Med-Surg: Chapter 18: Promoting Health in Patients with Immune disorders Flashcards

1
Q

Immunity

A

body’s ability to resist infection and disease

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2
Q

Innate Immunity

A

-provides first and second lines of defense

>when the first line of defense is breached, the second line of defense is initiated

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3
Q

First line of Defense

A

-physical, biochemical, and mechanical barriers

>offer surface protection to prevent the invasion of microbes

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4
Q

Second line of Defense

A

the inflammatory response

-initiated to prevent and/or limit infection, clean out the debris of dead cells, and initiate tissue healing

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5
Q

Adaptive (acquired) Immunity

A

Third line of defense

  • natural exposure (which will make antibodies in the body)
  • infection
  • transfer of maternal antibodies

> artificial exposure

  • vaccines
  • infusion of immune serum globulin

> is specific
protects by cellular-mediated (T cell) and humoral-mediated (B-cell antibodies) mechanisms

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6
Q

The Immune System When Competent

A

immune system wards off the penetration of foreign microbes and the proliferation of abnormal or malignant cells

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7
Q

The Immune System when Incompetent

A

the failure can lead to allergies, infection, cancer, and autoimmune and immunodeficiency disorders

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8
Q

Lymphatic System

A

-network of vessels that transports excess interstitial fluid that has not been reabsorbed (lymph fluid) back to the bloodstream, helping to maintain fluid balance
>system contains thousands of lymph nodes located superficially and deep within the tissues near the lymphatic vessels

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9
Q

Lymphatic System: Lymph Nodes

A

small glandular structures that house macrophages, lymphocytes, and monocytes that filter and phagocytize microorganisms and other invading particles from circulating lymphatic fluid
>this filtering prevents unwanted substances from reentering the bloodstream

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10
Q

Thymus

A

soft organ located within the chest cavity near the heart

  • large in children
  • decreases in size into adulthood
  • central lymphoid organ that produces thymosin (hormone that stimulates T-cell production) and is where T-cell development takes place
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11
Q

Bone Marrow

A

within the cavities of bone

  • consists of red (active) marrow and yellow (inactive) marrow
  • where B and T lymphocyte formation and differentiation of B and T cells occur
  • B cells stay within the bone marrow to mature
  • T cells migrate to the thymus to mature and become active as regulatory T cells (suppressor T cells) or effector T cells (helper T cells and cytotoxic T cells)
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12
Q

Spleen

A

-size of a fist, located in the LUQ of abdominal cavity
-blood filter
>red pulp= filtering site for old or damaged red blood cells; can also store blood
>white pulp= houses lymphocytes and macrophages, filtering unwanted debris
-if it is removed, patient may become immunocompromised; requiring lifelong antibiotics

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13
Q

Tonsils

A

function as traps to protect against bacteria and viruses that are inhaled

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14
Q

Adenoids

A

located at nasopharyngeal border

-defend against inhaled bacteria and viruses

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15
Q

Peyer’s Patches

A

lymphoid follicles located on the mucosa of the small intestine
-known as intestinal immune sensors and defend against pathogens that gain entry to the intestinal tract

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16
Q

Leukocytes

A

White Blood Cells

  • formed in the bone marrow and lymph tissue
  • mature in thymus or bone marrow
  • found in blood, lymphatic system, spleen, and other body tissues
  • mobile units traveling through the bloodstream to defend the body against infection
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17
Q

5 Types of Leukocytes

A

-Neutrophils
-Monocytes
-Eosinophils
-Basophils
-Lymphocytes (B and T cells)
>further classified into granulocytes or agranulocytes

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18
Q

Granulocytes

A

have granules in the cytoplasm and release histamine and other substances to defend the body against foreign materials by increasing capillary permeability through vasodilatory effects and mediating the inflammatory response
>Neutrophils, basophils, and eosinophils are all phagocytic (cells that engulf bacteria and debris) granulocytes

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19
Q

Neutrophils

A

phagocytes of early inflammation that destroy bacteria

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20
Q

Basophils

A

release heparin as an anticoagulant and histamine during the early inflammatory response

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21
Q

Eosinophils

A

phagocytes that destroy allergens and combat parasitic infections

22
Q

Agranulocytes

A

without granules in the cytoplasm

-monocytes and lymphocytes

23
Q

Monocytes

A

agranulocyte

  • presents pathogens to T cells for destruction
  • develop into macrophages
24
Q

Macrophages

A

phagocytes and initiators of the inflammatory response that digest and destroy, or phagocytize, microorganisms and other debris
-activate helper T cells by secreting signaling proteins (Cytokines), and presenting processed antigens for destruction by the T cell

25
Q

Lymphocytes

A

active in both humoral and cell-mediated immune responses
-formed in the bone marrow
-found in lymph nodes, spleen, and thymus
-enter bloodstream through lymphatic system
>B Lymphocytes
>T Lymphocytes
>Immunoglobulins

26
Q

B Lymphocytes

A

-involved in humoral immune responses
-mature in bone marrow
-produce antibodies, or immunoglobulins
>once B cells are exposed to a specific antigen for the first time, they proliferate and differentiate into plasma cells and memory cells
-B cells can function independently but typically require the help of T lymphocytes

27
Q

Antibodies

A

bind with specific antigens, marking them for destruction by other components of the immune system, or directly neutralize the antigen by inhibiting an essential function necessary for its survival

28
Q

Plasma Cells

A

secrete antibodies after the first exposure to the antigen

29
Q

Memory Cells

A

re-stimulated by the same antigen, mount a specific antigen-antibody response, sometimes long after the initial exposure

30
Q

Immunoglobulins (IgG)

A

or antibodies

  • B cells produce
  • 5 Classes: IgA, IgD, IgE, IgG, or IgM
31
Q

Immunoglobulin: IgA

A

found in exocrine-gland secretions such as breast milk and tears
>dominant in secretory-gland secretions such as breast milk, sweat, saliva, mucus, and tears

32
Q

Immunoglobulin: IgD

A

plays a role in B-cell activation

-located on surface of developing B lymphocytes

33
Q

Immunoglobulin: IgE

A

allergic reactions and parasitic infections

-least concentrated

34
Q

Immunoglobulin: IgG

A

effective against bacteria, viruses, and other toxins

  • most abundant
  • transported across placenta
35
Q

Immunoglobulin: IgM

A

initial antibody produced after an infection

  • largest
  • first antibody produced during the primary response to an antigen
  • expressed by competent B cells
36
Q

T Lymphocytes

A

-cellular-mediated immune response
-T-cell activation occurs when macrophages present the T-cell with a phagocytized antigen
>function: elimination of cells infected by pathogens, continued activation of the inflammatory response against persistent infections, and regulation of innate and adaptive immune responses
>Cytotoxic T cells (destroy the cell)
>Suppressor T cells
>Helper T cells
-T cells are needed by B cells in order to activate the B cell

37
Q

Cytotoxic T Cells

A

respond to foreign cells, including tumors, non-self cells, and virus-laden cells

38
Q

Helper T Cells

A
  • augment the effectiveness of the innate immune response by activating macrophages
  • augment both humoral and cellular immunity through the activation of B cells to produce antibodies
  • activate cytotoxic T cells and natural killer cells
39
Q

Suppressor T cells

A

activated by helper T cells when the immune response is no longer needed

40
Q

Natural Killer (NK) cells

A

another form of T cell

  • targets virus-infected and tumor cells
  • number increases as we age; helps control infections in elderly and important for successful aging
41
Q

Cytokines

A

-interleukins (ILs)
-interferon (IFN)
-tumor necrosis factor alpha (TNFa)
>small proteins that act to regulate immune responses

42
Q

Cytokines: Interleukins (ILs)

A

production occurs by macrophages and lymphocytes in response to the initiation of the inflammatory response
-responsible for the general enhancement or suppression of inflammation and the stimulation of leukocyte production and maturation

43
Q

Cytokines: Interferons

A

proteins that protect against viral infections and tumor growth
-do not destroy viruses directly; they prevent the virus from infecting the surrounding healthy cells and interfere with its ability to replicate

44
Q

Cytokines: Tumor Necrosis Factor Alpha

A

-produced by macrophages
-enhances inflammation
-involved in the regulation and production of immune cells
>Interleukins and Interferons rely on TNFa to mount an effective inflammatory response

45
Q

Complement

A

complex system of proteins

  • provides cell-killing effects for innate and acquired immunity
  • activates pathogens and inflammatory response
  • initiation of the complement can activate every component of the Inflammatory response
  • “complement” the antibacterial function of antibodies
  • complement proteins are synthesized in the liver and circulate in the bloodstream in an inactive form until activated by bacteria, viruses, fungi, tumor cells, antigen-antibody complexes, or endotoxins
46
Q

Active Immunity

A

antibodies or T cells are produced either after natural exposure to an antigen during illness or infection or after immunization

47
Q

Passive Immunity

A

happens when preformed antibodies or T lymphocytes are transferred from one individual to another

ex: a newborn acquires immunity from his/her mother through the placenta
ex: acquire immunity through transfusion of antibody-laden blood products

48
Q

Humoral Medicated Immunity

A
  • antibody mediated
  • cell type: B lymphocytes
  • defense modality: circulating antibodies
  • defends against extracellular microorganisms; bacteria, viruses
49
Q

Cellular-Mediated Immunity

A
  • cellular mediated
  • Cell type: T lymphocytes
  • defense modality: cell-to-cell contact
  • defends against intracellular microorganisms: fungi, viruses, bacteria, tumor and transplant antigens
50
Q

Changes in The Aging Immune Response

A
  • decline in T-cell function and antibody production when exposed to specific antigen challenges
  • have increased circulating antibody levels; leading to autoimmune disorders