NURS 5315 UTA Exam 2 Study Guide Graded A

HIV EIA (3rd generation immunoassay) - can use urine, saliva, or serum (most accurate), need to wait until 12 weeks post exposure to see antibodies, 99% accurate 4th generation immunoassay- "gold standard" measures P24 antigen can test 10 days post exposure Mast cell - Cellular bags of granules located in loose connective tisssue close to blood vessels. Activation initiates inflammatory process. Histamine - Causes vasodilation, increases vascular permeability, increases blood flow to the site of injury- causes erythema and swelling. Cytokines - Soluble factors that contribute to the regulation of innate or adaptive resistance by affecting other neighboring cells. Can be pro-inflammatory or anti-inflammatory. Can react quickly or be more delayed. Leukotrines - Released when mast cells degranulate, prolong the inflammatory process. Cause vasodilation, attract neutrophils, monocytes, and t of inhibition for singular. Prostaglandins - Released when mast cells degranulate, are produced by the arachidonic pathway. Cause vasodilation, platelet aggregation at site of injury, pain, and fever. Chemotactic factors - Biochemical substance that attracts leukocyte to the site of inflammation Neutrophils - Predominant leukocyte at work during the early stages of acute inflammation Monocytes - Become macrophages when entering the tissue, responsible for presenting antigens to the CD4 cell which triggers T-cell immunity and B-cell immunity. Releases additional cytokines IL1, IL6, TNF. Cytokine IL1 function - Causes fever, activates phagocytes & lymphocytes and also increases the release of IL6a Cytokine IL6 function - Stimulates production of acute phase reactants and promotes growth and stimulation of RBCs Cytokine TNF function - Causes fever, increases synthesis of proinflammatory proteins by liver, causes muscle wasting, induces thrombosis Cytokine growth factor function - Promotes production and maturation of neutrophils Complement - Functions include bacterial lysis, vasodilation and increased vascular permeability, triggers mast cell degranulation, chemotaxis, and opsonization. Kinin - Converted to bradykinin which is responsible for pain and chemotaxis, and it increases vascular permeability and vasodilation. Coagulation cascade - Factor XII activates kinin. Function is to form fibrin mesh to stop bleeding and trap micro organisms. COX1 - Prostaglandin of arachidonic pathway. Provides gastroprotection, platelet aggregation, fluid/electrolyte balance COX2 - Prostaglandin of arachidonic pathway. Responsible for pain, fever, renal protection, tissue repair, reproduction development. COX2 inhibitors- clinical implications - Protect gastric mucosa- prevent ulcers and bleeding. Removed from market r/t cardiac events except for Celebrex. Can impair renal function , monitor labs. Arachidonic pathway purpose - Synthesis of prostaglandins Non-selective NSAIDS - Inhibit COX1 and COX2, risk for gastric ulceration, GI bleeds, edema, renal impairment ASA - Blocks COX1 and COX2, also inhibits Thromboxane A2 and prostaglandins Corticosteroids - Inhibit phospholipase A2, preventing formation of prostaglandins, thromboxane A2, prostacyclin, and leukotrines Thromboxane - Vasoconstriction, platelet aggregation Prostacyclin - Vasodilation, platelet aggregation (most effective one) Type 1 hypersensitivity - E. Immediate response to allergen, food, meds, pollen, asthma, allergic reactions P. IgE binds with antigen at 1st exposure. Antigen binds with this complex at 2nd exposure. Inflammatory cascade initiates. C.M. Urticaria, rhinitis, conjunctivitis, angioedema, anaphylaxis Atopic disorders - Genetic Type 1 hypersensitivity, asthma, hay fever, eczema, urticaria