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Portage Pathophysiology Module 3 Problem Set, Exams of Advanced Education

Chamberlain College of NursingAdvanced Education

Portage Pathophysiology Module 3 Problem Set

Typology: Exams

2025/2026

Available from 04/02/2026

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Portage Pathophysiology Module 3
Problem Set
Immunity - CORRECT ANSWER โœ”โœ”โœ” protection from infectious disease
Immune response - CORRECT ANSWER โœ”โœ”โœ” The coordination of cells to provide
protection
Innate immunity - CORRECT ANSWER โœ”โœ”โœ” AKA - natural immunity: is the first line
of defense.
- This type of defense is in place before an infection takes place and can function
immediately. It is comprised of physical, chemical, cellular, and molecular defenses.
- It is generalized and non-specific
How does the skin act as a physical barrier? - CORRECT ANSWER โœ”โœ”โœ” The skin's
design makes it a strong physical barrier.
- It has closely packed cells in multiple layers that are continuously being shed.
- Keratin covers the skin, which creates a salty, acidic environment inhospitable to
microbes.
- It also contains antimicrobial proteins and lysozymes that inhibit microorganisms
and help to destroy them.
What cells are involved in innate immunity? - CORRECT ANSWER โœ”โœ”โœ” -
neutrophils
- macrophages
- dendritic cells (DC)
- natural killer (NK) cells
- intraepithelial lymphocytes
Where are cells of innate immunity derived from? - CORRECT ANSWER โœ”โœ”โœ”
hematopoietic stem cells in the bone marrow
Leukocytes - CORRECT ANSWER โœ”โœ”โœ” White blood cells that are heavily involved in
innate immune response
What are the 2 categories of leukocytes?
What type of leukocyte goes in each category? - CORRECT ANSWER โœ”โœ”โœ”
Granulocytes: (contain granules)
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Portage Pathophysiology Module 3

Problem Set

Immunity - CORRECT ANSWER โœ”โœ”โœ” protection from infectious disease Immune response - CORRECT ANSWER โœ”โœ”โœ” The coordination of cells to provide protection Innate immunity - CORRECT ANSWER โœ”โœ”โœ” AKA - natural immunity: is the first line of defense.

  • This type of defense is in place before an infection takes place and can function immediately. It is comprised of physical, chemical, cellular, and molecular defenses.
  • It is generalized and non-specific How does the skin act as a physical barrier? - CORRECT ANSWER โœ”โœ”โœ” The skin's design makes it a strong physical barrier.
  • It has closely packed cells in multiple layers that are continuously being shed.
  • Keratin covers the skin, which creates a salty, acidic environment inhospitable to microbes.
  • It also contains antimicrobial proteins and lysozymes that inhibit microorganisms and help to destroy them. What cells are involved in innate immunity? - CORRECT ANSWER โœ”โœ”โœ” - neutrophils
  • macrophages
  • dendritic cells (DC)
  • natural killer (NK) cells
  • intraepithelial lymphocytes Where are cells of innate immunity derived from? - CORRECT ANSWER โœ”โœ”โœ” hematopoietic stem cells in the bone marrow Leukocytes - CORRECT ANSWER โœ”โœ”โœ” White blood cells that are heavily involved in innate immune response What are the 2 categories of leukocytes? What type of leukocyte goes in each category? - CORRECT ANSWER โœ”โœ”โœ” Granulocytes: (contain granules)
  1. Neutrophils
  2. Basophils
  3. Eosinophils Agranulocytes: (lack granules)
  4. Lymphocytes
  5. Monocytes
  6. Macrophages Neutrophils - CORRECT ANSWER โœ”โœ”โœ” - most abundant cell in the body,
  • make up ~ 55% of all white blood cells.
  • They are an early responder in innate immunity and use phagocytosis to kill microbes. Basophils - CORRECT ANSWER โœ”โœ”โœ” - make up less than 1%
  • release histamine and proteolytic enzymes.
  • believed to play a role in allergic and parasitic infections as well Eosinophils - CORRECT ANSWER โœ”โœ”โœ” - make up 1-4%
  • become active in parasitic infections and allergic responses. Lymphocytes - CORRECT ANSWER โœ”โœ”โœ” - Found in blood and lymph tissue
  • make up 36%
  • primary cells of adaptive immunity
  • B lymphocytes (B cells) - make antibodies
  • T lymphocytes (T cells) - kill tumor cells and help control immune responses Monocytes - CORRECT ANSWER โœ”โœ”โœ” - largest in size of the white blood cells
  • make up 3-7%
  • They are released from the bone marrow and mature into macrophages and dendritic cells where they engage in the inflammatory response and phagocytize foreign substances and cellular debris. Macrophages - CORRECT ANSWER โœ”โœ”โœ” - long life span
  • reside in the tissues
  • are the first phagocyte that organisms encounter

Cell-mediated Immunity (T-lymphocytes) Humoral Immunity - CORRECT ANSWER โœ”โœ”โœ” - mediated by B-lymphocyte activation and subsequent antibody production.

  • the main defense against extracellular microbes and toxins. Cell-mediated immunity - CORRECT ANSWER โœ”โœ”โœ” - involves activation of specific T-lymphocytes (T-helper and T- cytotoxic lymphocytes)
  • defend the body against intracellular microbes, like viruses. What are the primary cells of adaptive immunity? - CORRECT ANSWER โœ”โœ”โœ” - APCs (antigen-presenting cells) - Macrophages and DCs
  • Lymphocytes - B (produce antibodies) and T (cell-mediated immunity). Antigen-presenting cells (APCs) - CORRECT ANSWER โœ”โœ”โœ” - such as macrophages and DCs
  • Activate lymphocytes
  • they process antigens into epitopes and present them on their cell surface. This activates the appropriate lymphocytes, which can be subdivided into regulatory and effector cells. What is on the surface of APCs? - CORRECT ANSWER โœ”โœ”โœ” Major histocompatibility complex (MHC) molecules
  • they 'hold and present' fragments of foreign antigens on the surface of the APC so that Helper T cells (T lymphocytes) recognizes the foreign antigen and initiate an immune response. What are lymphocytes divided into? - CORRECT ANSWER โœ”โœ”โœ” Regulatory cells - control the immune response Effector cells - work to eliminate the antigen Describe B & T lymphocytes and discuss their role in immunity: - CORRECT ANSWER โœ”โœ”โœ” - B lymphocytes produce the antibodies (humoral immunity)
  • T lymphocytes provide cell-mediated immunity.
  • only cells in the body that can distinguish and recognize specific antigens present on the surface of pathogens They have receptors with specific proteins that correlate with specific cell functions. CD "Cluster of Differential" - these are surface molecules that are given a number to describe a specific surface protein. (CD4 or CD8) are then recognized by antibodies. 371 clusters exist. T and B lymphocyte properties necessary for the adaptive immune response: - CORRECT ANSWER โœ”โœ”โœ” - Specificity
  • Diversity
  • Memory
  • Recognition What is the function of humoral immunity? What are the two waves of response? - CORRECT ANSWER โœ”โœ”โœ” B lymphocytes function in humoral immunity to produce antibodies. 2 waves of response:
  • Primary immune response - body first encounters a foreign antigen
  • Secondary immune response, (also referred to as that memory phase), occurs on repeated exposure to the antigen Immunoglobulins (Ig) and their 5 classes - CORRECT ANSWER โœ”โœ”โœ” Antibodies
  1. IgG (Gamma globulin) - 75%
  2. IgA - 15%. Secretory Ig found in saliva, tears, colostrum, and bronchial, GI, prostatic, and vaginal secretions. Provides immunity and stops the attachment of microbes on epithelial surfaces.
  3. IgM - 10%. Lysis of microorganisms. First Ig produces in response to an infection. The first antibody to be produced by the fetus and immature B lymphocytes.
  4. IgD - low levels and function unknown
  5. IgE - least common and responsible for inflammation and allergic responses, combating parasitic infections. What is the function of cellular immunity? - CORRECT ANSWER โœ”โœ”โœ” T lymphocytes make up the cellular immunity and function to activate other T and B

Asthma - Anaphylaxis - Primary early response (Type 1) - CORRECT ANSWER โœ”โœ”โœ” - begins 5 to 30 min of allergen exposure and subsides within 60 minutes. (CD4 T2H (Helper T cells) stimulates B cells to lead to IgE secretion from plasma cells.) Primary - production of IgE and mast cell sensitization. Antigens bind to mast cells and degranulate to release mediators (histamines and heparin). Secondary late response (Type 1) - CORRECT ANSWER โœ”โœ”โœ” - occurs 2 to 8 hours after resolution of the initial phase and can last several days. (CD4 T2H (Helper T cells) stimulates B cells to lead to IgE secretion from plasma cells.)

  • mast cells produce cytokines and membrane phospholipids. Cytokines - promote the migration of eosinophils and leukocytes to the site of allergen exposure. Athsma - CORRECT ANSWER โœ”โœ”โœ” Primary - vasodilation, vascular leakage, and smooth muscle contraction. Secondary - infiltration of tissues with eosinophils and other acute and chronic inflammatory cells, as well as tissue damage.
  • use a bronchodilator (inhaler) Allergic rhinitis - CORRECT ANSWER โœ”โœ”โœ” - Most common: 20-40% affected
  • confirmed by specific IgE antibodies and/or by a skin prick test
  • (runny nose), sneezing, nasal obstruction, nasal itching, and watery eyes Treatment: Antihistamines Intranasal corticosteroids

Anaphylaxis - CORRECT ANSWER โœ”โœ”โœ” - Severe IgE-mediated hypersensitivity reaction

  • wide spread release of histamine that produces vasodilation, hypotension, arterial hypoxia, and airway edema.
  • level of severity depends on the preexisting degree of sensitization and not with the quantity of exposure Anaphylaxis Grades - CORRECT ANSWER โœ”โœ”โœ” Grade I - reactions occur in the cutaneous and mucosal tissues with erythema and urticaria, with or without angioedema. Grade II - hypotension, tachycardia, dyspnea, and GI manifestations such as nausea, vomiting, diarrhea, and abdominal cramping from mucosal edema. Grade III - life threatening due to bronchospasm, cardiac dysrhythmias, and cardiac collapse. Grade IV - present with cardiac arrest and management is focused on resuscitation. Treatment - Epinephrine Pen What are type II hypersensitivity reactions? - CORRECT ANSWER โœ”โœ”โœ” Cytotoxic hypersensitivity reactions are antibody-mediated reactions. They are mediated by IgG or IgM antibodies directed against target antigens on specific host cell surfaces or tissues. 4 ways type II reactions occur: - CORRECT ANSWER โœ”โœ”โœ” (1) complement- activated cell destruction (2) antibody-mediated cell cytotoxicity (3) complement- and antibody-mediated inflammation (4) antibody-mediated cellular dysfunction. What are autoimmune disorders? - CORRECT ANSWER โœ”โœ”โœ” Autoimmune diseases occur when the body's immune system fails to differentiate self-antigens from nonself antigens and mounts an immunologic response against host tissues. What is self-tolerance? - CORRECT ANSWER โœ”โœ”โœ” The ability to distinguish self from non-self is termed self-tolerance What are the two processes of tolerance? - CORRECT ANSWER โœ”โœ”โœ” Central tolerance - is the elimination of autoreactive lymphocytes during maturation in the central lymphoid tissues.

They don't mean you will have an autoimmune disease. A trigger event may be a virus or other microorganism, a chemical substance, or a self-antigen from a body tissue that was previously hidden may lead to development. How do you diagnose an autoimmune disease? - CORRECT ANSWER โœ”โœ”โœ” Diagnosis is made by history, physical, and serological findings. Need:

  • evidence of an autoimmune reaction
  • the immunologic findings are not secondary to another condition
  • no other identifiable causes are found What is Graves' disease? - CORRECT ANSWER โœ”โœ”โœ” It is an abnormal stimulation of the thyroid gland by thyroid-stimulating antibodies (TSH receptor antibodies) that act through the normal TSH receptors.
  • It is a state of hyperthyroidism, goiter, and ophthalmopathy.
  • normalization of thyroid function by antithyroid medication What is SLE? - CORRECT ANSWER โœ”โœ”โœ” Systemic lupus erythematosus (SLE) is a chronic inflammatory disease termed the great imitator because it can affect almost any organ system. What is HIV? - CORRECT ANSWER โœ”โœ”โœ” HIV is a retrovirus that selectively attacks the CD4+ T lymphocytes, the immune cells responsible for coordinating the immune response to infection. Because of this, people with HIV infection are more susceptible to severe infections with ordinarily harmless organisms. How is HIV spread? - CORRECT ANSWER โœ”โœ”โœ” HIV is transmitted from one person to another through sexual contact, blood-to-blood contact, or from mother to child during pregnancy, birth, or breastfeeding. HIV is not spread via saliva or causal contact. What is seroconversion? - CORRECT ANSWER โœ”โœ”โœ” When an infected person's blood converts from being negative for HIV antibodies to being positive. Occurs between 1-3 months or as late as 6 months. What is the window period? - CORRECT ANSWER โœ”โœ”โœ” The time between infection and seroconversion is called the window period. What are signs and symptoms of acute (primary phase) HIV infection? - CORRECT ANSWER โœ”โœ”โœ” - fever, lymphadenopathy (swollen lymph nodes), sore throat, fatigue, muscle aches, night sweats, GI problems, maculopapular rash, and headache.
  • HIV attacks CD4+ cells so there is a decrease in the CD4+ T-cell count.
  • S and S manifest one-month post-HIV exposure What is the latent phase of HIV infection? - CORRECT ANSWER โœ”โœ”โœ” The latent phase is characterized by few signs or symptoms of illness.
  • 10-year duration when CD4+ T-cell count slowly falls from the normal range of 800-1000 cells/ฮผL to 200 cells/ฮผL or lower. What is the last phase of HIV infection? - CORRECT ANSWER โœ”โœ”โœ” The last phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/ฮผL or exhibits an AIDS-defining illness.
  • 60-70% of HIV-infected people develop AIDS within 10-11 years post-infection
  • If CD4+ T cells fall below 200 cells/ฮผL, death occurs within 2 - 3 years. What are opportunistic infections? - CORRECT ANSWER โœ”โœ”โœ” Opportunistic infections occur more often or are more severe in people with weakened immune systems. They are Viral, bacterial, fungal, and protozoan. Describe the different diagnostic methods for HIV. - CORRECT ANSWER โœ”โœ”โœ” Enzyme immunoassay (EIA) or enzyme-linked immunosorbent assay (ELISA) - The best diagnostic method to detect HIV is these HIV antibody tests. Western Blot assay - detect the presence of antibodies to specific viral antigens with a higher degree of specificity and sensitivity. done to confirm EIA positive results. This is because the EIA has a high false-positive result. Polymerase chain reaction (PCR) - is used to amplify and detect the presence of trace amounts of viral DNA in infected cells. Used to test infants born to infected mothers because these infants would have their mother's antibodies regardless is they are infected. Highly active antiretroviral therapy (HAART) - CORRECT ANSWER โœ”โœ”โœ” Combination of three (or four) antiviral agents often targeting entry/fusion events, reverse transcriptase, integrase, and protease enzymes.
  • Viral infections tend to decrease ___________ and increase _____________. - CORRECT ANSWER โœ”โœ”โœ” - Bacterial infections cause the neutrophil counts to increase.
  • Parasitic infections and allergic responses cause an increase in eosinophils.
  • Viral infections tend to decrease the neutrophils and increase the lymphocytes. What are the 3 stages of wound repair? - CORRECT ANSWER โœ”โœ”โœ” (1) the inflammatory phase - begins at the time of injury with the formation of a blood clot and migration of phagocytic WBCs into the wound site (2) the proliferative phase - build new tissue to fill the wound space with fibroblasts. (3) the wound contraction and remodeling phase - begin about 3 weeks after injury when a fibrous scar develops. Primary or secondary intention - CORRECT ANSWER โœ”โœ”โœ” Primary Intention - A sutured surgical incision Secondary Intention - Larger wounds, like burns, have a greater loss of tissue and contamination and heal slower and results in larger amounts of scar tissue. Keloid - CORRECT ANSWER โœ”โœ”โœ” tumor-like masses caused by excess production of scar tissue What factors can inhibit wound repair? - CORRECT ANSWER โœ”โœ”โœ” Factors that affect wound healing negatively include malnutrition, decreased blood flow and oxygen delivery, impaired inflammatory and immune responses, infection, wound separation, foreign bodies, and age.