Quiz 3: Immue System

Question 1

Function of the Immune and Lymphatic System

Answer 1

Protect the body from infection, produce and circulate lymphocytes and other immunity boosting cells

Lymphatic system is part of the immune system

Question 2

Immune and lymphatic chart review

Answer 2

Look for medical history of immune-related conditions such as…
• Allergies (know how severe the patient’s reactions usually are)
• Rheumatoid Arthritis (RA)
• Systemic Lupus Erythematosus (SLE aka Lupus)
• Fibromyalgia
• Inflammatory bowel diseases (e.g., Crohn’s)
• Ankylosing Spondylitis (AS)
• Myasthenia Gravis (MG)
• Surgery involving lymph nodes (node dissection, sentinel node biopsy, etc)
• May also look at family history of these conditions

Lab values:
• Serum rheumatoid factor (RF)

Question 3

Immune and Lymphatic Subjective Questions (Have you recently experienced….)

Answer 3

Change in skin or nail beds
• Fever or other constitutional symptoms (especially
recurrent or cyclical symptoms)
• Lymph node changes (tenderness, enlargement)
• Anaphylactic reaction
• Need to also ask about allergies and use of inhalers
and/or epi-pen

Question 4

Lymphatic and Immune specific subjective questions (History taking)

Answer 4

How long have you had this problem?
(acute versus chronic)
• Acute – less likely to be
immunologic, but not impossible
• Has the problem gone away and then
recurred?
• Have additional symptoms developed
or have other areas become
symptomatic over time?
• How is/has this condition been
previously managed? Are you
currently receiving treatment

Question 5

Edema

Answer 5

Edema (swelling) is a
symptom of another
condition or disease
process

Question 6

What is Lymphadema

Answer 6

Lymphedema is the
disease process itself
• Impairment of the
lymphatic system

Question 7

Immune and Lymphatic System Red Flags

Answer 7

Family history of systemic inflammatory
disorder may be the only indicator of an
immune system issue
• Recent or recurrent infection
• Bilateral/symmetrical small joint swelling
• Generalized weakness
• Nail bed changes à splinter hemorrhages
• Unexplained weight loss
• Night sweats

Question 8

Immune and Lymphatic System Emergency Conditions

Answer 8

/Sxs of anaphylactic shock: vocal hoarseness, difficulty
breathing, chest discomfort or tightness
• New onset of joint pain with a recent history of surgery
• Concern for bacterial infection or reactive arthritis
• Septic Joint: adusky blue discoloration or erythema
accompanied by exquisite tenderness
• Ask about recent history of infection of any kind anywhere
in the body

Question 9

Immune and Lymphatic System Urgent Conditions:

Answer 9

New onset joint pain within 6 weeks of surgery:
• Concerning when accompanied by constitutional symptoms, rash, or skin lesions
• In someone with undiagnosed RA à symmetric swelling and pain in peripheral joints may be an early sign
• Development of progressive neurologic symptoms within 1 to 3 weeks of
a previous infection or recent vaccination
• In someone with cervical RA à evidence of spinal cord compression
• Concern for C1-C2 subluxation or dislocation
• In someone with ankylosing spondylitis (AS): Presence of incontinence
(bowel or bladder)