Inflammation, Wound Healing, Immune Response, Allergic Disorders, Autoimmunity

Question 1

acute inflammation

Answer 1

healing occurs in 2-3 weeks, usually leaving no residual damage; neutrophils are predominant cell type at site of inflammation

Question 2

subacute inflammation

Answer 2

has same features as acute inflammation, but persists longer

Question 3

chronic inflammation

Answer 3

· may last for years; injurious agent persists or repeats injury to site.
o Predominant cell types involved are lymphocytes and macrophages
o May result from changes in immune system (autoimmune disease)

Question 4

healing process

Answer 4

final phase of the inflammation process is healing; consists of two major components: regeneration and repair

Question 5

regeneration

Answer 5

· the replacement of lost cells and tissues with cells of the same type

Question 6

repair

Answer 6

is health with connective tissue replacing lost cells and usually results in scar formation

Question 7

Clinical Manifestations (Local response to inflammation)

Answer 7

· Redness
· Heat
· Pain
· Swelling
· Loss of function

Question 8

Clinical Manifestations (Systemic response to inflammation)

Answer 8

· Increased WBC count with a shift to the left
· Malaise
· Nausea and anorexia
· Increased pulse and respiratory rate
· Fever (patient then experiences chills and shivering)

Question 9

acute intervention for inflammation

Answer 9

· Observation
· Vital signs
o Temperature may rise, pule and respirations may increase
· Fever management
o Antipyretic use should be considered
· RICE (rest, ice, compression, elevation

Question 10

drug therapy for inflammation

Answer 10

· Aspirin
· Acetaminophen
· NSAIDs
Corticosteroids

Question 11

immunity

Answer 11

body’s ability to resist disease
· Serves three functions: defense homeostasis and surveillance

Question 12

innate immunity

Answer 12

present at birth, first-line of defense against pathogens

Question 13

acquired immunity

Answer 13

Immunity that is present only after exposure and is highly specific, developed immunity

Question 14

active immunity

Answer 14

results from the invasion of the body by foreign substances such as microorganisms, with each reinvasion of the microorganisms, the body responds more rapidly and vigorously to fight off the invader. May result naturally from a disease or artificially through immunization with a less virulent antigen. Immunity takes time to develop but is long lasting.

Question 15

passive immunity

Answer 15

implies that the host receives antibodies to an antigen rather than synthesizing them. May take place naturally through the transfer of immunoglobulins across the placental membrane from mother to fetus. Artificial passive acquired immunity occurs through injection with gamma globulin (serum antibodies). The benefit of this immunity is its immediate effect. Immunity is short lived because the person does not synthesize the antibodies and consequently does not retain memory cells for the antigen.

Question 16

antigens

Answer 16

substances the body recognizes as foreign that elicit an immune response, most are composed of protein

Question 17

antibodies

Answer 17

immune globulins produced by lymphocytes in response to antigens

Question 18

Central (primary) lymphoid organs

Answer 18

bone marrow and thymus

Question 19

The thymus gland ____ with age.

Answer 19

shrinks

Question 20

· Peripheral lymphoid organs: Lymph nodes

Answer 20

§ Tonsils
§ Spleen
§ Lymphoid tissues associated with gut, genitals, bronchi, and skin
§ WBCs, and platelets

Question 21

· Mononuclear phagocytes

Answer 21

o Include monocytes in blood and macrophages found throughout body
o Capture, process, and present antigens to lymphocytes to initiate an immune response
o Capture antigens by phagocytosis

Question 22

· Lymphocytes

Answer 22

o Produced in bone marrow
o Eventually migrate to peripheral organs
o Differentiate into B and T lymphocytes
- T Cytotoxic cells
- T Helper cells

Question 23

Immunocompetence

Answer 23

body’s immune system can identify and inactive or destroy foreign substances

Question 24

Anaphylaxis

Answer 24

can occur when mediators are released systemically (e.g., after injection of a drug, after an insect sting). The reaction occurs within minutes and can be life threatening because of bronchial constriction and subsequent airway obstruction and vascular collapse.

Question 25

autoimmunity

Answer 25

an immune response against self in which the immune system no longer differentiates self from non-self
· Examples of autoimmune disease: RA, SLE, IBD, MS, Type 1 diabetes

Question 26

Allergic rhinitis

Answer 26

can occur year round or may be seasonal, causes include pollens, dust, and molds

Question 27

Angioedema

Answer 27

localized cutaneous lesions involving deeper layers of the skin, swelling is usually seen in the face

Question 28

Clinical Manifestations of Anaphylaxis

Answer 28

· Edema
· Itching at site of exposure to the allergen
· Wheal-and-flare reaction: a pale wheal containing edematous fluid surrounded by a red flare from the hyperemia
· Shock: rapid, weak pulse, hypotension, dilated pupils, dyspnea, possible cyanosis

Question 29

Clinical manifestations of allergic rhinitis

Answer 29

· Nasal discharge
· Sneezing
· Tearing
· Mucosal swelling with airway obstruction
· Pruritis around eyes, nose, throat and mouth

Question 30

Clinical manifestations of asthma

Answer 30

· Dyspnea
· Wheezing
· Coughing
· Tightness in the chest
· Thick sputum

Question 31

Clinical manifestation of Urticaria (hives)

Answer 31

· Transient wheals (pink, raised, edematous, pruritis areas)
· Pruritis

Question 32

Anaphylactic Shock Management

Answer 32

· Ensure patient airway, intubation if evidence of impending obstruction
· Remove insect stinger if present
· Establish IV access
· Epinephrine
· Give high-flow O2 via face mask as needed
· Nebulized albuterol for bronchospasm resistant to epinephrine
· Diphenhydramine IV for urticaria and itching
· Corticosteroids: Methylprednisone IV
· For hypotension: place recumbent and elevate legs, IV NS rapid bolus of 1-2 L
Ongoing monitoring: VS, O2 Sat, LOC, cardiac rhythm, UO

Question 33

Automatic Epinephrine Injectors

Answer 33

· Fill the prescription at once and keep at least 2 doses available
· Always keep at least 1 autoinjector with you
· Keep and autoinjector in a place where others an easily find it
· Keep in original case in room temperature away from cold and heat extremes
· Mark on calendar when autoinjector expires and replace id discolored or contains particles
· Use device if you see signs of anaphylaxis
· Inject to top of thigh slightly on outside at 90-degree angle, hold in place for 2-3 seconds
· You can inject through clothes, avoid pockets and seams where fabric is thick
After use call 911 and get to nearest hospital, take autoinjector with you