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Nursing Theory IV > Patho: Immune > Flashcards

Patho: Immune Flashcards

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1
Q

Defense Mechanisms

A 
First line of defense: skin
Second line of defense: body’s inflammatory
response
Third line of defense: immunity 
Leukocytes
- Granulocytes 
- Monocytes
- Lymphocytes
Lymphoid organs and tissues
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2
Q

Types of Immunity

A

Natural immunity
Active Immunity
- Naturally acquired: having disease
- Artificially acquired: immunizations
Passive Immunity
- Naturally acquired: neonates receive antibodies from mothers
- Artificially acquired: injecting serum with antibodies

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3
Q

Immunity

A 
Primary response
- First exposure to antigen
- 1 to 2 weeks before antibody titer reaches
efficacy 
Secondary response
- Repeat exposure to the same antigen
- More rapid response, with efficacy in 1 to 3
days
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4
Q

Types of Immunizations/ Vaccines

A

Inactivated vaccines
Live, attenuated vaccines
Toxoids

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5
Q

Recommended Immunizations for Adults

A

Measles-mumps-rubella (MMR)
Tetanus and diphtheria toxoids (Td)
Hepatitis B Influenza
Pneumonococcal

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6
Q

Altered Immune Responses: Hypersensitivity

A
  • I: Immediate hypersensitivity
  • II: Cytotoxic hypersensitivity
  • III: Immune hypersensitivity
  • IV: Delayed hypersensitivity
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7
Q

Type 1: Immediate Hypersensitivity

A 
Clinical Manifestations: 
Mild
- Hives
- Seasonal allergic rhinitis
- Eczema
More problematic symptoms 
- Throat constriction
- Localized edema
- Wheezing
- Tachycardia
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8
Q

Hypersensitivity Reactions

A 
 Type I hypersensitivity—allergic reactions  Common
- Caused by allergen
- Skin rashes
- Hay fever
Causative mechanism
- Exposure to allergen
- Development of IgEs
-Mast cells
Complications
- Anaphylaxis
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9
Q

Anaphylaxis: Anaphylactic Shock

A 
 Severe, life-threatening
 Systemic hypersensitivity reaction
 Decreased blood pressure caused by release of histamine
Airway obstruction
Severe hypoxia
Can be caused by:
- Latex materials
- Insect stings
- Nuts or shellfish; various drugs
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10
Q

Type II: Cytotoxic Hypersensitivity

A

Tissue specific reactions:
- Cells destroyed by antibody and complement - Cell destruction by phagocytosis
- Toxic products produced
- Antibody dependent cell mediation
- Cell malfunction
Manifestations are determined by tissue or organ affected

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11
Q

Type II: Immune Hypersensitivity

A

Immune complex mediated reactions
Antigen-antibody reactions
Body fails to identify self and reacts against itself 
Genetic component

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12
Q

Autoimmune Disorders

A

Development of antibodies against own cells or tissues
Autoantibodies are antibodies formed against self- antigens—loss of self-tolerance.
Disorder can affect single organs or tissues or can be generalized.
Examples:
- Hashimoto thyroiditis, systemic lupus
erythematosus, rheumatic fever, myasthenia gravis, scleroderma, pernicious anemia

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13
Q

Type IV: Cell-Mediated or Delayed Hypersensitivity

A 
Delayed response by sensitized T lymphocytes
Release of lymphokines
Inflammatory response
Destruction of the antigen
Examples: 
- Tuberculin test
- Contact dermatitis
- Allergic skin rash
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14
Q

Tissue and Organ Transplant Rejection

A 
Hyperacute rejection
- Immediately after transplantation
Acute rejection
- Develops after several weeks
Chronic, late rejection
- Occurs after months or years
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15
Q

Measuring Level of Immunity

A 
Serum immunoglobulins
- Measure levels of immunoglobulins
Antibody titer testing
- Identify antibody titer levels
Skin testing
- Detect impaired cell-mediated immunity
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16
Q

Tests to Detect Hypersensitivity

A
  • Radioallergosorbent test (RAST)
  • Skin tests
  • Prick test
  • Intradermal
  • Patch
17
Q

Serum Assays

A 
Antinuclear antibody (ANA) test
- Specific to screen for systemic lupus
erythematosis 
Rheumatoid factor (RF)
- Specific to screen for rheumatoid arthritis
18
Q

Acquired Immunodeficiency Syndrome (AIDS)

A

AIDS—chronic infectious disease caused by the human immunodeficiency virus (HIV)
HIV destroys helper T cells—CD4 lymphocytes
Loss of immune response
Increased susceptibility to secondary infections
and cancer
Prolonged latent period
Development may be suppressed by antivirals

19
Q

HIV Risk Factors

A 
Hemophiliacs
Patients who received a transfusion with HIV-
infected blood or blood products
Newborns and breast-fed infants of HIV-
infected mothers
Injection drug users
Partners having unprotected sex with those
infected
20
Q

HIV: The body’s response

A

The body’s response to HIV infection
- Mounts a defense against the HIV virus through antibodies and T cells
- About 12 weeks after infection, the body produces enough antibodies to be detected by standard HIV test
- HIV viral load begins to drop, indicating partial
effectiveness of the body to rid itself of HIV
- CD8 cells drop drastically in the late stages, and CD4 cells slowly decline throughout the whole infection

21
Q

Stages of HIV: Initial / Latent

A

Initial stage
- Lasts 4 to 8 weeks
- High levels of virus in the blood Generalized flulike symptoms
Latent stage
- Lasts 2 to 12 years
- Virus is inactive
- Levels are high in the lymph nodes but low in the blood

22
Q

Stages of HIV: Third Stage

A

Lasts 2 to 3 years
Patient experiences opportunistic infections
TH CD4 cells are usually

23
Q

AIDS

A

HIV-positive individual
- Virus is known to be in the body.
- No evidence of immunosuppression
AIDS
- Marked clinical symptoms, multiple complications
Individual often identified as HIV-positive before development of AIDS
- Current therapies start if HIV infection is diagnosed in the early stages.

24
Q

Diagnosis of Aids

A

AIDS is diagnosed when an individual with HIV develops at least one of these conditions:

  • Pneumocystis pneumonia
  • Recurrent bacterial pneumonia
  • Chronic herpes simplex virus infection
  • Esophageal candidiasis
  • Extrapulmonary tuberculosis
  • Kaposi’s sarcoma
  • Cytomegalovirus disease (other than liver, spleen or lymph nodes)
  • Central nervous system toxoplasmosis
  • HIV encephalopathy
  • Extrapulmonary cryptococcosis (including meningitis)
25
Q

HIV Manifestations

A

Initial stage
- Generalized flulike symptoms
Latent stage
- May have no symptoms initially
- Eventually, frequent and persistent infections
- Fever, night sweats, swollen lymph nodes, headache, skin lesions, sore throat, dyspnea, burning with urination, or diarrhea
- Extreme fatigue and weight loss

26
Q

HIV Complications

A

AIDs Dementia Complex- confusion cognitive impairment, memory loss, loss of coordination, balance, depression, eventually cannot talk or move, seizures then coma
Opportunistic Infections- Candida, fungal
TB
Cancers- kaposi’s sarcoma
Non-Hodgkins or Hodgkins lymphoma
Wasting syndrome

27
Q

HIV Complications

A

Pneumocystis jiroveci pneumonia
- Acquired by inhalation
- Second leading cause of death in AIDS patients
- Cysts prevent the exchange of gases - Shortness of breath on exertion, fever, and a
nonproductive cough

28
Q

Diagnostic Tests

A

HIV antibodies blood test
ELISA
West Blot test
Decrease in T-helper cells

Nursing Theory IV (12 decks)

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