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 6. Tcyto and NK cells attack cell with antigen 7,. macrophages destory pathogens

EXAM 2- immunity Flashcards by Hayden Bastion

6 roles of innate immunity

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

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igM

forms antibodies to ABO - involved in primary response to pathogen

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igA

lines mucous membranes

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igD

differentiates B lymphocytes

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igG

secondary pathogen response - cross placenta

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primary vs secondary response to pathogen

primary: igG and igM raise
secondary: igG raises drastically

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3 organs of immune

BM makes lymphocytes
lymph nodes filter material
spleen filters antigens

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immune cascade

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

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

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

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

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

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

epi or glucagon

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

transfusion rxn so stop transfusion

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

humoral

igM and igG binds to free antigens

complement activated

no skin test

SLE, RA, glomerulonephritis (AI)

immunospuressants, plasmapheresis

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

cell mediated

t cells attack antigens

TB skin test

contact dermatitis like poison ivy

corticosteroids (bc of inflammation)

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

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

citrate toxicity, stop plasmapheresis?

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what do all hypersens. rxs need

sensitivity to antigen that results in a primary and secondary response

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

h: anaphylaxis, transfusion rxn, bacterial infection

CM: TB, fungal infection, contact derm

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4 ways to manage chronic allergies

med bracelet
stress reduction
limit exposure
epi

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6 classes of meds plus example for allergies

antihistamines - loratidine
decongestants - phenylephrine
corticosteroids- prednisone
leukotriene antagonist- montelukast
mast cell stabilizer - cromlyn
antipruitic - diphen.

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what does loratidine do

controls edema and itching but NOT bronchoconstriction

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when to use cromlyn

NOT emergencies, reg basis

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what effect does phenylephrine have

dries up runny nose

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

skin tests

epi causes

vasoconstriction and bronchodilation

how does immunotherapy work

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

4 drugs that are immunosupressants

cyclosporine methotrexate hydroxychloroquine adalimumab

2 reasons to get immunotherapy

when drugs not working or allergy cannot be avoided

what is immunodef.

opposite of autoimmunity

4 interventions for immunodef patients

asepsis neutropenic (no flowers) remove cause reverse isolation

4 primary immunodef. disorders

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

6 factors for secondary immunodef

age stress meds!!! therapies malnutrition

2 roles of immunosupressants

control symptoms delay progression

what type of rxn is latex

type 1 and 4

when to use standard precuations 5

blood mucous secretions non intact skin body fluid

when to use transmission precuations

highly transmissable

4 interventions for HAI

hand washing gloves chlorohex appropriate PPE use

airborne vs contact vs droplet

a: chicken pox, measles, TB gloves, gown, goggles, N95 mask d: influenza, bacterial meningitis gloves, gown, goggles, reg mask

name 11 foods for latex food syndrome

apples avacado banana celery carrot chestnut kiwi melon papaya potato tomato

pathophys of HIV

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

3 characteristics of an acute HIV infection

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

MOA of ART

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

3 SE of antiretrovirals

fat redistribution, wasting insulin resistance high LDLs

when is preP used

to reduce risk for uninfected people getting sick

what to do if someone got a negative HIV test

come back in 3 weeks

ART drugs interactions

PPI and antacids

3 opportunistic diseases

penumococcal hepB influenza

what does it mean when viral load is undetectable

prevents sexual transmission virus not gone

when do opportunistic diseases occur

Cd4 <500

fluticasone class use education ***not on test

corticosteroid used for allergies should be used before runny nose occurs

cromyln class proper use **not on test

mast cell stabilizer used on reg schedule and not for emergencies

phenylephrine class MOA AE **not on test

sympathomomimetic, decongestant vasoconstriction rebound congestion

loratidine class use ed 2

2nd gen antihistamine controls edema and itching in allergies take b4 symptoms or right when they appear does NOT cause drowsiness

diphenhydramine class SE

2st gen antihistamine antipruitic - itching diminished effect with repeated use

ibuprofen class and MOA 4 AE do not take when

NSAID REVERSIBLE cox inhibition Gi ulcer, increased BP, bleeding, renal NOT for athritis - not an antiplatlet

cyclosporine class moa use AE

immunosupressant inhibits calcineurin prevents graft rejection INC risk for infection

celecoxib class use AE nursing

NSAID cox 2 inhibitor protects against colon cancer PROMOTION OF MI/STROKE check for sulfa allergy

adalimumab class report 2 cautions

biologic DMARD report fever above 100 not if active infection NO live vaccines

methotrexate class moa nursing 3 education

non biologic dmard dec b and t cell activity wear gloves no preg, no vaccines, no straight razor

hydroxychloroquine class moa AE

non biologic dmard inhibits toll like receptors retinopathy

prednisone moa chronic use AE 3

supresses lymphocytes skin thinning, inc infection, HYPERGLYCEMIA

acetylsalicyclic acid moa contraindications AE +s/s (5) education

inhibits cox 1 and 2 DONt give with active bleeding reyes syndrome - irritability, dec LOC, confusion, weakness, seizures no alcohol

HLA is responsible for

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

anergy

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

4 assessments for allergies

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