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Primary MODS
Organ Damage results directly from a specific cause such as ischemoa or inadequate tissue perfusion.
Causes of Primary MODS
Shock, Trauma or major surgery
Sign Symptoms of MODS
Stress and inflammatory responses may be mild and undetectable.
Secondary MODS
The next time there is an injury, ischemia or infection, the primed cells are activated, producing an exaggerated inflammatory response.
Progression on secondary MODS
The inflammatory response enters a self perpetuating cycle causing damage and vasolilation
Dissiminating intervascular coagulation
MODS 24 hours after resuscitation
Low grade fever
Altered Mental Status
General hypermetabolic, hyperdynamic state.
MODS within 24 to 72 hours
Pulmonary failure begins.
MODS within 7 to 10 days
Hepatic failyre begins
Intestinal failure begins
Renal Failure begins
MODS after 21 days
Single cell organisms with a cell membrane and cytoplasm but no organized nucleus.
Cause many common infections, and usually respond to antibiotic treatment
What does Bacteria Do?
Bacteria release toxins
-exotoxins are secreted during bacteria growth
-endotoxin are released when the bacteria die.
Sepsis, Septicemia
The systemic release of toxins.
The most insidious
Smaller than bacteria and cause most infections
Virus structure
No organized cellular structure except a protein coat (capsid) surrounding the internal genetic material (RNA and DNA)
What do Viruses do?
Do not produce toxins
-they replicate and may cause a malignancy
-they may attack immune cells and destroy the ability to ward off infection.
Virus treatment
They are difficult to treat and are usually treated symptomatically. Antibiotics are given to treat secondary infections.
Dont usually cause anything more serious than minor skin infections (thrush is fungal infection)
are more common in developing nations than in the united states. treatment depends on the organism and its location.
(Giardia is a parasitic infection). Can be treated with antiparasitic medication.
Most recently reconized class of infectious agents. They are similar to viruses but do not have protective capsids. (they affect neurologic tissue)
Anatomic Barriers
Sebacious Glands
Sweat tears saliva
Mechanical responses-respiratory, urinary, GI
3 lines of defense
Anatomic (external, nonspecific)
Inflammatory Response (internal, nonspecific)
Immune response (internal, specific;recognizes diseases and has antibodies)
Inflammatory Response
Works quickly, the cleaning system, no memory, multiple plasma protein systems, multiple cell types
Immune response
Very specifis
Has memory (long term), has antibodies, uses lymphocytes (one blood cell type), one plasma protien system.
Natural Immunity vs. Acquired Immunity
Natural part of Genetic Makeup. Acquired developes as an outcome of the immune response: active-exposure, Passive:transferred from one person to another.
Primary vs. Secondary Response
Primary: initial development of antibodies on response to the 1st exposure.
Secondary: swift, strong response of the immune system to repeated exposures to an antigen.
Humoral Immunity
Humoral immunity is the long term immunity to am antigen provided by antibodies produced by B lymphocytes. Can not fight off all infections by themselves. Need both T and B cell counts to stay healthy.
Cell Mediated Immunity
Cell mediated immunity is short term immunity to an antigen provided by T lymphocytes.
T Lymphocytes
Found in the thymus gland. old memory and killer cells directly attack incoming antigens.
Do not produce any antibodies
Recognize the presence of a foreign antigen and attack it directly.
B Lymphocyes
White Blood Cells
Respond to antigens and produce anibodies that attack the antigen.
Develop a memory for the antigen
Confer long term immunity to specific antigens
What are Lymphocytes
circulated throughout the body as part of the lymph system.
-B lymphocytes
-T lymphocytes
-Secretory lymphocytes
Are generated from stem cells in the bone marrow.
Components of Lymph System
Consists primarily of interstitial fluid carrying proteins, bacteria and other substances.
Location of Lymphatic System
Carries through lyphatic vessels are parralel but separate from blood vessels

2 lymph ducts in Thorax: Right(smaller drains right arm, right head & right side of thorax)and thoracic duct(larger in the left thorax drains the rest of the body)
Lymph Ducts
Ducts drain into the right and left subclavian veins. Lymph is returned from the blood through the tissues to the lymph system.
Induction of the immune response
The immune response must be triggered or induced.
Intigens and Immunogens
Antigens that are able to trigger the immune response are immunogens.
Not every antigen can trigger an immune response.
Characteristics of Antigenetic Immunogenisity
Sufficient foreigness
Sufficients size
Sufficient complexity
Presence in sufficient amounts
Histocompatibility Locus Antigens
The body recon=gnizes if a substance is self or nonself made as a result of certain antigens that are present in almost all cells of the body except RBCs
This determines compatibility of tissues and organs that will be grafted or transplanted from a donor.
The Rh System
Present -Rh positive
Absent - Rh Negative
Problems may occir with pregnancy
-usually with the 2nd pregnancy
Incompatibility can cause severe problems
-hemolytic disease in infants
ABO System
The ABO blood group consistes of only 2 antigens named A & B
People with blood type A carry A antigens
B type B antigens
O carry no antigens (universal donors)
Type O
Can give bood but can not receive blood.
Blood Groups
O (no antigens, Anti-A & Anti_b antibodies)
AB (A and B antigens, no antibodies)
B(B antigen, Anti-A antibody)
A(A antigen, Anti-B antibody)
What B cells do
B cells specialize through the processes of clonal diversity and clonal release

Developing through maturing of white blood cells
Precursor develops receptors for every possible type of antigen may encounter.

Deck Info