Nr507-Np Midterm Exam Questions With Correct Verified Answers | 100% Pass (A+ Certified)

NR507-NP MIDTERM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. Which of the following are considered the "first responders" of the innate immune system Correct Answer Neutrophils; they appear first in any immune response 2. Hives (urticaria) are an example of a: a. Type 1 Hypersensitivity reaction b. Type 2 Hypersensitivity reaction c. Type 3 Hypersensitivity reaction d. Type 4 Hypersensitivity reaction: A. Type 1 hypersensitivity reaction; hives (urticarial) are an example of a Type 1 hypersensitivity reaction mediated by the antibody, IgE and mast cells 3. Anaphylaxis is a ________ hypersensitivity reaction a. Type 1 b. Type 2 c. Type 3 d. Type 4: A. Type 1; they are mediated by IgE and mast cells. An individual who is highly sensitized to the antigen may experience anaphylaxis 4. Allergic contact dermatitis is an example of ________ hypersensitivity reaction. a. Type 1 b. Type 2 c. Type 3 d. Type 4: D. Allergic contact dermatitis is an example of Type 4 hypersensitivity reaction mediated by T-cells. When the individual comes in contact with the allergen (ex. poison ivy), an antigen complex is formed. On subsequent exposure to the antigen, sensitized T-cells activate the inflammatory process that causes the allergic contact dermatitis to appear 5. Type 2 (Cytotoxic) Hypersensitivity reactions are mediated by: a. IgA or IgE b. IgM or IgA c. IgG or IgM d. IgE or IgG: C. Type 2 hypersensitivity reaction is mediated by IgG or IgM 6. Type 1: Allergic Reaction: On initial encounter with an allergen, the individual will first produce IgE antibodies. After the allergen is cleared, the remaining IgE molecules will be bound by mast cells, basophils, and eosinophils that contain receptors for the IgE molecules. This process is referred to as sensitization. On subsequent exposure to the allergen, the IgE molecules located on the sensitized cells induces their immediate degranulation. This causes the release of inflammatory mediators such as histamine, leukotrienes, and prostaglandins that results in vasodilation, bronchial smooth muscle contraction, and mucus production. Type I hypersensitivity reactions can be local or systemic. Systemic reactions can result in anaphylaxis, a potentially life-threatening condition. Allergic asthma is an example of a Type I hypersensitivity reaction. On exposure to certain allergens (typically inhaled), individuals with allergic asthma experience inflammation of the airways, characterized by tissue swelling and excessive mucus production. This narrowing of the airways makes it difficult to breathe. 7. Type 2: Tissue-Specific: A Type II hypersensitivity reaction is tissue-specific and usually occurs as a result of haptens that cause an IgG antibody or IgM antibody mediated response. The antibodies are specifically directed to the antigen located on the cell membrane. A hapten is a small molecule that can cause an immune response when it attaches to a protein. Macrophages are the primary effector cells of Type II responses. Typical examples of Type II reactions are drug allergies, as well as allergies against infectious agents. The Type II response begins with the antibody binding to the antigen and may cause the following: 1. The cell to be destroyed by the antibody 2. Cell destruction through phagocytosis by macrophages 3. Damage to the cell by neutrophils triggering phagocytosis 4. Natural killer cells to release toxic substances that destroy the target cell 5. Malfunction of the cell without destruction Examples of type II reactions include drug allergies, hemolytic anemia, blood transfusion mismatch with resulting transfusion reaction and Rh hemolytic disease. 8. Type 3: Immune-Complex Reaction: The Type III hypersensitivity reaction is also an antigen-antibody response. The major difference between Type II and Type III responses is that in a Type II response, the antibody binds to the antigen on the cell surface, but in Type III responses, the antibody binds to the antigen in the blood or body fluids and then circulates to the tissue. Type III reactions are not organ specific and use neutrophils as the primary effector cell. In type III hypersensitivity reactions immune-complex deposition (ICD) causes autoimmune diseases, which is often a complication. As the disease progresses a more accumulation of immune-complexes occurs, and when the body becomes overloaded the complexes are deposited in the tissues and cause inflammation as the mononuclear phagocytes, erythrocytes, and complement system fail to remove immune complexes from the blood. One of the classic Type III reactions is serum sickness. 9. Type 4: Cell-Mediated/Delayed Reaction: The type IV hypersensitivity reactions are known as cell-mediated responses and use lymphocytes and macrophages as primary mediators. Unlike the first three types of responses, which are humoral immune functions, a Type IV response is mediated by T-lymphocytes and does not use antibodies. A typical reaction from a Type IV cell-mediated response would be a localized contact dermatitis. When the individual comes in contact with the antigen, T-cells are activated and move to the area of the antigen. The antigen is taken up, processed, and presented to macrophages, leading to epidermal reactions characterized by erythema, cellular infiltration and vesicles. This process is illustrated in contact dermatitis. 10. Type 1 Hypersensitivity Summary: Mechanism: IgE action on mast cells Examples: Hay fever Pathology: Mast cell degranulation results in an inflammatory response 11. Type 2 Hypersensitivity Summary: Mechanism: Tissue-specific destruction or impairment because of: 1. Antibody binding followed by lysis via complement 2. Antibody binding followed by macrophage phagocytosis 3. Antibody binding followed by neutrophil destruction 4. Antibody-dependent cell (NK)-mediated cytotoxicity, or 5. Antireceptor antibodies Examples: 1-ABO incompatibility 5-Graves' disease Pathology: 1-Complement damages RBC membrane and cells lyse 5-Autoantibodies specific for thyroid tissue impair receptor for TSH 12. Type 3 Hypersensitivity Summary: Mechanism: Antigen-Antibody complex deposited in tissues Examples: Raynaud's phenomenon Pathology: Complex deposited in small peripheral vessels in cool temperatures leading to vasoconstriction and blocked circulation 13. Type 4 cytotoxic hypersensitivity reactions are mediated by: a. B-cells b. T-cells c. IgA d. IgM: B. Type 4 hypersensitivity reaction is mediated by T-cells 14. The diagnosis for an individual who presents to the office with sudden swollen lips and eyes, shortness of breath and throat tightness after a bee sting is: a. anaphylaxis b. asthma c. reactive airway disease