NCA 622 Module 2 - Hypersensitivity Reactions, Immunology, Transplantation Exam
Questions with Correct Answers 100% Verified By Experts| 2025/2026 Latest Update
What is primary immune deficiencies vs secondary? -Primary - congenital or inherited (sex-
linked, autosomal dominant/recessive)
-Secondary - acquired later in life - AIDS, corticosteroids for suppression meds, etc
Which types of hypersensitivity reactions are antibody-mediated reaction, which are cell-
mediated? -Antibody-mediated - Type I, II, III (immediate)
-Cell-mediated - Type IV (Delayed)
What are the 4 types of Hypersensitivity reactions ACID:
I - Allergic, Anaphylactic and Atopic (IgE)
II - Cytotoxic (antibody-mediated)(IgG/IgM) - will see hemolysis
III - Immune complex (autoimmune disease) -vasculitis, arthritis, etc
IV - Delayed (cell-mediated) T-cell
All of the following are associated with type 1 hypersensitivity allergic reactions EXCEPT:
-hay fever
-angioedema
-serum sickness
-systemic anaphylaxis
-asthma
-eczema
-food and drug allergies
-allergic rhinitis Serum sickness
,What is hay fever? It is an allergic response usually to outdoor airborne allergens such as
pollen or sometimes indoor allergens such as dust mites or pet dander *also called allergic
rhinitis*
-Type I hypersensitivity reaction
What is serum sickness? allergic rxn 7 days after a new drug given.
you get immune complexes and fever, urticaria, etc.
-Type III hypersensitivity reaction
-Common causes are vaccines like rabies, immune modulating agents (rituximab and infliximab)
and anti-venoms
-Rash can kind of look like cauliflower
What is number 1 choice of medication for anaphylaxis? Epinephrine
When do Type 1 Hypersensitivity Reactions occur? Usually w/in 15min - 30min of exposure
-Immediate
-Or longer if drug was given orally w food
When do type IV hypersensitivity reactions occur? Around 72 hours later
A 21 y/o male with no PMH presents to the ED with facial swelling, urticaria, and hives after
attending a part where he ate lunch. As the ACNP, you are concerned with type 1
hypersensitivity reaction and know that this is due to a:
-IgM mediated reaction
-IgE mediated reaction
-IgG mediated reaction
,-Unrelated to any immunoglobulin mediated reaction. IgE mediated reaction
As an ACNP whom understands about Type 2 cytotoxic compliment mediated hypersensitivity
reactions, you also know that all of the following are examples of this type of reaction EXCEPT:
-Rheumatic fever
-ABO blood transfusion reactions
-Steven Johnson's Syndrome (SJS)
-Hemolytic Anemia
-Goodpasteur's Syndrome
-Rh hemolytic disease/incompatibility
-Hyperacute graft rejection Steven Johnson's Syndrome - Type IV
Serum sickness, rheumatoid arthritis, lupus, and an arthrus reaction are all what type of
hypersensitivity reaction? Type III - immune-complex mediated
As a current advanced practice nursing student studying immunology, you understand that a
Type 4 cell-mediated delayed hypersensitivity reaction includes all of the following EXCEPT:
-Contact dermatitis
-PPD skin testing
-Toxic Epidermal Necrolysis (TENs)
-SLE (Lupus) Lupus - Type III - immune-mediated
What are the 2 most common drugs that cause Type IV hypersensitivity reaction? (Delayed)
Sulfa and PCN
All of the following are clinical criteria for the diagnosis of Type 1 hypersensitivity anaphylaxis
EXCEPT:
, -Known allergen exposure followed by associated hypotension.
-Known allergen exposure with rash development alone.
-Allergen exposure followed by acute onset of shortness of breath, wheezing, and hypotension
with BP of 80/40.
-Known allergen exposure with associated rash, nausea, emesis, and dyspnea. -Known
allergen exposure with rash development alone.
What is IgE dependent anaphylaxis? -True anaphylaxis
-Acute syndrome initiated by a new allergen exposure AFTER a prior silent exposure has
sensitized the patient w IgE antibodies
If a patient presents with a Type 1 Hypersensitivity reaction, can they be sent home after the
reaction is taken care of? No, d/t late phase (secondary response) - could lead to another
reaction so need to be hospitalized for close monitoring
What are the different grades of Anaphylaxis: Type 1 Hypersensitivity Reaction? -Grade 1 -
Cutaneous and mucosal erythema and urticaria
-Grade 2 - multisystem signs - hypotension, tachycardia, dyspnea, GI disturbance (N/V/D)
-Grade 3 - bronchospasm, cardiac dysrhythmias
-Grade 4 - Cardiac arrest
What is the most severe form of Type 1 hypersensitivity reaction? Systemic anaphylaxis (can
see eosinophilia)
What lab results can be seen in someone with a Type 1 Hypersensitivity response? Type 1 =
Allergic IgE
-Eosinophilia
-Increased serum IgE levels
Questions with Correct Answers 100% Verified By Experts| 2025/2026 Latest Update
What is primary immune deficiencies vs secondary? -Primary - congenital or inherited (sex-
linked, autosomal dominant/recessive)
-Secondary - acquired later in life - AIDS, corticosteroids for suppression meds, etc
Which types of hypersensitivity reactions are antibody-mediated reaction, which are cell-
mediated? -Antibody-mediated - Type I, II, III (immediate)
-Cell-mediated - Type IV (Delayed)
What are the 4 types of Hypersensitivity reactions ACID:
I - Allergic, Anaphylactic and Atopic (IgE)
II - Cytotoxic (antibody-mediated)(IgG/IgM) - will see hemolysis
III - Immune complex (autoimmune disease) -vasculitis, arthritis, etc
IV - Delayed (cell-mediated) T-cell
All of the following are associated with type 1 hypersensitivity allergic reactions EXCEPT:
-hay fever
-angioedema
-serum sickness
-systemic anaphylaxis
-asthma
-eczema
-food and drug allergies
-allergic rhinitis Serum sickness
,What is hay fever? It is an allergic response usually to outdoor airborne allergens such as
pollen or sometimes indoor allergens such as dust mites or pet dander *also called allergic
rhinitis*
-Type I hypersensitivity reaction
What is serum sickness? allergic rxn 7 days after a new drug given.
you get immune complexes and fever, urticaria, etc.
-Type III hypersensitivity reaction
-Common causes are vaccines like rabies, immune modulating agents (rituximab and infliximab)
and anti-venoms
-Rash can kind of look like cauliflower
What is number 1 choice of medication for anaphylaxis? Epinephrine
When do Type 1 Hypersensitivity Reactions occur? Usually w/in 15min - 30min of exposure
-Immediate
-Or longer if drug was given orally w food
When do type IV hypersensitivity reactions occur? Around 72 hours later
A 21 y/o male with no PMH presents to the ED with facial swelling, urticaria, and hives after
attending a part where he ate lunch. As the ACNP, you are concerned with type 1
hypersensitivity reaction and know that this is due to a:
-IgM mediated reaction
-IgE mediated reaction
-IgG mediated reaction
,-Unrelated to any immunoglobulin mediated reaction. IgE mediated reaction
As an ACNP whom understands about Type 2 cytotoxic compliment mediated hypersensitivity
reactions, you also know that all of the following are examples of this type of reaction EXCEPT:
-Rheumatic fever
-ABO blood transfusion reactions
-Steven Johnson's Syndrome (SJS)
-Hemolytic Anemia
-Goodpasteur's Syndrome
-Rh hemolytic disease/incompatibility
-Hyperacute graft rejection Steven Johnson's Syndrome - Type IV
Serum sickness, rheumatoid arthritis, lupus, and an arthrus reaction are all what type of
hypersensitivity reaction? Type III - immune-complex mediated
As a current advanced practice nursing student studying immunology, you understand that a
Type 4 cell-mediated delayed hypersensitivity reaction includes all of the following EXCEPT:
-Contact dermatitis
-PPD skin testing
-Toxic Epidermal Necrolysis (TENs)
-SLE (Lupus) Lupus - Type III - immune-mediated
What are the 2 most common drugs that cause Type IV hypersensitivity reaction? (Delayed)
Sulfa and PCN
All of the following are clinical criteria for the diagnosis of Type 1 hypersensitivity anaphylaxis
EXCEPT:
, -Known allergen exposure followed by associated hypotension.
-Known allergen exposure with rash development alone.
-Allergen exposure followed by acute onset of shortness of breath, wheezing, and hypotension
with BP of 80/40.
-Known allergen exposure with associated rash, nausea, emesis, and dyspnea. -Known
allergen exposure with rash development alone.
What is IgE dependent anaphylaxis? -True anaphylaxis
-Acute syndrome initiated by a new allergen exposure AFTER a prior silent exposure has
sensitized the patient w IgE antibodies
If a patient presents with a Type 1 Hypersensitivity reaction, can they be sent home after the
reaction is taken care of? No, d/t late phase (secondary response) - could lead to another
reaction so need to be hospitalized for close monitoring
What are the different grades of Anaphylaxis: Type 1 Hypersensitivity Reaction? -Grade 1 -
Cutaneous and mucosal erythema and urticaria
-Grade 2 - multisystem signs - hypotension, tachycardia, dyspnea, GI disturbance (N/V/D)
-Grade 3 - bronchospasm, cardiac dysrhythmias
-Grade 4 - Cardiac arrest
What is the most severe form of Type 1 hypersensitivity reaction? Systemic anaphylaxis (can
see eosinophilia)
What lab results can be seen in someone with a Type 1 Hypersensitivity response? Type 1 =
Allergic IgE
-Eosinophilia
-Increased serum IgE levels
