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Pathophysiology for Nursing > Unit 1 Module 1: Body Defenses > Flashcards

Unit 1 Module 1: Body Defenses Flashcards

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1
Q

What type of cells are most commonly antigen presenting cells?

A

Macrophages, B cells, dendritic cells

Remember macrophages live in the tissues so they make a perfect cell to be an APC since they are out in the tissues can quickly pick up on an invader.

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2
Q

A patient presents to the clinic with an allergic reaction. This can be verified by an elevated in which WBC type?

A

Eosinophils

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3
Q

Based on what you learned about systemic manifestations of inflammation and fever. What action should the nurse take for a 20-year patient who has a fever of 101 from a viral infection.

A

Allow the fever to go without treatment, if the patient is able to tolerate the metabolic burden on the body.

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4
Q

Which of the top five Opportunistic infections are caused by a fungus?

A

cryptococcal meningitis and PCP pneumonia

The top 5 we need to know for this class are

  • PCP pneumonia
  • MAC
  • cytomegalovirus
  • cryptococcal meningitis
  • Kaposi’s sarcoma
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5
Q

erythema

A

Vasodilation causes increased blood flow

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6
Q

What is the best test to determine if a patient has HIV infection in an individual who is believed to have been infected 1 year ago?

A

4th generation assay test

The CDC recommends this test because it can detect within 14 days the presence of p24 HIV protein.

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7
Q

Which AIDS opportunistic infection causes blindness?

A

Cytomegalovirus

The top 5 we need to know for this class are

  • PCP pneumonia
  • MAC
  • cytomegalovirus
  • cryptococcal meningitis
  • Kaposi’s sarcoma
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8
Q

Which cells in the differential are immature cells and are elevated when there has been a “shift to the left”

A

stabs and bands

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9
Q

A patient presents to the emergency room with gastroenteritis and has an elevated WBC. What part of the differential will tell the provider that is it is most likely a viral infection?

A

lymphocytes

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10
Q

margination

A

The action of leukocytes adhering to blood vessel walls

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11
Q

WBC differential: slightly elevated WBC, high segs

A

inflammatory response (with a higher WBC overall, would be bacterial)

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12
Q

A patient has (seasonal) allergies and is starting to take an “anti-histamine” medication for the symptoms. Now that you understand pathophysiology, you now know that histamines are present because of

A

mast cell degeneration

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13
Q

phagocytosis

A

a cell (neutrophil or macrophage) ingests and disposes of foreign material or an invader

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14
Q

When the body encounters something, it checks to see if it is “self” or “non-self”. What marker does the body read to recognize “self”?

A

Human leukocyte antigen (more generally: major histocompatibility complex)

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15
Q

Opportunistic or pathogenic: Gastroenteritis

A

pathogenic

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16
Q

The loss of what type of cell in cell mediated immunity would have the greatest impact on the immune system?

A

T helper (CD4) cells

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17
Q

The nurse is evaluating a patient’s wound on his ankle. The site is red, swollen and painful to move. What action should the nurse take?

A

Teach the patient how to keep the wound clean and dry (no sign of infection yet)

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18
Q

WBC differential: high WBC, high stab/band neutrophils, normal segs, low lymphocytes

A

This can either be early in the infection or an overwhelming infection where more and more neutrophils are needed.

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19
Q

_______________cells make antibodies, which are proteins that are produced in response to one particular antigen.

A

B

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20
Q

HIV or AIDS: 36-year-old female recently diagnosed HIV positive with MAC (mycobacterium avium complex)

A

AIDS

It has to be CD4 less than 200 or AIDS defining illness.

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21
Q

What implications might there be for an individual with HIV who has an “undetectable” viral load?

A

It decreases the risk of transmission of the virus to others as there is less virus replicating in the bloodstream.

22
Q

HIV or AIDS: 44-year-old male with CD4 count of 160 being treated for oral candidiasis (thrush)

A

AIDS

It has to be CD4 less than 200 or AIDS defining illness.

23
Q

What enzymes are used in the process of HIV replication?

A

reverse transcriptase, integrase, protease

24
Q

A patient presents to the emergency department with pneumonia. The provider determines that the patient most likely has a [viral/bacterial/fungal] pneumonia because of elevated neutrophils.

A

bacterial

25
Q

A patient is fearful that he has been infected with HIV. The nurse recognizes that the first manifestations of HIV infection is/are:

A

Acute HIV infection looks like most viral infections with symptoms like fever, fatigue, night sweats, swollen lymph glands and muscle aches.

The drop in CD4 cells to a significant amount and the opportunistic infections don’t happen until the end of the disease process.

26
Q

Opportunistic or pathogenic: bacterial pneumonia

A

pathogenic

27
Q

Opportunistic or pathogenic: sinusitis

A

opportunistic

28
Q

Why does inflammation cause pain?

A

Increased fluid in the area puts pressure on nerve endings

29
Q

edema

A

Protein-rich fluid flows from vascular space into the tissues

30
Q

WBC differential: WBC 14,000, high monocytes

A

chronic infection – the neutrophils can no longer manage the problem because it has gone on too long

31
Q

Why does inflammation cause impaired function?

A

Edema and pain

32
Q

Which infection is most often seen when the patient’s CD4 cell count is below 50 cells/mm3?

A

MAC

33
Q

HIV or AIDS: 24-year-old female HIV positive with CD4 count of 250 and has invasive cervical cancer

A

AIDS

It has to be CD4 less than 200 or AIDS defining illness.

34
Q

chemotaxis

A

the communication method that is used to call other cells to the site of injury

35
Q

Opportunistic or pathogenic: tuberculosis

A

pathogenic

36
Q

Opportunistic or pathogenic: Oral candidiasis

A

Opportunistic

37
Q

Which cell is considered the most critical to acquired immunity?

A

T helper cells (CD4) both direct the cell-mediated immunity as well as activate B cells for humoral immunity to produce antibodies.

38
Q

How does an HIV infection occur in the body?

A

HIV infects CD4 cells and uses the cell as a factory for more HIV cells

39
Q

If a patient has chronic inflammation, which cells are present?

A

lymphocytes, fibroblasts, macrophages

40
Q

Opportunistic or pathogenic: PCP/PJP pneumonia

A

opportunistic

41
Q

Which one of the five antibodies (immunoglobulins) is the first ones to be produced and the one that gives us long term protection?

A

IgM then IgG

42
Q

This is the type of cell that displays a fragment of the antigen on it’s surface which makes it marked for recognition by T lymphocytes.

A

Antigen presenting cells (APC) is the type of cell. Macrophages are one type of APC. The MHC is the “barcode” type of designation that helps T cells know if it is “self” vs “nonself”.

43
Q

What is the benefit of memory cells in the immune system?

A

Quicker and more pronounced response the second time they encounter an invader.

44
Q

A patient has a rare immune disease that makes his natural killer cells not functional. The nurse recognizes that this patient is most at risk for what types of illness/disease?

A

cancer

Natural killer cells do surveillance in the body for cancer cells and eradicate them on their own.

45
Q

Opportunistic or pathogenic: Karposi’s sarcoma

A

opportunistic

46
Q

A fellow nursing student was running to class and fell acquiring a leg injury. What s/s would you expect without infection?

A
  • sharp pain
  • heat
  • tight skin
  • redness
47
Q

The 4th gen assay is positive but the HIV 1/HIV2 test is indeterminate. Which test would show positivity during the acute phase?

A

Nucleic acid test

48
Q

An HIV positive patient was started on new drug therapy for his HIV infection. What test would give the best indication if the drug therapy is effective?

A

Viral load * This gives the best idea of the change in the viral replication speed. The goal is to decrease viral replication to the point of undetectable.

49
Q

What cells are primarily responsible for the production of antibodies?

A

The B cells are the primary ones that produce antibodies. Although the T-cells give direction for B cells to start making antibodies.

50
Q

HIV or AIDS: 56-year-old diagnosed 10 years ago; now has a bacterial pneumonia

A

HIV

It has to be CD4 less than 200 or AIDS defining illness. Bacterial pneumonia is pathogenic. PCP/fungal pneumonia is opportunistic.

51
Q

mast cells

A

cells made up of granular bags that live in the tissues and can release chemical signals.

52
Q

Opportunistic or pathogenic: Mycobacterium avium complex (MAC)

A

opportunistic

Pathophysiology for Nursing (16 decks)

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