Chamberlain NR507 Midterm Exam, Exams of Advanced Education

Chamberlain NR507 Midterm Exam

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2025/2026

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Chamberlain NR507 Midterm Exam
Type 1 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - "Allergic reaction"
- Mediated by IgE.
- Inflammation d/t mast cell degranulation.
- Hay fever, hives (uticaria).
- Local s/s: itching, rash.
- Systemic: wheezing.
- Severe, systemic reaction: anaphylaxis: hypotension, severe bronchoconstriction.
- Main tx: epinephrine.
Type 2 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - Cytotoxic reaction;
tissue specific
- Macrophages are the primary effectors cells involved
- Causes tissue damage or alters function
- Examples: 1) Grave's disease- example of altering thyroid function, doesn't
destroy thyroid tissue. 2) ABO incompatibility- example of cell/tissue damage;
severe transfusion reaction occurs & the transfused erythrocytes are destroyed by
agglutination or complement-mediated lysis.
Difference between type 2 & 3 hypersensitivity reactions - CORRECT ANSWER
โœ”โœ”โœ” - Type 2: organ specific; antibody binds to the antigen on the cell surface.
- Type 3: not organ specific; 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.
Type 3 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - Immune complex
- Antigen-antibody complex deposited in the tissues
- Neutrophils are the primary effector cell
- Causes autoimmune diseases
- Examples: rheumatoid arthritis (joints), systemic lupus erythematosus (SLE,
organs)
Systemic Lupus Erythematosus (SLE) - CORRECT ANSWER โœ”โœ”โœ” - Facial rash
confined to the cheeks (malar rash)
- Discoid rash (raised patches, scaling)
- Photosensitivity (skin rash d/t sunlight exposure)
- Oral or nasopharyngeal ulcers
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Chamberlain NR507 Midterm Exam

Type 1 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - "Allergic reaction"

  • Mediated by IgE.
  • Inflammation d/t mast cell degranulation.
  • Hay fever, hives (uticaria).
  • Local s/s: itching, rash.
  • Systemic: wheezing.
  • Severe, systemic reaction: anaphylaxis: hypotension, severe bronchoconstriction.
  • Main tx: epinephrine. Type 2 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - Cytotoxic reaction; tissue specific
  • Macrophages are the primary effectors cells involved
  • Causes tissue damage or alters function
  • Examples: 1) Grave's disease- example of altering thyroid function, doesn't destroy thyroid tissue. 2) ABO incompatibility- example of cell/tissue damage; severe transfusion reaction occurs & the transfused erythrocytes are destroyed by agglutination or complement-mediated lysis. Difference between type 2 & 3 hypersensitivity reactions - CORRECT ANSWER โœ”โœ”โœ” - Type 2: organ specific; antibody binds to the antigen on the cell surface.
  • Type 3: not organ specific; 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. Type 3 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - Immune complex
  • Antigen-antibody complex deposited in the tissues
  • Neutrophils are the primary effector cell
  • Causes autoimmune diseases
  • Examples: rheumatoid arthritis (joints), systemic lupus erythematosus (SLE, organs) Systemic Lupus Erythematosus (SLE) - CORRECT ANSWER โœ”โœ”โœ” - Facial rash confined to the cheeks (malar rash)
  • Discoid rash (raised patches, scaling)
  • Photosensitivity (skin rash d/t sunlight exposure)
  • Oral or nasopharyngeal ulcers
  • Hematologic disorders (hemolytic anemia, leukopenia, lymphopenia, thrombocytopenia)
  • Immunologic disorders
  • Non-erosive arthritis of at least two peripheral joints
  • Serositis (pleurisy, pericarditis)
  • Renal disorder
  • Neurologic disorders (seizures, psychosis)
  • Presence of antinuclear antibody (ANA) Autoimmunity - CORRECT ANSWER โœ”โœ”โœ” - 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 (autoimmune and allergic reactions). Alloimmunity - CORRECT ANSWER โœ”โœ”โœ” - General term used to describe when an individual's immune system reacts against antigens on the tissues of other members of the same species.
  • Examples: Neonatal disease where the maternal immune system becomes sensitized against antigens expressed by the fetus, Transplant rejection, Transfusion reaction. Type 4 Hypersensitivity Reaction - CORRECT ANSWER โœ”โœ”โœ” - T-cell mediated
  • Lymphocytes
  • Does not involve antigen/antibody complexes
  • Delayed response
  • Ex: localized contact dermatitis. Treated with a topical corticosteroid (wouldn't use antihistamine since Type 4 doesn't involve mast cells and H1 receptors). Differentiating between the rash of a Type 1 vs Type 4 Reaction - CORRECT ANSWER โœ”โœ”โœ” - Type 1: Immediate hypersensitivity reactions, termed atopic dermatitis, are usually characterized by widely distributed lesions.
  • Type 4: 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 1 = Immediate -Type 4 = Delayed: Several days following contact, ex- poison ivy
  • Risk factor: older adults, H. Pylori infection, d/o affecting b-12 absorption, vegetarian/vegan
  • Lab values: low B-12, high MCV (macrocytic), normal MCHC (normochromic), low reticulocyte, and normal or high iron Hemolytic Anemia - CORRECT ANSWER โœ”โœ”โœ” - Destruction/lysis of red blood cells.
  • Causes: transfusion reaction (cytotoxic type 2), autoimmune reaction, drug- induced (allergic reaction) Acute blood loss anemia - CORRECT ANSWER โœ”โœ”โœ” - Trauma victims who are losing blood Aplastic Anemia - CORRECT ANSWER โœ”โœ”โœ” - Characterized by an absence of all formed blood elements caused by the failure of blood cell production in the bone marrow.
  • Diagnosis is made by blood tests and bone marrow biopsy.
  • Suspected if levels of circulating erythrocytes, leukocytes, and platelets are diminished. Sickle Cell Anemia - CORRECT ANSWER โœ”โœ”โœ” - Have sickle cell trait; caused by a mutation in the HBB gene that leads to the production of abnormal hemoglobin.
  • Autosomal recessive disorder; both parents must contribute an abnormal gene for a child to have the disorder. Thalassemia - CORRECT ANSWER โœ”โœ”โœ” - Inherited blood disorder that causes decreased circulating hemoglobin.
  • Many possible genetic mutations. Aortic Valve - CORRECT ANSWER โœ”โœ”โœ” - Valve located between the left ventricle and the aorta. Mitral Valve - CORRECT ANSWER โœ”โœ”โœ” - The valve between the left atrium and the left ventricle of the heart. Pulmonary Valve - CORRECT ANSWER โœ”โœ”โœ” - Valve positioned between the right ventricle and the pulmonary artery. Normal Blood Flow Through the Heart - CORRECT ANSWER โœ”โœ”โœ” Superior & Inferior vena cava -> Right atrium -> Tricuspid valve -> Right ventricle -> Pulmonary valve -> Pulmonary artery -> Lungs -> Left atrium -> Mitral valve -> Left ventricle -> Aortic valve -> Aorta -> Body. Tricuspid Valve - CORRECT ANSWER โœ”โœ”โœ” - Valve between the right atrium and the right ventricle. Cardiac Output (CO) - CORRECT ANSWER โœ”โœ”โœ” - The volume of blood pumped by each ventricle per minute.
  • Cardiac output (mL/min) = stroke volume (mL/beat) x heart rate (beats/min) Preload - CORRECT ANSWER โœ”โœ”โœ” - Amount of stretch that the cardiac muscle exhibits at the end of ventricular filling.
  • More volume -> more stretch = higher preload
  • "fluid" Afterload - CORRECT ANSWER โœ”โœ”โœ” - The force which the heart must contract against in order to pump blood.
  • aka systemic vascular resistance
  • "pressure" Hypertension has its most immediate effect on ___________. - CORRECT ANSWER โœ”โœ”โœ” Afterload Heart Failure - CORRECT ANSWER โœ”โœ”โœ” - Underlying patho: cardiac output < body's oxygen demands.
  • Overtime: decreased contractility, decreased stroke volume, increased left ventricular end-diastolic volume (LVEDV).
  • Causes dilation of the heart & increase in preload.
  • Major risk factor: long-standing hypertension Right-sided Heart Failure - CORRECT ANSWER โœ”โœ”โœ” - Inability of the right ventricle to provide adequate blood flow into pulmonary circulation.
  • Can occur due to left-sided HF d/t the back up of fluid from the left side to the right.
  • Can occur b/c of long-standing pulmonary issues (COPD).
  • S/S: right jugular venous distention, peripheral edema, hepatosplenomegaly Stages of Heart Failure (ACC/AHA) - CORRECT ANSWER โœ”โœ”โœ” - Stage A: patient has risk factors (CAD) but no symptoms; no structural heart damage.
  • Stage B: patient has structural heart damage (MI), but still no symptoms.
  • Stage C: patient is symptomatic with alteration in their daily functions due to dyspnea, swelling, etc. This is where their NYHA functional classifications come into play.
  • Stage D: end-stage heart failure- have maximized medications to treat it- may need heart transplant or pacemaker NYHA Functional Classifications - CORRECT ANSWER โœ”โœ”โœ” - Stage I: mild; no limitation of physical activity; ordinary physical activity doesn't cause symptoms.
  • Restrictive: low FVC, low FEV1, normal or >70% FEV1/FVC ratio, low TLC. Ex- interstitial lung disease. Asthma - CORRECT ANSWER โœ”โœ”โœ” - Constricted airways; chronic obstructive disease.
  • Intrinsic: triggered by non-allergic factors (chemicals, airborne irritants, infections, exercise, stress, chemicals), more common in adults.
  • Extrinsic: triggered by chronic allergic factors (pollen, dust mites, pet dander), elevated IgE, more common in children.
  • Mild/intermittent form: short-acting beta 2-agonist inhalers are prescribed.
  • Mild/persistent asthma will have night symptoms 3-4x/mo. Chronic obstructive pulmonary disease (COPD) - CORRECT ANSWER โœ”โœ”โœ” - Diagnosis is based on hx of symptoms, physical exam, chest imaging, pulmonary function tests, and blood gas analyses.
  • PFTs reveal airway obstruction (decreased FEV1) that is progressive and unresponsive to bronchodilators.
  • Includes Emphysema and Chronic Bronchitis COPD Classification: GOLD Criteria - CORRECT ANSWER โœ”โœ”โœ” - GOLD 1: Mild: FEV โ‰ฅ 80% predicted.
  • GOLD 2: Moderate: 50% โ‰ค FEV1 <80% predicted.
  • GOLD 3: Severe: 30% โ‰ค FEV1 <50% predicted.
  • GOLD 4: Very severe: FEV1 <30% predicted. Emphysema - CORRECT ANSWER โœ”โœ”โœ” - Damage occurs in the alveoli; impairs gas exchange.
  • Issue w/expiration; can get air in but cannot get it out -> air trapping.
  • S/S: pursed lip breathing, increased AP diameter, barrel chest, flattened diaphragm.
  • "pink puffer" Chronic Bronchitis - CORRECT ANSWER โœ”โœ”โœ” - Damage occurs in the airway (not alveoli).
  • S/S: productive cough with copious amounts of sputum, dyspnea, wheezing, rhonchi, and cyanosis of the skin & mucous membranes
  • "blue bloater" What type of hypersensitivity reaction is: child develops systemic anaphylaxis after eating peanut butter - CORRECT ANSWER โœ”โœ”โœ” Type 1 Hypersensitivity reaction

(Allergic/IgE mediated) What type of hypersensitivity reaction is: adult develops rejection of a transplanted heart - CORRECT ANSWER โœ”โœ”โœ” Type IV Hypersensitivity reaction (cell-mediated) What type of hypersensitivity reaction is: adult develops rash on legs from poison ivy after hiking in shorts - CORRECT ANSWER โœ”โœ”โœ” Type IV Hypersensitivity reaction (Cell-mediated) What type of hypersensitivity reaction is: adult develops hemolysis after mismatched blood transfusion - CORRECT ANSWER โœ”โœ”โœ” Type II Hypersensitivity reaction (Tissue-specific) Folate deficiency anemia is associated with chronic malnourishment and chronic abuse of __________. - CORRECT ANSWER โœ”โœ”โœ” Alcohol When describing the appearance of erythrocytes, terms that end with _________ refer to the hemoglobin content and terms that end with ________ refer to cell size. - CORRECT ANSWER โœ”โœ”โœ” -chromic -cytic Appearance of erythrocytes: iron deficiency anemia - CORRECT ANSWER โœ”โœ”โœ” microcytic, hypochromic Appearance of erythrocytes: aplastic anemia - CORRECT ANSWER โœ”โœ”โœ” normocytic, normochromic Appearance of erythrocytes: pernicious anemia (b-12 deficiency) - CORRECT ANSWER โœ”โœ”โœ” Macrocytic, normochromic Appearance of erythrocytes: folate deficiency anemia - CORRECT ANSWER โœ”โœ”โœ” macrocytic, normochromic Serum ferritin levels are used to evaluate _______ status when diagnosing anemia. - CORRECT ANSWER โœ”โœ”โœ” Iron Clinical manifestations of left heart failure - CORRECT ANSWER โœ”โœ”โœ” - Orthopnea

  • Dyspnea
  • Coughing pink, frothy sputum
  • Crackles upon auscultation
  • Pulmonary edema Clinical manifestations of right heart failure - CORRECT ANSWER โœ”โœ”โœ” - Ankle edema