immunity and cells lecture ❤

Phagocytic cells

are cells that engulf, ingest, and destroy foreign bodies or toxins

What are examples of phagocytic cells?

neutrophils + macrophages + monocytes + eosinophils + basophils

Phagocytic cells are the ----- line of defense?

FIRST!

Humoral cells

defend the body by producing specialized proteins called antibodies

What are examples of humoral cells?

B cells + plasma cell + Ig + memory cell

Humoral cells are the ----- line of defense?

SECOND!

Cell Mediated

hunt down and destroy cells that are infected by viruses, hijacked by intracellular bacteria, or turned cancerous

What are examples of cell mediated?

T Cells + helper T + suppressor T + cytotoxic T + natural killer cell

Cell mediated are the ----- line of defense?

THIRD!

Neutrophils are

short lived + if lab shows high result you are very infected!

Normal neutrophil counts is

1,500 to 8,000 cells/mcL (40-60% of total wbc count)

Neutropenia

Low neutrophil count increasing infection risk + less than 1000

Neutropenia nursing considerations include

no sitting flowers + limit visitors + vital signs (temp is most important) + handwashing + paper plates + do not share utensils + cough and deep breathe + assess skin breaks + monitor cbc count!

What isolation is neutropenia?

Reverse isolation! designed to protect immunocompromised patients with low white blood cell counts from outside infections. They prioritize meticulous hand hygiene, strict avoidance of sick contacts, dietary restrictions, and environmental controls to eliminate exposure to potential pathogens.

Macrophages are

longer lived and releases cytokines

High macrophages indicate

arthritis and covid 19

Monocytes are

immature!

High monocyte count indicates

atherosclerosis

Low monocyte count indicates

bone marrow suppression or severe systemic suppresion such as leukopenia

Eosinophils

are a type of disease-fighting white blood cell. They make up 1% to 5% of your total white blood cells and play a critical role in your immune system by regulating inflammation and destroying invading parasites or allergens

High levels of eosinophils indicates

asthma and eczema

Eosinophils help modulate immediate hypersensitivity reactions (allergic reactions) by

producing enzymes that break down and inactivate histamine!

IgE vs Eosinophils

Think of IgE as the alarm system and eosinophils as the emergency responders. When IgE antibodies detect an allergen, they attach to immune cells (including eosinophils). This triggers the eosinophils to release toxins that help fight the threat, which unfortunately also causes the inflammation and symptoms we experience during an allergic reaction.

Basophils

the least abundant type of white blood cell, making up less than 1% of your total circulating leukocytes. Despite their small numbers, they play a critical role in your immune system by releasing histamine and heparin to defend against allergens and infections

Basophils do what

inflammation + vasodilation + clotting off

B cells do what

produce antibodies + natural immunity

Natural (Innate) vs Artificial (also known as acquired) immunity

Natural (innate) immunity is the general, built-in defense system you are born with, providing immediate, non-specific protection against all germs. In contrast, artificial (acquired) immunity is a specialized defense developed later in life—either through exposure to a disease or via vaccines—which tailors a targeted attack against specific pathogens

What is natural immunity?

Immunity achieved through normal life processes. It's also referred to as "innate" immunity. Your body remembers antigens and fights it off in the future.

What are the two types of natural immunity?

active and passive

What is natural active immunity?

When you become immune after catching a disease. This is where you make your own lifelong immunity. An example would be chicken pox. This is the most preferred one to have out of all immunity. This also refers to our DNA component of immunity; think about feline leukemia. We aren't going to get this because our DNA doesn't allow us to get that disease.

What is natural passive immunity?

Passing antibodies from mother to baby via placenta or breastfeeding. These are temporary.

What is artificial immunity?

Immunity that is acquired when a person receives a vaccine or immunity from an external source.

What is artificial active immunity?

Acquiring one's own immunity against an attenuated pathogen. This is typically given by a vaccine. It can be lifelong but the length of activity can vary. This is why they may need to be kept up with boosters. These can be assessed via titers and boosters. These are only second “best” to natural active.

What is artificial passive immunity?

This is a temporary type of immunity where you get antibodies from an external source. Dr. Parker uses the example of getting antibodies (IV IG) for HPV or Hepatitis B to help treat the virus. This may be a way to control the virus and then the patient may receive a vaccine later.

Do you notice any trends that would help you remember/differentiate the different types of immunity?

Active=Permanent or long lasting

Passive=Temporary

Natural=from sources not man made

Artificial=sources that are man-made

Memory cell

fight past diseases

IgA

mucus membranes + prevent pathogen from entering + breast milk (newborn immunity) + protects against organisms found in food

IgM

first antibody produced

IgG

bloodborne + tissue infection

IgE

allergic reactions + hypersensitivity reactions

IgD

not highly active

Cell mediated

type of immunity provided by T cells + diagnosis affected by alteration including (AIDS + HIV + Autoimmune + Cancer)

HIV/AIDS stands for

Human Immunodeficiency Virus + Acquired Immunodeficiency Syndrome

HIV/AIDS

is a virus that attacks the body’s immune system, specifically the CD4 white blood cells. If left untreated, it progressively damages the immune system and can advance to AIDS (Acquired Immunodeficiency Syndrome), the most advanced stage of the disease

HIV/AIDS is defined by

a CD4 cell that is below 200 + a opportunistic infection (pneumonia or kaposi sarcoma) + HIV attaches to CD4 cell

HIV/AIDS transmission

sex + birth/breast feeding + needle stick + if a baby is born from HIV + mother they are HIV + antibodies but they will be negative

HIV/AIDS prevention + screening

PrEP is for indivisuals that are at a high risk + PEP

Pre-Exposure Prophylaxis (PrEP)

Daily medication (pills or long-acting injections) that prevents HIV infection if exposed. It is highly effective and recommended for individuals at high risk.

Post-Exposure Prophylaxis (PEP)

passive artificial + within 72 hours + take HIV meds for 28 days + follow up testing in 3-4 weeks @3months

HIV/AIDS s/s

fever + weight loss + sores

HIV/AIDS stage 1 s/s

2-4 weeks after exposure + flu-like symptoms

HIV/AIDS stage 2 s/s

latency + night sweats + 10-15 years

HIV/AIDS stage 3 s/s

CD4 is below 200 + opportunistic infection + anemia + thrombocytopenia + neutropenia

Pediatric considerations for HIV/AIDS

HIV to AIDS is quicker + failure to thrive

HIV/AIDS testing

Rapid HIV test (any antibodies) + EIA (nucleic acid test + most definite) + Blot

EIA test (Enzyme Immunoassay)

a test that screens for the presence of HIV antibodies in the blood + need 2 positive tests to take this

HIV/AIDS treatment

HAART Therapy + -vir therapy + combo (want to avoid resistance) + compliance is essential + talk about what could interfere with compliance

Allergic Reactions

ask what reaction they have to allergy

Hypersensitivity Type 1

anaphylactic + IgE + mast cells to histamines + typical allergy reaction

Hypersensitivity Type 2

cytotoxic reaction + IgG or IgM + body mistakes as foregin + blood transfusion reactions

Hypersensitivity Type 3

complex reaction + joints and kidneys

Hypersensitivity Type 4

delayed reaction

Histamines 1

hydroxyzine + do not operate heavy machinery + anticholinergic effects (ice chips) + photosensitivity

Histamines 2

pepcid + gastric cells

Prostaglandins

hormone like + vasodilation + smooth muscle contraction + pain receptors

Leukotrienes

smooth muscle contraction + more potent than histamines

Bradykinin

Bradykinin is a powerful vasodilator. During acute allergic reactions or anaphylaxis, increased bradykinin levels can cause profound drops in blood pressure and dangerous swelling (angioedema) in the throat or larynx.

Serotonin is a

potent vasoconstrictor

Assessment of allergic reaction should include

allergy history + labs (cbc + bodily fluids + serum IgE) + skin test (more accurate) such as intradermal injections on back or arm if tattoos + emergency equipment + do not take corticosteroids or antihistamines at least (48-96hr) before + food allergies + meds (-pens and sulfas)

treatments for allergic reaction include to

avoid + reintroduce + antihistamines + leukotriene receptor antagonists (taken daily + long term) + corticosteroids (watch for weight gain + CNS depression + hyperglycemia + taper off)

patients receiving allergy shots need to stay in office for how long?

30min!

Latex allergy

healthcare worked are most at risk! use latex free gloves!

Latex allergy s/s

rhinitis + conjunctivitis

Latex allergy t/x

avoid condoms

Anaphylaxis

vasodilators + increase permeability + bronchoconstriction + airway is priority! + wheezing to stridor + EPI + med alert bracelet + NS fluid for hypotension

Arthritis

inflammation of a joint

Arthritis risk factors

smoking + pollution + genetics

Arthritis s/s

articular and extraarticular

Articular vs Extra-Articular

"Articular" means inside or directly involving the joint (such as cartilage and joint space), while "extra-articular" means outside the joint capsule or surrounding soft tissues

Articular s/s of arthritis

bilateral + symmetric joint pain + morning joint stiffness + swelling + palpated joints feel spongy + starts in distal joints + overtime contracture

Extra-Articular s/s of arthritis

weight loss + fatigue + anemia + raynaud's phenomenon

Arthritis t/x

decrease joint pain + clinical remission + decrease. likelihood of joint deformity + minimize disability + cycling + lifting weights + reconstructive surgeries

Arthritis medications include

DMARDS + Hydroxychloroquine + Methotrexate + NSAIDS

DMARDS

Disease-modifying antirheumatic drugs for RA treatment + prevent inflammation + start within 3 months of diagnosis + results in 6 weeks

Hydroxychloroquine

monitor kidneys + cbc + bone marrow depression + annual eye exams

Methotrexate

prevent thrush + bone marrow suppression + could cause blistering if IV + fetal harm

NSAIDS

take with food

Lupus

a chronic autoimmune disease characterized by inflammation of various parts of the body

Lupus patho

body recognized self as foreign + b cells overproduce antibodies (clogs up capillaries)

Lupus s/s

butterfly rash + skin lesions + photosensitivity + joint pain + raynaud's + splintered nails + CBC shows anemia + leukopenia + thrombocytopenia

Lupus NC

manage pain + support group + collaborative care + smoking cessation + UV rays are a NO NO + avoid stressful situations + weight bearing activity