What is the definition of inflammation?
an immediate reaction to a tissue or invading organisms. Cannot immediate short-term protection.
What are the S&S of inflammation?
- decreased function
What is the difference between swelling and edema?
Edema is a type of swelling?
What do H1 receptors act on? What do H2 receptors act on? What are 2 examples of antihistamines
- H1: skin, lungs
- h2: gut
- Antihis: benadryl, Tagamet
Is immunity long or short acting? What kind of response is it? What does it depend on
- It is long lasting
- Is is an adaptive response (learned)
- it depends on exposure
- ex: Cpox, MMR
What is antibody-mediated immunity? What is an antigen? What is an antibody?
- it involves antigen-antibody interactions
- eliminates/destroys foreign proteins
- Antigen: protein that stimulates antibody production
- Antibody: recognize and neutralize antigens
How does immunity work?
the antigen (foreign protein) enters the body, the body recognizes the foreign protein, body becomes sensitized to the protein and antibodies are produced
What does sensitized mean?
What does sensitive mean?
- sensitized: to respond to stimuli
- Sensitive: same as sensitized
- Desensitized: no longer sensitive
- Hypersensitive: extreme reaction to antigen
What is active immunity? Passive?
- Active: Antigens enter the body and body makes antibodies against antigen (disease)
- Natural- without human assistance. Spread person to person
- Artificial- with human assistance (immunization) antigens given to pt. Body then makes antibodies. Does not cause disease. Needs repeated doses (booster)
- Passive: antigens in pt created by person or animal
- natural- mother to fetus through placenta or breast milk
- artificial- read-made antibodies given to inactive disease (rabies, tetanus)
Explain a transplant rejection. When does it begin? what occurs? What is considered acute? Chronic?
- It is hyper acute and begins with transplantation
- Necrosis occurs along with clotting, inflammation, cellular destruction and dysfunction of the transplanted organ
- acute: 1-3 months after transplant (necrosis and inflammation)
- chronic: scarring over time
What is the example of an immunosupressant drug?
What is HIV? AIDS?
- Human Immune deficiency virus: caused by virsu. Invades cells, interfering with cell production. Injects its genetic material int hosts DA in the CD4 + T-cell
- Acquired immune deficiency syndrome: everyone who has AIDS has HIV. Not everyone who has HIV has AIDS. Depends on number of CD4 + T-cells pt has and whether any opportunistic infections have occurred
What are the different stages of HIV and aids?
- Stage 1: confirmed HIV CD4+T lymphocytes > 500 cells/mm3. does not meet aids standards
- Stage 2: confirmed HIV 200-499 cells/mm3, does not meet AIDs criteria
- Stage 3: confirmed HIV < 200 cells/mm or higher count with AIDs conditions
- Stage 4: confirmed HIV no other information
What is seroconversion? If a person tests negative, can he/she still transmit it to another person? At what stage can a person transmit HIV? How is the Diagnosis of AIDs made?
- It is the time lag between time of infection/inoculation and antibody production
- Yes, if a person tests negative, can he/she still transmit it to another person
- A person can transmit HIV at any stage
- The diagnosis of Aids requires that the patient be HIV + and have either a CD4 T-cell count of <200 cells/mm3 or an opportunistic infection
How is HIV and AIDS transmitted? For each, what are the recommendations to prevent transmission?
- Sexual: mucous membranes + infected secretions= transmitted
- Recom: abstinence, monogamy,condoms
- Parenteral: transmitted via needles/ equipment, blood
- Recom: teach patient to bleach/water solution to wash needles; autologous blood transfusions
- Perinatal: from placenta, maternal blood/fluids, breast milk
- Recom: HIV + pregnancy, continue treatments
What are the common directions of transmission of HIV?
- An infected male to an uninfected female
- An infected male to a uninfected male
- Micro tears in rectum ( not stretchy or lubricated like vag)- use lubricant like coconut oil or commercial lubes
What are the common modes of transmission of HIV to health care workers? What prevention is used?
- nonintact skin + exposure = infection
- mucous membrane + exposure = infection
- prevention = standard precautions
What is the most common opportunistic infections? What are the signs and symptoms?
- pneumocystic pneumonia
- S&S: Dyspnea on exertion, dry cough, low grade fever, fatigue, wt loss, crackles in lungs
What is toxoplasmosis? How is it transmitted? WHat are the s&S?
- It is another opportunistic infection. It is a one celled parasite that reproduces only in cat feces
- Trans: by eating under cooked meat or handling cat feces
- S&S: decreased mental status
- Neuro deficits
What is Cryptosporidium? What does it cause?
- Another opportunistic infection; a microscopic parasite that causes diarrhea, electrolyte imbalance and severe muscle wasting; it is an intestinal infection
- (may be difficult to diagnose because diarrhea may just be a side effect caused by medication
What is Candida?
- another opportunistic infection; it is a fungus, overgrowth of noral flora, can be oral or esophageal or both (if its in mouth its probably in the throat)
- Can be vaginal as well in women
What is TB? What are the hallmark signs and symptoms? What tests are used?
- Another opportunistic infection
- Hallmark: cough, fever, chills, night sweats
- dyspnea, Chest pain, wt loss and anorexia
- Use the QuantiFERON Gold test because the pt is immunocompramised and the immune system will probably not show a reaction when using a PPD
What is Kaposi's Sarcoma? How is it diagnosed? What will you see with mouth lesions? how are mouth lesions diagnosed? What about the GI tract? Resp tract?
- Purple lesions on/all over body. What is on outside = on inside; its an AIDs-defining illness ( but not all people with it have AIDs)
- The mouth lesions: will be with/without candida, dx is by fine needle aspiration or tissue biopsy
- Gi tract: N/V/D, intestinal obstruction, dx by endoscopy
- Resp tract: Fever, cough, hemoptysis, dx made by bronchoscopy
What is AIDs Dementia?
- Similiar to other dementias
- it ranges from mild to severe
What testing is done for AIDS?
- Lymphocyte Counts: 5,000 to 10,000 cells/mm3 is normal; in AIDs < 3,500 cells/mm
- CD4 + T-cells: 500-1500 cell/mm3; Aids < 100
- ELISA: Enzyme-linked immunosorbent Assay. Tests pt's serum for antibodies to HIV
- Western Blot: tests for 4 HIV antigens
- Quantitative viral load testing: amt of HIV RNA in serum
What is anaphylaxis? What are the S&S?
- life threatnening "allergic reaction"
- occurs rapidly and is systemic
- Examples: shellfish, latex, peanuts, bees, wasps, fire ants
- S&S: constriction of airway, swelling of throat that makes it difficult to breathe, swelling of lips, tongue, mouth, face
- Severe drop in blood pressure (shock)
- rapid pulse
- dizziness, lightheadedness or loss of consciousness