Microbiology Ch. 14

Select all of the correct statements concerning SLE to test your understanding of the pathogenesis of autoimmune diseases.

- Autoantibodies bind self antigens forming immune complexes that accumulate in basement membranes of various organs. - Autoantibodies include those against white and red blood cells, and platelets.

Select all statements that apply to hemolytic disease of the newborn to test your understanding of this disorder.

- Fetal RBC leakage sensitizes the mother to make anti-Rh antibodies. - Anti-Rh antibodies that are IgG can cross the placenta and induce complement-mediated lysis of fetal RBCs. - Hemolytic disease is a Type II hypersensitivity reaction.

Select all of the correct statements concerning SCIDs to test your understanding of severe combined immunodeficiency disease.

- Most serious and lethal of the primary immunodeficiency diseases, caused by genetic defects - Involves loss or dysfunction of both humoral and cell-mediated immunity - Requires vigorous adherence to aseptic techniques to prevent infection

Type 4

- T-cell mediated - delayed hypersensitivity - contact dermatitis, graft rejection

Type 1 Hypersensitivity

- immediate - IgE-mediated, involving mast cells and basophils - anaphylaxis, allergies, asthma

Type 3

- immune complex mediated - IgG complexes in basement membranes - SLE, rheumatoid arthritis, serum sickness

Type 2

- involves IgG & IgM - blood group incompatibility

Percentage of population prone to atopic allergy

10-30

Generally, it is not possible to have an allergic reaction the ____ time a person is exposed to an antigen.

1st

Skin lesions due to hypersensitivity appear

24 hours after second exposure to antigen

Percentage of hospitalized patients experiencing drug allergy reactions

5-10

Percentage of allergic patients that benefit from desensitization therapy

70

Percentage of humans expressing Rh antigen on RBCs

85

Which of the following antigens are present on the patient's red blood cells?

A antigen

The mother has a second child who has Rh negative blood. What is the most appropriate action during her third pregnancy?

Administration of RhoGAM between 28 and 32 weeks of pregnancy and immediately after delivery

Choose the statement that does not describe the anaphylactic response to test your understanding of anaphylaxis.

Allergen route of entry is always due to inhalation.

Following delivery, the mother is educated regarding future pregnancies. Which of the following is the most appropriate statement by the RN?

Due to the risk of hemolytic disease of the newborn, you will require treatment during future pregnancies.

Most intermediate size antigen-antibody complexes are removed by phagocytosi

False

The antibody involved in Type I hypersensitivity is _____.

IgE

Which of these describes Type I hypersensitivity?

IgE-mediated and involves mast cells, helper T-cells, and histamine

The basic mechanism in Type II hypersensitivities involves:

IgG and IgM triggering cell destruction by complement and other mechanisms.

The first class of antibody synthesized in the host's first encounter with antigen is ________.

IgM

Select all of the statements that apply to both Type II and Type III hypersensitivity reactions.

Involve IgG antibodies Involve IgM antibodies Involve the activation of complement

Autograft

Involve the activation of complement

Upon delivery, blood type testing is done on the newborn. The newborn is found to have an AB positive blood type. Which of the following reactions may be expected?

No immune response in newborn or mother

People with this blood type are known as "universal donors."

O

Which of the following autoimmune diseases is the most likely diagnosis based upon the patient's presentation?

Systemic lupus erythematosus

MHC class II receptors are found on all of the following EXCEPT

T-Cells

Xenograft

Tissue transplant between individuals of different species

Isograft

Tissue transplant from an identical twin

What type of hypersensitivity do the patient's symptoms demonstrate?

Type III: Immune complex-mediated hypersensitivity

What type of hypersensitivity, mediated by IgE, do the patient's symptoms demonstrate?

What type of hypersensitivity, mediated by IgE, do the patient's symptoms demonstrate?

Intermediate size complexes

activate complement

Inhalant

airborne environmental allergen such as pollen

The patient's initial treatment plan involves all of the following, except:

albuterol inhaler

The RN may anticipate which of the following medications to be initiated for this patient?

all of these

Which of the following organs may be affected in the patient's disease?

all of these

Injectant

allergens such as drugs or venoms that pierce the skin

Ingestant

allergens that enter by mouth

Contactant

allergens that enter through the skin

No Hypersensitivity Reaction Occurs

an An rH positive mother is carrying her first rH positive fetus

An allergy is best described as ____.

an exaggerated immune response

Hypersensitivity or allergy is:

an excessive immune response that damages tissues.

Two key parts of the mechanisms responsible for transfusion reactions are:

antibodies and complement.

Which of the following stimulates cell-bound IgE molecules, resulting in degranulation of mast cells?

antigen

Immune complexes consist of

antigen plus antibody.

Allergens are:

antigens that do not affect some people but trigger extreme reactions in others.

On first exposure to antigen, T helper cells

become activated and increase in number.

All of the following are probable causes for the patient's new-onset of allergies, except:

cat dander

In providing education for this patient, the nurse describes the physiology of an allergic response. What is primarily responsible for her allergy symptoms?

cytokines

In IgE-mediated hypersensitivity, all of the following are needed EXCEPT:

cytotoxic T cells

In the presence of activated complement, neutrophils

degranulate and release enzymes that cause tissue damage

Allograft

exchange between genetically different individuals belonging to the same species

A hapten is an antigen that is capable of causing antibody production on its own.

false

Delayed hypersensitivity is due to the effects of the humoral part of the immune system.

false

True or False: Hemolytic transfusion reactions occur due to underreaction or loss of the immune system.

false

True or False: LPS is responsible for the destruction of red blood cells in this reaction.

false

The antigens that trigger Type II hypersensitivity are typically:

found on cell surfaces.

Select all of the conditions that result from IgE- and mast-cell-mediated allergic reactions.

hay fever allergic asthma food allergy reactions drug allergy reactions eczema

Histamine released by mast cells leads to all of the following symptoms except:

high fever

Please choose the answer that best completes the blanks of this sentence in the correct order. Immunopathology is the study of disease states or immune dysfunctions, which are divided into two categories: ___________ diseases (i.e., allergy) or diseases associated with __________ (i.e., AIDS).

hypersensitivity; immunodeficiency

Allergens that enter by the nose are called ________.

inhalants

IgE molecules attach to ____.

mast cells via their constant region

Which of the following statements by the patient demonstrates an understanding of autoimmune disease?

my body has formed antibodies against itself

Which type of cells produce antibodies?

plasma cells

Antibodies are composed of _____.

proteins

When T helper cells are exposed for the second time to hapten-peptide on antigen-presenting cells, they

release cytokines which attract more macrophages.

What role do cytokines play in this allergic reaction?

they stimulate b cells to proliferate

After complement activation, basophils may degranulate causing vasodilation.

true

The physician orders allergy skin testing to be performed on this patient. Following the antigenic challenge, what observation would indicate a positive atopic sensitivity to the given allergen?

wheel of 15mm