Lecture Day 2<br />
PneumocystisCarinii Pneumonia<br />Most common opportunistic infection,80%<br />ommonly found in the lungs of healthy peop...
Sx: nonproductive cough<br /> fever, chills, SOB, dyspnea, <br />weight loss and night sweats<br />Tx: trimethoprim-sulfam...
Mycobacterium Avium Complex<br />Also, M. intracellulare, , M. scrofulaceum are acid fast bacilli cause respiratory tract ...
Wasting Syndrome<br />Profound, involuntary weight loss exceeding 10% of baseline body weight and chronic diarrhea for mor...
Kaposi’s sarcoma<br />Most common HIV-related malignancy<br />Involves endothelial layers of blood and lymphatic vessels<b...
Cryptococcus Neoformans<br />Fungal infection that causes meningitis, and symptoms of fever, headache,malaise and stiff ne...
Post exposure prophylaxis<br />a course of antiretroviral drugs which is thought to reduce the risk of seroconversion afte...
Needle stick Injuries and aids<br />CDC guidelines generally recommend a PEP protocol with 3 or more antiviral drugs, when...
TREATMENT<br />There is currently no publicly available vaccine for HIV or cure for HIV or AIDS<br />&quot;highly active a...
HYPERSENSITIVITY<br />
Allergy- an inappropriate response of the immune system to normally harmless substances<br />Atopy- refers to allergic rea...
Antigens are divided into 2 groups:<br />Complete protein antigens-stimulate complete humoral response eg. Animal dander, ...
CHEMICAL MEDIATORS<br />
Primary mediators<br />found in mast cells<br />Histamine- causes erythema, localized edema, pruritus, contraction of bron...
Prostaglandins- are composed of unsaturated fatty acids, produce smooth muscle contraction, vasodilation and increased cap...
2. Secondary mediators<br />a. Leukotrienes- released by mast cells that initiate inflammatory response, cause smooth musc...
HYPERSENSITIVITY<br />Is a reflection of excessive or aberrant immune response<br />It does not usually occur with first e...
TYPES of hypersensitivities<br />Type I/ Anaphylactic <br />Characterized by edema in tissues , larynx and hypotension<br ...
Type II/ Cytotoxic<br />Occurs when the system mistakenly identifies a normal constituent of the body as foreign<br />Invo...
Type III/Immune Complex<br />Involves immune complexes formed when antigens bind to antibodies<br />Example: Systemic Lupu...
Type IV/Delayed type<br />Also called cellular hypersensitivity, occurs 24-72 hours after exposure to an allergen<br />Exa...
ALLERGIC DISORDERS<br />
Allergic Rhinitis<br />Also called hay fever, pollinosis<br />Sensitization begins with exposure and on re-exposure the na...
Contact Dermatitis<br />Or dermatitis venenata, a type IV hypersensitivity<br />Acute or chronic skin inflammation that re...
Atopic Dermatitis<br />A type I hypersensitivity, affects mostly children<br />Sx: pruritus and hyperirritability of the s...
Food Allergy<br />IgE mediated hypersensitivity<br />Most common: seafood, legumes, nuts, egg, milk and chocolate<br />SX:...
Serum sickness<br />A type III hypersensitivity, traditionally results from administration of antisera of animal sources<b...
Latex Allergy<br />Reaction to natural rubber proteins derived from the rubber tree (Heveabrasiliensis) found in Africa an...
Lecture  Day 2
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Lecture Day 2

  1. 1. Lecture Day 2<br />
  2. 2. PneumocystisCarinii Pneumonia<br />Most common opportunistic infection,80%<br />ommonly found in the lungs of healthy people, but being a source of opportunistic infection it can cause a lung infection in people with a weakened immune system<br />P. carinii, Pneumocystisjirovecii is a fungus and invades within pulmonary alveoli and forms consolidation in parenchyma<br />the disease attacks the interstitial, fibrous tissue of the lungs, with marked thickening of the alveolar septa and alveoli and leading to significant hypoxia<br />
  3. 3. Sx: nonproductive cough<br /> fever, chills, SOB, dyspnea, <br />weight loss and night sweats<br />Tx: trimethoprim-sulfamethomexazole, pentamidine and steroids<br />
  4. 4.
  5. 5. Mycobacterium Avium Complex<br />Also, M. intracellulare, , M. scrofulaceum are acid fast bacilli cause respiratory tract infection and increase mortality rates<br />Sx:include fever, fatigue, and weight loss<br />Tx: Clarithromycin/Azithromycin, Anti-tuberculosis medication<br />
  6. 6.
  7. 7. Wasting Syndrome<br />Profound, involuntary weight loss exceeding 10% of baseline body weight and chronic diarrhea for more than 30 days, intermittent fever<br />May be due to hypermetabolic state, anorexia, diarrhea, malnutrition, GI malabsorption, low food intake <br />Treatment:<br />Symptomatic,diet, control of diarrhea<br />
  8. 8.
  9. 9. Kaposi’s sarcoma<br />Most common HIV-related malignancy<br />Involves endothelial layers of blood and lymphatic vessels<br />First noted by Dr. Moritz Kaposi in 1872, a tumor caused by Human herpesvirus 8 <br />Sx: may range from localized cutaneous symptoms to disseminated disease which may appear brownish pink to deep purple<br />Treatment: palliative, HAART<br />
  10. 10.
  11. 11. Cryptococcus Neoformans<br />Fungal infection that causes meningitis, and symptoms of fever, headache,malaise and stiff neck<br />Tx: Amphotericin B, fluconazole<br />
  12. 12. Post exposure prophylaxis<br />a course of antiretroviral drugs which is thought to reduce the risk of seroconversion after events with high risk of exposure to HIV<br />To be most effective, treatment should begin within an hour of possible infection, and no longer than 72 hours post-exposure. Prophylactic treatment for HIV typically lasts four weeks<br />
  13. 13. Needle stick Injuries and aids<br />CDC guidelines generally recommend a PEP protocol with 3 or more antiviral drugs, when it is known that the donor was HIV positive<br />PEP drugs for prevention of HIV infection are given for 4 weeks and may include nucleoside reverse transcriptase inhibitors (NRTIs), nucleotide reverse transcriptase inhibitors (NtRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and a single fusion inhibitor. <br />Regardless whether PEP is instituted, follow-up of exposed individuals includes counseling and HIV testing by enzyme immunoassay to monitor for a possible seroconversion for at least 6 months after exposure. Such tests are done at baseline, 6 weeks, 12 weeks, and 6 months, and/or longer.<br />
  14. 14. TREATMENT<br />There is currently no publicly available vaccine for HIV or cure for HIV or AIDS<br />&quot;highly active antiretroviral therapy“(HAART)<br />Drugs that inhibit the reverse transcriptase prevent it from copying the RNA into DNA<br />Drugs called protease inhibitors prevent the viral protease from trimming down the large proteins made late during infection<br />
  15. 15. HYPERSENSITIVITY<br />
  16. 16. Allergy- an inappropriate response of the immune system to normally harmless substances<br />Atopy- refers to allergic reactions by the actions of IgE antibodies and a genetic predisposition to allergic conditions.<br />Mast cells- also called basophils, are trigerred by IgEs to release chemical mediators to produce allergic reactions<br />T cells- secrete substances called lymphokines that encourage cell growth, activation, destroys target cells, and stimulate macrophages<br />
  17. 17. Antigens are divided into 2 groups:<br />Complete protein antigens-stimulate complete humoral response eg. Animal dander, pollen, horse serum<br />Low molecular weight substances- eg. haptens<br />
  18. 18. CHEMICAL MEDIATORS<br />
  19. 19. Primary mediators<br />found in mast cells<br />Histamine- causes erythema, localized edema, pruritus, contraction of bronchial muscle,dilation of small venules and constriction of large ones.<br />
  20. 20. Prostaglandins- are composed of unsaturated fatty acids, produce smooth muscle contraction, vasodilation and increased capillary permeability.<br />
  21. 21. 2. Secondary mediators<br />a. Leukotrienes- released by mast cells that initiate inflammatory response, cause smooth muscle contraction,bronchial constriction and mucus secretion on the pathways.<br />b. Bradykinin- polypeptide that causes increase vascular permeability, vasodilation, hypotension, and smooth muscle contraction and stimulates nerve cell fibers<br />c. Serotonin- released during platelet aggregation causing contraction of bronchial smooth muscle<br />
  22. 22. HYPERSENSITIVITY<br />Is a reflection of excessive or aberrant immune response<br />It does not usually occur with first exposure to an allergen, but with re-exposure after sensitization in a predisposed individual<br />
  23. 23. TYPES of hypersensitivities<br />Type I/ Anaphylactic <br />Characterized by edema in tissues , larynx and hypotension<br />It is immediate and mediated by IgE antibodies<br />Example:asthma, urticaria,allergic rhinitis, <br />
  24. 24.
  25. 25. Type II/ Cytotoxic<br />Occurs when the system mistakenly identifies a normal constituent of the body as foreign<br />Involves binding of IgG and IgM antibodies resulting to destruction of cells<br />Example: myasthenia gravis, idiopathic thrombocytopenic purpura, hemolytic anemia<br />
  26. 26. Type III/Immune Complex<br />Involves immune complexes formed when antigens bind to antibodies<br />Example: Systemic Lupus Erythematosus, Rheumatoid arthritis<br />
  27. 27. Type IV/Delayed type<br />Also called cellular hypersensitivity, occurs 24-72 hours after exposure to an allergen<br />Example: contact dermatitis, mantoux test, transplant rejection<br />
  28. 28. ALLERGIC DISORDERS<br />
  29. 29. Allergic Rhinitis<br />Also called hay fever, pollinosis<br />Sensitization begins with exposure and on re-exposure the nasal mucosa reacts followed by edema formation and leukocyte infiltration<br />Sx: nasal congestion, watery nasal discharge, sneezing,nasal itching<br />Mgt: Avoid allergens, antihistamine, adrenergics, mast cell stabilizers, corticosteroids<br />
  30. 30.
  31. 31. Contact Dermatitis<br />Or dermatitis venenata, a type IV hypersensitivity<br />Acute or chronic skin inflammation that results from direct skin contact with chemicals or allergens<br />80% are due to excessive exposure to irritants<br />Sx: itching, burning, erythema, vesicles, edema, followed by weeping crusting , drying and peeling of the skin<br />
  32. 32.
  33. 33. Atopic Dermatitis<br />A type I hypersensitivity, affects mostly children<br />Sx: pruritus and hyperirritability of the skin<br />Chronic with remission and exacerbation<br />Mgt: wearing cotton fabrics, using mild detergent, avoiding allergens, moisturizer, <br />
  34. 34.
  35. 35. Food Allergy<br />IgE mediated hypersensitivity<br />Most common: seafood, legumes, nuts, egg, milk and chocolate<br />SX: urticaria, wheezing, cough, laryngeal edema, swelling of lips, tongue, abdominal pain, cramps, vomiting, diarrhea<br />Mgt: elimination of allergen, H1 and H2 blockers, antihistamine, corticosteroids<br />
  36. 36. Serum sickness<br />A type III hypersensitivity, traditionally results from administration of antisera of animal sources<br />Sx: usually begin 6-10 days after administration includes: inflammation of injection site, lymphadenopathy, tender joints, peripheral neuritis, vasculitis<br />Mgt: Antihistamines and corticosteroids<br />
  37. 37. Latex Allergy<br />Reaction to natural rubber proteins derived from the rubber tree (Heveabrasiliensis) found in Africa and Southeast Asia. <br />Implicated with rhinitis, conjunctivitis and contact dermatitis<br />Prevention:nonpowdered, low-protein latex and nonlatex gloves. <br />

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