Non specific defense mechanism

1st line=skin, mucous membranes ex ph GI lacrimal, saliva, secretion of skin

2nd line= phagocytic cells, antimicrobial protein, inflammatory response
Specific defense mech
3rd line= lymphocytes, antibodies, macrophages
Phagocytes= eat *neutrophil, macrophage*
Natural killer cell= lyse destruction of cell > release perforins
Cardinal Signs=Redness,heat,swelling,Pain,Limitation of joint movement
Important aspects of Immune system
1.it is antigen specific, it is systemic, it has memory
Specifc we have macrophage and lympho
Lymphocytes 2 major :
B lymphocytes(humoral)ab mediated= produce antibodies
T lymphocytes(cellular)cellular mediated=non ab producing lymphocytes
WBC=5-10k cumm
2major group:
a) Granulocytes = formed in bone marrow,chemotaxis
Neutrophils*polymorphonuclear leukocytes*=60% first to arrive
Eosinophils=2-4% stress, parasitic worms
Basophils=1% healing phase, release heparin
b) Agranulocytes (lymphocytes, monocytes)
CLASSES OF IMMUNOGLOBULIN
IgG Gammaglobulin=75-85% cross placenta, blood borne, tissue infect
IgM Macroglobulin= 7-10% effective with gram(-) bacteria, Rheu Arthri
IgA Secretory=10-15% body fluids, milk, saliva, mucus, blood, antge from food
IgE =0.002% attached to basophils, anaphylactic shock
IgD= 0.2% to 1% unclear, suppression of lymphocyte function
TYPES OF AG and AB REACTION
1. Agglutination = Ig disarms Ag to clump or stick together
2. Opsonization =Coats microbes
3. Neutralization = ab combines with exotoxins
4. Precipitation = ab reacts with ag resulting visible mass formation
5. Lysis= ab attacks cell membrane to dissolve, liquify
MAJOR CATEGORIES OF T CELL (Cell mediated)
a. Helper T cells=directors,managers recruit cells to fight > release lymphokines
b. Cytotoxic Killer Tcells = killing insert > release perforins n cytokines
c. Suppresor T cells= suppress both T and B cells
d. Memory Cells
STAGES of IMMUNE RESPONSE
1. Recognition stage = initiating event
2.Proliferation stage = turn to the nearest lymph node
3. Response stage =
4. Effector stage
NATURALLY ACQUIRED

Active = infection contact with pathogen

Passive= ab pass from mother to fetus via placenta or breast milk
ARTIFICIALLY ACQUIRED
Active = vaccine
Passive Injection of immune serum (gamma globulin)
TEN WARNING SIGNS
1. 8 or more new ear infection within 1yr
2. 2 or more sinus infection within 1yr
3. 2 or more months on antibiotics with little effects
4. 2 or more pneumonias within 1yr
5. failure of an infant to gain weight or grow normally
6. recurrent deep skin infection or organ abscesses
PHAGOCYTIC DEFECT (infections)
Hyperimmunoglobulinemia E (HIE)-wbc are unable to produce inflame resp.
B CELL DEFECT (anemia, hyperplasia, strepto haemophilus influenza aureas)B12
Agammaglobulinemia (Brutons dse)- all ab disappear from the pt plasma
Hypogammaglobulinemia-lack of differentiation of B cells into plasma
T CELL DEFECT (Hypoparathyroid, tetany, Conge Heart dse)Thymus graft
DiGeorges syndrome or thymic hypoplasia=thymus fails to develop
Chronic mucocutaneous candidiasis =dfect in Tcell immunity
COMBINED B-T CELL DEFICIENCY (ataxia muscle)
Ataxia-Telangiectasia =T and B cell immunity, neurologic dso
Severe combined immunodeficiency DSE = absence
Wiscott-Aldrich Syndrome = SCID + loss of platelets
AIDS=caused HIV wipes T-helper cells
RISK FACTORS OF AIDS
1. Unsafe sexual practice
2. Prostitution and multiple sex partners
3. Occupational exposures
4. Exposure to contaminated blood and needles
5. Perinatal exposure
6. Genital lesions associated with STD
Most common infection in aids = Pneumocystitis carinii pneumonia
1. Enzyme linked immunoabsorbent assay (ELISA)
>>> identifies ab against HIV, only indicates person has been exposed with aids
2. Western Blot Assay= identies HIV ab as identified by ELISA (IT SAYS +)
3.Radio-immunoprecipitation assay = detects HIV protein rather than ab

Frontal lobe = voluntary motor function, mood, attitude

Parietal= sensory pain,touch,temp, balance,taste
Occipital=vision
Temporal = smell, hear

CEREBELLUM=balance, muscle tone coordination

Neuron= cell body, dendrite, axon
NEUROTRANSMITTERS=acetylcholine,dopamine, epinephrine
Norepineprhine, GABA, Serotonin, glutamine
Meninges = Duramater, arachnoid, pia mater
CSF= 1.007 SG, clear odorless, 500ml daily
HEADACHE
Migraine- serotonin 4-72hrs
Cluster= men>women, inc. histamine 20min-2hrs, same side same time
Tension=most common, prolonged muscle contraction
AVOID TYRAMINE = cheese, chocolotae
CRANIAL NERVES
Olfactory, Optic, Occulomotor, Trochlear, Trigeminal, Abducens
Facial, Auditory, Glossopharyngeal, Vagus, Spinal acc. Hypoglossal
ICP= 5-15 mm HG, 10-20mmHG (Brunner)
SEIZURE PREDISPOSING FACTORS
Head trauma, tumors, cranial surgery, CNS infections, metabolic dso, circ dso
Partial = simple partial (conscious) complex partial
Generalized = absence seizure ( not aware of seizure) tonic-clonic most common
CVA (Cerebrovascular Accidents)
1.Ischemic = caused by thrombus and embolus
2. Hemorrhagic = caused by hypertensive bleeding
RF. HPN, Cardio dse, obesity, smoking, DM, hypercholesterolemia
MEDS for STROKE
Aspirin, diazepam, thrombolytics, stool softener, analgesics, antihypertensives
Alzheimer = 70yrs, amyloid plaques
Mild= amnesia, forgetfulness, floating around
Moderate=apraxia, aphasia, agnosia, agraphia, wandering
Severe= inc. irritability, coma, fragmented memory loss
MEDS= antipsychotics, anxiolytics, tacrine, donepezil, rivastigmine
Multiple sclerosis = women 20-40
Charcots triad = scanning speech, intentional tremors, nystagmus
Parkinsons = 5th decade , dec dopamine, tremor, excess sweat, depentia, depress
Cogentin, Artane, Parlodel, Akineton, Benadryl, Eldepryl, L-dopa, Sinement
Guillian-Barre Syndrome = attacks peripheral nerve myelin, campylobacter jejuni
Ascending weakness
Myasthenia Gravis (Motor dysfunction-pheripheral
= dso affects myoneural junction, exacerbated by exercise and move
Trigeminal Neuralgia= Tic douloureux, pain shooting, stabbing one side
Bells palsy = pressure paralysis, infection, tumor, hemorage, trauma
Amyotrophic Lateral Sclerosis =weakness, wasting of muscles
Creutzfeldt-Jakob disease (Spongiform encephalopathy) mad cow