Advanced Exam 4
Immune: protects against infection and cancer development. Hypersensitivity is an allergy,
which is an increased or excessive response to an antigen. Responses can be uncomfortable
such as itchy and water eyes, and sneezing. Or they can be life threatening such as allergic
asthma and anaphylaxis.
Rapid Hypersensitivity Reaction aka: Atopic Allergy including a histamine release.
- Reactions: sneezing, water/itchy eyes, widespread vasodilation, and bronchospasms.
- TX: prioritize.
Cytoxic Reaction: autoantibodies are directed against the host (autoimmune).
- Examples: anemia, ITP, transfusion reactions, and good pasture’s syndrome.
- TX: plasmapheresis.
Immune Complex Reaction: lodge in small vessels causing inflammation and vessel damage.
- Examples: rheumatoid arthritis, lupus, vasculitis, glomerulonephritis.
- S/S: fever, achy joints, rashes, and malaise.
Delayed Hypersensitivity Reactions: no antibody involvement.
- Example: poison ivy, PPD, and transplant rejection.
- TX: remove antigen, Benadryl, and corticosteroids.
Stimulating Reaction: normal cells are turned auto antibody. “Out of control cell.”
- Example: Grave’s disease
- TX: get rid of responding tissues.
Autoimmunity: immune response against healthy cells.
- Examples: lyme disease, lupus, scleroderma, fibromyalgia, and HIV/AIDS.
Lyme disease: from a tick and can cause arthritis. Quick treatment can cure.
- Stage 1: Localized. 1-30 days. Flu-like symptoms, bull’s eye rash, headache, pain and
stiffness in surrounding joints.
- Stage 2: Hits the blood stream. 2-12 weeks. Migrating pain, heart palpitations, facial
palsy, meningitis, radioculonephritis, and encephalitis.
- Stage 3: Will never recover. Months – years. Disabling. Paraparesis, polyneuropathy,
encephalopathy, panic attacks, and arthritis.
- Prevention: Wear protective clothing = hat, long sleeves and pants, sock tucked in, and
wear light colors. Use sprays like DEET, and permethrin.
- TX: vaccinations, antibiotics. (doxycycline, amoxicillin, and ceftriaxone)
Lupus Erythematosus: attack of healthy cells.
- Common in women, African and Asian, and 15-40 years.
- Types: Discoid effects the skin. Systemic everything = inflammation cascade. Effects
connective tissue in the heart, lungs, and kidneys, Lupus nephritis = death.
- S/S: butterfly rash on face, mouth sores, fever (exacerbation 1st s/s), fatigue, hair loss,
sunlight sensitivity, and myositis. Slide 21 for more specifics.
, - Complications: clots in legs or lungs, destruction of RBC, endocarditis, fluid around the
heart and lungs, pregnancy complications, stroke, and thrombocytopenia.
- TX: STERIODS, destroy their immune system, NSAIDs.
- Teaching: protective clothing, heart care, immunizations, and testing.
Scleroderma: SCARE TISSUE. Tissues get hard and thick.
- Localized affects the skin, before age 40, of European decent. Two types = Diffuse (it
goes everywhere), and Limited (just the trunk of the body)
- Systemic Limited: Affects the arm and face. CREST = Calcinosis, Raynaud’s Syndrome,
Esophageal dysfunction, Sclerodactyly, Telangiectasias. Diffuse: Rapid and progressive.
Affects large areas of the skin, kidneys, esophagus, heart, and lungs. Disabling.
- TX: treat the s/s. Nefedipine diltiazem, and felodeipne (Ca blockers) to block Ca to the
heart, causing vasodilation, and treating the Raynaud’s syndrome. Cyclophosphamide,
Methotrexate, NSAIDS, H2 blockers, and laser or plastic surgery.
- Teaching: maintain healthy lifestyle. Treat the Raynaud’s by no smoking, dress warm, and
take meds as scheduled. Treat stiff joints by stretching, exercising (swimming). Treat skin
problems with sunscreen, oil based lotions, and avoid strong soaps. Treat dry mouth by
brushing and flossing daily, dental checkups, call and report sores, pain, or loose teeth
and keep mouth moist. Treat GI by small frequent meals, don’t lay down 1-3 hours after
eating, raise HOB, and eat moist foods. Treat lungs damage by reporting fatigue (#1sign).
Treat heart issues by checking BP often, call if higher than normal, chest pain, or swollen
feet. Treat the kidney by weighing yourself daily, and monitor urination.
Fibromyalgia: not inflammatory. It’s a pain issue.
- Triggers: back of head, shoulders, upper outer butt, hips, lower neck, upper breast,
elbow, and just below knees on the inside.
- S/S: numbness, tingling, headaches, jaw pain, difficulty swallowing, fatigue, abdominal
pain, dysuria, dyspnea, chest pain, blurred vision, short term memory loss, and
hypoglycemia.
- TX: exercise if the best with using low impact and prescriptions. (Meds on slide 37).
Human growth hormone, sodium oxybate, praipexole, and stress management.
HIV: effects the cells in the immune system, leading to immune deficiency. At extreme high risk
for opportunistic infections.
- Transmission is based off sexual contact, exposure to bodily fluid which are
contaminated with blood, mother and child during pregnancy and delivery or
breastfeeding.
- -Risks are having unproductive anal or vaginal sex, having other sexually transmitted
diseases, sharing needles, receiving unsafe injections, blood transfusions, or medical
procedures.
- DX: look for antibodies that fight the HIV virus.
- Acute Infection: 1-2 weeks. Simple flu-like or mono symptoms, which makes you think
“how many people have they already infected?” Asymptomatic can last 1-3 years, and
up to 20. The symptoms start towards the end with fever, malaise, GI problems, muscle
spasms, and lymphadenopathy- 3-6 months & THEY HURT.
Immune: protects against infection and cancer development. Hypersensitivity is an allergy,
which is an increased or excessive response to an antigen. Responses can be uncomfortable
such as itchy and water eyes, and sneezing. Or they can be life threatening such as allergic
asthma and anaphylaxis.
Rapid Hypersensitivity Reaction aka: Atopic Allergy including a histamine release.
- Reactions: sneezing, water/itchy eyes, widespread vasodilation, and bronchospasms.
- TX: prioritize.
Cytoxic Reaction: autoantibodies are directed against the host (autoimmune).
- Examples: anemia, ITP, transfusion reactions, and good pasture’s syndrome.
- TX: plasmapheresis.
Immune Complex Reaction: lodge in small vessels causing inflammation and vessel damage.
- Examples: rheumatoid arthritis, lupus, vasculitis, glomerulonephritis.
- S/S: fever, achy joints, rashes, and malaise.
Delayed Hypersensitivity Reactions: no antibody involvement.
- Example: poison ivy, PPD, and transplant rejection.
- TX: remove antigen, Benadryl, and corticosteroids.
Stimulating Reaction: normal cells are turned auto antibody. “Out of control cell.”
- Example: Grave’s disease
- TX: get rid of responding tissues.
Autoimmunity: immune response against healthy cells.
- Examples: lyme disease, lupus, scleroderma, fibromyalgia, and HIV/AIDS.
Lyme disease: from a tick and can cause arthritis. Quick treatment can cure.
- Stage 1: Localized. 1-30 days. Flu-like symptoms, bull’s eye rash, headache, pain and
stiffness in surrounding joints.
- Stage 2: Hits the blood stream. 2-12 weeks. Migrating pain, heart palpitations, facial
palsy, meningitis, radioculonephritis, and encephalitis.
- Stage 3: Will never recover. Months – years. Disabling. Paraparesis, polyneuropathy,
encephalopathy, panic attacks, and arthritis.
- Prevention: Wear protective clothing = hat, long sleeves and pants, sock tucked in, and
wear light colors. Use sprays like DEET, and permethrin.
- TX: vaccinations, antibiotics. (doxycycline, amoxicillin, and ceftriaxone)
Lupus Erythematosus: attack of healthy cells.
- Common in women, African and Asian, and 15-40 years.
- Types: Discoid effects the skin. Systemic everything = inflammation cascade. Effects
connective tissue in the heart, lungs, and kidneys, Lupus nephritis = death.
- S/S: butterfly rash on face, mouth sores, fever (exacerbation 1st s/s), fatigue, hair loss,
sunlight sensitivity, and myositis. Slide 21 for more specifics.
, - Complications: clots in legs or lungs, destruction of RBC, endocarditis, fluid around the
heart and lungs, pregnancy complications, stroke, and thrombocytopenia.
- TX: STERIODS, destroy their immune system, NSAIDs.
- Teaching: protective clothing, heart care, immunizations, and testing.
Scleroderma: SCARE TISSUE. Tissues get hard and thick.
- Localized affects the skin, before age 40, of European decent. Two types = Diffuse (it
goes everywhere), and Limited (just the trunk of the body)
- Systemic Limited: Affects the arm and face. CREST = Calcinosis, Raynaud’s Syndrome,
Esophageal dysfunction, Sclerodactyly, Telangiectasias. Diffuse: Rapid and progressive.
Affects large areas of the skin, kidneys, esophagus, heart, and lungs. Disabling.
- TX: treat the s/s. Nefedipine diltiazem, and felodeipne (Ca blockers) to block Ca to the
heart, causing vasodilation, and treating the Raynaud’s syndrome. Cyclophosphamide,
Methotrexate, NSAIDS, H2 blockers, and laser or plastic surgery.
- Teaching: maintain healthy lifestyle. Treat the Raynaud’s by no smoking, dress warm, and
take meds as scheduled. Treat stiff joints by stretching, exercising (swimming). Treat skin
problems with sunscreen, oil based lotions, and avoid strong soaps. Treat dry mouth by
brushing and flossing daily, dental checkups, call and report sores, pain, or loose teeth
and keep mouth moist. Treat GI by small frequent meals, don’t lay down 1-3 hours after
eating, raise HOB, and eat moist foods. Treat lungs damage by reporting fatigue (#1sign).
Treat heart issues by checking BP often, call if higher than normal, chest pain, or swollen
feet. Treat the kidney by weighing yourself daily, and monitor urination.
Fibromyalgia: not inflammatory. It’s a pain issue.
- Triggers: back of head, shoulders, upper outer butt, hips, lower neck, upper breast,
elbow, and just below knees on the inside.
- S/S: numbness, tingling, headaches, jaw pain, difficulty swallowing, fatigue, abdominal
pain, dysuria, dyspnea, chest pain, blurred vision, short term memory loss, and
hypoglycemia.
- TX: exercise if the best with using low impact and prescriptions. (Meds on slide 37).
Human growth hormone, sodium oxybate, praipexole, and stress management.
HIV: effects the cells in the immune system, leading to immune deficiency. At extreme high risk
for opportunistic infections.
- Transmission is based off sexual contact, exposure to bodily fluid which are
contaminated with blood, mother and child during pregnancy and delivery or
breastfeeding.
- -Risks are having unproductive anal or vaginal sex, having other sexually transmitted
diseases, sharing needles, receiving unsafe injections, blood transfusions, or medical
procedures.
- DX: look for antibodies that fight the HIV virus.
- Acute Infection: 1-2 weeks. Simple flu-like or mono symptoms, which makes you think
“how many people have they already infected?” Asymptomatic can last 1-3 years, and
up to 20. The symptoms start towards the end with fever, malaise, GI problems, muscle
spasms, and lymphadenopathy- 3-6 months & THEY HURT.
