ALTERED IMMUNITY

This set of flashcards covers vocabulary and key diagnostic criteria for HIV, SLE, MS, and MG as presented in the Altered Immunity lecture notes.

HIV (Human Immunodeficiency Virus)

A retroactive virus that attacks the immune system by targeting WBCs and using viral envelope glycoproteins, known as docking proteins, to hijack CD4+ T-lymphocytes helper cells.

AIDS (HIV-3)

The most severe stage of HIV infection, diagnosed when the CD4 count drops below $200 ext{ cells/mm}^3$ or when a patient has a CD4 count greater than $200$ but presents with an opportunistic infection.

Long-term non-progressors (LTNP)

Patients who remain asymptomatic with a CD4 count within normal limits for more than ten years; also referred to as people living with HIV (PLWH).

Stage 0 (HIV Early Infection)

The period from infection with HIV to the development of HIV-specific antibodies, where the virus is replicating rapidly and the patient is highly contagious despite potentially testing negative on screening tests.

Viral set point

The equilibrium reached between HIV levels and the immune response if treatment is not started during the acute stage.

cART / HAART

Combination Antiretroviral Agent (or Highly-active Antiretroviral Agent) that inhibits HIV replication but does not kill the virus; adherence to the 90% rule (9 of 10 doses on time) is required to prevent resistance.

Pre-exposure Prophylaxis (PrEP)

The use of cART by an uninfected person to prevent HIV infection, requiring seven days of consistent dosing to reach steady levels and regular monitoring of kidney and liver function.

Postexposure Prophylaxis (PEP)

The use of cART for those exposed to HIV (occupational or non-occupational), which must be initiated within $36 ext{ hours}$ of exposure and continued for $28 ext{ days}$.

Systemic Lupus Erythematosus (SLE)

A chronic, progressive, autoimmune, inflammatory connective tissue disorder where antibody and immune complex depositions cause multisystem inflammation and organ damage.

Butterfly rash

The classic primary skin manifestation of Systemic Lupus Erythematosus occurring on the face.

Hydroxychloroquine

The cornerstone of SLE management; an anti-malarial drug with immunomodulating and anticlotting effects that requires frequent eye exams due to potential retinal damage.

Belimumab

A monoclonal antibody given IV or SQ for SLE that inhibits proinflammatory cytokines that stimulate the production of autoantibodies.

Multiple Sclerosis (MS)

A chronic inflammatory disease characterized by an immune response that causes demyelination of the myelin sheath and axonal nerve damage in the CNS white matter.

Relapsing-remitting MS

The most common type of Multiple Sclerosis, characterized by periods of symptomatic episodes followed by periods of remission.

Fingolimod

The first oral immunomodulator approved for MS, which carries a risk of causing bradycardia.

Natalizumab

A monoclonal antibody for MS that carries a risk for progressive multifocal leukoencephalopathy (PML), an opportunistic viral infection of the brain.

Dalfampridine

The only medication approved by the FDA specifically to improve walking ability in patients with Multiple Sclerosis.

Myasthenia Gravis (MG)

A rare, acquired autoimmune progressive disease where antibodies form against acetylcholine (Ach) postsynaptic receptors at the neuromuscular junction, reducing their number.

Ptosis

Drooping eyelids, which is the most common symptom (alongside diplopia) at the initial presentation of Myasthenia Gravis.

Pyridostigmine

An acetylcholinesterase inhibitor used for symptomatic treatment and maintenance; it is the mainstay of Myasthenia Gravis treatment.

Myasthenic crisis

An emergency caused by infection or insufficient MG medication where the priority is maintaining adequate respiratory function for effective gas exchange.

Cholinergic crisis

An emergency caused by too much MG medication; like a myasthenic crisis, the priority is maintaining respiratory function and monitoring for bronchospasms.

Thymectomy

A surgical intervention often performed in patients with Myasthenia Gravis, as the disease is frequently associated with thymic disorders.