The Immunocomprised Host Flashcards
What is it when a patient is immunocomprimised?
A state in which the immune system is unable to respond approiately and effectively to infectous mircoorganisms and there is a defect in one or more components of the immune system
What are the two different tyoes of immune deficeny?
Primary or congential immunodeficiecny and a secondary of aquired immunodeficieny
How would you know when to suspect a primary immune deficeny in children?
SPUR
S- sever infections that need the use of IV antibiotics or hospitalisation
P-persistant with the normal treatment
U- unusual site of infection or organism
R- recurrent - keeps coming back
What are the different types of primary immunodeficnies that you may see in practivce?
Predominatley antibody deficenies, Combined T cells and B cell deficeny and phagocytic defects
What are some of the antibdoy deficenies that may be present?
X linked gamma immunoglobin deficeny or burtons disease, where there is a complete lack of gamma globins
Or common varaible immunodefcieny where there are low levels of IgG, IgM and IgA, and you can also have selective IgG and IgA deficenies that are usually asymptomatic
What is severe combinded immunodeficeny?
A paitent is born with no T cells but no B cells prodcution, manifests early in life with failure to thrive, and vaccination could have fatal consequences
What is chronic granulmatous disease?
Naturophils fail to mount a resp burst (so is a phagocytic defect) , and there is a defect in the enzyme NADPH oxidase, and these patients are more at risk from the caltase enzyme
What is severe congenital neutropenia?
A shortage of neutrophils, and this causes the patients to be suspectible to infections and also usually presents early
What is cyclic neutropenia?
A white cell cell deficeny that occurs every 3 weeks, and lasts 3-6 days
What conditions are suggested by the onset of symptoms of PID at age less than 3 months?
Suggestive of a t cell or a phagocytic defect
What conditons are suggested by an onset of PID between 3 months and 5 years?
B cells antibody deficeny or a hagocytic defect
What condtions are suggested by a onset of conditions that is greater than 5 years?
Suggests a B cell, antibody or compelement or a secondary immune defeiceny
What are some of the supportive treatments that you may using in treatein a primary immunodeficeny?
Infection prevention and prophalyxis, avoid live infections, use UV irriadated and CV negative blood products only, nurtional support and treat any infections promptly and aggressively
What are some of the specific treatments that can be used for a primary immune deficeny?
SCID, heamopetic stem cells thearpy and immmunoglobin thearpy
What are some of the conditions that can result in a decreased production of immune products?
Lymphoproliferative diseases, liver diseases, infection, malnurtion
What are some of the potential causes of a splenectomy?
Autoimmune haemoltyic diseases, infracion, trauma, infliltration by a tumour
Why is the spleen so important?
It has immune functions, such as targeting blood borune apthogens, there is anitbody prodctuon andhas spenlic macrophages that are important in the removal of encaspulated bacteria
How would you manage an asplenic patient?
Pencillin prophalyxis, a medic alert bracelt, and immunisation against encapsulated bacteria
Why do patients with a haemotigical mlaignacy and chemothearpy have an increased suspecitibilty to infeciton?
There is chemothearpy induced damage to the mucosal barrier, chemothearpy induced neurtopenia, and vascualr damage
