2024 NR 507 ADVANCE PATHO
MIDTERM EXAM WITH CORRECT
ANSWERS
Differentiating Between the Rash of a Type 1 vs. Type IV Reaction - CORRECT
ANSWERS- •Type I: Immediate hypersensitivity reactions, termed atopic dermatitis,
are usually characterized by widely distributed lesions,
•Type IV: 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 I: immediate
-Type IV: delayed-several days following contact-e.g. poison ivy
Treatment of Type IV Rash - CORRECT ANSWERS- •A non-severe case of contact
dermatitis would be treated with a topical corticosteroid
•Why wouldn't we use epinephrine or antihistamines?
•Epinephrine is for emergent Type 1 anaphylactic reactions
•Antihistamines act on the H1 receptors
•Type IV doesn't involve mast cells and H1 receptors
•Antibiotics aren't appropriate since this is not an infection
Primary Immunodeficiency - CORRECT ANSWERS- •Most primary immune
deficiencies are the result of single gene defects
•Something is lacking with the immune system itself
•For example, B-lymphocyte deficiency-one of the most severe forms of a primary
immunodeficiency
,Secondary Immunodeficiency - CORRECT ANSWERS- •Secondary immunodeficiency
is a complication of some other physiologic condition or disease.
•Malnutrition is one of the most common causes worldwide
•For example, a patient who has HIV gets pneumocystis carinii
Hematology - CORRECT ANSWERS- •Anemias are the focus
•Involves RBCs
•Most of our body's iron stores come from the recycling of iron from old RBCs
Hypersensitivity: Type 1 - CORRECT ANSWERS- •Type 1: Allergic reaction
•Mediated by IgE
•Inflammation due to mast cell degranulation
•Local symptoms: itching, rash
•Systemic symptoms: wheezing
•Most dangerous form is an anaphylactic reaction-systemic response-hypotension,
severe bronchoconstriction
•Main treatment: epinephrine reverses the effects
Hypersensitivity: Type 2 - CORRECT ANSWERS- •Type 2: Cytotoxic reaction; tissue
specific (e.g. 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.
,Difference Between Type 2 and Type 3 - CORRECT ANSWERS- •Type 3 is not organ
specific
the antibody binds to soluble antigen outside the cell surface that was released into
the blood or body fluids, and the complex is then deposited in the tissues
Difference Between Type 2 and Type 3 - CORRECT ANSWERS- •Type 2 is organ
specific
•The antibody binds to the antigen on the cell surface
Hypersensitivity: Type 3-Examples - CORRECT ANSWERS- •Rheumatoid arthritis-
antigen/antibodies are deposited in the joints
•Systemic Lupus Erythematosus (SLE)-very closely related to autoimmunity-
antigen/antibodies deposit in organs that cause tissue damage
Scope of Damage of SLE-Type 3-autoimmune response - CORRECT ANSWERS-
•Facial rash confined to the cheeks (malar rash)
•Discoid rash (raised patches, scaling)
•Photosensitivity (development of skin rash developed as a result of exposure to
sunlight)
•Oral or nasopharyngeal ulcers
Scope of Damage of SLE-Type 3-autoimmune response cont. - CORRECT ANSWERS-
•Hematologic disorders (hemolytic anemia, leukopenia, lymphopenia, or
thrombocytopenia)
•Immunologic disorders (antibodies against double-stranded DNA [dsDNA] or Smith
[Sm] antigen, false-positive serologic test for syphilis, or antiphospholipid antibodies
[anticardiolipin antibody or lupus anticoagulant])
Scope of Damage of SLE-Type 3-autoimmune response cont. - CORRECT ANSWERS-
•Non-erosive arthritis of at least two peripheral joints
, •Serositis (pleurisy, pericarditis)
•Renal disorder (persistent proteinuria of >0.5 g/day or >3 g/day on dipstick or
cellular casts)
•Neurologic disorders (seizures or psychosis in the absence of known causes)
•Presence of antinuclear antibody (ANA)
A Word About Autoimmunity - CORRECT ANSWERS- •Autoimmune diseases 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 - CORRECT ANSWERS- •General term used to describe when an
individual's immune system reacts against antigens on the tissues of other
members of the same species
Examples of Alloimmunity - CORRECT ANSWERS- Hemolytic disease of the
newborn, transplant rejection, transfusion reaction
Hypersensitivity: Type 4 - CORRECT ANSWERS- •Delayed response
•Does not involve antigen/antibody complexes like Types I, II and III
•Is T-cell mediated
Example- TB Test
Relationship between Type II and Type IV Hypersensitivity Reactions - CORRECT
ANSWERS- •Organ rejection involves cytotoxicity (Type II)
MIDTERM EXAM WITH CORRECT
ANSWERS
Differentiating Between the Rash of a Type 1 vs. Type IV Reaction - CORRECT
ANSWERS- •Type I: Immediate hypersensitivity reactions, termed atopic dermatitis,
are usually characterized by widely distributed lesions,
•Type IV: 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 I: immediate
-Type IV: delayed-several days following contact-e.g. poison ivy
Treatment of Type IV Rash - CORRECT ANSWERS- •A non-severe case of contact
dermatitis would be treated with a topical corticosteroid
•Why wouldn't we use epinephrine or antihistamines?
•Epinephrine is for emergent Type 1 anaphylactic reactions
•Antihistamines act on the H1 receptors
•Type IV doesn't involve mast cells and H1 receptors
•Antibiotics aren't appropriate since this is not an infection
Primary Immunodeficiency - CORRECT ANSWERS- •Most primary immune
deficiencies are the result of single gene defects
•Something is lacking with the immune system itself
•For example, B-lymphocyte deficiency-one of the most severe forms of a primary
immunodeficiency
,Secondary Immunodeficiency - CORRECT ANSWERS- •Secondary immunodeficiency
is a complication of some other physiologic condition or disease.
•Malnutrition is one of the most common causes worldwide
•For example, a patient who has HIV gets pneumocystis carinii
Hematology - CORRECT ANSWERS- •Anemias are the focus
•Involves RBCs
•Most of our body's iron stores come from the recycling of iron from old RBCs
Hypersensitivity: Type 1 - CORRECT ANSWERS- •Type 1: Allergic reaction
•Mediated by IgE
•Inflammation due to mast cell degranulation
•Local symptoms: itching, rash
•Systemic symptoms: wheezing
•Most dangerous form is an anaphylactic reaction-systemic response-hypotension,
severe bronchoconstriction
•Main treatment: epinephrine reverses the effects
Hypersensitivity: Type 2 - CORRECT ANSWERS- •Type 2: Cytotoxic reaction; tissue
specific (e.g. 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.
,Difference Between Type 2 and Type 3 - CORRECT ANSWERS- •Type 3 is not organ
specific
the antibody binds to soluble antigen outside the cell surface that was released into
the blood or body fluids, and the complex is then deposited in the tissues
Difference Between Type 2 and Type 3 - CORRECT ANSWERS- •Type 2 is organ
specific
•The antibody binds to the antigen on the cell surface
Hypersensitivity: Type 3-Examples - CORRECT ANSWERS- •Rheumatoid arthritis-
antigen/antibodies are deposited in the joints
•Systemic Lupus Erythematosus (SLE)-very closely related to autoimmunity-
antigen/antibodies deposit in organs that cause tissue damage
Scope of Damage of SLE-Type 3-autoimmune response - CORRECT ANSWERS-
•Facial rash confined to the cheeks (malar rash)
•Discoid rash (raised patches, scaling)
•Photosensitivity (development of skin rash developed as a result of exposure to
sunlight)
•Oral or nasopharyngeal ulcers
Scope of Damage of SLE-Type 3-autoimmune response cont. - CORRECT ANSWERS-
•Hematologic disorders (hemolytic anemia, leukopenia, lymphopenia, or
thrombocytopenia)
•Immunologic disorders (antibodies against double-stranded DNA [dsDNA] or Smith
[Sm] antigen, false-positive serologic test for syphilis, or antiphospholipid antibodies
[anticardiolipin antibody or lupus anticoagulant])
Scope of Damage of SLE-Type 3-autoimmune response cont. - CORRECT ANSWERS-
•Non-erosive arthritis of at least two peripheral joints
, •Serositis (pleurisy, pericarditis)
•Renal disorder (persistent proteinuria of >0.5 g/day or >3 g/day on dipstick or
cellular casts)
•Neurologic disorders (seizures or psychosis in the absence of known causes)
•Presence of antinuclear antibody (ANA)
A Word About Autoimmunity - CORRECT ANSWERS- •Autoimmune diseases 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 - CORRECT ANSWERS- •General term used to describe when an
individual's immune system reacts against antigens on the tissues of other
members of the same species
Examples of Alloimmunity - CORRECT ANSWERS- Hemolytic disease of the
newborn, transplant rejection, transfusion reaction
Hypersensitivity: Type 4 - CORRECT ANSWERS- •Delayed response
•Does not involve antigen/antibody complexes like Types I, II and III
•Is T-cell mediated
Example- TB Test
Relationship between Type II and Type IV Hypersensitivity Reactions - CORRECT
ANSWERS- •Organ rejection involves cytotoxicity (Type II)
