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141 Cards in this Set

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__________ Acquired Immunity: Results from invasion of the body by foreign substances:
Natural acquired: Clinical infection of chickenpox, measles etc.
Artificial acquired: Immunization with antigen such as live or killed vaccines
Active Acquired Immunity
__________ Acquired Immunity: Results from receiving antibodies to an antigen
Natural: Transplacental and colostrums transfer form mother to child

Artificial: Injection of serum from immune human (globulin)
____________: substance that elicits an immune response
Passive Acquired Immunity
Antigens:
_______________Phagocytes: responsible for capturing, processing, and presenting the antigen to the lymphocyte
Mononuclear
___ lymphocytes: Originate in bone marrow, differentiates into plasma cells: produce antibodies
B lymphocytes
___ lymphocytes: Migrate from bone marrow to thymus and differentiate into T-cells; 70-80% of circulating lymphocytes
T lymphocytes
____ cytotoxic cells: attack antigens at the cell membrane level.
T cytotoxic cells:
____________ and __________: involved in the regulation of cell mediated and humoral antibody response. Referred to as immunoregulatory cells
T helper(CD4)
T suppressor(CD8) cells
___________ killer cells: not T or B cells, they are large lymphocytes; involved in cell mediated immunity
Natural killer cells
soluble factors released by WBC’s and a variety of other cells in the body; act as messengers between cell types; instruct cells to alter their proliferation, differentiation, secretion or activity.
Cytokines
A virus invades the body through a break in the skin or another portal of entry. The virus must make its way _______ a cell in order to replicate itself.
inside
A ____________ recognizes the antigens on the surface of the virus. The _____________ digests the virus and displays pieces of the virus (antigens) on its surface.
macrophage
macrophage
A ________________ cell recognizes the antigen displayed and binds to the macrophage. This binding stimulates the production of cytokines (interleukin-1 [IL-1] and tumor necrosis factor [TNF]) by the macrophage and interleukin-2 (IL-2) and -interferon ( IFN) by the T cell. These cytokines are intercellular messengers that provide communication among the cells.
T helper cell
_________ instructs other T helper cells and T cytotoxic cells to proliferate (multiply). T helper cells release cytokines, causing B cells to multiply and produce antibodies.
IL-2
T cytotoxic cells and natural killer cells _________ infected body cells.
Destroy
The antibodies bind to the virus and mark it for ____________ destruction
macrophage
Once the virus is gone, activated T and B cells are turned off by suppressor T cells. ___________ B and T cells remain behind to respond quickly if the same virus attacks again.
Activated
Humoral Immunity: B lymphocytes produce antibodies, result in B memory cells; protect against bacteria, viruses (________cellular),

Examples :

Anaphylactic shock

Atopic diseases

Transfusion reaction

Bacterial infection
extracellular
Cell-Mediated Immunity: T lymphocytes, macrophages, produces sensitized T cells, lymphokines, results in T memory cells, protects against fungus, viruses (________cellular), chronic infectious agents, tumor cells

Examples:

Tuberculosis

Fungal infections

Contact Dermatitis

Graft rejection

Destruction of Cancer cells
intracellular
Immune System: __________ in immune system, more susceptible to cancerous tumors and infections
deline
Anaphylaxis is the ______ severe Type I reaction and can be fatal if not treated promptly. Persons with previous allergic reactions to medications, bee stings, foods, etc. are advised to wear Medic Alert bracelets & may need teaching regarding Epi pens. Bronchospasm, angioedema, and respiratory distress/collapse are immediate and life threatening concerns in anaphylaxis.
most
________ reactions: inherited tendency to become sensitive to environmental allergens. Examples: allergic rhinitis, asthma, atopic dermatitis, and urticaria.

Allergy testing may be necessary to determine the antigen causing the reaction. Persons undergoing allergy testing must be off systemic steroids, antihistamines, aspirin and NSAIDS for up to 5 days before testing. The nurse should be familiar with the scratch method and the interdermal method of allergy skin testing. Avoiding the offending antigen, treatment with drugs (decongestants, antihistamines, steroids, mast cell stabilizers, leukotriene antagonists), desensitization therapy (AKA allergy shots), and complementary therapy (honey ingestion, aromatherapy) may be useful in treating type I hypersensitivity reactions.
Atopic reactions
The body makes special antibodies to _____ the tissues with foreign protein attached. The antibody binds to the self cell and triggers the cell’s destruction.
kill
Hemolytic transfusion reactions: receives ________ blood type
wrong
___________________ syndrome: rare disease involving lungs and kidneys can result in pulmonary hemorrhage of glomerulonephritis.
Goodpasture syndrome
Type III: Immune-Complex Reactions: Immune complex reactions occur when immune complexes are formed because of ____________ antigens. The complexes are deposited in the small blood vessel walls of various organs and cause tissue damage. This is seen in many connective tissue disorders (rheumatoid arthritis). Serum sickness is a Type III reaction caused by injection of a foreign protein (penicillins, antitoxins) and is self limiting.
excess
Type IV: Delayed Hypersensitivity Reactions: Cause the T lymphocyte to release lymphokines and destroy the antigen. The process usually takes _______ days. Are examples of type IV reactions. It is important to find out the cause of the reaction and remove it. Benadryl doesn’t help since this is a cellular response without a histamine release. Exposure to poison ivy, oak or sumac should be treated with immediate removal of clothing, rinsing the skin with copious amounts of cool water (no soap), and washing the clothing in hot water/detergent as soon as possible.
Contact dermatitis: poison ivy etc
Microbial hypersensitivity reactions
TB skin testing
Local insect sting reactions
Transplant rejection
2-3 days
Types of transplant rejection:
Hyperacute: begins _____________ after transplantation. An antibody mediated response (antigen-antibody complexes form) because the body recognizes the transplant organ as non-self & begins coagulation, occlusion, ischemia, necrosis, and massive cell destruction. The transplanted organ is lost
immediately
Acute: begins __ week – 3 months after transplant and causes organ damage due to antibody mediated vasculitis and cell mediated cell lysis. Organ damage occurs but the client may not lose the transplanted organ if medications are successful at controlling the damage.
1 week
___________: occurs over time. ________ inflammation causes fibrotic scarring with non-functional tissue replacing organ tissue. Known as AGA (accelerated graft atherosclerosis) in heart transplant recipients, this is the major cause of death in clients surviving heart transplants for more than one year.
Chronic
Chronic
Skin Tests
Procedure:
_____________ scratch or prick
_____________ injection
Cutaneous
Intracutaneous
___________ response is an immediate immune response which helps the body fight against acute bacterial or viral infections..
Humoral
The body's delayed hypersensitivity response which involves autoimmunity and allergic reactions is called the_____________ response.
cellular
_______________ immunity is present at birth and is also referred to as innate immunity.
Natural
_____________ acquired immunity is transferred from mother to baby via antibodies in the placenta & breast milk or by injections with animal serum containing antibodies.
Passively
_______________ acquired immunity occurs when the body produces its own antibodies to protect against a disease producing antigen.
Actively
_____________ T Cells (also known as CD4 cells) stimulate the activity of other leukocytes by secreting lymphokines which stimulate immune function. These cell counts are lowered in H.I.V. disease.
Helper
_____________ T cells prevent continuous overreaction (hypersensitivity reactions) to antigens by secreting lymphokines which have an inhibitory action on the immune system cells.
Suppressor
_________________ T cells exert cytotoxic effects without undergoing a period of sensitization.
Cytotoxic
______________________ cells bind with an infected cell's antigen and causes the death of the infected cell to prevent the spread of the infection.
Natural Killer
______________ rejection occurs immediately after transplantation and is unstoppable. Caused by an antigen-antibody response, it is seen mainly in people with donated transplant organs with different ABO blood types, multiple blood transfusions during lifetime, multiple pregnancies, or previous transplant clients. A blood clotting cascade starts and the transplanted organ must be removed as quickly as possible.
Hyperacute
_________________ rejection occurs most commonly with kidney transplants and begins within one week to three months after transplant. Antibodies may cause organ vasculitis or cytotoxic T cells and NK cells may enter the organ and cause damage. The rejection does not mean the transplanted organ will die, medications to alter the immune response may limit damage to the organ.
Acute graft
______________ rejection leads to organ destruction by causing atherosclerosis, fibrosis, and scar tissue in the organ. This rejection is the major cause of death in heart clients. The cause is not clear but it is thought to be a chronic inflammatory response.
Chronic
________________ skin testing is the most sensitive form of allergy skin testing involving injecting a small amount of the antigen under the skin. It is more painful than other test methods and must be performed over several sessions if many allergens are suspected.
Intradermal
________________ skin testing involves scratching the surface of the skin then applying a drop of the suspected allergen on the area of the scratch.
Scratch
Physical barriers, chemical barriers, interferon, inflammation, and phagocytosis are components of the body's ______________ immune response.
non specific
The nurse understands that a positive skin test reaction to an allergen stimulates __________ antibodies which are responsible for hypersensitivity type I reactions and are also elevated in intestinal parasite infections.
IgE
Capable of neutralizing viruses and inhibiting bacterial attachment,____ is found in external body secretions.
IgA
_____________ is the major antibody in the body and is capable of crossing the placenta with its antibacterial, antiviral and antitoxin properties.
IgG
The first antibody produced when exposed to an antigen is _____________.
IgM
The function of ____________ is unknown but it is thought to function only on the surface of B cells for regulation.
IgD
Human Immunodeficiency Virus (H.I.V.) is a secondary immunodeficiency disease which attacks the T ________ lymphocytes
Helper
_________ immunodeficiencies are present at birth and include DiGeorge syndrome and severe combined immune deficiency (SCID).
Primary
All secondary immunodeficiencies are caused by H.I.V.(true/false).
False
____________ occurs about one to three weeks after exposure to H.I.V. Flu like symptoms with a reddened, diffuse rash are the only symptoms at this stage of H.I.V. infection.
Acute retroviral infection
Symptoms of H.I.V. disease, including fever, fatigue, night sweats, headache, diarrhea, and oral infections, do not begin to occur until the CD4 count dips below _______.
500
___________ H.I.V. disease occurs when the CD4 count falls below 50. CNS symptoms increase and mortality is high at this point.
Advanced
_____________ sarcoma and other dermatologic symptoms present in the client with late symptomatic H.I.V. disease.
Kaposi's
The most sensitive test for H.I.V. antibodies is the _________________.
Western Blot
Routine H.I.V. screening measures test for the virus in the blood (true/false).
False
H.I.V. transmission can be prevented by ______________.
education
"Cocktail therapy" (several antiretrovirals taken concurrently) can decrease the viral load in the client with H.I.V. infection. This treatment is called highly activated antiretroviral therapy or ______________.
HARRT
The time from exposure to H.I.V. to antibody production in the body is called the _____________ time.
seroconversion
_________ is a life threatening hypersensitivity reaction that rapidly and systemically affects multiple organs.
anaphylaxis
In ____________ disorders, antibodies and/or lymphocytes are directed against healthy normal cells and tissues..
autoimmune
___________ is a medication which competes for histamine at the histamine receptor site.
antihistamine
A drug which cuases vasoconstriction and reduces edema to increase comfort is a _________________.
decogestant
________________ decrease inflammation and immune response in a short time.
Corticosteriods
Immediate hypersensitivity reactions occur within minutes after an antigen combines with ______________.
IgE
_________________ include hemolytic transfusion reactions, and drug induced hemolytic anemias. Cell damage and destruction occur
Type II cytotoxic reactions
Penicillin, cephalosporins, and antitoxin from animal sera are the main causes of __________________.
serum sickness
__________ hypersensitivity reactions take at least 24 hours to manifest and include contact dermatitis, PPD testing for TB, and graft rejections.
Cell mediated
A __________ rash is a typical manifestation of systemic lupus erythematosus.
butterfly
Clients with systemic lupus erythematosus are advised to avoid ___________ to prevent symptom exacerbation.
ultraviolet light
Chronic fatigue syndrome has shown some improvement with the intravenous administration of __________.
immunoglobulin G
The cause of autoimmune hemolytic anemia is ________.
unknown
Diffuse scleroderma, an autoimmune collagen disorder, usually begins with _______________ of the fingertips.
Raynauds's phenomenon
Reducing or decreasing an aspect of the immune system's ability to respond to an antigen is called ________________.
immunosuppression
__________ immunosuppression uses repeated exposure to an antigen to help the body suppress the antibody response, as in allergy testing.
Antigen specific
Side effects of __________ administration include febrile reactions, serum sickness, and occasionally anaphylaxis.
Antilymphocyte serum
____________ affects both B cells & T cells to suppress the immune system. The mechanism of action is not understood.
Corticosteriods
A treatment which uses identical copies of an antibody reacting with a single, specific part of the antigen, _______ antibodies may be useful in the treatment of cancers.
monoclonal
Antigen specific treatments, antilymphocyte serum, monoclonal antibodies, steroids, chemotherapy, radiation, and surgical removal of the lymphoid tissue all fall into the general category of _____ therapy.
immunosupressive therapy
______________ is prescribed to relieve pain, fever and inflammation. It can cause gastrointestinal symptoms and ulceration if used for a prolonged period of time.
ibuprofen
Drugs used to prevent or treat infections caused by pathogenic microorganisms are called ______________ Monitoring of repsonse to treatment, toxicity, and side effects of this classification of drugs is very important.
antibiotics
___________ (the trade name for low molecular weight heparin) works the same as heparin and is used to preven thrombosis and DVT in the client with musculoskeletal injury. It is not necessary to montitor the activated partial thromboplastin time (APTT) with this medication. Administration precautions include avoiding aspiration in subcutaneous injection.
lovenox
_____________ relieve moderate to severe pain by reducing pain sensation, producing sedation, and decreasing the emotional upset often associated with pain. Often requiring additional nursing accountability procedures, this class of drug should be evaluated to assure adequate pain control upon administration. The client should also be monitored for problems with safety while under the influence of this medication.
narcotics
_____________ or Zyloprim is a uric acid synthesis inhibitor used in the client with gout to reduce the amount of uric acid delivered to the kidneys by inhibiting uric acid production. Clients on this medication must drink at least 2000 mL of water per day to prevent complications from this medication.
allopurinol
One drug used to decrease the bone reabsorption in women who have had ovaries removed or have undergone menopausal changes is ______________ . It is important to teach clients to perform breast self exams and undergo annual mammograms and pelvic exams due to the increase rates of breast and endometrial cancers while on this drug.
estrogen
_____________ , the generic name for Fosamax, is a drug which inhibits bone resorption by osteoclasts. Erosive esophagitis is a problem with this medication and clients are instructed to take the drug with a full glass of water before breakfast and remain upright (sitting, standing) for at least 30 minutes after breakfast.
alendronate
__________ is an intranasally or subcutaneously administered hormone used to inhibit osteoclastic bone resorption.
calcitonin
A simple, uncomplicated fracture which does not cause a break in the skin is called a __________ fracture.
closed
An ____________ or compound fracture involves trauma to surrounding tissue and breaks the skin.
open
An _____________ fracture is a partial, cross-sectional break with incomplete bone disruption.
incomplete
A _______________ fracture is a cross-sectional break of the bone, which severs the periosteum.
complete
______________ fractures produce several breaks of the bone and cause bone splinters and fragments.
comminuted
_________________ fractures break one side of a bone and bend the other.
greenstick
____________ fractures involve a fracture twisting around the shaft of the bone and are indicative of child abuse in the absence of a plausible history.
spiral
A fracture occuring straight across the bone is called ____________.
transverse
__________ fractures occur at an angle across the bone.
oblique
The acronym ___________ is used to describe the musculoskeletal care principles of rest, ice, compression, and elevation of the affected area.
rice
__________, a life-threatening systemic complication of a fracture usually occurs 24-72 hours after the fracture. Symptoms include personality changes, restlessness, dyspnea, crackles, white sputum, and petechiae over the chest and buccal membranes.
fat embolus
____________________ occurs when increased pressure compresses nerves and blood vessels. Symptoms include deep unrelenting pain, hard edematous muscle, decreased tissue perfusion and impaired neurovascular checks. Treatments might include cast bivalve or removal, fasciotomy, or dressing release.
compartment syndrome
The ______________ makes up most of the bone's length and is composed of compact bone.
diaphysis
______________ is a fibrous connective membrane that covers and protects the diaphysis.
periosteum
The ends of the long bone consisting of thin layers of compact bone enclosing an area filled with spongy bone is called the ______________.
epiphysis
____________ is vascular tissue located in the medullary cavity of long bones and flat bones..
bone marrow
Fixed joints (eg., skull sutures) are called ________.
synarthroses
Slightly movable joints (eg., vertebral joints) are called _______________.
amphiarthroses
Freely moveable joints (eg., mandible, ear ossicles) are called ________________.
diarthroses
The ______________ is a tough, fibrous sheath surrounding the articulating bone.
joint capsule
Strong, fibrous connective tissue binding bone and providing joint stability are called ______________.
ligaments
Strong, fibrous, nonelastic connective tissue extending from a muscle sheath and binding muscles to bones is called ________________.
tendons
_______________ is a nonvascular, supporting connective tissue composed of various cells and fibers which absorbs weight, shock, stress and strain to protect bones, joints and tissues.
cartilage
A test using radiation or photographic images to detect musculoskeletal structure, integrity, texture, or density problems and can evaluate disease progression is called _________.
roentgenography
A ________ detects skeletal trauma and disease by determining the degree to which the matrix of the bone "takes up" a bone-seeking radioactive isotope.
bone scan
____________ is injection of radiopaques substance or air into the joint cavity to identify acute or chronic tears of the joint capsule or supporting ligaments for the knee, shoulder, ankle, hip, or wrist.
arthrography
An ___________ allows analysis of synovial fluid, blood, or pus aspirated from ajoint cavity.
arthrocentesis
An injection of a contrast agent into the subarachnoid space of the spine to detect herniation, tumor, and congenital or degenerative conditions of the spinal canal is called a ___________.
myelography
______________ measures muscle electrical impulses for diagnosis of muscle or nerve disease.
electromyography
A ___________.(aspiration, punch, needle or incision) studies bone, synovium, or muscle tissue
biopsy
_____________ shows soft tissue, bone, and the spinal cord in three-dimensional, cross-sectional images..
computed tomography scan
CT scan
____________ allows study of soft tissue in multiple planes of the body
magnetic resonance imaging
MRI
_________ identifies anemias, hemorrhage, infections, neoplastic conditions, lupus, blood dyscrasias, allergies, stress, and other conditions.
CBC
_______ identifies increases in osteoblastic activity and inflammatory conditions.
alkaline phosphatase
___________ elevation may identify skeletal muscle necrosis, atrophy, or trauma.
creatinine phosphokinase
_____________ elevation may identify skeletal muscle damage.
lactate dehydrogenase
___________ helps identify problems with calcium availabilty, absorption, or distribution in the blood.
serum calcium
__________ is used to evaluate the severity and course of an inflammatory process such as a bacterial infection.
(C) reactive protein
A measurement of the antibody found in rheumatoid arthritis and connective tissue diseases is called _________________.
rheumatoid factor
The reduction and alignment of a fracture through a surgical opening is called an _________________.
open reduction
The stabilization of a reduced fracture using screws, plates, nails, or pins is known as __________.
internal fixation
A ___________ involves plaicing bone tissue in an area to facilitate healing, stabilization, or replacement.
bone graft
Joint repair through a small arthroscope to avoid a large incision is called _________.
arthroplasty
involves immobilizing a ___________ joint through fusion.
arthrodesis
______________ is the replacement of a joint surface with a metal or plastic prosthetic.
joint replacement
____________ is moving a tendon insertion site to improve joint function.
tendon transfer
___________ is the cutting of a tendon.
tenotomy
___________, the removal of muscle fascia, is performed to relieve constriction in the area.
fasciotomy
______________ involves aligning bone by removing a wedge of the bone.
osetotomy
Osteoarthritis

lNoninflammatory disorder of the diarthrodial (synovial) joints

lSlowly progressive

lMore than ___________ of adults are affected by age 40

lBefore age _______, men are more often affected than women

lIncidence of OA after 50 is twice as great in __________
90%
50
women
Rheumatoid Arthritis (RA)

A chronic, ___________ disease characterized by ______________ of connective tissue in the diarthrodial (synovial) joints

Typically have periods of _________ and exacerbation

Affects all ethnic groups

Can occur at any time of life

Incidence ↑ with age

__________ are affected 2 to 3 times more frequently then ________

___________ appears to be a link
inflammation
systemic
remission
women
men
smoking