Unit 1 Module 1: Body Defenses Flashcards
What type of cells are most commonly antigen presenting cells?
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.
A patient presents to the clinic with an allergic reaction. This can be verified by an elevated in which WBC type?
Eosinophils
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.
Allow the fever to go without treatment, if the patient is able to tolerate the metabolic burden on the body.
Which of the top five Opportunistic infections are caused by a fungus?
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
erythema
Vasodilation causes increased blood flow
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?
4th generation assay test
The CDC recommends this test because it can detect within 14 days the presence of p24 HIV protein.
Which AIDS opportunistic infection causes blindness?
Cytomegalovirus
The top 5 we need to know for this class are
- PCP pneumonia
- MAC
- cytomegalovirus
- cryptococcal meningitis
- Kaposi’s sarcoma
Which cells in the differential are immature cells and are elevated when there has been a “shift to the left”
stabs and bands
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?
lymphocytes
margination
The action of leukocytes adhering to blood vessel walls
WBC differential: slightly elevated WBC, high segs
inflammatory response (with a higher WBC overall, would be bacterial)
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
mast cell degeneration
phagocytosis
a cell (neutrophil or macrophage) ingests and disposes of foreign material or an invader
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”?
Human leukocyte antigen (more generally: major histocompatibility complex)
Opportunistic or pathogenic: Gastroenteritis
pathogenic
The loss of what type of cell in cell mediated immunity would have the greatest impact on the immune system?
T helper (CD4) cells
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?
Teach the patient how to keep the wound clean and dry (no sign of infection yet)
WBC differential: high WBC, high stab/band neutrophils, normal segs, low lymphocytes
This can either be early in the infection or an overwhelming infection where more and more neutrophils are needed.
_______________cells make antibodies, which are proteins that are produced in response to one particular antigen.
B
HIV or AIDS: 36-year-old female recently diagnosed HIV positive with MAC (mycobacterium avium complex)
AIDS
It has to be CD4 less than 200 or AIDS defining illness.
What implications might there be for an individual with HIV who has an “undetectable” viral load?
It decreases the risk of transmission of the virus to others as there is less virus replicating in the bloodstream.
HIV or AIDS: 44-year-old male with CD4 count of 160 being treated for oral candidiasis (thrush)
AIDS
It has to be CD4 less than 200 or AIDS defining illness.
What enzymes are used in the process of HIV replication?
reverse transcriptase, integrase, protease
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.
bacterial
A patient is fearful that he has been infected with HIV. The nurse recognizes that the first manifestations of HIV infection is/are:
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.
Opportunistic or pathogenic: bacterial pneumonia
pathogenic
Opportunistic or pathogenic: sinusitis
opportunistic
Why does inflammation cause pain?
Increased fluid in the area puts pressure on nerve endings
edema
Protein-rich fluid flows from vascular space into the tissues
WBC differential: WBC 14,000, high monocytes
chronic infection – the neutrophils can no longer manage the problem because it has gone on too long
Why does inflammation cause impaired function?
Edema and pain
Which infection is most often seen when the patient’s CD4 cell count is below 50 cells/mm3?
MAC
HIV or AIDS: 24-year-old female HIV positive with CD4 count of 250 and has invasive cervical cancer
AIDS
It has to be CD4 less than 200 or AIDS defining illness.
chemotaxis
the communication method that is used to call other cells to the site of injury
Opportunistic or pathogenic: tuberculosis
pathogenic
Opportunistic or pathogenic: Oral candidiasis
Opportunistic
Which cell is considered the most critical to acquired immunity?
T helper cells (CD4) both direct the cell-mediated immunity as well as activate B cells for humoral immunity to produce antibodies.
How does an HIV infection occur in the body?
HIV infects CD4 cells and uses the cell as a factory for more HIV cells
If a patient has chronic inflammation, which cells are present?
lymphocytes, fibroblasts, macrophages
Opportunistic or pathogenic: PCP/PJP pneumonia
opportunistic
Which one of the five antibodies (immunoglobulins) is the first ones to be produced and the one that gives us long term protection?
IgM then IgG
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.
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”.
What is the benefit of memory cells in the immune system?
Quicker and more pronounced response the second time they encounter an invader.
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?
cancer
Natural killer cells do surveillance in the body for cancer cells and eradicate them on their own.
Opportunistic or pathogenic: Karposi’s sarcoma
opportunistic
A fellow nursing student was running to class and fell acquiring a leg injury. What s/s would you expect without infection?
- sharp pain
- heat
- tight skin
- redness
The 4th gen assay is positive but the HIV 1/HIV2 test is indeterminate. Which test would show positivity during the acute phase?
Nucleic acid test
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?
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.
What cells are primarily responsible for the production of antibodies?
The B cells are the primary ones that produce antibodies. Although the T-cells give direction for B cells to start making antibodies.
HIV or AIDS: 56-year-old diagnosed 10 years ago; now has a bacterial pneumonia
HIV
It has to be CD4 less than 200 or AIDS defining illness. Bacterial pneumonia is pathogenic. PCP/fungal pneumonia is opportunistic.
mast cells
cells made up of granular bags that live in the tissues and can release chemical signals.
Opportunistic or pathogenic: Mycobacterium avium complex (MAC)
opportunistic
