NR 507 FINAL EXAM STUDY GUIDE. LATEST 2020. A GRADE

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NR-507 Study Guide Chapters 1-5, 11-14, 16-20, 21-25, 27-3-33, 34-39, 40-47 1. Types of immunity-e.g. innate, active, etc (ch 7 ,191)  Innate immunity includes two lines of defense: natural bar... riers and inflammation Natural barriers are physical, mechanical, and biochemical barriers at the body’s surfaces and are in place at birth to prevent damage by substances in the environment and thwart infection by pathogenic microorganisms.  the natural epithelial barrier and inflammation confer innate resistance and protection, commonly referred to as innate, native, or natural immunity. Inflammation associated with infection usually initiates an adaptive process that results in a long-term and very effective immunity to the infecting microorganism, referred to as adaptive, acquired, or specific immunity.  Adaptive immunity is relatively slow to develop but has memory and more rapidly targets and eradicates a second infection with a particular disease-causing microorganism.  Innate immunity includes two lines of defense: natural barriers and inflammation. Natural barriers are physical, mechanical, and biochemical barriers at the body’s surfaces and are in place at birth to prevent damage by substances in the environment and thwart infection by pathogenic microorganisms INNATE IMMUNITY ADAPTIVE (ACQUIRED) IMMUNITY BARRIERS INFLAMMATORY RESPONSE Level of defense First line of defense against infection and tissue injury Second line of defense; occurs as a response to tissue injury or infection Third line ofdefense; initiated when innate immune system signals the cells ofadaptive immunity Timing of defense Constant Immediate response Delay between primary exposure to antigen and maximum response; immediate against secondary exposure to antigen Specificity Broadly specific Broadly specific Response is very specific toward “antigen” Cells Epithelial cells Mast cells, granulocytes (neutrophils, eosinophils, basophils), monocytes/macrophages, natural killer (NK) cells, platelets, endothelial cells T lymphocytes, B lymphocytes, macrophages, dendritic cells Memory No memory involved No memory involved Specific immunologic memory by T and B lymphocytes Peptides Defensins, cathelicidins, collectins, lactoferrin, bacterial toxins Complement, clotting factors, kinins Antibodies, complement Protection Protection includes anatomic barriers (i.e., skin and mucous membranes), cells and secretory molecules or cytokines (e.g., lysozymes, low pH of stomach and urine), and ciliary activity Protection includes vascular responses, cellular components (e.g., mast cells, neutrophils, macrophages), secretory molecules or cytokines, and activation of plasma protein systems Protection includes activated T and B lymphocytes, cytokines, and antibodies 2. Alveolar ventilation/perfusion- (ch, 34,pg 1238)  The relationship between arterial perfusion and alveolar gas pressure at the base of the lungs is best described as: arterial perfusion pressure exceeds alveolar gas pressure.  Effective gas exchange depends on an approximately even distribution of gas (ventilation) and blood (perfusion) in all portions of the lungs. The lungs are suspended from the hila in the thoracic cavity. When the individual is in an upright position (sitting or standing), gravity pulls the lungs down toward the diaphragm and compresses their lower portions or bases. 3. Dermatologic conditions e.g. pityriasis rosea (ch46, pg 1630/1631)  Psoriasis, pityriasis rosea, and lichen planus are inflammatory disorders characterized by papules, scales, plaques, and erythema  Psoriasis is a chronic, relapsing, proliferative, inflammatory disorder that involves the skin, scalp, and nails and can occur at any age.  Pityriasis rosea is a benign self-limiting inflammatory disorder that occurs more often in young adults, with seasonal peaks in the spring and fall. The cause is unknown but  thought to be associated with a virus (e.g., human herpesvirus 6 [HHV-6] and HHV-7) because of the timing and clustering of the outbreaks  Pityriasis rosea begins as a single lesion known as a herald patch that is circular, demarcated, and salmon-pink; is approximately 3 to 4 cm in diameter; and is usually located on the trunk  Lichen planus (LP) is a benign, autoimmune inflammatory disorder of the skin and mucous membranes with multiple clinical variations. The cause is unknown, but T cells, adhesion molecules, inflammatory cytokines, perforin, and antigen-presenting cells are involved.The infiltrate of T cells mediates immunoreactivity against basal layer keratinocytes, which have altered surface antigens and adhesion molecules  LP is also linked to hepatitis C virus. Some individuals develop lichenoid lesions after exposure to drugs or film-processing chemicals. The age of onset is usually between 30 and 70 years. The disorder begins with flat purple, polygonal, pruritic, nonscaling papules 2 to 4 mm in size, usually located on the wrists, ankles, lower legs, and genitalia  New lesions are pale pink and evolve into a dark violet. Persistent lesions may be thickened and red, forming hypertrophic LP. Oral lesions (oral lichen planus) appear as lacy white rings that must be differentiated from leukoplakia or oral candidiasis and they may be precancerous lesions 4. Croup (C 36,pg 1294)-  Croup illnesses can be divided into two categories: (1) acute laryngotracheobronchitis (croup) and (2) spasmodic croup. Diphtheria can be considered a croup illness but is now rare because of vaccinations. Croup illnesses are all characterized by infection and obstruction of the upper airways.  Croup is an acute laryngotracheobronchitis and most commonly occurs in children from 6 months to 3 years of age, with peak incidence at 2 years of age  The incidence of croup is highest in late autumn and winter, corresponding to the parainfluenza and RSV seasons, respectively. Croup is more common in boys than girls. In a significant portion of affected children, croup is a recurrent problem during childhood, and there is a family history of croup in about 15% of cases  Chickenpox (varicella) and herpes zoster (shingles) are produced by the varicella-zoster virus (VZV). VZV is a complex herpes group deoxyribonucleic acid (DNA) virus. The incubation period is 10 to 27 days, averaging 14 days. Productive infection occurs within keratinocytes such that the vesicular lesions occur in the epidermis, and an inflammatory infiltrate is often present 5. Types of anemia (ch 28,pg 987-1002)  anemia is a reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin. Anemias commonly result from (1) impaired erythrocyte production, (2) blood loss (acute or chronic), (3) increased erythrocyte destruction, or (4) a combination of these three factors.  Pernicious anemia (PA), the most common type of megaloblastic anemia, is caused by vitamin B12deficiency, which is often associated with the end stage of type A chronic atrophic (congenital or autoimmune) gastritis. PA results from inadequate vitamin B12 absorption because of autoantibodies against the B12transporter IF  Folate (folic acid) is an essential vitamin for RNA and DNA synthesis within the maturing erythrocyte. Folates are coenzymes required for the synthesis of thymine and purines (adenine and guanine) and the conversion of homocysteine to methionine. Deficient production of thymine, in particular, affects cells undergoing rapid division (e.g., bone marrow cells undergoing erythropoiesis). Humans are totally dependent on dietary intake to meet the daily requirement of 50 to 200 mcg/day. Folate deficiency anemia is caused by inadequate dietary intake of folate. Both anemias respond to replacement therapy.  The microcytic-hypochromic anemias are characterized by abnormally small erythrocytes that contain abnormally reduced amounts of hemoglobin  Microcytic-hypochromic anemia can result from (1) disorders of iron metabolism, (2) disorders ofporphyrin and heme synthesis, or (3) disorders of globin synthesis. Specific disorders include iron deficiency anemia, side roblastic anemia, and thalassemia [Show More]

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