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57 Cards in this Set
- Front
- Back
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What are some external immune defenses?
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intact skin
mucous membranes processes such as: coughing sneezing tears |
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Internal defenses provide ______ and tertiary protection though specific and ______ responses.
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seconday
nonspecific |
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The immune system is able to ____ the body's own cells or "self" from foreign substances "non-self," activate a response to detect and destroy ____ substances, ______ a response against the self, and memorize and store information.
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The immune system is able to distinguish the body's own cells or "self" from foreign substances "non-self," activate a response to detect and destroy foreign substances, suppress a response against the self, and memorize and store information.
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Foreign substances or _______ have unique markings on their cell surfaces that mark them as foreign.
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antigens
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Protective barriers activated by the presence of an antigen but not specific to that antigen include what 3 types? (NON specific immune function)
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chemical- bactericides, fungicides and enzymes in body secretions
interferon- protein produced in response to virus inflammation- an increased capillary permeability, vasodilation, phagocytosis, and elimination of cell products |
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Describe specific immune function
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Humoral response-
B lymphocytes- 1st responder to viral infection, recognize & respond to foreign antigen. Cell mediated T lymphocytes- protect against most invading organisms. (T helper cells) |
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What organ controls cell mediated immunity? How does it work?
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Thymus contains cells that mature into T cells and specifically reacts to viruses, parasites, fungi, foreign tissue and other antigens.
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What 2 organs act as filters to remove debris and antigens and foster contact with T lymphocytes?
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spleen and lymph nodes
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What organs filter debris and antigens entering the respiratory tract?
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tonsils & adenoids
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What organs act as filters to remove debris and antigens from entering GI tract?
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Peyer's Patches & Appendix
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Bone marrow contains stem cells for __ lymphocytes that mature and become _______-producing plasma cells that react to many bacteria, viruses, and other antigens. This organ controls what type of immunity?
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Bone marrow contains stem cells for B lymphocytes that mature and become antibody-producing plasma cells that react to many bacteria, viruses, and other antigens. This organ controls humoral immunity.
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True or False: a child's immune system is more mature than an adults and disorders manifest the same way as adults do.
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False. Children have immature immune systems and manifest disorders differently.
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What HIV stand for? What is it?
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Human Immunodeficiency Virus
It is an acquired cell-mediated immunodeficiency. |
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True or False: HIV can be asymptomatic, mild, moderate or severe in degree of symptoms.
What is the advanced manifestation of HIV? |
True.
AIDS: Acquired Immunodeficency Syndrome |
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How does one get HIV?
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from blood or body fluids
sexual contact needle sharing (i.e. IV drug use) perinatal transmission: placenta, delivery, or breast milk |
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How can a pregnant woman infected with HIV prevent transmitting the virus to her infant?
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take zidovudine (ZDV) prenatally
(likelhood of transmission decreased to 2%) do not breastfeed |
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The following signs are highly indicative of what?
-repeated or persistent respiratory tract infections -repeated otitis media or sinusitis -severe bacterial infections -opportunistic infections such as PCP or cryptosporidiosis -poor response to appropriate therapy |
immunodeficiency
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The following signs indicate what....
skin lesions failure to thrive or grow chronic diarrhea thrush hepatospenomegaly anemia thrombocytopenia neutropenia small or absent lymph nodes, tonsils, and adenoids |
these are somewhat suggestive signs of immunodeficiency
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How does the CDC classify clinical manifestations of HIV in children less than 13 y old
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Category N- Not symptomatic
Cat. A- mildly symptomatic Cat. B- moderately symptom. Cat. C- Severely symptomatic |
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What are some clinical manifestations of HIV?
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multiple infections
opportunistic infections failure to thrive PCP- pneumocystis jeroveci PNA multiple symptoms |
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What are some clinical manifestations of AIDS in children less than 13?
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multiple, recurrent bacterial infections
opportunistic infections encephalopathy lymphomas Kaposi sarcoma severe nutritional deficits w/o cause |
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What are the 2 types of active acquired immunity?
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cell mediated (T)
humoral (B) |
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How is HIV diagnosed?
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rapid HIV test
HIV DNA PCR assay HIIV RNA assay |
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What is the therapeutic management for HIV?
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maximize viral suppression
preserve immune function decrease disease progression delay medication resistance |
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What makes it difficult to check for HIV in children less than 18 months?
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maternal antibodies
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A C-section is indicated for a pregnant woman with HIV if ...
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if the mom has a high viral load @ 38 weeks
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An infant of a mother with HIV should get what?
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oral ZDV within 6-12 h after birth and continue for 6 weeks
also should get PCP prophylaxis at 4-6 weeks old -Trimethoprim/ sulfamethoxazole (Bactrim) |
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HIV infected infants and children should get ______________ medication, monitor which labs?
monitor growth & _______, need _______ support, and regular ___________. |
antiretroviral medications
monitor HIV RNA, CD4+ T Cell Assays development nutritional immunizations |
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True or False: AZT and ZDV are the same thing.
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true
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patients with HIV should not be given ____ vaccines
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live virus
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Systemic Lupus Erythematosus (SLE) is a chronic multisystem _______ disease that involves inflammation of _____ tissue. What organs are effected?
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autoimmune
connective Skin, joints, heart, lungs, kidneys, brain, circulatory vessels, cartilage, bone |
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Which gender is more often effected by Systemic Lupus Erythematosus (SLE) ?
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females
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true or false: Systemic Lupus Erythematosus (SLE) involves remissions and exacerbations.
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true
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What are the clinical manifestations of Systemic Lupus Erythematosus (SLE)?
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early manifestations:
malaise arthralgia fever of unknown origin Also can include: butterfly rash photosensitivity (many more, multisystems effected) |
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Therapeutic management for Systemic Lupus Erythematosus (SLE) includes the prevention of ______ and the avoidance of _____. Medications include ______ to suppress the inflammatory response. If there is renal progression, what medication is given? For arthritis and fever, ______ are given. Anticonvulsants and antihypertensives are given if there are _____ or _____ disorders. _____ is given for skin and joint problems.
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Therapeutic management for Systemic Lupus Erythematosus (SLE) includes the prevention of exacerbations and the avoidance of triggers. Medications include to suppress the inflammatory response. If there is renal progression, Cytoxan is given. For arthritis and fever, NSAIDs are given. Anticonvulsants and antihypertensives are given if there are renal or neurological disorders. Plaquenil is given for skin and joint problems.
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In treating Systemic Lupus Erythematosus (SLE), the treatment is tailored to the organ system or systems affected and is aimed at preventing exacerbations and complications. The goal of treatment is to use the least amount of _____ intervention needed.
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pharmacological
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Diet needs for a child with SLE include ____ and ____ restriction
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salt restriction to decrease fluid retention and prevent elevated BUN
low protein to preserve renal function |
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Diagnosis of SLE includes a ____ ANA test, presence of ___ DNA antibody and ___ phospholipid antiobody, a ____ BUN, a _____ gamma globulin a _____ ESR a ____Complement levels (C3 & C4). These tests can be used to continue monitoring the disease.
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Diagnosis of SLE includes a positive ANA test, presence of anti DNA antibody and antiphospholipid antibody, a elevated BUN, a elevated gamma globulin a elevated ESR a decreased Complement levels (C3 & C4).
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_______ therapy is part of the treatment regimen of SLE to reduce local and systemic _____ symptoms.
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corticosteroid
inflammatory |
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Corticosteroids are anti-inflammatory in that they inhibit the occurrence of e____, capillary _____, and migration of l_______. They are also immuno_______ in that they inhibit __ cells.
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Corticosteroids are anti-inflammatory in that they inhibit the occurrence of edema, capillary dilation, and migration of leukocytes. They are also immunosuppresive in that they inhibit T cells.
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The 3 types of corticosteroids used to treat SLE include: topical steroids which is _________ cream, systemic steroids such as _______, and inhaled steroids such as Beclomethasone (Qvar.)
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hydrocortisone
Prednisolone (Prelone) |
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Corticosteroids mimic the products of what organ?
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adrenal glands
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In administration of corticosteroids, what is preferred long term low dose or short term high dose?
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short term high dose
long term is very debilitating on body. |
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In long term administration of corticosteroids, supplemental steroids are indicated at time of acute ____ or ___.
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infection, surgery
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With corticosteroid therapy, ____virus vaccines should be substituted for live virus vaccines
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killed/dead
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Taper off corticosteroids to prevent an adrenal _____
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storm
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Do what after taking oral steroids?
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rinse with water
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Excessive use of steroids can cause topical and systemic issues such as...
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topical- skin atrophy, delayed wound healing
systemic- edema, GI irritation, susceptibility to infections, increased appetite |
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What are the 4 types of allergic reactions and an example of each?
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immediate- anaphylactic
cytotoxic- blood transfusion arthus- serum sickness delayed cell mediated- poison ivy |
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______ is a severe immediate hypersensitivity reaction to excessive release of chemical mediators. It involves respiratory signs such as throat swelling, bronchoconstriction with bronchospasm and edema as well as GI and integumentary systems.
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anaphylaxis
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what is utricaria?
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hives
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what are some causes of anaphylaxis?
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food allergy
medications i.e. antibiotics insect stings blood products |
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Signs of anaphylaxis
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laryngospasm (throat closes)
edema cyanosis which can lead to... hypotensive shock vascular collapse |
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The key to treating anaphylaxis is speed-- get it under control fast! What is the treatment of anaphylaxis?
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ensure adequate Airway, possibly by ET tube
injectable epinephrine administer O2 as needed corticosteroids antihistamines (benadryl, zantac, tagamet) keep child warm and lying flat or with feet slightly elevated. Start IV line |
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What is usually the primary cause of anaphylaxis?
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food allergy
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Impending ______ may present with the following initial symptoms:
sneezing tightness or tingling of mouth or face swelling of lips and tongue severe flushing, urticaria, and itching of the skin rapid development of erythema sense of impending doom |
anaphylaxis
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what is the medical term for itching?
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pruritis
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