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NURS 5315 EXAM 2 STUDY GUIDE
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NURS 5315 EXAM 2 STUDY GUIDE
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WBC, Hgb, HCT, MCV - numbers in anemia lectureExam 2 Study Guide: Modules 3, 4
Normal Lab Values
WBC 4.5-11 pH 7.35-7.45 PT 11-12.5 Na 135-145 Creatinine 0.5-1.3
Hemoglobin 13-16 PaCO2 35-45 INR <1.6 K 3.5-5 BUN 8-22
Hematocrit 37-49 PO2 80-100 PTT 23-33 Mg 1.2-2 Serum Osmolality 285-295
MCV 80-100 HCO3 22-28 Ca 8.5-10.5 Osmolar GAP <10
Platelet 130-400 Glucos 70-100 Anion GAP <10
e
F PO4 3-4.5
Inflammation, Altered Immunity and Infection
Immune System
- Examine the structure and function of the immune system.
Natural Immunity (innate resistance/immunity
Exists prior to exposure to a microbe
Born with it, based on genotypes & species
Skin, mucous membranes
Does not improve after exposure
Functions to kill invading microorganisms & activated acquired immunity
Cells of innate immunity: phagocytic cells, antigen presenting cells, natural killer cells, &
complement
- Active acquired immunity
Obtained after exposure to antigen
Improves with repeat exposure, antigen or immunization
- Passive acquired immunity
Acquired after the transfer of antibodies or T cells
Mother to fetus, antibodies cross placenta or breast milk
, Artificial is when antibodies are given to recipient to provide immunity
Rabies, tetanus, hepatitis, & snake bites
Immediate protection, but only lasts as long as the antibodies ~ 2 weeks
- Antigen – virus/bacteria
- Self-antigen
- Allergens
- Cell mediated immunity – governed by T cells
T cells are differentiated (named) by the expression of antigens on their cell membrane called
“cluster of differentiation” (CD).
CD4 cells = T-helper / T4 cells
Activate macrophages, B cells, cytotoxic T cells, & other CD4 cells
Release lymphokines that begin the inflammatory process
Mediate delayed hypersensitivity reactions (TB skin test)
Functions are performed by subgroup of CD4 cells called TH1 & TH2, release lymphokines
Type of T-lymphocyte Cells Function
T-Helper cells Activate macrophages, B-cells, cytotoxic T cells and other CD4 cells, release
lymphokines (TH1 & TH2), that being the inflammatory process. Mediate
delayed hypersensitivity reactions (TB skin test)
T-cytotoxic cells Kill virus infected cells, tumor cells, & allograft cells (transplant tissue) through
release of cytotoxic chemicals which destroy the cell membrane or induce
apoptosis.
NK Killer cells Contain granules that attack & kill virus infected or cancerous cells
T-Regulatory cells Slow or stop the immune response once the invader is defeated
Memory T cells – allow host to remember antigens & respond quicker & more vigorously after the
initial exposure. Liver for many years and can reproduce themselves
Activation of T Cells:
, Antigen enters host → Macrophage (or other APC) engulfs antigen → antigen expressed on
MHC class II → secretes IL 1 to attract CD4 cells → presents it to CD4-cells → CD4
differentiates into Th1 and Th2→ Th1 releases IL2 → activated cytotoxic T-cells (Tc) → Tc
receptor connects with MHC class I receptor on invader → cytotoxic chemicals released →
invader killed. Th2 releases IL4 → activates the humoral immune system
- Humoral Immune Response – governed by B cells
B cells mature into plasma cells that produce antibodies
5 classes of antibodies (glycoproteins): IgG, IgE, IgM, IgA, IgD
Type of B-
Lymphocyte Cells
Function
IgG - Most prominent immune globulin
- Elevated later in the infection
- Binds with viruses, bacteria, & toxins
- Activates complement, binds to macrophages
- Primary antibody in secondary immune response
- Levels rise faster in response to subsequent exposure to an antigen
- Only immune globulin that crosses the placenta
- Provides long lasting immunity
IgE - Binds to mast cells, eosinophils, & basophils
- Involved in parasitic infections & hypersensitivities (anaphylaxis) rx
IgM - Main immune globulin produced early in the primary immune response
- A high level indicates a recent infection
IgA - Main immune globulin in secretions & mucous membranes
- Prevents attachment of microorganisms to the mucous membranes
IgD???? - On surface of B-lymphocytes
- It signals B-cell activation
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