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Volume #3 - Chapter #5 – Immunology Questions With Verified Solution
Which of the following types of immunity provides protection from exposure to an antigen by getting a vaccination?
A.
Humoral
B.
Naturally acquired
C.
Induced active
D.
Passive - ANS-C. Induced active
Induced active immunity, also called artificially acquired immunity, can be derived by a purposeful exposure to an antigen, such as in a vaccination.
Which of the following is a substance that enters the human body and induces an immune response?
A.
Neutrophil
B.
Basophil
C.
Antibody
D.
Antigen - ANS-D. Antigen
An antigen is any substance capable of inducing an immune response. Most antigens are proteins.
What is the term for an unexpected and exaggerated reaction to a particular antigen?
A.
Primary response
B.
Induced passive immunity
C.
Envenomation
D.
Hypersensitivity - ANS-D. Hypersensitivity
Hypersensitivity is an unexpected and exaggerated reaction to a particular antigen. In many instances, hypersensitivity is used synonymously with the term allergy. In its extreme clinical presentation, it is known as an anaphylactic emergency.
What is the term for the initial exposure of an individual to an antigen?
A.
Hypersensitivity
B.
Anaphylaxis
C.
cellular immunity.
C.
humoral immunity.
D.
natural immunity. - ANS-humoral immunity
Humoral immunity is basically a chemical attack of the invading substance. The principal chemical agents of this attack are antibodies, also called immunoglobulins (Igs). Antibodies are a unique class of chemicals that are manufactured by specialized cells of the immune system called B cells. There are five different classes of antibodies: IgA, IgD, IgE, IgG, and IgM.
Following exposure to an antigen, the body will create antibodies specific for that antigen. This process is known as:
A.
induced active immunity.
B.
artificial immunity.
C.
passive immunity.
D.
naturally acquired immunity. - ANS-D. naturally acquired immunity
Naturally acquired immunity normally begins to develop after birth and is continually enhanced by exposure to new pathogens and antigens throughout life. For example, a child contracts chickenpox (varicella) at age 18 months. Following the infection, the child's immune system creates antibodies specific for the varicella virus. Repeated exposure to the varicella virus usually will not result in another infection. In fact, it is not unusual for a patient exposed to varicella to develop lifelong immunity to the infection.
How many days are needed following exposure to a new antigen so that the cellular and humoral components of the immune systems will respond to a response-inducing antigen?
A.
A few hours
B.
Several days
C.
None, response is immediate
D.
A few months - ANS-B. Several days
Following exposure to a new antigen, several days are required before both the cellular and humoral components of the immune system respond.
In an allergic reaction, what substance released by mast cells and basophils causes bronchoconstriction, increased intestinal motility, vasodilation, and increased vascular permeability?
A.
Histamine
B.
Epinephrine
C.
Toxins
D.
Acetylcholine - ANS-A. Histamine
Monitoring devices are not necessary
C.
Cardiac monitor, RAD-57, pulse oximetry
D.
Mechanical chest compression device, end-tidal carbon dioxide detector, tourniquets - ANS-A. Cardiac monitoring, pulse oximetry, end-tidal carbon dioxide detector
State-of-the-art advanced prehospital care of anaphylaxis includes use of all available monitoring devices. These include the cardiac monitor, the pulse oximeter, and, if the patient is intubated, an end- tidal carbon dioxide detector.
You are called for a female patient in respiratory distress. The patient reports an allergy to cats and bees; however, she is not aware of recent exposure to either. She states her current complaint is similar to previous episodes but the symptoms are much worse this time and developed much quicker than usual. Your primary concern would be:
A.
hyperventilation syndrome since there is no antigen.
B.
allergic reaction since the patient has had them before.
C.
pulmonary disease since exposure was delayed.
D.
an anaphylactic reaction despite the inability to identify the antigen. - ANS-D. an anaphylactic reaction despite the inability to identify the antigen.
The severity of the reaction is often related to the speed of onset. Reactions that develop very quickly tend to be much more severe. In this case there is a serious concern for anaphylactic reaction due to the
speed and severity of her symptoms. In a small percentage of patients, the onset of signs and symptoms may be delayed over an hour. The signs and symptoms of anaphylaxis can vary significantly.
You are called to an outpatient health care facility where a patient was scheduled to undergo imaging studies. The patient received the contrast media approximately one hour ago and now complains of an impending sense of doom, dizziness, and inability to catch her breath. What is your initial concern?
A.
Pulmonary embolism
B.
Cerebrovascular accident (CVA)
C.
Hyperventilation syndrome
D.
Anaphylactic reaction - ANS-D. Anaphylactic reaction
In a small percentage of patients the onset of signs and symptoms for a reaction to an antigen may be delayed over an hour. A rapid and focused assessment is crucial to the early detection and treatment of anaphylaxis. Patients suffering an anaphylactic reaction often have a sense of impending doom. This sense of impending doom is often followed by development of additional signs and symptoms.
How is the children's dosage of epinephrine calculated for anaphylactic shock?
A.
0.1 mg/kg given over 3-5 minutes IVP
B.
0.01 mg/kg given over 3-5 minutes IVP
C.
he is choking, and you again get a "no." While your partner starts the patient on high-flow oxygen via a nonrebreather mask, you get a radial pulse of 128 and thready and a blood pressure of 98/78. The pulse oximeter reads 92 percent on oxygen, and the strido - ANS-A. administer a fluid bolus of normal saline
Your patient's blood pressure and heart rate indicate vascular volume depletion due to third spacing of fluid. Your next priority would be to replace that fluid while carefully monitoring him for time to administer the next dose of epinephrine.
Your patient presents to you pale, diaphoretic, dyspneic, hypotensive, and complains of severe abdominal cramping. Inspiratory and expiratory wheezing is auscultated throughout all lung fields, and angioedema is also noted. What do you suspect is this patient's ailment?
A.
Anaphylaxis
B.
Acute anxiety
C.
Asthma attack
D.
Allergic reaction - ANS-A. Anaphylaxis
You would suspect anaphylaxis in the patient who presents with pale skin; is diaphoretic, dyspneic, hypotensive, and complains of severe abdominal cramping; has inspiratory and expiratory wheezing auscultated throughout all lung fields; and has angioedema.
Your patient is exhibiting signs and symptoms of an allergic reaction with dyspnea and wheezing. The blood pressure is still acceptable, but the pulse oximeter is dropping despite high-flow oxygen. What should the paramedic consider administering next?
A.
IV epinephrine
B.
Intramuscular diphenhydramine
C.
Intramuscular epinephrine
D.
IV diphenhydramine - ANS-C. Intramuscular epiniephrine
Any patient suffering an allergic reaction who exhibits dyspnea or wheezing should receive supplemental oxygen followed by intramuscular epinephrine 1:1,000.
You are called for a 24-year-old woman with a rash. You find her sitting in a chair, alert and oriented and states she itches all over. She states she has been ill with a cold and saw her physician yesterday. She was given a prescription for an antibiotic and took the first dose last night and a second about 1/2 hour ago. Auscultation of the chest reveals clear lung sounds. The patient's blood pressure is 108/64, pulse 110, ventilations 18. Initial management of this patient should include which of the following?
A.
Oxygen by nasal cannula at 4 Lpm and administration of epinephrine 0.1 mg of 1:10,000 solution IV
B.
Oxygen by simple face mask at 6 Lpm and administration of 125 mg of Solu-Medrol IV
C.
Oxygen by nonrebreather mask and administration of 12.5 mg of diphenhydramine IV
D.
Oxygen by nonrebreather mask and administration of 0.3-0.5 mg of 1:1,000 epinephrine IM - ANS-D. Oxygen by nonrebreather mask and administration of 0.3-0.5 mg of 1:1,000 epinephrine IM
