Immunity, Inflammation, Infectious Process

Question 1

Types of Immunity

Answer 1

Innate resistance: Natural barriers and the inflammatory response

Adaptive (acquired) immune system
Passive (short term immunity)

Question 2

First Line of Defense

Innate Immunity

Answer 2

Physical and mechanical barriers:
Skin and low skin temperature (prevent microorganism)
Linings of the gastrointestinal, genitourinary, and respiratory tracts

Include: Highly interconnected junction
Sloughing off of cells
Coughing and sneezing
“Washing” 
Vomiting
Urinating
Mucus and cilia

Question 3

First Line of Defense

Innate Immunity

Answer 3

Biochemical barriers
Synthesize and secrete substances to trap or destroy microorganisms

Ex: Antibacterial peptides in mucus, perspiration (sweat), saliva, tears, and earwax

Normal microbiome
Inhibits colonization by pathogens; releases chemicals that prevent infection
Vaginal: Lactobacillus

Question 4

Second Line of Defense

Answer 4

Inflammatory response
Causes
Infection, mechanical damage, ischemia, nutrient deprivation, temperature extremes, and radiation
Cellular and chemical components
Nonspecific
Rapidly initiated
No memory cells

Cardinal signs
Redness (erythema), heat, swelling, and pain

Vascular response
Blood vessel dilation, increased vascular permeability and leakage, white blood cell (WBC) adherence to the inner walls of the vessels, and migration through the vessels

Cellular chemotaxis
Attraction of platelets and other WBCs to the site of injury

Question 5

Local Manifestations of Acute Inflammation

Answer 5

Redness, heat, swelling, & pain

Serous exudate (transudate)/Watery exudate: Indicates early inflammation.

Fibrinous exudate
Thick, clotted exudate: Indicates more advanced inflammation.

Purulent exudate
Pus: Indicates a bacterial infection. Rich in proteins from WBCs, microbial organisms, and cellular debris.

Hemorrhagic exudate
Exudate containing blood: Indicates bleeding

Question 6

Systemic Manifestations of Acute Inflammation

Answer 6

Inflammatory mediators are released into the circulation
Lowering of pH
Leukocytosis or Leukopenia (WBC increase)
Fever or Pyrexia

Question 7

Chronic Inflammation

Answer 7

Causes tissue damage in common disabling diseases
Increases susceptibility to Cancer

Causes
Persistent infections or irritants
Obesity

Question 8

Resolution & Repair

Answer 8

Regeneration
Most favorable outcome

Resolution
Returning injured tissue to an approximation of their original structure and function

Repair
Replacement of destroyed tissue with scar tissue
Scar tissue: Primarily composed of collagen to restore the tensile strength of the tissue

Question 9

Healing by Primary and Secondary Intention

Answer 9

Primary intention –sutured surgical incision

Secondary intention- larger wounds which have a greater loss of tissue and contamination

Question 10

The characteristic vascular changes at the site of an injury produce?

Answer 10

Increased permeability and leakage

Question 11

Factors that Affect Wound Healing

Answer 11

Nutrition
Blood Flow & Oxygen Delivery
Impaired Inflammatory and Immune Responses
Infection, Wound separation and Foreign Bodies

Question 12

Nutritional Status

Answer 12

Local and systemic factors influence wound healing
Vitamin C and A play an essential role in the healing process
Vitamin C is needed for collagen synthesis
Vitamin A functions in stimulating and supporting epitheilial

Question 13

Possible Complications of

Wound Healing

Answer 13

Keloid (hyperplasia/scar tissue) 
Contractures 
Dehiscence (wound opens up)
Evisceration (organ is coming out of wound. High risk: lungs, chest)
Stricture (narrowing)
Fistula 
Adhesions (scar tissue internally)

Question 14

Wound Healing in the Elderly

Answer 14

Diminished immune function
A decrease in dermal thickness
A decline in collagen content
Loss of elasticity
Underlying illness

Question 15

Adaptive Immunity

Third line of Defense

Answer 15

Works together with inflammation.
Recognizes foreign or “nonself” substances (Antigens)
Provides long-term protection.
Is slower than innate but more specific.
Has memory.

Question 16

Active Immunity—Active Acquired Immunity

Answer 16

Antibodies or T cells are produced after either
a natural exposure to
an antigen or after immunization.

Is long lived.

Question 17

Passive Immunity—Passive Acquired Immunity

Answer 17

Preformed antibodies or T lymphocytes are transferred from a donor to a recipient.
Occurs naturally (placental transfer) or artificially (immunotherapy).
Is temporary or short lived.

Question 18

Which statement indicates the nurse has an accurate understanding concerning passive immunity?

Answer 18

“Can be transferred from a donor to a recipient.”

Question 19

Antigen

Answer 19

Is a molecule that can react with antibodies or receptors on B and T cells.
Is mostly protein but can be other molecules as well.
Immunogenic antigen: An antigen that can trigger an immune response

Question 20

Antibody

Answer 20

Is also called immunoglobulin (Ig).
Is produced by plasma cells.
Has several classes
IgG (most prevalent), IgA (Mostly in secretions), IgM (first contact/largest), IgE (most rare), and IgD (not well known)

Question 21

IgG

Answer 21

Most of protective activity against infection

Crosses the placenta

Question 22

IgA

Answer 22

Most of protective activity in body secretions

Question 23

IgE

Answer 23

Mediator of many common allergic responses

Defends against parasitic infections

Question 24

IgD

Answer 24

Functions as one type of

B-cell antigen receptor

Question 25

IgM

Answer 25

First antibody produced during the initial, or primary, response to an antigen

Question 26

Which information is most correct regarding IgAs?

Answer 26

Found in saliva and other body secretions.

Question 27

Aging and Immune Function

Answer 27

Decreased T-cell activity
Decreased production of specific antibodies
Decreased circulating memory B cells
Increased circulating autoantibodies: can cause autoimmune diseases