NR 507 ADVANCE PATHO. MIDTERM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 507 ADVANCE PATHO. MIDTERM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. Hypersensitivity Correct Answer Type 1: •Type 1: Allergic reaction •Mediated by IgE •Inflammation due to mast cell degranulation •Local symptoms: itching, rash •Systemic symptoms: wheezing •Most dangerous form is an anaphylactic reaction-systemic response hypotension, severe bronchoconstriction •Main treatment: epinephrine reverses the effects 2. Hypersensitivity Correct Answer Type 2: •Type 2: Cytotoxic reaction; tissue specific (e.g. thyroid tissue) •Macrophages are the primary effectors cells involved •Can cause tissue damage or alter function •Grave's disease (hyperthyroidism)-example of altering thyroid function, but does not destroy thyroid tissue •Incompatible blood type-example of cell/tissue damage that occurs; severe transfusion reaction occurs and the transfused erythrocytes are destroyed by agglutination or complement-mediated lysis. 3. Difference Between Type 2 and Type 3: •Type 3 is not organ specific the antibody binds to soluble antigen outside the cell surface that was released into the blood or body fluids, and the complex is then deposited in the tissues 4. Difference Between Type 2 and Type 3 Correct Answer •Type 2 is organ specific •The antibody binds to the antigen on the cell surface 5. Hypersensitivity Correct Answer Type 3-Examples: •Rheumatoid arthritis-antigen/antibodies are deposited in the joints •Systemic Lupus Erythematosus (SLE)-very closely related to autoimmunity-antigen/antibodies deposit in organs that cause tissue damage 6. Scope of Damage of SLE-Type 3-autoimmune response: •Facial rash confined to the cheeks (malar rash) •Discoid rash (raised patches, scaling) •Photosensitivity (development of skin rash developed as a result of exposure to sunlight) •Oral or nasopharyngeal ulcers 7. Scope of Damage of SLE-Type 3-autoimmune response cont Correct Answer •Hematologic disorders (hemolytic anemia, leukopenia, lymphopenia, or thrombocytopenia) •Immunologic disorders (antibodies against double-stranded DNA [dsDNA] or Smith [Sm] antigen, false-positive serologic test for syphilis, or antiphospholipid antibodies [anticardiolipin antibody or lupus anticoagulant]) 8. Scope of Damage of SLE-Type 3-autoimmune response cont Correct Answer •Non-erosive arthritis of at least two peripheral joints •Serositis (pleurisy, pericarditis) •Renal disorder (persistent proteinuria of 0.5 g/day or 3 g/day on dipstick or cellular casts) •Neurologic disorders (seizures or psychosis in the absence of known causes) •Presence of antinuclear antibody (ANA) 9. A Word About Autoimmunity Correct Answer •Autoimmune diseases can be familial. •Affected family members may not all develop the same disease, but several members may have different disorders characterized by a variety of hypersensitivity reactions •These include autoimmune and allergic reactions. •Associations with particular autoimmune diseases have been identified for a variety of major histocompatibility complex (MHC) alleles or non MHC genes. 10. Alloimmunity Correct 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 11. Examples of Alloimmunity Correct Answer Hemolytic disease of the newborn, transplant rejection, transfusion reaction 12. Hypersensitivity Correct Answer Type 4: •Delayed response •Does not involve antigen/antibody complexes like Types I, II and III •Is T-cell mediated Example- TB Test 13. Relationship between Type II and Type IV Hypersensitivity Reactions Correct Answer •Organ rejection involves cytotoxicity (Type II) •Also, T-cells play a major role in organ rejection (Type IV-completely T-cell mediated) • Antigens from target cells stimulate T-cells to differentiate into cytotoxic (Type II) T-cells •These T-cells have direct cytotoxic activity along with help T-cells involved in delayed hypersensitivity (type IV). 14. Differentiating Between the Rash of a Type 1 vs. Type IV Reaction Correct Answer •Type I: Immediate hypersensitivity reactions, termed atopic dermatitis, are usually characterized by widely distributed lesions, •Type IV: 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 I: immediate -Type IV: delayed-several days following contact-e.g. poison ivy 15. Treatment of Type IV Rash Correct Answer •A non-severe case of contact dermatitis would be treated with a topical corticosteroid •Why wouldn't we use epinephrine or antihistamines? •Epinephrine is for emergent Type 1 anaphylactic reactions •Antihistamines act on the H1 receptors •Type IV doesn't involve mast cells and H1 receptors •Antibiotics aren't appropriate since this is not an infection 16. Primary Immunodeficiency Correct Answer •Most primary immune deficiencies are the result of single gene defects •Something is lacking with the immune system itself •For example, B-lymphocyte deficiency-one of the most severe forms of a primary immunodeficiency 17. Secondary Immunodeficiency Correct Answer •Secondary immunodeficiency is a complication of some other physiologic condition or disease. •Malnutrition is one of the most common causes worldwide •For example, a patient who has HIV gets pneumocystis carinii 18. Hematology Correct Answer •Anemias are the focus •Involves RBCs •Most of our body's iron stores come from the recycling of iron from old RBCs 19. iron deficiency anemia LAB VALUES Correct Answer TEST Serum Ferritin Levels- DECREASE Red Blood Cell Distribution-INCREASE Serum Iron Levels- DECREASE Total Iron Binding Capacity-INCREASED Transferrin Saturation- DECREASED 20. Thalassemia lab values Correct Answer TEST Serum Ferritin Levels- INCREASE Red Blood Cell Distribution-NORMAL to INCREASE Serum Iron Levels-NORMAL to INCREASE Total Iron Binding Capacity-NORMAL Transferrin Saturation- NORMAL to INCREASE 21. Anemia of chronic disease LAB VALUES Correct Answer TEST Serum Ferritin Levels- NORMAL to INCREASED Red Blood Cell Distribution-NORMAL Serum Iron Levels-NORMAL TO DECREASE Total Iron Binding Capacity- SLIGHTLY DECREASE Transferrin Saturation- NORMAL to SLIGHTLY INCREASE 22. Siderblastic Anemia Lab Values Correct Answer TEST Serum Ferritin Levels- NORMAL to INCREASE Red Blood Cell Distribution- INCREASE Serum Iron Levels-NORMAL to INCREASE Total Iron Binding Capacity- NORMAL Transferrin Saturation- Normal to Increase 23. Mean Corpuscular Hemoglobin Concentration (MCHC) Correct Answer The measure of the average concentration or percentage of hemoglobin within a single RBC 24. When is the Mean Corpuscular Hemoglobin Concentration (MCHC) NORMAL Correct Answer •May be normal in many types of anemias (normochromic anemias) -Aplastic anemia -Post-hemorrhagic anemia -Hemolytic anemia 25. When is the (MCHC) Mean Corpuscular Hemoglobin Concentration LOW Correct Answer •May be low in: - Iron deficiency anemia -Sideroblastic anemia -Thalassemia 26. When is MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION (MCHC) HIGH: •May be high in: -Hereditary spherocytosis- a result of mild cellular dehydration; MCV is low, because of membrane loss and cell dehydration -Liver disease