NR 507 NP
MIDTERM EXAM
Verified Questions & Answers With Rationales
Advanced Pathophysiology
Chamberlain
CONSINST OF 100 QUESTIONS
WEEKS 1 – 4 COVERED
,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.
Correct Answer:
Mast Cell Degranulation
Expert Rationale:
Hay fever (allergic rhinitis) is a Type I hypersensitivity reaction. Upon allergen exposure,
IgE bound to mast cells triggers cross-linking and degranulation, releasing histamine,
leukotrienes, and prostaglandins that produce the classic rhinorrhea, sneezing, 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.
Correct Answer:
Eosinophilia
Expert Rationale:
Urticaria is a localized Type I hypersensitivity reaction involving mast cell degranulation
in the skin. The inflammatory cascade recruits eosinophils, making eosinophilia a
characteristic laboratory finding in allergic-mediated urticaria.
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.
,Correct Answer:
Anaphylaxis
Expert Rationale:
The acute onset of angioedema (swollen lips/eyes), respiratory compromise (shortness
of breath, throat tightness), and known allergen exposure (bee sting) constitutes
anaphylaxis—a systemic, life-threatening IgE-mediated reaction requiring immediate
epinephrine administration.
4. Damage occurs with ABO incompatibility because:
A. Complement damages RBC membrane causing cell lysis.
B. Mast cell degranulation.
C. Autoantibodies specific for thyroid tissue impairs the receptors for TSH.
D. Antigen/Antibody complexes attack the RBC.
Correct Answer:
Complement damages RBC membrane causing cell lysis
Expert Rationale:
ABO incompatibility triggers a Type II cytotoxic hypersensitivity reaction. Pre-formed
anti-A or anti-B antibodies bind to foreign RBC surface antigens, activating the classical
complement cascade and causing intravascular hemolysis via membrane attack
complex (MAC) formation.
5. Which 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.
Correct Answer:
It is the result of a single gene defect.
Expert Rationale:
Primary immunodeficiencies are congenital disorders arising from genetic mutations—
most commonly single gene defects (e.g., SCID, CGD, Wiskott-Aldrich). They are
present from birth and are distinct from secondary (acquired) immunodeficiencies.
, 6. _____________ is a predominant cause of secondary immune deficiencies
worldwide.
Correct Answer:
Malnutrition
7. An example of a secondary immunodeficiency is:
A. Job Syndrome.
B. Common Variable Immunodeficiency.
C. Familial Mediterranean Fever.
D. Pneumocystis Carinii.
Correct Answer:
Pneumocystis Carinii.
Expert Rationale:
Pneumocystis jirovecii (formerly carinii) pneumonia is an opportunistic infection that
occurs in immunocompromised hosts, most notably HIV/AIDS patients. It represents a
secondary (acquired) immunodeficiency resulting from viral destruction of CD4+ T-
helper cells.
8. An example of a primary immunodeficiency is:
A. Sinus Infection.
B. Human Immunodeficiency virus.
C. Pneumonia.
D. Chronic Granulomatous Disease.
Correct Answer:
Chronic Granulomatous Disease
Expert Rationale:
Chronic Granulomatous Disease (CGD) is a genetic defect in the NADPH oxidase
complex, impairing the phagocyte respiratory burst. It is a classic primary
immunodeficiency with X-linked or autosomal recessive inheritance.
9. True or False: Cancer is a secondary immunodeficiency.
Correct Answer:
True
MIDTERM EXAM
Verified Questions & Answers With Rationales
Advanced Pathophysiology
Chamberlain
CONSINST OF 100 QUESTIONS
WEEKS 1 – 4 COVERED
,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.
Correct Answer:
Mast Cell Degranulation
Expert Rationale:
Hay fever (allergic rhinitis) is a Type I hypersensitivity reaction. Upon allergen exposure,
IgE bound to mast cells triggers cross-linking and degranulation, releasing histamine,
leukotrienes, and prostaglandins that produce the classic rhinorrhea, sneezing, 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.
Correct Answer:
Eosinophilia
Expert Rationale:
Urticaria is a localized Type I hypersensitivity reaction involving mast cell degranulation
in the skin. The inflammatory cascade recruits eosinophils, making eosinophilia a
characteristic laboratory finding in allergic-mediated urticaria.
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.
,Correct Answer:
Anaphylaxis
Expert Rationale:
The acute onset of angioedema (swollen lips/eyes), respiratory compromise (shortness
of breath, throat tightness), and known allergen exposure (bee sting) constitutes
anaphylaxis—a systemic, life-threatening IgE-mediated reaction requiring immediate
epinephrine administration.
4. Damage occurs with ABO incompatibility because:
A. Complement damages RBC membrane causing cell lysis.
B. Mast cell degranulation.
C. Autoantibodies specific for thyroid tissue impairs the receptors for TSH.
D. Antigen/Antibody complexes attack the RBC.
Correct Answer:
Complement damages RBC membrane causing cell lysis
Expert Rationale:
ABO incompatibility triggers a Type II cytotoxic hypersensitivity reaction. Pre-formed
anti-A or anti-B antibodies bind to foreign RBC surface antigens, activating the classical
complement cascade and causing intravascular hemolysis via membrane attack
complex (MAC) formation.
5. Which 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.
Correct Answer:
It is the result of a single gene defect.
Expert Rationale:
Primary immunodeficiencies are congenital disorders arising from genetic mutations—
most commonly single gene defects (e.g., SCID, CGD, Wiskott-Aldrich). They are
present from birth and are distinct from secondary (acquired) immunodeficiencies.
, 6. _____________ is a predominant cause of secondary immune deficiencies
worldwide.
Correct Answer:
Malnutrition
7. An example of a secondary immunodeficiency is:
A. Job Syndrome.
B. Common Variable Immunodeficiency.
C. Familial Mediterranean Fever.
D. Pneumocystis Carinii.
Correct Answer:
Pneumocystis Carinii.
Expert Rationale:
Pneumocystis jirovecii (formerly carinii) pneumonia is an opportunistic infection that
occurs in immunocompromised hosts, most notably HIV/AIDS patients. It represents a
secondary (acquired) immunodeficiency resulting from viral destruction of CD4+ T-
helper cells.
8. An example of a primary immunodeficiency is:
A. Sinus Infection.
B. Human Immunodeficiency virus.
C. Pneumonia.
D. Chronic Granulomatous Disease.
Correct Answer:
Chronic Granulomatous Disease
Expert Rationale:
Chronic Granulomatous Disease (CGD) is a genetic defect in the NADPH oxidase
complex, impairing the phagocyte respiratory burst. It is a classic primary
immunodeficiency with X-linked or autosomal recessive inheritance.
9. True or False: Cancer is a secondary immunodeficiency.
Correct Answer:
True
