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Unit II Common Diseases and Disorders of Body Systems Copyright Copyright © 2010 © 2010 Delmar, Delmar, Cengage Cengage Learning. Learning. ALLALL RIGHTS RIGHTS RESERVED. RESERVED. Chapter 5 Immune System Diseases and Disorders Copyright Copyright © 2010 © 2010 Delmar, Delmar, Cengage Cengage Learning. Learning. ALLALL RIGHTS RIGHTS RESERVED. RESERVED. Anatomy and Physiology • Organs: – – – – – – Thymus gland Bone marrow Lymph nodes Spleen Liver Tonsils Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology • Types of immunity: – – – – Active natural Active artificial Passive natural Passive artificial Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Common Signs and Symptoms • Vary • Related to factors, such as the following: – Immunodeficient • Lack of immunity – Autoimmune • Immunity against self – Isoimmune • Immunity against other humans Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Testing • • • • • • Skin tests Desensitization Blood count Coombs’ test Anti-nuclear antibody (ANA) Rheumatoid factor (RF) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Allergies – E.g., hay fever, asthma – Common reactions: • Urticaria • Contact dermatitis Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Urticaria Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Allergies – Symptoms: • Elevated eosinophil count • Redness, heat, swelling, and itching • Runny nose, coughing, sneezing, wheezing, and nasal congestion Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Hay fever – Reaction to allergen in mucous membranes of nose and upper respiratory tract – Symptoms: • • • • Sneezing Watery eyes Runny nose Itching Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Hay fever – Causes of seasonal: • • • • Tree pollen Grasses Ragweed pollen Agricultural crops Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Hay fever – Causes of nonseasonal: • Dust mites • Pet dander • Food allergies Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Hay fever – Treatment: • Removal of allergen • Air-conditioned environment – Or move to different climate • Antihistamines • Allergy desensitization Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Asthma – Also known as bronchial asthma – Symptoms: • • • • • Extreme shortness of breath Difficulty breathing Wheezing Anxiety Cough Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Asthma – Treatment: • • • • Avoidance of causative allergens Desensitization Education Medication – No cure • But can be controlled Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Asthma Animation Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Anaphylaxis – Severe allergic response to allergen – Causes: • • • • Antibiotics Anesthetics Codeine Insulin Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Anaphylaxis – Causes: • • • • Vaccines Foods Pollens Latex Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Anaphylaxis – May be mild to life-threatening – Symptoms: • Itching of throat, tongue, and scalp • Edema of face and airways leading to difficulty breathing Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Anaphylaxis – Treatment: • • • • Emergency tracheostomy Epinephrine Corticosteroids Antihistamines Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Hypersensitivity Disorders • Food allergies – E.g., chocolate, shellfish – Symptoms: • Cramping • Diarrhea • Vomiting Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Contact Dermatitis • Acute or chronic allergic skin reaction – E.g., poison ivy Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Contact Dermatitis • Causes: – – – – – – Cosmetics Laundry products Plants Jewelry Paint Drugs Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Rheumatic fever – Follows group A strep infection – Occurs one to four weeks after strep infection • Sudden or gradual onset Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Rheumatic fever – Symptoms: • Fever • Malaise • Joint pain – Prevention: • Accurate diagnosis of strep infections Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Rheumatoid arthritis – Abnormal antibody that attacks or attaches to body’s own cells and tissues – RF antibody in blood indicative of disease – Classic sign: • Ulnar deviation – Progressive disease Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Rheumatoid arthritis – Treatment: • • • • • Anti-inflammatory medications Analgesics Exercise and rest routine Short-term corticosteroids Surgical joint replacement Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Myasthenia gravis – Slow onset Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Myasthenia gravis – Symptoms: • • • • • • Diplopia Ptosis Dysphagia Dysphonia Difficulty with facial expressions Fatigue Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Myasthenia gravis – Periods of remission and exacerbation – Treatment: • Mestinon • Plasma exchange Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Type 1 diabetes mellitus – Formerly known as insulin-dependent diabetes mellitus – Alters carbohydrate or sugar metabolism – Triggered by viral infections • E.g., rubella, mumps, influenza Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Lupus erythematosus – Two types: • Cutaneous – Discoid – Limited to skin • Systemic – Diffuse – Affects multiple systems Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Systemic lupus erythematosus (SLE) – Chronic with remissions and exacerbations – Symptoms: • • • • Butterfly rash Joint pain Fever Weight loss Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Systemic lupus erythematosus (SLE) – Symptomatic treatment: • • • • Non-steroidal anti-inflammatory drugs (NSAIDS) Antipyretics Analgesics Corticosteroids Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Scleroderma – Hardening, thickening, and shrinking of connective tissues • Including skin – Periods of remission and exacerbation – Symptoms: • Joint contractures • Raynaud’s phenomenon • Thick, leather-like, shiny, taut skin Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Autoimmune Disorders • Scleroderma – Treatment: • No cure or treatment • May use antibiotics, immunosuppressives, and anti-inflammatories • May be beneficial to perform muscle stretching and strengthening exercises Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Isoimmune Disorders • Blood transfusion reaction • Type of tissue transplant • Type O – Universal blood donor • Type AB – Universal blood recipient Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Isoimmune Disorders • Symptoms of transfusion: – Chills – Shivering – Fever Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Isoimmune Disorders • Erythroblastosis fetalis – Mother’s antibodies attack and destroy antigen on baby’s red blood cells (RBCs) • Ultimately causing death – Usually no problem with first baby of Rh-negative mother and Rh-positive baby Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Isoimmune Disorders • Erythroblastosis fetalis – Condition only affects Rh-positive babies carried by Rhnegative mothers – Also known as hemolytic disease of the newborn Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Isoimmune Disorders • Erythroblastosis fetalis – Treatment: • Transfusion of baby’s blood at birth – RhoGAM • Halted this condition • Given prophylactically after delivery of first fetus Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Organ Rejection • Human immune system attacks transplanted tissue • More closely matched donor decreases chance of rejection • Acute rejection occurs early • Chronic rejection occurs over long period Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Immune Deficiency Disorders • Inability of immune system to protect individual against disease • Congenital, genetic disorder or acquired Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Immune Deficiency Disorders • Acquired types may be due to: – Bone marrow suppression from chemotherapy and radiation – Medications given to organ transplant recipients – Immunodeficiency • E.g., acquired immunodeficiency syndrome (AIDS) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Immune Deficiency Disorders • AIDS – Human immunodeficiency virus (HIV) – Eradicates individual’s lymphocytes – Stages: • • • • Acute infection Asymptomatic HIV Symptomatic HIV Advanced HIV Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Immune Deficiency Disorders • Advanced HIV – T-cell count less than 50 per microliter – Anti-viral medications may slow HIV replication and disease progress • E.g., azidothymidine (AZT) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Immune Deficiency Disorders • Transmission of AIDS – Intimate contact and sharing of body fluids – Virus must enter bloodstream to cause infection – Misconceptions about transmission • Cannot acquire from toilet seats, doorknobs, furniture, water fountains, social kissing, coughing, or sneezing Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Immune Deficiency Disorders • AIDS primarily spread three ways: – Sexual intercourse – Sharing of hypodermic needles – In utero from infected mother to unborn baby Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rare Diseases • Severe combined immunodeficiency disease – Group of inherited disorders that cause partial or complete dysfunction of immune system Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Effects of Aging • Degenerated thymus gland • Changed function of antibodies Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.