Flashcards in Immunology Deck (116):
What are the first lines of defense against pathogens?
Physical and mechanical barriers like skin and the linings of the GI, GU, and respiratory tracts
What are the specific defenses of the first line of immunity?
Sloughing off of cells, coughing and sneezing, flushing, vomiting, mucous and cilia
What are the biochemical barriers our bodies have against toxins?
Synthesized and secreted saliva, tears, ear wax, sweat, mucus, and gastric pH; antimicrobial peptides; and normal bacteria flora
What is the body's second line of defense against pathogens?
What causes the inflammatory response?
Infection, mechanical damage, ischemia, nutrient deprivation, temperature extremes, and radiation
How does the inflammatory response protect the human body?
Neutralizing, elimination, or destroying organisms that invade the internal environment
What is the individual recognition on each of our cells that makes up the unique universal product code for each person?
Human Leukocyte Antigens (HLA)
About how many antigens make up the HLAs?
Provides immediate protection against the effects of tissue injury and foreign proteins
What kind of damage can result from excessive inflammatory response?
Heart attack, stroke, and other tissue damage
A process that occurs in response to tissue injury and to the invasion of organisms
What generally accompanies infection?
Nonspecific ingestion of microorganisms and foreign proteins; kills infection
Ingestion and phagocytosis
Releases histamine and heparin with tissue damage
Why is heparin released with tissue damage?
To prevent clot formation and help healing
Weak phagocytic and vasoactive amines during allergic reactions
Immune response of phagocytes, cytotoxic lymphocytes, and cytokines
Cell mediated immunity
What kind of lymphocytes does antibody mediated immunity use?
What do B lymphocytes do?
Formation of antibodies
Defense against invading foreign microorganisms
Activation of B cells and circulating antibodies
Antibody mediated immunity
Secretory protein on mucous membranes and outer body skin surfaces
Blood group markers that probably stimulate autoimmune diseases and responses
Mediates allergic and hypersensitivity reactions, protects against parasitic infections
Regulates lymphocyte activation and suppression
What is the most common immunoglobulin?
Which immunoglobulin is the first line of defense?
Which lymphocyte is involved in cell mediated immunity?
What initiates cell mediated immunity?
What types of cells can T lymphocytes differentiate into?
Helper/inducer, suppressor, and killer cells
Selectively targets non-self cells like viruses, grafts, and transplants
Non-selectively attacks non-self cells, especially cancer cells
Killer T Cells
These cells become sensitive to foreign cells and proteins
Small protein hormones produced by WBCs like interleukin, TNF and erythropoietin
What three components make up immune competence?
Cell mediated immunity, antibody mediated immunity, and inflammation
What is the sequence of inflammatory response?
Vascular, Cellular Exudates, Tissue Repair and Replacement
What is the purpose of cellular exudates?
They take away debris
What changes in the blood vessels occur during inflammation?
Constriction, hyperemia, and edema
Clumping of foreign particles to keep them together and expel them
What produces antibodies?
Body learns to make or receives antibodies
Antigen enters, body makes specific antibody
Antigen enters without assistance
Natural active Immunity
Vaccination (does not cause disease attenuated)
Artificial active immunity
Immunity passed, not created; short acting then destroyed
Name examples of natural passive immunity
Breast milk, colostrum, or placenta
Name some examples of artificial passive immunity
Rabies, snake bites, immunoglobulin shots
Name examples of Natural Active Immunity
Getting the disease
Name examples of Artificial Active Immunity
What type of immunity is the most effective and longest lasting?
Natural Active Immunity
Immunity through having the disorder
Where are the T cells like natural killer cells and cytokines produced?
Type of cytotoxic lymphocyte that constitute a major component of the innate immune system by rejecting tumors and cells infected by viruses
Natural Killer Cells
How do natural killer cells work?
Release small cytoplasmic granules of proteins that are programmed to cause the death of the target cell
Why are natural killer cells "natural"?
They don't require any activation in order to kill any cell missing the "self" marker
What is the purpose of suppressor cells?
To prevent overreaction and hypersensitivity
How does cell mediated immunity help to protect the body?
Through the ability to differentiate self from non-self and preventing the development of cancer and metastasis after exposure to carcinogens
What kind of problems can T cells and NK cells cause?
Hyper acute, acute, and chronic organ rejection
What drugs are used to prevent transplant rejection?
Sandimune, prednisone, prograf, cell cept, and imuran
Increased or excessive response to the presence of an antigen to which the patient has been exposed
Atopic allergy; this is the most common type of hypersensitivity
Type 1 Rapid Hypersensitivity Reactions
In what ways can allergens be contacted?
Inhalation, ingestion, and contact
What is the best intervention for allergies?
What are the signs and symptoms of anaphylaxis?
Feeling of uneasiness, pruritus urticaria, erythema, angioedema of the eyes, lips, or tongue, bronchoconstriciton, congestion, rhinorrhea, and dyspnea
What drugs can be used to treat allergies?
Decongestants, antihistamines, corticosteriods, mast cell stabilizers, leukotriene antagonists, complementary and alternative therapies, and desensitization therapy
What are the nursing interventions for a patient with anaphylaxis?
Establish airway, epinephrine, antihistamines, oxygen, and fluids
Hypersensitivity reaction in which the body makes special autoantibodies directed against self cells that have some form of foreign protein attached to them
Type 2 Cytotoxic Reaction
Hypersensitivity reaction in which excess antigens cause immune complexes to form in the blood and lodge in small blood vessels
Type 3 Immune Complex Reactions
What are clinical examples of cytotoxic reactions?
Hemolytic anemias, thrombocytopenic purpura, hemolytic transfusion reactions, Goodpasture's syndrome, and drug induced hemolytic anemia
What can immune complex reactions result in?
Inflammation, causing tissue or vessel damage
Where do immune complexes generally settle?
Kidneys, skin, joints, and small blood vessels
What are the clinical manifestations of immune complex reactions?
Rheumatoid arthritis, SLE, and Serum sickness
Hypersensitivity reaction in which a local collection of lymphocytes and macrophages cause edema, induration, ischemia, and tissue damage
Type 4 Delayed Hypersensitivity Reactions
What is the reactive cell in a type 4 reaction?
What are the clinical manifestations of Delayed Hypersensitivity Reactions?
Contact dermatitis, insect stings, tissue transplant rejection, sarcoidosis, and Positive PPDs
Hypersensitivity reaction in which excess stimulation of a normal cell surface receptor by an autoantibody results in a continuous "turned-on" state for the cell
Type 5 Stimulatory Reaction
What is the clinical manifestation of stimulatory reactions?
What is the most common type of allergic reaction?
The process whereby a person develops an inappropriate immune response and antibodies and/or lymphocytes are directed against healthy normal cells and tissues
Chronic, progressive, inflammatory connective tissue disorder that can cause major body organs and systems to fail
What is the characteristic symptom of Lupus?
Spontaneous remissions and exacerbations
In patients with Lupus, what do the autoimmune complexes tend to be attracted to?
Glomeruli of the Kidneys
What are the two types of Lupus?
Dermoid and Systemic
What are the signs and symptoms of Lupus?
Skin involvement (butterfly rash), polyarthritis, osteonecrosis, muscle atrophy, fever and fatigue, renal involvement, pleural effusions, pericarditis, Raynaud's phenomenon, and neurologic manifestations
What is the treatment for Lupus?
Prednisone, tylenol or NSAIDs, immunosuppressive agents
How is Lupus diagnosed?
Skin biopsy, CBC, body system function assessment, and the presence of C-reactive protein
Group of problems that often appear with other autoimmune disorders, such as dry eyes, dry mucous membranes of the nose and mouth, vaginal dryness, and insufficient tears
How is Sjogren's Syndrome treated?
Can be slowed by suppressing immune and inflammatory responses
Autoimmune disorder in which autoantibodies are made against the glomerular basement membrane and neutrophils of the lungs and kidneys
What are the signs and symptoms of Goodpasture's Syndrome?
SOB, hemoptysis, decreased urine output, weight gain, edema, hypertension, and tachycardia
What is the treatment for Goodpasture's Syndrome?
High dose corticosteroids
What is the most common secondary immunogenicity disease in the world?
What type of virus is HIV?
Single stranded retrovirus
What cells should an HIV positive patient watch?
What kinds of opportunistic infections occur in HIV positive patients?
Pneumocystis pneumonia, meningitis, encephalitis, herpes simplex virus, gastroenteritis, shingles, TB, Kaposi's Sarcoma, oral yeast infection, and oral "hairy" leukoplakia
What is the distinction between HIV and AIDS?
The number of CD4 cells and whether any opportunistic infections have occured
At what CD4 count is a HIV patient considered to have AIDS?
Less than 200
What are the clinical categories of HIV?
Asymptomatic, Symptomatic by early, and AIDS
What is a normal CD4 count?
Greater than 650
What nursing interventions should be used with an AIDS patient?
Reduce risk of infection, mouth care, pressure ulcer care, support group, safe sex, and watch for signs and symptoms of neurologic infections
What are the types of drugs prescribed to slow the growth of the HIV virus?
Nucleoside Analog Reverse Transcriptase Inhibitors
When are NARTI drugs contraindicated?
In patients with abnormal liver function tests
What are the screening tools for HIV?
Oral fluid, Urine tests, RNA tests, ETA Enzyme Immunoassay tests
What kind of drugs inhibit viral replication?
What should patients taking protease inhibitors be educated on?
Take them with food, may cause dizziness, never stop taking them, may cause low blood pressures
What is the window for developing HIV antibodies?
25 days usually, but it could take up to 6 months
The ability to recognize self versus non-self, which is necessary to prevent healthy body cells from being destroyed along with invaders
When is immune function most efficient?
What precautions should be used on an HIV positive patient?
If a patient is having an allergic response to IV medication, what should you do?
Change the tubing and instill normal saline
Which monoclonal antibody is being investigated for benefit to patients with severe Sjogren Syndrome?
How is Goodpasture's syndrome treated?
Kidney supportive or replacement therapy
Who is HIV most prevalent in?