NUR 228 Exam 1

Question 1

Hypersensitivity

Answer 1

a NORMAL immune response that is inappropriately triggered OR excessive OR produces undesirable effects on the body.

Question 2

What are two basic triggers?

Answer 2

antigen-antibody reaction
antigen-lymphocyte interaction

Question 3

What is in common between types I, II, III hypersensitivity reactions?

Answer 3

they are all mediated by antibodies produced by B cells
-specifically PLASMA cells

Question 4

What causes type IV hypersensitivity

Answer 4

mediated by T cells

Question 5

What kind of hypersensitivity reactions does meds typically cause?

Answer 5

type I and IV

Question 6

What type of hypersensitivity reaction does PCN cause

Answer 6

all four types

Question 7

What kind of mediated reaction is type I

Answer 7

IgE mediated reaction

Question 8

Type I hypersensitivity reaction

Answer 8

caused by B cells
Immediate reaction
occurs after being sensitized to an antigen

Question 9

what antigens cause type I hypersensitivity?

Answer 9

environmental(pet dander, bee stings)
Foods (nuts, seafood, eggs)
Medications (penicillin, contrast dye)

Question 10

What are key immune cells involved in Type 1 reaction?

Answer 10

B lymphocytes
IgE (antibody)
Mast cells (granulocyte)

Question 11

Etiology of Type 1

Answer 11

Genetic link
1 parent allergic=30%
2 parents allergic= 50%

Question 12

What is the pathogenesis of type 1?

Answer 12

-person exposed
-IgE antibody made
-IgE antibody attaches to mast cell
-person exposed again
-allergen binds to the IgE antibodies that are attached to the mast cells
-triggers the release of chemical mediators from the mast cell

Question 13

Potent vasodilation causes

Answer 13

stuffy nose
lower blood pressure
wheals on skin

Question 14

Increased vascular permeability causes

Answer 14

edema
runny nose

Question 15

Bronchial smooth muscle constriction causes

Answer 15

breathing difficulties
wheezing

Question 16

Stimulates irritant receptors causes

Answer 16

itching

Question 17

Atopic reactions

Answer 17

local
inherited tendency to become sensitive to allergens
Ex: allergic rhinitis, asthma, urticaria(hives)

Question 18

Anaphylactic reaction

Answer 18

systemic
life threatening because of bronchial constriction, airway obstruction, vascular collapse.
treat quickly

Question 19

Most common triggers of atopic and anaphylactic reactions?

Answer 19

Atopic: pollen, dust, mold, animal dander
Anaphylactic: meds, bee stings, foods

Question 20

What causes the symptoms from a type 1 hypersensitivity reaction?

Answer 20

release of chemical mediators

Question 21

What is type II caused by?

Answer 21

b-cells

Question 22

Etiology of Type II reactions

Answer 22

exposure to antigen or foreign tissue/cells
antigens are located on cell surface

Question 23

What are the key characteristics of a type II reaction

Answer 23

-antigens stimulate antibody production
-antibodies recognize and attach to cell surface antigens
-direct destruction of targeted cells that contain the antigen
——-cell lysis
——-phagocytosis

Question 24

what immune cells are involved with a type II reaction?

Answer 24

antibodies (IgG and IgM)
complement
WBCs (phagocytes)

Question 25

what are the examples of antigens of type II

Answer 25

blood some of your body's own cells (autoimmune) erythroblastosis fetalis

Question 26

What are some example disorders from type II

Answer 26

blood transfusion reaction newborn/mother Rh incompatibility autoimmune disorders certain drug reactions

Question 27

What are some examples of type II manifestations of a transfusion rx?

Answer 27

Fever Chills angina N/V restlessness and anxiety headache

Question 28

What kind of reaction is type III?

Answer 28

Immune complex reaction

Question 29

Key characteristics of type III hypersensitivity

Answer 29

antigen-antibody COMPLEXES (attach to each other) form deposit into tissues inflammatory response causes tissue damage

Question 30

Etiology of Type III HSRx?

Answer 30

autoimmune low grade infection inhaled antigens from molds or contaminated plants

Question 31

What are possible offending antigens for type III?

Answer 31

bodys own tissues/dna Inhaled antigens from mold or contaminated plants bacteria or viruses

Question 32

What are key immune cells involved in type III sensitivity?

Answer 32

IgG and IgM antibodies that clump with antigens complement neutrophils and mast cells

Question 33

Type III Pathogenesis?

Answer 33

antigen-antibody complex formed in blood deposits in tissue activation of complement + chemoattraction of neutrophils Fc Receptor Release of enzymes and free radicals Tissue distruction

Question 34

What are clinical manifestations of Type III?

Answer 34

depends on where the complexes are deposited in the tissue Rheumatoid arthritis: joints Glomerulonephritis: kidney failure Systemic lupus erythematosus: skin and organs

Question 35

What are the primary differences between type II and type III?

Answer 35

type II- reactions occur on the cell surface and result in direct cell death or malfunction type III- immune complexes are deposited into tissues and the resulting INFLAMMATION destroys the tissue

Question 36

What is type IV hypersensitivity?

Answer 36

Delayed hypersensitivity

Question 37

What are key characteristics of Type IV hypersensitivity

Answer 37

delayed hypersensitivity response NO antibody involvement

Question 38

What are key immune cells for type IV

Answer 38

T cells Cytokines Mast cells and macrophages

Question 39

Etiology of type IV

Answer 39

delayed cellular reaction to an antigen

Question 40

What are some antigens for type IV

Answer 40

plant oils cosmetics nickel tuberculin organ transplant skin graft

Question 41

Type IV pathogenesis

Answer 41

small incomplete antigen (hapten) penetrates the skin Hapten combines with human protein to form the complete antigen T cells become aware of antigen T cells attack the antigen via: -direct attack of t cell -release of cytokines -macrophages

Question 42

what are clinical manifestations of type IV

Answer 42

generally peak 48-72 hours contact dermatitis tuberculin hypersensitivity

Question 43

Autoimmunity

Answer 43

the immune system recognizes "self" cells as foreign an immune responses is initiated your bodies own tissues are injured

Question 44

Etiology of autoimmunity

Answer 44

genetic factors environmental triggers

Question 45

antigenic mimicry

Answer 45

some viruses/bacteria look like "self" self cells similar to these foreign cells are attacked

Question 46

Risk factors of autoimmunity

Answer 46

over age 50 genetics female African american, hispanic, asian, native american viral bacterial infections