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Infection > The Immunocompromised Host > Flashcards

The Immunocompromised Host Flashcards

1
Q

Define an Immunocompromised Host

What is the cause?

A

A state in which the immune system is unable to respond appropriately and effectively to infectious microorganisms

Defect in 1/ more components of the immune system

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2
Q

Compare the 2 types of Immunocompromised state

A 
Primary Immunodeficiency (congenital);
- Due to gene defect
Secondary Immunodeficiency (acquired);
- Due to an underlying disease/ treatment
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3
Q

What are 3 ways a gene defect leads to immunodeficiency (Primary)

A
  • Missing protein
  • Missing cell
  • Non functional components of immune system
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4
Q

What are 2 ways an underlying disease/ treatment leads to immunodeficiency (Secondary)

A
  • Decreased production/ function of immune components
  • Loss/ Increased catabolism of immune components

(Main cause of secondary immunodeficiency is malnutrition)

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5
Q

What are 4 things to consider when suspecting the possibility of immunodeficiency

A
  • Age
  • Sex
  • Site of infection
  • Type of microbe
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6
Q

When should you suspect immunodeficiency?

A

When infections are SPUR;

Severe
Persistent
Unusual
Recurrent

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7
Q

What are 5 warning signs of Primary Immunodeficiency (PID) in Children?

A
  • Family history of PID
  • Need of IV Antibiotics to clear infections
  • Persistent thrush in mouth/ fungal infection on skin
  • Recurrent, deep skin or organ abscesses
  • Failure of an infant to gain weight/ grow normally
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8
Q

What are 5 warning signs of Primary Immunodeficiency (PID) in Adults?

A
  • Family history of PID
  • Need of IV Antibiotics to clear infections
  • Persistent thrush in mouth/ fungal infection on skin
  • Recurrent, deep skin or organ abscesses
  • Chronic diarrhoea with weight loss
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9
Q

What are 3 limitations of the ‘10 warning signs’ of PID (Primary Immunodeficiency)

A
  • Lack of population based evidence
  • Patients present differently
  • Patients can present with non infectious manifestations
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10
Q

What is Severe Combined Immunodeficiency (SCID)

A

A PID, characterised by defects in both T and B lymphocytes

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11
Q

What is Common Variable Immunodeficiency (CVID)?

A

A PID, characterised by recurrent infections and low antibody levels (IgM, IgA, IgG)

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12
Q

What is Bruton’s disease?

A

An X-linked PID, characterised by a defect in B cell development and a reduced immunoglobulin production

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13
Q

What are 2 causes of immunodeficiency involving antibody defects?

A
  • Defect in B cell development

- Defect in antibody production

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14
Q

What are 2 causes of immunodeficiency involving T cell defects?

A
  • T cell defects

- Combined B and T cell defects

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15
Q

What are 3 causes of immunodeficiency involving phagocytic defects?

A
  • Defects in respiratory burst
  • Defect in fusion of lysosome/ phagosomes
  • Defect in neutrophil production and chemotaxis
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16
Q

What is Chronic Granulomatous disease?

A

An X-linked PID where the Superoxide radical can’t be made, so pathogens can’t be phagocytosed.

(Increased susceptibility to bacteria and fungi)

17
Q

What defects are suggested by PID symptom onset;

  1. <6 months old
  2. > 6 months and <5 years old
  3. > 5 years old
A
  1. Suggests T cell or Phagocyte defect
  2. Suggests B cell antibody or Phagocyte defect
  3. Suggests B cell/ Antibody/ Complement defect or SID

(T cells are vital so a defect would present before 6 months of age)

18
Q

What are 2 methods of management of PIDs

A
  • Supportive treatment

- Specific treatment

19
Q

What is the goal of Immunoglobulin Replacement Therapy (IRT)? (It is a life long treatment)

What are 2 formulations used?

What are 3 conditions it can be used to treat?

A

To get serum IgG above 8g/L

  • IvIg
  • ScIg (young patients)
  • CVID
  • Bruton’s disease (XLA)
  • Hyper IgM Syndrome
20
Q

List 5 causes of Decreased production of immune components, leading to SIDs

A
  • Malnutrition (most common)
  • Infection
  • Liver disease
  • Haematological malignancies
  • Splenectomy
21
Q

List 2 causes of Increased loss of immune components, leading to SIDs

A
  • Burns

- Protein losing conditions

22
Q

In patients with haematological abnormalities, what are 3 causes of increased infection susceptibility?

A
  • Chemotherapy induced neutropenia
  • Chemotherapy induced damage to mucosal barriers
  • Vascular catheters
23
Q

How do you treat Febrile Neutropenia?

A
  • Immediate antibiotic therapy (Tazocin)

- Asses risk of sepsis

Infection (26 decks)

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