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NCA spring > EXAM 2- immunity > Flashcards

EXAM 2- immunity Flashcards

1
Q

6 roles of innate immunity

A

enhances chemotaxis
enhances phagocytosis
mediates inflammation
destroys pathogens
increases cell lysis
increases vascular permeability

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2
Q

igM

A

forms antibodies to ABO - involved in primary response to pathogen

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3
Q

igA

A

lines mucous membranes

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4
Q

igD

A

differentiates B lymphocytes

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5
Q

igG

A

secondary pathogen response - cross placenta

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6
Q

primary vs secondary response to pathogen

A

primary: igG and igM raise
secondary: igG raises drastically

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7
Q

3 organs of immune

A

BM makes lymphocytes
lymph nodes filter material
spleen filters antigens

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8
Q

immune cascade

A
  1. macrophade englufs virus and displays antigens on surface
  2. T helper cells notice and bind releasing cytokines (IL1)
  3. this signals tcytoxic cells and Thelper cells to proliferate
  4. Thelper cells release cytokines (IL2)
  5. B cells proliferate into plasma cells and B memory cells
  6. plasma cells produce antibodies and the antibody attach to antigen on virus to mark it for destruction
    ALSO
  7. Tcyto and NK cells attack cell with antigen
    7,. macrophages destory pathogens
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9
Q

type 1 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 5 disorders

A

-humoral
-IgE binds to mast cells and release histamine
-yes, wheal and flare
-allergies, asthma, uticaria, angioedema, anaphylaxis

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10
Q

anaphylaxis
- type of rxn
-type of response
- first signs
-4 s/s of shock
-treatment - what is on metoprolol?

A

humoral
hypersensitivity 1
edema at site and itching
-hypotension, dilated pupils, rapid and weak pulse, dyspnea
- epi but glucagon is on BB

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11
Q

type 2 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 3 disorders
- tx

A

humoral

igM and igG binds to antigen on cell surface and complement is activated

no skin test

transfusion rxn, good pasture, graves

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12
Q

what to do if someone is having dypnea, weak rapid pulse, hypotension

A

epi or glucagon

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13
Q

what to do if someone has a fever, sweating, tachycardic, bloody urine

A

transfusion rxn so stop transfusion

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14
Q

type 3 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 3 disorders
- tx

A

humoral

igM and igG binds to free antigens

complement activated

no skin test

SLE, RA, glomerulonephritis (AI)

immunospuressants, plasmapheresis

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15
Q

type 4 hypersensitivity
- what type of response
- what is binding/releasing
- is there a skin test?
- name 3 disorders
- tx

A

cell mediated

t cells attack antigens

TB skin test

contact dermatitis like poison ivy

corticosteroids (bc of inflammation)

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16
Q

what is plasmapheresis
when is it used
3 SE and how to prevent them

A

replaces plasma with saline, LR, albumin
used for AI when meds dont work

albumin replacement can deplete immunoglobulin stores for weeks

hypotension- give slowly and vasalvagal

citrate toxicity

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17
Q

what to do if someone has hypocalcemia, dizziness, HA, parasthesia

A

citrate toxicity, stop plasmapheresis?

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18
Q

what do all hypersens. rxs need

A

sensitivity to antigen that results in a primary and secondary response

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19
Q

examples of humoral (3) and cell mediated infections(4)

A

h: anaphylaxis, transfusion rxn, bacterial infection

CM: TB, fungal infection, contact derm

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20
Q

4 ways to manage chronic allergies

A

med bracelet
stress reduction
limit exposure
epi

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21
Q

6 classes of meds plus example for allergies

A
  1. antihistamines - loratidine
  2. decongestants - phenylephrine
  3. corticosteroids- prednisone
  4. leukotriene antagonist- montelukast
  5. mast cell stabilizer - cromlyn
  6. antipruitic - diphen.
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22
Q

what does loratidine do

A

controls edema and itching but NOT bronchoconstriction

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23
Q

when to use cromlyn

A

NOT emergencies, reg basis

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24
Q

what effect does phenylephrine have

A

dries up runny nose

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25
Q

if someone has AI or taking antihistamines, what should they avoid

A

skin tests

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26
Q

epi causes

A

vasoconstriction and bronchodilation

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27
Q

how does immunotherapy work

A

IM or sub q - builds up igG which blocks igE from binding and releasing histamine - so blocks histamine release

28
Q

4 drugs that are immunosupressants

A

cyclosporine
methotrexate
hydroxychloroquine
adalimumab

29
Q

2 reasons to get immunotherapy

A

when drugs not working or allergy cannot be avoided

30
Q

what is immunodef.

A

opposite of autoimmunity

31
Q

4 interventions for immunodef patients

A

asepsis
neutropenic (no flowers)
remove cause
reverse isolation

32
Q

4 primary immunodef. disorders

A

b cell def,
t cells def
x linked rec disorder
phagocytic defect

33
Q

6 factors for secondary immunodef

A

age
stress
meds!!!
therapies
malnutrition

34
Q

2 roles of immunosupressants

A

control symptoms
delay progression

35
Q

what type of rxn is latex

A

type 1 and 4

36
Q

when to use standard precuations 5

A

blood
mucous
secretions
non intact skin
body fluid

37
Q

when to use transmission precuations

A

highly transmissable

38
Q

4 interventions for HAI

A

hand washing
gloves
chlorohex
appropriate PPE use

39
Q

airborne vs contact vs droplet

A

a: chicken pox, measles, TB
gloves, gown, goggles, N95 mask

d: influenza, bacterial meningitis
gloves, gown, goggles, reg mask

40
Q

name 11 foods for latex food syndrome

A

apples
avacado
banana
celery
carrot
chestnut
kiwi
melon
papaya
potato
tomato

41
Q

pathophys of HIV

A

HIV is an RNA virus -
it enters CD4 cell
reverse transcripterase is released
RNA becomes DNA
protease cleaves DNA
HIV virions created that have a rapid CD4 destruction

42
Q

3 characteristics of an acute HIV infection

A

1-3 weeks
- HIGH viral load
- VERY infectious
-flu like symptoms

43
Q

MOA of ART

A

delays progression by inhibiting viral RNA replication aka decreasing RNA viral levels

44
Q

3 SE of antiretrovirals

A

fat redistribution, wasting
insulin resistance
high LDLs

45
Q

when is preP used

A

to reduce risk for uninfected people getting sick

46
Q

what to do if someone got a negative HIV test

A

come back in 3 weeks

47
Q

ART drugs interactions

A

PPI and antacids

48
Q

3 opportunistic diseases

A

penumococcal
hepB
influenza

49
Q

what does it mean when viral load is undetectable

A

prevents sexual transmission
virus not gone

50
Q

when do opportunistic diseases occur

A

Cd4 <500

51
Q

fluticasone
class
use
education
***not on test

A

corticosteroid used for allergies

should be used before runny nose occurs

52
Q

cromyln
class
proper use
**not on test

A

mast cell stabilizer

used on reg schedule and not for emergencies

53
Q

phenylephrine
class
MOA
AE
**not on test

A

sympathomomimetic, decongestant
vasoconstriction

rebound congestion

54
Q

loratidine
class
use
ed 2

A

2nd gen antihistamine

controls edema and itching in allergies

take b4 symptoms or right when they appear

does NOT cause drowsiness

55
Q

diphenhydramine
class
SE

A

2st gen antihistamine

antipruitic - itching

diminished effect with repeated use

56
Q

ibuprofen
class and MOA

4 AE

do not take when

A

NSAID
REVERSIBLE cox inhibition

Gi ulcer, increased BP, bleeding, renal

NOT for athritis - not an antiplatlet

57
Q

cyclosporine

class
moa
use
AE

A

immunosupressant

inhibits calcineurin

prevents graft rejection

INC risk for infection

58
Q

celecoxib
class
use

AE
nursing

A

NSAID

cox 2 inhibitor

protects against colon cancer

PROMOTION OF MI/STROKE

check for sulfa allergy

59
Q

adalimumab
class
report
2 cautions

A

biologic DMARD

report fever above 100

not if active infection
NO live vaccines

60
Q

methotrexate
class
moa
nursing

3 education

A

non biologic dmard
dec b and t cell activity

wear gloves

no preg, no vaccines, no straight razor

61
Q

hydroxychloroquine

class
moa
AE

A

non biologic dmard

inhibits toll like receptors

retinopathy

62
Q

prednisone

moa
chronic use AE 3

A

supresses lymphocytes

skin thinning, inc infection, HYPERGLYCEMIA

63
Q

acetylsalicyclic acid

moa

contraindications

AE +s/s (5)

education

A

inhibits cox 1 and 2

DONt give with active bleeding

reyes syndrome - irritability, dec LOC, confusion, weakness, seizures

no alcohol

64
Q

HLA is responsible for

A

rejection of genetically unlike
tissues. It consists of a series of linked genes that occur together on the sixth chromosome in
humans.

65
Q

anergy

A

an immunodeficient condition characterized by lack of or diminished reaction to an
antigen or a group of antigens, is common.

66
Q

4 assessments for allergies

A

comprehensive patient history, physical examination, diagnostic workup, and skin testing for
allergens

NCA spring (9 decks)

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