Immune System Disorders/Immunizations/Infectious Diseases

Question 1

Major histocompatibility markers

Answer 1

Cell markers unique to each individual - on all cells

Question 2

Protective systems (4)

Answer 2

Skin - first line
Secretions - saliva, tears, sweat - contain chemicals that kill organisms
Stomach acid
Coughing/sneezing - eliminates organisms from body

Question 3

Primary lymphoid organs

Answer 3

Thymus, bone marrow, liver

Question 4

Secondary lymphoid organs

Answer 4

Spleen, lymph nodes, gut associated lymphoid tissue

Question 5

Non-specific immune defenses

Answer 5

Redness, heat, swelling, pain

Question 6

Specific immune defeses

Answer 6

Antibody immunity

Question 7

Type I hypersensitivity reaction

Answer 7

Allergic or atopic reaction mediated by IgE

Question 8

Type II hypersensitivity reaction

Answer 8

Hemolytic disease

Question 9

Type III hypersensitivity reaction

Answer 9

Antigen-antibody reaction that affects vascular epithelium - serum sickness

Question 10

Type IV hypersensitivity reaction

Answer 10

T-cell mediated hypersensitivity - contact dermatitis

Question 11

Cell-mediated immunity develops ____

Answer 11

In early life

Question 12

Humoral antibody immunity develops ____

Answer 12

At age 7-8

Question 13

HIV/AIDS signs

Answer 13

FTT, weight loss, failure to reach developmental milestones, frequent/chronic/unusual child illnesses, chronic diarrhea, hepatomegaly, splenomegaly, lymphadenopathy
May remain asymptomatic until 3 years of age

Question 14

HIV screening

Answer 14

Infants under 18 months require virologic assays to directly detect HIV due to persistence of maternal HIV antibodies
Recommended at 2 weeks, 4 weeks, and 4 months for infants with known exposure

Question 15

HIV treatment

Answer 15

Prevent opportunistic infections, offer high calorie/high protein foods, only eat peeled or cooked fruits and vegetables

Question 16

Severe combined immunodeficiency disorder (SCID)

Answer 16

Congenital primary immunodeficiency disorder usually characterized by severe defect in T and B lymphocyte systems - prone to infection
Autosomal recessive or x-linked

Question 17

SCID treatment

Answer 17

Bone marrow transplant

Question 18

Juvenile idiopathic arthritis

Answer 18

Autoimmune inflammatory disorder

Systemic, oligoarthritis, polyarthritis

Question 19

Systemic JIA signs

Answer 19

High fever, painful joints, malaise, myalgia, rash, affects internal organs - pleuritis, pericarditis, adenomegaly, hepatomegaly

Question 20

Oligoarthitis

Answer 20

Involves few joints (less than 5), typically the large ones

Three variations - type I, II, III

Question 21

Polyarthritis

Answer 21

Involves 5 or more joints

Two variations - type I, II

Question 22

Naturally acquired active immunity

Answer 22

Immune system makes antibodies in response to infection

Question 23

Naturally acquired passive immunity

Answer 23

Antibodies passed on to infant through placenta or colostrum

Question 24

Artificially acquired active immunity

Answer 24

Immune system makes antibodies in response to vaccines

Question 25

Artificially acquired passive immunity

Answer 25

Injected antibodies - no stimulation of immune response

Question 26

ID lab studies

Answer 26

C&S - performed on body fluids to detect organisms Enzyme linked immunosorbent assay (ELISA) - detect viral antigens in body fluids Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) - elevated with infections Lumbar puncture

Question 27

Febrile seizures

Answer 27

Seizures associated with high fevers (102-104 degrees), occur in children 6 months-5 years

Question 28

Signs of sepsis in neonates

Answer 28

Initial signs - poor sucking and feeding, weak cry, lethargy, irritability Subsequent signs - pallor, cyanosis, mottling, decreased pain response, hypotension, tachycardia, irregular respirations, jaundice, dehydration, temperature instability, GI disturbances, seizures, hypotonia, tremors

Question 29

Most common cause of sepsis

Answer 29

Group B streptococci

Question 30

Most common causes of meningitis in neonates

Answer 30

E. Coli and group B streptococci

Question 31

Most common causes of meningitis in children

Answer 31

Neisseria meningitidis and streptococcus pneumoniae

Question 32

Meningitis

Answer 32

Bacteria enters the meninges and spreads through blood stream into CSF fluid - causes hydrocephalus, increased ICP, permanent necrosis of brain cells

Question 33

Signs of meningitis in neonates

Answer 33

Poor feeding, irritability, high pitched cry, bulging fontanel, fever or low temperature, resistance to being held, opisthotonos (hyperextension of neck and spine, late sign)

Question 34

Signs of meningitis in older children

Answer 34

Respiratory and GI problems, nuchal rigidity, tripod posturing, Kernig's and Brudzinski's sign

Question 35

CSF analysis for menigitis

Answer 35

Establishes diagnosis and causative agent of meningitis CSF cloudy, WBC elevated, protein elevated, glucose decreased LP should not be done if child has increased ICP to prevent brain herniation

Question 36

Meningitis treatment

Answer 36

Monitor I/Os - fluid intake may be lowered to prevent cerebral edema, SIADH Steroids, antibiotics, anticonvulsants

Question 37

Measles (rubeola) signs

Answer 37

Prodromal stage - fever, malaise, coryza (inflammation of nasal lining), cough, conjunctivitis, photophobia, Koplik spots on inside of cheek - evolve into pinpoint white papules with erythematous base Rash appears 3-4 days later - reddened maculopapular rash on face, gradually spreads downwards Spread through direct contact with droplets

Question 38

Rubella

Answer 38

Rash that starts on face and rapidly spreads downward - discrete pinkish-red maculopapular rash Spread through direct and indirect contact

Question 39

Varicella

Answer 39

Multi-lesion rash that includes macules, papules, vesicles, pustules, and crusts - centripetal (primarily on trunk) Is communicable 1-2 days before rash develops until all lesions are crusted over Spread through direct contact

Question 40

Erythema infectiosum (fifth disease)

Answer 40

Caused by parvovirus, spread through respiratory secretions and blood 3-stage rash: 1 - erythema on face, "slapped" appearance 2 - symmetrical, red, maculopapular rash appears on extremities 3 - rash subsides Communicable before rash appears - starts with URI symptoms, then rash appears as an immune response

Question 41

Exanthema subitum (roseola)

Answer 41

Caused by HSV, spread through respiratory and saliva contact High fever that drops and rash appears - starts on upper back and neck, spreads down trunk and to extremities

Question 42

Scarlet fever

Answer 42

Caused by group A beta-hemolytic streptococci, spread through direct and indirect contact, droplets Rash intense in joint folds, skin desquamates and feels like sand paper, strawberry tongue (coated, papillae red and swollen)

Question 43

Scarlet fever treatment

Answer 43

Penicillin, erythromycin

Question 44

Diphtheria

Answer 44

Spread through direct contact and air | Nasal congestion, lymphadenitis, "bull neck", tough fibrous membrane along resp. tract --> mechanical airway obstruction

Question 45

Pertussis (whooping cough) treatment

Answer 45

Erythromycin, clarithromycin, azithromycin | Pertussis immunoglobulin