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53 Cards in this Set
- Front
- Back
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Why does innate immunity dec with age?
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Disregulation occurs with age
Skin thinner, dec'd acidity in GI tract More shallow breathing = urine less acidic and more bone to UTI Phagocytes dec function Interferon production decreases |
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Why does acquired immunity dec with age?
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Dec'd size of thymus gland (50 yo = 5-15% normal size and by age 60 = no detectable thryoid homrone)
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Why does susceptibility to cancer and infection inc with age?
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Number of circulating T cells dec with age
Sepcific AB response to antigenic challenges dec's 50-85% and you have inc'd number of auto antibodies |
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Nutritional status and immune fxt
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Dec in calories, protein, Vit A, E will dec immune function
Zine is imp component of T and B cell fxt |
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Medication and chemo affect of Immune system
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Side effects of chemo will suppress blood cell formation in the bone marrow, which will have immunosupressant effects
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Surgery and anesthesia affects on immune system?
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Dec T and B cell function for one month post-op
Why we must be careful of pt coming out of surgery |
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Burn patients affect on immune system
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Dec external defenses
Dec cell mediated immunity and humeral response Blood serum contains non-specific immunosuppressive factors Effects of stress can lead to compliations |
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Exercise effecs on immune system
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Mod ex imporves immune system's ability to fxt
Strenuous ex knocks down immune system for 4 weeks or so |
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Primary immunodeficiency dx
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Defect involving T or B cells, or lymphoid tissue
95 of em' |
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Examples of secondary immunodeficiencies
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Leukemia, hodkin's dx, viral infections
Alcoholism, DM, cancer Iatrogenic causes: immunosuppresant drugs, radiation, spleneectomy |
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How do immunosuppresant drugs specifically affect immune system?
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Cytotoxic drugs will kill immunocompetent cells by interfering with lymphocyte sytem and release of immunoglobulins
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Affect of corticosteroids
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Block tissue infiltration by neutrophils and monocytes
Interference with T cell production in bone marrow Inhibits immunoglobulin synthesis and prevents immunoglobulins (B cell receptors) from binding to antigen |
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Affects of cyclosporin
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Used post-transplant
Selectively suppress proliferation and development of helper T cells |
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Antilymphocyte serum
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Reduce t cell number and function
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Total Nodal Irradiation
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Cytotoxic to most lymphocytes
Used to treat Hodkin's dz or severe RA Maked you extremely immunocompromised |
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What happens to body flora when immunocompromised?
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Body flora becomes pathogenic and a source of infection
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What is HIV marked by?
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Essentially an infection of the immune system
Progressive destruction of Cell Mediated as well as changes in humeral immunity Elements of autoimmunity are evident |
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What does HIV result in?
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Opportuinistic infections and a variety of cancers
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Progression of HIV to aids
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Start off as asymptmatic zero positive HIV
Early symptomatic HIV Advanced HIV (full blown aids) progression to this level is due to a host of genetic and viral factors -Not everyone exposed to aids will contract it |
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Where are the majority of the bodies immune cells located
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GI tract--70-80%
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Are any viruses curable with medication?
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None
The best way to deal with viruses are vaccinations |
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How many new instances of HIV/year?
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40,000
Was 150,000 in mid 80s |
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Risk factors for HIV transmission
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IV drug use (1/2 of all cases)
Exchange of bodily fluids (esp. blood and semen) High risk behaviors (unproteced anal, oral, vaginal sex and ass to mouth) 6 or more sexual partners in the previous year Sexual activity with a known carrier Sex for money |
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Who are most likely to get HIV?
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Black females 4x more likely as white females secondary to inc'd IV drug use nd sex wit infected men
41% cases are from men having sex with men (gay) |
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Age range of most ppl diagnosed wiht AIDs
Teens? |
20-49
25% of STD cases (not jsut HIV) |
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What does probability of contracting AIDs inc with?
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Inc viral load of the infected person
If viral load < 1500 copies/mL, probability of transmission is minimal |
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Explain Asymptomatic stage
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Seroconversion occurs over first 3-6 weeks when virus replicated in blood
After a few months, very little of virus in blood and may see HIV ABs in serum |
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What does the HIV retrovirus destroy?
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Infects CD4 cells in the lymph and essentially kills them, which results in inactivation of T4 helper cells
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Direct and Indirect effect of HIV
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Direct: destruction of CD4 and neuro glial cels
Indirect: Massive immunodeficient effect |
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What happens what HIV progresses and now is capable of knocking down the immune system?
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Oportunistic infections
Unusual malignancies Autoimmunity type of dx processes (RA-like symptoms, lymphoid neumlocytis) Neurologic dysfxt - AIDs dementia, HIV encephalopathy, peripheral neuropathies |
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What type of neurologic dysfxt is common in AIDs?
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AIDs dementia
HIV encephalopathy Peripheral neuropathies |
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What is the significance of the fact that the HIV virse has a high mutation rate?
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Virus changes very quickly and body can't fight it
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3 stages of HIV/AIDs
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Asymptomatic stage: >500 CD4 cell/mm cubed
Early symptomatic stag: 200-500 CD4 cell/mm cubed AIDs: < or equal to 200 CD4 cell/mm cubed |
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Describe the asymptomatic stage of HIV
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Some laboratoy evidence of seroconversion
Some ppl will get acute, but self-limiting infections |
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Describe the early symptomatic stage of HIV
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Persisent and generalized adenopathy (swollen lymph noes)
Wt loss and fatigue Night sweats Neurologic s/s Opportunistic infections (Cetomegalovirus and Taxoplasmosis) |
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Two types of common opportunistic infections that occur in early symptomatic stage
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Cetomegalovirus, which may lead to peripheral neuropathy
Taxoplasmosis (parasitic dx) that affect CNS |
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Describe stage 3 of HIV: Full blown aids
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AIDs encephalopathy
Osteomyelitis Bacterial myositis HIV wasting (disproportionae loss of metabolically active tissue) HIV associated myopathy |
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Why is early detection of HIV important? Diagnosis tests?
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Get tx going right away and prevent dx from spreading
ELISA - enzyme linked immunosorbant assay Western Blot Test |
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What is Tx for HIV focuses on and what is the most common tx?
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Focused on CD4 count and viral load
Highly active retroviral therapy AZT = classic drug cocktail |
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What is AZT? What does it do?
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Retroviral therapy
Protease inhibitor, reverse transcriptas inhibitors Messes up ability for HIV to transcribe the HIV RNA into DNA |
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How good is the retroviral therapy? What will happen eventually?
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Suppresses HIV replication and it's gotten to the point that these drugs can reduce the HIV load to below detectable levels
BAD = ppl think they're cured and they become resistant to cocktail May develop various metabolic disorders = avascular necrosis, lactic acidosis, insulin resistant |
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Most likely cause of death wth AIDs?
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Kidney or liver failure
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CFIDS, what does it stand for and other names for it?
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Chronic Fatigue and Immune Dysfxt Syndrome (CFIDS)
AKA chronic fatigue syndrome, chronic epstein-barr virus, Yuppy flu, neuro myesthesis |
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What is CFIDS?
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Sore throat, mm pain, fever, weakness
Progresses: mm pain, forgetfullness, prolonged/overwhelming fatigue for greater than 6 months Affects 200 out of 100,000 Not a lot known about it No specific diagnostic confirmation or tx/cure 1/3 of ppl ge better in 5 years, 1/2 still have it after 10 years Thought to be related to some form of immune dysfxt |
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What is Type I hypersensitivity and what does it include?
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Immediate hypersensitivity, allergic disorders, anaphylaxis
Includes hayfever, allergic rhinitis, unticaria, anaphylactic shock |
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Explain how Type 1 hypersensitivity occurs?
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IgE istead of IgG produced in response to an allergen
This resides on mast cells and CT especially the upper resp tract, GI tract, and dermis IgE meets pathogen and there is an immediate histabmine release and the release of inflammatory mediators |
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Where does IgE reside?
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On mast cells and CT
Epecially URT, GI tract, and dermis |
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What happens in type 1 hypersensitivity if response becomes systemic?
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Wide spread release of histamine which results in sysemic vasodilation, bronchospasm, inc'd mucous scretions, edema, and anaphylaxis
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What is anaphylaxis and what type of hypersensitivity is it associated with? Causes?
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Life-threatning emergency which req's immediate injection of epi to resotre BP and open aireways
Bee stings, and penicillin, foods, animal dander, latex produces |
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What is Type II hypersensitivity?
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Cytotoxi reactions to self-antigens
Body's own tissue is recognized as foreign - results in activation of complemnt system, agglutination, and phagocytosis of "pathogn" |
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Explain type II hypersensitivity in regards to rheumatic fever or group A emolytic streptococci
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Cross reaction from exogenous pathways within endogenous tissues
They're attacked by immune system, but are similar to mitral valve, so body attacks mitral valve Attack normal tissue same way you attack invading pathogen b/c pathogen looks the same as endogenous tissue |
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What is Type III hyersensitivity?
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Immune Complex Disease
Occurs when circulating immune complexes deposit tissue around small BVs and activate the complement Causes acute inflamm and local tissue injry (vasculitis) or SLE |
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What is Type IV hypersensitivity?
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Cell mediated immunity
Delayed hypersensitivity response such as contact dermatitis or graft host dxin transplant rejection Antigen is processed by macrophages and presented to T cells Sensitized T cells release lymphokines which recruit other lymphocytes, monocytes,and macrophages |
