Micro Compromised Pt – Flashcards
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| What are the two types of immune compromise |
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| Primary/congenital and secondary/acquired |
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| What are the types of primary immune compromise |
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| Innate and acquired defects |
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| What are 4 innate immune defects and less than a sentence on what each is |
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| Complement deficiency Chronic granulmatous disease: lysosomal enz deficiency Chediak hagashi disease: photolysis one fusion issue Leukocyte adhesion deficiency: migration and diapedisis deficiency |
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| What are 5 acquired immune defects and less than a sentence on what each is |
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| SCID: Pro T cannot go to immature T cell CCID: B cells cannot make antibodies Amaglobulinemia: pre B cannot go to pro B DiGeorge: thymic aplasia stops immature T to CD4/8 ANA deficiency: stem cell cannot differentiate into T or B cell |
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| What are 9 general causes of secondary immune deficiency |
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| Malnutrition Age Surgery/ procedures Smoking Infection Drugs Disease Burns Nosocomial |
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| What are four causes of malnutrition leading to immune deficiency |
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| Diet: protein, calories Cachexia Drugs Parasite blocks absorption |
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| What is cachexia |
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| Wasting associated with anemia and hypoalbuminemia |
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| Why is treating cachexia anemia not a great idea |
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| The pt is compromised and increased fe will give bacteria help |
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| 8 diseases that cause immune deficiency |
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| HIV Measles Mumps Diabetes Renal Liver Cancer Hsv |
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| How does diabetes cause immune deficiency |
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| Decreases opsonization and chemo taxis leading to vascular disease, neuropathy, and infection |
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| What are three common infections of diabetes and their agents of cause |
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| Skin infection Otitis: p. aerugrosa, s. Aureus Zygmucormucosis |
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| How does smoking cause immune deficiency |
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| Lung tumors are due decreased clearance of secretions and colonization of microbes |
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| Why are immune suppressants used |
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| Rheumatoid arthritis Transplants |
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| Why do antacids cause immune deficiency |
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| Increase pH and cause a more favorable environment for some microbes |
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| Why do antibiotics cause immune deficiency |
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| Reduce normal flora |
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| Why does chemo cause immune deficiency |
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| Reduces WBC and can cause neutropenia |
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| What three procedures are associated with immune deficiency |
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| Endoscopy Radiation Splenectomy |
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| What is most likely to attack someone with a splenectomy |
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| Encapsulated microbes |
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| What are four things most likely to infect burns |
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| GPC normal flora Aspergillosis Candidiasis Pseudomonas aerugrosa |
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| Five common infectious agents in immune deficiency |
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| Borrelia hermesi Borrelia recurrants M. Lepre Viruses that interfere with mhc 1 HIV |
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| How d a HIV cause immune deficiency |
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| Decreases CD4 |
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| How does m. Lepre cause immune deficiency |
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| Reduces humoral and cmi by infecting macrophages and T cells and disseminating to bone, nerves, and nerves |
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| How does borrelia cause immune difficiency |
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| Surface antigen alteration |
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| What are four innate defenses and some examples of each |
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| Barrier: skin, mucosa, urine, saliva, cilia, Chemicals: complement ph enzymes Phagocytosis Mannose lectin binding and alternate complement pathway |
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| What is cmi |
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| Intracellular organisms activate macrophages, CD 8 and NK Los |
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| What is humoral immunity |
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| Extra cellular organisms activate neutralization, opsonization, phagocytosis, comolement |
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| What are the two categories of classic pathogens Of immune deficiency |
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| GPC GNR |
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| What are the opportunist GNR |
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| Enterobacteriae P. aerugrosa Mycobacterium Strenophoma Burkholderda |
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| 5 virulence factors of p. aerugrosa |
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| Polysaccharide capsule: anti phagocytes, antibiotics, alveolar Protease Exotoxin A |
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| What does p. aerugrosa look like on an antibiotic plate |
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| Blue green |
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| What are infections p. aerugrosa can cause |
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| Lower respiratory infection with CF Bacteremia leading to neutropenia Skin infections in diabetes and burns: folliculitis, ulcers (ethyema), otitis media |
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| Mhcofacterium virulence factor and it's downfall |
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| Mycloic acid: resistance to drying, acid alcohol, immune system Slow growth |
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| How is mycobacterium stained, what part |
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| Carbofushion stains membrane (not peptidoglycan or Mycloic acid) |
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| What are the types of mycobacterium, which are opportunists and which are pathogens |
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| Pathogens: m. Bovis, tb Opportunist: Mac, m.kansasii |
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| Wag are 5 non systemic fungi that affect compromised |
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| Candidiasis Cryptococus neoformins Pneumocystis jirvocci Aspergillosis fumbigatous/nigus Zygomycetes |
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| What are six systemic fungi that affect compromised |
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| Blastomycosis dermatitis Coccidioes immitis H. Capaitulum Paraccioidoies brasilians Sporothrix schenkii - inhaled |
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| What are 4 viruses that affect immune compromised |
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| Cmv Hsv Bk Jc |
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| What are 4 parasites that affect immune compromised |
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| Giardiasis Cryptosporidium parvum Stronglides Toxoplasmosis |
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| Five infections candidiasis causes |
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| Vaginal thrush Oral thrush Chronic Mucocutaneous candidiasis (impaired cmi against candidiasis) Endocarditis Skin infection |
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| What does h. Capitulum look like in tissue, blood, and as a mold |
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| Tissue: small irregular yeast Blood: yeast in macrophage looks bubbly Mold: microconidia |
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| Pjp transmission and moa |
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| Aerosol Bm damage affects alveolar capillary gas exchange |
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| Who does pjs infect most, when |
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| Aids cd4 < 200 |
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| How is pjp diagnosed |
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| Ground glass granular bilateral on chest X-ray Thick walled cyst in sputum and tissue |
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| What is the primary site for aspergillosis |
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| Lung then it disseminates |
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| Aspergillosis is the causative commonly in these four diseases |
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| Neutropenia Transplant marrow Corticosteroids Chemo |
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| How is aspergillus identified |
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| Branching at 45 deg |
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| Where does zygomycs infect |
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| Vascular Tissue Lung |
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| Zygomyces is the causative agent in these 4 disease |
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| Diabetes Chemo Neutropenia Steroids |
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| What disease does bk virus cause |
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| Hemorrhagic systitus |
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| What disease does jc virus cause |
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| Progressive multi focal leukoencepholopathy |
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| Infection process of jc |
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| Inhale Infect tonsil Latent in kidney Moves to marrow Immune suppression activated Spreads into blood |
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| Infection process of candia |
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| Inhale spore Microcomdia and acrospore recruit pmn and macrophages Cause inflammation Move to tissues Become yeast / sprohule Go o nodes in lower respiratory hilar and cause suppression Pulmonary disease and dissemination |
