Immune System Flashcards

1
Q

How many line of defense does the body have and what are they?

A

3

-Physical and chemical (innate)
-nonspecific (innate)
-specific (acquired)

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2
Q

What is the innate immunity?

A

provides broad defense against infection.

Physical
chemical

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3
Q

What are physical barriers?

A

skin
mucous membranes
nose hair

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4
Q

what are chemical carriers?

A

lysozyme (enzymes in tears that acts like an antibiotic)

Gastric juices in stomach to destry bacteria

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5
Q

What is nonspecific resistance ?

A

Phagocytic cells (ingest and destroy)

inflammation (brings more WBC to the party)

fever (inhibits bacterial growth and increases rate of tissue repair)

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6
Q

What is acquired adaptive immunity

A
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7
Q

What is Specific resistance?

A

Antigens!

-specific substances (proteins) found in foreign microbes.

these produce an immune response

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8
Q

What are the steps in the immune response (during specific acquired immunity)

A

1) antigen is detected by a macrophage

2) T-cells (fire and police) they are the first responders

3) T-cells secrete interleukin 2
…..need to add (slide 8)

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9
Q

ImmWhat are the 3 major T cells?

A

1) cytotoxic (poke holes)

2) helper T cells (sound the alarm)

3) Memory (remain dormant, and allow a faster response if antigen is detected again)

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10
Q

What are antibodies also called?

A

Immunoglobulins (Ig’s)

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11
Q

What do immunizations do

A

Use portions of pathogens to stimulate T & B cells response.

Live
Inactivated
Toxoid

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12
Q

What is a live vaccines

A

Used for Viruses

-contain a weakened version of pathogens

-similar immune response to natural infection

-examples: MMR & Vericella

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13
Q

what is a inactivated vaccines

A

Used for Viruses

Use a “killed” version of the pathogen

Example: polio

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14
Q

what is toxoid vaccines

A

Used for Bacteria

Use the toxins produced by bacteria to stimulate the immune response

Example: Diphtheria and tetanus of the DTap

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15
Q

What is subunit vaccine

A

Used for both viruses and bacteria

contains parts of the pathogen

Example: DTap

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16
Q

What is Conjugate vaccine

A

Used for bacteria

Used with bacteria that have protective polysaccharide coatings

Example: H-Flu

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17
Q

What is mRNA Vaccines

A

Uses messenger RNA (mRNA)

0immune cells use the mRNA as a “blueprint” to build similar protein

stimulate adaptive immune response

person is NOT exposed to pathogen

vaccine has not effect on DNA

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18
Q

Vaccine History

A

Vacca = cow

Started by Edward Jenner 1796

Cow-pox (taken from cow-pox pustule)

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19
Q

What are allergies?

A

Immune reaction to foreign substances

The immune system overreacts by producing antibodies (IgE) to travel around and release chemicals causing reaction

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20
Q

Anaphylaxis

A

Histamines causes the blood vessels to expand

-Dangerous drop in blood pressure

-fluid can leak into the lungs, causing swelling and pulmonary edema

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21
Q

What is allergy testing?

A

Can be completed using a blood test (but can be less accurate)

Typically done with skin test

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22
Q

What are the 3 major types of skin cancer?

A

1) Bastal Cell Carcinoma
2) Squamous Cell Carcinoma
3) Malignant Melanoma (big bad one)

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23
Q

What are risk factors for developing skin cancer?

A

-sun exposure
-Predisposition (genetics
-Skin tone
-exposure to toxic chemicals
-frequent sunburns as a child

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24
Q

Describe Basal cell carcinoma

A

“pearly” glossy, shiny, waxy appearance

-raised edges w/ depressed center

-slow growing, waxy to manage, rarely metastasizes

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25
Q

Describe Squamous cell carcinoma

A

-“crusty” hard-covering, scaly, pink or reddish and raised lesion

-faster growing than BBC and can metastasize

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26
Q

How do we assess for skin cancer?

A

ABCDE

A - asymmetry
B - Boarders
C - color
D - diameter
E - Evolving shape/size/color

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27
Q

describe malignant melanoma

A

*most deadly form of skin cancer

-not asymmetrical
-not well defined boarders
-multiple colors
-large (greater than 5cm)
-evolve and grows

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28
Q

What are skin cancer treatments

A

Cryosurgery (freezing)
excisional biopsy
radiation
Chemo
MOHS surgery

29
Q

When would you use MOHS Surgery?

A

Used for cancers that have a high risk of returning

goal is to remove all cancer one later at a time

30
Q

Nursing intervention for skin cancer

A

routine wound care

31
Q

Pt education for prevention of skin cancer

A

-Avoid direct skin exposure (between 10-4)
-wear long sleeves, sunglasses, hats
-use sunscreen15 or higher
-avoid tanning beds and toxic chemical burns

32
Q

What is HIV

A

Human immunodeficiency virus

-Enters CD4+ T cells and replicates killing T-cells

33
Q

What are clinical manifestations of HIV

A
34
Q

What are complications from HIV

A

Opportunistic infections
Resp failure
Cachexia and wasting

35
Q

How do we diagnose HIV

A

CBC
Serum antibody test
Western blot test
viral load testing
CD4+T cell count
other testing

36
Q

What medications are used for HIV

A

-Antiretrovirals
-meds to opportunistic infections
-antidepressant
-nutrition therapy

37
Q

Prevention for HIV

A

-Safe sex
-Know sex partners
-blood and blood components

38
Q

What should we be assessing in a person with HIV?

A

-nutritional status
-skin integrity
-respt status
-neurologic status
fluid and electrolyte balance
-knowledge level

39
Q

Rheumatoid Arthritis

A

-Autoimmune disease
-diffuse connective tissue disease
-degenerative

40
Q

Causes for RA

A

Genetics
infection
female hormones
environmental factors
occupational exposures

41
Q

What are manifestations of RA

A

-joint pain
-swelling
-warmth
-erythema
-lack of function
-deformities
-RA nodules

42
Q

What are complications that can come from RA?

A

-bone marrow suppression
-anemia
-GI disturbances

43
Q

How do we diagnose RA

A

-ANA (Antinuclear antibody)
-RF (rheumatoid factor)

Everything else is extra
-CRP, CBC, ESR, Ig, IgM, IgG

xray of joints
radionuclide scans
direct arthroscopy
synovial/fluid aspirate
synovial membrane biopsy

44
Q

Medical management for RA

A

-balance of rest and exercise
-biologic response modifiers
-therapy
(occupational therapy is usually for hands)
-nutrition

45
Q

Medications for RA

A

NSAID
COX-2 (Celebrex)
Methotrexate
analgesics
immunosuppressants
antidepressants
steroids

46
Q

Nursing interventions for RA

A

-Relieve pain
-reduce fatigue
-increase mobility
-facilitate self care
-improving body image
-monitor for complications

47
Q

What is Lupus?

A

autoimmune condition that causes inflammation to organs, joints, and tissues

Chronic condition with periods of flair ups

48
Q

Risk factors for Lupis

A

genetics
sun exposure
infection
hormones

49
Q

S/S of lupus

A

butterfly rash
photosensitivity
mouth ulcers
GI issues
joints and muscles
mental issues (fog, seizures, fever)
heart failure

50
Q

labs used to determine Lupus

A

ANA
ESR
CRP
CBC

51
Q

Medical management for Lupus

A

steroids
NSAIDS
Hydrochloroquine
Immunosuppressants
Biologics

52
Q

Pt education for Lupus

A

-teach to determine triggers for flare ups (sun, stress, skickness)

53
Q

What is Gout

A

Excess Serum uric acid build up

can lead to joint damage

54
Q

Uric acid can build up due to what kind of foods?

A

Foods high in purine?

-internal organ meats (liver, kidneys, sweetbrads)

-other red meats
-alcohol (especially beer)
-seafood (anchovies, sardines, scallops)

55
Q

What are manifestations of Gout

A

-joint pain and inflammation
-mostly seen in big tow
-can increase risk for kidney stones

56
Q

What meds can increase Gout

A

aspirin
cyclosporin
loop and thiazide diuretics

57
Q

What meds help gout

A

-Allopurinol
-Colchicine (ONLY FOR FLAR UPS)
-NSAIDS
-corticosteroids

58
Q

What is fibromyalgia

A

Chronic disorder that causes pain and tenderness throughout the body

-causes fatiuge and trouble sleeping

59
Q

Manifestations / symptoms of fibromyalgia

A

-pain and stiffness (all over)
-fatigue and tiredness
-depression and anxiety
-sleep problems
-cognitive (thinking, memory, concentration, headaches)
-tingling or numbness

60
Q

Risk factors for Fibromyalgia

A

-Age (usually after 40, but can affect anyone)
-gender (women)
-stressful events, PTSD
-repetitive injuries
-illness
-family history
-obesity

61
Q

Diagnostics for Fibromyalgia

A

labs: ANA, CRP. ESR, CBS
Xrays
history

62
Q

Medical management for fibromyalgia

A

-SSRI/SNRI
-Muscle relaxant
-gabapentin
-Lyrica (pregabalin)
-PT

63
Q

What is Psoriasis?

A

Autoimmune disorder where there is hyperproliferation of the epidermis and inflammation.

this leads to scaly patches on the skin

64
Q

Risk factors for Psoriasis

A

-genetics
-stress
-smoking and alcohol
-infections
-obesity
-cold, dry air

65
Q

Types of Psoriasis

A

-Erythrodermc - very red and rashlike (lesions, rate, temperature variations, dysregulation)

-Guttate - pink / red spot (activated by upper respt infection

-Inverse - located in armpits, groin, skin folds

-Plaque (most common) patches that are thick, red, white sclaes

-Pustular - pus filled blisters and red skin (activated by chemicals, medication and infections

66
Q

How do we manage psoriasis?

A

MOISTURIZE!
-emollients
-Salicylic acid
-corticosteroids
-antifungal

meds to suppress immune system
-methotrexate
-biological therapy (last option)

UV phototherapy

67
Q

What is Eczema? (Atopic Dermatitis)

A

Chronic inflammatory skin disease, more common in children (5 and under), but can affect adults

***many times goes hand and hand with asthma, allergic rhinitis, and conjunctivitis

68
Q

manifestations of Eczema

A

dry
scaly
itchy
red
rash

69
Q

Medical management for Eczema?

A

MOISTURIZE

corticosteroid creams
biologics
avoid triggers