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VN 148 finals
| Question | Answer |
|---|---|
| IMMUNITY | the body's defense system against pathogens, other foreign agents and cancer cells. |
| ANTIGEN | a substance that stimulates the formation of antibodies |
| ANTIBODIES | are proteins which destroy antigens. Immunoglobins. |
| ANTIBODY TITER | the level of antibodies in the blood |
| ORGANS INVOLVED W IMMUNITY | bone marrow, thymus, lymph nodes, liver, spleen, tonsils/adenoids |
| CLASSIFICATION OF THE IMMUNE SYSTEM | non specific & specific immunity |
| NON SPECIFIC IMMUNITY | consists of FIRST LINE DEFENSE and SECOND LINE DEFENSE |
| FIRST LINE DEFENSE | skin, mucous membrane and secretions |
| SECOND LINE DEFENSE | phagocytosis, inflammation, fever,protective proteins and natural killer cells |
| SPECIFIC IMMUNITY | are the third line of defense. Consists of T lymphocytes (T cells), B lymphocytes (B cells) and macrophages |
| T LYMPHOCYTES | cell to cell attack; matures in thymus gland; form in stem cells and bone marrow; 70-80% of circulating lymphocytes |
| B LYMPHOCYTES | interract with antogen and creates antibody; residence in lymphoid tissue; 20-30% of circulating lymphocytes |
| MACROPHAGES | goes and gobble things up |
| TYPES OF IMMUNITY | genetic immunity and acquired immunity |
| GENETIC IMMUNITY | inherent immunity; inborn, innate or species immunity |
| ACQUIRED IMMUNITY | natural and artificial |
| ACQUIRED IMMUNITY - Natural | ACTIVE VS PASSIVE. Active - body fights off. PASSIVE - passed on by parent. |
| ACQUIRED IMMUNITY - Artificial | vaccination and injection of immunoglobulins |
| IMMUNOGLOBULINS | antibodies; proteins secreted by the B cells. Found in plasma. There are five major types found in human adults: IgG, IgA, IgM, IgE and IgD |
| VACCINES | antigen-bearing substances injected into a person in an attempt to stimulate antibody production. There are two types: killed or attenuated & Toxoid |
| IgA | found in high concentrations in the mucuous membranes, particularly those lining the respiratory passages and gastrointestinal tract, as well as in saliva and tears |
| IgG | the most abundant type of antibody, is found in all body fluids and protects against bacterial and viral infections |
| IgM | which is found mainly in the blood and lymph fluid, is the first to be made by the body to fight a new infection |
| IgE | which is associated mainly with allergic reactions (when the immune system overreacts to environmental antigens such as pollen or pet dander). It is found in the lungs, skin and mucuous membranes. |
| IgD | which exists in minute amounts in the blood, is the least understood antibody. |
| DISORDERS OF THE IMMUNE SYSTEM | allergic responses, autoimmune diseases, immunodefciency diseases |
| ALLERGIC REACTION TREATMENT | epinephrine, injection or cortisol |
| ANAPHYLAXIS TREATMENT | epinephrine, aminophylline, diphenhydramine, corticosteroids, dopamine, nebulized bronchodilator and oxygen |
| AUTOIMMUNE DISEASES | autoimmunity, people's T cells attack own body, cause extensive tissue damage and organ dysfunction and organ rejection. IE: thyroiditis, lupus, rheumatic fever, diabetes type I |
| AUTOIMMUNE DISEASES - TREATMENT | varies depending on the specific disease, tissue affected, & presenting symptoms. Corticosteroids & NSAIDs for inflammation. Immunosuppression therapy for autoimmune response. |
| IMMUNODEFICIENCY DISEASES | incompetent or deficient immune system. Congential or acquired |
| WBC DISORDERS OF THE IMMUNE SYSTEM: NEUTROPENIA | total #of neutrophils abnormally low, increasing risk of infection. Caused by decreased bone marrow production, chemotherapy, radiation therapy, certain drugs or an autoimmune reaction. Also by increased neutrophil utilization bec of overwhelming infectio |
| WBC DISORDERS OF THE IMMUNE SYSTEM: NEUTROPENIA - sites of infection | lung, blood, skin, urinary tract, GI |
| WBC DISORDERS OF THE IMMUNE SYSTEM: NEUTROPENIA - Goal | antibiotic therapy - support pt until pt's own wbc are available to fight the infection. It is important to minimize pt's exposure to infectious agents by instituting compromised host precautions |
| LEUKEMIA | cancer of the wbc; bone marrow produces too many immature wbc. Immature wbc leave pt at great risk for life-threatening infections. Factors: exposure to large doses of ionizing radiation or exposure to certain chem such as benzene, a compound found in gas |
| LEUKEMIA - s/s | fevers, night sweats, fatigue, paleness, tachycardia and tachypnea, petechiae or purpura, epistaxis (nose bleed), gingival bleeding, melena or menorrhagia, wt loss & swollen lymph nodes |
| LEUKEMIA - medical diagnosis | CBC w extremely high wbc, bone marrow biopsy |
| LEUKEMIA - medical treatment | chemotherapy, antibiotics & blood transfusions |
| HYPERSENSITIVITY REACTIONS | exaggerated immune responses that can be uncomfortable and harmful to the pt. |
| HYPERSENSITIVITY REACTIONS - types | classified accdg to the time between exposure and reaction, immune mechanism involved, and site of reaction |
| HYPERSENSITIVITY REACTIONS - TYPE 1 | immediate hypersensitivity reactions are mediated by IgE reacting to common allergens, such as dust, pollen, animal dander, insect stings or various drugs. Either local, resulting in local swelling & discomfort, or systemic resulting in anaphylaxis |
| HYPERSENSITIVITY REACTIONS - TYPE 2 | are mediated by antibody reactions; can occur with a mismatched blood transfusion or as response to various drugs |
| HYPERSENSITIVITY REACTIONS - TYPE 3 | result in tissue damage resulting from precipitation of antigen-antibody immune complexes. Can occur with autoimmune reactions, some occupational diseases, or as response to various drugs |
| HYPERSENSITIVITY REACTIONS - TYPE 4 | delayed- results from immune cells migrating to the site of exposure days after the eposure to the antigen. Can occur with contact dermatitis, measles rash, tuberculin skin testing or various drugs |
| IDIOPATHIC THROMBOCYTOPENIC PURPURA (ITP) | IgG mistakenly helps destroy pt's platelets. DRUGS that induce ITP: sulfonamide, thiazide; TREATMENT: steroids and IVIG intravenous immune globulin |
| THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP) | exaggerated immune response to vessel injury that results in extensive clot formation and decreased blood flow to the site. Pts critically ill; develop fever, etc. MAIN TREATMENT: plasmapheresis. Others: steroids, antiplatelet agents, splenectomy |
| SYSTEMIC LUPUS ERYTHEMATOSUS | autoimmune disease: immune system unable to recognize itself; mounts an immune response against its own proteins |
| SYSTEMIC LUPUS ERYTHEMATOSUS S/S | fatigue, malaise, fever, joints are swollen, |
| STAGES OF HIV INFECTION | INITIAL STAGE, LATENT STAGE & THIRD STAGE |
| INITIAL STAGE OF HIV | lasts 4-8 wks. High levels of virus in blood, generalized flu like symptoms |
| LATENT STAGE OF HIV | lasts 2-12 yrs. Virus is inactive. Levels are high in the lymph nodes but low in the blood |
| THIRD STAGE OF HIV | lasts 2-3 yrs. Pt experiences opportunistic infections. TH CD4 cells are usually <500 cells/mm. viral levels in the blood increase. AIDS = CD4 cell levels drop <200 cells. This stage ends in death, usually within a yr. |
| S/S LATENT stage | may have no symptoms initially. Fever, night sweats, swollen lymph nodes, headache, skin lessions, sore throat, dypsnea, burning w urination, diarrhea. Extreme fatigue and wt loss. |
| OPPORTUNISTIC INFECTIONS | when CD4 cells, CD8 cells and HIV antibodies fall below normal, infections and cancers take advantage and cause infection or cancer in the body. Causes: parasites, fungi, bacteria, viruses. Leading cause of death with AIDS is PNEUMONIA |
| PARASITIC INFECTIONS - CRYPTOSPORIDIOSIS & ISOSPORIASIS | fairly common; watery diarrhea. Nursing care: prevent dehydration and maintain fluid electrolyte balance. |
| PARASITIC INFECTIONS - TOXOPLASMOSIS | cats, mammals and birds serve as host. Can become infected by ingesting contaminated, undercooked meats or vegetables or by contact with cat feces. Affect any tissue; mainly brain lungs, eyes. Most common immunosuppressed pts. |
| FUNGAL INFECTIONS - MICROSPORIDIOSIS | source is unknown. Watery diarrhea w wt loss, malabsorption, abd cramps and flatulence. No curative therapy; treat the symptoms. |
| FUNGAL INFECTIONS - PNEUMOCYSTIS JIROVECI PNEUMONIA | acquired by inhalation; 2nd leading cause of death in AIDS pts. Cysts prevent the exchange of gases. SOB on exertion, fever and a nonproductive cough. Treated with Bactrim, dapsone, clindamycin and pentamidine |
| FUNGAL INFECTIONS - ASPERGILLOSIS | lives in soil, water and air. Pulmonary infection can develop when spores are inhaled. Causes fever, cough, dyspnea, chest pain and hemoptysis. Usually fatal w/in 8 wks. Avoid wet, cool places; decreases risk of infection. |
| FUNGAL INFECTIONS - CANDIDIASIS | found in most foods, soil and inanimate objects. Approx 80% of HIV pts will develop. Affects the mouth, vagina and or anus. THRUSH: oral form of this. Plaques can be scraped off. |
| FUNGAL INFECTIONS - COCCIDIOIDOMYCOSIS | endemic in the southwestern US and N mexico. Particles inhaled into the lungs. Fever,wt loss,fatigue, dry cough or pleuritic chest pain. Dissemination to the other organs may occur. Shld avoid exposure to disturbed soils in endemic areas. |
| FUNGAL INFECTIONS - CRYPTOCOCCOSIS | most common systemic fungal infection in AIDS pt. symptoms appear approx 30 days after exposure. Fever, h/a, malaise, nausea, vomiting, altered mental status, and a stiff neck. |
| FUNGAL INFECTIONS - HISTOPLASMOSIS | endemic in the C & S US. Found in soil and bird droppings. Involves the lungs after spores are inhaled, then can be disseminated to the other organs. Fever, night sweats, wt loss, and shortness of breath. Avoid cleaning bird cages to prevent infection. |
| VIRAL INFECTION - CYTOMEGALOVIRUS (CMV) | found in semen, cervical secretions, saliva, urine, blood and organs. Mainly transmitted by blood and body fluids through unprotected sex, complications include chrorioreitnitis, radiculopathy, subacute encephalitis, colitis, esphagitis, and pneumonia |
| VIRAL INFECTION - HERPES SIMPLEX (HSV) AND HERPES ZOSTER (HZV) | reactivated HSV in HIV pts can cause serious disease and tissue destruction. HSV infection follows predictable pattern. Most pts carry HZV bec of exposure to chicken pox as a child. Reactivation of HZV occurs as SHINGLES. |
| VIRAL INFECTION - ORAL HAIRY LEUKOPLAKIA (OHL) | thick, white patches on the buccal mucosa, soft palate, floor of mouth and tongue. Assoc with Epstein-Barr virus. More common amongst smokers. Mouth is painful. |
| VIRAL INFECTION - MULTIFOCAL LEUKOENCEPHALOPATHY | caused by Jamestown Canyon virus. Develps on 2% or 4% of AIDS pts. Progressive degeneration of white matter of brain. Death w/in 4-6 mo after onset of symptoms. S/S weakness & progressively impaired speech, vision, & motor function. NO effective treatment |
| BACTERIAL INFECTION- BACILLIARY ANGIOMATOSIS (BA) | causes skin lession, may affect any organ. Transmitted by cats and their fleas due to bite or scratch. Papules/plaques occur anywhere on the skin. Advise HIV pts to avoid rough play with cats and make sure they are treated for fleas. |
| BACTERIAL INFECTION- MYCOBACTERUM AVIUM COMPLEX (MAC) | found everywhere, including most food, animal & soil sources. May affect any organ of the body. Causes fever, fatigue, wt loss, night sweats, abd pain and diarrhea. NOT Contagious. |
| BACTERIAL INFECTION- MYCOBACTERIUM TUBERCULOSIS (TB) | HIV pts much more likely than a healthy person to become infected with TB if exposed, especially when CD4 counts drop below 200 |
| KAPOSIS SARCOMA | common neoplasm that develops with AIDS. Affects skin first, appers as macular painless, nonpruiritic lesion. Color varies: pink, red, purple & brown. TUMORS SPREAD TO GI SYSTEM & LUNGS. Treat: observation, HAART, surgical removal, cryo/radio/chemotherapy |
| LYMPHOMAS | a type of cancer that originates in lymphoid tissue: bone marrow, spleen, thymus gland. Two types: hodgkin's and non hodgkins. 2nd most common malignancy in AIDS pts. Causes fever, night sweats, wt loss. Diagnosis based on a biopsy of lymphoid tissue. |
| MEDICAL DIAGNOSIS OF HIV | POSITIVE HIV ANTIBODY TEST: ELISA (done first, 99% reliable) and WESTERN BLOT - used as confirmation test. |
| AIDS DIAGNOSIS | CD4 COUNT OF <200 cells/mm3; asymptomatic, with category B symptoms and category C symptoms regardless of CD4 count. |
| MEDICAL TREATMENT: HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) | recommended for HIV viral load of 5000-30,000 copies/mL and CD4 counts. Usual drug combination: 1 protease inhibitor and 2 nucleoside reverse transcriptase inhibitors. GI upset common; reason for noncompliance. May S/E;usually subside in a few wks. |
| 7 cancer warning signs - CAUTION | Change in bladder or bowel habits; A sore that does not heal; Unusual bleeding or discharge; Thickening or lump in breast or elsewhere; Indigestion or difficulty swallowing; Obvious change in a wart or mole; Nagging cough or horseness |
| BENIGN TUMORS | relatively harmless, primarily because they do not spread to other parts of the body. They can create pressure on or obstruct body organs. Surgical removal is recommended |
| MALIGNANT TUMORS | they can invade nearby tissues or dispearse cells to colonize distant parts of the body |
| METASTASIS OF MALIGNANT TUMORS | process by which cancer spreads to distan sites. Most common sites are LIVER, BRAIN, BONE and LUNGS. Once it has occurred, treatment is more difficult and less likely curative |
| CARCINOGENS | substances that damage cell DNA, causing normal cells to become malignant. IE: cigarette smoke, asbestos, nitrites and mercury |
| STAGING SYSTEM OF CANCER | TNM - tumor, n to regional lymph nodes and M to distant metastases |
| DISSEMINATED INTRAVASCULAR COAGULATION (DIC) s/s | normal clotting factor is exaggerated, which depletes clotting factors. Early signs: petechiae, ecchymoses, prolonged bleeding from venipuncture. Late signs: signs of vascular obstruction, tachycardia, dyspnea, GI bleeding, heart failure. Shock |
Created by:
jekjes
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