functional immune system
non self proteins on cell membranes that promote an immune response
human Leukocyte antigens
key to recognize self
Immature undifferentiated cells produced in the bone marrow
meaning each cell has more then one potential outcome
neutrophil (aka granulocytes)
- Involved in inflammation
- -phagocytic -55-70% of WBCs
- mature cells called "segs"
- only mature cells can b phagocytic
Left Shift (bandemia)
when neutrophils change frim mostly mature to immature cells. because bone marrow can not keep up with infection
- Involved in inflammation and stimulate longer lasting immune system response
- (AMI) antibody mediated immunity (CMI) cell mediated immunity
- -phagocytic and can participate in multiple phagocytic events.
- release chemicals heparin, histamine, serotonin, kinins, and leukotrienes. these chemicals produce the manifestations of inflammation
- -make up 1% of WBC
contain chemicals that sometimes induce inflammation and other times limit the inflammation, these cells increase during an allergic reaction
Innate native immunity (Natural Immunity)
- Can be a barrier to prevent organisms from entering the body. cannot be developed or transferred from one person to another and is not adaptive to exposure or invasion by foreign proteins.
- -skin, complement, and natural killer cells. inflammatory response.
- the immunity that a persons body learns to make (or can receive) as an adaptive response to invasion by organisms or foreign proteins.
- -(AMI antibody mediated immunity)
- occurs when antigens enter the body and the body responds by actively making the antibodies
- -natural or artifical conditions
Natural Active immunity
occurs when the antigen enters the body without human assistence.and in turn the bosy makes antibodies. this is the most effective and the longest lasting.
Artifical Active immunity
- vaccinations and immunizations.
- lasts many years and will require a booster
- antibodies are in a persons body but were not created there, rather were created in another person or animal and were transferred there.
- -only used for short term protection against a specific antigen
Natural Passive Immunity
antibodies are passed from mother to fetusvia placenta or breastmilk
Artifical passive immunity
- involves injecting a person with antibodies that were produced in another person or animal -this is temporary and will only last a few days
- -rabies snake bites,tetnus
- continuous immune suppression used after a solid organ transplant
- -an episode of acute rejection deos not mean the patient will lose the organ
five cardinal manifestations of inflammation
redness, warmth, swelling, pain and loss of function
any disease or condition involving the Musculoskeletal system.
Connective tissue diseases
- known as autoimmune disorders
- -characterized by chronic pain, progressive joint deterioration.which results in decreased function
- inflammation of one or more joints.
- -non-inflammatory arthritis=is non systemic ex:osteoarthritis
- -inflammatory arthritis=is systemic ex:RA and Lupus
Osteoarthritis aka degenerative joint disease (DJD)
- a progressive deterioration and loss of cartilage in one or more joints.primarily wieght bearing joints.-nodal(with hand involvement)
- -synovitis=synovial inflammation, in advance disease.
- subluxation=partial joint dislocation
Risk factors for Osteoarthritis
Smoking, Age (biggest factor),genetics, obesity, trauma
a continuous grating sensation caused by irregular cartilage, may be felt or heard when joint goes through range of motion
is bony necrosis secondary to lack of blood flow, usually from trauma or prolong steroid use
Tx for OA
- Tylenol, Lidocaine, NSAIDs, Opioids, cortisone injections.
- discontinue NSAIDs and Hormone replacement therapy a week before surgery to reduce VTE
Prevention of thrombolytic events VTE, DVT, PE
anticoagulants, antiembolism stockings, SCD's, early ambulation and exercise,
- chronic systemic, progressive, autoimmune disease.
- early manifestations:inflammation systemic:low grade fever, fatigue, weakness, anorexia, paresthesias late manifestations:deformities moderate to severe pain.
- systemic:osteoporosis, severe fatigue, anemia, weight loss, subcu nodules, vasculitis, pericardiitis, renal disease.
- -chronic progressive inflammatory disorder that can cause major damageto body and organs could cause them to fail
- -has butterfly shaped rash on face, has exacerbations, have kidney involvement. cause vasculitis, which deprive organs of blood/oxygen, coin lesions=discoid lupus
- pericarditits is most common cardiac manifestation.Raynauds phenomenon=on exposure to cold or extreme stress.
- diet: reduce salt, fat and cholesterol intake.
- Tx: corticosteroid
- chronic inflammatory autoimmune connective tissue disease, means harding of the skin.
- Calcinosis(calcium deposits)
- Raynauds disease
- Esophageal dysmotility
- Sclerodactyly scleroderma of the digits
- Telanhiectasia spider like hemangiomas
autoamputation of the distal digits
when tips of the digits spontaneously fall off
- is systemic disease in which urate crystals deposit in the joints and other body tissues, usually accumulate in the big toe (Podagra) and feet.
- Tophi=deposits of sodium urate crystals, most commonly found on the outer ear, arms or fingers near joints.
- diet:avoid organ foods, shellfish, aspirin and diuretics.
- teach to drink plenty of fluids in order to prevent an attack.
an autoimmune disease that causes blistering in the epidermis. The client has large flaccid blisters (bullae). Because the blisters are in the epidermis, they have a thin covering of skin and break easily, leaving large denuded areas of skin. On initial examination, clients may have crusting areas instead of intact blisters. .
Zalcitabine (ddC, Hivid)
is an antiretroviral (nucleoside reverse transcriptase inhibitor) used to manage human immunodeficiency virus infection in combination with other antiretrovirals. Zalcitabine also has been used as a single agent in clients who are intolerant of other regimens. Zalcitabine can cause serious liver damage, and liver function studies should be monitored closely.
is toxic to the kidneys. The serum creatinine level is monitored before therapy, two or three times per week during induction therapy, and at least weekly during maintenance therapy. Foscarnet also may cause decreased levels of calcium, magnesium, phosphorus, and potassium. Thus, these levels also are measured with the same frequency.
- could cause leukopenia and anemia
- monitor CBC
- could cause pancreatitis, watch serum amylase
- can also cause liver failure
- Zalcitabine slows the progression of acquired immunodeficiency syndrome (AIDS) by improving the CD4+ cell count.
- counts<500 cells indicate need for treatment
- the immune system fails to get rid of antigen-antibody immune complexes from the glomerular membrane. As a result, the affected person will begin to experience decreased glomerular filtration with development of signs of chronic renal failure.
- -type 3 hypersensitivity repsonse
Hydroxychloroquine sulfate (Plaqunil)
Ocular toxicity is an adverse reaction with the use of hydroxychloroquine sulfate. An eye examination should be performed when medication therapy is started and after 6 months of therapy.
have the job of making antibodies and mediating humoral immunity
Immune response three phases
Specific immune responses have three main phases. These include the recognition phase, the activation phase, and the effector phase. Memory is not a feature of an immune response.
Jobs of Eosinophils, basophils, dendritic and neutrophils
Eosinophils attack and destroy foreign particles that have been coated with antibodies of the IgE class. Their usual target is helminths (parasitic worms). Basophils mediate immediate hypersensitivity reactions. Dendritic cells perform the same antigen-presenting task as that of macrophages. Neutrophils phagocytize foreign particles such as bacteria.
Interferon is produced by several types of cells and is effective against a wide variety of viruses. It works on the host cells to induce protection and differs from an antibody, which inactivates viruses found outside the cells.
ESR (erythrocyte sedimentation rate)
- a rate greater then 20 indicates infection
- the normal ESR range is 0 to 30 mm/hr. Generally, an ESR value of 30 to 40 mm/hr indicates mild inflammation, 40 to 70 mm/hr indicates moderate inflammation, and 70 to 150 mm/hr indicates severe inflammation.
a decrease in the number of all cell types. This finding is most likely caused by a direct attack of all blood cells or bone marrow by immune complexes. found in SLE(lupus)
Superior vena cava syndrome
Superior vena cava syndrome occurs when the superior vena cava is compressed or obstructed by tumor growth. Early signs and symptoms generally occur in the morning and include edema of the face, especially around the eyes, and client complaints of tightness of a shirt or blouse collar. As the compression worsens the client experiences edema of the hands and arms. Mental status changes and cyanosis are late signs
syndrome of inappropriate antidiuretic hormone (SIADH)
- tumors can produce like effects on ADH.
- -mild S/S include weakness, muscle cramps, loss of appitite, fatigue, Na 115-120(decreased)
- -moderate S/S include:water intoxication, wt gain, personality changesm confusion, and extreme muscle weakness
- -severe=Na<110 could cause seizures, coma and eventually death
- -interventions=initiate fluid restriction,increase Na, tx with chemo and radiation