Test 2 Flashcards
1
Q
humoral imune response vs. cell mediated response
A
Humoral: comprised of B cells, plasma cells are produced and secrete antigen-specific antibodies, memory cells
Cell-Mediated: comprised of a variety of T cells, Th (Helper T)
2
Q
categories of insulin
A
- Rapid acting: lispro, aspart (w/i 10-15 min)
- Short acting: regular (w/i 30 min)
- Intermediate acting: NPH
- Premixed insulins: 70% NPH/30% regular
- 70% NPL/30% regular
- 50% NPL/50% regular
- Long acting: glargine, determir
3
Q
S/S:
- normal or elevated BS at bedtime
- decreased BS at 2-3 am to hypoglycemic levels
- increased BS in AM caused by production of counter-regulatory hormones
A
Somogyi effect
4
Q
somogyi effect treatment
A
decrease evening dose of intermediate-acting insulin or increase bedtime snack
5
Q
S/S:
- relatively normal BS until about 3-4 AM, then glucose levels begin to rise
- nocturnal surge of growth hormone
A
dawn phenomenon
6
Q
treatment of dawn phenomenon
A
change time of evening intermediate-acting insulin from dinnertime to bedtime
7
Q
how to differentiate somogyi effect from dawn phenomenon
A
measure BS at 3am, if rising BS levels, then dawn phenomenon, if decreased BS: Somogyi
8
Q
agent: Paramyxovirus
incubation: 14-21 days
communicable: immediately before and after parotid gland swelling
source: saliva of infected persons, possible urine
transmission: direct contact with droplet
assessment: jaw or ear pain, parotid glandular swelling, may cause orchitis and encephalitis
precautions: droplet
A
Mumps
9
Q
type of hypersensitivity response:
immediate: IgE mediated
ex: rhinitis/anaphylaxis
A
Type 1 hypersensitivity reaction
10
Q
type of hypersensitivity response:
cytotoxic: antibody-mediated
- ex: transfusion reaction
A
Type 2 hypersensitivity reaction
11
Q
type of hypersensitivity response:
mediated: Immune complex
- ex: Rheumatoid arthritis
A
Type 3 hypersensitivity reaction
12
Q
type of hypersensitivity response:
delayed: t-cell mediated
- ex: poison ivy, PPD
A
Type 4 hypersensitivity reaction
13
Q
phase 1 type hypersensitivity reactions (2)
A
Initial or early response:
- 5-30 minutes
- vasodilation, vascular leakage and smooth muscle spasm
Secondary response:
- 2-8 hours after exposure
- swelling of mucosal tissues, mucous production, leukocyte infiltration and bronchospasm
14
Q
- Reaction of humoral response system
- Occurs within 15-30 minutes of exposure
- Examples: Transfusion reactions, drug reactions, myasthenia gravis, thyroiditis, autoimmune hemolytic anemia
A
Type II Hypersensitivity
15
Q
- AKA tissue specific reactions
- IgG or IgM antibodies bind with cells or tissue specific antigens
- cell/tissue destruction
- Activation of compliment: cell lysis, phagocytosis
- Antibody mediated: target
A
Type II- antibody mediated cytotoxic disorders
16
Q
- antibody binding to surgace antigens on cell
- C 5-9 complex with the antibody to form membrane attack complex
- resulting in cell lysis
- example: ABO blood type incompatibility
A
activation of complement cell lysis
17
Q
- antibody binding to surgace antigens on cell
- tissue macrophages bind to the cell surface by opsonization
- cell is destroyed by?
A
activation compliment phagocytosis
18
Q
-antigens on the cell surface bind with antibodies
-natural killer T cells bind with the antibodies and kill the cell
-
A
antibody mediated cell lysis
19
Q
In ________ clinical manifestations are dependent upon the specific tissue?
A
type II disorders
20
Q
- reaction of the humoral response system
- failure to remove antigen-antibody complexes from the circulation and tissues
- longer response time
- Examples: glomerulonephritis, systemic lupus erythematosis, rheumatoid arthritis
A
type III hypersensitivity
21
Q
- circulating antigens
- formation of insoluble antigen-antibody (A-A) complexes
- A-A deposition in vessel walls and tissues–>compliment activation
- Acute inflammation
- tissue damage
A
type III immune complex disorders
22
Q
_______ & _______ can cause type III reactions along with IV, drugs, foods, and some insect bites
A
viruses and bacteria
23
Q
serum sickness
A
- serum acts as foreign body or antigen
- symptoms of serum sickness include: rash, lymphadenopathy, arthralgia
- symptoms develop 7 days post exposure
24
Q
- delayed hypersensitivity
- cell-mediated response
- tissue is damaged as a result of a delayed T-cell reaction to an antigen
- normally occurs within 1-14 days after exposure
- ex: contact dermatitis from latex allergy, tuberculin reactions, transplant rejections
A
type IV hypersensitivity
25
- direct cytotoxicity-->tissue destruction
- delayed type hypersensitivity: inflammation, swelling, pruritis
- patho: cell mediated and antibody driven
type IV cell mediated manifestations
26
graft vs. host disease etiology and patho
etiology: bone marrow transplant, blood or blood product transfusion in the severely immunocompromised
patho: donor t cells attack host tissue antigens
27
clinical manifestation of graft vs host acute
- rash on the soles and palms spreading to entire body
- GI, bloody stools, nausea and abdominal pain
- liver dysfunction
- may resolve or become chronic > 100 days
28
k-12 vaccines (5)
- Dtap/Tdap
- polio
- measles/mumps/reubella
- hep B
- Varicella
29
Pre-K vaccines (6)
- dtap/DT
- polio
- measles/mumps/reubella
- hep b
- varicella
- hib
30
recommended immunizations adolescent (6)
- Tdap
- influenza
- pneumococcal if they have chronic disease
- meningococcal
- hep B
- HPV
31
college immunizations (2)
- meningococcal disease
| - hep B
32
recommended immunizations adults (6)
- hep B
- influenza
- pneumococal
- pertussis
- varicella
- TD
33
rotavirus vaccine
- causes vomiting and diarrhea-->dehydration in infants-->hospitalization
- highly contagious
- 2 vaccines: administered orally, rotateq 3 doses, rotarix 2 doses
- cont. ind.: allergy to previous immunization or latex
- precautions: moderate to severe illness, gastroenteritis, pre-existing gastrointestinal disease
34
pertussis
- incubation: 6-20 days
- communicable: presence of resp. secretions
- source: discharge from rep. tract of infected person
- transmission: droplet, direct contact, indirect contact with freshly contaminated objects
- course:
- catarrhal stage: 9-14 days, mild fever, headache, anorexia, persistent couch with tearing
- paroxysmal- 14-28 days, flushed face, cyanosis, dyspnea, lymphocytosis
- convalescent: 21 days, cough and vomiting less
35
roseola
- agent: human herpes virus type 6
- incubation: 5-15 days
- communicable period: unknown
- assessment: sudden high fever, rose pink macular rash, nursing care is supportive
36
- agent: paromyxovirus
- incubation: 10-20 days
- communicable period: 4 days before to 5 days after appearance of rash
- source: resp. tract secretions, blood, urine
- transmission: airborne particles, direct contact with droplets, transplacental
- assessment: cough, conjunctivitis, fever, malaise, red, maculopapular rash, KOPLIK'S SPOTS
- precautions: airborne droplet
Rubeola
37
- incubation: 14-21 days
- communicable: 7 days before to 5 days after appearance of rash
- source: nasopharyngeal secretions, blood, urine, or feces of infected person
- transmission: airborne or direct with droplets transplacental
- assessment: fever, malaise, pink red maculopapular rash, petechiae red, pinpoint spots on soft palate
- precautions: airborne, isolate from pregnant women
Rubella
38
etiology: hypersensitivity of tracheobronchial tree to various stimuli. Reactive airway disease. exposure to inhaled and occasionally ingested irritants, pollen, dust mites, mold
-extrinsic: allergic
-intrinsic: non-allergic
-IgE mediated Type I hypersensitivity
Clinical manifestations: episodic wheezing, chest tightness (worse at night), prolonged expiration, airtrapping, dyspnea, fatigue
asthma
39
asthma dx tests
```
CXR: hyperinflation of lung
CBC: increased eosinophils
Sputum: increased eosinophils
Serum theophylline levels
PFT: forced expiratory volume decreased
ABG's
```
40
asthma long-term control meds and quick relief meds
- long term: inhaled corticosteroids, inhaled long-acting beta2-agonist, leukotriene modifiers, mast cell stabilizers, theophylline
- Quick relief measures: inhaled short-acting beta2-agonist
41
emphysema patho
decrease a1-antitrypsin activity-->destruction of elastic tissue-->destruction of alveoli-->impaired gas exchange
42
ABG normals
```
ph: 7.35-7.45
PCO2: 38-42
PO2:80-100
HCO3: 24-21
Base excess/deficit: + or - 2
```
43
adenoiditis
- stertorous breathing: snoring, nasal quality speech
| - pain in ear, recurring otitis media
44
bronchiolitis/RSV clinical manifestations
tachypnea, tachycardia, wheezing, crackles, rhonchi, intercostal and subcostal retractions, cyanosis, difficulty feeding
45
risk: smoking, chronic disease, impaired immune status
- manifestations: 2-10 days post-exposure, fever, dry cough, malaise, weakness, arthralgia, lethargy, CNS and GI symptoms, pneumonia and hyponatremia, diarrhea, confusion
legionare's disease
46
common type 1 clinical manifestations
lethargy, stupor, weight loss, Kussmaul breathing (hyperventilation), smell of acetone, nausea, vomiting, ABD pain
47
Diabetes Mellitus dx
- fasting BG>126
- casual BG>= 200
- oral glucose tolerence test>200
- glycosylated hemoglobin (A1C or HbgA1c) > = 6.5%
48
neuropathy patho
hyperglycemia-->increased intracellular sorbitol interferes with ion pumps-->schwann cell damage-->decreased conduction velocity
49
hypoglycemia description
mild: 40-60
mod: 20-40
severe: less than 20
- "insulin reaction" occurs when BG falls less than 70
- caused by too much insulin or oral hypoglycemic agent, too much exercise, too little food
- treatment: (mild) 15 gm CHO
- if unconscious: 0.5-1.0 mg glucagon
50
difference between primary and secondary immune response
- primary: 1st exposure to antigen, latent period
| - secondary: rapid production of large amounts of antibodies. Immediate response, may last for several years
51
- initiated when antigen binds with the antibody receptors on the surface of the mature B cell
- triggers a sequence of events that results in production of plasma cells that secrete antibodies (immunoglobulin molecules) IgM, IgA, IgD, IgG, IgF
humoral immune response
52
total 24 hour chest tube drainage
500-1000 drainage
| avg: no more than 100 during 1st 3 hrs. post op.
53
most vaccine are give IM, but ____, ____, & _____ are sub Q
IPV, MMR, Varicella
54
stage 2 HIV infection
- no aids defining condition &
- CD4+ T-lymphocyte count of 200-499 cells OR
- CD4+ T-lymphocyte percentage of total lymphocytes of 14-28%
55
stage 1 HIV infection
- no aids defining condition &
- CD4+ T-lymphocyte count of > or = 500 cells OR
- CD4+ T-lymphocyte percentage of total lymphocytes of > = 29%
56
insoluble A-A complexes deposit primarily in ____?
vessels, kidneys, joints, & heart (type III immune complex disorders)
57
clinical course typical, rapid, slow (HIV)
- typical: aids develops 10-12 years after infection
- rapid: aids develops less than 5 years from infection
- slow: aids develops 15 years or more after infection
58
potent vasodilator, increased cap permeability, contraction of bronchial smooth muscle, dilation of the small blood vessels
Histamine (H1)
59
increased gastric acid secretion, decreased release of histamine from mast/basophil cells
Histamine (H2)
60
attract neutrophils and eeosinophils
Chemotactic factors
61
- reaction of humoral response system
- responses are immediate and may be life threatening
- reaction may occur within 15-30 minutes of exposure
type I hypersensitivity
62
inflammatory vs. immune
inflammatory (innate): non-specific, first line of defense, immediate, passive (antibody transfer), active (immunizations)
-imune (adaptive): specific, sustained, antibody or cell mediated, natural, passive (maternal), active (infection)
63
when resented with an antigen, helper T-cells produced signaling substances such as interferon, interleukin, and tumor necrosis. Inflammation and other body activities are promoted
cell-mediated immune response
64
- antigen-recognition by T-cells, macrophages
- immunity against pathogens that live inside cells (viruses)
- fungal infection
- rejection of transplanted tissues
- contact hypersensitivity reactions
- tumor immunity
cell-mediated immunity
65
factors impacting immune response
- stress
- chronic illness
- exercise
- increased IgG and IgM
- nutrients: Vit A, C, D, E, B6, folate, B12, copper, selenium, and zinc
- ginseng ist thought to boost immune system
- yogurt
66
systemic (anaphylactic) vs. local (atopic)
*both are type I reactions
Systemic: ingestion or injection of the antigen. Generalized response of hypotension, respiratory distress, GI cramping, hives, itching, angioedema
Local: allergic rhinnitis, some food allergies, allergic dermatitis, asthma
67
second exposure
antigen binds with the IgE-->degranulation of the mast cell or basophil-->release of allergy producing mediators-->histamine and chemotactic factors
68
clinical progression of HIV infection
Primary: "widow period", contagious, acute seroconversion illness, HIV antibody will test negative
Latent phase: asymptomatic and symptomatic, gradual CD4+ count drop
AIDS: overt symptoms of immunodepression, CD4+ count <200 &/or an AIDS defining illness
69
stage III HIV infection
AIDS: CD4+ T-lymphocyte count <200 or percentage total lymphocytes of 14% or documentation of AIDS defining condition
70
Diphtheria
incubation: 2-5 days
communicable: 2-4 weeks
source: discharge from mucous membranes, skin, other lesions
transmission: direct contact with infected person, carrier, contaminated objects
71
diphtheria pt. centered care
risk for transmission: droplet precautions, administer diphtheria antitoxin, administer antibiotics
72
inactivated polio vaccine
sub Q, given @ 2 months, 4 months, 6-18 months, 4-6 years
| contraindicated: allergy to previous immunization or vaccine component
73
varicella
incubation: 13-17 days
communicable: 1-2 days before rash, 6 days after 1st crop of vesicles when crust have formed
source: resp tract secretions of infected person, skin lesions
transmission: direct contact, airborne droplet, objects
assessment: macular rash, slight fever, malaise, anorexia
* droplet and contact precautions (isolation)
74
fifth disease
agent: human parovirus B19
incubation: 4-14 days
source: infected person
transmission: unknown, possibly respiratory and blood
assessment: 3 stage rash, slapped appearance 1-4 days, macular papular rash on extremities 7 days or more, rash subsides but may reappear to stressors
75
Slapped face appearance, macular papular rash starting on extremities
fifth disease
76
acid/base pneumonic
```
ROME
Respiratory
Opposite (ph up, PCO2 down: alkalosis)
(ph down, PCO2 up: acidosis)
Metabolic
Equal (ph up, HCO3 up: alkalosis)
(ph down, HCO3 down: acidosis)
```
77
chronic bronchitis clinical manifestations
"Blue Bloaters"
- productive cough
- frequent resp infections
- early dyspnea on exertion (DOE)
- wheezes and crackles
- hypercapnia
- hypoxemia
78
chronic respiratory acidosis with metabolic compensation, PaCO2>50
hypercapnia
79
cyanosis, pulmonary HTn and Cor Pulmonale, increased erythropoietin: secondary polycythemia
-PaO2<60
hypoxemia
80
compare bronchitis and emphysema
Bronchitis: inflammation and structural changes, increased mucous (bronchioles)
Emphysema: destruction and enlargement of air spaces (alveoli)
81
chambers of chest tubes
1. collects fluid draining from pt.
2. water seal prevents air from re-entering pleural space
3. suction control system
82
trachea position child & adult
- bifurcation in children @ T3 level, right mainstem bronchus has steeper slope than adults
- bifurcation in adults is at T6 level
83
eustachian tube in children
position is at less of an angle (more horizontal) in the young child, resulting in decreased drainage
-end of eustachian tube in nasal pharynx opens during sucking
84
nasopharyngitis young child vs older child
young child: fever, sneezing, vomiting, diarrhea
| older child: dryness and irritation of nose/throat, sneezing, aches, cough
85
pharynitis young child vs older child
young child: fever, malaise, anorexia, headaches
| older child: fever, headache, dysphagia, abd pain
86
tonsilitis
masses of lymphoid tissue in pairs
- often occurs with pharyngitis
- characterized by fever, dysphagia, or respiratory problems forcing breathing to take place through nose
87
otitis media with effusion
inflammation of the middle ear in which a collection of fluid is present in the middle ear space
88
chronic otitis media with effusion
middle ear effusion that persists beyond 3 months
89
acute otitis media
a rapid and short onset of signs and symptoms lasting approx. 3 weeks
90
antibiotic for otitis media
oral amoxicillin
91
croup
- hoarseness, resonant cough, "barking" or "brassy"
- caused by swelling or obstruction in the region of the larynx
- usually described according to primary anatomic area affected ex: laryngitis, laryngotrachiobronchitis (LTB)
92
croup vs. epiglotitis
croup: VIRAL, fever, hoarseness, resonant cough, inspiratory strider, risk for significant narrowing airway with inflammation, humidity for treatment
epiglotitis: BACTERIAL, high fever, rapidly progressive course, dysphagia, drooling, dysphonia, distressed inspiratory efforts, antibiotics needed
93
bronchitis vs. bronchiolitis
bronchitis: excess mucous narrows airways
bronchiolits: excess swelling of bronchiole walls narrows airways
94
bronchiolitis/RSV
- rhyno syncytial virus
- 2-6 month olds
- infection of bronchial mucosa leading to obstruction
- starts out with upper respiratory infection and progresses to respiratory distress
- diagnosed with RSV wash
95
bronchiolitis/RSV meds
- bronchodilators
- steroids
- Beta-antagonists
- antiviral: virazole
- sunagis and RespiGam are prevention drugs
96
"glucose intolerance"
- fasting BG >126
- disorder of endocrine pancreas
- deficiency of insulin secreted by the beta cells of the islet of Langerhaus OR defective insulin receptors, early destruction of insulin
diabetes mellitus
97
- absolute insulin deficiency
| - autoimmune mediated specific loss of beta cells in the pancreatic islets
Diabetes type 1
98
- fasting hyperglycemia despite availability of insulin
- impaired release of insulin, inadequate or defective insulin receptors increase hepatic glucose production
- increased resistance to action of insulin
- impaired suppression of glucose production in liver, increasing circulating FFA's
diabetes type 2
99
-increased free fatty acids?
- insulin resistance in peripheral tiddue leads to inhibition of glucose uptake and storage of glycogen
- increased liver FFA's-->decreased sensitivity to insulin-->increased glucose production-->stimulation of B cell-->B cell exhaustion
100
metabolic syndrome dx requires?
1. abdominal obesity: men >40 inches, women> 35 inches
2. Triglycerides >=150
3. decreased HDL: men 130/85
5. Fasting Plasma Glucose >100
101
hemoglobin A1C reference values
1. 9%, poor diabetic control
102
- severe insulin deficiency-->hyperglycemia, glycosuria, increased lipolysis
- etiology: severe stress (release of counter regulatory hormones), cortisol, epi, glucagon
- infection
- pregnancy
Diabetic Ketoacidosis
103
Hyperglycemic, Hyperosmolar, Nonketotic Coma/Syndrom (HHNK/S)
- Type 2 DM
- severe hyperglycemia>600
- etiology: incresed insulin resistance, excessive CHO intake
104
diabetes hypoglycemia
- BG <50-60
- neuro: headache, vague feeling of abnormal sensorium, difficulty w/problem solving
- SNS activation: sweating, shaking, paplitations, tachycardia
105
specificity
- reaction to one antigen
- different immune response for each different antigen
- antigen specific antibody production
106
memory
long-lasting protection, residual set of cells that are specific to an antigen remain in the body
107
- inflammation of lung parenchyma
- bacterial, viral, fungal, protozoan, lung infection
- community acquired vs. hospital acquired
pneumonia
108
clinical manifestations acute bronchitis
non-productive--> productive cough, clear or purulent, lasts 10-20 days. Wheezing, dyspnea on exertion, fever, chills, malaise, headache
109
reversible inflammation of the mucous membrane of the trachea bronchial tubes, and bronchioles resulting from respiratory tract infection, usually viral.
acute bronchitis
110
influenza antiviral drugs
tamiflu, relenza, symmetrel, glumadine, tylenol, nsaids, antitussives
111
- infant upright during bottle feeding and breastfeeding: no popping of bottles
- avoid use of pacifiers
- recognize initial signs
- eliminate tobacco smoke and known allergens from environment
otitis media prevention
112
otitis media when to call the doctor
decreased hearing, increased drainage, pain bleeding, fever
113
inflammation of the middle ear without reference to etiology or pathogenisis
otitis media
114
post op T/A surgery most obvious sign of early bleeding is?
- the childs continuous swallowing of trickling blood
| - when child is sleeping, note frequency of swallowing and notify surgeon immediately
115
key to understanding prevention of URI
meticulous handwashing and avoiding exposure to infected persons
116
atelectasis
collapse part or all of a lung
117
hypercapnia aka hypercarbia
excess carbon dioxide in the blood
118
hypoxemia
a low level of oxygen in the blood
119
hypoxia
reduction in oxygen supply to the tissues
120
kyphotic spine
dowager hump
121
barrel chest
1:1 ratio of depth and width vs. the normal 2:1
122
- sweat chloride test
- autosomal recessive disorder of chromosome 7
- clinical course: slow progressive decline, respiratory, pancreatic:diabetes
- complications: respiratory infection
cystic fibrosis
123
-6-12 months age at dx: recurrent resp. infections, malabsorption, failure to thrive
Resp: persistent cough, frequent pulmonary infections, barrel chest, clubbing of the fingers
GI: oily stools, malnutrition
cystic fibrosis
124
"pink puffers"
-early dyspnea, thin, barrel chest, increased lung capacity and residual volume, diminished breath sounds
etiology: antitrypsin deficiency (autosomal recessive), smoking, aging, air pollution, recurrent infection
characterized by: abnormal enlargement of the alveoli and alveolar ducts, destruction of alveolar walls, loss of elasticity, hyperinflation of lungs
emphysema
125
- chronic excessive mucous production, chronic inflammation
- hypertrophy of bronchial mucosal glands
- goblet cells increase in number and size
- loss of cilia
- altered function of alveolar macrophages
chronic bronchitis
126
varicella vaccine contraindicated ?
contraindicated for pregnancy, allergy, immunodeficiency
127
agent: group A beta-hemolytic streptococci
incubation: 1-7 days
communicable: 10 days during incubation period and clinical illness, during 1st 2 weeks of carrier stage
transmission: direct contact with person or droplet, contaminated objects, ingestion of contaminated milk, or other foods
assessment: high fever/flushed cheeks, vomiting, enlarged lymph node, red-fine sandpaper-like rash, desquamination sheet-like sloughing skin, white strawberry--> red strawberry tongue, tonsils & pharynx enflamed
scarlet fever
128
- 2 doses, 12-15 months, then kindergarten.
- if no record, 11-12 year old visit
- contraindicated: allergy, pregnancy, known immunodeficiency
* postpone 3-6 months if child received immunoglobulins
MMR vaccine
129
agent: enterovirus
incubation: 7-10 days
communicable: unknown
source: direct contact with oral pharyngeal or fecal
transmission: direct contact
symptoms: soreness and stiffness of trunk, neck, limbs, CNS paralysis
precautions: enteric, *resp status is huge in the individuals
Polio
130
- Administered via IM route
- 3 dose series: birth, 1-2 months, 6-18 months
- infant of HBsAG+ mother: receive within 12 hrs of brith
- tested for antibody after series completion
Hepatitis B Vaccine
131
prodromal
how long is the disease process (s/s) going to last
132
incubation period
between invasion of organism to signs and symptoms
133
premature infants and vaccines
- receive full dose at same chronological age
- contraindicated: significant febrile seizure, active seizure disorders, encephalopathy (DTAP)
- infants with congenital heart and premature infants immunization agains RSV
134
IM vs SubQ needle gauge and length
IM: 25 gauge (can be 22), 1" (can be 1 1/2)
SubQ: 25 (can be 22), 5/8"
135
Stage 4 HIV
- confirmed HIV
| - no information available on CD4+ T-lymphocyte count or % and no information available on AIDS defining conditions
136
AIDS clinical manifestations
- HIV wasting syndrome: fever, diarrhea, weight loss
- generalized lymphaenopathy
- opportunistic infection
- malignancy
137
CD4+ T-lymphocytes (T-Helper cells, T4 lymphocytes)
- cell mediated immunity
- production of immunoglobulins and activation of T cells and macrophages
- normal CD4+ 800-10,000
138
2 strands of viral RNA, 3 enzymes: reverse transcriptase, integrase, protease
HIV
139
Host vs. Graft types
Hyperacute: minutes to hours
Acute: usually within 1st six months
Chronic: ongoing
140
Host vs Graft disease
- aka "rejection"
- immune response to transplant tissue
- rejection of the transplanted organ by the recipients immune system
141
- genetic pre-disposition
- gender (female: estrogen)
- failure to delete auto-reactive T or B cells
mechanism of autoimmunity
142
failure of the immune system to differentiate from non self
- formation of auto-antibodies
- failure of T-cells to recognize self
autoimmune disorders
143
excessive immune response
autoimmune disease: failure of the body to recognize it's own HLA. Antibody production against self. SLE, rheumatoid arthritis, scleroderma
Hypersensitivity/Allergic Response: Excessive response to an antigen. Type 1-IV response
144
act as messengers between t cells, b cells, monocytes, & neutrophils
cytokines
145
acquired passive immunity
- introduction of serum with antibodies
- temporary because no direct stimulation of person's immune response
- gamma globulin to prevent hep A
146
acquired active immunity
- naturally acquired: result of immune ststems response to foreign substance. Most durable if developed during disease
- artificially acquired: immunization, vaccines, toxoids
147
natural immunity
- not produced by immune response: present at birth
| - mother's antibodies pass through placenta to fetus
148
oral hypoglycemics
- used to treat type two
| - glucophage (metformin) is drug of choice
149
most common cause of end stage renal disease. Hyperglycemia along with HTN-->destruction of nephrons
nephropathy
150
retinopathy
microaneurysms in the retinal arterioles-->hemorrhage-->scaring-->blindness
