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ESA3 > Infection Week 10 - Immunodeficiency > Flashcards

Infection Week 10 - Immunodeficiency Flashcards

1
Q

Why do patients get permanent tissue damage when immunodeficient?

A

As it takes a while to diagnose and get symptoms, so often quite late when diagnosed

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2
Q

What is an Immunocompromised host?

A

A host which has an immune system which is unable to respond appropriately and effectively enough to infectious microorganisms.

A host which has a defect in one or more components of the immune system

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3
Q

What are the Immunocompromised patients at risk of?

A

Infections from opportunistic pathogens

Infections from normal/otherwise harmless pathogens

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4
Q

How do we recognise that a patient may be immunodeficient?

A 
If the infections are 
Severe
Persistant
Unusual
Recurrent
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5
Q

What are the 2 Classifications of immunodeficiency?

Give a quick definition of each

A

Primary- intrinsic and usually inherited defect

Secondary- decreased production of immune components due to … Malnutrition, infection, liver disease, splenectomy etc

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6
Q

Why are primary immune deficiencies more often in males?

A

As they are X linked

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7
Q

What are the four primary immune deficiencies?

A

B cell
T cell
Complement
Phagocyte

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8
Q

Describe the types of B cell deficiencies?

A 
Unable to mature into plasma cells
Unable to become IgA
Impaired development (due to Brutons disease)
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9
Q

What are patients with B cells more at risk of?

Organisms and Diseases

A

Makes them more succeptable to bacteria and fungi so…
More respiratory infections (bronchiectasis)
Succeptable to Giardia (GI)
Increase in auto immune disease
Increase in gastric carcinoma and lymphoma

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10
Q

How do you treat B cell deficiencies

A

Immunoglobulin replacement therapies
Prophylaxis
Avoid radiation
Manage respiratory function

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11
Q

What are the types of phagocyte deficiency?

A

Defect in CD18 so doesn’t adhere
Can fail to form phagolysosome
Can lack respiratory burst
Cyclic neutropenia

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12
Q

What do patients get with a phagocyte deficiency?

A

Prolonged and recurrent infections
Get ulcers on membranes
Abcesses
Invasive aspergillosis

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13
Q

How do you treat a phagocyte deficiency?

A

Prophylactic antibiotics and fun gals
Surgery
Stem cells
Interferon G

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14
Q

What are the types/causes of T cell deficiencies?

A

Can lack a thymus
Stem cell defects
Thymocytes die
Defective development

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15
Q

What species are T cell deficient patients susceptible to?

A

Viruses and Fungi

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16
Q

What does a deficiency in C1.2.4 lead to?

A

Immune complex diseases

17
Q

What does a deficiency in C3 lead to?

A

Recurrent bacterial infections

18
Q

What does a deficiency in C5-9 lead to?

A

Recurrent neisserial infections

19
Q

What patients get secondary immunodeficiencies?

A

Asplenic
Haematological malignancies
Protein losing conditions and burns (as they lose immune components in fluid etc)

20
Q

Why do asplenic patients become immunodeficient?

A

The spleen usually makes macrophages and produces antibodies (acute IgM and long term IgG) as well as acting as a filter for blood

Becoming asplenic increases succeptability to encapsulated bacteria (lack opsonins)

21
Q

What are the bacteria that asplenic patients are more succeptable to?
Examples…

A

Encapsulated bacteria

Neisseria meningitidis, Strep. Pneumoniae, H influenzae

22
Q

What is OPSI?

A

Overwhelming post splenectomy infection

23
Q

How do you treat/prevent OPSI?

A

Life long penicillin prophylaxis

Immunisation

24
Q

What are the types of haematological malignancy immune deficiencies?

A

Both increase infection risk
Chemotherapy induced
Due to vascular catheter or Hickman lines

25
Q

How do we test Humeral immunity?

A

Measure antibodies in response to test immunisation

Testing for IgG, IgA, IgM

26
Q

How do we test cell mediated immunity?

A

FBC for lymphocytes
In vitro test for T cell function
Lymphocyte subset analysis

27
Q

How do we test phagocytic cells

A

Neutrophil function test

Adhesion molecule expression

28
Q

What other test do we do for immunodeficiency?

A

Test for complement proteins

Definitive tests

29
Q

What is immunodeficiency associated with?

A

Autoimmune disease

Malignancy

ESA3 (17 decks)

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