Exam 4 - Immune Flashcards by Jessica Maskell

what is innate memory?

non specific; immunity we were born with

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what is adaptive memory?

specific; immunity that is changing through life

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what is a hypersensitivity reaction?

a reaction by the immune system that is undesirable

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what are the types of hypersensitivity reactions?

type 1: allergy
type 2: cytotoxic
type 3: immune complex disease
type 4: delayed type, cell mediated, antibody independent

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what is an antibody

fights against invader

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what is an antigen

bad guy that produces immune response

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what is cytotoxic?

antibodies produced by the immune response bind to the antigens on the patients own cell surface

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what is the immune complex disease?

occurs when there is accumulation of immune complexes that have not been adequately cleared by innate immune cells

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what are the steps of an allergic reaction?

allergen introduced
plasma cell creates IgE
IgE antibodies attach to mast cells
allergen is reintroduced
allergen attaches to IgE
histamine released

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what are treatments for an allergic reaction (10)

remove the allergen
administer epipen
antihistamines
corticosteroids
bronchodilator 
o2
IV fluid for BP
vasopressors
intubation
tracheostomy

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what are the ways to administer the epinephrine

subcut/IM/IV

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what are the two types of immunodeficient disorders

primary and secondary

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what is a primary immunodeficient disease

genetic mutations; found in children and infants

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what is a secondary immunodeficient disease

acquired; viral infection; toxin; med therapy

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what is the cause of RA?

unknown etiology; immune related

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what are the autoantibodies related to RA?

rheumatoid factors: IgG and IgM

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what do rheumatoid factors do?

attack healthy tissue especially in the synovium

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what are the other autoantibodies related to RA?

CD-4 T helper cells
Neutrophils
Immune complexes
B and T cell lymphocytes

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what are the stages of RA?

Synvotitis
Pannus
Fibrous anklosis
Bony anklosis

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Synvoitis

synovial membrane is inflamed and thickened

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pannus

extensive cartilage loss/exposed

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Fibrous anklosis

joint invaded by fibrous connective

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bony anklosis

bones are fused

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what are the types of deformities

swan neck
ulnar drift
boutinnere
nodules

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what are the signs and symptoms of RA

``` joint pain tenderness swelling AM stiffness fatigue, anorexia, low grade fever ```

what is the pattern to find RA

bilat; symmetrical

what are systemic issues deriving from RA

vasculitis parasthesia pleurisy/pulmonary hypertension sjogrens

what is sjogrens?

dry eyes, mouth and vagina

how many tests should be abnormal to get an idea of RA?

3 or more

what tests are usually all high to determine

CRP anti-nuclear eythrocyte sedimentation

what other tests do they run to determine RA

CBC ANTI CCP RHEUM. FACT.

what is first course of treatment for RA patients?

NSAIDs

what is a DMARD

disease modifying anti rheumatic drugs

what are the DMARD I

methotrexate hydroxycholeoquine (plaquenil) sulfasalozine (azulfidine)

what are the DMARD II

Enbrel (etanercept) | remicade (infliximab)

what drug is - an immunosuppressant - should have no sun exposure - no alcohol use - causes bleeding, jaundice, dry cough, SOB, blood in urine and clay stool

methotrexate

what drug is - an antimalarial - causes retinal damage and psychosis - eyes start seeing orange

plaqenil (hydroxycholroquine)

what drug causes - lymphoma - chf and seizures

enbrel

what do DMARD II do?

block cytokines which cause no immune response

what corticosteroid is taken by mouth for RA

prednisone

what corticosteroid is taken through IV for Ra

methylprednisolone (solumedrol)

what do corticosteroids do for RA

anti inflammatory, immunosupress | help while DMARD is starting to work

``` what drugs for RA increase risk of infection increase risk of osteoporosis increase blood glucose increase gastric acid secretion and cause ulcers cause mood disturbances increase sodium and water cause retention and loss of potassium CUSHING ```

corticosteroids

what are nursing interventions for corticosteroids

``` give in the morning with food monitor mood increase insulin PRN watch infection give supplements (calcium and vit D) TAPER OFF ```

what happens if you don't taper your corticosteroid?

adrenal insufficinecy

what is a cytokine

a protein that has an effect on the interaction of cells (general)

what is systematic erythrematosus lupus?

progressive inflammatory connective tissue disease

what does SLE do?

immune complexes form in serum and organ tissues and cause vasculitis, depriving them of oxygen and blood

what organs are usually effected by SLE

kidney lung and brain

why do they think SLE is caused

over exposure to sun, autoimmune

what is a side effect of SLE?

paranoid psychosis

``` butterfly rash alopecia osteonecrosis polyarthritis myotitis(muscle inflam) pericarditis decrease in WBC and platelets ```

systemic lupus

what are diagnostic criteria of systemic lupus?

``` same as RA usually ANA CBC CRP ESR PT/PTT urinalysis kidney and liver function ```

what are pharmacological treatments for lupus

``` topical cortisone (rash) hydroxycholroquine (plaquenil) NSAIDs corticosteroids immunosuppressants (methotrex) cyclosporin psytotoxin ```

alloimmunity

immune response to non self antigens from members of same species

prep for blood or tissue transplant

typing: - same blood type - type donor and receiver - 3 antigen match

what is the goal of immunosuppression

to calm it down and not attack everything

common immunosuppressive drugs

cyclosporin lmuran corticosteroids

acute rejection signs

fever, loss of function and clots

what is broad spectrum

against gram positive and gram negative bacteria

what is narrow spectrum

only against a family of bacteria

what is an advantage to narrow spectrum antibiotics

less change on resistance | will not kill as many of our normal bacteria

what are the two types of immunity

nonspecific | specific

nonspecific immunity

initial reaction against foreign antigen

specific immunity

production against a particular antigen

what are the different WBC

``` neutrophils eosinphils basophils lymphocytes monocytes ```

neutrophil

innate | attach to walls and eat cells, block passage of germs

lymphocytes

humoral | make antibodies

monocytes

eater of dead cells

eosinphils

release toxin to kill pathogens

what is a raise in eosinophils tell you?

allergy

basophils

dilate vessles to bring more immune cells in - contains histamine

leukocytosis

increase in total number of WBC

what are the antibiotic classifications (7)

``` penicillins cephalasporins aminoglycosides sulfonamides fluoroquinolones antiprotozoals vancomyocin ```

disrupts bac cell walls gram positive - narrow spectrum allergic rxn is common side effect

penicillin

largest of the antibiotic class inhibits cell wall synthesis gram negative each generation has a broader spectrum 1-4th gen effective against gram positive after 4th gen can enter CSF and help brain infections

cephalasporins

bacterial protein synthesis inhibitor aerobic gram neg narrow spectrum measure peak and trough!

aminoglycoside

inhibits bacterial growth gram positive and negative broad spec high resistance

sulfonamides

``` disrupts bacterial DNA synthesis gram negative some new gen can do gram positive broad (newer) do not pair with anti coagulants increase fluids for the kidneys cipro, levofloxican -oxican ```

fluroquinolones

``` inhibits pathogen DNA and RNA synthesis effective against anaerobes bacteria and parasite give by mouth or iv used for infection and peptic ulcer disease ```

antiprotazoals

``` serious gram positive infection given IV measure peak and trough for dosing nephro and liver toxic dilute in 100 ml at least ```

vancomyocin

how to treat pseudomembranous colitis (c. diff)

vancomycin by mouth

macrophages in the elderly

toxicity in tumor cells decrease

T cells in elderly

function decreases

B cells in elderly

fewer number and less effective

What is an example of specificity theory

Nociceptor and neuropathic pain

What is the example of gate control theory

Pain transmission fibers

Neuromatrix pain is exemplified by what

Phantom limb pain

What are endorphins

Peptides released in the CNS

What do endorphins do?

Activate opioids receptors

What other peptides have opioid like properties

Enkephalins and dynorphins

amoxicillin

penicillin

cephtriaxones, cephalexine

chephlasporin

gentamiocin, streptomyocin

aminoglycosides

ciprofloxican, levofloxican

fluroquinolones

pentamide, nitazoxnide

antiprotazoals

Exam 4 - Immune Flashcards

(96 cards)