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Health Psychology > immune mediated diseases > Flashcards

immune mediated diseases Flashcards

1
Q
  • HIV disease/AIDS
  • Cancer
  • Rheumatic diseases
  • Asthma
A

immune mediated diseases

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2
Q

– Retrovirus that is implicated in development of AIDS
– Primary target is the CD4 lymphocyte (helper T cell)
– Causes cell death of CD4 T cells

A

hiv

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3
Q

– Progressive impairment of the immune system by the
human immunodeficiency virus (HIV)
– A diagnosis is based on
• Low CD4 counts 5000 copies per ml
• The presence of one or more specific opportunistic infections or malignancies

A

aids

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4
Q

• First appearance is unknown
– Central Africa
– First confirmed case was in the Congo in 1959
– Spread rapidly through heterosexual population
• High rate of extramarital sex
• Low rate of condom use
• High rate of gonorrhea
• Medical clinics reused needles to promote vaccinations

A

aids history

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5
Q

• End of 2012: Living with HIV/AIDS
– 35.3 million people were living with HIV
• 2.3 million people became newly infected
• 1.6 million died of AIDS-related causes
• Nearly 1 in every 20 adults in Sub-Saharan Africa are living with HIV
(69% of all people with HIV)
• In the US, > 1.1 million people are living with HIV
– Almost 1 in 5 (18.1%) are unaware of their infection
• More than 25 million deaths over the past 3 decades

A

aids brief history

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6
Q

• HIV is a retrovirus
– Attacks immune system, especially the helper T cells (CD4’s) and macrophages
– Transmitted by exchange of cell-containing bodily fluids, such as semen and blood
– Highly variable time between contracting virus and developing AIDS symptoms

A

how we get aids: virus

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7
Q

-drug users, homosexual men, heterosexual population, transmission from mother to child

A

aids transmission

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8
Q

• Acute HIV infection
– Within a week or so
– Mild early symptoms: Fever, sore throat, flu-like
symptoms
• 3 to 6 weeks
– Infection abates, asymptomatic period
• Amount of virus gradually rises: HIV Disease
– Immune system compromised
– Opportunistic infections (viruses and parasites) and malignancies, such as Kaposi’s sarcoma, occur
– Common symptom for women: Gynecologic infection

A

how hiv infection progresses

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9
Q

• Actions taken to decrease morbidity and
mortality from disease
• Primary
– Avoid development of disease
• Secondary
– Early disease detection to prevent progression
and symptom development
• Tertiary
– Reduce negative impact of established disease

A

prevention

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10
Q

• Taking measures to combat risk factors for
illness before an illness ever has a chance to
develop
• Two general strategies
– Employ behavior-change methods to alter
problematic behaviors
– Keep people from developing poor health habits in the first place

A

primary preverntion

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11
Q

– Early detection/screening
– Teach patients behaviors to prevent spread of HIV
– Antiretroviral drug therapy to keep HIV disease from occurring

A

secondary prevention

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12
Q

– Antiretroviral drug therapy and adherence training

– Cognitive behavioral therapy

A

tertiary prevention

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13
Q

– Dramatically improved health of those with HIV
– Treatments are complex: combinations of drugs
– Adherence is critical
– Side effects unpleasant
– Adherence is variable

A

highly active antiretroviral therapy (HAART)

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14
Q 
• Test positive for HIV, not yet AIDS
– People live with a threatening event
– Live with uncertainty and fear
• Initial response
– Psychological distress
– Sharply curtail HIV risk-related behaviors
– Make positive changes in health
• Interventions that reduce depression are 
valuable
A

Psychosocial Impact of HIV

Infection

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15
Q 
– Major barrier to controlling spread of HIV:
Not disclosing HIV status
– Those who don’t disclose:
Less likely to use condoms
– \_\_\_ has benefits
• Positive health consequences
• More CD4 cells than non-disclosers 
• \_\_\_\_ of sexuality
– Also linked to HIV outcomes
– Remaining “in the closet” associated with
• Faster progression of HIV disease
A

disclosure

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16
Q

• Education
• Health Beliefs and AIDS Risk-Related Behavior
– One must perceive oneself as capable of controlling risk-related activity
– Behaviors become integrated into ‘sexual styles

A

Interventions to Reduce the

Spread of HIV/AIDS

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17
Q

• Targeting IV Drug Use
– Needle exchange programs
• Cognitive-Behavioral Interventions
– Decrease distress among HIV+ individuals
– Buffer psychological/immunologic consequences
– Improve surveillance of opportunistic infections
• HIV Prevention Programs
– School-based interventions about safe sex
– Communication & condom use skills
– Target behaviors associated with high-risk sex
(alcohol, drugs)
– Target norms (monogamy, abstinence)

A

Interventions to Reduce the

Spread of HIV/AIDS

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18
Q 
• HIV disease/AIDS is now a chronic disease
– Employment
• Men with HIV continue working
• Unemployed may not return to work
– Fear and prejudice
• Many have an intense fear of AIDS
• Many blame the victims for their disease: Especially gay and IV drug users
• Coping Skills
– Coping effectiveness training
– Perceived control & self-efficacy
• Social Support
A

Coping with HIV+ Status and Aids

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19
Q

• HIV-infected gay men
– Rapid course of disease for those with more
stress
– Slower course of disease with more social support
• Negative beliefs about self
– Correlated with decline in helper T cells
• Finding meaning and optimism associated
with better outcomes
• Writing interventions promoting optimistic
thinking about the future
– Led to greater reported adherence to medication
– Less distress from side effects

A

Psychosocial Factors that Affect its Course

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20
Q

-set of >100 diseases
- all result from dna dysfunction
• Neoplastic growth
– Rapid cell growth and proliferation (unlimited)
– Cancerous cells provide no benefits to body
– Cancerous cells sap the body’s resources
• Neoplastic cells may be:
– Benign
– Malignant

A

cancer

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21
Q

remain localized and usually less threatneing

A

benign neoplastic cells

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22
Q

more dangerous; invade and destroy surrounding tissue and may metasasize

A

malignant neoplastic cells

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23
Q

– Carcinomas
– Sarcomas
– Leukemias
– Lymphoma

A

malignant growths of cancer

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24
Q
  • Cancers of the epithelial tissue

* Skin, stomach lining, mucous membranes, etc.

A

carcinomas(malignant)

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25
Q
  • Cancers of the connective tissue

* Bone, muscles, cartilage, etc.

A

sarcomas(malignant)

26
Q
  • Cancers of the blood cells

* Stem cells, white blood cells

A

leukemias(malignant)

27
Q
  • Cancer of the lymphatic system

* Rarer

A

lymphoma(malignant)

28
Q
  • Many cancers are species-specific
  • Develop in different ways in different species
  • Many cancers have long/irregular growth cycles
  • High within-species variability
A

why is cancer hard to study

29
Q

many cancers have genetic basis and some are ethnically linked
– Overall, African-Americans have a 40-50% greater incidence of and mortality from cancer than do European Americans
– Hispanic Americans, Asian Americans, and Native Americans have lower rates than African- and European-Americans
– Most differences are attributable to
• Access in medical care
• Adherence to treatment
• Knowledge
• Attitudes about cancer
• Socioeconomic status

A

cancer risk factors beyond control

30
Q

– U.S. Anglo men > bladder cancer rates
– U.S. Anglo men > malignant melanoma rates
– U.S. Hispanic women > cervical cancer
– African American men > prostate cancer
– Japanese Americans > stomach cancer
– Chinese Americans > liver cancer
– African American women > mortality breast cancer

A

examples of ethnic differences with risk factors

31
Q 
• Age(Strongest risk factor)
• Environment:
– Exposure occurs at work or home
– Radiation
– Asbestos
– Radon
– Pesticides
– Motor exhaust
– Chemicals[ Arsenic, benzene, chromium, nickel, vinyl chloride, etc]
A

risk factors for cancer

32
Q

poor diet and
tobacco use– Lung, breast, head and neck cancers
– Additive or synergistic effect with
• Socioeconomic level, occupation, ethnicity, building materials of home, birth control pills

A

cancer Behavioral Risk Factors

33
Q

• Carcinogenic foods
– Natural foods aren’t necessarily safer than ones with preservatives
– Spoiled food causes stomach cancer
– Dietary fat is risk factor for colon and breast cancer
– High cholesterol is risk factor for testicular cancer
– Preserved/charred/smoked meats are a risk factor for colorectal cancer
– Salt-cured meats are a risk factor for stomach cancer
– Obesity and diet receive a lot of attention as risk factors for colorectal cancer and many others

A

Foods That May Cause Cancer

34
Q

– Haven’t identified specific foods or nutrients
– Beta-carotene
• Form of vitamin A in sweet potatoes and carrots
– Vitamin C, Folate, Calcium
– Selenium
• Trace element found in grains and grain-fed meats
– Flavonols
• Product of plant metabolism and antioxidants
• Apples, onions, garlic, scallions, leeks, tea, string beans,
broccoli, green peppers, blueberries
– Water

A

Protective foods

35
Q 
– Healthy diet and weight control
• High fiber
• High in fruits, vegetables, whole grains, low-fat dairy products, fish, poultry
• Low in red meat, refined grains
– Vitamin and mineral supplements
A

protective foods

36
Q

• Alcohol
– Cancers of the tongue, tonsils, esophagus, pancreas, breast, and liver
– Synergistic effect with smoking
• Sedentary lifestyle
• Ultraviolet light exposure
– Cumulative exposure and occasional severe sunburn are risk factors for skin cancer
– Especially important for light-skinned, fair-haired, blue-eyed people

A

Behavioral Risk Factors

37
Q

– AIDS-related carcinomas
• Kaposi’s sarcoma
• Non-Hodgkin’s lymphoma
– HPV infection and cervical and head & neck cancers
– Early age at first intercourse and large number of partners
• Cancers of the cervix, vagina, ovary, prostate

A

sexual behavior risk factor

38
Q 
• Negative emotionality & tendency to repress or deny emotions
• Uncontrollable stress & feelings of helplessness 
• Other, weaker risk factors
– Experience of serious loss
– Low level of social support
– Chronic depression
– Negative emotional states
– A “fighting spirit”
– Life events
– Fatalistic view of the world
– Active coping style
A

psychosocial risk factors

39
Q

• Psychological stress
– Adversely affects ability of NK cells to destroy tumors
– NK cells activity is important in survival rates for
certain cancers, such as breast cancer
• Ways that patients cope with cancer stress
– Associated with inflammatory processes (IL-6) that play a role in tumor progression

A

Stress and Coping

40
Q 
Approximately 68% of cancer victims live at least 5 yearsafter their diagnosis
• Surgery
• Radiation
• Chemotherapy
• Hormonal treatments
• Immunotherapy
A

Cancer Treatments

41
Q 
• Coping with physical limitations
– Pain and discomfort
– Downregulation of immune system,vulnerability to other disorders
– Fatigue
• Treatment-related problems
– Cosmetic problems:Surgical removal of organs
– Body image concerns
– Use of prosthesis
– Conditioned nausea and immune 
suppression
A

Adjusting to Cancer

42
Q 
• Intermittent and long-term depression
• Restriction of usual activities
• Issues involving social support 
cancer because it increases their own risks
• Marital and sexual relationships
• Psychological adjustment( PTSD)
• Self-presentation
A

Cancer:

Psychosocial Issues

43
Q

amount of psychological problems (with the
exception of depression) experienced by cancer
patients Is significantly less than people suffering from psychiatric disorders
• Finding meaning in cancer
• Optimism associated with better outcomes

A

coping with cancer

44
Q

• Pharmacologic Interventions center on
– Nausea /vomiting, eating difficulties, emotional disorders, pain
• Cognitive-Behavioral interventions focus on
– Stress, pain, appetite control, side effects
– Distraction, relaxation & guided imagery helps coping with chemotherapy
– Also Mindfulness-based stress reduction interventions & Exercise
– Enhance social support
• Psychotherapeutic interventions involve
– Meeting psychosocial and informational needs
– Individual, family, or group
• Support groups

A

cancer interventions

45
Q

• Autoimmunity: A condition in which the body
produces an immune response against its own
tissue constituents
– Most prevalent autoimmune disorder
– means “inflammation of a joint”
• Three major forms
– Rheumatoid, osteoarthritis, gout

A

arthritis

46
Q

• Crippling form of arthritis believed to result from
an autoimmune process
– Usually attacking small joints of hands, feet, wrists, knees, ankles, and neck
• Primarily affects :40-70 age group/ Women
• Main complications are Pain, limitations in activities, need to be dependent on
others
• Depression

A

rheumatoid arthritis

47
Q

– Development of disease
• Negative life events (in the past 2 years) may precede disease onset
– Aggravation of disease
• Increases in interpersonal stressors in the previous week predicts increases in disease activity
• Better spousal relationships buffer the effects of interpersonal stress on RA
• Following a hurricane, RA patients were classified in later stages of disease and had more flares than compared to before the hurricane
• Mediated by immune system

A

rheumatoid arthritis stress

48
Q 
– Aspirin, NSAIDs & Cox-2 inhibitors to relieve 
inflammation and pain
– Rest
– Supervised exercise
• Cognitive-behavioral interventions
– Enhancement of perceived self-efficacy
– Optimism
– Relapse prevention strategies
• Juvenile RA appears between 2 and 5 years
A

rheumatoid arthritis treatment

49
Q

• Form of arthritis that results when the articular
cartilage (smooth lining of a joint) begins to
crack or wear away because of overuse of a
particular joint
– May also result from injury or other causes
– Usually affects weight-bearing joints
– Common among athletes and the elderly
– More common in women
• Treatment
– Keeping weight down, exercise, aspirin (NSAIDs), steroids

A

Osteoarthritis

50
Q 
• A form of arthritis produced by a 
buildup of uric acid in the body 
(kidneys can’t excrete the acid)
– More prevalent in men than in women
– Uric acid build up produces crystals that 
become lodged in the joints
– Most commonly affected area - big toe
• Blood supply cannot carry away crystals
A

gout

51
Q 
– Avoid alcohol and certain foods; 
maintain proper weight, exercise, fluid 
intake; no aspirin since it slows uric acid 
removal
– Untreated, gout can be deadly
A

gout treatment

52
Q 
Untreated can lead to
– Kidney disease
– High blood pressure
– Coronary heart disease
– Stroke
• Triggers
– Foods
– Stress
– Infections
– Some antibiotics
– Diuretics
A

gout

53
Q

alcohol, anchovies, sardines in oil, fish roes, herring, yeast, organ meat, meat extracts, concomme, gravies

A

gout: purinecontaining foods to be avoided

54
Q

hearts , herring, mussels, yeast, smelt, sardines, sweetbreads

A

foods high in purines

55
Q

• High fat foods and foods containing trans
fat (partically hydrogenated vegetable oils)
• Drink plenty of fluids/water, exercise and maintain a healthy body weight. Diets
designed for quick or extreme weight loss can
increase uric acid levels in the blood and worsen
symptoms.

A

other food to avoid when have gout

56
Q

• More severe allergic reaction
• Triggers
– Dust, dander, pollens, mold, fungi
– Animal dander, cockroaches
– Respiratory infections, smoke, other air pollutants –perfume
– Stress or exercise
• Produce bronchial spasms & hyperventilation
• Muscle constriction, swelling, & inflammation of
airtubes → ↑mucus → bronchiole obstruction → ↓O & ↑CO2

A

asthma

57
Q 
• Dramatic increase in past 20-30 years
• 1 in 10 children may have \_\_\_ 
• Reasons are not fully known
– >130 million worldwide have it
– More in industrialized countries
– More in urban than rural areas
– Paradoxical Issue:
Correlation: Children with lots of childhood 
infectious diseases are LESS LIKELY to develop 
allergies
• Improved hygiene → ↑allergies?
A

asthma

58
Q

– Traditional view
• Allergic reaction to substances in environment
– Genetic vulnerability
• Diathesis-stress model
• Genetic vulnerability for immune system to overreact to certain environmental agents if exposed
– Hygiene hypothesis
• Result of cleanliness
• Immune systems haven’t been exposed to many allergens so when exposed overreact
– Refinement of hygiene hypothesis
• Combines it with diathesis-stress and people are either sensitized or protected

A

asthma theories

59
Q

• Trouble breathing or can’t breathe
– Associated with fear and anxiety
• Frequent attacks leads to decreases in self efficacy for management of the disease
• Can cause respiratory failure and death

A

Asthma Attacks

60
Q

– Patient needs to be active in management
– Track Peak Expiratory Flow Rate and identify warning
range
– Take preventive medications
• Usually anti-inflammatory corticosteroid inhalers
• Adherence is a problem
– Use emergency inhalers when you have an attack
• Bronchodilators

A

develop management plan for asthma

Health Psychology (16 decks)

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