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NR 507: ADVANCED
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[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
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Hypersensitivity: Type 1
Type 1: Allergic reaction, Mediated by IgE, Inflammation due to mast cell degranulation
Local symptoms:
-itching
-rash
Systemic symptoms:
-wheezing
Most dangerous = anaphylactic reaction
systemic response of hypotension, severe bronchoconstriction
Main treatment: epinephrine reverses the effects
Hypersensitivity: Type 2
Type 2: Cytotoxic reaction; tissue specific (ex: thyroid tissue)
Macrophages are the primary effectors cells involved
Can cause tissue damage or alter function
Grave's disease (hyperthyroidism) - example of altering thyroid function, but does not
destroy thyroid tissue
Incompatible blood type- example of cell/tissue damage that occurs; severe
transfusion reaction occurs and the transfused erythrocytes are destroyed by
agglutination or complement-mediated lysis.
Type 1 Hypersensitivity VS. Type 2 Hypersensitivity
Type 1 Hypersensitivity
Organ Specific
Antibody binds to the antigen on the cell surface
Type 2 Hypersensitivity
Not Organ Specific
Antibody binds to the soluble antigen outside the cell surface that was released into the
blood or body fluids, and the complex is then deposited in the tissues
Hypersensitivity: Type 3 - Examples
Rheumatoid arthritis: Antigen/antibodies are deposited in the joints
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Systemic Lupus Erythematosus (SLE)- very closely related to autoimmunity-
antigen/antibodies deposit in organs that cause tissue damage
Hypersensitivity: Type 4
Delayed response
Does not involve antigen/antibody complexes like Types 1, 2 and 3
Is T-cell mediated
Differentiating Between the Rash of a Type 1 vs. Type 4 Reaction:
Type 1: Immediate hypersensitivity reactions, termed atopic dermatitis, are usually
characterized by widely distributed lesions
Type 4: Contact dermatitis (delayed hypersensitivity) consists of lesions only at the site
of contact with the allergen
The key determinant is the timing of the rash:
-Type 1 = Immediate
-Type 4 = Delayed: Several days following contact, ex would be poison ivy
Treatment of Type 4 Rash
A non-severe case of contact dermatitis would be treated with topical corticosteroid.
Why not epinephrine or antihistamines?
-Epinephrine is for emergent Type 1 anaphylactic reactions. Antihistamines act on the
H1 receptors. Type 4 does not involve mast cells and H1 receptors.
Antibiotics not appropriate since not an infection
Autoimmunity
Autoimmune disease can be familial, Affected family members may not all develop the
same disease, but several members may have different disorders characterized by a
variety of hypersensitivity reactions, These include autoimmune and allergic reactions
Associations with particular autoimmune diseases have been identified for a variety of
major histocompatibility complex (MHC) alleles or non-MHC genes
Alloimmunity
General term used to describe when an individual's immune system reacts against
antigens on the tissues of other members of the same species.
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Examples: Neonatal disease where the maternal immune system becomes sensitized
against antigens expressed by the fetus, Transplant rejection, Transfusion reaction
Primary Immunodeficiency
Most primary immune deficiencies are result of single gene defects
Something is lacking with the immune system itself.
Example: B-lymphocyte deficiency - one of the most severe forms of a primary
immunodeficiency
Secondary Immunodeficiency
Complication of some other physiological condition/disease, Malnutrition one of most
common causes worldwide. Example: Pt. with HIV gets pneumocystis carinii
Hematology
Anemias, Involve RBCs, Most of body's iron stores come from the recycling of iron from
old RBCs
Iron Deficiency Anemia
Microcytic/Hypochromic Anemia, Caused by disorders of hemoglobin synthesis,
particularly iron deficiency, Ferritin is an important measurement that reflects the
body's total iron stores, The NP will order a ferritin level to get an idea of the body's total
iron stores, Low ferritin reflects anemia
Major Lab Marker for Anemia
Increased RBC distribution width (RDW) is one of the earliest lab markers in developing
microcytic or macrocytic anemia
Folate Deficiency
Can cause megaloblastic anemia, Alcoholics can easily get folate deficiency
Ferritin level normal
Hgb low
Hct low
Vitamin B-12 Deficiency
Fatigue, Dyspnea, Peripheral Neuropathy in BLE (numbness and tingling)
Risk Factors: Older adults, H-pylori infection
Affects Vitamin B-12 absorption
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NR 507: ADVANCED
PATHOPHYSIOLOGY
MIDTERM/EXIT 2025
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
NR 507 ADVANCED PATHOPHYSIOLOGY MIDTERM FINAL Page 1 Questions Answers Updated 2026
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Hypersensitivity: Type 1
Type 1: Allergic reaction, Mediated by IgE, Inflammation due to mast cell degranulation
Local symptoms:
-itching
-rash
Systemic symptoms:
-wheezing
Most dangerous = anaphylactic reaction
systemic response of hypotension, severe bronchoconstriction
Main treatment: epinephrine reverses the effects
Hypersensitivity: Type 2
Type 2: Cytotoxic reaction; tissue specific (ex: thyroid tissue)
Macrophages are the primary effectors cells involved
Can cause tissue damage or alter function
Grave's disease (hyperthyroidism) - example of altering thyroid function, but does not
destroy thyroid tissue
Incompatible blood type- example of cell/tissue damage that occurs; severe
transfusion reaction occurs and the transfused erythrocytes are destroyed by
agglutination or complement-mediated lysis.
Type 1 Hypersensitivity VS. Type 2 Hypersensitivity
Type 1 Hypersensitivity
Organ Specific
Antibody binds to the antigen on the cell surface
Type 2 Hypersensitivity
Not Organ Specific
Antibody binds to the soluble antigen outside the cell surface that was released into the
blood or body fluids, and the complex is then deposited in the tissues
Hypersensitivity: Type 3 - Examples
Rheumatoid arthritis: Antigen/antibodies are deposited in the joints
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Systemic Lupus Erythematosus (SLE)- very closely related to autoimmunity-
antigen/antibodies deposit in organs that cause tissue damage
Hypersensitivity: Type 4
Delayed response
Does not involve antigen/antibody complexes like Types 1, 2 and 3
Is T-cell mediated
Differentiating Between the Rash of a Type 1 vs. Type 4 Reaction:
Type 1: Immediate hypersensitivity reactions, termed atopic dermatitis, are usually
characterized by widely distributed lesions
Type 4: Contact dermatitis (delayed hypersensitivity) consists of lesions only at the site
of contact with the allergen
The key determinant is the timing of the rash:
-Type 1 = Immediate
-Type 4 = Delayed: Several days following contact, ex would be poison ivy
Treatment of Type 4 Rash
A non-severe case of contact dermatitis would be treated with topical corticosteroid.
Why not epinephrine or antihistamines?
-Epinephrine is for emergent Type 1 anaphylactic reactions. Antihistamines act on the
H1 receptors. Type 4 does not involve mast cells and H1 receptors.
Antibiotics not appropriate since not an infection
Autoimmunity
Autoimmune disease can be familial, Affected family members may not all develop the
same disease, but several members may have different disorders characterized by a
variety of hypersensitivity reactions, These include autoimmune and allergic reactions
Associations with particular autoimmune diseases have been identified for a variety of
major histocompatibility complex (MHC) alleles or non-MHC genes
Alloimmunity
General term used to describe when an individual's immune system reacts against
antigens on the tissues of other members of the same species.
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Examples: Neonatal disease where the maternal immune system becomes sensitized
against antigens expressed by the fetus, Transplant rejection, Transfusion reaction
Primary Immunodeficiency
Most primary immune deficiencies are result of single gene defects
Something is lacking with the immune system itself.
Example: B-lymphocyte deficiency - one of the most severe forms of a primary
immunodeficiency
Secondary Immunodeficiency
Complication of some other physiological condition/disease, Malnutrition one of most
common causes worldwide. Example: Pt. with HIV gets pneumocystis carinii
Hematology
Anemias, Involve RBCs, Most of body's iron stores come from the recycling of iron from
old RBCs
Iron Deficiency Anemia
Microcytic/Hypochromic Anemia, Caused by disorders of hemoglobin synthesis,
particularly iron deficiency, Ferritin is an important measurement that reflects the
body's total iron stores, The NP will order a ferritin level to get an idea of the body's total
iron stores, Low ferritin reflects anemia
Major Lab Marker for Anemia
Increased RBC distribution width (RDW) is one of the earliest lab markers in developing
microcytic or macrocytic anemia
Folate Deficiency
Can cause megaloblastic anemia, Alcoholics can easily get folate deficiency
Ferritin level normal
Hgb low
Hct low
Vitamin B-12 Deficiency
Fatigue, Dyspnea, Peripheral Neuropathy in BLE (numbness and tingling)
Risk Factors: Older adults, H-pylori infection
Affects Vitamin B-12 absorption
NR 507 ADVANCED PATHOPHYSIOLOGY MIDTERM FINAL Page 4 Questions Answers Updated 2026
