NURS 753 Final Exam Study Pack | Therapeutic
Modalities Practice Questions + Rationales |
PMHNP Liberty University
What is natural active acquired immunity? - ANSWER -Pathogens enter the body and cause
illness; antibodies form. When we just get an infection--There is memory
Ex. Person has rubella once.
What is artificial active acquired immunity? - ANSWER -Vaccine (live or attenuated organisms)
is injected into the body. No illness results but antibodies form. There is memory.
Ex. Person receives measles vaccine.
What is natural passive acquired immunity? - ANSWER -Antibodies are passed directly from
mother to child to provide temporary protection: no memory.
Ex. Passage through placenta during pregnancy; consumption of breastmilk; lasts about 1 year.
What is natural artificial passive immunity? - ANSWER -Antibodies are injected into the body
(antiserum) to provide temporary protection or to minimize the severity of an infection. There is
no memory.
Ex. Gamma globulin injection to treat immunologic disease, such as idiopathic
thrombocytopenia purpura; human immunoglobulin to treat hepatitis A and B.
What are live, attenuated vaccines? - ANSWER -attenuated vaccines that are created from
weakened wild viruses or bacteria that can replicate without causing diseases. Live, attenuated
vaccines create an almost identical immune response as active infection. (ex: Varicella, MMR)
What are inactivated vaccines? - ANSWER -Vaccines that are made from whole or fractions of
viruses or bacterial antigen or the toxin produced by the bacteria. The response stimulated is
mainly humoral with little or no stimulation of cellular immunity.
(Example: Polio, rabies, hepatitis A)
What are fractional vaccines? - ANSWER -Vaccines that are protein-based vaccines made by
modifying the toxins produced by some bacteria; the modification does not cause disease. (ex:
Tdap and meningococcus)
What is recombinant vaccines? - ANSWER -Vaccines that are developed through genetic
engineering technology and can include the use of the pathogen's DNA, genetic medication of a
,pathogen, and a viral vector which is a virus that has been modified to insert genetic material into
cells. (Ex: Hepatitis B, HPV, COVID-19)
What is type 1 hypersensitivity? - ANSWER -The difference between a normal immune
response and a type I hypersensitivity response is that the antibody produced is IgE instead of
IgA, IgG, or IgM. The IgE coats the mast cells and basophils, making them sensitive to the
allergen. Histamine is the mediator causing many symptoms.
Ex. Asthma, allergic rhinitis, systemic anaphylaxis
What is type 2 hypersensitivity? - ANSWER -o Involves the destruction of antigens on target
cells or tissue.
§ The antigens may be intrinsic (self) or extrinsic (absorbed through exposure). T
§ IgG or IgM antibodies bind with an individual's own specific cell or tissue antigens, activating
the complement system.
§ The result is destruction or a malfunctioning cell.
§ Recognition of these cells by macrophages triggers antibody production.
§ Examples of type II reactions include blood transfusion reactions and erythroblastosis fetalis.
What is type 3 hypersensitivity? - ANSWER -o Circulating antigen-antibody complexes that
have not been adequately cleared by the innate blood-borne immune cells accumulate and
become deposited in tissues
§ Characteristics of the antigen-antibody complex will determine where and with what tissue the
complex will bind.
§ Tissues often affected in this way include the kidneys, joints, skin, and blood vessels.
§ The accumulation of the complexes triggers the complement system, causing local
inflammation and increased vascular permeability
Examples of type III reactions include autoimmune disorders
What is type 4 hypersensitivity? - ANSWER -o Delayed processing of the antigen by
macrophages. Type 4 is not antibody mediated. These reactions can cause severe tissue injury
and fibrosis.
§ Examples of type IV reactions include tuberculin skin testing, transplant reactions, and contact
dermatitis from poison ivy. Treatment for type IV reactions is disease specific. ---per lecture
what she wants us to know about type 4.
What is primary immunodeficiency? - ANSWER -involves basic developmental failures, many
of which result from genetic or congenital abnormalities
, What is secondary immunodeficiency? - ANSWER -Refers to a loss of immune function
because of a specific cause; such causes may include infection, splenectomy, malnutrition,
hepatic disease, drug therapy, or stress.
WHICH PROCESSES REQUIRE CELL ENERGY? - ANSWER -Active Transport, Pinocytosis
What is active transport? - ANSWER -§ The movement against concentration gradients by
proteins utilizing energy, usually ATP
§ REQUIRES cellular energy
§ Example: Sodium-Potassium Pump
· Energy is required to move sodium out of the cell where the concentrations are high and move
potassium into the cell where the concentrations are high.
· Example: Hyperkalemia
§ Endocytosis:
· Bringing a substance into the cell that is too large to pass by other means
· Phagocytosis (solids), pinocytosis (liquids)
· Think of immune system destroying foreign material (phagocytosis)
§ Exocytosis:
· Release of large particles from the cell onto the cell membrane
· Usually accomplished via a vesicle
· Example: hormone secretion
What is passive transport? - ANSWER -o Osmosis:
§ Passive movement of water or any solvent across the cellular membrane from an area of low
solute concentration to high solute concentration
§ Water is an important solvent, ie fluid that can dissolve the vital solutes we need to live
· Sodium, Potassium, Calcium, Chloride etc.
§ Our cellular membrane is very permeable to water as the solvent but not as permeable to the
solutes
§ Water will move as needed to achieve equivalent concentrations of solutes on both sides of the
membrane via osmosis
§ Balance of water must be maintained, or the cell will lyse due to high intracellular water
concentration
What is autosomal dominant disorder? - ANSWER -§ Passed from an affected parent to an
offspring, male and female are equally capable of transmission
§ One parent must have the trait
§ Can occur with homozygous and heterozygous allele pairs
§ Homozygous fetus is unlikely to survive or to have severe disability (disease will be doubly
severe with two expressing alleles)????
, What is autosomal recessive disorder? - ANSWER -§ Single-gene mutations passed from an
affected parent to an offspring regardless of sex, but they occur only in homozygous (aa) allele
pairs
§ Heterozygous parents are carriers of the disorder but do not have the phenotype
§ Likely to continue through generations because of carriers
DEFINE VIRCHOW'S TRIAD. HOW IS THIS APPLICABLE TO THE DEVELOPMENT OF
CHRONIC CARDIOVASCULAR DISEASE? - ANSWER -Three conditions: endothelia injury,
sluggish blood flow, and increased coagulopathy> Virchow Triad > promote thrombus formation
§ When a vessel wall is injured, the endothelial damage attacks platelets and inflammatory
mediators to the site, thereby stimulating clot formation. Stagnant blood flow allows platelets
and clothing factors to accumulate and adhere to the vessel wall. Hypercoagulopathy states
promote clot formation inappropriately.
o Most emboli in the arterial system originate in the left side of the heart and travel to other
organs such as the brain and the heart, causing an infarction.
What is HFrEF? - ANSWER -HFrEF (heart failure with reduced EF)àsystolic dysfunction
What is HFpEF? - ANSWER -HFpEF (heart failure with preserved EF)àdiastolic dysfunction
Can HFrEF and HFpEF occur together? - ANSWER -Yes, EF < or = to 40%
WHAT ARE THE LAYERS OF CARDIAC TISSUE - ANSWER -Epicardium, myocardium,
endocardium
Function of epicardium - ANSWER -Outer layer> protecting the heart, producing factors that
help the cardiac cells properly develop, and ensuring proper response to cardiac cell injury.
Function of myocardium - ANSWER -Muscle portion of the organ, thicker on left chambers...
why? à contracts and releases involuntarily and is responsible for keeping the heart pumping
blood around the body
§ Muscle of the heart
§ Muscles of the ventricles (especially Left Ventricle) are thicker than the atrium because the
distance and pressure against these chambers must pump blood
§ Atria are receiving chambers that pump blood to their respective ventricles
§ Ventricles pump blood to the low-pressure lungs and high-pressure circulation
function of the endocardium - ANSWER -Inner epithelial layer making up cardiac valves -->
keeps the blood flowing through the heart separate from the myocardium, or cardiac muscles
Modalities Practice Questions + Rationales |
PMHNP Liberty University
What is natural active acquired immunity? - ANSWER -Pathogens enter the body and cause
illness; antibodies form. When we just get an infection--There is memory
Ex. Person has rubella once.
What is artificial active acquired immunity? - ANSWER -Vaccine (live or attenuated organisms)
is injected into the body. No illness results but antibodies form. There is memory.
Ex. Person receives measles vaccine.
What is natural passive acquired immunity? - ANSWER -Antibodies are passed directly from
mother to child to provide temporary protection: no memory.
Ex. Passage through placenta during pregnancy; consumption of breastmilk; lasts about 1 year.
What is natural artificial passive immunity? - ANSWER -Antibodies are injected into the body
(antiserum) to provide temporary protection or to minimize the severity of an infection. There is
no memory.
Ex. Gamma globulin injection to treat immunologic disease, such as idiopathic
thrombocytopenia purpura; human immunoglobulin to treat hepatitis A and B.
What are live, attenuated vaccines? - ANSWER -attenuated vaccines that are created from
weakened wild viruses or bacteria that can replicate without causing diseases. Live, attenuated
vaccines create an almost identical immune response as active infection. (ex: Varicella, MMR)
What are inactivated vaccines? - ANSWER -Vaccines that are made from whole or fractions of
viruses or bacterial antigen or the toxin produced by the bacteria. The response stimulated is
mainly humoral with little or no stimulation of cellular immunity.
(Example: Polio, rabies, hepatitis A)
What are fractional vaccines? - ANSWER -Vaccines that are protein-based vaccines made by
modifying the toxins produced by some bacteria; the modification does not cause disease. (ex:
Tdap and meningococcus)
What is recombinant vaccines? - ANSWER -Vaccines that are developed through genetic
engineering technology and can include the use of the pathogen's DNA, genetic medication of a
,pathogen, and a viral vector which is a virus that has been modified to insert genetic material into
cells. (Ex: Hepatitis B, HPV, COVID-19)
What is type 1 hypersensitivity? - ANSWER -The difference between a normal immune
response and a type I hypersensitivity response is that the antibody produced is IgE instead of
IgA, IgG, or IgM. The IgE coats the mast cells and basophils, making them sensitive to the
allergen. Histamine is the mediator causing many symptoms.
Ex. Asthma, allergic rhinitis, systemic anaphylaxis
What is type 2 hypersensitivity? - ANSWER -o Involves the destruction of antigens on target
cells or tissue.
§ The antigens may be intrinsic (self) or extrinsic (absorbed through exposure). T
§ IgG or IgM antibodies bind with an individual's own specific cell or tissue antigens, activating
the complement system.
§ The result is destruction or a malfunctioning cell.
§ Recognition of these cells by macrophages triggers antibody production.
§ Examples of type II reactions include blood transfusion reactions and erythroblastosis fetalis.
What is type 3 hypersensitivity? - ANSWER -o Circulating antigen-antibody complexes that
have not been adequately cleared by the innate blood-borne immune cells accumulate and
become deposited in tissues
§ Characteristics of the antigen-antibody complex will determine where and with what tissue the
complex will bind.
§ Tissues often affected in this way include the kidneys, joints, skin, and blood vessels.
§ The accumulation of the complexes triggers the complement system, causing local
inflammation and increased vascular permeability
Examples of type III reactions include autoimmune disorders
What is type 4 hypersensitivity? - ANSWER -o Delayed processing of the antigen by
macrophages. Type 4 is not antibody mediated. These reactions can cause severe tissue injury
and fibrosis.
§ Examples of type IV reactions include tuberculin skin testing, transplant reactions, and contact
dermatitis from poison ivy. Treatment for type IV reactions is disease specific. ---per lecture
what she wants us to know about type 4.
What is primary immunodeficiency? - ANSWER -involves basic developmental failures, many
of which result from genetic or congenital abnormalities
, What is secondary immunodeficiency? - ANSWER -Refers to a loss of immune function
because of a specific cause; such causes may include infection, splenectomy, malnutrition,
hepatic disease, drug therapy, or stress.
WHICH PROCESSES REQUIRE CELL ENERGY? - ANSWER -Active Transport, Pinocytosis
What is active transport? - ANSWER -§ The movement against concentration gradients by
proteins utilizing energy, usually ATP
§ REQUIRES cellular energy
§ Example: Sodium-Potassium Pump
· Energy is required to move sodium out of the cell where the concentrations are high and move
potassium into the cell where the concentrations are high.
· Example: Hyperkalemia
§ Endocytosis:
· Bringing a substance into the cell that is too large to pass by other means
· Phagocytosis (solids), pinocytosis (liquids)
· Think of immune system destroying foreign material (phagocytosis)
§ Exocytosis:
· Release of large particles from the cell onto the cell membrane
· Usually accomplished via a vesicle
· Example: hormone secretion
What is passive transport? - ANSWER -o Osmosis:
§ Passive movement of water or any solvent across the cellular membrane from an area of low
solute concentration to high solute concentration
§ Water is an important solvent, ie fluid that can dissolve the vital solutes we need to live
· Sodium, Potassium, Calcium, Chloride etc.
§ Our cellular membrane is very permeable to water as the solvent but not as permeable to the
solutes
§ Water will move as needed to achieve equivalent concentrations of solutes on both sides of the
membrane via osmosis
§ Balance of water must be maintained, or the cell will lyse due to high intracellular water
concentration
What is autosomal dominant disorder? - ANSWER -§ Passed from an affected parent to an
offspring, male and female are equally capable of transmission
§ One parent must have the trait
§ Can occur with homozygous and heterozygous allele pairs
§ Homozygous fetus is unlikely to survive or to have severe disability (disease will be doubly
severe with two expressing alleles)????
, What is autosomal recessive disorder? - ANSWER -§ Single-gene mutations passed from an
affected parent to an offspring regardless of sex, but they occur only in homozygous (aa) allele
pairs
§ Heterozygous parents are carriers of the disorder but do not have the phenotype
§ Likely to continue through generations because of carriers
DEFINE VIRCHOW'S TRIAD. HOW IS THIS APPLICABLE TO THE DEVELOPMENT OF
CHRONIC CARDIOVASCULAR DISEASE? - ANSWER -Three conditions: endothelia injury,
sluggish blood flow, and increased coagulopathy> Virchow Triad > promote thrombus formation
§ When a vessel wall is injured, the endothelial damage attacks platelets and inflammatory
mediators to the site, thereby stimulating clot formation. Stagnant blood flow allows platelets
and clothing factors to accumulate and adhere to the vessel wall. Hypercoagulopathy states
promote clot formation inappropriately.
o Most emboli in the arterial system originate in the left side of the heart and travel to other
organs such as the brain and the heart, causing an infarction.
What is HFrEF? - ANSWER -HFrEF (heart failure with reduced EF)àsystolic dysfunction
What is HFpEF? - ANSWER -HFpEF (heart failure with preserved EF)àdiastolic dysfunction
Can HFrEF and HFpEF occur together? - ANSWER -Yes, EF < or = to 40%
WHAT ARE THE LAYERS OF CARDIAC TISSUE - ANSWER -Epicardium, myocardium,
endocardium
Function of epicardium - ANSWER -Outer layer> protecting the heart, producing factors that
help the cardiac cells properly develop, and ensuring proper response to cardiac cell injury.
Function of myocardium - ANSWER -Muscle portion of the organ, thicker on left chambers...
why? à contracts and releases involuntarily and is responsible for keeping the heart pumping
blood around the body
§ Muscle of the heart
§ Muscles of the ventricles (especially Left Ventricle) are thicker than the atrium because the
distance and pressure against these chambers must pump blood
§ Atria are receiving chambers that pump blood to their respective ventricles
§ Ventricles pump blood to the low-pressure lungs and high-pressure circulation
function of the endocardium - ANSWER -Inner epithelial layer making up cardiac valves -->
keeps the blood flowing through the heart separate from the myocardium, or cardiac muscles
