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.
Unit II
Common Diseases and Disorders of Body Systems
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Chapter 5
Immune System Diseases and Disorders
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Anatomy and Physiology
• Organs:– Thymus gland
– Bone marrow
– Lymph nodes
– Spleen
– Liver
– Tonsils
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Anatomy and Physiology
• Types of immunity:– Active natural
– Active artificial
– Passive natural
– Passive artificial
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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
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Diagnostic Testing
• Skin tests
• Desensitization
• Blood count
• Coombs’ test
• Anti-nuclear antibody (ANA)
• Rheumatoid factor (RF)
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Hypersensitivity Disorders
• Allergies– E.g., hay fever, asthma
– Common reactions:• Urticaria
• Contact dermatitis
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Urticaria
Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University
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Hypersensitivity Disorders
• Allergies– Symptoms:
• Elevated eosinophil count
• Redness, heat, swelling, and itching
• Runny nose, coughing, sneezing, wheezing, and nasal congestion
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Hypersensitivity Disorders
• Hay fever– Reaction to allergen in mucous membranes of nose and
upper respiratory tract
– Symptoms:• Sneezing
• Watery eyes
• Runny nose
• Itching
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Hypersensitivity Disorders
• Hay fever– Causes of seasonal:
• Tree pollen
• Grasses
• Ragweed pollen
• Agricultural crops
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Hypersensitivity Disorders
• Hay fever– Causes of nonseasonal:
• Dust mites
• Pet dander
• Food allergies
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Hypersensitivity Disorders
• Hay fever– Treatment:
• Removal of allergen
• Air-conditioned environment– Or move to different climate
• Antihistamines
• Allergy desensitization
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Hypersensitivity Disorders
• Asthma– Also known as bronchial asthma
– Symptoms:• Extreme shortness of breath
• Difficulty breathing
• Wheezing
• Anxiety
• Cough
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Hypersensitivity Disorders
• Asthma– Treatment:
• Avoidance of causative allergens
• Desensitization
• Education
• Medication
– No cure• But can be controlled
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Animation
Click Here to Play Asthma Animation
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Hypersensitivity Disorders
• Anaphylaxis– Severe allergic response to allergen
– Causes:• Antibiotics
• Anesthetics
• Codeine
• Insulin
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Hypersensitivity Disorders
• Anaphylaxis– Causes:
• Vaccines
• Foods
• Pollens
• Latex
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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
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Hypersensitivity Disorders
• Anaphylaxis– Treatment:
• Emergency tracheostomy
• Epinephrine
• Corticosteroids
• Antihistamines
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Hypersensitivity Disorders
• Food allergies– E.g., chocolate, shellfish
– Symptoms:• Cramping
• Diarrhea
• Vomiting
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Contact Dermatitis
• Acute or chronic allergic skin reaction– E.g., poison ivy
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Contact Dermatitis
• Causes:– Cosmetics
– Laundry products
– Plants
– Jewelry
– Paint
– Drugs
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Autoimmune Disorders
• Rheumatic fever– Follows group A strep infection
– Occurs one to four weeks after strep infection• Sudden or gradual onset
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Autoimmune Disorders
• Rheumatic fever– Symptoms:
• Fever
• Malaise
• Joint pain
– Prevention:• Accurate diagnosis of strep infections
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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
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Autoimmune Disorders
• Rheumatoid arthritis– Treatment:
• Anti-inflammatory medications
• Analgesics
• Exercise and rest routine
• Short-term corticosteroids
• Surgical joint replacement
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Autoimmune Disorders
• Myasthenia gravis– Slow onset
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Autoimmune Disorders
• Myasthenia gravis– Symptoms:
• Diplopia
• Ptosis
• Dysphagia
• Dysphonia
• Difficulty with facial expressions
• Fatigue
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Autoimmune Disorders
• Myasthenia gravis– Periods of remission and exacerbation
– Treatment:• Mestinon
• Plasma exchange
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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
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Autoimmune Disorders
• Lupus erythematosus– Two types:
• Cutaneous– Discoid
– Limited to skin
• Systemic– Diffuse
– Affects multiple systems
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Autoimmune Disorders
• Systemic lupus erythematosus (SLE)– Chronic with remissions and exacerbations
– Symptoms:• Butterfly rash
• Joint pain
• Fever
• Weight loss
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Autoimmune Disorders
• Systemic lupus erythematosus (SLE)– Symptomatic treatment:
• Non-steroidal anti-inflammatory drugs (NSAIDS)
• Antipyretics
• Analgesics
• Corticosteroids
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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
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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
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Isoimmune Disorders
• Blood transfusion reaction
• Type of tissue transplant
• Type O– Universal blood donor
• Type AB– Universal blood recipient
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Isoimmune Disorders
• Symptoms of transfusion:– Chills
– Shivering
– Fever
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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
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Isoimmune Disorders
• Erythroblastosis fetalis– Condition only affects Rh-positive babies carried by Rh-
negative mothers
– Also known as hemolytic disease of the newborn
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Isoimmune Disorders
• Erythroblastosis fetalis– Treatment:
• Transfusion of baby’s blood at birth
– RhoGAM• Halted this condition
• Given prophylactically after delivery of first fetus
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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
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Immune Deficiency Disorders
• Inability of immune system to protect individual against disease
• Congenital, genetic disorder or acquired
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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)
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Immune Deficiency Disorders
• AIDS– Human immunodeficiency virus (HIV)
– Eradicates individual’s lymphocytes
– Stages:• Acute infection
• Asymptomatic HIV
• Symptomatic HIV
• Advanced HIV
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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)
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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
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Immune Deficiency Disorders
• AIDS primarily spread three ways:– Sexual intercourse
– Sharing of hypodermic needles
– In utero from infected mother to unborn baby
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Rare Diseases
• Severe combined immunodeficiency disease– Group of inherited disorders that cause partial or complete
dysfunction of immune system
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Effects of Aging
• Degenerated thymus gland
• Changed function of antibodies