HIV and Juvenile Idiopathic Arthritis Quiz

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Questions and Answers

What is the primary consequence of HIV infection on the immune system?

Destruction of CD4+ T-helper cells (correct)

Enhanced function of Killer T cells

Activation of B cells without CD4+ T cells

Increased production of CD4+ T-helper cells

Which of the following is NOT a method of HIV transmission?

Unprotected sexual activities

Sharing needles

Through hugs and social kisses (correct)

Through breast milk

During which period of HIV infection does the viral load initially peak?

Latency period

AIDS diagnosis

Initial Viremia (correct)

Chronic asymptomatic period

What is the risk factor for maternal-child transmission of HIV?

Transmission before or during birth Signup and view all the answers

What type of virus is HIV classified as?

A retrovirus Signup and view all the answers

What role do CD4+ T-helper cells play in the immune response?

They activate B cells and Killer T cells Signup and view all the answers

Which of the following correctly identifies the latency period of HIV?

2-12 years after initial viremia Signup and view all the answers

What is the estimated number of people living with HIV/AIDS worldwide by the end of 2019?

38 million Signup and view all the answers

What is a requirement for the diagnosis of Juvenile Idiopathic Arthritis (JIA)?

Arthritis present for at least 6 weeks Signup and view all the answers

Which type of JIA is characterized by involvement of fewer than 3 joints?

Oligoarthritis Signup and view all the answers

Which symptom is commonly associated with Juvenile Idiopathic Arthritis?

Spiking fevers occurring at the same time each day Signup and view all the answers

What is a potential complication in the cervical spine if JIA progresses?

Subluxation and ankyloses Signup and view all the answers

What is the incidence rate of Severe Combined Immunodeficiency (SCID) in infants born in Canada?

1 in 70,000 Signup and view all the answers

What is the estimated prevalence of SCID in Indigenous infants?

1 in 20,000 births Signup and view all the answers

Which of the following best characterizes the etiology of SCID?

X-linked recessive affecting more males Signup and view all the answers

What is a common clinical manifestation of SCID in affected infants?

Failure to thrive due to chronic infections Signup and view all the answers

Which treatment was available for SCID patients like David Vetter in the 1970s?

Bone marrow transplant from a direct match Signup and view all the answers

What is the estimated prevalence range of long COVID symptoms remaining after 12 weeks?

3% to 11.7% Signup and view all the answers

Which of the following describes a key descriptor of long COVID?

New symptoms presenting after organ damage Signup and view all the answers

Which mechanism is thought to potentially contribute to long COVID?

Virus-driven cellular alterations affecting the nervous system Signup and view all the answers

What factor is believed to play a role in the etiology of long COVID?

Dysregulated immune system dysfunction Signup and view all the answers

Which immune system manifestation is associated with long COVID?

Decreased amounts of dendritic cells Signup and view all the answers

What cardiovascular symptom is commonly reported in long COVID patients?

Fatigue Signup and view all the answers

Which neurological sign is associated with long COVID?

Persistent anosmia Signup and view all the answers

Which gastrointestinal symptom is commonly seen in long COVID patients?

Disrupted microbiome Signup and view all the answers

What is a potential consequence of antibodies against the ACE2 receptor in COVID-19 patients?

Proinflammatory state Signup and view all the answers

Which dermatological symptom is reported in long COVID patients?

Skin rashes Signup and view all the answers

Which symptom is part of the nursing assessment for long COVID related to the gastrointestinal system?

Abdominal pain Signup and view all the answers

Which factor contributes to DVT risk in long COVID patients?

Prolonged immobility Signup and view all the answers

Which of the following plays a role in the long-lasting effects seen in lymphocytes of long COVID patients?

Phenotypic and functional disorders Signup and view all the answers

Which of the following clinical assessments is relevant for neuro-related symptoms in long COVID?

Checking orientation and alertness Signup and view all the answers

What is a critical CD4+ T cell count that indicates the onset of AIDS?

200 CD4+ T cells per cubic millimetre Signup and view all the answers

Which of the following is NOT a typical early symptom of HIV?

Skin lesions Signup and view all the answers

In the asymptomatic phase of HIV, what is the status of CD4 T cells and the viral load?

Normal CD4 count, high viral load Signup and view all the answers

What type of test determines the presence of HIV RNA in the blood?

Nucleic acid test (NAT) Signup and view all the answers

Which of the following conditions is associated with late-stage AIDS?

Chronic cough Signup and view all the answers

Which opportunistic infection is commonly associated with HIV/AIDS?

Candidiasis Signup and view all the answers

What is the expected minimum weight loss percentage to be considered significant in AIDS?

10% Signup and view all the answers

In HIV nursing assessment, which of the following is a particularly relevant neurological concern?

Confusion and memory issues Signup and view all the answers

What is a major obstetrical complication associated with parents living with HIV?

Increased risk of perinatal loss Signup and view all the answers

Which type of cancer is associated with AIDS?

Kaposi's sarcoma Signup and view all the answers

What laboratory findings indicate a person is likely to improve from AIDS?

Low viral load and high CD4 count Signup and view all the answers

What is the first test typically done to diagnose HIV infection?

Antibody test Signup and view all the answers

Which opportunistic infection is characterized by pneumonia in AIDS patients?

Pneumocystis pneumonia Signup and view all the answers

What is the effect of ART on viral load in HIV patients?

Reduces viral load Signup and view all the answers

What demographic is most commonly affected by Systemic Lupus Erythematosus (SLE)?

Women aged 20-40 Signup and view all the answers

Which of the following is a common clinical manifestation of SLE?

Vasculitis and rash Signup and view all the answers

What lab test is most indicative of Systemic Lupus Erythematosus?

Antinuclear antibody (ANA) Signup and view all the answers

Which sign is often observed in patients with rheumatoid arthritis (RA)?

Swan neck appearance in joints Signup and view all the answers

What is a notable hematological abnormality commonly seen in SLE patients?

Anemia Signup and view all the answers

Which of the following is NOT a common sign of SLE?

Failure to thrive Signup and view all the answers

What are the common triggers for Systemic Lupus Erythematosus?

UV light and infections Signup and view all the answers

What type of joint involvement is characteristic of rheumatoid arthritis?

Symmetrical joint swelling Signup and view all the answers

Which of these is a key feature of lupus nephritis?

Proteinuria Signup and view all the answers

In SLE, which neurologic disorder symptom might be observed?

Seizures Signup and view all the answers

What skin manifestation is commonly associated with SLE?

Discoid rash Signup and view all the answers

What is a common pharmacological treatment for rheumatoid arthritis?

NSAIDs Signup and view all the answers

Which of the following disorders is classified as an autoimmune disease?

Rheumatoid arthritis Signup and view all the answers

What is typically assessed in SLE patients during a nursing assessment for cardiovascular health?

Dysrhythmias and hypertension Signup and view all the answers

Study Notes

Introduction to Immunology Course

Course title: Introduction to Immunology
Presenter: Sarah Nixon RN MN
Date: January 14, 2025

Topics and Objectives

Topics: Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis, Severe Combined Immunodeficiency (SCID), Pediatric conditions, Long Covid
Objectives: Reflect on anatomy and physiology of the immune system and its connection to chronic illness, explain pathophysiology of listed conditions, examine relevant nursing assessments, clinical manifestations and relevant lab values for various conditions

HIV and Acquired Immune Deficiency Syndrome (AIDS)

Global HIV/AIDS prevalence (2019): 38 million people
HIV's effect: Infects and destroys CD4+ T-helper cells (Th cells)
Other CD4+ cells affected: Monocytes, macrophages, astrocytes, oligodendrocytes
HIV’s destructive nature: Th cells activate B cells and Killer T cells in response to invaders
HIV reproduction: Requires host cells
Retrovirus nature: HIV is a retrovirus

HIV Transmission

Transmission methods include: blood-borne pathogens, blood/blood products, IV medication use, heterosexual and homosexual activity, and maternal-child transmission (low risk via breast milk)
Transmission methods excluded: mosquitoes, ticks, other insects, hugging, shaking hands, sharing dishes/toilets, or social kissing that does not involve fluid exchange, or exchanging body fluids

HIV Pathophysiology

Initial viremia: High viral load, see peak blue wave
Latency period: 2–12 years
Progression: Ability of HIV to destroy CD4+ Th cells exceeds body's ability to replace them, leading to lower CD4+ counts, and a compromised immune system, resulting in the development of severe health problems (AIDS), fewer than 200 CD4+ T cells/cubic millimeter constitutes AIDS

Diagnostic Tests

Nucleic acid tests (NATs): Check blood for viral RNA to determine viral load
Antibody and antigen tests: Test for presence of HIV antibodies and antigens. HIV produces antigen p24 before antibodies. Antibody tests can be done via venous blood, oral fluid, or finger prick.

Typical AIDS Progression

Asymptomatic seronegative status
Asymptomatic seropositive status
Subclinical immunity deficiency
Lymphadenopathy (early AIDS)
AIDS-related complex (middle stage) with symptoms
AIDS (in later stage)

AIDS Clinical Manifestations

Fatigue: Unexplained weight loss (>10%), fever;
Lymphadenopathy: Swollen lymph nodes
Skin/mucous lesions: purplish-red nodules, and skin lesions
Cough: Persistent diarrhea; oral thrush (tongue/mouth);
Perianal lesions: Herpes simplex infection
Cancers: Kaposi's sarcoma, other cancers related to AIDS
Cytomegalovirus retinitis: Infections in the eyes.

Opportunistic Infections

Fungal infections: Candidiasis, cryptococcus, coccidioidomycosis, histoplasmosis
Bacterial infections: Mycobacterium avium complex (MAC), tuberculosis, nocardiosis, salmonella
Viral infections: Cytomegalovirus (CMV), herpes simplex
Other infections: Cellulitis, osteomyelitis, endocarditis, varicella zoster virus

HIV and AIDS Nursing Assessment

Nursing assessment for HIV: Neuro, CV, Resp, GI, GU, Integ; Health History, Labs
Nursing assessment for AIDS: Neuro, CV, Resp, GI, GU, Integ, labs; clinical symptoms of opportunistic infections; analysis of CD4 cell counts.

Obstetric Considerations for HIV Positive Women

Increased risk of preterm labor, premature rupture of membranes, perinatal loss, IUGR
Post partum risks: UTIs, vaginitis, postpartum endometritis, poor wound healing ,HIV-related thrombocytopenia (increased risk for hemorrhage)

Neonatal/Pediatric AIDS

Neonatal Transmission: Placental, blood contact at birth, breastfeeding
Symptoms often different than adult cases
Increased risk for non-hodgkin lymphoma, Kaposi sarcoma.
Common signs: Oral candidiasis, bacterial infections, failure to thrive, developmental delay, parotitis, lymphadenopathy, hepatosplenomegaly, chronic or recurrent diarrhea

Systemic Lupus Erythematosus (SLE)

Autoimmune disease
Affects: 1 in 2000 Canadians
Most common in women (20-40 age range)
Increased risk for black individuals
Etiology: chronic, inflammatory, connective tissue disease of unknown origin (multifactorial)

SLE Clinical Manifestations

Common clinical manifestations : fatigue, fever, muscle pain, headache, skin lesions, joint pain, cardiovascular diseases, hematological abnormalities, kidney disease
Often systemic throughout the body

SLE Pathophysiology

Autoimmune response against one's own tissues : Inflammatory process; Autoantibodies (immunoglobulins aka RF – Rheumatic factor). RF binding to antigens, formations of immune complexes, increasing RF levels in the blood, and increase in inflammatory response are part of the condition’s vicious cycle.

SLE Nursing Assessment-

Neurological assessments: seizures, cognitive disturbances, strokes, meningitis, headaches
Cardiovascular assessments: Dysrhythmias, HTN, hypercholesterolemia, edema, antiphospholipid syndrome, pericarditis
Respiratory assessments: Tachypnea with cough, pleurisy
Gastro-intestinal assesments: abdominal pain
Genitourinary assessments: Lupus nephritis, end-stage kidney failure
Integumentary assessments: Malar rash, alopecia, discoid erythema, urticaria, purpura, petechiae, leg ulcers
Musculoskeletal assessments: polyarthralgia, morning joint stiffness, arthritis
Lab tests: CBC, ANA, electrolytes, magnesium, TNT, coagulation, CRP

Rheumatoid Arthritis (RA)

Chronic, systemic, inflammatory autoimmune disorder
Affects joints symmetrically (wrists, hands, elbows, shoulders, knees, and ankles).

RA Pathophysiology

Inflammatory process
Autoantibodies (immunoglobulins) known as RF form immune complexes
Stimulation of T and B lymphocytes increases RF levels, amplifying the inflammatory response.
Affects joints symmetrically.
Formation of pannus, a highly vascular tissue that erodes cartilage
Eventually leading to loss of joint laxity, subluxation and joint contracture.

RA Clinical Manifestations

Onset: Usually gradual
Course, progressive with remission and exacerbations
Pain & Stiffness: Predominant on arising, lasting more than an hour, can occur after prolonged inactivity
Affected joints: Appear red, hot, swollen and tender; decreasing range of motion, and weakness
Systemic manifestations: Fatigue, weakness, anorexia, weight loss, fever, rheumatoid nodules and anemia

RA Deformities

Swan neck deformity
Boutonniere deformity
Ulnar deviation
Hallux valgus

RA Complications

Joint destruction, flexion contractures, hand deformities, difficulty grasping, nodular myositis
Cataracts, glaucoma
Nodules on vocal cords, carpal tunnel syndrome, cardiac complications, pulmonary complications, lymphadenopathy and splenomegaly

RA Nursing Assessment

Neurological: pain, fatigue, brain fog, weakness, fever,
Cardiovascular: anemia, thromboses, vasculitis,
Respiratory: pleuritis, parenchymal nodules, pneumoconiosis, Caplan syndrome, diffuse pulmonary fibrosis
Gastrointestinal: anorexia, weight loss, mesenteric infarction,
Genitourinary: kidney damage
Musculoskeletal: pannus, joint stiffness, joint deformities, and rashes
Skin: Rashes, nodules
Labs: CBC, ESR, RF, anti-CCP, ANA, CRP

Juvenile Idiopathic Arthritis (JIA)

Childhood inflammatory autoimmune condition affecting joints, lymph nodes, and spleen
Requirement for diagnosis: At least 6 weeks of arthritis
Distinct onset styles: Oligoarthritis (3 or fewer joints); Polyarthritis (more than 3 joints); Still's disease (severe systemic onset)

JIA Differences from RA

Common in JIA: Chronic uveitis (eye inflammation)
Serum tests may exclude Rheumatoid Factor (RF)
Potential for cervical spine subluxation and ankylosis
Can have significant effects on growth and adult morbidity with long-term disease progression.

JIA Clinical Manifestations

Insidious or abrupt onset, often with morning stiffness, complaints of joint pain or abnormal joint use, history of absences from school or physical education classes
Spiking fevers are common
Rash may occur
Other conditions common with JIA including psoriasis

Long COVID

Post-COVID-19 condition
Epidemiology: Prevalence in the UK (3-11.7% in 12 weeks).
Substantial impact on social and professional life
Etiology: Limited knowledge, with antibodies against ACE2 receptor, possible inflammation, involvement of the nervous system, and dysregulation of the immune system

Long COVID Clinical Manifestations

Neurological: cognitive and mental health disorders, pain, headaches, fatigue, anosmia (loss of smell) or ageusia (loss of taste).
Cardiovascular: Fatigue at rest, dyspnea, chest pain
Respiratory: Dyspnea, chest pain, cough
Gastrointestinal: Abdominal pain, bloating, changes in bowel habits
Immune disorders: Continuing inflammation, disrupted microbiome, autoimmunity.
Other: skin rashes, irritation

Long COVID Nursing Assessment

Neurological: sleep disturbances, fatigue, headaches, taste/smell loss, numbness, and nerve pain
Cardiovascular: Fatigue, SOB, chest pain
Respiratory: Shortness of breath, dyspnea, chest pain, cough
Gastrointestinal: Abdominal pain, bowel issues
Musculoskeletal: DVT risk factors, pain, swelling in the lower legs
Skin: rashes and irritation

Key Points Review

Proper head-to-toe assessment is crucial for understanding HIV/AIDS-related illnesses (neuro, CV, Resp, GI, and GU systems), SLE, and RA and connections to other systems.
Lab value alterations and immunity are significant for accurate assessment
Focus on pathophysiology, clinical manifestations, and nursing skills for relevant illnesses.

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Description

Test your knowledge on the effects of HIV on the immune system and key aspects of Juvenile Idiopathic Arthritis. This quiz covers important topics such as transmission methods, symptom identification, and diagnosis requirements. Dive into the knowledge of immunology and pediatric diseases in one go!