Quiz 4 Flashcards
(72 cards)
1) What is Fibromyalgia:
(how to remember)
1AA) Myalgia =
1A) What is etiology of fibromyalgia?
1B) s/s of fibromyalgia
2) How would a Dr. diagnosis this to determine someone has it?
3) Will symptoms ever go away?
4) What causes it?
5) BEST way to improve it?
1) A chronic disorder of widespread Musculoskeletal pain, fatigue, and tenderness in localized areas ALL OVER the body. IT IS WIDE SPREAD MUSCLE PAIN ALL OVER.
(remember: my muscle fibers are weak/fatigued)
1AA) Myalgia means pain of a muscle
1A) Might have etiology from no exercise / stretching, joint pain, nerve pain, etc. This can’t be cured. But you can get medications, stress therapy, sleep therapy, PT
1B) Patient will have muscle weakness all over, pain, fatigue, can’t sleep well, sensitivity to pain/cold, anxiety or mood swings
2) A Dr. tests 18 different spots on the body, and if they have pain in 11+, they will be diagnosed with fibromyalgia. Has to have 4 quadrant pain for 3+ months (basically all over the body)
3) They don’t really ever go away. Can’t really cure it.
4) Multi-factorial: diet, stress, genetics, environment, nerve issues, lack of exercise
5) EXERCISE. Other ways are e-stim or ultrasound.
1) Explain HIV / Aids:
1A) HIV and AIDS stand for what?
2) Does HIV always lead to AIDS?
3) Can you get rid of HIV?
(scroll down … see below)
- Incidence:
- Prevalence:
- Etiology / Risk factors:
- Pathogenesis:
- Clinical manifestations (s/s):
- Medical management:
- Implications for the PT:
1) HIV is a virus spread through certain body fluids (mainly by sexual contact … blood and semen) that attacks the body’s immune system, specifically the CD4 cells, often called T cells. Over time, HIV can destroy many of these CD4 cells which means that the body can’t fight off infections and disease. These special CD4 cells help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body. This damage to the immune system makes it harder and harder for the body to fight off infections and some other diseases … which could lead to AIDS.
HIV attacks certain cells in the immune system and prevents them from carrying out their proper immunity functions against microbes. When the immune system is sufficiently weakened, infected people catch atypical and severe infections. This is then called the Acquired Immunodeficiency Syndrome, or AIDS.
1A)
HIV = human immunodeficiency virus
AIDS = acquired immunodeficiency syndrome
2) Not always, but HIV can lead to AIDS if not treated. If you don’t treat HIV, you get AIDS and that basically means immune system just doesn’t work.
3) NO. Once you have HIV, you have it FOR LIFE.
- Incidence and Prevelence: AIDS is an EPIDEMIC with more people contracting it (but less people dying from it because of prevelence of ANTIRETROVIRAL drugs to help boost immune system). From America to especially Sub-Saharan Africa where it is prevalent. 33 million people world wide have AIDS. First cases in America was 1981. Most times you see it in men having sex with men and injection drug users.
- Etiology / Risk factors: AIDS comes from those with HIV (type 1), and you get HIV through exchange of body fluids (blood and semen) and having multiple partners. It isn’t contagious or passed in casual encounters, but typically through exchanging bodily fluids.
- Pathogenesis: HIV leads to breakdown of T4 (helper or CD4 cells) which regulate the immune response, and HIV destroys them.
- Clinical manifestations (s/s): Flu, LOWER CD4 count, fatigue, swollen lymph glands, weight loss, neurologic decline in advancing HIV
- Medical management: First is PREVENTION / EDUCATION about sexual activity, condoms, safe sex, etc. Second is SCREENING or HIV testing. THIRD, counseling, behavior counseling / change programs, exercise, etc. But most importantly you need to get antiretroviral drugs (ARV’s).
- Implications for the PT: Remember HIV is NOT contagious. Be sensitive. Be professional. Help treat muscle / movement weakness.
Compare and contrast:
Innate vs. acquired/adaptive immunity
Innate:
- Natural or within you. FIRST LINE OF DEFENSE
- Can usually resolve most pathogens
- First line of defense: Skin, mucous membranes, tears, saliva, cough
- Second line of defense: WBC’s, inflammatory response, NK cells, CD4’s
- Immediate response in few hours (but lower potency)
- Won’t remember past antigens, they work the same every time.
- NOT SPECIFIC, NO MEMORY **
Acquired / Adaptive:
- Developed ability of a person to defend itself against a pathogen
- 3rd line of defense
- An IMMUNE response because of an External or Environmental (not innate) immune response: vaccines, antibodies, breast milk
- Slower response over days/weeks (but higher potency)
- They are adaptive so they remember past antigens and fight them again and again
- Antigen specific
- SPECIFIC and MEMORY
*** As its name suggests, the innate immune system consists of cells and proteins that are always present and ready to mobilize and fight microbes at the site of infection. The main components of the innate immune system are 1) physical epithelial barriers, 2) phagocytic leukocytes, 3) dendritic cells, 4) a special type of lymphocyte called a natural killer (NK) cell, and 5) circulating plasma proteins.
The adaptive immune system, on the other hand, is called into action against pathogens that are able to evade or overcome innate IMMUNE defenses. Components of the adaptive immune system are normally silent; however, when activated, these components “adapt” to the presence of infectious agents by activating, proliferating, and creating potent mechanisms for neutralizing or eliminating the microbes. There are two types of adaptive immune responses: humoral immunity, mediated by ANTIBODIES produced by B lymphocytes, and cell-mediated immunity, mediated by T lymphocytes.
What is immunity
If I’m immune to something, what does that mean?
Our ability to resist a particular infection or toxin by the action of specific antibodies or sensitized / specialized white blood cells.
The immune system in our bodies fights infections, bacteria, viruses, or other foreign toxins that invade us. We often resist bacteria and infections or toxins by the action of specific antibodies or sensitized white blood cells within us.
If I’m immune: I can fight it, it doesn’t effect me, my body innately or adaptively kills pathogen, I have antibodies or WBC’s that can attack and kill it, I’m following standard precautions, my 3 lines of defense are working.
An example of when our immune system is bad:
- Organ transplant rejection
- Autoimmunities (see flashcard below … but examples are multiple sclerosis, rheumatoid arthritis, lupus)
Would this be innate or adaptive / acquired immunity?
Nonspecific, doesn’t distinguish the foreign invader so it doesn’t remember the invader for future encounters. It won’t adapt.
Innate immunity.
Example of first line of defense:
Example of second line of defense:
Example of third line of defense:
1st: Skin, mucous membrane, tears, saliva, wax in ears, cough/sneeze
2nd: WBC’s (neutrophils, etc.), CD4’s, internal immune system, INFLAMMATORY response to cell injury/death
3rd: immune response … vaccines, antibodies, breast milk, etc.
Would neutrophils, phagocytes, WBC’s be innate or adaptive … and 1st or 2nd line of defense?
Innate
2nd line of defense
Would this be innate or adaptive / acquired immunity?
Characterized by specificity and memory by recognizing previous antigens and forming antibodies to recognize and stop foreign invader?
Adaptive / acquired immunity
SPECIFIC and MEMORY
Examples of adaptive / acquired immunities:
- Antibodies (externally injected or internally created)
- Vaccines
- Breast milk
1) What are the two types of adaptive immunities?
Explain each …
2)
A) Antibodies belong to humoral or cell-mediated?
B) T Lymphocytes belong to humoral or cell-mediated?
3)
Antibodies =
T Lymphocytes =
1) Humoral and cell-mediated immunity
Depending on the kind of foreign invasion, two different immune responses occur:
A) The humoral response (or antibody‐mediated response) involves B lymphocyte cells that recognize antigens or pathogens that are circulating in the lymph or blood (“humor” is a medieval term for body fluid) and creates ANITBODIES to tag antigen to have other cells kill it. (Antibodies recognize foreign antigen and kill it).
B) Cell-mediated immunity is an immune response that does not involve antibodies, but rather involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. (Cell adapts to phagocytize pathogen).
Antibodies = humoral
T Lymphocytes = cell-mediated
What is active vs. passive immunity
Active immunity: Your body naturally / directly responds to pathogen by creating its own antibodies to fight foreign toxin. This takes time for the body to create those antibodies, but when it does, those antibodies are in you for life.
Passive immunity: You get antibodies from outside your body. Whether from a mother’s milk, or vaccine, you get antibodies from somewhere else. This is immediate immune response, but won’t last forever because no memory cells are created … you just get effects till antibodies wear off.
Active and Passive immunity both have natural and artificial forms.
What is natural vs. artificial immunity:
An antibody the body naturally creates is an example of:
A mother’s breast milk is an example of:
A vaccine shot is an example of:
Natural: immunity develops due to natural events
Artificial: immunity develops due to medical intervention
Antibody: Natural active immunity
Breast Milk: Natural passive immunity
Vaccine: Artificial active immunity
- Passive natural: mother to fetus across placenta or through breast milk
- Passive artificial: inoculation of antibody or antitoxin
Internal vs. External Defense systems (with immunity):
Which is 1st line of defense, which is 2nd line of defense?
External (1st line of defense):
- Skin
- Mucous membrane
- Tears
- Saliva
- Nose hairs
- Cough reflex / sneeze
Internal (2nd and 3rd line of defense):
- Inflammation response
- WBC’s
- Phagocytic cells (WBCs, neutrophils, NK cells)
- Stomach acid
- Immune system response
- Antibodies
What is a pathogen
A foreign micro organism (bacteria, virus, fungi, infection, etc) that is not natural to human and our immune system fights or tries to destroy it.
Describe the immune response … and its 5 phases:
Accronym for 5 steps:
When the body gets a foreign invader, it sees the foreign antigen (protein on surface of cell) and whether recognized or not, it sends signals throughout body to fight it. If antigen is NOT part of your DNA or doesn’t recognize it, body will fight it.
First, your innate immune system will kick in. If somehow it already got through 1st line of defense, then your 2nd line will kick in. If the pathogen is recognized and antibodies are already circulating and produced (B cells), they will go tag foreign invader to tell other immune cells (T cells) to phagocytize and come kill it.
If your body doesn’t recognize it and you have no antibodies, body will create some antibodies naturally or get them unnaturally from external source.
The “tagged” foreign invader will first have WBC’s rush to it to phagocytize and kill it. Inflammation response kicks in. Histamines are released and prostaglandins.
Then your innate immune system kicks in (described above) and your acquired immune system also kicks in if it recognizes this foreign invader (thus body will already have antibodies produced). You also may have passive immunities / antibodies from vaccines that kick in.
Accronym: RAETM (Rate … raet your memory)
Recognition: ????
Amplification:
Effector:
Termination:
Memory:
1) Explain diff. between the B Lymphocytes and T Lymphocytes
2) (How to remember?)
3) Where do B-Lymphocytes originate from?
1) Lymphocytes are WBC’s.
B lymphocytes fight foreign bacteria/virus by creating ANTIBODIES that attach to a specific antigen on the foreign cell and “mark” it to be tagged and killed by other immune cells.
T lymphocytes will then ATTACK the “marked” anTigens directly and help control the immune response. The T “helper” cells go kill foreign cell, and T “suppressor” cells turn off immune response. They also release chemicals, known as cytokines, which control the entire immune response.
2) REMEMBER:
(B = B for antiBodies)
(T = TT for aTTack the Taged invader … helper/suppresor)
3) B-lymphocytes come from BONE MARROW (B for Bone marrow)
Describe changes that occur with aging that affect the immune system
As you get older, the immune system starts to break down and become disregulated. In other words - immune function declines and there is a reduced resistance to pathogens and increased risk of exposure and tumors, etc.
- Decreased resistance to pathogens
- Skin breaks down (ulcers or bacteria enter)
- WBC’s or phagocytes decrease
- Decrease in antibody production
- Increased incidence of tumors
- Increased falls / bruises … which requires more WBC’s
- Nutrition declines
- Bone/muscle weakness
- Lack of energy / fatigue
What other factors, in addition to aging, affect immunity
- Nutrition
- Enviornment pollution and germs exposure
- Exposure to chemicals and drugs (needles)
- Medications
- Stress
- Socioeconomic status
- Sleep deprivation
- Hormone swings/insufficiencies
- Trauma / Burns
- Sexual practices
- Following ‘standard precautions’ or not
How does exercise affect the immune system?
When would you do moderate and/or intense exercise during immunodeficiency period?
*** Depending on the intensity, exercise can enhance or suppress the immune system’s function. Exercise always helps!
So if you do moderate exercise, the immune system is enhanced. Moderate exercise limits heart disease, strengthens bones and muscles. Maybe it circulates blood more so WBCs get distributed, or increase body temp to kill (heat up) bacteria, and slows down the release of stress hormones. It produces endorphins.
But, intense exercise can be followed by impairment / weakness of immune system. It suppresses NK cells, lymphocytes.
1) What is Primary Immunodeficiency
2) Are primary or secondary immunodeficiencies more common?
- Incidence:
- Prevalence:
- Etiology / Risk factors:
- Pathogenesis:
- Clinical manifestations (s/s):
- Medical management:
- Implications for the PT:
1) Primary immunodeficiency diseases (PI) are a group of about 95 rare, inherited (GENETIC) chronic disorders in which part of the body’s immune system is missing or functions improperly. It effects one or more components of the immune system … like T cells, B cells, NK cells, phagocytic cells, etc.
Primary immunodeficiency disease: A disorder caused by a GENETIC or inherited flaw (genetic defect of cells in immune system) in the immune system that increases the susceptibility to infections. Primary immunodeficiency diseases are unlike secondary or acquired immune deficiency diseases, which are caused by infectious, chemical or radiological agents.
2) PI’s are NOT very common.
- Incidence: 95 inherited immunodeficiency disorders
- Prevalence:
- Etiology / Risk factors: GENETICALLY determined
- Pathogenesis:
- Clinical manifestations (s/s):
- Medical management:
- Implications for the PT: Book said we as PT’s rarely encounter these conditions.
What is Secondary Immunodeficiency
Examples:
A secondary immune deficiency disease occurs when the immune system is compromised due to an EXTERNAL or environmental factor (not genetic). Examples of these outside forces include HIV, chemotherapy, severe burns, malnutrition, chronic fatigue disease, hypersensitivity.
These are acquired (not genetic) and WAY more common than primary immunodeficiencies.
Examples Include:
- HIV
- Chronic fatique syndrome
- Hypersensitivities (allergies Type 1-4)
- Leukemia (Chemotherapy)
- Autoimmune diseases
- Hodgkin’s disease (Lymph cancer)
- Malnutrition
- Alcoholism
- Diabetes Mellitus (Genetic ?????)
- Cancer
What is the most common secondary immunodeficiency
HIV
Advanced HIV is:
AIDS (acquired immunodeficiency syndrome)
