PTA 160: Pathophysiology Chapter 4 — Immune System

What is immunology?

The study of the physiologic mechanisms that allow the body to recognize foreign materials and neutralize or eliminate them.

What is the main function of the immune system?

To protect the body from infection and disease.

What are the two types of immunity?

Innate immunity and acquired immunity.

What is innate immunity?

The body's first line of defense against pathogens; it does not distinguish among different types of invaders.

What is acquired immunity?

Immunity characterized by specificity and memory.

What factors can affect immunity?

Age, nutrition, environmental pollution, trauma, medication, splenectomy, stress, exposure to toxic chemicals, current illness, and sleep disturbance.

How does moderate exercise affect the immune system?

Immune function is enhanced during moderate exercise.

What is the role of exercise in physical therapy related to immunity?

Exercise can help prevent illness and support a healthy lifestyle.

What should a PTA consider when comparing strenuous and moderate exercise?

The PTA should consider the exercise intensity and evaluate the client before and after exercise.

What is the "neck check" mentioned in the immune system slides?

A screening concept referenced in the slides when considering exercise in relation to illness symptoms.

What is immunodeficiency?

A condition in which immune function is insufficient, increasing the risk of infection.

What is a major consequence of immunodeficiency?

Increased risk of developing infections.

What are risk factors for complications related to immunodeficiency?

Poor physiologic and psychological health, old age, coexisting diseases, invasive procedures, and treatments.

What is important when treating immunodeficient patients in physical therapy?

Infection-control strategies are important.

What complications are common in immunodeficient patients?

Pulmonary complications.

What functional challenges may immunodeficient patients experience?

They may be debilitated and fatigue easily.

What does HIV stand for?

Human Immunodeficiency Virus.

What does HIV do to the body?

It infects the immune system and, if untreated, can cause progressive and profound immune suppression.

Why are people with advanced HIV vulnerable to opportunistic infections?

Their immune systems become weakened and less able to fight infections.

What are the three phases of HIV listed in the slides?

Asymptomatic HIV, symptomatic HIV, and acquired immunodeficiency syndrome (AIDS).

What is the primary cause of HIV infection listed in the slides?

The Type 1 retrovirus.

How is HIV transmitted according to the slides?

Through the exchange of certain body fluids; transmission is associated with high-risk behaviors.

Which immune cells are infected by HIV according to the slides?

T4 helper lymphocytes, macrophages, and B cells.

How does HIV spread through the body according to the slides?

The virus begins in the blood, moves into tissues to infect T4 cells in lymph tissues, and then returns to the blood to infect remaining lymphocytes.

What characterizes asymptomatic HIV?

The infected person is clinically healthy and capable of normal daily activities.

What are clinical manifestations of symptomatic HIV?

Generalized adenopathy, diarrhea, weight loss, night sweats, fever, and fatigue that limits physical and recreational activities.

What manifestations may occur with advanced HIV/AIDS?

CNS,PNS,and ANS involvement; dermatologic conditions; infections; dry, flaking skin; telangiectasia; and Kaposi sarcoma.

What diagnostic tests for HIV are listed in the slides?

HIV-1 antibody enzyme test and Western blot test.

How does the cost of the Western blot test compare with the other listed HIV test?

The slides identify the Western blot test as more expensive.

Is there a cure for AIDS according to the slides?

no cure has been found for AIDS.

What do the slides state about an effective HIV vaccine?

there is no effective vaccine at this time.

What are the goals of HIV treatment listed in the slides?

Stop HIV from replicating, increase T4 helper lymphocyte numbers, and delay HIV progression.

What is one of the most significant threats to effective HIV therapy?

Drug resistance.

What additional treatments for HIV-related conditions are listed in the slides?

NSAIDs, pain medication, surgical procedures, and nonpharmacologic interventions.

What are the benefits of combination therapies for people with AIDS?

Extending lives and survival, helping avoid hospitalization, and supporting a return to work.

How should a PTA interact with a patient who has HIV?

Provide a discreet, nonjudgmental environment and assure confidentiality.

Do patients with HIV need to be isolated during physical therapy according to the slides?

No. The transmission risk is exceedingly small and patients do not need to be isolated.

What should a PTA be prepared for when treating a patient with HIV?

Possible seizures.

What role can exercise play for people with HIV?

Exercise can have clinically significant effects on immune responsiveness.

How long must chronic fatigue syndrome (CFS) symptoms last according to the slides?

Six months or longer.

What is the etiology of chronic fatigue syndrome according to the slides?

It is multifactorial and may involve viral infections, immune dysfunction, central nervous system dysfunction, exercise capacity, sleep patterns, and genetics.

What are clinical manifestations of chronic fatigue syndrome?

Sore throat, fever, muscle pain, muscle weakness, NMH, periods of exacerbation and remission, and post-exertional malaise.

What is post-exertional malaise?

A symptom listed in the slides as part of chronic fatigue syndrome, associated with the condition's response to exertion.

Is there a known cure for chronic fatigue syndrome according to the slides?

No known cure at this time.

What are the treatment goals for chronic fatigue syndrome?

Symptom relief and improved function.

What treatment approach is recommended for chronic fatigue syndrome?

A combination of drug and nondrug therapy, along with lifestyle changes.

What is the PTA's role when treating a patient with chronic fatigue syndrome?

Supervise exercise, avoid overactivity, pace exercises, recommend support groups, observe breathing patterns and posture, include stretching, strengthening, and cardio training, and monitor vital signs.

What is hypersensitivity?

An increased immune response to an antigen or allergen that results in tissue destruction.

What can an exaggerated or inappropriate immune response cause?

Hypersensitivity disorders.

What is an allergen?

A special class of antigen that causes an allergic response.

How can allergens enter or contact the body according to the slides?

They can be inhaled, eaten, injected, or contact the skin.

What is Type I hypersensitivity?

Immediate hypersensitivity.

What are examples of Type I hypersensitivity listed in the slides?

Hay fever and anaphylaxis.

Which immunoglobulin is involved in Type I hypersensitivity?

Immunoglobulin E (IgE).

What happens when IgE encounters the relevant antigen in Type I hypersensitivity?

Histamine is released.

What can widespread histamine release cause?

Systemic vasodilation, bronchospasm, increased mucus secretion, and edema.

What are signs and symptoms of Type I hypersensitivity?

Wheezing, hypotension, swelling, urticaria, rhinitis, rhinorrhea, and anaphylaxis.

What is Type II hypersensitivity?

A reaction in which the body's own tissue is recognized as foreign.

What are examples of Type II hypersensitivity disorders listed in the slides?

Blood transfusion reactions, hemolytic disease of the newborn, and autoimmune hemolytic anemia.

What characterizes Type III hypersensitivity in the slides?

Overproduction of immunoglobulin antibody.

What are examples of Type III hypersensitivity listed in the slides?

Vasculitis and systemic lupus erythematosus (SLE).

What is Type IV hypersensitivity?

Delayed hypersensitivity.

What are examples of Type IV hypersensitivity listed in the slides?

Latex sensitivity, poison ivy, and the response to a TB skin test.

What is an autoimmune disease?

A condition in which the immune system directs immune responses against normal self-tissue, becoming self-destructive.

How many autoimmune diseases do the slides report have been identified?

More than 56.

What body areas can autoimmune diseases affect?

Everything from the skin and joints to vital organs.

What factors may contribute to autoimmune diseases?

Genetic, hormonal, and environmental influences.

Has one gene been identified as responsible for autoimmune diseases according to the slides?

No. The slides state that no single responsible gene has been identified.

What happens during the pathogenesis of autoimmune diseases?

Normal cells become targets of destructive immune responses, resulting in tissue damage.

What are clinical manifestations of autoimmune diseases?

Synovitis, vasculitis, myositis, skin rash, nephritis, fatigue, malaise, myalgia, and arthralgia.

How are autoimmune diseases diagnosed and treated according to the slides?

Diagnosis may involve laboratory tests; treatment varies by disease and may include corticosteroids.

What is lupus erythematosus?

A chronic inflammatory autoimmune disorder.

What are the two forms of lupus listed in the slides?

Discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE).

Who is primarily affected by SLE according to the slides?

Young women.

What factors play a role in SLE?

Genetic and environmental factors.

What possible contributing factors to SLE are listed in the slides?

Immunologic, environmental, hormonal, and genetic factors; the cause remains unknown, and SLE shows a strong familial link.

What happens during the pathogenesis of SLE?

The body produces antinuclear antibodies (ANAs) against its own cells.

Which blood cells may be targeted by antibodies in SLE according to the slides?

Red blood cells (RBCs), neutrophils, platelets, and lymphocytes.

Which body systems may be affected by SLE?

Musculoskeletal, cutaneous and membranous, cardiopulmonary, central nervous, renal, and other systems.

What musculoskeletal symptoms can occur with SLE?

Arthralgia and arthritis; tenosynovitis and tendon rupture may also occur.

What cutaneous manifestations can occur with SLE?

Skin rash, vasculitis, diffuse or patchy alopecia, and painless ulcers of the mucous membranes.

What cardiopulmonary manifestations can occur with SLE?

Inflammation of the layers of the heart, dyspnea, tachycardia, and pneumonitis.

What central nervous system manifestations can occur with SLE?

Headaches, irritability, depression, emotional instability, seizures, CVA, changes in verbal memory, attention and language skills, and progressive cognitive impairment.

What renal manifestations can occur with SLE?

Hematuria, proteinuria, and kidney failure.

What other manifestations of SLE are listed in the slides?

Anemia from decreased erythrocytes, amenorrhea in women, occasional enlargement of lymph nodes, and gastrointestinal involvement.

What is the PTA's role when treating a patient with SLE?

Support the overall treatment plan, allow adequate rest, provide education, and teach activity pacing and energy conservation.

What is fibromyalgia?

Also called fibromyalgia syndrome (FMS); a chronic muscle pain syndrome.

What is one key symptom of fibromyalgia identified by the American College of Rheumatology?

Widespread tender points.

How common is fibromyalgia according to the slides?

The slides report that it occurs in more than 6 million Americans.

Who is affected by fibromyalgia according to the slides?

Women are affected more than men; the slides state that 90% of affected individuals are women and list an age range of 20–55 years.

What are risk factors for fibromyalgia?

Prolonged anxiety, emotional stress, trauma, rapid steroid withdrawal, hypothyroidism, and infection. It may also develop without an obvious triggering event or illness.

What possible etiologic factors are associated with fibromyalgia?

Diet, viral origin, sleep disorder, occupational factors, seasonal or environmental influences, psychological distress, and familial or hereditary links.

What are clinical manifestations of fibromyalgia?

Muscle pain, diffuse pain or tender points, sleep disturbances, worsening symptoms with stress, and decreased circulation during exercise.

What are the treatment goals for fibromyalgia?

Lessen pain and fatigue and eliminate sleep disturbance.

What treatment strategies for fibromyalgia are listed in the slides?

Work modifications, modalities, and exercise.

What types of exercise are listed for fibromyalgia?

Aerobic exercise, gentle stretching, resistance exercise, and aquatic therapy.