Immunity Lecture

You are exposed to an antigen and the body does the work of making the antibodies. You will have long term protection b/c the cells remember

Immunity given to a baby from their mother through the placenta or boob milk

Vaccines are given, they are not enough to make you sick but are enough to have your body make antibodies. Takes weeks to develop, only lasts a few years so need to get boosters - i.e. Tetanus get booster ever 10 years

Antibodies are man made and given to you by a shot - immediate and temporary since the body doesn't make a constant supply

Memory cells: recognize self from non-self, remembers which cells are bad. Cytokines: chemical messengers in the body that send signals to regulate processes in the body like moderate cell growth and function. Macrophage: send chemical messages about which cells to kill during inflammation. T-cells: helper, killer, suppressor cells that keep body from over reacting, keeps homeostasis

B-cells: sensitized and producers of antibodies and have memory. Plasma cells: secretes immunoglobins. Memory cell: remembers antigen for future. Complement system: 25 proteins circle body fluids and enhance the immune response by stimulating histamine (inflammation), increasing vascular permeability for antibodies to get out, chemotaxis, phagocytosis, and cell lysis.

Swelling of eyelids, lips, hands, etc - immediately look in the throat. Need to trach before airway gets more swollen - possible wheezing or stridor (always medical emergency) - need epi pen and lots of fluids

Little to no immune response, "bubble-boy" - defect in B&T lymphocytes causing reduced or no defense for viruses, bacteria, or fungi. It's an inherited mutation in interleukin 2 receptor or lack of enzyme adenosine deaminase - no treatment just strict protective isolation forever

React to self - there is a defect in recognizing self form non-self. Ex. Scleroderma

An under-reaction b/c of reduced T helper cells leading to reduced B cell function. Ex HIV (CD4<200)

Age (elderly less competent immune system), gender (women more likely to be immunocompromised b/c of estrogen), nutrition (malnourished not able to have good immune system), psychoneuro factors (the more stressed = more susceptible to immunocompetence), organ pathologies (if not all organs functioning then impaired immune system), medications, radiation (both can have immunosuppressive effects either as side effect or intended purpose - i.e. steroids w/ inflammatory response)

fever, chills, malaise, lymphadenopathy, pharyngitis, GI disturbance (diarrhea or vomiting, Nausea)

WBC, differential, CD4 ratios, bone marrow biopsy, serum globulins, delayed hypersensitivity tests, advanced assays

Index to infection susceptibility and system response. Higher concentration in immature cells is a "shift to the left" which signals acute infection. The bone marrow releases immature neutrophils with an acute infection. Neutropenia <1000. Normal is 3000-7000. Absolue Neutrophil Count (ANC) - percentage of neutrophils in WBC. Should be 50-70 & but need to know WBC volume b/c if WBC abnormally low can give unreliable & of neutrophil

Life expectance <1 yr, Age<65, Ejection fraction (amount of blood ejected by left ventricle - normal 50%)<25%, pulmonary vascular resistance WNL, absence of active infection, stable psychosocial status, no current alcohol/drug abuse

Chronic, irreversible disease, Liver/billiary tree primary malignant tumors, primary sclerosing cholangitis, hepatic metabolic diseases, fulminant hepatic failure (toxins, hepatitis), no malignancies

Advanced sequelae of liver disease (varices, hepatorenal syndrome), systemic conditions (sepsis, CVS, DM, severe HTN), intellectual limitations/psychosocial instability, active alcoholism, advanced catabolic state, portal vein thrombosis

End-stage renal disease, evaluation of poor efficacy of hemodialysis for maintenance, cost savings (benefit-risk: cheaper to get transplant than be on dialysis). Bad kidneys stay unless polycystic kidney disease. Put new kidneys in lower closer to bladder

Immediate, can happen within a min - usually within 12-24 hours. Not very oftemn anymore b/c check if organs compatible before hand. Due to memory of B cells, they kills the tissue b/c it doesn't recognize it - causes clotting, choking blood supply and killing organ

Days to months after transplant. b/c of T-cells. Inflammation of walls of vessels (vasculitis)

Humoral attack, slowly happens overtime b/c of fibrotic scarring. Chronic inflammatory response. Vessels damaged leading to progressive ischemia

Slow metabolic, decrease in sensory and mobility. Higher risks with surgery, healing, nosocomial infections, accidents, concomitant conditions and safety

prevent antecedent conditions (factors that precede) - wear seat belts and helmets, have well-balanced meals, not smoking, no or minimal alcohol, immunizations, and maintaining ideal body weight

Once conditions (factors) present, prevent/manage from becoming disease/pathology - yearly PAP smears, monthly breast or testicular self-exams, mammograms, TB skin tests, tonometry tests

Disease/damage to organ/body so want to prevent complications, rehab to function - cardiac rehab, rehab for CVA,head injury, arthritis pain & ADL management clinic