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D & D Exam 1 > Chapter 16-Disorders of the Immune Response > Flashcards

Chapter 16-Disorders of the Immune Response Flashcards

(53 cards)

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1
Q

What is the immune response?

A

Defense network that has evolved to protect against invading microorganisms

Prevents proliferation of cancer cells (natural killer cells)

Mediate the healing of damaged tissue

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2
Q

Hypersensitivity disorders

A

Excessive/inappropriate activation of immune system

Type 1 - immediate hypersensitivity disorders

Type 2 - antibody-mediated disorders

Type 3 - immune complex - mediated disorders

Type 4 - T cell mediated disorders

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3
Q

Hypersensitivity disorder Type 1

A

“Allergic reactions”

Begin rapidly

Mediators are released from mast cells

Phases
1. Initial or early response
-vasodilation (BP v)
-vascular leakage
-smooth muscle contraction
Occurs within 5-30 mins and subsides within 60 mins
  1. Secondary or late phase
    - sets in about 2-8 hours later and lasts for several days
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4
Q

What is the antigen responsible for a Type 1 reaction called?

A

allergen

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5
Q

What is a systemic Type 1 reaction called?

A

Anaphylactic shock

Widespread vasodilation (BP v = not getting to organs)

Airway constriction

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6
Q

When mast cells degranulate, histamine is released?

A

True

Histamine is one of the first chemical mediators released

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7
Q

What are mast cells?

A

Granulocytes found in connective tissue

We don’t know normal function, yet

Activated when injured

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8
Q

Anaphylaxis

A

Systemic response to inflammatory mediators released in Type 1 hypersensitivity

Histamine, acetylcholine, kinins, leukotrienes, and prostaglandins all cause vasodilation

Acetylcholine, kinins, leukotrienes and prostaglandins all can cause broncho-constriction (inability to breathe)

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9
Q

Why give epinephrine for anaphylaxis?

A

Epinephrine is a potent vasoconstrictor, which will help reverse the extreme vasodilation that caused the blood pressure to decrease and not allow blood to get to the organs.

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10
Q

Type II sensitivity

A

Antibody mediated hypersensitivity reaction

ONLY SYSTEMATIC

Mediated by IgG or IgM

Blood transfusion reactions

Newborns with incompatible ABO or Rh factors (RoGam)

sometimes in drug reactions

  • cell destruction (lysis)
  • can be fatal
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11
Q

What happened if incompatible blood is given in transfusion?

A

Hemolysis (cells blow up)

Not only are cells not able to carry oxygen but the broken up pieces of RBCs (large) go back through kidneys and can actually block kidneys and cause renal failure

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12
Q

Type III hypersensitivity

A

Immune mediated disorder

Systemic or local

Immune complexes produce inflammatory effect - damages are tissue (deposit in tissues)

Serum sickness - insoluble complexes are deposited in vessel tissue

May cause local tissue necrosis because of deposits

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13
Q

Type IV hypersensitivity

A

Cell mediated hypersensitivity disorder

Occurs when tissue damage causes cell mediated immune responses with T-lymphocytes causing cell and tissue injury

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14
Q

Allergic contact dermatitis

A

“Atopic allergic reaction”

inflammatory process of the skin

Re-exposure to an allergen - “hives”

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15
Q

Autologous graft

A

same person transplant

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16
Q

Syngenetic graft

A

from a twin

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17
Q

Allogenetic graft

A

same species

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18
Q

Self tolerance

A

Mechanism where host recognizes what cells are self (host) cells and what are non self cells (antigen)

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19
Q

Alloantigens

A

Recognized as foreign

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20
Q

Graft vs host

A

When the host attacks and rejects the transplanted organ/tissue

T cells are central to causing the rejection

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21
Q

Most autoimmune diseases are more common in women than men?

A

True

Maybe an estrogen link

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22
Q

What are local autoimmune diseases?

Study These Flashcards
A

Discoid lupus

Atropic gastritis

Autoimmune adrenalitis

Temporal arteritis

23
Q

What are some systemic autoimmune diseases?

Study These Flashcards
A

Systemic lupus erythmatosus

Rheumatoid arthritis

Scleroderma

Autoimmune hemolytic anemia

24
Q

Immunodeficiency disorders of B cell function

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A

Impairs the ability to produce antibodies

25
Immunodeficiency disorders of T cell function
Impairs the ability to orchestrate the immune system Cannot protect against intracellular infection/cancer
26
Immunodeficiency disorders combined B and T cell dysfunction
Affect all aspects of immune function Absence of immune system "Bubble Boy"
27
Acquired immunodeficiency syndrome
AIDS Caused by infection with HIV Causes profound immunosuppression Currently a pandemic (spreading) HIV - if carrying disease AIDS - infection
28
Pathophysiology of HIV
Carries genetic material in RNA (retrovirus) HIV 1 or HIV2 most common in US is HIV 1 Infects CD4, T helper cells, macrophages and dendritic cells CD4 + T cells are necessary for immune functions
29
What are the 8 steps to HIV replication?
1. Binds to CD4+ T cell 2. Uncoating - RNA is injected into cell 3. DNA synthesis - uses reverse transcriptase enzyme 4. Integration - new DNA enters nucleus (integrase) 5. transcription - DNA makes single strand RNA 6. translation - ribosomal RNA uses mRNA to create polyprotein 7. cleavage - protease enzyme cuts polyprotein chain into individual proteins that will make new virus 8. Proteins and viral RNA are assembled into new HIV viruses and releases.
30
Primary phase of HIV infection
2-4 weeks after exposure Last few days to 2 weeks
31
Latency phase of HIV infection
No signs or symptoms Median time is 10 years Can see lymphadenopathy (swollen lymphoid tissue)
32
Overt AIDS phase
CD4 + T cell count is less than 200 cells/microliter Can lead to death within 2-3 years Increases risk of opportunistic infection
33
Window period
Time receiving infection to when it shows up positive (about 25 days)
34
Symptoms of AIDS
Pheumocytosis Pneumonia
35
Opportunistic infections of respiratory tract
PCP pneumocystis pneumonia TB
36
Opportunistic infections of the GI tract
Thrush Herpes simplex Esophagitis Diarrhea (salmonella, giardia, c-difficile)
37
Nervous system infections caused by HIV
(usually late complications) AIDS dementia complex Cognitive and motor dysfunction
38
Opportunistic infections of the nervous system
Taxoplasmosis (parasite that invades CNS)
39
Karposi sarcoma
Malignancy of endothelial cells that line small blood vessels Most frequent malignancy associated with AIDS Lesions can be found on skin, in mouth, GI tract, lungs
40
Non Hodgkin lymphoma
AIDS more susceptible Fever, night sweats, weight loss
41
Cervical dysplasia
Progress rapidly to cervical cancer in women with HIV
42
Wasting syndrome
AIDS defining illness Involuntary weight loss of at least 10% of baseline body weight with the presence of diarrhea Diagnosis made when no other cause can be identified (anorexia, metabolic abnormalities, endocrine dysfunction and malabsorption all contribute) Cachectic - wasting away
43
Cachectic
wasting away
44
What is a nurses role in HIV/AIDS?
Astute infection control Excellent respiratory assessments (lungs are usually where first infection shows up) Hand washing Protect not only self from infections but protect patient from opportunistic infections
45
What are the diagnostic methods for HIV and AIDS?
ELISA test and the Western Blot
46
Is there treatment for HIV or AIDS?
No cure Multiple drug combinations are used to delay disease process, decrease severity of symptoms and in some cases, stop seroconversion Can often be problems with compliance because there are so many pills to take and maybe not enough money to pay for them all or simply the patient does not want to take so many pills.
47
Urticaria
hives
48
Dermatitis
inflammation of the skin
49
What are some examples of Type III Hypersensitivity?
- "Farmer's Lung" | - Reactive Arthritis
50
Histiocompatability
important for organ transplants | -Is the new organ compatible with the host body?
51
Discuss Autoimmune Diseases.
- immune system can no longer distinguish self from non-self antigens - unknown etiology - environmental factors could contribute - genetic susceptibility could increase incidence and severity of autoimmune diseases - not uncommon for a person to end up with multiple autoimmune diseases
52
Discuss Immunodeficiency Disorders.
- congenital or inherited - renders a person susceptible to disease normally prevented by an intact immune system - Disorders of B cell function - Disorders of T cell function - Combined T and B cell dysfunction
53
How is HIV Transmitted?
1. sexual contact 2. blood to blood contact 3. infected mother to offspring 4. Transfusions of blood products before 1985 5. Needle sharing 6. Occupational HIV infection among healthcare workers is uncommon (needle-stick) 7. Can be transmitted even when no symptoms are present

D & D Exam 1 (5 decks)

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