Immune Patho

What is the mechanism of type 4 hyper reaction?

"Cell mediated immunity" Cytotoxic T cells and helper cells (CD4) recognize antigen in a major histocompatibility complex, resulting in further macrophage-mediated proliferation of helper cells ex (contact dermatitis, temporal arteritis, transplant rejection

What is the patho of HIV?

HIV infects helper t cells (CD4), enters cell, uncoats RNA to DNA, Latent HIV infections, viral budding infects other cells

What gives the ability for HIV to mutate rapidly?

HIV is an error prone enzyme

What is the primary player in hypersensitivity reactions?

Histamine

What antibody is linked with hypersensitivity reactions?

IgE

What is the most numerous antibody?

IgG

What is the mechanism of type 3 hyper reaction?

IgG, IgM Antibody complexes are deposited in various tissues such as skin, kidneys, or joints, triggering immune response by complement activation. ex (serum sickness, arthus reaction, systemic lupus erythematosus)

What is the mechanism of type 2 hyper reaction?

IgG, IgM antibodies bind to cell surfaces, triggering immune response by complement activation ex (transfusion reaction, Hashimoto's thyroiditis)

What is the mechanism of IgE?

Ige binds to mast cells, release histamine, trypsin and arachnodic acid. (examples conjunctivitis, asthma, anaphylaxis)

What are the complications of hypersensivity reaction?

Anaphylaxis sudden, death can occur w/o med intervention

An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health? A.A mismatch between bone resorption and remodeling B.Immunologically mediated joint inflammation C.Excessive collagen production and deposition D. Cytokine release following mechanical joint injury

B

Some members of the population are so sensitive to certain antigens that they react within minutes by developing itching, hives, and skin erythema, followed shortly thereafter by bronchospasm and respiratory distress. What is this near-immediate reaction commonly known as? A.Antigen reaction B.Anaphylactic reaction C.Hyposensitive reaction D. Arthus reaction

B

What is the etiology of hypersensitivity reactions?

-Atopy (genetic predisposition/ allergic rhinitis, asthma, eczema) -Atopic (hives) -Anaphylactic (systemic)

What do RA and SLE have in common?

-Chronic, rheumatic, inflammatory, autoimmune disorders -Systemic, immune mediated inflammation -Joint pain and stiffness -Exacerbations and Remissions

Which cellular mediate is involved in the development of type 1 hypersensitivity? A.Mast cells B.Plasma cells C.Monocytes D.Arachidonic acid

A

What are atopic reactions?

Acute asthma, urticaria, allergic conjunctivitis, hay fever, food allergies, abx allergies

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology? A."Environment is the biggest contributing factor to the development of RA." B."Exposure to workplace chemicals is a causative agent." C."Genetic predisposition is very likely." D."The disease is most common in those under 30."

C

What is AIDS?

CD4 < 200 disease caused by HIV profound immunosuppression and a/w opportunistic infections, malignancies, wasting and CNS degeneration

What cell does HIV target?

CD4 Tcells

What is the #1 cause of death in patients with lupus?

CV disease

What is the pathology of type 1 (immediate) hypersensitivity response?

First exposure- sensitization of mast or basophil cells Second exposure: two phases -primary: vasodilation, vascular leakage, and smooth muscle contraction (30 min) -secondary: infiltration of tissues with inflammatory cells, tissue destruction in the form of epithelial cell damage (2-8 hours) can last days

What are the clinical manifestations to RA?

Joint stiffness boggy joints Panus tissue ankloysis (fixation of joint) Systemic Swan neck deformity Boutonniere deformity Baker cyst

What are the risk factors of HIV?

MSM IVDU Risky sexual behaviors

What cells serve as a reservoir of HIV during chronic infection (latent phase)?

Macrophages and microglial cells

What are the complications of HIV?

Opportunistic infections causes death NOT AIDS

What is the distinct feature of RA?

Panus tissue

What are the clinical manifestations of HIV?

Stage 1- fever fatigue, mono ss stage 2- no symptoms, lymph node stage 3- death in 2-3, opportunistic infections (diarrhea pneumonia CNS changes)

What is the patho of Lupus?

T&B cells hyperactivity, inc production of antibodies, tissue damage (organ membranes, microvascular)

True or false HIV lack the machinery needed for self replication > require living host cell to survive?

True

True or false HIV must transcribe RNA to DNA to be active

True

What type of hypersensitivity reactions is characterized by systemic lupus erythematosus?

Type 3- immune complex hypersensitivity

What is the relation between HIV and CD4 production?

stage 1- inc viral replications/ dec CD4 stage 2- immune system controls viral replication (gradual decline in CD4 cell count) stage 3- AIDS CD4 < 200

What is the patho of RA?

When exposed to an allergen, produce rheumatoid factor, immune complexes gather in synovial fluid, cause inflammatory response/ degranulation > release cytokines/ synovial cell undergo reactive hyperplasia/ *Panus tissue distinct feature of rheumatoid arthritis

What is a hypersensitivity disorder?

abnormal and excessive response of the activated immune system that causes injury and damage to host tissue

What are the clinical manifestations of Lupus?

acute or insidious *butterfly rash arthritis fever, fatigue, weight loss

What is Lupus?

attacks own tissue global loss of self tolerance PWV no cure

What is the transmission of HIV?

blood semen preejaculate vaginal secretions breast milk

HIV 1 and 2?

both genetically different types (RNA)

What are complications of Lupus?

cardiovascular disease kidney failure pregnancy complications

What is the strongest risk factor correlated with Rheumatoid arthritis?

cigarettes

What is the nursing care for anaphylaxis?

immediate remove inciting agent give epinephrine keep in supine position

What is the difference in patho with OA and RA?

inflammation causes injury in RA Injury causes inflammation in OA

What is the leading cause of death in HIV?

pneumonia, TB

What are the 4 types of hypertensivity Disorders?

type 1- immediate type 2- antibody mediated type 3- complement mediated type 4- t cell mediated

What are the clinical manifestations of anaphylaxis?

wheezing hypotension urticaria angioedema

What is anaphylaxis?

widespread of histamine (vasodilation, inc vascular permeability) into the systemic circulation, related to degree of SENSIVITY not quantity of allergen.

The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement? A."Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular." B."Rheumatoid arthritis is a chronic autoimmune system disease that affects a single joint." C."Only upper extremity diarthrodial joint can be involved." D."The disease will not fluctuate in occurrence."

A

What is the most important intervention in the management of anaphylaxis? A.Establish a stable airway and IV access, as well as administration of epinephrine B.Obtain the health history, height, and weight C.Assess urinary output, peripheral pulses, and diet preferences D.Assess temperature, activity level, and marital status

A

What is autoimmune disease/ etiology?

lack of self-tolerance genetic (polygenetic) environmental immune can be specific type or systemic