NURS 3366 ACTUAL CORE EXAM TEST QUESTIONS AND
SOLUTIONS RATED A+
✔✔What are the downsides of using steroids? - ✔✔side effects related to suppression
of protective roles of prostaglandins
-stomach ulcers, hypertension, renal failure, easier bleeding, low immunity/ inability to
combat infection, increased skin fragility
✔✔Where do NSAIDS work in the arachidonic pathway? - ✔✔suppress inflammation,
but lower in the arachidonic pathway and are NOT as powerful
✔✔What do NSAIDS treat? - ✔✔not as bad as side effects and are used for
headaches, general aches and pains rather than to suppress more serious inflammatory
conditions'
ibuprofen, aspirin, naproxen
✔✔When would you definitely need to bring in the 3rd line of defense (immunocyte
response)? - ✔✔if microbes are involved in the inflammatory "mix"
✔✔What are the major players in the immune system and what do they do? - ✔✔B
lymphocytes- "humoral immunity"
T lymphocytes- "cell-mediated immunity"
✔✔Describe humoral immunity process? - ✔✔B cells-- differentiate into plasma cells--
antibodies (immunoglobulins) specific to microbes
✔✔How do antibodies defeat microbes? - ✔✔-neutralization, opsonization
NEUT (inactivation)- neutralize bacterial toxins by binding to toxins of bacteria, and
renders toxins unable to bind to host tissues; PREVENTS ATTACHEMENT
OPSON: "coats" bacteria and promotes phagocytosis by optimizing recognition and
"digestibility" of antigen to phagocytes
✔✔What are the categories of hypersensitive immunocyte response? - ✔✔allergic
response, alloimmune response, and autoimmune response
✔✔What is allergic hypersensitivity? - ✔✔-Initiated by environmental allergens (pollen,
dander, perfume, medication, food)
-if it enters body for first time, primary response of creating an antibody occurs and will
cause reaction second time exposed
,-if genetically programmed, it will involve IgE antibody and after initial exposure- IgE
binds to mast cells and sensitizes the mast cell and on REPEATED exposure- allergens
receptors bind to IgE on sensitized mast cell and initiates degranulation of mast cell so
HISTAMINE is released and binds to H1 receptors of surrounding tissue and causes
reaction
✔✔For allergic hypersensitivity, once a person is sensitized, the S/S will appear
immediately upon ___ or ____ - ✔✔2nd or more exposure
✔✔What is local reaction to allergic hypersensitivity? - ✔✔-dermatitis, local rash,
itching, swelling from histamine, leukotriene and PG effects
✔✔What is systemic reaction to allergic hypersensitivity? - ✔✔anaphalaxis
-when someone is severely allergic to allergen
-histamine, leukotrienes and PGs are overactivated throughout the body
✔✔What are the S/S from systemic allergic hypersensitivity? - ✔✔-hives (urticaria)
-itching all over
-angioedema (abnormal vasodilation and edema of small blood vessels in lips and
hands)
-nausea, vomiting, diarrhea, cramps
-wheezing (from bronchial edema)
-hypotension if shock is bad enough caused by systemic vasodilation
✔✔What is autoimmune hypersensitivity? - ✔✔hypersensitivity to self antigens
✔✔Why does autoimmune hyper. occur? Example? - ✔✔-sometimes after "fight off"
infection, immunocyte system stays "primed"
-instead of standing down, our immunocyte system begins attacking antigens on own
cells
EX:
rheumatic heart disease
-strep throat resolves, instead of antibodies standing down, they "look around" for
something that resembles strep antigen and the heart valve cells appear to be a close
match and autoantibodies begin attacking them and the heart valve can malfunction and
become floppy and weak
-possible sequela of strep throat is bad heart valves due to autoimmune attack
✔✔Genetic factors are important in autoimmune diseases- presence of certain ___ in
people with certain autoimmune diseases is significantly different - ✔✔HLA antigens
-on cell membranes of most of our tissue and declare "I am self"
, ✔✔Autoimmune diseases are often categorized according to the two possible "drivers"-
- ✔✔autoantibody attack (humoral)
auto T cell response (cell mediated)
✔✔What is humoral autoimmune response? - ✔✔autoantibody attacks tissue cells,
opsonizing them and causing them to be phagocytized by macrophages as if they were
bacteria
-triggers inflammatory reponse which causes damage to target tissues and usual S&S
of inflammation in those organs/tissues
✔✔What is cell mediated autoimmune response? - ✔✔-instead of autoantibody,
"attacker" is our own t cells which attack our tissue and trigger damaging inflammation
and S&S
✔✔How will we categorize autoimmune diseases? - ✔✔tissue specific or systemic
✔✔What are tissue specific autoimmune diseases? - ✔✔MS, Graves disease,
Goodpasture's syndrome, myasthenia gravis, type-1 diabetes, celiac disease,
autoimmune hemolytic anemia
✔✔What is MS? - ✔✔t lymphocytes destroy random patches of myelin sheath that
insulates fibers of neurons in the brain
-assymetric weakness/malfunction of various areas of the body
✔✔What is Grave's disease? - ✔✔-causes most cases of hyperthyroidism
-autoantibody stimulates thyroid glands to oversecrete TH
✔✔What is Goodpasture's syndrome? - ✔✔-autoantibody attacks connective tissue in
pulmonary and glomerular basement membrane
-results in pulmonary hemorrhage and glomerulonephritis
✔✔What is myasthenia gravis? - ✔✔-autoantibody attacks acetylcholine receptors (tells
muscles when to contract)on cells of muscles
-causes muscle weakness
✔✔What is type 1 diabetes? - ✔✔-t cells destroy insulin-producing cells
-without insulin, glucose accumulates in blood and no energy source for cells
✔✔What is celiac disease? - ✔✔-caused by intolerance of protein called gluten found in
wheat
-gluten triggers attack by t cells of intestinal lining and causes diarrhea
SOLUTIONS RATED A+
✔✔What are the downsides of using steroids? - ✔✔side effects related to suppression
of protective roles of prostaglandins
-stomach ulcers, hypertension, renal failure, easier bleeding, low immunity/ inability to
combat infection, increased skin fragility
✔✔Where do NSAIDS work in the arachidonic pathway? - ✔✔suppress inflammation,
but lower in the arachidonic pathway and are NOT as powerful
✔✔What do NSAIDS treat? - ✔✔not as bad as side effects and are used for
headaches, general aches and pains rather than to suppress more serious inflammatory
conditions'
ibuprofen, aspirin, naproxen
✔✔When would you definitely need to bring in the 3rd line of defense (immunocyte
response)? - ✔✔if microbes are involved in the inflammatory "mix"
✔✔What are the major players in the immune system and what do they do? - ✔✔B
lymphocytes- "humoral immunity"
T lymphocytes- "cell-mediated immunity"
✔✔Describe humoral immunity process? - ✔✔B cells-- differentiate into plasma cells--
antibodies (immunoglobulins) specific to microbes
✔✔How do antibodies defeat microbes? - ✔✔-neutralization, opsonization
NEUT (inactivation)- neutralize bacterial toxins by binding to toxins of bacteria, and
renders toxins unable to bind to host tissues; PREVENTS ATTACHEMENT
OPSON: "coats" bacteria and promotes phagocytosis by optimizing recognition and
"digestibility" of antigen to phagocytes
✔✔What are the categories of hypersensitive immunocyte response? - ✔✔allergic
response, alloimmune response, and autoimmune response
✔✔What is allergic hypersensitivity? - ✔✔-Initiated by environmental allergens (pollen,
dander, perfume, medication, food)
-if it enters body for first time, primary response of creating an antibody occurs and will
cause reaction second time exposed
,-if genetically programmed, it will involve IgE antibody and after initial exposure- IgE
binds to mast cells and sensitizes the mast cell and on REPEATED exposure- allergens
receptors bind to IgE on sensitized mast cell and initiates degranulation of mast cell so
HISTAMINE is released and binds to H1 receptors of surrounding tissue and causes
reaction
✔✔For allergic hypersensitivity, once a person is sensitized, the S/S will appear
immediately upon ___ or ____ - ✔✔2nd or more exposure
✔✔What is local reaction to allergic hypersensitivity? - ✔✔-dermatitis, local rash,
itching, swelling from histamine, leukotriene and PG effects
✔✔What is systemic reaction to allergic hypersensitivity? - ✔✔anaphalaxis
-when someone is severely allergic to allergen
-histamine, leukotrienes and PGs are overactivated throughout the body
✔✔What are the S/S from systemic allergic hypersensitivity? - ✔✔-hives (urticaria)
-itching all over
-angioedema (abnormal vasodilation and edema of small blood vessels in lips and
hands)
-nausea, vomiting, diarrhea, cramps
-wheezing (from bronchial edema)
-hypotension if shock is bad enough caused by systemic vasodilation
✔✔What is autoimmune hypersensitivity? - ✔✔hypersensitivity to self antigens
✔✔Why does autoimmune hyper. occur? Example? - ✔✔-sometimes after "fight off"
infection, immunocyte system stays "primed"
-instead of standing down, our immunocyte system begins attacking antigens on own
cells
EX:
rheumatic heart disease
-strep throat resolves, instead of antibodies standing down, they "look around" for
something that resembles strep antigen and the heart valve cells appear to be a close
match and autoantibodies begin attacking them and the heart valve can malfunction and
become floppy and weak
-possible sequela of strep throat is bad heart valves due to autoimmune attack
✔✔Genetic factors are important in autoimmune diseases- presence of certain ___ in
people with certain autoimmune diseases is significantly different - ✔✔HLA antigens
-on cell membranes of most of our tissue and declare "I am self"
, ✔✔Autoimmune diseases are often categorized according to the two possible "drivers"-
- ✔✔autoantibody attack (humoral)
auto T cell response (cell mediated)
✔✔What is humoral autoimmune response? - ✔✔autoantibody attacks tissue cells,
opsonizing them and causing them to be phagocytized by macrophages as if they were
bacteria
-triggers inflammatory reponse which causes damage to target tissues and usual S&S
of inflammation in those organs/tissues
✔✔What is cell mediated autoimmune response? - ✔✔-instead of autoantibody,
"attacker" is our own t cells which attack our tissue and trigger damaging inflammation
and S&S
✔✔How will we categorize autoimmune diseases? - ✔✔tissue specific or systemic
✔✔What are tissue specific autoimmune diseases? - ✔✔MS, Graves disease,
Goodpasture's syndrome, myasthenia gravis, type-1 diabetes, celiac disease,
autoimmune hemolytic anemia
✔✔What is MS? - ✔✔t lymphocytes destroy random patches of myelin sheath that
insulates fibers of neurons in the brain
-assymetric weakness/malfunction of various areas of the body
✔✔What is Grave's disease? - ✔✔-causes most cases of hyperthyroidism
-autoantibody stimulates thyroid glands to oversecrete TH
✔✔What is Goodpasture's syndrome? - ✔✔-autoantibody attacks connective tissue in
pulmonary and glomerular basement membrane
-results in pulmonary hemorrhage and glomerulonephritis
✔✔What is myasthenia gravis? - ✔✔-autoantibody attacks acetylcholine receptors (tells
muscles when to contract)on cells of muscles
-causes muscle weakness
✔✔What is type 1 diabetes? - ✔✔-t cells destroy insulin-producing cells
-without insulin, glucose accumulates in blood and no energy source for cells
✔✔What is celiac disease? - ✔✔-caused by intolerance of protein called gluten found in
wheat
-gluten triggers attack by t cells of intestinal lining and causes diarrhea
