第七单元免疫、变态反应、结缔组织病(Seventhunitimmunity,allergy,connectivetissuedisease)

1、最新资料推荐第七单元免疫、变态反响、结缔组织病(Seventh unit immunity, allergy, connective tissuedisease )第七 单元 免疫、变态反响、结缔组织病(Seventh unit immunity, allergy, connective tissue disease ) 第七 单元 免疫、变态反 应、 结缔组织病 ( Seventh unit immunity, allergy, connective tissue disease ) Unit seventh, immunity, allergy, connective tissue dis

2、ease.Txt you can not makeeveryone satisfied, because not all people are people, successful people are in a way cattle B, road erection do you think I will watch you die? I will close my eyes with the seventh unit of immunity, allergy, connective tissue disease Section 1 Characteristics of pediatric

3、immune system Specific cellular immunity (T cell immunity) (I) thymus: thymus is the central immune organ, and lymphoid stem cells differentiate into mature T cells (CD3 positive, CD4 or CD8 single positive) sites. (two) T cells: the function of CD4+T cells is to modulate immune responses, called he

4、lper T cells (TH). CD8+ cells function as cytotoxic antigens, termed cytotoxic T cells. (three) cytokines: a varietyof cytokinescan be produced in the process of immune response. TH1 cells secrete interferon gamma,interleukin -2, and TH2cells secrete1 / 10 interleukin -4, 5, 6, 8, and 9. Two, specif

5、ic humoral immunity (B cell immunity) (1) bone marrow and lymph nodes: the bone marrow is the mature site of B cells and functions as a capsule. (two) B cells: compared with T cell immunity, B cells develop slowly. (three) immunoglobulin: the immunoglobulin with antibody activity is called immunoglo

6、bulin. 1.IgG: through the placenta, there are four subclasses, with the highest proportion of IgG1. IgG1 targets protein antigens, antibodies, and IgG2 against polysaccharide antigen antibodies, and IgG4is associated with allergies. 2.IgM:not through the placenta,IgM high at birth, need to further d

7、etect specific antibodies, clear whether the presence of intrauterine infection. Earlyadult level. 3.lgA: high lgA in cord blood suggests intrauterine infection and local anti infection of secretorylgA mucosa. 4.lgD (5 years of age, adult 20%) and lgE (7 years of age) are difficult to pass through t

8、he placenta. Three、nonspecific immunity Phagocytosis: large mononuclear cells and neutrophils are the major phagocytic cells in circulation. (two) complement system: reached adult level in 612 months.Second section bronchial asthma Bronchial asthma is a chronic inflammatory disease of the airways, w

9、hich is involved in a variety of cells, especially mast cells and eosinophils and T最新资料推荐lymphocytes, and is highly reactive to the airways. I. diagnosis (emphasis) (1) infant asthma diagnostic criteria: age 3 years. 1.more than 3 times of wheezing 3 points 2. lungwheezing 2 points 3. wheezing sympt

10、oms, sudden attack 1 points 4., other specific history of 1 5. of one or two relatives have asthma 1 points Standard for evaluation: total score more than 5 points for the diagnosis of infant asthma; such as lung wheeze do the following tests: (1)1 g of epinephrine, each 0.01mg/kgsubcutaneous inject

11、ion, 1520 minutes later, if wheezing relief or wheezing significantly reduced, plus 2 points; II to salbutamol aerosol or its water solution after inhalation, observe the wheezing wheezing or changes, such as reduced obviously can be 2 points. (two) diagnosis of asthma in children over 3 years old 1

12、. asthma is recurrent (or may be traced to some allergen or irritation factor) 2. episodes ofwheezing occur in the lungs 3., antiasthmatic drugs effective.Suspected cases give 1 per thousand per 0.01mg/kg subcutaneous injection of epinephrine, or salbutamol aerosol inhalation or its water solution a

13、fter 15 minutes if asthmaremission or wheeze decreased is helpful to the diagnosis of. (three) diagnostic criteria of cough variant asthma 1. cough3 / 10continued or repeated attacks 1 months, often accompanied by nocturnal or early morning paroxysmal cough, less sputum, increased after exercise. 2.

14、, no clinical symptoms of infection, or long-term antibiotic treatment invalid. 3. bronchodilatorcan relieve cough onset (the basic condition forthe diagnosisof thisdisease)4. have allergies toindividuals or families, Airway reactivity test and allergen detection can be used as auxiliary diagnosis.

15、Two, treatment(1) removal of the cause of disease (two) control seizure; 1. bronchodilator (1) Adrenomimetic drugs: drugs commonly used in the salbutamol (Shu Chuanling); the terbutaline (Shu Chuanning and Bricasol); Kle Tero (clenbuterol). Inhalation therapy is the first choice. (2) theophylline dr

16、ugs: aminophylline, sustained-release theophylline.(3)anticholinergic agents:ipratropium bromide. 2.glucocorticoids:the first choice for the treatment of asthma.(1): inhalation of beclomethasone, budesonide. (2) oral medication: short-term treatment of patients with more severe condition. 3. antibio

17、tics:use with respiratory tractbacterial infections. (three) treatment of persistent status of asthma; 1. oxygen inhalation: oxygen concentration of 40%, maintain PaO270 90mmHg. 2. rehydration and correction of最新资料推荐acidosis:supplement 1/5 sodic solution with sodiumbicarbonate, correct acidosis. 3.

18、glucocorticoid drugs: intravenous hydrocortisone or methylprednisolone. 4. bronchodilator: 1. Inhalation of salbutamol aerosol 1 times every 12 hours; aminophylline intravenous drip; the above treatment is not good, can be injected intravenously with salbutamol. 5. isoproterenol: the above treatment

19、 is invalid, try 0.1 g/kg per minute intravenous drip. 6. sedatives: chloral hydrate enema. 7.: the persistent respiratory mechanical breathing difficulties; the decreased breath sounds, then wheezedisappeared; the respiratory muscle fatigue and the thoracic activity is limited; the disturbance of c

20、onsciousness, and even coma; the inhaled 40% oxygen and cyanosis still no improvement, PaCO2 = 65mmHg. Three, prevention (I) self-education Management: (two) prevention of recurrence 1. immunotherapy (1) desensitization therapy (2) immune modulation treatment: can use thymus peptideand Chinesetradit

21、ionalmedicine to wait. 2.sodium citrate:should be inthe first 1 months before the onset of good season began medication. Ketotifen 3. 4. inhaled corticosteroid aerosol can relieve asthmatic children, should continue to maintain the5 / 10amount of inhalation for 6-24 months. The third section is acut

22、e rheumatic fever Hair age is 5-15, and heart attack is the most serious. Can cause permanent heart valve disease. First, etiology and pathogenesis: A group B hemolytic streptococcus infection after the immune response. Two, clinical manifestations (2,3, 4, 5) (I) general performanceAcute onset feve

23、r at 3840 degrees, about half of the children before the onset of 1-4 have a history of upper respiratory tract infection. Lethargy, fatigue, anorexia, pale, sweating, nasal bleeding. (two) cardiac inflammation: 40 to 50% involving the heart, is the only persistent organ damage. 1. myocarditis: tach

24、ycardia, heart enlargement, heart failure, electrocardiogram is the most common one degree atrioventricular block. 2. endocarditis: major invasion of the mitral valve and / or aortic valve. 3.pericarditis:pericardial effusion, pericarditis is usually full of inflammation. (three) arthritis: seen in

25、50 to 60%patients, mostly migratory arthritis, mainly knee, ankle, elbow and wrist joints. No deformity of joint. (four) dancing sickness: 3 7%. The course of disease is about 1-3 months. (five) skin symptoms; 1. subcutaneous nodules: in 5% of rheumatic fever children, often accompanied by cardiac i

26、nflammation. 2. ring最新资料推荐erythema: rare. Three. Diagnostic criteria The diagnostic criteria of Jones include 3 parts: main manifestations;secondary manifestations; evidence of streptococcal infection.In the presence of streptococcal infection, there are two main manifestations, or a major manifesta

27、tion and two secondary manifestations, after excluding other diseases can be diagnosed. Four, treatment and Prevention (1) rest: 8 people who have no heart attack stay in bed for 2 weeks; the patients with cardiac inflammation stay in bed for 4 weeks; the patients with heart failure stay in bed for

28、two weeks. (two) elimination of streptococcal infection: penicillin for 2 weeks. (three) wind dampheat treatment: 1. aspirin: without cardiac inflammation, use 80 to 100mg/kg every day, 48 weeks. 2.glucocorticoids:Patients with cardiac inflammation weretreated with prednisone daily 2mg/kg, 812 weeks

29、. (four) the treatment of congestive heart failure:large dosemethylprednisolone,10 to 30mg/kg per day, for 13 days.Careful use of digitalis. (five) the treatment of chorea: can use phenobarbital,valium and other sedative. (six)prevention: long-acting penicillin 1 million 200 thousand units, 1 times

30、a month intramuscular injection, at least 5 years.7 / 10Exercises 1., the highest proportion of IgG subclasses in the serum is (A) A.IgG1 B.IgG2 C.IgG3 D.IgG4 E.IgG5 answer number: 21070101 What 2.Th1 cells produce is (answer: A) A. interleukin 2 B. interleukin 4 C. interleukin 5 D. interleukin 6 E.

31、 interleukin 8 answer number: 21070102 3. does not meet the cough variant asthma characteristic (answer: C) A. coughs repeatedly for 1 months B. cough aggravated after exercise C. phlegm D. has no fever Cough relievingE.after inhalation of salbutamol answer number: 21070103 4. the treatment of asthm

32、a status iscorrect (answer:B) A.inhalation of sodium citrate B. glucocorticoid intravenous drip C. oral propranolol D. high dose gamma globulin E. application of digitalis yellow answer number: 21070104 5. the organ of continuous rheumatic fever injury is (answer: D) A. joint deformity B. renal fail

33、ure C. coronary artery aneurysm D. heart valve disease E. pulmonary fibrosis answer number: 210701056. the most commonelectrocardiographic change in rheumatic fever is (answer: D) A. ventricular premature contraction Prolongation of B.QT interval C. the right atrium is large D. degree I atrioventric

34、ular block E. third degree atrioventricular block answer number: 21070106 7. about the children' s最新资料推荐immune system, the mistake is (answer: C) A. in neonatal period, the function of various T lymphocyte subsets is insufficient B. secreted IgA is available in breast milk C.IgG cannot pass thro

35、ugh the placenta D. high levels of IgMin cord blood suggest intrauterine infection The concentration of serum complement in E. children reached theadult level from 6 to December after birth answer number:210701078. The correct understanding of children ' sspecific fine fluid immunity is (answer:

36、 C) The developmentof A.B cell immunity is earlier than that of T cells The class B.IgG antibody response should occur only 1 years after birth Class C.IgM antibodies can be produced during the fetal period The B cell volume of D. full-term neonates is lower than thatof adults E. immunoglobulin can not pass through the placenta answer number: 21070108 9. the most basic treatment for asthma in infants is application (answer: A) A. local glucocorticoid B. whole body glucocorticoid C. beta 2 adrenergic receptor agonists D. theophylline drugs E. cell membranestabilizer answer nu