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Semester 2-Infection > Session 10-Immunocompromised Host > Flashcards

Session 10-Immunocompromised Host Flashcards

1
Q

What is an immunocompromised host?

A

State in which immune system is unable to respond appropriately and effectively to infectious microorganisms due to defect in one or more components of immune system

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2
Q

Why is a host immunocompromised?

A

1) primary immunodeficiency (congenital)

2) secondary immunodeficiency (acquired)

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3
Q

What is primary immunodeficiency due to?

A

Intrinsic gene defect - missing protein, missing cell, non-functional components

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4
Q

What is secondary immunodeficiency due to?

A

Underlying disease/treatment - decreased production/function of immune components, increased loss or catabolism of immune components

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5
Q

When should you suspect an immunodeficiency?

A 
Infections suggesting underlying immune deficiency defined as SPUR:
Severe
Persistent (despite treatment)
Unusual (site of infection/microbe)
Recurrent (same microbe)
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6
Q

How can primary immune deficiencies be recognised and diagnosed?

A

10 warning signs (two or more of each infection)

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7
Q

What are the limitations of the 10 warning signs?

A
  • general use
  • PID patients with different defects/presentations
  • PID patients with non-infectious manifestations (autoimmunity, malignancy)
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8
Q

Which three primary immunodeficiency diseases do we need to know?

A
  • Common variable immunodeficiency (CVID)
  • Selective IgA deficiency
  • IgG subclass deficiency
  • severe combined immunodeficiency (SCID)
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9
Q

What does an age of symptom onset of less than 6 months suggest?

A

T cell or phagocyte defect

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10
Q

What does an age of symptom onset of more than 6 months but less than 5 years suggest?

A

B cell/antibody or phagocyte defect

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11
Q

What does an age of symptom onset of more than five years suggest?

A

B cell/antibody/complement or secondary immunodeficiency

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12
Q

Which infections are commonly associated with Complement deficiency?

A
  • pyogenic infections (C3)
  • meningitis/sepsis (C5-C9)
  • Haemophilus influenzae and other encapsulated bacteria
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13
Q

Which infections are commonly associated with phagocytic defects?

A
  • skin/mucous infections
  • deep seated infections
  • invasive fungal infection (aspergillosis)
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14
Q

Which infections are commonly associated with antibody deficiency?

A
  • strep
  • staph
  • Haemophilus influenzae
  • GI
  • Malignancies
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15
Q

Which infections are commonly associated with T cell defects?

A
  • deep skin and tissue abscesses
  • opportunistic infections
  • death if not treated
  • all viruses
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16
Q

Describe the supportive treatment of primary immunodeficiency diseases

A
  • infection prevention (prophylactic antimicrobials)
  • treat infections promptly
  • nutritional support (vitamins A/D)
17
Q

Describe the specific treatment methods of primary immunodeficiency diseases

A
  • regular immunoglobulin therapy

- SCID: haematopoietic stem cell therapy

18
Q

Which conditions are treated with immunoglobulin replacement therapy?

A
  • common variable immunodeficiency (CVID)
  • x linked agammaglobulinaemia (Bruton’s disease)
  • hyper-IgM syndrome
19
Q

What are secondary immune deficiencies caused by?

A
  • malnutrition
  • infection (HIV)
  • liver disease
  • lymphoproliferative diseases
  • splenectomy
20
Q

What are the causes of splenectomy?

A 
Infarction 
Trauma
Autoimmune haemolytic disease
Infiltration 
Coeliac disease
Congenital
21
Q

Why is the spleen so important?

A
  • antibody production (IgM and IgG)

- splenic macrophages (removal of opsonised microbes and removal of immune complexes)

22
Q

How does an asplenic/splenectomised patient present?

A
  • increased susceptibility to encapsulated bacteria: Haemophilus influenzae, strep pneumoniae and neisseria meningitidis
  • OPSI (overwhelming post-splenectomy infection) -> sepsis and meningitis
23
Q

Describe the management methods for an asplenic/splenectomised patient

A
  • penicillin prophylaxis (life-long)
  • immunisation against encapsulated bacteria
  • medic alert bracelet
24
Q

Which infections do patients with haematological malignancies have an increased susceptibility to?

A
  • chemotherapy-induced neutropenia
  • chemotherapy-induced damage to mucosal barriers
  • vascular catheters
25
Q

What type of deficiency do viruses and fungi lead to?

A

T cell deficiency

26
Q

What type of deficiency do bacteria and fungi lead to?

A

B cell/granulocytes deficiency

Semester 2-Infection (15 decks)

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