NUR 2063 Essentials of Pathophysiology

1. Innate Defense Barriers – •Nonspecific •Immediate response •Distinguish self from nonself •Do not distinguish between pathogens •Include •Skin and mucous membranes •Chemicals 2. Innate Defense Barriers – •Physical and chemical barriers not completely impenetrable. •Additional bloodborne innate defenses include •Inflammatory response •Pyrogens •Interferons •Complement proteins 3. Inflammatory Response – •Vascular reaction. •Triggered by mast cells. •Manifestations include erythema, edema, warmth, heat, and pain. 4. Pyrogens – •Fever-producing molecules •Produced by macrophages •Create an unpleasant environment for bacterial growth •Severe fever—life-threatening 5. Systemic Lupus Erythematosus - - -Chronic inflammatory autoimmune condition. --May affect connective tissue of any body organ. --Remission and exacerbations—stressors tend to trigger. --Disease progression varies from mild to severe. --More common in women, Asians, and African Americans. --Cause is unclear, but it's thought that B cells are activated to produce autoantibodies and autoantigens that combine to form immune complexes, which attack the body's own tissues. 6. Systemic Lupus Erythematosus(2 of 4) - uDiagnostic criteria (four or more of the following) uSerositis uOral ulcers uArthritis uPhotosensitivity uBlood disorders (decreased count) uRenal involvement u uImmunological phenomena uAntinuclear antibody uNeurological disorders (seizures/psychosis) uMalar rash (butterfly rash over cheeks) uDiscoid rash (patchy redness that can cause scarring) 7. Systemic Lupus Erythematosus(3 of 4) Diagnosis – •Diagnosis •11 criteria, X-rays, elevated sedimentation rate, C-reactive protein, urinalysis, echocardiogram, and blood test for complications 8. Systemic Lupus Erythematosus treatment - Treatment: •No cure—only symptom management •Stress management and health promotion behaviors Pharmacological: •NSAIDs, antimalarials, corticosteroids, immunosuppressants, and DMARDs •Plasmapheresis •Prognosis improves with early diagnosis and treatment. 9. AIDS Classification System – •Two systems, one based on lab findings and the other based on clinical manifestations •Laboratory findings—CD4 cell count •Category 1: > 500 cells/μL •Category 2: 200-499 •Category 3: < 200 •Clinical presentation •Category A: asymptomatic •Category B: some less serious manifestations of immune deficiency •Category C: AIDS-defining illnesses present 10. Disorders of the WBCs - •Leukocytes: key players in the inflammatory response and in fighting infections •Normal range = 5,000 to 10,000 cells/mL3 blood •Leukopenia: decreased levels •Leukocytosis: increased levels 11. Infectious Mononucleosis(1 of 2) - u"Kissing disease"—oral transmission. uSelf-limiting. uMost prevalent in adolescents and young adults. uCaused by Epstein-Barr virus in the herpes family. uEBV infects the B cells by killing the cell or being incorporated into its genome. uThose B cells incorporated with EBV produce heterophileantibodies. Once the disease is eliminated, a few B cells remain altered, giving the individual an asymptomatic infection 12. Infectious Mononucleosis(2 of 2) - Manifestations: •Insidious onset. •Incubation = 4-8 weeks. •Initially see anorexia, malaise, and chills. •Manifestations intensify to include leukocytosis, fever, chills, sore throat, and lymphopathy. •Acute illness usually lasts 2-3 weeks; may not fully recover for 2-3 months. Treatment: symptomatic and supportive 13. Leukemia – •Second most common blood cancer •Cancer of the leukocytes •Leukemia cells abnormally proliferate, crowding normal blood cells •Risk factors: exposure to chemical, viral, and radiation mutagens; smoking; use of chemotherapies; certain disease conditions (e.g., Down syndrome); and immunodeficiency disorder 14. Acute lymphoblastic leukemia: - •Affects primarily children •Responds well to therapy •Good prognosis 15. Acute myeloid leukemia – •Affects primarily adults •Responds fairly well to treatment •Prognosis somewhat worse than that of acute lymphoblastic leukemia 16. Chronic lymphoid leukemia –