Module 6 Flashcards
What are the first lines of defense for the immune system?
Skin, mucous, tears, normal flora and urine flow
How does mucous prevent infections?
Nasal hairs, cough, and sneeze reflexes protect the respiratory tract
How do tears prevent infections?
Contain antibodies and enzymes that destroy bacteria
How does urine flow prevent infections?
Acidic urine, and immunoglobulin work together to impede bacterial growth
what occurs when the “first line of defense” fails?
Immune-mediated inflammatory reaction
What are some features of the innate immune system?
Response is non-specific
Exposure leads to immediate maximal response
Cell-mediated and humoral components
No immunological memory
What does “innate” mean?
Occurs naturally
What does “adaptive” mean?
Acquired
What are some features of the adaptive immune system?
Pathogen and antigen specific response
Delay between exposure and maximal response
Cell-mediated and humoral components
Exposure leads to immunological memory
What are the second and third line of defence ?
Innate (inflammatory) and acquired (immune) response
When the immune system is triggered what occurs?
Phagocytic granulocytes (usually neutrophils) to the site of tissue injury (second line of defence. This is followed (up to 48 hours later) with an influx of cells consising of macrophages and T-cells (third line of defence)
What is involved in the initial inflammatory reaction?
Dilation and increased permeability of small blood vessles designed o trap and destory harmful molecules
What is the third line of defense?
Acquired immunity
How does acquired immunity happen?
through prior exposure or vaccines
What are the 2 components of the immune response?
Recognition of the presence of foreign substances
Taking action to destroy foreign substances
What does SIRS stand for?
Systemic inflammatory response syndrome
What is occurring in SIRS?
Its the uncontrolled inflammatory reactions that result from system mediator release.
These mediators are secreted by immune cells that are responding to infection, trauma, pancreatitis, burns or surgery
What are some cell mediators released in the immune response?
histamine, cytokins, and endotoxins, signal immune cells, such as T-cells and macrophages, to travel to the site of infection.
What is an infection?
A host response to the presence of microorganisms or tissue invasion by microorganisms
What is bacteremia?
The presence of viable bacteria in circulating blood
What are the 4 conditions that are associated with SIRS?
Temperature >38 or <36
Heart rate >90 BPM
Resp rate >20 breaths per min or PaCO2 <32mm hg
WBC > 12 pr <4, or >10% immature (band) forms
What is sepsis
The systemic inflammatory response to infection, IN association with infection
Clinical manifestations of sepsis are the same as SIRS
What is multi-organ dysfunction syndrome
Presence of altered organ function in acutely ill patients where homoeostasis cannot be maintained without intervention
What is severe sepsis?
Sepsis associated with organ dysfunction, hypoperfusion or hypotension. Hypoperfusion and perfusion abnormalities may
include but are not limited to lactic acidosis, oliguria or an acute alteration in mental status. Hypotension is defined as a
systolic blood pressure 90 mmHg or a decrease in 40 mmHg from baseline in the absence of other causes.
What is septic shock?
Sepsis with hypotension despite adequate fluid resuscitation, plus perfusion abnormalities as severe sepsis. Patients who are on inotropic support may not be hypotensive when the perfusion abnormalities are measured
What type of response is inflammation?
non-specific
How much blood are the kidneys perfused with every mintue and what percen of cardaic output does this repersent?
1200ml
20-25% of CO
What are the three main functions of the kidneys?
Maintenance of body composition
Excretion of metabolic end products and foreign substances
Production and secretion of enzymes and hormones
How do the kidneys help with maintenance of body composition?
The body’s principal method of regulating body fluid volume, osmolarity, electrolyte concentration, and pH balance, electrolytes regulated by changes in urinary excretion include sodium, potassium, chloride, calcium, magnesium, and phosphate.
How do the kidneys help with excretion of metabolic end products and foreign substances?
The kidneys excrete many of the end products of metabolism, most notably urea. The kidneys also excrete many toxins and drugs from the body.
How do the kidneys help with production and secretion of enzyme and hormones?
The kidneys are responsible for the production and excretion of three major enzymes and hormones. These are: renin, which is important in the regulation of blood pressure; erythropoietin, which stimulates maturation of erythrocytes in the bone marrow; and vitamin D3, which is important in regulation of calcium and phosphate balance.
What is acute renal failure?
The abrupt decline in renal function resulting in the inability to excrete metabolic wastes and maintain proper fluid and electrolyte balance
What is the action and what part of the kidney does anti-diuretic hormone work on?
Makes the tubule impermeable to water, causing the body to retain water
Acts on the distal tubule of the kidney and collecting ducts
What is the action and what part of the kidney does aldosterone work on?
Regulates sodium retention and potassium secretion
Acts on the kidney tubules
What is the action and what part of the kidney does atrial natriurectic peptide (ANP)
Produced by heart in response to over-stretching the atrial walls or fluid overload. Promotes loss of sodium and water
Acts on the kidney tubules
