Basics
What type of immunity (INNATE OR ADAPTIVE) Provides protection but only to a specific antigen
INNATE
ADAPTIVE
What are the two types of adaptive immunity and what cells are they made up of?
Humoral (b-cells)(antibodies)
Cell Mediated (t-cells)(lymphocytes)
After a long day of studying pathopharm I decide to go to a Jonas Brother's concert. At that concert my friend coughs on me. The next day I wake up and I too am coughing causing me to miss clinical! UGH
Five years later the same cough is going around at a Harry Styles concert, people are coughing everywhere but I don't fret because I know I have what kind of immunity?
Naturally Acquired Active Immunity
(Active means your body produced the antibodies)
Malar or butterfly rash indicates what?
Extra 100 points if you can name the mnemonic to help remember the other s/sx
Systemic Lupus?
SOAP BRAIN MD
(Serositis, oral ulcers, arthritis, photosensitivity, blood disorders, renal involvement, Ana titer (antibody), I (do not need to know), Neurological Disorders, Malar, Discoid skin lesions
True or False the spleen is a part of the immune system
True- produces lymphocytes and traps pathogens
What patients should we assume are immunocompromised?
Organ transplant, Cancer patients (on chemo), taking corticosteroids, etc.
What are the two types of t cells and what do they do?
Helper t cells (CD4) cells- bridge between humoral and cell mediated. Activate b-cells to produce antibodies
Effector cells (cytotoxic)(killer)(CD8) t cells- destroy cells infected with viruses by releases chemicals that break down the cell wall
My patient is a new mother, I am talking to her about the importance and benefit of breastfeeding. One benefit of breastfeeding a baby is that they receive IgA antibodies from the mother that helps their immune function. What type of immunity is this an example of?
Naturally Acquired Passive Immunity
(Artificial immunity would be in a healthcare setting or something of the such)
A patient with Myastenia Gravis is experiencing contractures in their arms and legs and a has a noticeable decrease in the size of their thymus. Are these signs of MA?
No.
Usually they have muscle weakness, problems walking, talking, change in their voice, ptosis. and an enlarged thymus
This is an autoimmune disease that creates antibodies that block/destroy acetylcholine receptors b/w nerves and muscles.
What are some nursing precautions for people with immunodeficiencies?
No raw meat, no fresh flowers, limit visitors, avoid exposure to pathogens
You enter the room of your patient who has redness, edema and pain what kind of response is this (think basic), what is this response triggered by?
Inflammation
Histamines (stimulates vasodilation, prostaglandins and stimulates pain)
What are the two kind of B-cells and what do they do?
Memory B cells- secondary immune response
Plasma B cells- each has a receptor for a specific antigen and they eliminate bacteria and produce inflammatory response
What type of antibody (Ig) mediated Type one hypersensitivity and basically what is type one hypersensitivity and what causes it?
IgE
inappropriate rxn to antigen which results in inflammation.
IgE coats the cells making them sensitive
You are assigned a patient who reports chronic tingling and weakness in his legs and arms after having a GI infection, and now it seems to be affecting his respirations. What does the nurse immediately suspect,
extra 100 points: how does one treat this issue?
Guillian-Barre- immune system attacks myelin sheath of the peripheral nervous system
No cure but give plasmapheresis and high immunoglobulin therapy for 3-5 days
A child was born with an immunodeficiency. Is this an example of primary or secondary immunodeficiency
primary
secondary= reflecting an underlying disease or factor (viral) suppressing the immune system (can be chemo too)
What releases Pyrogens? When are they released? What do they trigger?
Macrophages
After exposure to bacteria
travel to hypothalamus where they trigger an increase of temperature
NOTE: WHY? because increased temp, limits bacteria growth!
Is the complement system innate or adaptive and what does it entail
innate and it is blood plasma proteins that enhance the action of antibodies
(they always circulate but when they meet foreign substances they activate)
Your patient received a liver transplant 2 months ago. They are back because they are rejecting the organ.
Since you are a good nurse you can identify what kind of rejection this would be classified as and how to treat it.
Acute rejection (b/w days 4 and 3 months after transplant)
reversible with immunosuppressants (cyclosporine and corticosteroids)
A patient come in to the ER complaining on xerophtalmia and xerostomia chronically. Right away the nurse suspects _________ an autoimmmune condition causing inflammation of exocrine glands
Sjogrens Syndrome
Casie had to get some skin from a monkey to heal a burn
Danielle got a transplant from her identical twin
Sierra had a random donation of tissue from another human transplanted on her abdomen
Which sister got a isograft?
extra 100 points if you can classify the other types fo grafts
Danielle= isograft (identical twin)
Kim- autograft
Casie- xenograft
Sierra- allograft
Which patients have fevers that are DANGEROUS!
1). 27 year old man with a fever of 105.3
2). 2 month old with a temp of 101.4
3). 4 month old with temp of 102.1
4). 74 year old female with temp of 103.9
1, 2and 3!
Adult life threatening temp= 105
0-3 month dangerous temp= 100.4 (rectal)
3-6 month dangerous temp= 102
NOTE: 103.9 requires interventions but not LIFE THREATENING dangerously high on its own (administer acetometophin)
IgG, IgE, IgD, IgM, IgA
-associated with allergic rxns
- most abundant (fights bacteria, viruses, and toxins)
-first produced by adaptive immunity
-usually found in tears, mucus, breast milk and destroys pathogens before they gain access to internal tissues
IgG- Most abundant (has the most g's)
IgM (first produced)
IgE- associated with allergic rxns
IgA- tears,mucus
IgD- dont need to know
What two types of organ rejection are irreversible (there are 3 total types of organ rejection)
Hyperacute rejection- occurs immediately-3 days
(need new organ irreversible)
Chronic rejection- occurs 4 months- years after transplant. Irreversible
OH NO!
the MD is a bad MD and gave you orders of two treatments for two separate patients. One patient has Lupus and the other has Myastenia Gravis, and he did not label them.
You fall down and mix up the orders.
One calls for you to schedule a surgery and start a plasmapheresis and the other calls for the start of DMARDS (disease modifying anti-rheumatic drugs) and Prednisone.
Which order is for which patient?
Thymectomy and plasmaphoresis = MA (even tho lupus uses plasmaphoresis too)
DMARDS and corticosterioids/NSAID (pulse pulse therapy- giving high does of meds such as corticosteroids intermittently to max therapeutic effects)= SLE
CHALLENGE!!!!
As IgG increases which Ig (antibody decreases)?
IgM
(IgM is the initial antibody released and then IgG gets released which is the antibody that fights of viral/bacterial infections