copyright © 2010 delmar, cengage learning. all rights reserved. unit ii common diseases and...

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Unit II

Common Diseases and Disorders of Body Systems

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 5

Immune System Diseases and Disorders

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Anatomy and Physiology

• Organs:– Thymus gland

– Bone marrow

– Lymph nodes

– Spleen

– Liver

– Tonsils


Anatomy and Physiology

• Types of immunity:– Active natural

– Active artificial

– Passive natural

– Passive artificial


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


Diagnostic Testing

• Skin tests

• Desensitization

• Blood count

• Coombs’ test

• Anti-nuclear antibody (ANA)

• Rheumatoid factor (RF)


Hypersensitivity Disorders

• Allergies– E.g., hay fever, asthma

– Common reactions:• Urticaria

• Contact dermatitis


Urticaria

Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University



• Allergies– Symptoms:

• Elevated eosinophil count

• Redness, heat, swelling, and itching

• Runny nose, coughing, sneezing, wheezing, and nasal congestion



• Hay fever– Reaction to allergen in mucous membranes of nose and

upper respiratory tract

– Symptoms:• Sneezing

• Watery eyes

• Runny nose

• Itching



• Hay fever– Causes of seasonal:

• Tree pollen

• Grasses

• Ragweed pollen

• Agricultural crops



• Hay fever– Causes of nonseasonal:

• Dust mites

• Pet dander

• Food allergies



• Hay fever– Treatment:

• Removal of allergen

• Air-conditioned environment– Or move to different climate

• Antihistamines

• Allergy desensitization



• Asthma– Also known as bronchial asthma

– Symptoms:• Extreme shortness of breath

• Difficulty breathing

• Wheezing

• Anxiety

• Cough



• Asthma– Treatment:

• Avoidance of causative allergens

• Desensitization

• Education

• Medication

– No cure• But can be controlled


Animation

Click Here to Play Asthma Animation



• Anaphylaxis– Severe allergic response to allergen

– Causes:• Antibiotics

• Anesthetics

• Codeine

• Insulin



• Anaphylaxis– Causes:

• Vaccines

• Foods

• Pollens

• Latex



• Anaphylaxis– May be mild to life-threatening

– Symptoms:• Itching of throat, tongue, and scalp

• Edema of face and airways leading to difficulty breathing



• Anaphylaxis– Treatment:

• Emergency tracheostomy

• Epinephrine

• Corticosteroids

• Antihistamines



• Food allergies– E.g., chocolate, shellfish

– Symptoms:• Cramping

• Diarrhea

• Vomiting


Contact Dermatitis

• Acute or chronic allergic skin reaction– E.g., poison ivy


Contact Dermatitis

• Causes:– Cosmetics

– Laundry products

– Plants

– Jewelry

– Paint

– Drugs


Autoimmune Disorders

• Rheumatic fever– Follows group A strep infection

– Occurs one to four weeks after strep infection• Sudden or gradual onset



• Rheumatic fever– Symptoms:

• Fever

• Malaise

• Joint pain

– Prevention:• Accurate diagnosis of strep infections



• 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



• Rheumatoid arthritis– Treatment:

• Anti-inflammatory medications

• Analgesics

• Exercise and rest routine

• Short-term corticosteroids

• Surgical joint replacement



• Myasthenia gravis– Slow onset



• Myasthenia gravis– Symptoms:

• Diplopia

• Ptosis

• Dysphagia

• Dysphonia

• Difficulty with facial expressions

• Fatigue



• Myasthenia gravis– Periods of remission and exacerbation

– Treatment:• Mestinon

• Plasma exchange



• 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



• Lupus erythematosus– Two types:

• Cutaneous– Discoid

– Limited to skin

• Systemic– Diffuse

– Affects multiple systems



• Systemic lupus erythematosus (SLE)– Chronic with remissions and exacerbations

– Symptoms:• Butterfly rash

• Joint pain

• Fever

• Weight loss



• Systemic lupus erythematosus (SLE)– Symptomatic treatment:

• Non-steroidal anti-inflammatory drugs (NSAIDS)

• Antipyretics

• Analgesics

• Corticosteroids



• 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



• Scleroderma– Treatment:

• No cure or treatment

• May use antibiotics, immunosuppressives, and anti-inflammatories

• May be beneficial to perform muscle stretching and strengthening exercises


Isoimmune Disorders

• Blood transfusion reaction

• Type of tissue transplant

• Type O– Universal blood donor

• Type AB– Universal blood recipient


Isoimmune Disorders

• Symptoms of transfusion:– Chills

– Shivering

– Fever


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


Isoimmune Disorders

• Erythroblastosis fetalis– Condition only affects Rh-positive babies carried by Rh-

negative mothers

– Also known as hemolytic disease of the newborn


Isoimmune Disorders

• Erythroblastosis fetalis– Treatment:

• Transfusion of baby’s blood at birth

– RhoGAM• Halted this condition

• Given prophylactically after delivery of first fetus


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


Immune Deficiency Disorders

• Inability of immune system to protect individual against disease

• Congenital, genetic disorder or acquired



• 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)



• AIDS– Human immunodeficiency virus (HIV)

– Eradicates individual’s lymphocytes

– Stages:• Acute infection

• Asymptomatic HIV

• Symptomatic HIV

• Advanced HIV



• Advanced HIV– T-cell count less than 50 per microliter

– Anti-viral medications may slow HIV replication and disease progress

• E.g., azidothymidine (AZT)



• 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



• AIDS primarily spread three ways:– Sexual intercourse

– Sharing of hypodermic needles

– In utero from infected mother to unborn baby


Rare Diseases

• Severe combined immunodeficiency disease– Group of inherited disorders that cause partial or complete

dysfunction of immune system


Effects of Aging

• Degenerated thymus gland

• Changed function of antibodies

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