers attenuate the response to epinephrine and the combo may cause the pt to develop bradycardia and hypotension

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24
Q

True or False

If a pt is on Beta blockers, you should withhold epinephrine in treating anaphylaxis.

A

False. Give it, but monitor for bradycardia and hypotension

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25
Q

A pt on beta blockers receives epinephrine and develops bradycardia, what may be given and how?

A
  • Atropine
  • 0.5mg via IM or SubQ every 10 mins
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26
Q

What drug may be used to treat hypotension for a pt who has rec’d epinephrine and how would it be administered?

A
  • Glucagon
  • 1mg IV bolus followed by 1-5mg/hr infusion
27
Q

True or False

The initial exposure triggers the response and mass release of chemical mediators seen in the overreaction or hypersensitivity of anaphylactic shock.

A
  • FALSE!
  • Overreaction or hypersensitivity seen in anaphylactic shock is NOT due to the first exposure but the SECOND causes a trigger response and mass release of chemical mediators
28
Q

Name the four different types of immune reactions.

A

I: Atopic or Contact Dermatitis

II: Cytotoxic and Cytolytic reactions

III: Immune complex reactions

IV: Hypersensitivity reactions

29
Q

What does “atopic” mean?

A

A form of allergy in which a hypersensitivity reaction such as dermatitis or asthma may occur in a part of the body not in contact with the allergen

30
Q

What are some of the conditions that can result of type I reactions?

A
  • Allergic rhinitis
  • Atopic dermatitis
  • Urticaria (hives)
  • Angioedema
31
Q

Atopic reactions can happen as a response to _____ conditions.

A

Environmental

32
Q

What are the target areas for a type I immune reaction?

A
  • conjunctiva of eyes
  • mucosa of upper respiratory tract
33
Q

What are the s/s of a type I immune reaction?

A
  • Sneezing
  • Nasal discharge
  • Itching of the throat
  • Eyes watering
34
Q

Allergic rhinitis is triggered by a sensitivity to:

A
  • Grasses
  • Pollens
  • Dust
  • Animal dander
  • Mold
35
Q

What is atopic dermatitis?

A
  • Atopic dermatitis (eczema) is a condition that makes your skin red and itchy.
  • It’s common in children but can occur at any age.
  • Atopic dermatitis is long lasting (chronic) and tends to flare periodically.
  • It may be accompanied by asthma or hay fever.
36
Q

What is Urticaria (hives)

A
  • Transient wheals
  • Red, itchy welts that result from a skin reaction.
  • The welts vary in size and appear and fade repeatedly as the reaction runs its course
37
Q

What is Angioedema?

A
  • An abrupt and short-lived swelling of the skin and mucous membranes.
  • All parts of the body may be affected but swelling most often occurs around the eyes and lips.
38
Q

Define Type II Cytotoxic/Cytolytic reactions.

A

Direct binding of IgG or IgM antibodies to an antigen on the cell surface that target the cell for destruction

39
Q

An incompatible blood transfusion results in what type of immune reaction?

A

Type II

40
Q

Explain the patho of an incompatible blood transfusion.

A
  • Antigens coat foreign erythyrocytes
  • Clumping occurs and causes blockage of small blood vessels resulting in a depletion of clotting factors
  • Phagocytosis of agglutinated (clumped) cells
  • Release of hemoglobin into the urine and plasma
  • Cytotoxic reaction causes vasospasm in the kidney resulting in blockage of kidney tubules
41
Q

Type III immune reactions are associated with _____ disorders.

A

Autoimmune

42
Q

What is the patho of a Type III immune response?

A
  • An abnormal immune response is mediated by the formation of antigen-antibody aggregates called “immune complexes.”
  • They can precipitate in various tissues such as skin, joints, vessels, or glomeruli, and trigger the classical complement pathway.
43
Q

What are some examples of conditions that cause a Type III immune response?

A
  • SLE
  • RA
  • Acute glomerular nephritis
44
Q

Type IV immune reaction is a _____ response.

A

Cell mediated

45
Q

How does a type IV immune reaction develop?

A
  • Sensitized T lymphocytes attack antigens or release cytokines which attract macrophages into the area
  • It is a type of hypersensitivity reaction that takes several days to develop.
46
Q

Contact dermatitis is a example of what type of immune reaction?

A

Type IV

47
Q

What are some ways that hypersensitive allergic reactions may be mediated?

A
  • Reducing exposure
  • Desensitizing (immunotherapy)
  • Chronic allergies: lifestyle changes
  • Allergen recognition and control
48
Q

An example of a sympathomimetic decongestant drug is…

A

Adrenaline

49
Q

How/why are antipuritics used?

A

topically applied protect skin and provide relief from itching (calamine lotion, coal, tar preparations)

50
Q

What do anti-mast cell stabilizing drugs do?

A

Inhibit cytokine release thus immune reactions

51
Q

When is immunotherapy used?

A

When the allergen cannot be avoided

52
Q

A RAST test is used to determine…

A

sensitivity to certain food types, severe anaphylactic reactions

53
Q

What type of blood test is used for dx of allergies?

A

CBC w/ diff

54
Q

Eosinophil count is elevated with type __ sensitivity.

A

1

55
Q

What type of skin tests may be used for allergy dx?

A
  • Patch
  • Scratch or prick
  • Intradermal
56
Q

If a person has a skin test done, the hypersensitive reaction will occur when?

A

w/in minutes

57
Q

How long will the positive reaction to a scratch test last?

A

8-12hrs

58
Q

With patch testing, the patch needs to be worn for ___ hours then the patient should come back for the site to be assessed.

A

48 – 72hrs

59
Q

How is immunotherapy performed?

A
  • Accurate record keeping to prevent an adverse reaction
  • After administration anticipate adverse reactions (puritis urticarial, sneezing laryngeal edema)
  • Administer away from the joint so a tourniquet can be applied in an emergency
  • Rotate the site
  • Ensure you don’t inject into the bloodstream
  • Observe for any reaction
60
Q

What is apheresis?

A

Separation of blood into its separate components followed by the removal of 1 or more of the separated components

61
Q

What is Plasmapheresis?

A
  • Aka: plasma exchange
  • Removal of plasma containing components thought to cause disease and replacement with saline, fresh frozen plasma, or albumin
62
Q

What are some side effects of plasmapheresis?

A

Hypotension and as the result of a vasovagal reaction citrate toxicity

63
Q

Citrate is used as an _____ and may cause _____ manifesting as a headache dizziness or paresthesias.

A

Anticoagulant, hypocalcaemia

MS_Primers for Exam 3 Content (13 decks)

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