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Immune & Autoimmune Disorders

NRS 233 - Pathophysiology II
by

Katrina Dielman

on 19 April 2016

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Transcript of Immune & Autoimmune Disorders

Immune & Autoimmune Disorders
NRS 233: Pathophysiology II
Type 1 Hypersensitivity
HIV/AIDS
Suppressed Immune System
Adaptive Immunity
Deficient
Immune Response

Excessive or Inappropriate
Immune Response

References
Giddens, J. (2013).
Concepts for nursing practice
(1st ed.). St. Louis, MO: Elsevier Mosby.
Copstead, L. & Banasik, J. (2014).
Pathophysiology
(5th ed.). St. Louis, MO: Elsevier.
Type III
Hypersensitivity
HIV/AIDS
T-helper cells (CD4) = 75% of all T lymphocytes
Lymph System Organs
MHC-I:
All cells that have a nucleus
MHC-II:
From antigen-presenting cells - dendrites, macrophages, B-lymphocytes
Exaggerated
Immune Response
Type I
Hypersensitivity -

Anaphylaxis
Type III

Hypersensitivity -

RA
&
SLE
Rheumatoid Arthritis
Systemic Lupus
Erythematosus
Felver, L. (2013). Online Materials:
PROP- Pathophysiology online.
Retrieved from https://evolve.elsevier.com/
YouTube videos embedded on some slides.
KhanAcademy.org. (n.d.).
B Cells, CD4+...
Retrieved from https://www.khanacademy.org/science/biology/human-biology/immunology/v/review-of-b-cells-cd4-t-cells-and-cd8-t-cells
Immune-complex

mediated
reaction
Immediate
Neutrophils
IgG
+ complement
IgE-mediated
reaction
Immediate
Mast cells
IgE
No complement
Sequence & Treatment
Anaphylaxis
Autoantibodies
bind to various joint antigens, forming
immune complexes
in the joint.
Activates
complement
Activates
neutrophils
Forms a mass of tissue known as
pannus
that covers the articular cartilage
Cells of the pannus secrete many
cytokines
and destructive enzymes that degrade cartilage and activate osteoclasts to degrade bone
Joint deformities occur from destruction of cartilage and bone, fibrosis, and damage to ligaments and tendons that causes
subluxation
and
contractures
IgG antibodies
develop against many different
self antigens
(kidneys, arteries, joints, & skin)
Immune complex
deposition
Complement
and
neutrophil
activation that triggers inflammation
Malar rash
ANA = antinuclear antibodies
(antibodies against normal nuclear antigens)
1. Sensitization
- APCs process & present antigen to naive B-lymphocytes
2.
B-lymphocytes (
plasma cells
) produce
IgE antibodies
3.
IgE antibodies attach to
mast cells
4.

Antigen
binds to antibodies on mast cell
5.

Mast cells degranulate
& release/secrete histamine, enzymes, chemotactic agents, prostaglandins, leukotrienes, & cytokines
6.

Inflammatory symptoms
develop
Monitoring HIV Status
Labs:
HIV antibody
screening
Blood tests:
A positive ELISA test needs confirmation with a Western Blot
Conversion occurs 3 weeks - 3 months after infection
Oral saliva:
Home test kits are recommended for use 3 months after exposure - Positive tests need follow-up

Viral load
testing to determine viral burden
Useful to determine disease progression and/or treatment success

CD4+ T-cell count
to determine impact upon immune system
Antibodies
IgG
- Primary immunoglobulin in the blood -
80% to 85% of circulating immunoglobulins
May enter tissue spaces
Selectively crosses the placenta
Coats antigen for more effective and efficient presentation for an immune response
Binds to macrophages and neutrophils for increased phagocytosis

IgD
- Found within the cell membrane of B lymphocytes

IgE
- Responsible for allergy symptoms and increases in the presence of parasitic worms
Normally found in trace amounts

IgA
- Protects entrances to the body
Found in high concentrations in body fluids (tears, saliva, secretions of the respiratory and gastrointestinal [GI] tracts)

IgM
- Remains in the blood and efficiently kills bacteria
Largest of the immunoglobulins
First antibody produced with an initial (primary) immune response
Complement System
Works to enhance the immune response
Helps rid the body of antibody-antigen complexes

Comprised of
25 major proteins
Circulate in an inactive form in the blood
Engage in a cascade of interactions when the first protein molecule (C1) encounters an antigen-antibody complex

Also responsible for
dilation & leaking of fluid
from the vascular system
Leads to redness & swelling during the inflammatory process
Full transcript