Immune and Integumentary Systems exam questions with correct answers verified by expert 20, Exams of Nursing

Download Immune and Integumentary Systems exam questions with correct answers verified by expert 20 and more Exams Nursing in PDF only on Docsity!

with correct answers verified by expert 2024

1. What are the characteristics of innate immunity?: It is our nonspecific immune system that will immediately engage with anything suspicious, it includes things we are born with such as barriers and mucosal linings
2. What is the first line of defense?: Physical, mechanical and biomedical barriers
3. What are physical barriers included in the first line of defense?: Skin and low temp/pH of skin
4. What are mechanical barriers included in the first line of defense?: Linings of the gastrointestinal, genitourinary and respiratory tracts that do things such as slough off old cells, vomiting, urinating, or have mucous and cilia
5. What are biomechanical barriers included in the first line of defense?: - Things on the skins surface such as secretions that trap or destroy microorganisms (sweat, saliva, tears, earwax etc), antimicrobial peptides that trap and kill or inhibit the growth if disease-causing bacteria, fungi and viruses (the acidic environment of the skin and surfactant in the lungs) and normal microbiome which inhibits colonization of pathogens by secreting chemicals that prevent infection

with correct answers verified by expert 2024

(in vagina and intestines)

6. What is the second line of defense?: Inflammation
7. What are the characteristics of inflammation?: It is a protective response that supports recovery from injury and disease, is activated by an injury to vascularized tissue and the response is initiated by "guardian cells" (mast cells, macrophages and dendritic cells)
8. What causes inflammation?: Infection, mechanical damage, ischemia, nutrient deprivation, temperature extremes and radiation
9. What kind of response in inflammation? What is the purpose of the re- sponse(s)?: Inflammation is a nonspecific response where inflammatory mediators are released and it causes both vascular and cellular responses, together they work to destroy pathogens, limit tissue damage and promote healing
10. Wha is the purpose of inflammatory mediators?: Migration of leukocytes, platelets, plasma proteins and other biochemical mediators from the circulation into the nearby damaged tissue
11. What role do platelets play in inflammation?: They gather at the injury site and bind to WBCs, they help call other WBCs to the area and also

with correct answers verified by expert 2024

release cytokines and chemokines which then differentiate monocytes into macrophages and dendritic cells

12. What are the cardinal signs of inflammation?: Rubor (redness/erythema), calor (heat), tumor (swelling), dolor (pain) and functio laesa (loss of function)
13. What is the cellular response to inflammation?: The inflammatory response is initiated by plasma proteins, mast cells, tissue macrophages, dendritic cells and

with correct answers verified by expert 2024

other leukocytes move out of the blood vessels and travel quickly to the area of invasion or injury

14. What does the movement of all those cells out of the blood vessels in re- sponse to plasma protein initiating inflammation cause?: Blood vessel dilation, increased vascular permeability and leakage, WBC (neutrophils) adherence to the inner walls of the vessels and migration through the vessels (diapedesis)
15. What are the different types of WBCs (leukocytes)?: Neutrophils, lympho- cytes, eosinophils, monocytes, macrophage and basophils
16. Which of those leukocytes (WBCs) are phagocytes?: Monocytes, macrophages and neutrophils
17. What do neutrophils do?: They're the first to respond to bacteria or a virus, they remove debris in sterile lesions and perform phagocytosis of bacteria in nonsterile lesions
18. What do lymphocytes do?: They fight infections by producing antibodies
19. What do eosinophils do?: Known for their role in allergy symptoms
20. What do monocytes do?: They clean up dead cells

with correct answers verified by expert 2024

21. What do basophils do?: Known for their role in asthma
22. What are dendritic cells and what do they do?: They are antigen- presenting cells and they stimulate antigen specific T cell activation and responses
23. What do macrophages do?: They remove apoptic cells and microbes, they are important cellular initiators of inflammation and they help in wound healing
24. What do neutrophils do during inflammation?: They are the most important phagocyte in the cellular response, they arrive early to the scene in high numbers to ingest bacteria, dead cells and cellular debris, they are short lived so once they do their job they become part of the purulent exudate (pus)
25. After neutrophils get to the scene and do their job, what happens next in the inflammation process and when?: 24 hours after the neutrophils get to the scene, monocytes (that are produced in bone marrow) enter the circulation and migrate to the inflammatory site where they differentiate into macrophages and dendritic cells

with correct answers verified by expert 2024

26. How long does it take for large numbers of monocytes to get to the inflammatory site?: 3-7 days
27. How does a monocyte become a macrophage or a dendritic cell?: The monocyte is stimulated by either a cytokine, chemokine, TLR ligands or other things and then it differentiates into a macrophage or a dendritic cell
28. What kinds of macrophages are in tissues?: Kupffer cells (from the liver), alveolar macrophages (from the lungs) and microglia (from the brain)
29. Once in the tissues, what do the cells and chemicals associated with the inflammatory response do?: They prevent and limit infection and further damage, limit and control the inflammatory process, interact with components of the adaptive immune system and prepare the area of injury for healing
30. What is the one other inflammatory response that helps aid in the activa- tion of the inflammatory process?: When there is tissue injury it causes mast cell degranulation which then releases histamines (which triggers an immune response), this causes a vascular response and leads to

with correct answers verified by expert 2024

presentations of inflammation

31. What are the hallmark presentations of inflammation and what they cause?: Vasodilation (causes redness and warmth), increased capillary perme- ability (causes edema), cellular infiltration phagocytosis (causes there to be pus), thrombosis (prevents bleeding) and stimulation of nerve endings (causes pain)
32. What do eosinophils do in inflammation?: They provide defense against parasites and regulate vascular mediators which helps control vascular effects of inflammation
33. What do basophils do in inflammation?: Are similar to mast cells but are not the same, they are an important source for cytokine IL-4 and are associated with allergies and asthma, their role in inflammation is uncertain
34. What are natural killer cells (NK)?: They recognize and eliminate cells that are infected with viruses and cancer ells in the blood
35. What are the explicit vascular responses to injury that causes inflamma- tion?: Vasodilation of the capillaries, increased capillary permeability and increased blood flow to the area

with correct answers verified by expert 2024

36. What are the 3 kinds of plasma proteins activated as one of the initial activators of inflammation?: Complement, clotting factors and kinins
37. What is the third line of defense?: Adaptive immunity
38. Is our adaptive immunity acquired actively or passively?: It is acquired actively
39. What are the basic characteristics of adaptive immunity?: It allows the body to recognize an antigen (foreigner), target the antigen and limit response to an antigen, it has a memory after the first exposure to an antigen so the response is more rapid if there is a second encounter, it has to ability to determine self from non-self and can be actively or passively acquired
40. Lymphocytes are a leukocyte (WBC), what is their main function?: They are the main components of the adaptive immune system response
41. What are B lymphocytes and what do they do?: They're a WBC that produces antibodies (humoral immunity) and they attack pathogens outside of the cell
42. What are T lymphocytes and what do they do?: They're a WBC that

with correct answers verified by expert 2024

plays a role in cellular immunity, they rely on antigen presenting cells, they are intracellular (work inside the affected cell) and they kill viruses and cancers from inside the cell

43. What is something important about the relationship of B and T lympho- cytes?: They work together
44. What is humoral immunity?: Immunity that works by sending out important antibodies
45. What does humoral immunity do and where does it take place?: Antibodies patrol the body "humors" (fluids like blood and lymph) and fight off viruses and bacteria moving around in the interstitial space between the cells
46. How does the adaptive immune system get activated?: Antigens are large signaling molecules that are not normally found in the body, they act as flags that stimulate the adaptive immunity process
47. Where are B lymphocytes produced and where do they mature?: They are produced and mature in the bone marrow
48. What skills do B lymphocytes acquire as they mature?: The ability to detect an antigen, immunocompetence and self-tolerance

with correct answers verified by expert 2024

49. What is immunocompetence?: The ability to recognize and bind to a particular antigen
50. What is self-tolerance?: Knowing how to not attack your own bodies cells
51. When will B lymphocytes become activated?: Once one of the antibodies the B lymphocyte presents on its membrane interact with their corresponding antigen on a pathogens membrane
52. What happens when a B lymphocyte gets activated?: Once it finds the antigen that corresponds to its antibody, it binds to it and then the lymphocyte goes crazy replicating itself quickly to produce a lot of similar cells with instructions for the exact same antibodies that are designed to fight that one particular antigen
53. What are the roles of the clones being made by the B lymphocytes?: Most become effector cells (active fighters), some become memory B cells
54. Do antibodies kill the antigen and the pathogen?: No, antibodies cannot do the killing themselves, but they do make it hard for intruders to take hold by the processes of neutralization and agglutination

with correct answers verified by expert 2024

55. What is neutralization?: When antibodies physically block the binding sites on viruses or bacterial toxins so they cannot bind to your tissues
56. What is agglutination?: When antibodies use their multiple binding sites to bind to multiple antigens at once (neutralization to more than one antigen at once), the clumps of antigens don't move as well which makes it easier for the macrophages to come and eat them
57. What are antibodies also doing while they block the antigens from binding to your tissues?: They are calling in phagocytes from the innate immune system and special lymphocytes from the adaptive immune system to destroy the antigens in the antigen-antibody clumps
58. What is the whole process described above with the B lymphocytes called?: Active humoral immunity
59. What is one downside to antibodies that are acquired passively?: They don't produce memory cells until after they encounter the cell for the first time
60. What is cell mediated immunity?: An immune response that happens when all other immunities have failed and the cells have been breached by pathogens, now cells will fight cells

with correct answers verified by expert 2024

61. What do T lymphocytes do?: They go after body cells that have been hijacked by things like viruses, bacteria or that have become cancerous
62. What do T lymphocytes cause?: Inflammation, activation of macrophages, activate other T lymphocytes and regulate much of the immune response
63. In your innate and acquired immune responses, what do macrophages do once they have destroyed a pathogen and what is the result called?: They wear the proteins of the broken up pathogen on the outside of their cell, they are called major histocompatibility complexes (MHCs)
64. What are cells that present MHCs called?: Professional antigen presenting cells
65. What cells have MHCs? What is the purpose?: All cells have a class- MHC, it shows other cells that it is normal, cells that are presenting proteins other than a class-1 MHC are basically asking to be killed
66. What 3 kinds of cells wear class-2 MHC proteins?: Macrophages, dendritic cells and b lymphocytes
67. What do class-2 MHC proteins do?: They bind to fragments of exogenous antigens (like a virus that been engulfed, broken up and

with correct answers verified by expert 2024

displayed to get the attention of other cells)

68. Why are MHCs essential to the cellular immune response?: The T lympho- cytes cannot actually detect the whole antigen, they can only recognize them when they are diced up and are decorating the outside of an antigen presenting cell
69. Where are t lymphocytes produced and where do they mature?: They are produced in the bone marrow and mature in the thymus
70. What are the two kinds of T lymphocytes?: Helper T cells and cytotoxic T cells
71. What do helper T cells do?: They don't actually kill but they activate cells that do the killing and they call the shots for the whole adaptive immune response
72. What do cytotoxic T cells do?: They kill the infected cells
73. What will helper T cells bind to?: They will only bind to 1 specific combination of a class-2 MHC protein and a particular antigen
74. What happens when a helper T cell does bind?: It gets activated and then it goes crazy replicating itself which makes some memory T cells and regulatory T cells while also alerting other cells of the problem by

with correct answers verified by expert 2024

releasing cytokines

75. What do cytotoxic T cells do when they encounter a cell that is presenting pathogen protein on their class-1 MHCs?: The cytotoxic T cells see that as a white flag, that the cell is surrendering for death, so it will bind to the affected cell and punch holes in the membrane by releasing enzymes (granzymes and perforins) which causes apoptosis, the cytotoxic T cell then detaches and goes to find more cells to kill
76. What is the negative effect of an hyperactive immune system?: It cannot distinguish between self and non-self cells
77. What do regulatory T cells produced by T lymphocyte replication after binding to a class-2 MHC and antigen do?: They help prevent a hyperactive immune system by releasing inhibiting cytokines that tell other immune cells to stand down once the initial threat has been handled
78. What are some characteristics of a newborns innate immunity?: Their innate immunity is suppressed, they are more at risk for infection, sepsis and meningitis
79. What are some characteristics of an elderly persons innate immunity?: -

with correct answers verified by expert 2024

Immunity decreases with aging, this puts the elder at higher risk for infections and chronic inflammatory disease, their immune response is slower and they are also slower to heal

80. What are the 5 types of antibodies?: IgA, IgD, IgE, IgG and IgM
81. What does IgA do?: Is found in secretions like mucous, saliva and tears, it can bind to an inactivate pathogens in the mucous
82. What does IgD do?: Functions as a B cell receptor of antigens on early B cells
83. What does IgE do?: Is expressed by B cells and plasma cells when the immune system is primed against a foreign antigen, it causes mast cells to release histamine and other chemicals into the bloodstream which can trigger an allergic reaction (commonly found in parasitic infections)
84. What does IgG do?: Is the most common and it roams around the extracellular fluid looking for pathogens to flag so other immune cells can recognize or activate the complementing system
85. What does IgM do?: Is the first antibody produced by B cells in response to a bacterial infection, it is found on the surface of mature B cells and binds to the complimentary pathogen causing

with correct answers verified by expert 2024

agglutination

86. What is a human leukocyte antigen (HLA)?: An HLA is a protein that acts as a marker on most cells in the body (all except RBCs), that the immune system uses to determine whether the cells are apart of the body or not (it is an MHC)
87. What role do HLAs play in organ transplantation?: The donor and the receiv- er's HLAs have to be matched as closely as possible to one another for a successful outcome 88. What kind of responses are primary and secondary immune responses?- : They are cellular responses
88. What is a primary immune response?: It it when your body encounters an antigen for the first time, there is a lag period after exposure and then it usually takes 5-7 days for IgM antibodies to be detected in circulation which is followed by IgG production for the same antigen (the amount of IgG may be the same or a little less than the IgM)
89. What is a secondary immune response?: It is the second time your body encounters a pathogen at another time, there is a rapid increase of IgG and there is much more than in a primary immune response but

with correct answers verified by expert 2024

IgM levels look identical to levels in a primary response

91. What are some alterations of acquired immunity in newborns?: They have passive acquired immunity, they get it before birth through the placenta and then from colostrum after birth and newborn T cells do not have the adaptive character- istics of a normal adaptive immune cell so their T cells work in an innate immune response way where it is rapid and nonspecific
92. What are some alterations of acquired immunity in the elderly?: It is slower to respond and they have a harder time fighting things off due to the slow response time
93. What are the layers of the skin from exterior to interie?: The epidermis, dermis and hypodermis which is the subcutaneous tissue
94. What are the functions of the skin?: Provides a protective barrier, acts as a sensory organ, prevents loss of moisture and reduces harmful effects of UV rays
95. What are the 4 phases of wound healing?: Hemostasis, inflammatory, prolif- erative and remodeling
96. What happens during the hemostasis stage of wound healing?: Coagu-

with correct answers verified by expert 2024

lation, we need to clot off blood to stop the bleeding, platelets, neutrophils and macrophages enter the surrounding tissue, fibrin mesh of blood clot acts as scaf- folding and platelets release growth factors

97. What happens during the inflammatory stage of wound healing?: Inflamma- tion, a scab starts to form, fibroblasts, neutrophils and macrophages are circulating in the tissue near the injured area (to clean it up and heal or help with growth depending on the cell), the blood vessel under the injury site is leaky to let those cells in, lymph drains away debris and debridement occurs
98. What happens during the proliferative stage of would healing?: Fibroblasts proliferate (synthesized by collagen) which causes the production of new tissue to start forming from the bottom up (starts 3-4 days after injury and lasts for 2 weeks), there is new capillary formation, cells from healthy tissue grow into the wound (epithelialization), wound contracts through the actions of myofibroblasts anf cellular differentiation occurs

with correct answers verified by expert 2024

99. What happens in the remodeling stage of wound healing?: The dermis and epidermis are freshly healed and need to heal because new skin loses its elasticity can be easily reopened, can least several weeks to years, cellular differentiation continues, scar tissue forms and scar remodeling occurs
100. What is the difference between wound healing by primary or secondary intention?: We want wounds to heal/close with primary intention but some are too deep or too wide so they will heal/close with secondary intention which is when the new tissues grow from the bottom up to the top before the new skin grows
101. What are different ways wounds can be held together in primary intention healing?: With sutures, staples, steri strips etc
102. Wha is tertiary intention wound healing?: When you let the wound close up a little bit with secondary intention and then if there are no problems such as edema, infection, foreign bodies or granulating tissue then the wound can be closed like in primary intention (there is less scarring than secondary intention this way)
103. In a wound that closes with secondary intention, what is happening

with correct answers verified by expert 2024

under the new epithelium when it closes and is healing in the healing stage?: The wound is contracting underneath the skin even though the wound is closed

104. What are some characteristics of a chronic wound?: Increased infection, impaired fibroblast migration, impaired angiogenesis (blood vessel production), missing growth chemicals and/or impaired ECM synthesis
105. What are some characteristics of dysfunctional wound healing where the wound is stuck in persistent inflammation?: Theres infection, oxidative stress, decreased angiogenesis and increased amounts of reactive oxygen species, pro-in- flammatory signals and macrophages
106. What are some causes of dysfunctional wound healing other than per- sistent inflammation?: Ischemia, excessive bleeding, diabetes mellitus, obesity inadequate nutrition, some drugs and smoking
107. What is the pneumonic used (and its parts) for healing problems?: DIDNT HEAL, D:diabetes, I:infection, D:drugs, N:nutrition, T:tissue necrosis, H:hypoxia, E:excessive tension on wound edge, A:another wound, L:low temperature

with correct answers verified by expert 2024

108. What are the 6 types of pressure injuries?: Stage 1, 2, 3, 4, suspected deep tissue injury and unstageable
109. What does a stage 1 pressure wound look like?: Non-blanchable redness of the skin
110. What does a stage 2 pressure injury look like?: Partial thickness skin loss, exposed dermis but shallow
111. What does a stage 3 pressure injury look like?: Full thickness skin loss, there is sloughing and it is deep, it enters the subcutaneous tissue
112. What does a stage 4 pressure injury look like?: Full thickness tissue loss, there is exposed muscle and tendons and can even be down to the bone
113. What does an unstageable pressure injury look like?: Can have up to full thickness tissue loss but is covered by necrotic tissue so we cannot see the depth/range of the injury
114. What does a suspected deep tissue injury look like?: The depth is un- known, the skin is a maroon or deep purple color, dermis is intact, it is non-blanching and the skin feels boggy

with correct answers verified by expert 2024

115. What are stage 2 pressure injuries commonly mistaken for?: Skin tears
116. What leads to hypersensitivity reactions?: Excessive or misdirected adap- tive immune responses that cause injury or disease to the host, they can be mild or life threatening, there are 4 types and they can often occur at the same time
117. What are the 3 types of hypersensitivity disorders?: Allergy, autoimmunity and alloimmunity
118. What is the hypersensitivity disorder, allergy?: An immune response that is exaggerated against noninfectious environmental substances
119. What is the hypersensitivity disorder, autoimmunity?: An immune re- sponse that is misdirected against the bodies own cells
120. What is the hypersensitivity disorder, alloimmunity?: An immune response directed against beneficial foreign issues such as transfusions or transplants
121. Whats an immediate hypersensitivity reaction?: A reaction that occurs with- in minutes to hours, an example is anaphylaxis which can

with correct answers verified by expert 2024

be systemic or cutaneous

122. What is a delayed hypersensitivity reaction?: A reaction that takes several hours to appear, the maximum severity occurs days after re- exposure to the antigen (such as poison ivy exposure)
123. What are the 4 types of hypersensitivity reactions?: Type 1: Anaphylaxis, Type 2: Cytotoxic, Type 3: Immune-complex, Type 4: Delayed (ACID)
124. What mediates each type of hypersensitivity reaction?: Type 1: IgE mediat- ed, Type 2: Tissue specific reactions mediated, Type 3: Immune- complex mediated, Type 4: Cell mediated
125. How do Type 1: Anaphylaxis hypersensitivity reactions work?: IgE an- tibodies bind to receptors on the surface of mast cells during the sensitization phase (when it has encountered the pathogen), after IgE binds, the mast cells release histamine from mast cell degeneration and they also synthesize secondary mediators such as leukotrienes, prostaglandins and platelet activating factor that act slower but have similar effects as histamine, the release of histamine causes the allergic reaction to take place

with correct answers verified by expert 2024

126. What is another name for the antigen that causes this allergic reaction to take place?: Allergens
127. What are some examples of allergens?: Pollen, molds/fungi, foods like eggs or milk, animals, cigarette smoke and components of house dust
128. What are some examples of Type 1 hypersensitivity reactions?: Allergic rhinitis, asthma, anaphylaxis and atopic dermatitis (eczema)
129. How likely are children to develop allergies if one of their parents already has an allergy to it? Two parents?: 40%, 80%
130. What regulates the synthesis of IgE antibodies that are needed for a Type 1: Anaphylaxis hypersensitivity reaction?: Cytokines
131. What is something important to not about histamine and its manifesta- tions after its released?: There is 2 types of histamine, H1 and H2 and they have different manifestations but they can occur in an antagonistic fashion at the same time
132. What are the manifestations of histamine 1 in a Type 1 hypersensitivity reaction?: Smooth muscle contraction that causes bronchial constriction, edema, vasodilation and permeability

with correct answers verified by expert 2024

133. What are the manifestations of histamine 2 in a Type 1 hypersensitivity reaction?: Increases gastric secretions and decreases the release of histamine from mast cells and basophils which is anti- inflammatory
134. How do Type 2: Cytotoxic hypersensitivity reactions work?: They are generally immune reactions against a specific cell or tissue, antibodies (IgG and IgM) target cells coated with the specific antigen on cell membranes causing cell destruction and phagocytosis
135. What are some examples of a Type 2: Cytotoxic hypersensitivity reac- tion?: An acute transfusion reaction and hemolytic disease of the newborn
136. How do Type 3: Immune complex hypersensitivity reactions work?: An unidentifiable (soluble) antigen combines with antibodies (immunoglobulins) within the circulation of blood or body fluids and is deposited in the tissues (vessel walls), this is called an immune complex and they cause local or systemic organ dysfunction
137. What the outcomes of systemic organ dysfunction caused by a Type 3: immune complex hypersensitivity reaction?: Systemic lupus