NURS 644 Test 2 Study Guide: Immunity, Infections, and Disorders |
Verified study with Complete Solutions | Spring 2026 set | A+ Graded |
100% correct | Franklin University
Chapter 2 Immunity
Examples of primary immunodeficiency -Primary Immunodeficiency■ Defect in immune system■ Genetic
or congenital abnormalities● E.g. hypogammaglobulinemia. C3 deficiency. IgG and IgA disorders. IgA
deficiency, hyper-IgM syndrome). DiGeorge syndrome, Wiskott-Aldrich syndrome). asplenia, severe
congenital neutropenia.
Retroviral syndrome - Acute retroviral syndrome● (usually within 4 weeks) → flulike symptoms○ malaise, HA,
sore throat, myalgia/arthralgia, nausea,diarrhea, rash, lymphadenopathy○ Viral load very high (>1 million)○
CD4+ low○ Transmission risk is HIGH
How does HIV enter the cell using chemokine receptors -Macrophages are also a target, and the virus GP120
needs to bind with a coreceptor known as chemokine receptor (CCR5) which allows for viral entry. To attach to
the T cells, the virus GP120 must attach to another coreceptor known as chemokine receptor 4 (CXCR4) and
the CD4+ cell. Once attached and bound, the second part of the life cycle is known as fusion, which is the
joining of the virus protein (glycoprotein 41), and the CD4+ membrane, which then allows entry.
Passive and active immunization-Ex: rabies infection treated with combination of immunoglobulin (passive)
and killed form of virus (active. Active
■ Immunity is gained by actively engaging with antigen
■ Invasion or vaccination
● Ex: varicella (chickenpox) vaccine
○ Passive
■ Receive antibodies made by another person, animal, or recombinant DNA (outsided
the body)
MMR vaccination education -multiple doses, live attenuated, longer protection, can cause infection in
immunocomprimised.
Types of immunosuppression therapy -(e.g., corticosteroids and cyclosporine)
Clinical manifestations, diagnostic tests, education for patients with SLE – type III hypersensitivity.
Autoimmune. Antigen-autibody complex deposition and accumulation in tissue activates complement system.
Systemic
● Fatigue, fever
■ Musculoskeletal
● Polyarthritis, arthralgia
, lOMoAR cPSD| 61371432
■ Skin
● Butterfly rash
■ Kidneys
● glomerulonephritis
■ Lungs
■ Heart
■ Blood vessels
■ Central nervous system
■ Hematologic
○ What are the most likely manifestations at onset? Review TABLE 2-6
■ Fatigue, fever, polyarthritis, arthralgia, butterfly rash, and glomerulonephritis have greater than 35%
incidence at onset.. Immunologic tests for antibodies■need at least one positive for diagnosis:● ANA
(antinuclear
antibodies)○Positive ANA titer● Anti-Smith antibodies○ “Very specific”● Anti-double stranded DNA○ Specific to
SLE, Clinical Criteria for SLE Diagnosis○Skin: Acute/subacute cutaneous—Malar rash (“butterfly” rash over the
cheeksof the face), photosensitivity; Chronic cutaneous lesions—(e.g., discoid lupus—rough, scaly, raised, red
circular)○Oral ulcers—look like aphthous ulcer (i.e. cold sore) but can also be in nose○Alopecia— usually
patchy○Synovitis—joint inflammation causes pain, swelling usually symmetrical, two ormore joints and can
migrate○Serositis (inflammation of the serous membranes that line the lungs [pleura],heart [pericardium], and
inner abdomen
[peritoneum])○Hemolytic anemia○Leukopenia (< 4,000/mm3)○Lymphocytopenia (<
1,000/mm3)○Thrombocytopenia (100,000/mm3)○Neurologic disorder (e.g., brain irritation manifested as
seizures or psychosis)○Renal: RBC casts, Proteinuria (>0.5 g/ 24 hours), Positive biopsy (nephritis), evenif no
other criteria is present○RBC casts○Protein/creatinine (> 0.5)○Positive biopsy, even if no other criteria is
presen. General strategies include stressreduction, exercise, and sleep. Medications include nonsteroidal anti-
inflammatory drugs(NSAIDs) to reduce pain and inflammation in joints, muscles, and other
tissues.Corticosteroids may also be used to treat SLE.
Lyme disease serology
HIV diagnostic testing, 1st 2nd and 3rd categories - antibody-only testing, combination antigen and antibody
testing,Three categories of testing● Antibody only○ IgM and IgG against HIV-1 and HIV-2● Combination antigen
P24 and antibody○ Antibodies■ tested for HIV-1 and HIV-2■ include IgG and IgM○ P24 protein■ makes up
capsid/viral core of HIV■ P24 antigen is for HIV-1 detection○ *Recommended by the CDC as the initialscreening
test■ If test negative = no further testing necessary■ Positive = HIV-1/HIV-2 antibody
differentiationimmunoassay (not Western blot or ELISA) toconfirm
HIV-1, HIV-2, or both● If test is negative or indeterminate →viral RNA should be done● Viral detection○ P24
antigen and HIV genetic material○ Genetic testing – HIV RNA most commonly used. What is the
recommended testing for HIV? Combination antigen P24 and antibody
Granulomas
What type of organisms invade host cells-viruses. IC facultative bacteria- gnorrhoeae, legionella, and
mycobacterium. Ic obligate bacteria-chlamydia.