ADN 520 - Immunity
Study online at https://quizlet.com/_i0rzr8
1. Autoimmunity: the immune system cannot differentiate between itself and other antigens. Can affect almost
any muscle or tissue in the body
2. Cells: - CD4: helper T cells
- CD8: Killer T-Cells
3. Rx Factors for Autoimmune Disorders: - Family hx, infections, sex (women more likely)
4. Rheumatic Disorders: - Don't just include rheumatoid arthritis
- Affect skeletal muscles, bone, cartilage, ligaments, tendons, and joints
5. Expected findings with Auto-Immunity: - Fatigue, chronic pain, frequent infections
- Stiff, weak, joint swelling
6. Diagnosing Auto-Immune Disorders: - Serological testing (e.g ELISA): detect presence of anti-
bodies to tissue antigens (auto-antibodies) indicates that the body is attacking itself)
7. Labs w/Autoimmune Disorders: - ESR: elevates with inflammation (Higher means more inflamma-
tion)
- CRP: elevates with inflammation
- Hct: decreased due to RBC destruction from chronic inflammation
- Creatinine: increased with kidney damage from excretion of large molecules (e.g. RBC)
- RBC: decreased because the lysis of the cells
8. Rheumatoid Arthritis (RA): - A chronic, progressive, systemic, inflammatory autoimmune disease
process that primarily affects the synovial joints
- Involves the joints bilaterally (typically see upper joints such as the hands and wrist affected first)
9. Pathophysiology of RA: - Synovial tissue is attacked by the WBC's, collagen is broken down causing
edema, proliferation of the synovial membrane, and pannus formation which destroys cartilage and can erode the
bone.
- New blood vessels form in the synovial membrane, contributing to advancement.
10. Pannus: The newly formed vascular granulation tissue in joint's "bare area"
11. Manifestations of RA: - Joint stiffness/pain/swelling that is usually bilaterally symmetrical
- Fatigue (one of the earliest warning signs)
- Weakness, morning sitfness
- Weight loss, pain upon inspiration, xerostomia (dry mouth)
12. Joints Affected: - The joints in the hands/wrist are affected first, but knee is most commonly affected
- Joint deformities are a late sign, but swelling, warmth, and redness are very common
- Become deformed
1/6
, ADN 520 - Immunity
Study online at https://quizlet.com/_i0rzr8
13. Diagnosis of RA: History, physical, and laboratory testing
- Anti-CCP Antibodies: checks an antibody level that is common in most with rheumatoid arthritis
- Rheumatoid Factor Antibody: high titer (1:40-1:60) would indicate severe disease, other autoimmune diseases can
increase RF titer.
- Antinuclear antibody titer (ANA): antibody produced against one's own DNA, positive w/other diseases
14. Labs that Elevate w/Autoimmune Diseases: - ESR: associated w/inflammation
- WBC: elevated during exacerbation
- CRP: elevated w/inflammation
15. NSAIDs: - Inhibit prostaglandin synthesis to produce: antipyretic, anti-inflammatory, & analgesic effects
- Usually aspirin (Motrin) and naproxen (Naprosyn)
- Can cause GI upset, GI bleeding, and kidney damage
16. DMARD's: Non-Biological: - Used before biological. Trying to prevent inflammation and joint damage
- Methotrexate and cyclosporin
- Take 6 weeks on average to work, but used before biological because they are less expensive and have less
contraindications
17. DMARD's: Biological: - adalimumab (Humira), etanerupt (Enbrel), and infiximab (Remicade)
- Expensive and should be given SQ or IV.
- Block TNF (Cytokine w/inflammation)
- Contra w/HTN, diabetes, CHF, and renal impairment
18. Corticosteroids: - Interfere with inflammation: prostaglandin synthesis, response of inflammatory cells, and
neutrophils
- Not for long term therapy, usually for exacerbation
- Can cause cataracts, osteoporosis, high glucose
19. Non-Pharmacological Management of RA: - Diet: high in protein, iron, and vitamins. Focus on
whole foods. Small frequent meals are okay too.
- Exercise: stretching, low impact, water exercises. Weight reduction can help relieve stress on the joints.
- Sleep: setting a time to go to bed and get up, comfortable room temp, avoiding caffeine/alcohol before bed.
- Comfort: Rest periods, specialty mattresses , splints, hot/cold, scheduled pain meds
20. Pregnant Women: - Can take tylenol and cyclosporin (not methotrexate)
21. Types of Organ Donation: - Autograft: self donation (least chance of rejection)
- Allograft: not self, can be relative or non-relative
- Syngeneic: identical twin with exact HLA
2/6
Study online at https://quizlet.com/_i0rzr8
1. Autoimmunity: the immune system cannot differentiate between itself and other antigens. Can affect almost
any muscle or tissue in the body
2. Cells: - CD4: helper T cells
- CD8: Killer T-Cells
3. Rx Factors for Autoimmune Disorders: - Family hx, infections, sex (women more likely)
4. Rheumatic Disorders: - Don't just include rheumatoid arthritis
- Affect skeletal muscles, bone, cartilage, ligaments, tendons, and joints
5. Expected findings with Auto-Immunity: - Fatigue, chronic pain, frequent infections
- Stiff, weak, joint swelling
6. Diagnosing Auto-Immune Disorders: - Serological testing (e.g ELISA): detect presence of anti-
bodies to tissue antigens (auto-antibodies) indicates that the body is attacking itself)
7. Labs w/Autoimmune Disorders: - ESR: elevates with inflammation (Higher means more inflamma-
tion)
- CRP: elevates with inflammation
- Hct: decreased due to RBC destruction from chronic inflammation
- Creatinine: increased with kidney damage from excretion of large molecules (e.g. RBC)
- RBC: decreased because the lysis of the cells
8. Rheumatoid Arthritis (RA): - A chronic, progressive, systemic, inflammatory autoimmune disease
process that primarily affects the synovial joints
- Involves the joints bilaterally (typically see upper joints such as the hands and wrist affected first)
9. Pathophysiology of RA: - Synovial tissue is attacked by the WBC's, collagen is broken down causing
edema, proliferation of the synovial membrane, and pannus formation which destroys cartilage and can erode the
bone.
- New blood vessels form in the synovial membrane, contributing to advancement.
10. Pannus: The newly formed vascular granulation tissue in joint's "bare area"
11. Manifestations of RA: - Joint stiffness/pain/swelling that is usually bilaterally symmetrical
- Fatigue (one of the earliest warning signs)
- Weakness, morning sitfness
- Weight loss, pain upon inspiration, xerostomia (dry mouth)
12. Joints Affected: - The joints in the hands/wrist are affected first, but knee is most commonly affected
- Joint deformities are a late sign, but swelling, warmth, and redness are very common
- Become deformed
1/6
, ADN 520 - Immunity
Study online at https://quizlet.com/_i0rzr8
13. Diagnosis of RA: History, physical, and laboratory testing
- Anti-CCP Antibodies: checks an antibody level that is common in most with rheumatoid arthritis
- Rheumatoid Factor Antibody: high titer (1:40-1:60) would indicate severe disease, other autoimmune diseases can
increase RF titer.
- Antinuclear antibody titer (ANA): antibody produced against one's own DNA, positive w/other diseases
14. Labs that Elevate w/Autoimmune Diseases: - ESR: associated w/inflammation
- WBC: elevated during exacerbation
- CRP: elevated w/inflammation
15. NSAIDs: - Inhibit prostaglandin synthesis to produce: antipyretic, anti-inflammatory, & analgesic effects
- Usually aspirin (Motrin) and naproxen (Naprosyn)
- Can cause GI upset, GI bleeding, and kidney damage
16. DMARD's: Non-Biological: - Used before biological. Trying to prevent inflammation and joint damage
- Methotrexate and cyclosporin
- Take 6 weeks on average to work, but used before biological because they are less expensive and have less
contraindications
17. DMARD's: Biological: - adalimumab (Humira), etanerupt (Enbrel), and infiximab (Remicade)
- Expensive and should be given SQ or IV.
- Block TNF (Cytokine w/inflammation)
- Contra w/HTN, diabetes, CHF, and renal impairment
18. Corticosteroids: - Interfere with inflammation: prostaglandin synthesis, response of inflammatory cells, and
neutrophils
- Not for long term therapy, usually for exacerbation
- Can cause cataracts, osteoporosis, high glucose
19. Non-Pharmacological Management of RA: - Diet: high in protein, iron, and vitamins. Focus on
whole foods. Small frequent meals are okay too.
- Exercise: stretching, low impact, water exercises. Weight reduction can help relieve stress on the joints.
- Sleep: setting a time to go to bed and get up, comfortable room temp, avoiding caffeine/alcohol before bed.
- Comfort: Rest periods, specialty mattresses , splints, hot/cold, scheduled pain meds
20. Pregnant Women: - Can take tylenol and cyclosporin (not methotrexate)
21. Types of Organ Donation: - Autograft: self donation (least chance of rejection)
- Allograft: not self, can be relative or non-relative
- Syngeneic: identical twin with exact HLA
2/6
