NR 507
MIDTERM EXAM
Advanced Pathophysiology
Chamberlain University
100 Exam-Style Practice Questions
Immunology, Hypersensitivity & Immunodeficiency
With Highlighted Answers & Detailed Rationales
✔ Correct answers are highlighted in green
📖 Rationales are highlighted in yellow
,NR 507 | Advanced Pathophysiology – Midterm Exam Practice
1. Which of the following is the underlying pathology for hay fever?
A. Formation of autoantibodies.
B. Activation of complement.
C. Destruction by T-cells.
D. Mast cell degranulation.
✔ Answer: D. Mast cell degranulation.
📖 Rationale: Hay fever (allergic rhinitis) is a Type I (IgE-mediated) hypersensitivity reaction. Allergens
cross-link IgE antibodies on mast cells, triggering degranulation and release of histamine and other
mediators, causing the classic symptoms of sneezing, itching, and nasal congestion.
2. Which of the following assessment findings would be expected in a patient who presents with
urticaria?
A. Eosinophilia.
B. Decreased thyroid-stimulation hormone level.
C. Thrombocytopenia.
D. Leukopenia.
✔ Answer: A. Eosinophilia.
📖 Rationale: Urticaria (hives) is an allergic reaction involving IgE-mediated mast cell degranulation.
Eosinophils are recruited to sites of allergic inflammation and are elevated in the blood (eosinophilia) during
allergic reactions. Eosinophils help modulate the immune response by releasing enzymes that inactivate
mast cell mediators.
3. The diagnosis for an individual who presents to the office with sudden swollen lips and eyes,
shortness of breath, and throat tightness after a bee sting is:
A. Anaphylaxis.
B. Asthma.
C. Angioedema.
D. Reactive airway disease.
✔ Answer: A. Anaphylaxis.
📖 Rationale: Anaphylaxis is a severe, life-threatening systemic Type I hypersensitivity reaction triggered
by allergens such as bee venom. It involves massive IgE-mediated mast cell degranulation causing
angioedema, bronchospasm (throat tightness/shortness of breath), and potentially circulatory collapse.
Immediate epinephrine is the treatment of choice.
4. Damage occurs with ABO incompatibility because:
A. Mast cell degranulation.
B. Autoantibodies specific for thyroid tissue impair the receptors for TSH.
C. Antigen/Antibody complexes attack the RBC.
D. Complement damages RBC membrane causing cell lysis.
✔ Answer: D. Complement damages RBC membrane causing cell lysis.
Page 2 of 30
, NR 507 | Advanced Pathophysiology – Midterm Exam Practice
📖 Rationale: ABO incompatibility is a Type II (cytotoxic) hypersensitivity reaction. Preformed IgM
antibodies against incompatible ABO antigens activate the complement cascade, which damages and lyses
the red blood cell membrane, leading to intravascular hemolysis, hemoglobinuria, and potentially acute renal
failure.
5. Which of the following statements is true about a primary immunodeficiency?
A. It is the result of a single gene defect.
B. It appears primarily in older adults.
C. It is usually inherited.
D. It is the result of multiple gene defects.
✔ Answer: C. It is usually inherited.
📖 Rationale: Primary immunodeficiencies are disorders caused by intrinsic defects in the immune system,
most often due to genetic mutations inherited from one or both parents. They typically manifest in infancy or
early childhood and may involve defects in B cells, T cells, complement, or phagocytes. While some are
single-gene defects, the defining feature is that they are usually inherited.
6. ________________ is a predominant cause of secondary immune deficiencies worldwide.
A. Malnutrition.
B. HIV infection.
C. Chemotherapy.
D. Autoimmune disease.
✔ Answer: A. Malnutrition.
📖 Rationale: Malnutrition is the most common cause of secondary (acquired) immunodeficiency
worldwide, particularly in developing countries. Protein-energy malnutrition impairs production of
lymphocytes, immunoglobulins, and complement proteins, leaving individuals vulnerable to opportunistic and
common infections.
7. An example of a secondary immunodeficiency is:
A. Job Syndrome.
B. Common Variable Immunodeficiency.
C. Familial Mediterranean Fever.
D. Pneumocystis Carinii pneumonia (PCP).
✔ Answer: D. Pneumocystis Carinii pneumonia (PCP).
📖 Rationale: Pneumocystis carinii (now jirovecii) pneumonia is an opportunistic infection that arises in
individuals with secondary (acquired) immunodeficiency, most notably AIDS (HIV infection). It is not a
primary immunodeficiency itself but serves as an indicator disease of profound immune suppression. Job
Syndrome and Common Variable Immunodeficiency are examples of primary immunodeficiencies.
8. An example of a primary immunodeficiency is:
A. Sinopulmonary infections due to HIV.
B. Severe Combined Immunodeficiency (SCID).
Page 3 of 30
MIDTERM EXAM
Advanced Pathophysiology
Chamberlain University
100 Exam-Style Practice Questions
Immunology, Hypersensitivity & Immunodeficiency
With Highlighted Answers & Detailed Rationales
✔ Correct answers are highlighted in green
📖 Rationales are highlighted in yellow
,NR 507 | Advanced Pathophysiology – Midterm Exam Practice
1. Which of the following is the underlying pathology for hay fever?
A. Formation of autoantibodies.
B. Activation of complement.
C. Destruction by T-cells.
D. Mast cell degranulation.
✔ Answer: D. Mast cell degranulation.
📖 Rationale: Hay fever (allergic rhinitis) is a Type I (IgE-mediated) hypersensitivity reaction. Allergens
cross-link IgE antibodies on mast cells, triggering degranulation and release of histamine and other
mediators, causing the classic symptoms of sneezing, itching, and nasal congestion.
2. Which of the following assessment findings would be expected in a patient who presents with
urticaria?
A. Eosinophilia.
B. Decreased thyroid-stimulation hormone level.
C. Thrombocytopenia.
D. Leukopenia.
✔ Answer: A. Eosinophilia.
📖 Rationale: Urticaria (hives) is an allergic reaction involving IgE-mediated mast cell degranulation.
Eosinophils are recruited to sites of allergic inflammation and are elevated in the blood (eosinophilia) during
allergic reactions. Eosinophils help modulate the immune response by releasing enzymes that inactivate
mast cell mediators.
3. The diagnosis for an individual who presents to the office with sudden swollen lips and eyes,
shortness of breath, and throat tightness after a bee sting is:
A. Anaphylaxis.
B. Asthma.
C. Angioedema.
D. Reactive airway disease.
✔ Answer: A. Anaphylaxis.
📖 Rationale: Anaphylaxis is a severe, life-threatening systemic Type I hypersensitivity reaction triggered
by allergens such as bee venom. It involves massive IgE-mediated mast cell degranulation causing
angioedema, bronchospasm (throat tightness/shortness of breath), and potentially circulatory collapse.
Immediate epinephrine is the treatment of choice.
4. Damage occurs with ABO incompatibility because:
A. Mast cell degranulation.
B. Autoantibodies specific for thyroid tissue impair the receptors for TSH.
C. Antigen/Antibody complexes attack the RBC.
D. Complement damages RBC membrane causing cell lysis.
✔ Answer: D. Complement damages RBC membrane causing cell lysis.
Page 2 of 30
, NR 507 | Advanced Pathophysiology – Midterm Exam Practice
📖 Rationale: ABO incompatibility is a Type II (cytotoxic) hypersensitivity reaction. Preformed IgM
antibodies against incompatible ABO antigens activate the complement cascade, which damages and lyses
the red blood cell membrane, leading to intravascular hemolysis, hemoglobinuria, and potentially acute renal
failure.
5. Which of the following statements is true about a primary immunodeficiency?
A. It is the result of a single gene defect.
B. It appears primarily in older adults.
C. It is usually inherited.
D. It is the result of multiple gene defects.
✔ Answer: C. It is usually inherited.
📖 Rationale: Primary immunodeficiencies are disorders caused by intrinsic defects in the immune system,
most often due to genetic mutations inherited from one or both parents. They typically manifest in infancy or
early childhood and may involve defects in B cells, T cells, complement, or phagocytes. While some are
single-gene defects, the defining feature is that they are usually inherited.
6. ________________ is a predominant cause of secondary immune deficiencies worldwide.
A. Malnutrition.
B. HIV infection.
C. Chemotherapy.
D. Autoimmune disease.
✔ Answer: A. Malnutrition.
📖 Rationale: Malnutrition is the most common cause of secondary (acquired) immunodeficiency
worldwide, particularly in developing countries. Protein-energy malnutrition impairs production of
lymphocytes, immunoglobulins, and complement proteins, leaving individuals vulnerable to opportunistic and
common infections.
7. An example of a secondary immunodeficiency is:
A. Job Syndrome.
B. Common Variable Immunodeficiency.
C. Familial Mediterranean Fever.
D. Pneumocystis Carinii pneumonia (PCP).
✔ Answer: D. Pneumocystis Carinii pneumonia (PCP).
📖 Rationale: Pneumocystis carinii (now jirovecii) pneumonia is an opportunistic infection that arises in
individuals with secondary (acquired) immunodeficiency, most notably AIDS (HIV infection). It is not a
primary immunodeficiency itself but serves as an indicator disease of profound immune suppression. Job
Syndrome and Common Variable Immunodeficiency are examples of primary immunodeficiencies.
8. An example of a primary immunodeficiency is:
A. Sinopulmonary infections due to HIV.
B. Severe Combined Immunodeficiency (SCID).
Page 3 of 30
