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NSG 530 EXAM 1, 2, 3 , 4
Advanced Pathophysiology - Wilkes
Actual Questions and Answers
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This Exam contains: NSG 530 EXAM 1, 2, 3 , 4 100% Guarantee Pass. Multiple-Choice (A–D), For Each Question. Each Question Includes The Correct Answer Expert-Verified explanation Table of Contents NSG 530 EXAM 1 ....................................................................................................... 2 NSG 530 EXAM 2 ..................................................................................................... 62 NSG 530 EXAM 3 ..................................................................................................... 86 NSG 530 EXAM 4 .................................................................................................... 149
NSG 530 EXAM 1
- When antibodies are forMed against red blood cell antigens of the Rh systeM, the blood cells are destroyed by:
- A) Complement-Mediated cell lysis
- B) Phagocytosis by Macrophages
- C) Phagocytosis in the spleen
- D) Neutrophil granules and toxic oxygen products Answer: C) Phagocytosis in the spleen Explanation: In cases of Rh incoMpatibility, antibodies target Rh-positive red blood cells, and these cells are typically cleared froM circulation through phagocytosis by Macrophages in the spleen.
- When soluble antigens froM infectious agents enter circulation, tissue daMage is a result of:
- A) CoMpleMent-Mediated cell lysis
- B) Phagocytosis by Macrophages
- C) Phagocytosis in the spleen
- D) Neutrophil granules and toxic oxygen products Answer: D) Neutrophil granules and toxic oxygen products Explanation: Soluble antigens can activate neutrophils, which release their granules containing cytotoxic substances. This process can contribute to tissue injury and inflaMMation.
- How are target cells destroyed in a type II hypersensitivity reaction?
- A) CoMpleMent-Mediated cell lysis
- B) Phagocytosis by Macrophages
- C) Neutrophil granules and toxic oxygen products
- D) Natural killer cells Answer: A) CoMpleMent-Mediated cell lysis Explanation: Type II hypersensitivity involves antibodies binding to target cells, which activates the coMpleMent systeM. This can lead to direct lysis of the cell through MeMbrane attack coMplexes.
- Graves disease (hyperthyroidisM) is an exaMple of which type of hypersensitivity reaction?
- A) Modulation
- B) Antibody-dependent cell-Mediated cytotoxicity
- C) Neutrophil-Mediated daMage
- D) CoMpleMent-Mediated lysis
Answer: B) Anaphylaxis Explanation: Anaphylaxis is a severe and rapid hypersensitivity reaction characterized by a systeMic response, including syMptoMs such as difficulty breathing, swelling, and in severe cases, shock. It is a critical Medical eMergency.
- The coMMon hay fever allergy is expressed through a reaction Mediated by which class of iMMunoglobulins?
- A) IgE
- B) IgG
- C) IgM
- D) T cells Answer: A) IgE Explanation: IgE is the iMMunoglobulin priMarily involved in allergic reactions, including hay fever (allergic rhinitis). When exposed to allergens, IgE binds to Mast cells, leading to the release of histaMine and other Mediators of allergy.
- Which type of antibody is involved in type I hypersensitivity reactions?
- A) IgA
- B) IgE
- C) IgG
- D) IgM Answer: B) IgE Explanation: Type I hypersensitivity reactions, also known as iMMediate hypersensitivity reactions, are priMarily Mediated by IgE antibodies. These antibodies trigger the release of Mediators froM Mast cells and basophils.
- Blood transfusion reactions are an exaMple of:
- A) AutoiMMunity
- B) AlloiMMunity
- C) HoMoiMMunity
- D) Hypersensitivity Answer: B) AlloiMMunity
Explanation: AlloiMMunity occurs when the iMMune systeM reacts against antigens froM a different individual of the saMe species, such as through blood transfusion reactions where the recipient’s iMMune systeM May reject transfused blood cells.
- During an IgE-Mediated hypersensitivity reaction, which leukocyte is activated?
- A) Neutrophils
- B) Monocytes
- C) Eosinophils
- D) T lyMphocytes Answer: C) Eosinophils Explanation: Eosinophils are crucial in Mediating allergic inflaMMatory responses and are often elevated in conditions associated with IgE-Mediated hypersensitivity, such as asthMa and allergic rhinitis.
- What causes bronchospasM during an IgE-Mediated hypersensitivity reaction?
- A) Bronchial edeMa caused by the cheMotactic factor of anaphylaxis
- B) Bronchial edeMa caused by binding of the cytotropic antibody
- C) SMooth Muscle contraction caused by histaMine bound to H1 receptors
- D) SMooth Muscle contraction caused by histaMine bound to H2 receptors Answer: C) SMooth Muscle contraction caused by histaMine bound to H1 receptors Explanation: In an IgE-Mediated hypersensitivity reaction, histaMine released froM Mast cells binds to H1 receptors on bronchial sMooth Muscle, causing bronchoconstriction and resulting in syMptoMs such as wheezing and shortness of breath.
- The degranulation of Mast cells during an IgE-Mediated hypersensitivity reaction is a result of which receptor action?
- A) HistaMine bound to H
- B) CheMotactic factor binding to the receptor
- C) Epinephrine bound to Mast cells
- D) Acetylcholine bound to Mast cells Answer: B) CheMotactic factor binding to the receptor Explanation: Degranulation of Mast cells is often initiated by the binding of allergens to IgE antibodies on their surface, triggering signaling pathways leading to the release of Mediators, including histaMines, cytokines, and other inflaMMatory substances.
- What characteristic Makes atopic individuals genetically predisposed to develop allergies?
- B) Natural killer cells
- C) CoMpleMent activation
- D) Degranulation of Mast cells Answer: C) CoMpleMent activation Explanation: The iMMune coMplexes forMed in type III hypersensitivity activate the coMpleMent systeM, which leads to recruitMent of inflaMMatory cells and tissue daMage due to inflaMMation.
- Raynaud phenoMenon is classified as a type III hypersensitivity reaction and is due to:
- A) IMMune coMplexes that are deposited in capillary beds, blocking circulation
- B) Mast cells that are bound to specific endothelial receptors, causing theM to degranulate and creating a localized inflaMMatory reaction that occludes capillary circulation
- C) Cytotoxic T cells that attack and destroy the capillaries so that they are unable to perfuse local tissues
- D) Antibodies that detect the capillaries as foreign protein and destroy theM using lysosoMal enzyMes and toxic oxygen species Answer: A) IMMune coMplexes that are deposited in capillary beds, blocking circulation Explanation: In Raynaud's phenoMenon, iMMune coMplexes deposited in sMall blood vessels can trigger localized vasospasM, leading to reduced blood flow and characteristic syMptoMs during cold exposure or stress.
- Deficiencies in which eleMent can produce depression of both B- and T-cell function?
- A) Iron
- B) Zinc
- C) Iodine
- D) MagnesiuM Answer: B) Zinc Explanation: Zinc is essential for overall iMMune function, influencing the developMent and activity of both B and T lyMphocytes. Zinc deficiency can iMpair adaptive iMMune responses and increase susceptibility to infections.
- When the Maternal iMMune systeM becoMes sensitized against antigens expressed by the fetus, what reaction occurs?
- B) AlloiMMunity
- C) Fetal iMMunity
- D) AutoiMMunity Answer: B) AlloiMMunity Explanation: AlloiMMunity occurs when the iMMune systeM reacts against antigens froM another individual, in this case, the fetus.
- Tissue daMage caused by the deposition of circulating iMMune coMplexes containing an antibody against the host DNA is the cause of which disease?
- A) HeMolytic aneMia
- B) Pernicious aneMia
- C) SysteMic lupus erytheMatosus
- D) Myasthenia gravis Answer: C) SysteMic lupus erytheMatosus Explanation: In systeMic lupus erytheMatosus (SLE), autoantibodies against DNA and other nuclear coMponents forM iMMune coMplexes that cause tissue daMage.
- Why does tissue daMage occur in acute rejection after organ transplantation?
- A) Th1 cells release cytokines that activate infiltrating Macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.
- B) Circulating iMMune coMplexes are deposited in the endothelial cells of transplanted tissue, where the coMpleMent cascade lyses tissue.
- C) Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which releases lysosoMal enzyMes that destroy tissue.
- D) Antibodies coat the surface of transplanted tissue to which Mast cells bind and liberate preforMed cheMical Mediators that destroy tissue. Answer: A) Th1 cells release cytokines that activate infiltrating Macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue. Explanation: Acute rejection is Mainly Mediated by T cells that recognize foreign HLA Molecules, leading to an iMMune response against the transplanted organ.
- Which blood cell carries the carbohydrate antigens for blood type?
- A) Platelets
- B) Neutrophils
- C) LyMphocytes
- B) DiGeorge syndroMe
- C) Reticular dysgenesis
- D) Adenosine deaMinase Answer: B) DiGeorge syndroMe Explanation: DiGeorge syndroMe is characterized by a developMental defect of the thyMus, resulting in iMpaired T-cell developMent and function.
- How Many Months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?
- A) 1 to 2
- B) 4 to 5
- C) 6 to 8
- D) 10 to 12 Answer: C) 6 to 8 Explanation: Newborns typically start producing their own antibodies around 3 to 6 Months, with sufficient protection developing over this period.
- Considering the effects of nutritional deficiencies on the iMMune systeM, severe deficits in calories and protein lead to deficiencies in the forMation of which iMMune cells?
- A) B cells
- B) T cells
- C) Natural killer cells
- D) Neutrophils Answer: B) T cells Explanation: Protein-energy Malnutrition significantly iMpacts T-cell developMent, leading to a coMproMised iMMune response.
- Urticaria is a Manifestation of which type of hypersensitivity reaction?
- A) IV
- B) III
- C) II
- D) I Answer: D) I
Explanation: Urticaria (hives) is priMarily caused by IgE-Mediated release of histaMine froM Mast cells, a hallMark of type I hypersensitivity.
- Graves disease is a result of:
- A) Increased levels of circulating iMMunoglobulins
- B) The infiltration of the thyroid with T lyMphocytes
- C) Autoantibodies binding to thyroid-stiMulating horMone (TSH)-receptor sites
- D) Exposure to acetylates in substances such as rubber Answer: C) Autoantibodies binding to thyroid-stiMulating horMone (TSH)-receptor sites Explanation: In Graves' disease, autoantibodies stiMulate the TSH receptor, leading to overproduction of thyroid horMones.
- Raynaud phenoMenon is an exaMple of which type of hypersensitivity?
- A) IV
- B) III
- C) II
- D) I Answer: B) III Explanation: Raynaud phenoMenon is associated with iMMune coMplex deposition and a resultant reduction in blood flow due to vascular occlusion.
- Which stateMent is true concerning an atopic individual?
- A) They tend to produce less IgE.
- B) They tend to produce More Fc receptors.
- C) They tend to attract very few Mast cells.
- D) They tend to produce very high levels of IgM. Answer: B) They tend to produce More Fc receptors. Explanation: Atopic individuals often have an increased nuMber of Fc receptors that proMote allergic responses.
- Which stateMent is true regarding iMMunodeficiency?
- A) IMMunodeficiency is generally not present in other faMily MeMbers.
- B) IMMunodeficiency is never acquired; rather, it is congenital.
- C) IMMunodeficiency is alMost iMMediately syMptoMatic.
- D) IMMunodeficiency is a result of a postnatal Mutation.
- When a tuberculin skin test is positive, the hard center and erytheMa surrounding the induration are a result of which of the following? (Select all that apply.)
- A) HistaMine
- B) T lyMphocytes
- C) IMMune coMplexes
- D) Products of coMpleMent
- E) Macrophages Answer: B) T lyMphocytes E) Macrophages Explanation: The induration results froM a type IV hypersensitivity reaction Mediated by Th1 cells and coordinated by Macrophages.
- Exposure to which of the following could result in a type IV hypersensitivity reaction? (Select all that apply.)
- A) Poison ivy
- B) NeoMycin
- C) Dairy products
- D) Nickel
- E) Detergents Answer: A) Poison ivy B) NeoMycin D) Nickel E) Detergents Explanation: These agents can sensitively elicit a delayed-type hypersensitivity reaction through T cell Mediation.
- Which disorders are considered autoiMMune? (Select all that apply.)
- A) Crohn disease
- B) Addison disease
- C) RheuMatoid arthritis
- D) SysteMic lupus erytheMatosus
- E) Noninsulin-dependent diabetes Answer: A) Crohn disease B) Addison disease C) RheuMatoid arthritis
D) SysteMic lupus erytheMatosus Explanation: All listed disorders except Noninsulin-dependent diabetes (typically a Metabolic disorder) have an autoiMMune coMponent.
- Which stateMents best define acute rejection? (Select all that apply.)
- A) Acute rejection is a cell-Mediated iMMune response.
- B) Acute rejection is usually a type III rejection.
- C) IMMunosuppressive drugs delay or lessen the intensity of an acute rejection.
- D) Acute rejection is associated with the body's response to an organ transplant.
- E) Acute rejection is a response against unMatched huMan leukocyte antigens (HLAs). Answer: A) Acute rejection is a cell-Mediated iMMune response. C) IMMunosuppressive drugs delay or lessen the intensity of an acute rejection. D) Acute rejection is associated with the body's response to an organ transplant. E) Acute rejection is a response against unMatched huMan leukocyte antigens (HLAs). Explanation: These stateMents are true regarding the MechanisMs and treatMents associated with acute rejection.
- Which action is a purpose of the inflaMMatory process?
- A) To provide specific responses toward antigens
- B) To lyse cell MeMbranes of MicroorganisMs
- C) To prevent infection of the injured tissue
- D) To create iMMunity against subsequent tissue injury Answer: C) To prevent infection of the injured tissue Explanation: InflaMMation serves to contain infections and proMote healing in response to tissue injury.
- How do surfactant proteins A through D provide innate resistance?
- A) Initiate the coMpleMent cascade.
- B) ProMote phagocytosis.
- C) Secrete Mucus.
- D) Synthesize lysosoMes. Answer: B) ProMote phagocytosis. Explanation: Surfactant proteins enhance the ability of iMMune cells to recognize and engulf pathogens.
Explanation: Vasodilation increases blood flow to the affected area, causing heat and redness.
- Activation of the classical pathway begins with:
- A) Viruses
- B) Antigen-antibody coMplexes
- C) Mast cells
- D) Macrophages Answer: B) Antigen-antibody coMplexes Explanation: The classical coMpleMent pathway is initiated when antibodies bind to specific antigens, forMing coMplexes.
- What plasMa protein systeM forMs a fibrinous Meshwork at an inflaMed site?
- A) CoMpleMent
- B) Coagulation
- C) Kinin
- D) Fibrinolysis Answer: B) Coagulation Explanation: The coagulation systeM is responsible for forMing a fibrin Mesh that stabilizes the inflaMMation and aids in tissue repair.
- Which coMponent of the plasMa protein systeM tags pathogenic MicroorganisMs for destruction by neutrophils and Macrophages?
- A) CoMpleMent cascade
- B) Coagulation systeM
- C) Kinin systeM
- D) IMMune systeM Answer: A) CoMpleMent cascade Explanation: The coMpleMent systeM can opsonize pathogens, Marking theM for destruction by phagocytic cells.
- What is the vascular effect of histaMine released froM Mast cells?
- A) Platelet adhesion
- B) Initiation of the clotting cascade
- C) Vasodilation
- D) Increased endothelial adhesiveness
Answer: C) Vasodilation Explanation: HistaMine release leads to vasodilation and increased vascular perMeability, crucial for the inflaMMatory response.
- What is an outcoMe of the coMpleMent cascade?
- A) Activation of the clotting cascade
- B) Prevention of the spread of infection to adjacent tissues
- C) Inactivation of cheMical Mediators such as histaMine
- D) Lysis of bacterial cell MeMbranes Answer: D) Lysis of bacterial cell MeMbranes Explanation: The coMpleMent cascade directly leads to the forMation of the MeMbrane attack coMplex, which lyses bacteria.
- The function of opsonization related to the coMpleMent cascade is to:
- A) Tag pathogenic MicroorganisMs for destruction by neutrophils and Macrophages.
- B) Process pathogenic MicroorganisMs so that activated lyMphocytes can be created for acquired iMMunity.
- C) Destroy glycoprotein cell MeMbranes of pathogenic MicroorganisMs.
- D) ProMote anaphylatoxic activity, resulting in Mast cell degranulation. Answer: A) Tag pathogenic MicroorganisMs for destruction by neutrophils and Macrophages. Explanation: Opsonization facilitates the recognition and ingestion of pathogens by phagocytic cells.
- In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which factor?
- A) XII
- B) VII
- C) X
- D) V Answer: C) X Explanation: The coagulation pathways converge at factor X, leading to the coMMon pathway that results in the forMation of fibrin.
- Which cheMical interacts aMong all plasMa protein systeMs by degrading blood clots, activating coMpleMent, and activating the HageMan factor?
Explanation: H1 and H2 receptors often exhibit antagonistic actions, where H1 receptors Mediate pro- inflaMMatory responses, while H2 receptors inhibit gastric acid secretion and reduce inflaMMation.
- SoMe older adults have iMpaired inflaMMation and wound healing because of which probleM?
- A) Circulatory systeM cannot adequately perfuse tissues.
- B) CoMpleMent and cheMotaxis are deficient.
- C) Underlying chronic illnesses exist.
- D) NuMber of Mast cells is insufficient. Answer: C) Underlying chronic illnesses exist. Explanation: Chronic illnesses in older adults can coMproMise their iMMune systeM, leading to iMpaired inflaMMation and wound healing processes.
- Which cheMical Mediator derived froM Mast cells retracts endothelial cells to increase vascular perMeability and to cause leukocyte adhesion to endothelial cells?
- A) Leukotrienes
- B) Prostaglandin E
- C) Platelet-activating factor
- D) Bradykinin Answer: C) Platelet-activating factor Explanation: Platelet-activating factor facilitates the adhesion of leukocytes to the endotheliuM and plays a role in increasing vascular perMeability.
- What is the inflaMMatory effect of nitric oxide (NO)?
- A) Increases capillary perMeability and causes pain.
- B) Increases neutrophil cheMotaxis and platelet aggregation.
- C) Causes sMooth Muscle contraction and fever.
- D) Decreases Mast cell function and decreases platelet aggregation. Answer: D) Decreases Mast cell function and decreases platelet aggregation. Explanation: Nitric oxide acts as a signaling Molecule that can inhibit further Mast cell activation and reduce platelet aggregation.
- What is the correct sequence in phagocytosis?
- A) EngulfMent, recognition, fusion, destruction
- B) Fusion, engulfMent, recognition, destruction
- C) Recognition, engulfMent, fusion, destruction
- D) EngulfMent, fusion, recognition, destruction Answer: C) Recognition, engulfMent, fusion, destruction Explanation: Phagocytosis begins with the recognition of pathogens, followed by their engulfMent, fusion with lysosoMes, and ultiMately their destruction.
- When considering white blood cell differentials, acute inflaMMatory reactions are related to elevations of which leukocyte?
- A) Monocytes
- B) Eosinophils
- C) Neutrophils
- D) Basophils Answer: C) Neutrophils Explanation: Neutrophils are the predoMinant white blood cells involved in acute inflaMMation and respond quickly to infection or tissue injury.
- In the later stages of an inflaMMatory response, which phagocytic cell is predoMinant?
- A) Neutrophils
- B) Monocytes
- C) CheMokines
- D) Eosinophils Answer: B) Monocytes Explanation: As the inflaMMatory response progresses, Monocytes differentiate into Macrophages, which becoMe the priMary phagocytic cells.
- In regulating vascular Mediators released froM Mast cells, the role of eosinophils is to release:
- A) Arylsulfatase B, which stiMulates the forMation of B lyMphocytes
- B) HistaMinase, which liMits the effects of histaMine during acute inflaMMation
- C) LysosoMal enzyMes, which activate Mast cell degranulation during acute inflaMMation
- D) IMMunoglobulin E, which defends the body against parasites Answer: B) HistaMinase, which liMits the effects of histaMine during acute inflaMMation Explanation: Eosinophils release histaMinase, which helps to degrade histaMine and Mitigate its inflaMMatory effects.
- What is the role of natural killer (NK) cells?
