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What is the definition of inflammation?
an immediate reaction to a tissue or invading organisms. Cannot immediate short-term protection.
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What are the S&S of inflammation?
- Warmth
- redness
- swelling
- pain
- decreased function
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What is the difference between swelling and edema?
Edema is a type of swelling?
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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
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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
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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
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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
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What does sensitized mean?
What does sensitive mean?
Desensitized? Hypersensitive?
- sensitized: to respond to stimuli
- Sensitive: same as sensitized
- Desensitized: no longer sensitive
- Hypersensitive: extreme reaction to antigen
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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)
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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
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What is the example of an immunosupressant drug?
cyclosprine (sandimmune)
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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
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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
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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
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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
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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
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What are the common modes of transmission of HIV to health care workers? What prevention is used?
- Needlesticks
- nonintact skin + exposure = infection
- mucous membrane + exposure = infection
- prevention = standard precautions
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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
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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
- HA
- Fever
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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
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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
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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
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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
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What is AIDs Dementia?
- Similiar to other dementias
- it ranges from mild to severe
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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
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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
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