B – CELLS - Makers of Antibodies
NCM112OFI
BS. NURSING
ALTHEA P. GELLA BSN III HALL
INMMUNOLOGY
IMMUNE SYSTEM
- Collection of organs cells , tissues and
molecules that mediate the immune
response.
- Protects body from invaders germs
such as bacteria , viruses , fungi ,
toxins (chemical microbes )
IMMUNITY
- Body specific protective response to
foreign agent or organism resistance
to disease specifically infections
disease.
7 PARTS OF IMMUNE SYSTEM
1. White Blood Cells ( WBC)
2. Antibodies
3. Complement system
4. Lymphatic system
5. Spleen
6. Bone marrow
7. Thymus
WHITE BLOOD CELLS ( WBC)
Key players in the immune system made in
the bone marrow and part or lymphatic
system.
⬇️
Move through blood and tissue throughout
the body , looking for foreign invaders such
as bacteria, viruses , parasites and fungi.
⬇️
Launch an immune attack
WBC – LYMPHOCYTES
- Helps fight viruses and make
antibodies
T- CELLS - Cytotoxic, called the killer cells
( thymus cells )
DIFFERENT TYPES OF WBC
(NLMEB) – Never let monkeys eat bananas
1. Neutrophils – (natural immunity)
first to respond to bacteria or viruses.
2. Eosinophils – know for their role in
allergy symptoms. ( cancer cells )
3. Lymphocytes – fight infections
(allergies) by producing antibodies.
4. Monocytes – clean up damage cells.
5. Basophils – involved in allergic
response.
ANTIBODIES
Helps body fight microbes or the toxins
(poisons ) they produce.
⬇️
Recognizing substances called antigens
on surface of the microbe, or in the
chemical they produce , mark the
microbes of toxins as foreign.
⬇️
Mark these antigens for destruction
⬇️
Many cells , proteins and chemicals are
involved in the attack
ANTIBODY – Is a protein produced by
immune system in response to the
presence of an antigen.
ANTIGEN- Is a substance that indices
production of antibodies.
COMPLEMENT SYSTEM
Made up of small proteins found in the
blood.
⬇️
Made by the liver
⬇️
 Help or complement the work of
antibodies, phagocytic cells
⬇️
To clear pathogens from an organisms
LYMPHATIC SYSTEM
- A network of delicate tubes
throughout the body.
MAIN ROLES
1. Manage fluid levels in body.
2. React to bacteria.
3. Deal with cancer cell.
4. Deal with cell production that would
results in disease or disorders.
5. Absorb some fats in diet from the
intestine.
MAID UP OF
• LYMPH NODES – (bean shape)
lymph glands which trap
microbes ( This is why its
swells )
• LYMPH VESSELS - Carry lymph
colorless fluid that battles the
body tissue and contains WBC.
2
THE SPLEEN
The spleen controls the level of white blood
cells, red blood cells and platelets (small cells
that form blood clots).
RED PULP – ( old injured RBC / destroyed)
The red pulp acts like a filter
WHITE PULP – contains lymphocytes
(immunologic functions) As part of the
immune system, the white pulp produces
white blood cells. These blood cells make
antibodies. Antibodies fight infection.
Blood – filtering organ that removes
microbes contains WBC destroyed old ,
damage RBC.
Makes disease -fighting components of
immune system (antibodies & lymphocytes)
BONE MARROW
Spongy tissue found inside the bones
produces RBC, platelets, WBC lymphocytes
are produced in the marrow & play an
important part in the body’s immune system.
Healthy bone marrow releases blood cells
into the bloodstream when they are mature
and when required. Without bone marrow,
our bodies could not produce the white cells
we need to fight infection, the red blood cells INNATE IMMUNE RESPONSE
we need to carry oxygen, and the platelets
• Cells are non-specific
we need to stop bleeding.
• Response = fast (minutes-
hours)

THE THYMUS • No memory (always the same

response)

Is the body’s first line of defense against

germs entering the body. It responds in the
same way to all germs and foreign
substances, which is why it is sometimes
referred to as the “nonspecific” immune
system.

NATURAL IMMUNITY

First line of host defense following antigen

exposure, because it protects the host
Small gland in the lymphatic system that without remembering prior contact
makes and trains special WBC called T-
CELLS help immune system fight disease and ⬇️
infections (signal product & matural of Production of cytokines, other effector
lymphocytes). It filters & monitor blood molecules
content it produces the WBC called T-
⬇️
LYMPHOCYTES. The thymus is inside the
ribcage, just behind the breastbone. It filters Activate cells to control pathogens or
and monitors our blood content. promote development of acquired Immune
response.
BODY’S OTHER DEFENSE @ MICROBES
ADAPTIVE IMMUNE RESPONSE - Is also
1. SKIN – waterproof barrier secretes oil
referred to as acquired immunity or specific
with bacteria-killing properties
immunity and is only found in vertebrates.
2. LUNGS – Mucous in the lungs
The adaptive immune response is specific to
(phlegm) traps foreign particles small
the pathogen presented. The adaptive
hairs (cilia) wave the mucous upwards
immune response is meant to attack non-self
so it can be coughed out.
pathogens but can sometimes make errors
3. DIGESTIVE TRACT – Mucous ñining
and attack itself.
contains antibodies acid in the
stomach can kill most microbes. Cell involved Monocytes, macrophages,
4. OTHERS - body fluids : skin oil, saliva dendrite cells
tears contain anti-bacterial enzymes
Natural killer cells – basophils, eosinophils,
the constant flushing of the urinary
granulocytes
tract & the bowel.
▼
TYPES OF IMMUNITY
Release cell mediators histamine, bradykinin,
• INNATE IMMUNE RESPONSE
prostaglandins
• ADAPTIVE IMMUNE RESPONSE
▼

Phagocytosis
3

A type of immunity that develops when a
person’s immune system responds to a
foreign substance or microorganism, or that
occurs after a person receives antibodies
from another source
MACROPHAGES - Tissue-resident or
infiltrated immune cells critical for innate
immunity, normal tissue development,
homeostasis, & repair of damaged tissue
Classified as to function
1. Classically-activated (M1)
macrophages,
2. Wound-healing macrophages or
alternatively-activated (M2)
macrophages
3. Regulatory macrophages (Mregs).
INFLAMMATORY RESPONSE (major
function of natural immune system)
4
RESPONSE TO INVASION
1. PHAGOCYTIC IMMUNE RESPONSE -
Phagocytosis is a specific form of
endocytosis by which cells internalize
solid matter, including microbial
pathogens
3 main groups of phagocytes:
❖ Monocytes macrophages,
❖ Granulocytes
❖ Dendritic cells
Dendritic cells - A special type of immune cell
found in Tissues, such as the skin, & boosts
immune responses by showing antigens on
its surface to other cells of the immune
system.
2. HUMORAL IMMUNE RESPONSE
(ANTIBODY RESPONSE) - Is mediated
by antibody molecules secreted by
plasma cells Deals with antigens from
Pathogens that are freely Circulating,
or outside the infected Cells.
▼
Antibodies produced by the B cells will
bind to antigens,
▼
Neutralizing them, or causing lysis
(dissolution or destruction of cells by a
lysin) or phagocytosis.
3. CELLULAR IMMUNE RESPONSE - Cell-
mediated immune Responses involve
the destruction of infected cells by
cytotoxic T cells, or the destruction of
intracellular pathogens by
macrophages.
T cells part of the immune. System &
develop from stem cells, In the bone
marrow (migrate Thymus for
development)
 TYPES OF T LYMPHOCYTES

THE AUTOIMMUNITY

- Is the failure of an organisms in

recognizing its own constituent parts
as non self , which allows an immune
response against its own cells and
tissues. Any disease that results is
termed an autoimmune disease.
Autoimmunity is often caused by a
lack of germ development of a target
body and as such the immune
response acts againts its own cells and
tissues.

ANAPHYLAXIS
Causes the immune system to release a flood
of chemicals that can cause shock.

A clinical response to an Immediate

immunologic Reaction between a specific
Antigen & antibody

Resulting from rapid Release of IgE mediated

Chemicals

Induce severe life Threatening allergic

Reaction

5
COMMON CAUSES OF ANAPHYLACTIC IgA - IgA-15% Appears in body fluids(blood,
REACTIONS saliva, breast milk, pulmonary, GI, vaginal
secretions protects against respiratory, GI,
CAUSE TYPES
Foods Fish and shellfish, nuts GUT Infections prevents absorption of
(almonds, hazel, brazil antigens from food passes thru breast milk to
nuts & peanuts ) eggs , neonate for protection.
pulses, milk and
sesame seeds. B- CELLS

Drugs Opioids, antibiotics B-cells produce antibodies to fight bacteria &

(penicilin , viruses.
cephalosporins,
amphotericin, ⬇️
ciprofloxacin,
vancomycin, non- Y-shaped proteins specific to each pathogen
steroidal anti-
⬇️
inflamatory drugs
(NSAIDS ) able to lock onto the surface of an invading
anaesthetics , muscle
relaxants , aspirin. cell
Venoms Wasp stings and bee
⬇️
stings
Latex Gloves mark it for destruction by other immune
cells
IMMUNOGLOBULINS
T- CELLS
( IgG, IgE, IgD ) glycoprotein molecules
T cells (T lymphocytes)
produced by plasma cells (WBC). Act as a
critical part of the immune response by ⬇️
recognizing & binding to particular antigens, Directly killing infected host cells
such as bacteria or viruses, & aiding in their
⬇️
destruction.
activating other immune cells, producing
(IgM & IgA ) found in lymph nodes tonsils
cytokines & regulating the immune response.
appendix peyer’s patches of intestinal tract
blood & lymph THE ANTIGEN

IgG - IgG -75% appears in serum & tissues

assumes a major role in blood- borne &
tissue infection activates complement system
enhances phagocytosis crosses placenta

IgE – IgE – 0.004 % appears in serum takes

part in allergic & some hypersensitivity
reactions combats parasitic infections.

IgD – IgD-0.2% appears in small amount in

serum possibly influences B lymphocytes.
Complete antigen one that both induces an
IgM – IgM-10% appears in intravascular
immune response & reacts with the products
serum appears as the first antibody
of it,
produced in response to bacterial or viral
infections activate complement system
6
Ex. Animal dander, pollen Incomplete antigen
or hasten is unable to induce an immune
response alone but is able to react with the
products of it, e.g., antibodies.

CHEMICAL MEDIATORS

PRIMARY MEDIATORS
Histamine - chemical created in the body
released by WBC into the bloodstream when
the immune system is defending against a
potential allergen

Acts on histamine 1 (H1) and histamine 2

(H2) receptors

Cause contraction of smooth muscles of the PROSTAGLANDIN - Group of lipids made at

airway & GIT, increased vasopermeability &
vasodilation, enhanced mucous production,
Pruritus, cutaneous vasodilation, & gastric
acid secretion.
sites of tissue Damage or infection that are
involved in Dealing with injury & illness.
Control processes such as inflammation,
blood flow, the formation of blood clots & the
induction of labour.

EOSINOPHIL CHEMOTACTIC FACTOR OF PRODUCE: smooth muscle contraction

ANAPHYLAXIS
▼
affect movement of eosinophils (granular
leukocytes)
▼
to the site of allergen preformed in the mast
cell & released in disrupted mast cell
PLATELET –ACTIVATING FACTOR
▼
initiating platelet aggregation & leukocyte
infiltration at the sites of immediate
hypersensitivity reactions
▼ edema stimulate nerve fibers causing pain
vasodilation increased capillary permeability
fever , pain in allergic responses are partly
due to prostaglandins.
SECONDARYMEDIATORS
LEUKOTRINES initiate inflammatory
response cause smooth muscle contraction
bronchial constriction mucus secretions in
airways wheal , flare reactions of skin 100 -
1000 x more potent in causing
bronchospasm than histamine
BRADYKININ cause increased vascular
permeability vasodilation hypotension
contraction of smooyh muscles (bronchi)
increased permeability in capillaries caus

cause bronchoconstriction & vascular SEROTONIN potent vasoconstrictor

permeability. contraction of bronchial smooth muscle.

7
SIGNS & SYMPTOMS vasopressors , Maintain BP ,
hemodynamic status.
4. EPINEPHRINE 1:1000 SQ, FF IV
INFUSION
5. Causes constriction, or tightening, of
the blood vessels – Decreases
Swelling, increase BP
6. In the heart, it increases the rate and
force of contraction – increasing
Cardiac output raising BP
7. Antagonizes histamine by Acting on
effector cells in a Direction opposite of
histamine.
8. AMINOPHYLLINE &
BRONCHODILATOR

MANAGEMENT

1. ASSESS ABC CPR – CARDIAC ARREST

SUPPLEMENTAL O2
2. ANTIHISTAMINES -
Diphenhydramine — 25 to 50 mg IV
over 5 minutes, may be Repeated
every 4 to 6 hours PRN Up maximum
dose of 400 mg/24H.
3. CORTICOSTEROIDS - IVFs normal
saline, volume, Expanders ,

8
MULTIPLE SCLEROSIS
IMMUNE-MEDIATED PROGRESSIVE
DEMYELINATING DISEASE OF THE CNS

(ETIOLOGY: UNKNOWN)

Epstein-Barr Virus (EBV) ---human

herpesvirus 4, is a member of the herpes
virus family – one of the most common
human viruses

WHAT IS MS ?

- Multiple sclerosis (MS) is a chronic

disease of the central nervous system.
MS is unpredictable. Some people may Characteristics Excitability Conductivity
be only mildly affected. Others may Ability to influence other neurons.
lose the ability to see clearly, write,
speak, or walk. Early symptoms can
include vision problems, trouble
walking, and tingling feelings.

Fatty-protein coating Provides protective

Insulation Allows electrical Impulses to
travel Quickly & efficiently Maintains
strength of the Impulse message as it
Travels down the axon.

9
 PATHOPHYSIOLOGY OF MS

sensitized t- cells, b lymphocytes cross the bb

⬇️

remains in cns, promote infiltration –

inflammation

⬇️

production of inflammatory cytokines &

reactive o2 species

⬇️

demyelination, destruction of
oligodendrocytes
AREAS AFFECTED
⬇️
1. Optic
formation of plaques 2. Cortico spinal
⬇️ 3. Cortico Bulbar
4. Posterior columns Of Sc
scarring, destruction of sheath
5. Medial Longitudinal Fasciculus
⬇️ 6. Spinocere bellar
7. Cerebellar
scattered irregularly throughout cns
corticobulbar tract carries upper motor
⬇️
neuron input to motor nuclei of trigeminal,
interruption of nerve impulses facial, glossopharyngeal, vagus, accessory,
⬇️ and hypoglossal nerves.

multiple sclerosis corticospinal tract pyramidal tract carry

movement-related information from the
cerebral cortex to the spinal cord. the
cerebellum is for making postural
adjustments to maintain balance.

the cerebellum is for making postural

adjustments to maintain balance.

spinocerebellar tracts carry unconscious

proprioceptive information gleaned from
muscle spindles, golgi tendon organs, and
joint capsules to the cerebellum.

Medial longitudinal Fasciculus – found in

Brainstem is a set of Crossed fibers with
Ascending and Descending fibers. Links the 3
CN which Control EOM, & CN VIII

10
 THE SIGNS AND SYMPTOMS
DIAGNOSTIC TESTS
Charcot triad describes cholangitis as clinical
findings of fever, right upper abdominal pain,
and jaundice.
11
1. CT SCAN – A CT scan is a diagnostic
imaging procedure that uses a
combination of X-rays and computer
technology to produce images of the
inside of the body.
2. MRI – Magnetic Resonance Imaging
(MRI) is a non-invasive imaging
technology that produces three
dimensional detailed anatomical
images. It is often used for disease
detection, diagnosis, and treatment
monitoring.
3. PROTIEN Electrophoresis CSF – uses
an electrical current on a csf sample to
separate out types of protein called
immunoglobulins.
4. Visual Evoked Response
determined By EEG: delayed – visual
evoked potential (VEP) Measures
electrical response of The brain’s
primary visual cortex To a visual
stimulus. To measure The electrical
 response place 3 Electrodes on the 4. For secondary progressive:
scalp. • Novantrone – reduces
frequency of relapses.
TREATMENT
1. DISEASE-MODIFYING - Pharmacologic NURSING
therapy
INTERVENTION
• A VONEX (Beta Interferon 1a, IM) PROMOTE OPTIMUM MOBILITY

• B ETASERON (Beta Interferon1b) A. MUSCLE-STRETCHING &

STRENGTHENING EXERCISES
• C OPAXONE (Glatiramer Acetate)
B. WALKING EXERCISES TO
• R EBIF (Beta Interferon 1a) IMPROVE GAIT USE WIDE –
IMMUNE ENHANCERS BASED GAIT
C. ASSISTIVE DEVICES: CANES,
2. FOR ACUTE EXACERBATIONS:
WALKER, RAILS, WHEELCHAIR
• Corticosteroids (Methylprednisolone) AS NEEDED
D. MINIMIZE SPASTICITY &
• ACTH
CONTRACTURES
• Plasmapheresis – Plasmapheresis Plasma, •Administer medication as
is separated from the blood cells plasma is ordered
replaced with another solution such as saline •Exercises
or albumin, or the plasma is treated and E. ACTIVITY & REST
returned to body. • Frequent rest Periods
3. FOR TREATMENT OF SYMPTOMS • Fatigue Exacerbates
Symptoms
• For spasticity:
F. ENCOURAGE INDEPENDENCE
• Baclofen (Lioresal), IN SELF CARE
G. PREVENT COMPLICATIONS OF
• Benzodiazepine Valium)
IMMOBILITY
• Dantrolene (Dantrium)
PREVENT INJURY
• Tizanidine ( Zanaflex)
• Test bath water With thermometer
• For fatigue: • Amantadine ( Symmetryl)
• Avoid heating Pads, hot water Bottles
• Fluoxetine (Prozac)
• Frequent position Changes
• For ataxia:
• Inspect body parts For injury
• Beta adrenergic blockers – Inderal
ENHANCE BLADDER & BOWEL CONTROL
• Antiseizure agents – Neurontin
1. Force fluids 3000 ml/day
• Benzodiazepines – Klonopin 2. Use of acid-ash foods (cranberry,
• For bladder problems: grape juices
3. URINARY RETENTION: Intermittent
• Ascorbic acid (vit C)
Catheterization Bethanecol chloride
• Anticholinergics 4. URINARY INCONTINENCE:Establish
voiding schedule

12
Anticholinergic: Propantheline bromide,
Tolterodine (Detrol)
DIABETES MELLITUS
Chronic autoimmune disease that prevents
Pancreas from making Insulin

TYPE 1 DIABETES MELLITUS

BOWEL

• ADEQUATE FLUIDS
• DIETARY FIBER
• BOWEL

TRAINING PROGRAM

ENHANCE COMMUNICATION & MANAGING

SWALLOWING DIFFICULTIES

*REFER FOR SPEECH

THERAPY/SWALLOWING PROBLEMS

*PREVENT ASPIRATION
1. IDDM
2. JUVENILE ONSET YOUNG <30 YRS
PROVIDE PSYCHOLOGICAL SUPPORT 3. BRITTLE DM
1. Refer to MS Societies & Community 4. KETOSIS PRONE DM
Agencies 5. 5%-10% of Cases
2. Provide no False hope
3. Provide compassion In adapting to
Changes in body Image & self concept.
4. Encourage Positive Attitude, assist in
setting Realistic goals

PROMOTING SEXUAL FUNCTIONING

• USE OF ALTERNATIVE METHODS FOR

SEXUAL GRATIFICATION

• REFER FOR SEXUAL COUNSELLING

PROVIDE TEACHING & DISCHARGE

PLANNING

1. Well-balanced dieat
2. Fresh air & sunshine
3. Avoid fatigue, overheating chilling
stress infection
4. Balance between activity & rest
5. Use of energy conversation techniques
6. Regular exercise (walking, swimming,
biking)

13
 FAST FACTS:

✓ Type 1 diabetes affects about 1.6 million

people in The U.S

✓ Can be triggered by any virus, including a

cold

✓ Most people with T1D are diagnosed in the

ER as Children

✓ They require insulin

✓ Affects less than 30 years old

✓ Common: boys

✓ Cause: unknown

Cause suspected:

O Unknown → Genetics

O Lifestyle

O Weight

O Familial factor

O Co-existing endocrine problems

✓ Insulin dependent diabetes mellitus

(IDDM)

✓ Once Called as JUVENILE DM

✓ 5% - 10% of cases

✓ Brittle DM

Hard-to-control diabetes (also called labile

Diabetes). It is characterized by wide
variations Or “swings” in blood glucose
(sugar) in which Blood glucose levels can
quickly move from too High (hyperglycemia)
to too low (hypoglycemia).

✓ KETOSIS PRONE DM

Type 2 diabetes is a form of diabetes that

Usually presents with diabetic ketoacidosis
(DKA) in patients who are not insulin
Dependent.

14
ENDOCRINE SYSTEM - Endocrine glands
release hormones into the Bloodstream. This
lets the hormones travel to Cells in other
parts of the body. The endocrine Hormones
help control mood, growth and development,
the way our organs work, metabolism , and
reproduction. The endocrine System
regulates how much of each hormone is
released.
Triiodothyronine (T3) – is a thyroid
hormone. It plays an important role In the
body’s control of metabolism (the many
processes that control the rate of activity in
Cells and tissues). A laboratory test can be
done To measure the amount of T3 in your
blood.
Thyroxine (T4) - is produced by the thyroid
gland under Regulation from the
hypothalamus and pituitary gland. The
feedback loop signals to The hypothalamus
in to release thyrotropinreleasing hormone,
which then stimulates the pituitary gland to
release the thyroid stimulating hormone
✓ increased T3 levels even for short period
can cause Insulin resistance; thereby
contributing to T2DM.
⬆METABOLIC RATE stimulate the ⬆ of
SUGAR LEVELS
Corticosteroids and Catecholamines
➢ both responsible for the delivery of energy
➢ energy is important because without
energy, insulin will not work
➢ insulin makes energy
INSULIN – Insulin is an essential hormone. It
helps Your body turn food into energy and
Controls your blood sugar levels. If you have
diabetes, your body can’t make enough
insulin or can’t use it properly. Your Provider
can prescribe human-made insulin That you
take through an injection (shot), Injectable
pen or pump.
15
CORTICOSTEROIDS
- ANTI-INFLAMMATORY
- Corticosteroid medicines such as
Prednisolone and dexamethasone
(commonly called steroids) can
change how Your body handles
carbohydrates and sugars (also known
as glucose). They can Raise your blood
sugar level by blocking the Action of
your insulin.
CATHECOLAMINES – The body releases
catecholamines in Response to emotional or
physical stress. Catecholamines are
responsible for the Body’s “fight-or-flight”
response. Dopamine, adrenaline, and
noradrenaline Are all catecholamines,
Catecholamines and a number of other
Hormones released during stress states
Contribute to the development of
Hyperglycemia by directly stimulating
Glucose production and interfering with
Tissue disposal of glucose.
IN DIABETES MELLITUS: ➢ Chronic
complex alteration in metabolism of CHO
(carbohydrates), CHON (protein), and fats
with the Developments of complications:
a.) Macrovascular – large blood
vessels
b.) Microvascular – small blood
vessels
c.) Neuropathies – functions of the
nerve
Pancreas – it is both an endocrine and
exocrine glands
Endocrine – produces hormones
Exocrine – for digestion of food
Enzymes - Proteins that help speed up
metabolism, or the Chemical reactions in our
bodies. They build some Substances and
break others down. All living things have,
Enzymes. Our bodies naturally produce
enzymes.
 a.) Amylase – absorption of
carbohydrates
b.) Trypsin – absorption of protein
c.) Lipase – splitting of fats
❖ B cells – secretion insulin
❖ A cells – secretion of glucagon
❖ Delta – secretion of somatostatin
2. Glucagon
- Is a hormone that your pancreas
makes to help Regulate your blood
glucose (sugar) levels. Glucagon
increases your blood sugar level and
Prevents it from dropping too low,
whereas insulin, another hormone,
decreases blood sugar levels.
3.Somatostatin - Commonly known as
growth hormone inhibiting hormone,
prevents the pituitary Gland from secreting
GH. Somatostatin is generated in a variety of
additional places, Including the
gastrointestinal (GI) tract, the pancreas, and
the central nervous system (CNS).
✓ B and A cells – coordination of work to
maintain Insulin
Normal insulin: 60-100 mg/dl (for in
general: kids, adults, older patients)
✓ Carbohydrates is the main source of
energy
✓ 2000 calories/ day is the standard calorie
intake
✓ CHO – 80%-60
1g = 4 cal
Ex. 1000g of CHO
÷4
-----------------
250 calories
✓ For every 50 added = add 1 min to insulin
16
Pancreas → beta cells → insulin
Once the muscles uses the food
(carbohydrates) for Energy, it then goes to
the liver (the remaining Carbs) to covert to
glycogen (glycogenesis) to Distribute as
adipose tissue or fats (for storage).
Note: PROTEINS should note be broken
because it Is for repair and building
Proteins (CHON): 10%-20%
Fats: 30% → 1gm = 9 calories
Fats are used during the starvation level. The
glucagon works during the starvation level
while the pancreas rests Glucagon works to
maintain the sugar levels.
8-12 hours without carbohydrates, proteins
will Break in the liver ⬇️
O This process is called glycogenolysis ⬇️
O Send it back to the blood for maintenance
of sugar ⬇️
O Glycogenolysis – to provide immediate
energy and to maintain blood glucose levels
during fasting.
❖ Free fatty acids (FFA) -an essential energy
source, especially During starvation,
exercise, and pregnancy
❖ Lypolysis - Lipolysis is the process of
breaking down Lipids. It entails hydrolysis
whereby a Triglyceride, for instance, is
broken down Into free fatty acids and
glycerol.
FFA → LYPOLYSIS → liver for oxidation →
ketones
• Human leukocyte antigen - Their genes
carry leukocyte antigens
• Anti GAD65 - Prevents the release of insulin
in B cells
• Absolute deprivation of insulin related to
Destruction of B cells → DM type 1
• DM type 2 – produces insulin but just not MANAGEMENT
working. Your fat, liver, and muscle cells do
✓ Education
not respond Correctly to insulin.
✓ Nutrition
SIGNS AND SYMPTOMS

Polyuria ✓ Activity
⬆️urination
Polydipsia ⬆ thirst ✓ Insulin
Polyphagia ⬆ hunger
• Weight loss ✓ SMBG (SELF-MONITORING BLOOD
• Fatigue GLUCOSE)

• ⬆ frequency of infections

• Rapid onset

• Insulin dependent

• Familial tendency

OBJECTIVES OF NUTRITIONAL THERAPY

IN DM

1. Control of total caloric intake to

attain or Maintain reasonable
weight
2. Control of blood glucose to
maintain health and Prevent
complications
3. Address individual nutritional
needs
4. Normalization of lipids and BP
• Peak incidence from 10 to 15 years to reduce risk for
Cardiovascular disease
• Polydipsia – excessive thirst
5. Modify lifestyle as needed to
• Polyphagia – excessive hunger treat obesity, Hyperlipidemia,
• Kussmaul’s breathing – deep breaths CV disease, and neropathy

• acetone smell – fruity-smelling

• Polyuria – excessive urine

• Glycosuria – presence of glucose in urine

• Nocturia – the need for patients to get up at

Night on a regular basis to urinate.

• Ketonuria – the excretion of abnormally

large Amounts of ketone bodies in the urine.

17
• Protein
- Beans, legumes, eggs, seafood, dairy,
peas, Tofu, lean meats, poultry
• Fats
- Avocado, canola oil, nuts like almonds,
Cashews, pecans, and peanuts. Olive
oil and Olives (low NA). peanut butter
and peanut Oil. Sunflower oil.
• Fiber
- Improves glucose level
- Decreases need for exogenous insulin
- Decreases total cholesterol, LDL levels
Additional notes:
• Simple sugar – has the most sugar Fructose
ex. Pineapple. (even if the label says
Unsweetened)
• Complex sugars – ex. Bread, rice
• Triglycerides – fats came from sugars
Note: MILK still has sugar (lactose). So,
choose milk w/o Lactose (soy, rice, almond,
coconut-based, cashew, oat Milks)
• Splenda sugar – alternative for table
Sweeteneers. Contains calories but lesser.
Sweeteners for diabetic patients.
• Eat green leafy vegetables
• Avocado (good fat)
• Recommend fiber – for it delays absorption
of Carbohydrates.
WHY DOES EXERCISE IMPROVE
CIRCULATION?
➔ IT STIMULATES NOREPINEPRINE AND
18
EPINEPHRINE
➔ Norephi and Ephi help maintain normal
Blood glucose levels by stimulating Glucagon
release, glycogenolysis, and foodc
onsumption, and by inhibiting insulin
Release.
EXERCISE GUIDELINES:
✓ Check blood glucose levels frequently or
before Exercising
Note:
❖ Hypoglycemia -- < than 60 mg/dl
❖ If patient is hyperglycemic – do not
exercise
When Blood glucose is > 250 mg/dl. It
increases Glucagon, catecholamines, growth
hormone.
✓ Exercise 1 to 2 hours after meal to prevent
Hypoglycemia.
✓ Consume a carbohydrate snack before and
During prolonged exercise.
✓ Lipodystrophy – hypertrophy of cell. It
causes Swelling and redness.
✓ Storage of insulin: refrigerator or freezer.
Or if Not available, just do not place it under
direct Sunlight. Sunlight damages insulin.
NURSING CONSIDERATION
For administration:
1. Prepare food before injecting the
insulin Or patient will be
hypoglycemic
2. Provide food in between meals
3. Advice to never miss a meal
4. Do not shake insulin vigorously (shake
only by placing it between 2 palms.)
Clear first, the cloudy
5. Do not mix with other insulins because
it has High ph levels.
 For severe hypoglycemia:

- Can cause coma and seizure because

the Brain needs both glucose and
oxygen.

WHAT TO GIVE PATIENT WHEN

HYPOGLY?19

SELF-MONITORING OF BLOOD GLUCOSE

✓ Injecting insulin 2,3,4x /day

✓ HgbA1c

- Is a simple blood test that measures

✓ Peak – sugar will decrease. On this time,

you will Monitor the patient for
hypoglycemia. If peak Happens, give meal to
avoid hypogly.

✓ Rapid acting – is injected before a meal to

prevent Your blood glucose from rising, and
to correct high Blood sugars.

✓ Regular or short-acting: also use syringe U-

100. It is The only insulin type that can be
given via IV. Normally, all insulins are give
via IM or SQ.

✓ Long-acting: no danger of hypoglycemia

What are the manifestation of hypoglycemia?

your Average blood sugar levels over
- Importantly, SWEATING the past 3 months.
- Tremors

19
 Among adults in

RHEUMATOID
ARTHRITIS

their 60’S.

Pannus is a membrane of granulation Tissue

composed of mesenchyme- & bone Marrow-
derived cells.

Stimulates the release of IL-1, platelet-

derived growth factor, prostaglandins, &
Substance P by macrophages,

COLLAGENASE

Cause cartilage destruction & bone Erosion

INCIDENCE

Recent research: Prevalence increased with

age, Body mass index, physical inactivity,
worsening physical & mental health. Highest
among adults who were unable to work,
disabled, or had fair or poor self-rated health.

➢ 14 million people
globally have RA
(WHO 2021)
➢ 1.36 million adults
in U.S.
Rheumatology
International,2017
➢ Begin at any age,
Increases with age.
Onset highest

20

What are the stages of rheumatoid
arthritis?
The four stages of rheumatoid arthritis are
known as synovitis, pannus, fibrous
ankylosis, and bony ankylosis.
Stage I: Synovitis
21
During stage I, you may start having mild
symptoms, including joint pain and joint
stiffness. Most commonly, this affects the
hands and fingers, as well as the ankles and
knees. The immune system has begun
attacking the joint tissue, causing the
synovial membrane to swell and become
inflamed.
Stage II: Pannus
In stage II of rheumatoid arthritis, the
continued inflammation has led to a thinning
of the cartilage. Normally, cartilage helps
provide some cushion for the bones and
makes joint motion more fluid. Without all
that cushion, joint pain and stiffness may
worsen. This also sets the stage for joint
damage. Without the protection of cartilage,
the bones may begin to erode at the joint.
Stage III: Fibrous Ankylosis
Ankylosis is a term for when bones start to
fuse together at a joint, causing unusual lack
of mobility. In stage III, the damaged joint
area starts to fuse with a connective fibrous
tissue. This will severely limit your range of
motion, which may make simple tasks even
more difficult. At this point, your joints may
start to appear bent and crooked.
Stage IV: Bony Ankylosis
As the name suggests, stage IV is when the
bones fuse together with actual bone tissue
instead of just a connective fibrous tissue. At
this stage, pain actually goes away, but so
does the ability to move. The joint is
essentially gone, so you can’t bend or flex the
area. Once someone has stage IV rheumatoid
arthritis, they may have trouble doing the
tasks and hobbies that they normally would.
THE SIGNS AND SYMPTOMS ERYTHROCYTE SEDIMENTATION RATE
MEASURES THE RATE RBC SETTLE OUT OF
UNCLOTTED BLOOD IN 1 HOUR MEN < 50
yrs : < 15 mm/h , Men > 50 yrs : < 20 mm/h
Female < 50 yrs: < 25 mm/h, Female > 50
yrs: < 30 mm/h, Increase is seen in
inflammatory connective tissue disease.

ASSESSMENT/ DIAGNOSTICS

❖ HISTORY
❖ PE
❖ LABORATORY STUDIES

WBC COUNT MEASURES CIRCULATING

LEUKOCYTES N: 4,500 – 11,000 CELLs/m

HEMATOCRIT MEASURES THE SIZE

CAPACITY , NUMBER OF CELLS PRESENT IN
THE BLOOD MALE: 42% - 52% FEMALE:
35% - 47% DECREASE IN CHRONIC
INFLAMMATION.

MANAGEMENT

PHARMACOLOGIC THERAPY

❖ SALICYLATES – ASPIRIN

22
 ❖ NSAID’s – VOLTAREN , DICLOFENAC,
IBUPROFEN
❖ DMARD’s alter disease progression &
decrease or stop further tissue damage
❖ Non biologic DMARD’s reduce
proinflammatory cytokines(cell
Signaling proteins), increase anti
inflammatory cytokines
❖ Biologic DMARD’s – target a a certain
cell or molecule within The immune
system to treat specific rheumatologic
condition.
DMARD’S :
ANTIMALARIALS
HYDROXYCHLOROQUINE(PLAQUENIL)
CHOROQUINE (ARALEN) MOA: Anti
inflammatory, inhibits lysosomal
enzymes.
Sulfasalazine (Azulfidine) Anti
inflammatory, reduces lymphocyte
Response.
Gold containing Compounds
Aurothioglucose (Solganal) Gold sodium
thiomalate (Myochrysine) Auranofin
(Ridaura) MOA: inhibits T & B cell,
Activity, suppress Synovitis during active
Stage of rheumatoid Disease.
Penicillamine (Depen) Anti
inflammatory inhibits T cell function,
impairs Antigen presentation.
Immunosuppressives Methotrexate
( Rheumatrex) Moa: immune suppression
IMMUNODULATORS PYRIMIDINE
SYNTHESIS INHIBITOR Leflunomide:
antiproliferative, Anti inflammatory
Corticosteroid Prednisone Moa: anti
Inflammatory
Cyclosporin( Neoral Moa: immune
suppression By inhibiting T lymphocytes.
23
Non Pharmacologic Pain Management
● Heat application to relieve pain,
stiffness , Muscle spasm Warm baths,
shower, warm moist compress Paraffin
baths (dips) offer concentrated heat
● therapeutic exercise
● use of assistive devices for ambulation,
braces, splints
● adequate rest and sleep
● balance nutrition
SYSTEMATIC LUPUS
ERYTHEMATOSUS
What is SLE?
❖ Systemic lupus erythematosus (SLE),
is the most common type of lupus. SLE
is an autoimmune disease in which the
immune system attacks its own
tissues, causing widespread
inflammation and tissue damage in the
affected organs.
❖ It can affect the joints, skin, brain,
lungs, kidneys, and blood vessels.
❖ There is no cure for lupus, but medical
interventions and lifestyle changes can
help control it.
What causes SLE?
The causes of SLE are unknown, but are
believed to be linked to environmental,
genetic, and hormonal factors.
THE SIGNS AND SYMPTOMS
The signs and symptoms of lupus that you
experience will depend on which body
systems are affected by the disease. The most
common signs and symptoms include:
❖ Fatigue
❖ Fever
❖ Joint pain, stiffness and swelling
 ❖ Butterfly-shaped rash on the face that
covers the cheeks and bridge of the
nose or rashes elsewhere on the body
❖ Skin lesions that appear or worsen
with sun exposure
❖ Fingers and toes that turn white or
blue when exposed to cold or during
stressful periods
❖ Shortness of breath
❖ Chest pain
❖ Dry eyes
❖ Headaches, confusion and memory
loss.

❖ Cutaneous lupus erythematosus,

which affects only the skin.
❖ Drug-induced lupus, a short-term
type of lupus caused by certain
medicines.
❖ Neonatal lupus, a rare type of lupus
that affects newborn babies.

INCIDENCE

Any age, most are diagnosed in 20s and 30s6

– 10x > women

African Americans than caucasians.

TYPES OF LUPUS

There are several different types of lupus:

❖ Systemic lupus erythematosus

(SLE) is the most common and most
serious type of lupus. SLE affects all
parts of the body.
24
 ❖ NSAIDs Ex. Ibuprofen & diclofenac
❖ IM or intraarticular (injection into the
Joint) methylprednisolone N 80 to120
mg.
INITIAL TREATMENT
❖ Local Corticosteroid
❖ Oral prednisolone ≤20 mg daily for 1–
2 Weeks
❖ High–Sun Protectio Factor (SPF)
sunscreen along With avoiding
sunlight is advised to prevent skin
lesions
❖ MAINTENANCE TREATMENT –
DISEASE MODIFYING DRUGS
HYDROXYCHLOROQUINE
METHOTREXATE LOW DOSE
PREDNISOLONE (7.5 mg/DAY)

Hydroxychloroquine & other antimalarials

Calm overactive immune system helps
prevent blood clots & organ damage

↓ lupus inflammation flares, treat symptoms

– skin Inflammation, hair loss, mouth sores,
fatigue, and Joint pain.

Methotrexate now a standard

immunosuppressive treatment for lupus
Reduces joint pain & swelling by Blocking
folic acid production.

25
MODERATE SLE Characterized by Fever,
Rash up to 2/9 body surface area, Cutaneous
vasculitis (inflammation of the blood vessels
Of the skin), Hair loss with scalp
inflammation, Liver or joint disease,
Inflammation of the pleura or Pericardium
(the tissues Surrounding the lungs and the
Heart Platelet count of 25–49 × 109/l.

Moderate SLE requires the following

drugs:

•Corticosteroids – higher doses of ❖ Muscle pain

prednisolone ❖ Severe inflammation of the pleura
• IM or IV methylprednisolone. and/or Pericardium with fluid
accumulation.
•Methotrexate

• azathioprine

•mycophenolate mofetil

•cyclosporine

•hydroxychloroquine

Belimumab (Benlysta” , GlaxoSmithKline)

Immunosuppressant monoclonal antibody
that inhibits B cell Differentiation into
antibodyproducing plasma cells. (For cases
that do not respond to treatments) PLASMAPHERESIS (removal of Antibodies
from the plasma) may be required for
patients with low Blood counts not
responding to Treatment.

Severe SLE

A life-threatening condition – affect vital

Organs including the kidneys & brain

❖ Involvement of the Intestines, brain,

spinal cord, and optic nerve.
❖ Rash > 2/9 body surface area
❖ Fluid accumulation in the abdomen
❖ Extremely low platelet count < 25 ×
109/l

26

Nursing goals include
Relief of pain and discomfort, Relief of
fatigue, Maintenance of skin integrity,
Compliance with the prescribed medications,
Increased knowledge regarding the Disease,
Absence of complications.
begin within the first five years after
lupus symptoms start to appear. This
is one of the more serious
complications of lupus. Also, kidney
inflammation is not usually painful so
you don’t know when it’s happening.
That is why it’s important for people
with lupus to get regular urine and
blood tests for kidney disease.

ADDITIONAL NOTES

CAUSES INCLUDE

Health Problems Include:

Heart disease.

- Lupus raises the risk of the most

common type of heart disease, called
coronary artery disease (CAD). This is
partly because people with lupus have
more CAD risk factors, which include
high blood pressure, high cholesterol,
and type 2 diabetes. Lupus causes
inflammation (swelling), which also
increases the risk for CAD. Women
with lupus may be less ¬¬active
because of fatigue, joint problems, and
muscle pain, and this also puts them at
risk for heart disease. In one study,
women with lupus were 50 times
more likely to have chest pain or a
heart attack than other women of the
same age.3

Osteoporosis.

- Medicines that treat lupus may cause

bone loss. Bone loss can lead to
osteoporosis, a condition that causes
weak and broken bones. Also, pain and
Treatment for lupus nephritis works
fatigue can keep women with lupus
best if caught early.
from getting physical activity. Staying
active can help prevent bone loss. The environment.

Kidney disease. - Sunlight, stress, smoking, certain

medicines, and viruses may trigger
- More than half of all people with lupus
symptoms in people who are most
have kidney problems, called lupus
likely to get lupus due to their genes.
nephritis. Kidney problems often

27
Hormones such as estrogen.

- Lupus is more common in women

during their childbearing years when
estrogen levels are highest.

Problems with the immune system.

INFECTIONS
Infection occurs when viruses, bacteria, or
other microbes enter your body and begin to
multiply. Disease, which typically happens in
a small proportion of infected people, occurs
when the cells in your body are damaged as a
result of infection, and signs and symptoms
of an illness appear.

THE LYMPHATIC SYSTEM

Lymphatic system is a network of organs,

vessels and tissues that work together to
move a colorless, watery fluid (lymph) back
into your circulatory system (your
bloodstream). As a vital part of your
immune system, your lymphatic system
protects you from infection and destroys old
or abnormal cells your body doesn’t need.
Lymphatic system functions also include
maintaining normal fluid levels in your body How Do Infections Occur?
and absorbing fats and fat-soluble vitamins An infection occurs when germs enter the
so they can make their way into your body, increase in number, and cause a
bloodstream. reaction of the body. Three things are
necessary for an infection to occur:

Source: Places where infectious agents

(germs) live (e.g., sinks, surfaces, human
skin).

Susceptible Person with a way for germs to

enter the body.

Transmission: a way germs are moved to

the susceptible person.

28
CHAIN OF INFECTION HUMAN INFECTIOUS DISEASE

Germs (agent)

- Bacteria
- Viruses
- Parasites

Where germs live (reservoir)

- People
- Animals/Pets (dogs, cats, reptiles)
- Wild animals
- Food
- Soil
- Water

How germs get out (portal of exit)

- Mouth (vomit, saliva)

- Cuts in the skin (blood)
- During diapering and toileting stool
- Germs get around (mode of
transmission)
- Contact (hands, toys, sand)
- Droplets (when you speak, sneeze or
cough)

How germs get in (portal of entry)

- Mouth
- Cuts in the skin
- Eyes BREAKING THE CHAIN OF INFECTION

Next sick person (susceptible host) Certain conditions must be met in order for a
microbe or infectious disease to be spread
- Babies
from person to person. This process, called
- Children
the chain of infection, can only occur when
- Elderly
all six links in the chain are intact. By
- People with a weakened immune
breaking this chain at any of the links, the
system
spread of infection is stopped.
- Unimmunized people
- Anyone
- Cycle repeats

29

5 MOMENTS OF HAND HYGIENE
The 5 Moments for Hand Hygiene approach
was designed by the World Health
Organization to minimize the risk of
transmission of microorganisms between a
healthcare worker, the patient, and the
environment.
Before touching a patient
- Shaking hands, assisting a patient to
move, allied health interventions,
touching any medical device
connected to the patient (for example,
intravenous line pump, urinary
catheter)
30
Before any personal care activities that
require physical contact
- Bathing, dressing, brushing hair,
putting on personal aids such as
glasses.
Before providing any non-invasive
treatment
- Applying an oxygen mask or nasal
cannula, fitting slings/braces,
application of incontinence aids
(including condom drainage),
conducting an oral examination
without using a sharp instrument
(such as using a mirror probe),
performing oral X-ray.
Before taking any non-invasive
observations
- Taking a pulse, blood pressure, oxygen
saturation, temperature, chest
auscultation, abdominal palpation,
applying ECG electrodes,
cardiotocography .
Before the preparation or administration
of oral medications
- Oral medications, nebulised
medications
Before providing oral care and feeding
- Feeding a patient (excluding feeding
via nasogastric tube or percutaneous
endoscopic gastrostomy), brushing
teeth or dentures.
 SYMPTOMATIC

WHAT IS PATHOGENS? - When someone has the common

symptoms associated with a disease or
- A pathogen is defined as an organism
condition, they are considered
causing disease to its host, with the
symptomatic.
severity of the disease symptoms
- With symptoms, as a symptomatic
referred to as virulence. Pathogens are
infection. Characteristic of an illness or
taxonomically widely diverse and
other medical condition. Directed at
comprise viruses and bacteria as well
the symptoms as symptomatic
as unicellular and multicellular
treatment
eukaryotes.
- Transmission of pathogens can occur
by direct contact, through
contaminated food, body fluids or
objects, by airborne inhalation or
through vector organisms.
Transmissibility is the probability of
an infection, given a contact between
an infected host and a noninfected
host.

DIFFERENCE OF ASYMPTOMATIC &

SYMPTOMATIC

Why is herd immunity important?

ASYMPTOMATIC
- Herd immunity occurs when a large
- Asymptomatic diseases are where a
portion of a community (the herd)
disease or infection does not lead to
becomes immune to a disease. The
any symptoms. Some people will
spread of disease from person to
remain asymptomatic throughout
person becomes unlikely when herd
their disease course, whereas others
immunity is achieved. As a result, the
will eventually become symptomatic
whole community becomes protected
later on.
not just those who are immune.
- Asymptomatic disease is where a
person is infected with a disease (or
- Often, a percentage of the population
develops a disease; diagnosed) but
must be capable of getting a disease in
fails to display any noticeable
order for it to spread. This is called a
symptoms. These are also referred to
threshold proportion. If the
as subclinical diseases or infections.
proportion of the population that is
However, if symptoms do eventually
immune to the disease is greater than
develop after a period of being
this threshold, the spread of the
asymptomatic, then that phase is
disease will decline. This is known as
known as pre-symptomatic.
the herd immunity threshold

31

WHAT IS THE IMPORTANCE OF
PRECAUTIONS
Standard precautions are meant to reduce
the risk of transmission of blood borne and
other pathogens from both recognized and
unrecognized sources. They are the basic
level of infection control precautions which
are to be used, as a minimum, in the care of
all patients.
1985
Universal precautions were introduced by
the Centers for Disease Control (CDC) in
1985, mostly in response to the human
immunodeficiency virus (HIV) epidemic.
INNATE
( INBORN/CONGENITAL)
- Present at birth, nonspecific, 1st
defense (immediate response )
3 MAIN BARRIERS
1. Physical – skin (organs )
2. Physiological (HCI , saliva , fluids )
3. Cellular – WBC
ADAPTIVE
( ACQUIRED)
- In once in a lifetime, adaptive and
remembered previously encountered
antigen. (Specific)
32
ADAPTIVE/ACQUIRED TYPES
1. NA ( NATURALLY ACTIVE) –
exposure to actual infections.
2. NP ( NATURALLY PASSIVE )
3. AA ( ARTIFICIALLY ACTIVE) –
vaccination /immunization
4. AP ( ARTIFICIALLY PASSIVE) –
immunoglobulins, antiserum
ACTIVE ( to stimulate antibodies)
PASSIVE ( for preparing
(immunoglobulins antibodies )
RESPONSE TO INVASION
1. PHAGOCYTIC IMMUNE SYSTEM
2. HUMORAL IMMUNE SYSTEM
3. CELLULAR IMMUNE SYSTEM –
antibodies production.
Republic Act No. 10152, otherwise known
as the “Mandatory Infants and Children
Health Immunization Act of 2011” was
enacted to mandate the adoption of a
comprehensive and sustainable
immunization program for vaccine-
preventable diseases for all Filipino children
and infants.
EPIDEMIC – high spread constantly present.
ENDEMIC – low spread constantly present
PANDEMIC – outbreak
MODE OF TRANSMISSION
- Direct transmission
line of - Indirect transmission
DIRECT TRANSMISSION
- Pathogens may be transferred directly
to other host ( ex. Hand shake ,
hugging, kissing, sex)
INDIRECT TRANSMISSION
- Occurs when there is no direct human-
human interaction/transfers. ( ex.
Objects, air , vector )
PRECAUTIONS
1. Contact precautions (yellow )
2. Droplets precautions ( green)
3. Airborne Precautions ( blue)
4. Protective Environment (orange)
ADULT INFECTIONS
DISEASE
TUBERCULOSIS
What is tuberculosis?
Tuberculosis is an infectious disease that
can cause infection in your lungs or other
tissues. It commonly affects your lungs, but it
can also affect other organs like your spine,
brain or kidneys. The word “tuberculosis”
comes from a Latin word for “nodule” or
something that sticks out. Tuberculosis is
also known as TB. Not everyone who
becomes infected with TB gets sick, but if you
do get sick you need to be treated.
33
TUBERCULOSIS CLINICAL CLASSIFICATION
1. PRIMARY INFECTION
2. LATENT INFECTION
3. ACTIVE INFECTION
PRIMARY INFECTION
- Primary tuberculosis is usually
acquired by inhalation of infected
particles. Inhaled bacilli pass into the
lung, where damage is usually but not
always confined to one segment with
concurrent involvement of draining,
frequently hilar, lymph nodes. This
gives rise to the primary (Ghon)
complex.
LATENT INFECTION
- For latent TB which is newly
diagnosed: Usually a 6 to 12 month
course of antibiotic called isoniazid
will be given to kill off the TB
organisms in the body. Some people
with latent TB may be treated with a
shorter course of 2 antibiotics for only
3 months.
ACTIVE INFECTION
- For active TB: Your healthcare
provider may prescribe 3 or more
antibiotics in combination for 6 to 9
months or longer. Examples include:
isoniazid, rifampin, pyrazinamide, and
ethambutol. People usually begin to
improve within a few weeks of the
start of treatment. After several weeks
of treatment with the correct
medicines, the person is usually no
longer contagious, if treatment is
carried through to the end, as
prescribed by a healthcare provider.