CHAMBERLAIN NR507 MIDTERM EXAM
QUESTIONS AND ANSWERS
Alloimmunity - Answer-- 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: Neonatal disease where the maternal immune system becomes sensitized
against antigens expressed by the fetus, Transplant rejection, Transfusion reaction.
Type 4 Hypersensitivity Reaction - Answer-- T-cell mediated
- Lymphocytes
- Does not involve antigen/antibody complexes
- Delayed response
- Ex: localized contact dermatitis. Treated with a topical corticosteroid (wouldn't use
antihistamine since Type 4 doesn't involve mast cells and H1 receptors).
Differentiating between the rash of a Type 1 vs Type 4 Reaction - Answer-- Type 1:
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.
The key determinant is the timing of the rash:
-Type 1 = Immediate
-Type 4 = Delayed: Several days following contact, ex- poison ivy
Primary Immunodeficiency - Answer-- Most are the result of single gene defects.
- Occurs d/t immune system development defect.
- Antibody deficiencies, B- and T-cell deficiencies, phagocytic cell defects, complement
deficiency
- Ex: chronic granulomatous disease, familial Mediterranean fever, common variable
immunodeficiency
Secondary Immunodeficiency - Answer-- Complication of some other physiologic
condition or disease.
- Malnutrition is one of the most common causes worldwide.
- Cancer, drugs, chemotherapeutic agents.
Most of our body's iron stores come from..... - Answer-The recycling of iron from old red
blood cells (RBCs)
Mean Corpuscular Hemoglobin Concentration (MCHC) - Answer-- Measure of the
average concentration of hemoglobin inside a single red blood cell.
- Normal (normochromic anemia): aplastic anemia, post-hemorrhagic anemia, hemolytic
anemia.
, - Low (hypochromic): iron deficiency anemia, sideroblastic anemia, thalassemia.
- High (hyperchromic): hereditary spherocytosis, liver disease, hyperthyroidism, sickle
cell disease.
Iron Deficiency Anemia - Answer-- Microcytic & hypochromic
- Caused by disorders of hemoglobin synthesis
- Lab: ferritin (reflects the body's total iron stores -> low reflects anemia, but does not
tell you what type)
Increased ____ ________ ______ is one of the earliest lab markers in developing
macrocytic anemia. - Answer-RBC distribution width (RDW)
Folate Deficiency - Answer-- Megaloblastic anemia
- Alcoholism, malnutrition
- Lab values: folate (low), MCV (high- macrocytic), MCHC (normal- normochromic),
reticulocyte (normal or high), serum iron (normal or low).
Vitamin B-12 Deficiency - Answer-- Pernicious anemia
- S/S: fatigue, dyspnea, peripheral neuropathy (numbness & tingling) in bilateral lower
extremities (BLE)
- Risk factor: older adults, H. Pylori infection, d/o affecting b-12 absorption,
vegetarian/vegan
- Lab values: low B-12, high MCV (macrocytic), normal MCHC (normochromic), low
reticulocyte, and normal or high iron
Hemolytic Anemia - Answer-- Destruction/lysis of red blood cells.
- Causes: transfusion reaction (cytotoxic type 2), autoimmune reaction, drug-induced
(allergic reaction)
Acute blood loss anemia - Answer-- Trauma victims who are losing blood
Aplastic Anemia - Answer-- Characterized by an absence of all formed blood elements
caused by the failure of blood cell production in the bone marrow.
- Diagnosis is made by blood tests and bone marrow biopsy.
- Suspected if levels of circulating erythrocytes, leukocytes, and platelets are
diminished.
Sickle Cell Anemia - Answer-- Have sickle cell trait; caused by a mutation in the HBB
gene that leads to the production of abnormal hemoglobin.
- Autosomal recessive disorder; both parents must contribute an abnormal gene for a
child to have the disorder.
Thalassemia - Answer-- Inherited blood disorder that causes decreased circulating
hemoglobin.
- Many possible genetic mutations.
QUESTIONS AND ANSWERS
Alloimmunity - Answer-- 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: Neonatal disease where the maternal immune system becomes sensitized
against antigens expressed by the fetus, Transplant rejection, Transfusion reaction.
Type 4 Hypersensitivity Reaction - Answer-- T-cell mediated
- Lymphocytes
- Does not involve antigen/antibody complexes
- Delayed response
- Ex: localized contact dermatitis. Treated with a topical corticosteroid (wouldn't use
antihistamine since Type 4 doesn't involve mast cells and H1 receptors).
Differentiating between the rash of a Type 1 vs Type 4 Reaction - Answer-- Type 1:
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.
The key determinant is the timing of the rash:
-Type 1 = Immediate
-Type 4 = Delayed: Several days following contact, ex- poison ivy
Primary Immunodeficiency - Answer-- Most are the result of single gene defects.
- Occurs d/t immune system development defect.
- Antibody deficiencies, B- and T-cell deficiencies, phagocytic cell defects, complement
deficiency
- Ex: chronic granulomatous disease, familial Mediterranean fever, common variable
immunodeficiency
Secondary Immunodeficiency - Answer-- Complication of some other physiologic
condition or disease.
- Malnutrition is one of the most common causes worldwide.
- Cancer, drugs, chemotherapeutic agents.
Most of our body's iron stores come from..... - Answer-The recycling of iron from old red
blood cells (RBCs)
Mean Corpuscular Hemoglobin Concentration (MCHC) - Answer-- Measure of the
average concentration of hemoglobin inside a single red blood cell.
- Normal (normochromic anemia): aplastic anemia, post-hemorrhagic anemia, hemolytic
anemia.
, - Low (hypochromic): iron deficiency anemia, sideroblastic anemia, thalassemia.
- High (hyperchromic): hereditary spherocytosis, liver disease, hyperthyroidism, sickle
cell disease.
Iron Deficiency Anemia - Answer-- Microcytic & hypochromic
- Caused by disorders of hemoglobin synthesis
- Lab: ferritin (reflects the body's total iron stores -> low reflects anemia, but does not
tell you what type)
Increased ____ ________ ______ is one of the earliest lab markers in developing
macrocytic anemia. - Answer-RBC distribution width (RDW)
Folate Deficiency - Answer-- Megaloblastic anemia
- Alcoholism, malnutrition
- Lab values: folate (low), MCV (high- macrocytic), MCHC (normal- normochromic),
reticulocyte (normal or high), serum iron (normal or low).
Vitamin B-12 Deficiency - Answer-- Pernicious anemia
- S/S: fatigue, dyspnea, peripheral neuropathy (numbness & tingling) in bilateral lower
extremities (BLE)
- Risk factor: older adults, H. Pylori infection, d/o affecting b-12 absorption,
vegetarian/vegan
- Lab values: low B-12, high MCV (macrocytic), normal MCHC (normochromic), low
reticulocyte, and normal or high iron
Hemolytic Anemia - Answer-- Destruction/lysis of red blood cells.
- Causes: transfusion reaction (cytotoxic type 2), autoimmune reaction, drug-induced
(allergic reaction)
Acute blood loss anemia - Answer-- Trauma victims who are losing blood
Aplastic Anemia - Answer-- Characterized by an absence of all formed blood elements
caused by the failure of blood cell production in the bone marrow.
- Diagnosis is made by blood tests and bone marrow biopsy.
- Suspected if levels of circulating erythrocytes, leukocytes, and platelets are
diminished.
Sickle Cell Anemia - Answer-- Have sickle cell trait; caused by a mutation in the HBB
gene that leads to the production of abnormal hemoglobin.
- Autosomal recessive disorder; both parents must contribute an abnormal gene for a
child to have the disorder.
Thalassemia - Answer-- Inherited blood disorder that causes decreased circulating
hemoglobin.
- Many possible genetic mutations.
