Med Surg
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| What are lympocytes | B cells and T cells that gererated from stem cells in the bone marrow
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| Where do B lympocytes mature | in the bone marrow
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| What do T lympocytes mature | in the thymus
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| What is humoral response | proliferation of b cells, memory cells, and plasma cells that produce antibodies
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| Cellular immunity | T lympocytes attack invaders directly, secrete cytokines, it includes helper t cells, killer t cells, cytotoxic t cells, suppressor t cells
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| What happens with cellular immunity | recognition of foreign antigen by helper T cells (CD4), killer T cells lyses cells (CD8), memory T cells remember specific foreign antigen, suppressor T cells limit immune response
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| How is interferon activated | when cell is attacked by virus it activates interferon.
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| What does interferon do | signals neighboring cells and triggers their resistance mechanism, it activates immune cells (killer T cells) that kill invating pathogens,
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| What are nonspecific defenses | skin, nasal secretion, cilia body, saliva, tears, sweat, stomach secretions, inflammation process, chills, fever, macrophages, phagocytes
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| What are specific defenses | neurtophils, interferon, antibodies, antigen presenting cells (APC), natural killer cells, b cells, t cells
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| What are antibodies | basic functional unit of the immune system, a protein molecule formed in response to exposure of antigen
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| what are interleukins | a substance produced during immune responses to induce, maintain, control the immune system
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| what are cytokines | proteins produced by WBC that regulate the immune response during inflammation
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| Types of immunity | natural and acquired
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| What is natural immunity | nonspecific response to any foreign invader; WBC, inflammatory response, physical barriers
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| What is acquired immunity | specific against a foreign antigen, result of prior exposure to an antigen, can be active or passive
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| What is active immunity | antibodies are formed, produced by the body in response to stimulation by a disease causing organism or a vaccine
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| What is naturally acquired immuninty | acquired when recover from disease
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| What is artificially acquired immunity | acquired through vaccine, can be long term or short term
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| What is passive immunity | transferred from one source to another; plasma to fetus, mother's breast milk to infant, injection of preformed antibodies (gamma globulin), it is temporary
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| What are antigens | foreign substances that invade the body, when detected several types of cells work togerher to recognize and respond to it
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| Role of antibodies | agglutination of antigens, opsonization (antigen marked to be destroyed by phagocytes), promote release of vasoactive substance which activate the complement system and phagocytosis
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| What are immunoglobulins | antibodies; IgA, IgM, IgE, IgD, IgM
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| IgG | appears in serum and tissues, major role in bloodborne and tissue infection, activates complement system, enhances phagocytosis, crosses placenta
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| IgM | mostly in intravascular serum, first in response to bacterial and viral infection, activates the complement system
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| IgA | in body fluid, passes to neonate in breast milk for protection, protects against infection
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| IgE | in serum, plays part in allergic reaction, combats parasitic infections
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| IgD | appears in small amount in the serum, act as antigen receptor of B cell
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| What is the complement system | a series of proteins that are floating in the blood stream, play a role in destruction of invading organism (lysing or bursting of antigens); activated in 2 ways classic and alternative
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| How is classic complement system activated | activated after the formation of an antigen-antibody complex
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| How is alternative complement system activated | by the release of bacterial products (endotoxin)
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| Aging and the immune system | decreases with age, more susceptible to infections, autoimmune disorders more common, thymus gland decreases in size, increase production of immature T cells, decrease antibody response,
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| Types of hypersensitivity reactions | allergic reactions, anaphylaxis, hemolytic transfusion reactions, transplant rejections
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| What is an allergy reaction | hypersensitive reaction to an allergen initiated by immunological mechanism that is usually mediated by IgE antibodies.
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| Most common type of allergic reactions | hay fever, astham, hives
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| What happens during an allergic reaction | allergen triggers the B cell to make IgE antibody, which attaches to the mast cell; when that allergen reappears, it binds to the IgE and triggers the mast cell to release histamine
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| What is a hypersensitivity reaction | a reflection of excessive or aberrant immune response
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| Types of hypersensitivity reactions | Type I anaphylactic, Type II Cytotoxic,
Type III Immune Complex, Type IV Delayed type
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| Type I Anaphylactic reaction | humoral immunity; antigen attaches to IgE antibody on mast cell, this causes mast cell to release hisamine
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| Type I characteristics | vasodilation, increased capillary permeability, smooth muscle contraction and eosinophilia
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| Type I s/s | laryngeal stridor, angioedema, hypotension, broncial, GI, or uterine spasm, hives, extrinsic asthma, allergic rhinitis, systemic anaphylaxis
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| Type II cytotoxic reaction | IgM or IgG antibody bind to cell bound antigen. Lead to cell and tissue damage. This reaction is result of mastaken identity, when the system identifies a normal consitutent of the body as foreign and activates the complement cascade
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| Type II examples | myasthenia gravis, goodpasture's syndrome, pernicious anemia, hemolytic diease of the newborn, transfusion reaction, and thrombocytopenia
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| Type III Immune complex | A complex of antigen and antibodies in blood stream, activate complement system causing vasodiation and tissue damage.
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| Type III associated with what diseases | systemic lupus erythematosus, serum sickness, nephritis, and rheumatoid arthritis
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| Type III s/s | urticaria, joint pain, fever, rash, adenopathy (swollen glands)
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| Type IV delayed or cellular reaction | cell medicated reaction; occurs in 1-3 days after exposure to an antigen. Results in tissue damage, involves activity of lymphokines, macrophages, and lysozymes.
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| Type IV | erythema and itching are common
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| Type IV disease examples | conact dermatitis, graft-versus-host diease, hashimoto's yroiditis, sarcoidosis
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| Meds for allergic reaction | O2, epinephrine for anaphylactic reactions, antihistamines, coricosteroids
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| S/S of mild anaphylaxis | peripheral tingling, warm sensation, anxiety, itching, wheezing, cough
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| s/s of moderate anaphlaxis | onset occurs first 2 hrs of exposure; flushing, warmth, nasal congestion, periorbitial swelling, pruritus, sneezing, tearing of the eyes
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| s/s of severe anaphylaxis reaction | same as mild and moderate; progress to bronchospasm, laryngeal edema, severe dyspnea, hypotension, tachycardia, cyanosis, coma, cardiac arrest
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| What is MRSA | bacteria which develop resistance to antibiotics
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| MRSA treatment | oxacillin, vancomycin
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| What is VRE | multidrug resistant strain, part of normal gastrointestinal and genital tract flora, spread by direct patient to patient contact or indirectly via hands and personnel, contaminated evnironmental surface or paitent care equipment
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