Immune System & HIV/AIDS – Exam Review

Flashcards cover innate vs. acquired immunity, immune responses, inflammatory stages, antibody classes, active/passive immunity, diagnostic tests, nursing assessment, standard precautions & PEP, HIV transmission, staging, viral load/CD4, geriatric considerations, and key infections such as PCP.

What is immunity?

The body’s protective response to invading organisms (antigens).

Name four factors that can weaken the immune system.

Stress, medications, emotions, trauma/surgery (also illness, autoimmune disorders).

Give two examples of autoimmune disorders.

Lupus and rheumatoid arthritis (others: Type 1 diabetes, MS).

Differentiate innate (natural) and acquired immunity.

Innate = present at birth, nonspecific (skin, mucous, inflammation). Acquired = develops after exposure or vaccination, specific to an antigen (B/T-cell mediated).

Which immunity includes the inflammatory response?

Innate (natural) immunity.

List the three lines of defense against invasion (p. 1180).

1) Phagocytic immune response 2) Humoral (antibody) response 3) Cellular immune response.

What are the four basic stages of an immune response?

Recognition → Proliferation → Response → Effector.

Describe the three stages of the inflammatory response.

1) Redness, warmth, edema, pain 2) WBC migration/exudate formation 3) Tissue repair & scar formation.

Define humoral immunity.

Production of antibodies by B-lymphocytes in response to a specific antigen.

Define cellular immunity.

T-cells attack pathogens directly (cytotoxic, helper, suppressor, memory T-cells).

Name the five classes of immunoglobulins.

IgG, IgA, IgM, IgD, IgE.

Which immunoglobulin is associated with allergic reactions?

IgE.

Active vs. passive immunity – key difference?

Active = body makes its own antibodies; Passive = antibodies are given to the body.

Give an example of passive natural immunity.

Antibodies passed from mother to infant via breast milk or placenta.

Give an example of passive artificial immunity.

IV administration of immunoglobulin (e.g., IVIG).

What is the normal intraocular pressure (bonus from side talk)?

10–21 mm Hg.

Standard Precautions include wearing gloves when?

Whenever there is potential for hands to contact blood, body fluids, mucous membranes, or non-intact skin.

Outline immediate steps after a needle-stick with possible HIV blood (Box 36-4).

1) Wash area with soap & water 2) Notify supervisor & file report 3) Identify source patient & test 4) Report to Employee Health/ED immediately 5) Baseline labs & start PEP within 2 hrs (≤72 hrs) 6) 4-week antiretroviral course & follow-up testing 1, 3, 6 mos.

What does PEP stand for?

Post-Exposure Prophylaxis.

What does PrEP stand for and who uses it?

Pre-Exposure Prophylaxis; used by high-risk, HIV-negative individuals to prevent infection.

Most common opportunistic infection in AIDS?

Pneumocystis jirovecii pneumonia (PCP).

HIV transmission routes (3 main).

1) Blood/blood products 2) Sexual fluids (semen, vaginal/rectal) 3) Perinatal (placenta, birth, breast milk).

Is HIV spread by casual contact or saliva?

No – not by casual contact; saliva alone is not a transmission route.

High-risk group with increasing new HIV cases in U.S.

Men who have sex with men (MSM).

Why are older adults at risk for undiagnosed HIV?

Less condom use, new dating after widow/divorce, symptoms mistaken for aging/dementia.

What is viral load testing used for?

Measures amount of HIV RNA; predicts disease progression and monitors therapy.

CD4 count defining AIDS diagnosis.

CD4 count <200 cells/µL (or AIDS-defining illness).

Stages of HIV infection by CDC (simplified).

1) Primary/acute infection 2) Asymptomatic (latent) 3) Symptomatic HIV 4) AIDS.

Primary HIV infection hallmark

High viral replication before antibodies develop (may resemble flu).

Asymptomatic HIV stage – typical CD4 range

CD4 500–1 500 (book uses 500-200; below 500 begins symptomatic).

Example of hypersensitivity (allergy) diagnostic tests (Table 35-4).

Skin prick/scratch test, patch test, intradermal test, RAST (radioallergosorbent), total IgE.

Key nursing assessment points for immune dysfunction.

History of infections/allergies, meds, nutrition, lymph node size, skin/mucous membranes, respiratory status, joints for warmth/swelling.

Describe angioedema and common drug trigger.

Rapid swelling of lips, face, airway; can follow ACE-inhibitor (e.g., lisinopril) use—medical emergency.

Most effective defense mechanism producing ‘weapons’ against antigens.

Production of antibodies.

First line of cellular defense (garbage trucks).

Phagocytic granulocytes/macrophages ingest foreign material.

Purpose of complement system (brief).

Enhances ability of antibodies & phagocytes to clear microbes and damaged cells.

Incubation period (infection stages).

Time from pathogen entry to appearance of general symptoms; pathogen replicating unnoticed.

Prodromal stage (infection).

Nonspecific symptoms like fever, fatigue, malaise before full illness.

Convalescence stage (infection).

Recovery period; symptoms resolve, tissue repairs, possible residual damage.

True/False: Most allergic diseases are diagnosed solely by blood tests.

False – skin testing and history are essential; labs are supportive only.

Protective effect of vaccination is due to which immunity?

Humoral (antibody-mediated) active artificial immunity.