NCA 622 MODULE 2 WITH COMPLETE
SOLUTIONS 100% VERIFIED!!
What is primary immune deficiencies vs secondary? - ANSWER -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? - ANSWER -Antibody-mediated - Type I, II, III (immediate)
-Cell-mediated - Type IV (Delayed)
What are the 4 types of Hypersensitivity reactions - ANSWER 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 - ANSWER Serum sickness
,What is hay fever? - ANSWER 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? - ANSWER 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? - ANSWER Epinephrine
When do Type 1 Hypersensitivity Reactions occur? - ANSWER Usually w/in 15min -
30min of exposure
-Immediate
-Or longer if drug was given orally w food
When do type IV hypersensitivity reactions occur? - ANSWER 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. - ANSWER 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 - ANSWER Steven Johnson's Syndrome - Type IV
Serum sickness, rheumatoid arthritis, lupus, and an arthrus reaction are all what type of
hypersensitivity reaction? - ANSWER 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) - ANSWER Lupus - Type III - immune-mediated
What are the 2 most common drugs that cause Type IV hypersensitivity reaction? -
ANSWER (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. -
ANSWER -Known allergen exposure with rash development alone.
What is IgE dependent anaphylaxis? - ANSWER -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? - ANSWER 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? -
ANSWER -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? - ANSWER Systemic
anaphylaxis (can see eosinophilia)
What lab results can be seen in someone with a Type 1 Hypersensitivity response? -
ANSWER Type 1 = Allergic IgE
SOLUTIONS 100% VERIFIED!!
What is primary immune deficiencies vs secondary? - ANSWER -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? - ANSWER -Antibody-mediated - Type I, II, III (immediate)
-Cell-mediated - Type IV (Delayed)
What are the 4 types of Hypersensitivity reactions - ANSWER 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 - ANSWER Serum sickness
,What is hay fever? - ANSWER 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? - ANSWER 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? - ANSWER Epinephrine
When do Type 1 Hypersensitivity Reactions occur? - ANSWER Usually w/in 15min -
30min of exposure
-Immediate
-Or longer if drug was given orally w food
When do type IV hypersensitivity reactions occur? - ANSWER 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. - ANSWER 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 - ANSWER Steven Johnson's Syndrome - Type IV
Serum sickness, rheumatoid arthritis, lupus, and an arthrus reaction are all what type of
hypersensitivity reaction? - ANSWER 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) - ANSWER Lupus - Type III - immune-mediated
What are the 2 most common drugs that cause Type IV hypersensitivity reaction? -
ANSWER (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. -
ANSWER -Known allergen exposure with rash development alone.
What is IgE dependent anaphylaxis? - ANSWER -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? - ANSWER 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? -
ANSWER -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? - ANSWER Systemic
anaphylaxis (can see eosinophilia)
What lab results can be seen in someone with a Type 1 Hypersensitivity response? -
ANSWER Type 1 = Allergic IgE
