NR507 MIDTERM EXAM QUESTIONS
AND ANSWERS
Hypersensitivity: Type 2
can cause ____________ - Answer-tissue damage or alter function
Hypersensitivity: Type 2
example of altered function - Answer-graves disease (hyperthyroidism)-example of
altering thyroid function, but does not destroy thyroid tissue
Hypersensitivity: Type 2
example of tissue damage - Answer-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
Hypersensitivity: Type 3 - Answer-Not organ specific
Immune complex-mediated hypersensitivity reactions
-the antibody binds to soluble antigen outside the cell surface and the complex is
deposited in the tissues
Hypersensitivity: Type 3
Examples - Answer-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 - Answer-facial rash confined
to cheeks (malar rash)
discoid rash (raised patches, scaling)
photosensitivity
oral or nasopharyngeal ulcers
hematologic disorders
immunologic disorders
non-erosive arthritis of at lease 2 peripheral joints
serositis
renal disorder
neurologic disorder
ANA
Autoimmune diseases can be ______ - Answer-familial
Associations with particular autoimmune diseases have been identified for a variety of
major ____________ or _____________ - Answer-histocompatibility complex (MHC)
alleles or non-MHC genes
,Alloimmunity - Answer-AKA isoimmunity
immune system of one individual produces a reaction against tissues of another
individual
Alloimmunity examples - Answer--Neonatal disease where the maternal immune system
becomes sensitized against antigens expressed by the fetus
-Transplant rejection
-Transfusion reaction
Hypersensitivity: Type 4 - Answer-T-cell mediated
delayed response
Does not involve antigen/antibody complexes
Hypersensitivity: Type 4
typical reaction - Answer-localized contact dermatitis
(symptoms usually occur a few days later)
Differentiating between type 1 and type 4 rash reactions - Answer-Type I: 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 -Example: poison ivy
How to treat Type 4 hypersensitivity rash - Answer-non-severe case of contact
dermatitis: tx with topical corticosteroid
How to treat emergent Type 1 anaphylactic reactions - Answer-epinephrine
Antihistamines act on _____________ - Answer-H1 receptors
Primary immune deficiency - Answer-congenital
-caused generally by a genetic abnormality
60% of cases, symptoms within first 2 years of life
most primary immune deficiencies are the result of ______________ - Answer-single
gene defects
one of the most severe forms of primary immunodeficiency - Answer-B-lymphocyte
deficiency
secondary immune deficiency - Answer-acquired
-caused by illness, such as cancer or viral infection
-caused by normal physiological changes, such as aging
, -more common than congenital
most common cause of secondary immunodeficiency worldwide - Answer-malnutrition
most common symptom of immune deficiencies - Answer-recurrent severe infections
hematopoiesis - Answer-blood cell formation
most of our body's iron stores come from ____________________________ - Answer-
the recycling of iron from old RBCs
erythropoiesis - Answer-formation of red blood cells (7 day process)
lab values for: Iron Deficiency Anemia - Answer-Serum ferritin level: Decreased
RBC distribution width: Increased
Serum iron level: Decreased
Total iron-binding capacity: Increased
Transferrin saturation: Decreased
lab values for: Thalassemia - Answer-Serum ferritin level: Increased
RBC distribution width: Normal to incrased
Serum iron level: Normal to increased
Total iron-binding capacity: Normal
Transferrin saturation: Normal to increased
lab values for: Anemia of Chronic Disease - Answer-Serum ferritin level: Normal to
increased
RBC distribution width: Normal
Serum iron level: Normal to decreased
Total iron-binding capacity: Slightly decreased
Transferrin saturation: Normal to slightly decreased
lab values for: Sideroblastic Anemia - Answer-Serum ferritin level: Normal to increased
RBC distribution width: Increased
Serum iron level: Normal to increased
Total iron-binding capacity: Normal
Transferrin saturation: Normal to increased
MCHC - Answer-Mean Corpuscular Hemoglobin Concentration
measure of the average concentration of hemoglobin inside a single red blood cell
MCHC normal in many anemias: - Answer-aplastic anemia
post-hemorrhagic anemia
hemolytic anemia
AND ANSWERS
Hypersensitivity: Type 2
can cause ____________ - Answer-tissue damage or alter function
Hypersensitivity: Type 2
example of altered function - Answer-graves disease (hyperthyroidism)-example of
altering thyroid function, but does not destroy thyroid tissue
Hypersensitivity: Type 2
example of tissue damage - Answer-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
Hypersensitivity: Type 3 - Answer-Not organ specific
Immune complex-mediated hypersensitivity reactions
-the antibody binds to soluble antigen outside the cell surface and the complex is
deposited in the tissues
Hypersensitivity: Type 3
Examples - Answer-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 - Answer-facial rash confined
to cheeks (malar rash)
discoid rash (raised patches, scaling)
photosensitivity
oral or nasopharyngeal ulcers
hematologic disorders
immunologic disorders
non-erosive arthritis of at lease 2 peripheral joints
serositis
renal disorder
neurologic disorder
ANA
Autoimmune diseases can be ______ - Answer-familial
Associations with particular autoimmune diseases have been identified for a variety of
major ____________ or _____________ - Answer-histocompatibility complex (MHC)
alleles or non-MHC genes
,Alloimmunity - Answer-AKA isoimmunity
immune system of one individual produces a reaction against tissues of another
individual
Alloimmunity examples - Answer--Neonatal disease where the maternal immune system
becomes sensitized against antigens expressed by the fetus
-Transplant rejection
-Transfusion reaction
Hypersensitivity: Type 4 - Answer-T-cell mediated
delayed response
Does not involve antigen/antibody complexes
Hypersensitivity: Type 4
typical reaction - Answer-localized contact dermatitis
(symptoms usually occur a few days later)
Differentiating between type 1 and type 4 rash reactions - Answer-Type I: 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 -Example: poison ivy
How to treat Type 4 hypersensitivity rash - Answer-non-severe case of contact
dermatitis: tx with topical corticosteroid
How to treat emergent Type 1 anaphylactic reactions - Answer-epinephrine
Antihistamines act on _____________ - Answer-H1 receptors
Primary immune deficiency - Answer-congenital
-caused generally by a genetic abnormality
60% of cases, symptoms within first 2 years of life
most primary immune deficiencies are the result of ______________ - Answer-single
gene defects
one of the most severe forms of primary immunodeficiency - Answer-B-lymphocyte
deficiency
secondary immune deficiency - Answer-acquired
-caused by illness, such as cancer or viral infection
-caused by normal physiological changes, such as aging
, -more common than congenital
most common cause of secondary immunodeficiency worldwide - Answer-malnutrition
most common symptom of immune deficiencies - Answer-recurrent severe infections
hematopoiesis - Answer-blood cell formation
most of our body's iron stores come from ____________________________ - Answer-
the recycling of iron from old RBCs
erythropoiesis - Answer-formation of red blood cells (7 day process)
lab values for: Iron Deficiency Anemia - Answer-Serum ferritin level: Decreased
RBC distribution width: Increased
Serum iron level: Decreased
Total iron-binding capacity: Increased
Transferrin saturation: Decreased
lab values for: Thalassemia - Answer-Serum ferritin level: Increased
RBC distribution width: Normal to incrased
Serum iron level: Normal to increased
Total iron-binding capacity: Normal
Transferrin saturation: Normal to increased
lab values for: Anemia of Chronic Disease - Answer-Serum ferritin level: Normal to
increased
RBC distribution width: Normal
Serum iron level: Normal to decreased
Total iron-binding capacity: Slightly decreased
Transferrin saturation: Normal to slightly decreased
lab values for: Sideroblastic Anemia - Answer-Serum ferritin level: Normal to increased
RBC distribution width: Increased
Serum iron level: Normal to increased
Total iron-binding capacity: Normal
Transferrin saturation: Normal to increased
MCHC - Answer-Mean Corpuscular Hemoglobin Concentration
measure of the average concentration of hemoglobin inside a single red blood cell
MCHC normal in many anemias: - Answer-aplastic anemia
post-hemorrhagic anemia
hemolytic anemia
