WGU D236 PATHOPHYSIOLOGY OBJECTIVE ASSESSMENT
AND PRACTICE EXAM.
QUESTION: What are the 3 layers of human defense? What happens during each?
- Correct Ans- Physical- protect against damage and infection are composed of tightly associated epithelial
cells including those of the skin and of the membranous sheets lining the gastrointestinal, genitourinary, and
respiratory tracts. Mechanical- "washing" the surfaces (sloughing off of dead skin, vomiting, urination,
coughing). Biochemical barriers- secrets substances meant to trap of destroy microorganisms. (Mucus, sweat,
saliva, tears, sebaceous glands, and earwax).
QUESTION: What is the second line of defense and the process?
- Correct Ans- Inflammatory response- rapid and nonspecific, protective response to cellular injury from any
cause. It can occur only in vascularized tissue.
QUESTION: How do acute and chronic inflammation differ?
- Correct Ans- Acute- Short duration, 8-10 days from onset to healing. The three systemic changes associated
with the acute inflammatory response are fever, leukocytosis, and plasma protein synthesis. Chronic
inflammation- can be a continuation of acute inflammation that last 2 weeks or longer. It can also occur as a
distinct process without much preceding acute inflammation.
QUESTION: What are the phases of wound healing and the process that takes place during each
- Correct Ans- Phase 1- Inflammation- includes coagulation and the infiltration of cells that participate in
wound healing, including platelets, neutrophils, and macrophages. Phase 2- Proliferation and New Tissue
Formation (Reconstruction)- wound begins to heal. This stage begins 3-4 days after injury and continues for as
long as 2 weeks. Phase 3- Remodeling and Maturation- phase for recovering normal tissue structure that can
persist for years
QUESTION: How does the inflammatory response differ in neonates?
- Correct Ans- Neonates often have transiently depressed inflammatory function, particularly neutrophil
chemotaxis and alternative complement activity.
1|Page
,QUESTION: How and why does aging affect innate immunity?
- Correct Ans- Aging alters the tissue microenvironment and macrophage function with changes in wound
healing neoangiogenesis and fibrosis.
QUESTION: What is the third line of defense and the process that takes place?
- Correct Ans- Adaptive immunity (immune response or immunity)- the third line of defense in the human
body. Consists of lymphocytes and serum proteins called antibodies. - Secondary responder-augments the
initial defenses against infection and provides long term security against re-infection. - B cells- humeral can kill
free floating pathogens - T cells- cell - mediated- can kill pathogens hiding inside cells.
QUESTION: How and why does the neonate have a poorly developed immune response? - Correct Ans- The
human neonate has a poorly developed immune response, particularly in the production of IgG. The fetus and
neonate are protected in utero and during the first few post-natal months by maternal antibody that was
actively transported across the placenta.
QUESTION: What terms are collectively known as hypersensitivity reactions?
- Correct Ans- Allergy, autoimmunity, and alloimmunity are collectively known as hypersensitivity reactions.
Hypersensitivity Response I - IgE mediated- primary cause of common allergies. Binds with mast cells which
release histamine. (initiates allergic reaction). Histamine release leads to bronchial smooth muscle contraction,
bronchoconstriction, and immune response II- tissue specific- wrong blood type administered or hemolytic
disease of the newborn. Complement pathway activated III- Immune complex mediated IV- cell mediated -
graft rejection
QUESTION: What are some causes of autoimmune diseases? - Correct Ans- Autoimmune disease can be
caused by the exposure of a previously sequestered antigen, the development of a neoantigen, the
complications of infectious disease, the emergence of a forbidden clone of lymphocytes, or the consequence of
ineffective peripheral tolerance. The mechanisms for imitation of autoimmune diseases may already be within
humans.
2|Page
,QUESTION: What are some examples of alloimmune disorders? And why do these occur? - Correct Ans-
Alloimmunity is the immune systems reaction against antigens on the tissues of other members of the same
species. - Transient neonatal disease - Transplant rejection - Transfusion reaction
QUESTION: What causes an immune deficiency? - Correct Ans- Immune deficiencies are either congenital or
acquired. Primary immune deficiencies are caused by genetic defects that disrupt lymphocyte development,
whereas secondary immune deficiencies are secondary to disease or other physiologic alterations.
QUESTION: What are autoinflammatory diseases characterized by?
- Correct Ans- Autoinflammatory disorders are characterized by abnormally high levels of inflammation
secondary to mutations in control of inflammasome activation or in defects in cellular receptors of cytokines
designed to decrease inflammation.
QUESTION: What are some causes of Acquired immunodeficiencies? - Correct Ans- Acquired
immunodeficiencies are caused by superimposed conditions, such as aging, malnutrition, infections,
malignancies, physical or psychologic trauma, environmental factors, some medical treatments, or other
diseases.
QUESTION: How are deficiencies in immunity treated?
- Correct Ans- Deficiencies in immunity usually are treated by replacement therapy. Deficient antibody
production is treated by replacement of missing immunoglobulins with commercial gamma globulin
preparations. Lymphocyte deficiencies are treated with the replacement of host lymphocytes with transplants
of bone marrow, fetal liver, or fetal thymus from a donor.
QUESTION: What are the four distinct phases of infectious disease?
- Correct Ans- 1. Incubation Period - initial exposure to onset of the first symptoms 2. Prodromal Stage -
occurrence of initial symptoms which are usually mild 3. Invasion Period- pathogen is multiplying rapidly- the
immune and inflammatory responses have been activated. 4. Convalescence- immune-inflammatory system
removes infection, symptoms subside...or disease could be fatal
3|Page
, QUESTION: Describe some direct and indirect ways for transmission of infectious diseases? - Correct Ans-
Direct transmission is through direct contact with infections of another person (fungal, skin lesions, scabies,
STIs, lice, herpes). Indirect transmission is through contact with contaminated materials or surfaces.
QUESTION: Detail characteristics of HIV including causes, transmission, risks, treatments, etc. - Correct Ans- -
causes Acquired Immodeficiency Syndrome (AIDS) - transmission-blood or blood products, IV drug use,
intercourse - major immunologic finding in AIDS is the striking decrease in the number of CD4 + Th Cells. -
Treatment for HIV infection is a combination of drugs called highly active antiretroviral therapy (HAART), that
attacks different portions of the viral replication pathway
QUESTION: What are some effective countermeasures for infectious disease transmission? - Correct Ans-
Control insect vector population, modern sanitation facilities, clean water, vaccines.
QUESTION: How do the incidence and prevalence rate differ?
- Correct Ans- Incidence rate is the number of new cases of a disease reported during a specific period, divided
by the number of individuals in the population. Prevalence rate is the proportion of the population affected by
a disease at a specific point in time.
QUESTION: How is relative risk used in relation to disease processes?
- Correct Ans- Relative risk is a probability, not an actual outcome, to determine the relative risk you take the
increased rate of the disease among individuals exposed to a risk factor and divide by the incidence rate of the
disease among individuals not exposed to a risk factor.
QUESTION: What are some examples of diseases that correspond with the liability model? - Correct Ans- -
Liability threshold model
Pyloric stenosis
Autism spectrum
Congenital malformations
QUESTION: What are empirical risks and how do they affect disease?
4|Page
AND PRACTICE EXAM.
QUESTION: What are the 3 layers of human defense? What happens during each?
- Correct Ans- Physical- protect against damage and infection are composed of tightly associated epithelial
cells including those of the skin and of the membranous sheets lining the gastrointestinal, genitourinary, and
respiratory tracts. Mechanical- "washing" the surfaces (sloughing off of dead skin, vomiting, urination,
coughing). Biochemical barriers- secrets substances meant to trap of destroy microorganisms. (Mucus, sweat,
saliva, tears, sebaceous glands, and earwax).
QUESTION: What is the second line of defense and the process?
- Correct Ans- Inflammatory response- rapid and nonspecific, protective response to cellular injury from any
cause. It can occur only in vascularized tissue.
QUESTION: How do acute and chronic inflammation differ?
- Correct Ans- Acute- Short duration, 8-10 days from onset to healing. The three systemic changes associated
with the acute inflammatory response are fever, leukocytosis, and plasma protein synthesis. Chronic
inflammation- can be a continuation of acute inflammation that last 2 weeks or longer. It can also occur as a
distinct process without much preceding acute inflammation.
QUESTION: What are the phases of wound healing and the process that takes place during each
- Correct Ans- Phase 1- Inflammation- includes coagulation and the infiltration of cells that participate in
wound healing, including platelets, neutrophils, and macrophages. Phase 2- Proliferation and New Tissue
Formation (Reconstruction)- wound begins to heal. This stage begins 3-4 days after injury and continues for as
long as 2 weeks. Phase 3- Remodeling and Maturation- phase for recovering normal tissue structure that can
persist for years
QUESTION: How does the inflammatory response differ in neonates?
- Correct Ans- Neonates often have transiently depressed inflammatory function, particularly neutrophil
chemotaxis and alternative complement activity.
1|Page
,QUESTION: How and why does aging affect innate immunity?
- Correct Ans- Aging alters the tissue microenvironment and macrophage function with changes in wound
healing neoangiogenesis and fibrosis.
QUESTION: What is the third line of defense and the process that takes place?
- Correct Ans- Adaptive immunity (immune response or immunity)- the third line of defense in the human
body. Consists of lymphocytes and serum proteins called antibodies. - Secondary responder-augments the
initial defenses against infection and provides long term security against re-infection. - B cells- humeral can kill
free floating pathogens - T cells- cell - mediated- can kill pathogens hiding inside cells.
QUESTION: How and why does the neonate have a poorly developed immune response? - Correct Ans- The
human neonate has a poorly developed immune response, particularly in the production of IgG. The fetus and
neonate are protected in utero and during the first few post-natal months by maternal antibody that was
actively transported across the placenta.
QUESTION: What terms are collectively known as hypersensitivity reactions?
- Correct Ans- Allergy, autoimmunity, and alloimmunity are collectively known as hypersensitivity reactions.
Hypersensitivity Response I - IgE mediated- primary cause of common allergies. Binds with mast cells which
release histamine. (initiates allergic reaction). Histamine release leads to bronchial smooth muscle contraction,
bronchoconstriction, and immune response II- tissue specific- wrong blood type administered or hemolytic
disease of the newborn. Complement pathway activated III- Immune complex mediated IV- cell mediated -
graft rejection
QUESTION: What are some causes of autoimmune diseases? - Correct Ans- Autoimmune disease can be
caused by the exposure of a previously sequestered antigen, the development of a neoantigen, the
complications of infectious disease, the emergence of a forbidden clone of lymphocytes, or the consequence of
ineffective peripheral tolerance. The mechanisms for imitation of autoimmune diseases may already be within
humans.
2|Page
,QUESTION: What are some examples of alloimmune disorders? And why do these occur? - Correct Ans-
Alloimmunity is the immune systems reaction against antigens on the tissues of other members of the same
species. - Transient neonatal disease - Transplant rejection - Transfusion reaction
QUESTION: What causes an immune deficiency? - Correct Ans- Immune deficiencies are either congenital or
acquired. Primary immune deficiencies are caused by genetic defects that disrupt lymphocyte development,
whereas secondary immune deficiencies are secondary to disease or other physiologic alterations.
QUESTION: What are autoinflammatory diseases characterized by?
- Correct Ans- Autoinflammatory disorders are characterized by abnormally high levels of inflammation
secondary to mutations in control of inflammasome activation or in defects in cellular receptors of cytokines
designed to decrease inflammation.
QUESTION: What are some causes of Acquired immunodeficiencies? - Correct Ans- Acquired
immunodeficiencies are caused by superimposed conditions, such as aging, malnutrition, infections,
malignancies, physical or psychologic trauma, environmental factors, some medical treatments, or other
diseases.
QUESTION: How are deficiencies in immunity treated?
- Correct Ans- Deficiencies in immunity usually are treated by replacement therapy. Deficient antibody
production is treated by replacement of missing immunoglobulins with commercial gamma globulin
preparations. Lymphocyte deficiencies are treated with the replacement of host lymphocytes with transplants
of bone marrow, fetal liver, or fetal thymus from a donor.
QUESTION: What are the four distinct phases of infectious disease?
- Correct Ans- 1. Incubation Period - initial exposure to onset of the first symptoms 2. Prodromal Stage -
occurrence of initial symptoms which are usually mild 3. Invasion Period- pathogen is multiplying rapidly- the
immune and inflammatory responses have been activated. 4. Convalescence- immune-inflammatory system
removes infection, symptoms subside...or disease could be fatal
3|Page
, QUESTION: Describe some direct and indirect ways for transmission of infectious diseases? - Correct Ans-
Direct transmission is through direct contact with infections of another person (fungal, skin lesions, scabies,
STIs, lice, herpes). Indirect transmission is through contact with contaminated materials or surfaces.
QUESTION: Detail characteristics of HIV including causes, transmission, risks, treatments, etc. - Correct Ans- -
causes Acquired Immodeficiency Syndrome (AIDS) - transmission-blood or blood products, IV drug use,
intercourse - major immunologic finding in AIDS is the striking decrease in the number of CD4 + Th Cells. -
Treatment for HIV infection is a combination of drugs called highly active antiretroviral therapy (HAART), that
attacks different portions of the viral replication pathway
QUESTION: What are some effective countermeasures for infectious disease transmission? - Correct Ans-
Control insect vector population, modern sanitation facilities, clean water, vaccines.
QUESTION: How do the incidence and prevalence rate differ?
- Correct Ans- Incidence rate is the number of new cases of a disease reported during a specific period, divided
by the number of individuals in the population. Prevalence rate is the proportion of the population affected by
a disease at a specific point in time.
QUESTION: How is relative risk used in relation to disease processes?
- Correct Ans- Relative risk is a probability, not an actual outcome, to determine the relative risk you take the
increased rate of the disease among individuals exposed to a risk factor and divide by the incidence rate of the
disease among individuals not exposed to a risk factor.
QUESTION: What are some examples of diseases that correspond with the liability model? - Correct Ans- -
Liability threshold model
Pyloric stenosis
Autism spectrum
Congenital malformations
QUESTION: What are empirical risks and how do they affect disease?
4|Page
