HLTH module 3: immunodeficiency

Question 1

what is immunodeficiency?

Answer 1

a loss of function of the immune system, leading to increased risk of infection and cancer

Question 2

primary deficiencies

Answer 2

involve a basic development failure somewhere in the immune system (ex. bone marrow)

Question 3

examples of primary deficiencies

Answer 3

hypogammaglobulinemia and DiGeorge syndrome

Question 4

hypogammaglobulinemia

Answer 4

low antibody levels because of a B-cell defect

Question 5

DiGeorge Syndrome

Answer 5

hypoplasia of the thymus

Question 6

hypoplasia

Answer 6

incomplete development of a tissue

Question 7

secondary immunodeficiency

Answer 7

aka acquired immunodeficiency; loss of the immune system response resulting from specific causes; can occur with infection (particularly viral infections), removal of the spleen, malnutrition, liver disease, the use of immunosuppressive drugs, and radiation or chemo

Question 8

why is cancer associated with immonodeficency?

Answer 8

because there is malnutrition, blood loss, and the effects of treatment that depress bone marrow production of WBCs

Question 9

how do glucocorticoids increase immunodeficiency?

Answer 9

they decrease leukocyte production, cause atrophy of lymph nodes, and suppression of the immune response

Question 10

why does stress cause immunodeficiency?

Answer 10

because high levels of glucocorticoids are produced in the body

Question 11

how does AIDS or HIV cause immunodeficiency

Answer 11

by affecting T-helper cells, causing an increased risk to secondary infections and cancer

Question 12

what drugs are important for immunodeficient individuals?

Answer 12

prophylactic antimicrobial drugs (these are preventative antibiotics)

Question 13

what are increased risks for immunodeficient individuals?

Answer 13

higher risk of cancer and opportunistic infections from normally harmless microorganisms

Question 14

treatment for immunodeficient individuals

Answer 14

replacement therapy for antibodies using gamma globulins, as well as sometimes bone marrow or thymus transplants

Question 15

HIV stages

Answer 15

prolonged period followed by a period of active infection

Question 16

what is AIDS?

Answer 16

the active stage of infection in individuals with the HIV virus

Question 17

what are markers that someone may be HIV positive?

Answer 17

P carinii pneumonia or Kaposi sarcoma cancer with no other pathologies present

Question 18

how is HIV transferred?

Answer 18

usually male-to-male sexual contact, but also heterosexual contact, drug injection, and a combination of drug use and male-to-male sexual contact

Question 19

what type of virus is HIV?

Answer 19

a retrovirus and this means that is has an RNA genome

Question 20

what is the subfamily of the HIV virus?

Answer 20

lentivirus

Question 21

where is HIV-1 commonly found?

Answer 21

US and Europe

Question 22

where is HIV-2 commonly found?

Answer 22

central Africa

Question 23

what specific T-helper lymphocyte does HIV affect?

Answer 23

the CD4 positive ones

Question 24

HIV and the lymphatic system relationship

Answer 24

the virus often uses the lymph nodes, tonsils, and spleen as a reservoir for continued infection

Question 25

HIV virus anatomy

Answer 25

the core contains two strands of RNA and the enzyme reverse transcriptase; the coat is covered with a lipid envelope studded with spikes of glycoproteins that the virus uses to attach to human cells

Question 26

what type of HIV transmission develops quickest?

Answer 26

injections

Question 27

how is HIV tested for?

Answer 27

looking for antibodies and viral RNA or DNA through polymerase chain reaction technology; can also look for opportunistic infections of cancers

Question 28

why can antibodies not destroy HIV virus?

Answer 28

because the virus is hidden safely inside host cells in the lymphoid tissue, there are slight mutations in the viral envelope, and the destruction of T-helper cells and macrophages depresses the immune system

Question 29

what measures should healthcare workers take when working with a HIV patient?

Answer 29

should always assume that there is a risk of infection, should seek counselling, and postexposure prophylaxis

Question 30

who are individuals with high risk of HIV?

Answer 30

those who are intravenous drug users and those with multiple shared sexual partners

Question 31

what drug helps to protect the fetus from an HIV mother?

Answer 31

azidothymidine

Question 32

three-stage process for HIV testing

Answer 32

1. look for HIV1/2 antigen or antibody 2/ differentiate between HIV1/2 antibodies 3. use a nucleic acid test to confirm HIV-1 positivity and eliminate a false negative

Question 33

what do CD4 lymphocytes change to during opportunistic infection?

Answer 33

CD8

Question 34

what antibody increases during HIV infection?

Answer 34

igG

Question 35

HIV symptoms during the first phase

Answer 35

flu like symptoms including low fever, fatigue, and sore throat

Question 36

HIV symptoms during the second phase

Answer 36

enlarged lymph nodes or general lymphadenopathy; many exhibit no symptoms during this phase

Question 37

final acute stage symptoms of HIV

Answer 37

GI effects, neurological effects, secondary infections, infection around the teeth, weight loss, necrosis, and malignancies

Question 38

HIV encephalopathy

Answer 38

aka general brain dysfunction; is the AIDS dementia by brain cell infection, often aggravated by malignant tumors

Question 39

HIV encephalopathy signs

Answer 39

confusion, cognitive impairment, memory loss, loss of coordination and balance, and depression

Question 40

what is the primary cause of death in AIDS patients?

Answer 40

secondary infections

Question 41

what does kaposi sarcoma affect?

Answer 41

the skin, mucous membranes and internal organs; skin appears purple or brown and is not itchy

Question 42

signs of AIDS in children

Answer 42

children are usually smaller, exhibit failure to thrive, have developmental delays, and neurologic impairs (seizures and poor motor skills)

Question 43

six classes of HIV drugs

Answer 43

non nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, protease inhibitors, fusion inhibitors, CCR5 antagonists, and integrase strand transfer inhibitors

Question 44

antiretroviral therapy

Answer 44

the use of multiple drugs to treat HIV; often used in combinations of 3-5 to prolong the latent phase

Question 45

when should HIV treatment begin?

Answer 45

when severe symptoms are present, when CD-4 positive T cell count is less than 500, during pregnancy, during HIV-related kidney disease, and ongoing treatment for hep B

Question 46

sepsis

Answer 46

a toxic condition resulting from the spread of bacteria or their toxic products from a focus of infection; combination of SIRS and infection

Question 47

SIRS

Answer 47

systemic inflammatory response syndrome

Question 48

signs of SIRS

Answer 48

high or low temperature, high heart rate, and high or low WBC

Question 49

causes of sepsis

Answer 49

endogenous tissue damage (ex. pancreatitis), immune freak out, exogenous tissue damage (ex. burns), miscellaneous (thyroid storm, exam jitters)

Question 50

how does sepsis happen

Answer 50

a bacterium comes in contact with an immune cell, causing cytokines migrate to injury site via vasodilation, as well as coagulation