NR507 Final exam Study Guide1.
Chapters 1-5, 11-14, 16-20, 21-25, 27-3-33, 34-39, 40-47
1. Types of immunity-e.g. innate, active, etc (ch 7 ,191)
➢ Innate immunity includes two lines of defense: natural barriers and
inflammation Natural barriers are physical, mechanical, and biochemical
barriers at the body’s surfaces and are in place at birth to prevent damage by
substances in the environment and thwart infection by pathogenic
microorganisms.
➢ the natural epithelial barrier and inflammation confer innate resistance and protection,
commonly referred
to as innate, native, or natural immunity. Inflammation associated with
infection usually initiates an adaptive process that results in a long-term and
very effective immunity to the infecting microorganism, referred to as adaptive,
acquired, or specific immunity.
➢ Adaptive immunity is relatively slow to develop but has memory and more
rapidly targets and eradicates a second infection with a particular disease-
causing microorganism.
➢ Innate immunity includes two lines of defense: natural barriers and inflammation. Natural
barriers are
physical, mechanical, and biochemical barriers at the body’s surfaces and are in
place at birth to prevent damage by substances in the environment and thwart
infection by pathogenic microorganisms
INNATE IMMUNITY
INFLAMMATORY
BARRIERS ADAPTIVE (ACQUIRED) IMMUNITY
RESPONSE
Level of First line of defense Second line of defense; occurs Third line ofdefense;
defense against infection and tissue as a response to tissue injury initiated when innate
injury or infection immune system signals
the cells ofadaptive
immunity
Timing of Constant Immediate response Delay between primary
defense exposure to antigen and
maximum response;
immediate against
secondary exposure to
antigen
Specificity Broadly specific Broadly specific Response is very
specific toward
“antigen”
Cells Epithelial cells Mast cells, granulocytes T lymphocytes, B
(neutrophils, eosinophils, lymphocytes,
basophils), macrophages,
1
, monocytes/macrophages, dendritic cells
natural killer (NK) cells,
platelets, endothelial cells
Memory No memory involved No memory involved Specific immunologic
memory by T and B
lymphocytes
Peptides Defensins, Complement, clotting factors, Antibodies, complement
cathelicidins, kinins
collectins, lactoferrin,
bacterial toxins
Protection Protection includes Protection includes vascular Protection includes
anatomic barriers (i.e., responses, cellular components activated T and B
skin and mucous (e.g., mast cells, neutrophils, lymphocytes, cytokines,
membranes), cells and macrophages), secretory and antibodies
secretory molecules or molecules or cytokines, and
cytokines (e.g., lysozymes, activation of plasma protein
low pH of stomach and systems
urine), and ciliary activity
2. Alveolar ventilation/perfusion- (ch, 34,pg 1238)
➢ The relationship between arterial perfusion and alveolar gas pressure at the base of
the lungs is best described as: arterial perfusion pressure exceeds alveolar gas
pressure.
➢ Effective gas exchange depends on an approximately even distribution of gas (ventilation) and
blood (perfusion) in all
portions of the lungs. The lungs are suspended from the hila in the thoracic cavity.
When the individual is in an upright position (sitting or standing), gravity pulls the lungs
down toward the diaphragm and compresses their lower portions or bases.
3. Dermatologic conditions e.g. pityriasis rosea (ch46, pg 1630/1631)
➢ Psoriasis, pityriasis rosea, and lichen planus are inflammatory disorders characterized
by papules, scales, plaques, and erythema
➢ Psoriasis is a chronic, relapsing, proliferative, inflammatory disorder that involves the skin, scalp,
and nails and can
occur at any age.
➢ Pityriasis rosea is a benign self-limiting inflammatory disorder that occurs more often
in young adults, with seasonal peaks in the spring and fall. The cause is unknown but
➢ thought to be associated with a virus (e.g., human herpesvirus 6 [HHV-6] and HHV-7) because of
the timing and
clustering of the outbreaks
2
, ➢ Pityriasis rosea begins as a single lesion known as a herald patch that is circular,
demarcated, and salmon-pink; is approximately 3 to 4 cm in diameter; and is usually
located on the trunk
➢ Lichen planus (LP) is a benign, autoimmune inflammatory disorder of the skin and mucous
membranes with multiple
clinical variations. The cause is unknown, but T cells, adhesion molecules,
inflammatory cytokines, perforin, and antigen-presenting cells are involved.The
infiltrate of T cells mediates immunoreactivity against basal layer keratinocytes,
which have altered surface antigens and adhesion molecules
➢ LP is also linked to hepatitis C virus. Some individuals develop lichenoid lesions
after exposure to drugs or film- processing chemicals. The age of onset is usually
between 30 and 70 years. The disorder begins with flat purple, polygonal, pruritic,
nonscaling papules 2 to 4 mm in size, usually located on the wrists, ankles, lower
legs, and genitalia
➢ New lesions are pale pink and evolve into a dark violet. Persistent lesions may be
thickened and red, forming hypertrophic LP. Oral lesions (oral lichen planus)
appear as lacy white rings that must be differentiated from leukoplakia or oral
candidiasis and they may be precancerous lesions
4. Croup (C 36,pg 1294)-
➢ Croup illnesses can be divided into two categories: (1) acute
laryngotracheobronchitis (croup) and (2) spasmodic croup. Diphtheria can
be considered a croup illness but is now rare because of vaccinations.
Croup illnesses are all characterized by infection and obstruction of the
upper airways.
➢ Croup is an acute laryngotracheobronchitis and most commonly occurs in children from 6
months to 3 years of
age, with peak incidence at 2 years of age
➢ The incidence of croup is highest in late autumn and winter, corresponding to the
parainfluenza and RSV seasons, respectively. Croup is more common in boys than
girls. In a significant portion of affected children, croup is a recurrent problem
during childhood, and there is a family history of croup in about 15% of cases
➢ Chickenpox (varicella) and herpes zoster (shingles) are produced by the varicella-zoster virus
(VZV). VZV is a
complex herpes group deoxyribonucleic acid (DNA) virus. The incubation period is
10 to 27 days, averaging 14 days. Productive infection occurs within keratinocytes
such that the vesicular lesions occur in the epidermis, and an inflammatory infiltrate
is often present
5. Types of anemia (ch 28,pg 987-1002)
➢ anemia is a reduction in the total number of erythrocytes in the circulating blood
or a decrease in the quality or quantity of hemoglobin. Anemias commonly result
from (1) impaired erythrocyte production, (2) blood loss (acute or chronic), (3)
increased erythrocyte destruction, or (4) a combination of these three factors.
➢ Pernicious anemia (PA), the most common type of megaloblastic anemia, is caused
by vitamin B12deficiency, which is often associated with the end stage of type A
chronic atrophic (congenital or autoimmune) gastritis. PA
results from inadequate vitamin B12 absorption because of autoantibodies against the
B12transporter IF
➢ Folate (folic acid) is an essential vitamin for RNA and DNA synthesis within the
3
, maturing erythrocyte. Folates are coenzymes required for the synthesis of thymine
and purines (adenine and guanine) and the
conversion of homocysteine to methionine. Deficient production of thymine, in
particular, affects cells undergoing rapid division (e.g., bone marrow cells
undergoing erythropoiesis). Humans are totally dependent on dietary intake to
meet the daily requirement of 50 to 200 mcg/day. Folate deficiency anemia is
caused by inadequate dietary intake of folate. Both anemias respond to
replacement therapy.
➢ The microcytic-hypochromic anemias are characterized by abnormally
small erythrocytes that contain abnormally reduced amounts of hemoglobin
➢ Microcytic-hypochromic anemia can result from (1) disorders of iron metabolism, (2)
disorders ofporphyrin and
heme synthesis, or (3) disorders of globin synthesis. Specific disorders include iron
deficiency anemia, side roblastic anemia, and thalassemia
➢ Iron deficiency anemia (IDA) is the most common type of anemia worldwide, occurring in
both developing and
developed countries and affecting as many as one fifth of the world population.
Certain populations are at high risk for developing hypoferremia and IDA and
include individuals living in poverty, women of childbearing age, and children. Iron
deficiency in children is associated with numerous adverse health-related
manifestations, especially cognitive impairment, which may be irreversible
➢ Sideroblastic anemias (SAs) are a heterogeneous group of disorders characterized
by anemia of varying severity caused by a defect in mitochondrial heme
synthesis.SA is characterized by the presence of ringed side roblasts within the
bone marrow. SA results from defects in mitochondrial metabolism leading to
ineffective iron uptake and dysfunctional heme synthesis. The characteristic cell in
the bone marrow, a ringed sideroblast, is an erythroblast containing iron granules
arranged around the nucleus. SAs may be hereditary or acquired, and treatment
varies depending on the cause.
➢ Normocytic-normochromic anemias (NNAs) are characterized by erythrocytes that are
relatively normal in size
and hemoglobin content but insufficient in number. These anemias have no common
etiology, pathologic
4
Chapters 1-5, 11-14, 16-20, 21-25, 27-3-33, 34-39, 40-47
1. Types of immunity-e.g. innate, active, etc (ch 7 ,191)
➢ Innate immunity includes two lines of defense: natural barriers and
inflammation Natural barriers are physical, mechanical, and biochemical
barriers at the body’s surfaces and are in place at birth to prevent damage by
substances in the environment and thwart infection by pathogenic
microorganisms.
➢ the natural epithelial barrier and inflammation confer innate resistance and protection,
commonly referred
to as innate, native, or natural immunity. Inflammation associated with
infection usually initiates an adaptive process that results in a long-term and
very effective immunity to the infecting microorganism, referred to as adaptive,
acquired, or specific immunity.
➢ Adaptive immunity is relatively slow to develop but has memory and more
rapidly targets and eradicates a second infection with a particular disease-
causing microorganism.
➢ Innate immunity includes two lines of defense: natural barriers and inflammation. Natural
barriers are
physical, mechanical, and biochemical barriers at the body’s surfaces and are in
place at birth to prevent damage by substances in the environment and thwart
infection by pathogenic microorganisms
INNATE IMMUNITY
INFLAMMATORY
BARRIERS ADAPTIVE (ACQUIRED) IMMUNITY
RESPONSE
Level of First line of defense Second line of defense; occurs Third line ofdefense;
defense against infection and tissue as a response to tissue injury initiated when innate
injury or infection immune system signals
the cells ofadaptive
immunity
Timing of Constant Immediate response Delay between primary
defense exposure to antigen and
maximum response;
immediate against
secondary exposure to
antigen
Specificity Broadly specific Broadly specific Response is very
specific toward
“antigen”
Cells Epithelial cells Mast cells, granulocytes T lymphocytes, B
(neutrophils, eosinophils, lymphocytes,
basophils), macrophages,
1
, monocytes/macrophages, dendritic cells
natural killer (NK) cells,
platelets, endothelial cells
Memory No memory involved No memory involved Specific immunologic
memory by T and B
lymphocytes
Peptides Defensins, Complement, clotting factors, Antibodies, complement
cathelicidins, kinins
collectins, lactoferrin,
bacterial toxins
Protection Protection includes Protection includes vascular Protection includes
anatomic barriers (i.e., responses, cellular components activated T and B
skin and mucous (e.g., mast cells, neutrophils, lymphocytes, cytokines,
membranes), cells and macrophages), secretory and antibodies
secretory molecules or molecules or cytokines, and
cytokines (e.g., lysozymes, activation of plasma protein
low pH of stomach and systems
urine), and ciliary activity
2. Alveolar ventilation/perfusion- (ch, 34,pg 1238)
➢ The relationship between arterial perfusion and alveolar gas pressure at the base of
the lungs is best described as: arterial perfusion pressure exceeds alveolar gas
pressure.
➢ Effective gas exchange depends on an approximately even distribution of gas (ventilation) and
blood (perfusion) in all
portions of the lungs. The lungs are suspended from the hila in the thoracic cavity.
When the individual is in an upright position (sitting or standing), gravity pulls the lungs
down toward the diaphragm and compresses their lower portions or bases.
3. Dermatologic conditions e.g. pityriasis rosea (ch46, pg 1630/1631)
➢ Psoriasis, pityriasis rosea, and lichen planus are inflammatory disorders characterized
by papules, scales, plaques, and erythema
➢ Psoriasis is a chronic, relapsing, proliferative, inflammatory disorder that involves the skin, scalp,
and nails and can
occur at any age.
➢ Pityriasis rosea is a benign self-limiting inflammatory disorder that occurs more often
in young adults, with seasonal peaks in the spring and fall. The cause is unknown but
➢ thought to be associated with a virus (e.g., human herpesvirus 6 [HHV-6] and HHV-7) because of
the timing and
clustering of the outbreaks
2
, ➢ Pityriasis rosea begins as a single lesion known as a herald patch that is circular,
demarcated, and salmon-pink; is approximately 3 to 4 cm in diameter; and is usually
located on the trunk
➢ Lichen planus (LP) is a benign, autoimmune inflammatory disorder of the skin and mucous
membranes with multiple
clinical variations. The cause is unknown, but T cells, adhesion molecules,
inflammatory cytokines, perforin, and antigen-presenting cells are involved.The
infiltrate of T cells mediates immunoreactivity against basal layer keratinocytes,
which have altered surface antigens and adhesion molecules
➢ LP is also linked to hepatitis C virus. Some individuals develop lichenoid lesions
after exposure to drugs or film- processing chemicals. The age of onset is usually
between 30 and 70 years. The disorder begins with flat purple, polygonal, pruritic,
nonscaling papules 2 to 4 mm in size, usually located on the wrists, ankles, lower
legs, and genitalia
➢ New lesions are pale pink and evolve into a dark violet. Persistent lesions may be
thickened and red, forming hypertrophic LP. Oral lesions (oral lichen planus)
appear as lacy white rings that must be differentiated from leukoplakia or oral
candidiasis and they may be precancerous lesions
4. Croup (C 36,pg 1294)-
➢ Croup illnesses can be divided into two categories: (1) acute
laryngotracheobronchitis (croup) and (2) spasmodic croup. Diphtheria can
be considered a croup illness but is now rare because of vaccinations.
Croup illnesses are all characterized by infection and obstruction of the
upper airways.
➢ Croup is an acute laryngotracheobronchitis and most commonly occurs in children from 6
months to 3 years of
age, with peak incidence at 2 years of age
➢ The incidence of croup is highest in late autumn and winter, corresponding to the
parainfluenza and RSV seasons, respectively. Croup is more common in boys than
girls. In a significant portion of affected children, croup is a recurrent problem
during childhood, and there is a family history of croup in about 15% of cases
➢ Chickenpox (varicella) and herpes zoster (shingles) are produced by the varicella-zoster virus
(VZV). VZV is a
complex herpes group deoxyribonucleic acid (DNA) virus. The incubation period is
10 to 27 days, averaging 14 days. Productive infection occurs within keratinocytes
such that the vesicular lesions occur in the epidermis, and an inflammatory infiltrate
is often present
5. Types of anemia (ch 28,pg 987-1002)
➢ anemia is a reduction in the total number of erythrocytes in the circulating blood
or a decrease in the quality or quantity of hemoglobin. Anemias commonly result
from (1) impaired erythrocyte production, (2) blood loss (acute or chronic), (3)
increased erythrocyte destruction, or (4) a combination of these three factors.
➢ Pernicious anemia (PA), the most common type of megaloblastic anemia, is caused
by vitamin B12deficiency, which is often associated with the end stage of type A
chronic atrophic (congenital or autoimmune) gastritis. PA
results from inadequate vitamin B12 absorption because of autoantibodies against the
B12transporter IF
➢ Folate (folic acid) is an essential vitamin for RNA and DNA synthesis within the
3
, maturing erythrocyte. Folates are coenzymes required for the synthesis of thymine
and purines (adenine and guanine) and the
conversion of homocysteine to methionine. Deficient production of thymine, in
particular, affects cells undergoing rapid division (e.g., bone marrow cells
undergoing erythropoiesis). Humans are totally dependent on dietary intake to
meet the daily requirement of 50 to 200 mcg/day. Folate deficiency anemia is
caused by inadequate dietary intake of folate. Both anemias respond to
replacement therapy.
➢ The microcytic-hypochromic anemias are characterized by abnormally
small erythrocytes that contain abnormally reduced amounts of hemoglobin
➢ Microcytic-hypochromic anemia can result from (1) disorders of iron metabolism, (2)
disorders ofporphyrin and
heme synthesis, or (3) disorders of globin synthesis. Specific disorders include iron
deficiency anemia, side roblastic anemia, and thalassemia
➢ Iron deficiency anemia (IDA) is the most common type of anemia worldwide, occurring in
both developing and
developed countries and affecting as many as one fifth of the world population.
Certain populations are at high risk for developing hypoferremia and IDA and
include individuals living in poverty, women of childbearing age, and children. Iron
deficiency in children is associated with numerous adverse health-related
manifestations, especially cognitive impairment, which may be irreversible
➢ Sideroblastic anemias (SAs) are a heterogeneous group of disorders characterized
by anemia of varying severity caused by a defect in mitochondrial heme
synthesis.SA is characterized by the presence of ringed side roblasts within the
bone marrow. SA results from defects in mitochondrial metabolism leading to
ineffective iron uptake and dysfunctional heme synthesis. The characteristic cell in
the bone marrow, a ringed sideroblast, is an erythroblast containing iron granules
arranged around the nucleus. SAs may be hereditary or acquired, and treatment
varies depending on the cause.
➢ Normocytic-normochromic anemias (NNAs) are characterized by erythrocytes that are
relatively normal in size
and hemoglobin content but insufficient in number. These anemias have no common
etiology, pathologic
4
