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Flashcards in Immunology Deck (116):
0

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

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What are the specific defenses of the first line of immunity?

Sloughing off of cells, coughing and sneezing, flushing, vomiting, mucous and cilia

2

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

3

What is the body's second line of defense against pathogens?

Inflammatory response

4

What causes the inflammatory response?

Infection, mechanical damage, ischemia, nutrient deprivation, temperature extremes, and radiation

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How does the inflammatory response protect the human body?

Neutralizing, elimination, or destroying organisms that invade the internal environment

6

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)

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About how many antigens make up the HLAs?

40

8

Provides immediate protection against the effects of tissue injury and foreign proteins

Inflammation

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What kind of damage can result from excessive inflammatory response?

Heart attack, stroke, and other tissue damage

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A process that occurs in response to tissue injury and to the invasion of organisms

Infection

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What generally accompanies infection?

Inflammation

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Nonspecific ingestion of microorganisms and foreign proteins; kills infection

Neutrophils

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Ingestion and phagocytosis

Macrophages

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Releases histamine and heparin with tissue damage

Basophils

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Why is heparin released with tissue damage?

To prevent clot formation and help healing

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Weak phagocytic and vasoactive amines during allergic reactions

Eosinophils

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Immune response of phagocytes, cytotoxic lymphocytes, and cytokines

Cell mediated immunity

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What kind of lymphocytes does antibody mediated immunity use?

B lymphocytes

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What do B lymphocytes do?

Formation of antibodies

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Defense against invading foreign microorganisms

IgG

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Activation of B cells and circulating antibodies

Antibody mediated immunity

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Secretory protein on mucous membranes and outer body skin surfaces

IgA

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Blood group markers that probably stimulate autoimmune diseases and responses

IgM

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Mediates allergic and hypersensitivity reactions, protects against parasitic infections

IgE

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Regulates lymphocyte activation and suppression

IgD

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What is the most common immunoglobulin?

IgG

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Which immunoglobulin is the first line of defense?

IgA

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Which lymphocyte is involved in cell mediated immunity?

T lymphocytes

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What initiates cell mediated immunity?

Macrophages

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What types of cells can T lymphocytes differentiate into?

Helper/inducer, suppressor, and killer cells

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Selectively targets non-self cells like viruses, grafts, and transplants

T Cells

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Non-selectively attacks non-self cells, especially cancer cells

Killer T Cells

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These cells become sensitive to foreign cells and proteins

B Cells

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Small protein hormones produced by WBCs like interleukin, TNF and erythropoietin

Cytokines

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What three components make up immune competence?

Cell mediated immunity, antibody mediated immunity, and inflammation

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What is the sequence of inflammatory response?

Vascular, Cellular Exudates, Tissue Repair and Replacement

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What is the purpose of cellular exudates?

They take away debris

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What changes in the blood vessels occur during inflammation?

Constriction, hyperemia, and edema

39

Clumping of foreign particles to keep them together and expel them

Agglutination

40

What produces antibodies?

B lymphocytes

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Natural immunity

Innate-Native Immunity

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Body learns to make or receives antibodies

Adaptive immunity

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Antigen enters, body makes specific antibody

Active immunity

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Antigen enters without assistance

Natural active Immunity

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Vaccination (does not cause disease attenuated)

Artificial active immunity

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Immunity passed, not created; short acting then destroyed

Passive immunity

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Name examples of natural passive immunity

Breast milk, colostrum, or placenta

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Name some examples of artificial passive immunity

Rabies, snake bites, immunoglobulin shots

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Name examples of Natural Active Immunity

Getting the disease

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Name examples of Artificial Active Immunity

Vaccines

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What type of immunity is the most effective and longest lasting?

Natural Active Immunity

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Immunity through having the disorder

Adaptive Immunity

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Where are the T cells like natural killer cells and cytokines produced?

Thymus Gland

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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

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How do natural killer cells work?

Release small cytoplasmic granules of proteins that are programmed to cause the death of the target cell

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Why are natural killer cells "natural"?

They don't require any activation in order to kill any cell missing the "self" marker

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What is the purpose of suppressor cells?

To prevent overreaction and hypersensitivity

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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

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What kind of problems can T cells and NK cells cause?

Hyper acute, acute, and chronic organ rejection

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What drugs are used to prevent transplant rejection?

Sandimune, prednisone, prograf, cell cept, and imuran

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Increased or excessive response to the presence of an antigen to which the patient has been exposed

Hypersensitivities

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Atopic allergy; this is the most common type of hypersensitivity

Type 1 Rapid Hypersensitivity Reactions

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In what ways can allergens be contacted?

Inhalation, ingestion, and contact

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What is the best intervention for allergies?

Avoidance therapy

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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

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What drugs can be used to treat allergies?

Decongestants, antihistamines, corticosteriods, mast cell stabilizers, leukotriene antagonists, complementary and alternative therapies, and desensitization therapy

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What are the nursing interventions for a patient with anaphylaxis?

Establish airway, epinephrine, antihistamines, oxygen, and fluids

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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

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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

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What are clinical examples of cytotoxic reactions?

Hemolytic anemias, thrombocytopenic purpura, hemolytic transfusion reactions, Goodpasture's syndrome, and drug induced hemolytic anemia

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What can immune complex reactions result in?

Inflammation, causing tissue or vessel damage

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Where do immune complexes generally settle?

Kidneys, skin, joints, and small blood vessels

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What are the clinical manifestations of immune complex reactions?

Rheumatoid arthritis, SLE, and Serum sickness

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Hypersensitivity reaction in which a local collection of lymphocytes and macrophages cause edema, induration, ischemia, and tissue damage

Type 4 Delayed Hypersensitivity Reactions

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What is the reactive cell in a type 4 reaction?

T Lymphocyte

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What are the clinical manifestations of Delayed Hypersensitivity Reactions?

Contact dermatitis, insect stings, tissue transplant rejection, sarcoidosis, and Positive PPDs

77

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

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What is the clinical manifestation of stimulatory reactions?

Graves' disease

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What is the most common type of allergic reaction?

Contact Dermatitis

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The process whereby a person develops an inappropriate immune response and antibodies and/or lymphocytes are directed against healthy normal cells and tissues

Autoimmunity

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Chronic, progressive, inflammatory connective tissue disorder that can cause major body organs and systems to fail

Lupus Erythematosus

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What is the characteristic symptom of Lupus?

Spontaneous remissions and exacerbations

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In patients with Lupus, what do the autoimmune complexes tend to be attracted to?

Glomeruli of the Kidneys

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What are the two types of Lupus?

Dermoid and Systemic

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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

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What is the treatment for Lupus?

Prednisone, tylenol or NSAIDs, immunosuppressive agents

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How is Lupus diagnosed?

Skin biopsy, CBC, body system function assessment, and the presence of C-reactive protein

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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

Sjogren's Syndrome

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How is Sjogren's Syndrome treated?

Can be slowed by suppressing immune and inflammatory responses

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Autoimmune disorder in which autoantibodies are made against the glomerular basement membrane and neutrophils of the lungs and kidneys

Goodpasture's Syndrome

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What are the signs and symptoms of Goodpasture's Syndrome?

SOB, hemoptysis, decreased urine output, weight gain, edema, hypertension, and tachycardia

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What is the treatment for Goodpasture's Syndrome?

High dose corticosteroids

93

What is the most common secondary immunogenicity disease in the world?

AIDs

94

What type of virus is HIV?

Single stranded retrovirus

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What cells should an HIV positive patient watch?

CD4

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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

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What is the distinction between HIV and AIDS?

The number of CD4 cells and whether any opportunistic infections have occured

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At what CD4 count is a HIV patient considered to have AIDS?

Less than 200

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What are the clinical categories of HIV?

Asymptomatic, Symptomatic by early, and AIDS

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What is a normal CD4 count?

Greater than 650

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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

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What are the types of drugs prescribed to slow the growth of the HIV virus?

Nucleoside Analog Reverse Transcriptase Inhibitors

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When are NARTI drugs contraindicated?

In patients with abnormal liver function tests

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What are the screening tools for HIV?

Oral fluid, Urine tests, RNA tests, ETA Enzyme Immunoassay tests

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What kind of drugs inhibit viral replication?

Protease Inhibitors

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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

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What is the window for developing HIV antibodies?

25 days usually, but it could take up to 6 months

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The ability to recognize self versus non-self, which is necessary to prevent healthy body cells from being destroyed along with invaders

Self-Tolerance

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When is immune function most efficient?

In 20s-30s

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What precautions should be used on an HIV positive patient?

Standard

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If a patient is having an allergic response to IV medication, what should you do?

Change the tubing and instill normal saline

112

Which monoclonal antibody is being investigated for benefit to patients with severe Sjogren Syndrome?

Rituximab

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How is Goodpasture's syndrome treated?

Kidney supportive or replacement therapy

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Who is HIV most prevalent in?

Women

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What does the HIV virus do to CD4 cells?

Removes them from circulation, making the immune system weaker