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Final for Critical Care > Immunological > Flashcards

Immunological Flashcards

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1
Q

What is a primary immunodeficiency?

A

a group of more than 300 rare, chronic disorders in which part of the bodies immune system is missing or functions improperly.

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2
Q

What are the signs of a primary immune deficiency?

A
  • increased susceptibility to infections
  • more frequent infections
  • longer lasting infections
  • opportunistic infections
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3
Q

what is an opportunistic infection?

A

an infection a person with a healthy immune system likely wouldn’t get

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4
Q

other symptoms of opportunistic infection?

A
  • affects natural immune system
  • cannot initiate -inflammatory response
  • bacterial, fungal, viral infections
  • recurring abscesses, bronchitis and sinusitits.
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5
Q

what type of cells cannot reach the vascular system with a PI?

A

neutrophils unable to reach site of infection, and remain in the vascular system

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6
Q

What is HIV?

A

human immune deficiency virus

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7
Q

What type of infection is HIV classified as?

A

a chronic infection, treated as outpatient

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8
Q

what is AIDS?

A

autoimmune deficiency syndrome

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9
Q

what type of infection is AIDS classified as?

A

Acute, maybe requiring hospitalization

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10
Q

what body fluids can HIV-1 be transmitted through?

A 
blood
seminal fluid
vaginal secretions
amniotic fluid
breastmilk
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11
Q

how soon after exposure to AIDS/HIV should antivirals be started?

A

within 72 hours of exposure

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12
Q

what are stages of HIV based on?

A

stages based on clinical condition and CD4+T cell count

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13
Q

how soon are antibodies produced after infection?

A

antibodies are produced usually within 3-12 weeks after infection

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14
Q

What tests detect antibodies?

A

Blood test, EIA

if EIA is positive; Western blot assay confirms seropositivity

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15
Q

what company uses saliva to perform an EIA?

A

OraSure

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16
Q

what do you do when you are exposed to HIV/AIDS?

A

wash area with soap and water, flush splashes to the nose, mouth, or skin with water
report incident to your supervisor
immediately seek medical treatment

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17
Q

manifestations of HIV?

A

can include any system

infection, malignancy of body tissue

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18
Q

what are the respiratory issues with HIV and AIDS?

A

pneumocystitis pneumonia
Tuberculosis
oral candidiasis

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19
Q

what is the most common respiratory condition with HIV and AIDS?

A

pneumocystis pneumonia

80% without prophylactic treatment

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20
Q

how does pneumocystis pneumonia present?

A

initially vague symptoms, progress to significant pulmonary impairment and respiratory failure

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21
Q

how is pneumocystis pneumonia diagnosed?

A

sputum, bronchial-alveolar lavage, transbronch biopsy

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22
Q

tuberculosis with HIV/AIDS?

A

often latent disease, 10% risk developing active

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23
Q

how common is oral candidiasis with HIV and AIDS?

A

occurs in almost all patients

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24
Q

symptoms of GI problems with HIV/AIDS?

A
  • loss appetite, N/V, oral and esophageal candidiasis, chronic diarrhea
  • related to direct affect of virus or tx protocol
  • weight loss, progressive tissue wasting
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25
oncologic s/s r/t HIV and AIDS?
kaposi's sarcoma lymphoma invasive cervical cancer
26
what is kaposi's sarcoma?
- endothelial layer blood and lymphatic vessels - localized cutaneous lesions to disseminated multi organ - prognosis depends on extent of tumor, other HIV infections, CD4+ count
27
lymphoma with AIDS?
b-cell lymphoma 2nd most common malignancy with HIV and AIDS | -often aggressive growth and resistance to tx
28
neurologic r/t HIV and AIDS?
Related to action HIV on nervous system tissue, opportunistic infections, neoplasms, cerebrovascular changes, encephalopathies, treatment complications. Includes inflammation, atrophy, demyelination, necrosis
29
neuro conditions r/t HIV and AIDS?
- peripheral neuropathy - HIV encephalopathy - cryptococcus neoformans meningitis - progresive multifocal leukoencephalopathy
30
integumentary conditions r/t HIV and AIDS?
``` kaposi herpes zoster molluscum contagiousum seborrheic dermatitis generalized folliculitis ```
31
endocrine conditions r/t HIV and AIDS?
infiltration and destruction of endocrine glands
32
gynecologic conditions r/t HIV and AIDS?
recurrent candidiasis ulcerative STDs HPV
33
what are the s/s of diffuse connective tissue disease?
- chronic | - inflammation and degenerative connective tissue
34
what is the diffuse connective tissue disease?
rheumatoid arthritis
35
what is the autoimmune reaction in synovial tissue?
- degenerative changes in muscle fibers | - loss tendon and ligament elasticity and contractile power
36
what gender is RA more common in?
females 2:1 versus males 4:1
37
s/s of RA?
- joint pain, swelling, warmth, erythema, lack of function, deformity depending on disease stage and severity - joint stiffness in AM - deformities in hands and feet
38
where does joint pain begin with RA?
small joints, hands, wrists and feet
39
where does RA progress to?
knees, shoulders, hips, elbows, ankles, cervical spine, and TMJ
40
How is RA diagnosed?
- rheumatoid nodules - exam - x-rays - presence rheumatoid factor (75%) - elevated ESR - low RBC and C4 complement - positive CRP, antinuclear antibody
41
management of RA?
education (balance, rest and exercise) salicylate and NSAIDS management in first two years improve outcomes methotrexate successful preventing joint destruction and long term disability
42
what are the classifications of RA?
- moderate erosive RA - Advanced unremitting RA - persistent Erosive RA
43
what is the tx for moderate erosive RA?
-formal program OT/PT | cyclosporine immunosuppressant may be added to medication regimen, enhances methotrexate
44
what is the tx for advanced unremitting RA?
immunosuppressant agents- affect antibody production at cellular level high dose methotrexate may cause bone marrow suppression, anemia, GO disturbance, rashes
45
tx of persistent erosive RA?
reconstructive surgery, when pain is not controlled, interferes with independence. Synovectomy, tenorrhaphy, arthrodesis, arthroplasty corticosteroids-low dose use while slower acting meds take effect
46
What is SLE?
systemic lupus erythematosus (SLE), an autoimmune disease in which the bodys immune sytem mistakenly attacks healthy tissue in many parts of the body
47
what systems can lupus effect?
can affect any system
48
what does lupus do to the skin?
- arthralgia, arthritis - papulosquamous or annular lesions - chronic rash with erythematous papules or plaques that can scar. - butterfly shaped rash on bridge of nose and cheeks - oral lesions
49
what does lupus do to the cardio system?
pericarditis and artherosclerosis
50
what does lupus do to the renal system?
hypertension
51
what does lupus do to the neuro system?
varied and frequent, subtle behavior and cognitive changes
52
common symptoms of lupus?
- swollen joints - fever - chest pain - hair loss - mouth ulcers - swollen lymph nodes, fatigue - red rash most commonly on the face
53
how is lupus diagnosed?
-exam, H and P, blood tests -skin assessment rashes, hyper or depigmentation sensitivity to sunlight or ultraviolet light alopecia oral ulcers -pericardial, pleural infiltrates -positive ANA -moderate to severe anemia -thrombocytopenia, leukocytosis, leukopenia
54
tx for lupus?
NSAIDS corticosteroids immunosupressives (cyclophosphamide, azathioprine, cyclosporine)
55
what is the most important med for treatment of lupus?
corticosteroids topical for cutaneous low dose oral for minor disease activity high dose oral or IV for major disease activity
56
what is scleroderma?
excessive accumulation of collagen in tissues
57
what does scleroderma start as?
skin involvement | initially inflammation causes edema, taut, smooth, shiny skin appearance
58
how common is scleroderma and what causes it?
relatively rare, and the cause is unknown
59
what changes after the initial phase of scleroderma?
undergoes fibrotic changes, loss of elasticity and movement | tissue becomes nonfunctional
60
what other body parts does scleroderma occur in?
blood vessels major organs body systems
61
how does scleroderma begin?
with Raynaud's phenomenon and swelling of hands
62
manifestations of scleroderma?
- increasing hardness and rigidity of skin - wrinkle and lines - obliterated - extremities stiffen, lose - mobility - mask like face and rigid mouth - left ventricular heart failure, hard esophagus, scarred lungs, hardened intestinal mucosa - progressive renal failure
63
what is CREST?
a calcinosis, raynauds phenomenon, esophageal hardening, sclerodactyly, telangiectasia
64
diagnostics for scleroderma?
no definitive test - skin biopsy ID cellular changes - pulmonary studies show VP abnormalities - EKG - esophageal study - positive ANA
65
management of scleroderma?
- depends on presentation - pain management - limit disability - moderate exercise to avoid contracture - avoid extreme temperature - lotion
66
treatment of scleroderma?
calcium channel blockers to improve raynaud's | -anti-inflammatory agents control stiffness, arthralgia, general discomfort

Final for Critical Care (3 decks)

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