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87 Cards in this Set
- Front
- Back
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List some effects of aging on the immune system:
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-increase incidences of tumors
- greater susceptibility to infections - thymic involution - decreased cell-mediated immunity - decreased delayed hypersensitivity rxn - decreased IL1 and IL2 synthesis |
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Exists when the body's immune system can ID and inactivate/destroy foreign substances
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immunocompetence
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When the immune response is overreactive against foreign antigens or fails to remain self-tolerance, resulting in tissue damage
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hypersensitivity reaction
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A type of hypersensitivity reaction that occurs when the body fails to recognize self-proteins and reacts against its own protein
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autoimmune disease
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Which types of hypersensitivity reactions are immediate and are examples of humoral immunity?
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Types I, II, and III
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What type of hypersensitivity reaction is delayed and is related to cell-mediated immunity?
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Type IV
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Which type of hypersensitivity reaction is anaphylxis? Which kind of antibodies are involved?
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Type I, IgE
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What are some examples of type I IgE-mediated reactions?
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allergic rhinitis
asthma anaphylaxis |
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What are some examples of type II hypersensitivity (cytotoxic) reactions that use IgG and IgM?
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transfusion reaction
goodpasture syndrome autoimmune thrombocytopenic purpura graves' disease |
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What are some examples of type III hypersensitivity (immune complex) reactions that use IgG and IgM antibodies?
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SLE
rheumatoid arthritis |
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Having an inherited tendency to become sensitive to environmental allergens; 20% of the population.
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Atopic
(Atopic reactions are type I) |
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What are the five atopic diseases?
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allergic rhinitis
ashtma atopic dermatitis urticaria angioedema |
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Most common type I hypersensitivity reaction. May be seasonal or year round. S/S: nasal discharge, sneezing, lacrimation, mucosal swelling, airway obstruction, and pruritus around eyes,nose,throat, and mouth. AKA hay fever.
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Allergic rhinitis
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An atopic type I hypersensitivity reaction; patients manifest dyspnea, wheezing, coughing, tightness in chest, and thick sputum.
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asthma
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An atopic type I hypersensitivity reaction; a chronic, inherited skin disorder characterized by exacerbations and remissions. It involves vasodilation of blood vessels, resulting in interstitial edema with vesicle formation.
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Atopic dermatitis
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A atopic type I hypersensitivity reaction; a cutaneous reaction against systemic allergens characterized by transient wheals that vary in size and shape and may occur throughout the body.
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Urticaria (Hives)
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An atopic (type I hypersensitivity) reaction; a localized cutaneous lesion involving deeper layers of the skin and submucosa. Principal areas of involvement are eyelids, lips, tongue, larynx, hands, feet, GI tract, and genitalia. the outer skin may appear normal or has a reddish hue.
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Angioedema
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Type II hypersensitivity reactions are called:
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cytotoxic and cytolytic reactions
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Reactions involving the direct binding of IgG or IgM antibodies to an antigen on the cell surface- this activates complement system and produces reaction. Cellular tissue is destroyed by cytolysis or enhanced phagocytosis.
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Type II: cytotoxic oand cytolytic reactions
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What are some antigens involved in the type II cytotoxic and cytolytic reactions?
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ABO blood group
Rh factor drugs |
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What are some disorders caused by type II reactions?
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ABO incompatibility transfusion rxn
Rh incompatibility transfusion rxn hemolytic dz of newborn Goodpasture syndrome anemias, leukopenias, r/t autoimmune or drugs |
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Occurs when a recipient receives ABO incompatible blood from a donor.
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hemolytic transfusion rxn
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An antibody-mediated autoimmune reaction involving the lungs and kidneys- can result in pulmonary hemorrhage and glomerulonephritis.
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Goodpasture syndrome
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What are type III reactions called?
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Immune-complex reactions
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Tissue damage occurs secondary to antigen-antibody complexes in this type of hypersensitivity rxn.
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Type III: immune-complex reactions
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What are some diseases associated with type III (immune-complex) reactions?
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SLE
Acute glomerulonephritis Rheumatoid Arthritis |
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What is a type IV hypersensitivity reaction called?
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delayed hypersensitivity
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A hypersensitivity reaction where sensitized T lymphocytes attack antigens or release cytokines (which attract macrophages/enzymes) and cause tissue damage. It takes 24-48 hours for response to occur.
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Type IV: delayed hypersensitivity reaction
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What are some examples of hypersensitivity type IV reactions (delayed hypersensitivity rxns)?
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contact dermatitis
transplant rejections hypersensitivity rxns to bacterial, fungal, and viral infections |
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An example of a delayed hypersensitivity rxn involving the skin in reponse to metal compounds, rubber compounds, poison ivy, poison oak, poison sumac, cosmetics, and dyes.
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Contact dermatitis
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The best drugs for treating allergic rhinitis and urticaria. Act by blocking histamine.
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antihistamines
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A decongestant drug: the drug of choice to treat anaphylactic reactions. it causes vasoconstriction of peripheral blood vessels and relaxes bronchial smooth muscle.
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epinephrine
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Effective in treating allergic rhinitis- in nasal formulations or oral for more severe allergies.
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Corticosteroids
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Topical drug to protect the skin when it is not broken- protect the skin and provide relief from itching.
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antipruritic drugs
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Inhibit the release of histamines, leukotrienes, and other agents from mast cell after IgE-antigen interaction. Used in the managment of asthma and tx of allergic rhinitis. Low incidence of side effects
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Mast Cell-Stabilizing drugs
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Oral treatment for allergic rhinitis and asthma. Blocks leukotriene.
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Leukotriene Receptor Antagonist
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The recommended treatment for control of allergic symptoms when the allergen cannot be avoided and drug therapy is not effective.
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immunotherapy
*Is absolutely indicated in people with anaphylactic reactions to insect venom |
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How does immunotherapy work?
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involves administrateion of small titers of an allergen extract in increasing strengths until hyposensitivity to the specific allergen is achieved.
Aims at blocking IgE by binding with IgG. Aim is to keep the "Blocking" IgG antibodies at high levels. *food allergens cannot be safely treated |
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An acquired disorder in which certain people exposed to various foods and chemicals in the environment have many symptoms r/t multiple body systems. symptoms usually objective- include fatigue, HA, dizziness, nausea, pain, etc. Any chemical can initiate symptoms, but odor is principle trigger
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MCS- multiple chemical sensitivities
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The principle factors in developing autoimmune disorders are: (there are 2)
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1) the inheritance of susceptibility genes, which may contribute to the failure of self-tolerance
2) initiation of autoreactivity by triggers such as infection, which may activate self-reactive lymphocytes. |
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A systemic autoimmune dz characterized by damage to multiple organs.
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Systemic Lupus Erythematosus
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the use of a procedure to separate components of the blood followed by the removal of 1 or more compounds.
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Apheresis
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The removal of plasma containing components causing or thought to cause disease
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Plasmapheresis
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When the immune system does not adequately protect the body
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immunodeficiency
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Immunodeficiency disorder involve an impairment of one or more of: (there are 5)
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1) phagocytosis
2) humoral response 3) cell-mediated response 4) complement 5) combined humoral and cell-mediated deficiency. |
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Immunodeficiency disorders are __________ if the immune cells are improperly developed or _______ if the deficiency iscaused by illness or treatment.
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primary
secondary |
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Occurs when an immunoincompetent patient is transfused or transplanted with immunocompetent cells. May result from infusion from any blood product containting viable lymphocyes, and from the transplantation of fetal thymus, fetal liver, or bone marrow. The graft rejects the host or recipient tissue.
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GVH- graft versus host disease
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What factors must be matched to donors for recipients of organ transplantation?
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ABO blood
HLA (human leukocyte antigen) typing |
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A test done for organ transplantation- uses serum from the recipient mixed with donor lymphocytes to test for any preformed cytotoxic (anti-HLA) antibodies to potential donor organ.
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crossmatch
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What does a positive crossmatch indicate?
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The recipient has cytotoxic anti-HLA antibodies for the donor organ. Is an absolute contraindicateion to the transplantation.
*If transplanted, the organ would undergo hyperacute rejection. |
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Rejection of organ occuring minutes to hours after transplantation
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hyperacute rejection
*no tx! |
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Rejection of organ occuring days to months after transplantation. Mediated by recipient's T cytotoxic lymphocytes which attack foreign organ.
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Acute reection
*usually reversible with additional immunosuppressive therapy |
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Rejection of organ occuring over months or years- is irreversible.
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Chronic rejection
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Therapy used to adequately suppress the immune response to prevent transplant rejection in organ recipients while maintaining sufficient recipient immunity to prevent overwhelming infection.
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Immunosuppressive therapy.
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Name the main immunosuppressive agents: (there are 4)
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1) calcineurin inhibitors (ex. cyclosporin and prograf)
2) corticosteroids (ex. solu-medrol) 3) mycophenolate mofetil (CellCept) 4) sirolimus (Rapamune) |
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Most effective immunosuppressants- prevent cell-mediated attact against transplanted organ
*potentially nephrotoxic |
Calcineurin Inhibitors
*Prograf, Sandimmune |
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An immunosuppressive agent approved in renal transplant recipients
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Sirolimus (Rapamune)
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Exibits suppressive effects on both T and B lymphocytes. Has been shown to decrease incidence of late graft loss.
*SE: nausea, vomiting, diarrhea |
Mycophenolate Mofeti (CellCept)
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Used for preventing and treating acute rejection episodes.
*uses mouse antibodies |
Monoclonal antibodies
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Induction therapy (severely immunosuppress a pt immediately after transplantation to prevent rejection) or treatment for acute rejection. MAde by immunizing horses with human lymphocytes and purified.
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Polyclonal antibody
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A form of genetic engineering involving taking segments of DNA from one type of organizm and combining them with genes from a second organism.
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recombinant DNA technology.
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What can recombinant DNA technology be used for?
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making human insulin
making cytokines |
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A way to provide a way to make many copies of DNA or RNA sequence in a few hours when rapid genetic diagnosis is needed.
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Polymerase chain reaction
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What can polymerase chain reactions be used for?
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- used in forensic medicine to identify DNA of criminal suspects
- confirm HIV (especially important when infant tests positive for HIV from mother and can't distinguish if the antibodies from the infant's blood are from the baby or mom) |
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When connective tissue and fibrin deposits collect in the blood vessels and organs leading to necrosis of the blood vessels, lypmh nodes, GI tract, and pleura, the patient has...
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lupus (SLE)
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What are some main s/s of SLE?
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-erythema of face
-butterfly rash of face -dry, scaly raised rash on upper body -fever -anorexia -photosensitivity -elevated erythrocyte sedimentation rate and C-reactive protein level -joint pain -anemia |
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What are some nursing interventions one would do for a patient with SLE?
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-monitor skin integrity
-treat anemia - high vitamin, iron, and protein diet - topical/systemic corticosteroids - avoid sunlight - assist w/ plasmapheresis - monitor for orgain involvement (note that lupus nephritis occurs early in disease process) |
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A chronic diseasethat is characterized by inflammation, fibrosis, and sclerosis. It causes fibric changes involving the skin, synovial membranes, esophagus, heart, lungs, kidneys, and GI tract.
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scleroderma
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What are some s/s of scleroderma?
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- stiffness/weakness
- pitting edema - taut and shiny skin - think skin that adheres to underlying structures - dysphagia - joint contractures, decreased ROM, inabillity to perform ADLs |
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What are some nursing intervetntions for scleroderma?
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-maintain a constant room temp
- eliminate foods tat stimulate gastric secretions - supportive therapy - corticosteroids |
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A collagen disease; a form of systemic vasculitis that causes inflammation of the arteries in visceral organs, brain, and skin.
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Polyarteritis nodosa
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What are the most frequent causes of death in polyarteritis nodosa?
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renal disorders and cardiac involvement
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Who does polyarteritis nodosa effect?
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middle-aged men
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What are some s/s of polyarteritis nodosa?
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-weakness
- low fever - severe abd pain - bloody diarrhea - weight loss - elevated ESR |
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What are some nursing interventions for polyarteritis nodosa?
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- supportive care
- well-balanced diet - corticosteroids and analgesics |
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A rare autoimmune disease that occurs predominately between middle and old age.
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pemphigus
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What is the treatment goal for pemphigus?
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to suppress the immune response that causes blister formation
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what are s/s of pemphigus?
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- fragile, flaccid bullae
- partial thickness wounds that bleed, weep, and form crusts when bullae are disrupted - nikolsky's sign- separation of the epidermis caused by rubbing the skin - leukocytosis, eosinophilia, foul-smelling discharge from skin |
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What are some nursing interventions for pemphigus?
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- supportive care
- oral hygiene/sooth oral lesions - soothing baths as prescribed - topical/systemic antibiotics - corticosteroids and ccytotoxic agents as prescribed |
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An autoimmune disease involving the lungs and kidenys. Autoantibodies are made against the glomerular basement membrane and alveolar basement membrane.
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Goodpasture's syndrome
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Who does goodpasture's syndrome mainly affect?
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males and young adults who smoke.
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What are some s/s of Goodpasture's syndrome?
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- CM indicating pulmonary and renal involvement
- SOB - hemoptysis - decreased urine output - edema/weight gain - HTN, tachycardia |
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What are some nursing interventions for goodpasture's syndrome?
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- suppress autoimmune response
- plasmapheresis to remove the autoantibodies - supportive therapy |
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An infection acquired from a tick bite- a spirochete (Borrelia burgdorferi) stimulates inflammatory cytokines and autoimmune mechanisms
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Lyme Disease
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when do symptoms of lyme disease first occur? what are some?
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- occurs days to months following the bite
- small red pimple develops- spreads to ring-shapped rash (or rash may not occur) - flu-like symptoms |
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What are some s/s of lyme disease in advanced stages?
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- joint pain
- neurological complications - cardiac complications - large joint involvement - arthritis |
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What are some interventions for lyme disease?
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- obtain a blood test 4-6 weeks after bite to detect presence of disease (testing before this time is not reliable)
- antibiotics as prescribed |
