Podcast
Questions and Answers
A patient develops a rash and shortness of breath after receiving a new medication. Which immunoglobulin is most likely involved in this immediate hypersensitivity reaction?
A patient develops a rash and shortness of breath after receiving a new medication. Which immunoglobulin is most likely involved in this immediate hypersensitivity reaction?
- IgE (correct)
- IgG
- IgM
- IgA
A client with a history of rheumatoid arthritis is undergoing a diagnostic workup. If the erythrocyte sedimentation rate (ESR) is elevated, but the C-reactive protein (CRP) is within normal limits, what is the most likely explanation for this discrepancy?
A client with a history of rheumatoid arthritis is undergoing a diagnostic workup. If the erythrocyte sedimentation rate (ESR) is elevated, but the C-reactive protein (CRP) is within normal limits, what is the most likely explanation for this discrepancy?
- The ESR elevation is due to chronic inflammation associated with rheumatoid arthritis, while CRP reflects acute inflammation. (correct)
- The patient's rheumatoid arthritis is in remission, leading to a false negative CRP result.
- The patient is experiencing an acute bacterial infection, masking the CRP elevation.
- The patient has recently started taking high-dose corticosteroids, suppressing the CRP response.
A patient is scheduled to receive a tetanus and diphtheria (Td) booster vaccine. What type of immunity will this vaccine provide?
A patient is scheduled to receive a tetanus and diphtheria (Td) booster vaccine. What type of immunity will this vaccine provide?
- Naturally acquired passive immunity
- Artificially acquired active immunity (correct)
- Artificially acquired passive immunity
- Naturally acquired active immunity
An elderly patient is scheduled to receive the influenza vaccine. Considering the effects of immunosenescence, what should the nurse anticipate regarding the patient's immune response?
An elderly patient is scheduled to receive the influenza vaccine. Considering the effects of immunosenescence, what should the nurse anticipate regarding the patient's immune response?
A patient with a history of severe allergic reactions is prescribed an epinephrine auto-injector. What crucial teaching point should the nurse emphasize regarding its use?
A patient with a history of severe allergic reactions is prescribed an epinephrine auto-injector. What crucial teaching point should the nurse emphasize regarding its use?
A patient undergoes a splenectomy due to an immune disorder. What long-term complication is the patient most at risk for?
A patient undergoes a splenectomy due to an immune disorder. What long-term complication is the patient most at risk for?
A patient is diagnosed with systemic lupus erythematosus (SLE). What subjective data is most pertinent to gather during the initial assessment?
A patient is diagnosed with systemic lupus erythematosus (SLE). What subjective data is most pertinent to gather during the initial assessment?
A patient with HIV has a CD4 count of 150 cells/microL. Which intervention is most critical to include in the patient's plan of care?
A patient with HIV has a CD4 count of 150 cells/microL. Which intervention is most critical to include in the patient's plan of care?
A nurse is preparing a patient for a skin test to identify potential allergens. What should the nurse do before the procedure?
A nurse is preparing a patient for a skin test to identify potential allergens. What should the nurse do before the procedure?
A patient with rheumatoid arthritis is prescribed a monoclonal antibody. How do monoclonal antibodies work in treating immune disorders?
A patient with rheumatoid arthritis is prescribed a monoclonal antibody. How do monoclonal antibodies work in treating immune disorders?
Following a kidney transplant, a patient is prescribed immunosuppressant medications. What is a critical nursing intervention for this patient?
Following a kidney transplant, a patient is prescribed immunosuppressant medications. What is a critical nursing intervention for this patient?
A patient reports a latex allergy. Which food items should the nurse advise the patient to avoid?
A patient reports a latex allergy. Which food items should the nurse advise the patient to avoid?
A patient undergoing sublingual immunotherapy (SLIT) for allergic rhinitis asks about potential side effects. What response is most accurate?
A patient undergoing sublingual immunotherapy (SLIT) for allergic rhinitis asks about potential side effects. What response is most accurate?
A patient with a suspected immune disorder presents with persistent diarrhea alternating with constipation. Which condition should the nurse suspect?
A patient with a suspected immune disorder presents with persistent diarrhea alternating with constipation. Which condition should the nurse suspect?
A nurse assesses an older adult patient and notes a history of frequent infections, fatigue, and delayed wound healing. What age-related change in the immune system is most likely contributing to these findings?
A nurse assesses an older adult patient and notes a history of frequent infections, fatigue, and delayed wound healing. What age-related change in the immune system is most likely contributing to these findings?
A patient with a known allergy is accidentally exposed to the allergen. What is the priority nursing action?
A patient with a known allergy is accidentally exposed to the allergen. What is the priority nursing action?
Which statement accurately describes the role of complement proteins in humoral immunity?
Which statement accurately describes the role of complement proteins in humoral immunity?
A patient is diagnosed with a genetic disorder that affects T-cell maturation. Which immune process will be most compromised?
A patient is diagnosed with a genetic disorder that affects T-cell maturation. Which immune process will be most compromised?
A patient is prescribed interferon therapy. For which condition is this medication most likely indicated.
A patient is prescribed interferon therapy. For which condition is this medication most likely indicated.
A patient who is HIV positive reports night sweats, fatigue, and a persistent cough. What opportunistic infection is most likely?
A patient who is HIV positive reports night sweats, fatigue, and a persistent cough. What opportunistic infection is most likely?
A patient asks the nurse, "Why is it important to get a flu shot every year?" What is the nurse's best response?
A patient asks the nurse, "Why is it important to get a flu shot every year?" What is the nurse's best response?
A patient with a family history of autoimmune disorders is concerned about her risk. The nurse should provide education about which modifiable lifestyle factors that can support immune health?
A patient with a family history of autoimmune disorders is concerned about her risk. The nurse should provide education about which modifiable lifestyle factors that can support immune health?
A patient on immunosuppressants after an organ transplant reports a low-grade fever. What additional signs and symptoms are important to assess to determine the severity of a potential infection?
A patient on immunosuppressants after an organ transplant reports a low-grade fever. What additional signs and symptoms are important to assess to determine the severity of a potential infection?
A health care provider orders a CD4 count for a patient diagnosed with HIV. What should the nurse explain to the patient about the purpose of this test?
A health care provider orders a CD4 count for a patient diagnosed with HIV. What should the nurse explain to the patient about the purpose of this test?
Which immunoglobulin is the first to be produced during an acute infection,
Which immunoglobulin is the first to be produced during an acute infection,
A patient undergoing diagnostic testing for a suspected immune disorder asks the nurse about the purpose of antinuclear antibody (ANA) test. What is the nurse's best response?
A patient undergoing diagnostic testing for a suspected immune disorder asks the nurse about the purpose of antinuclear antibody (ANA) test. What is the nurse's best response?
Which statement accurately describes the function of natural killer (NK) cells in the immune system?
Which statement accurately describes the function of natural killer (NK) cells in the immune system?
What nursing intervention is essential when caring for a patient immediately post-biopsy?
What nursing intervention is essential when caring for a patient immediately post-biopsy?
A patient presents with a history of exercise-induced asthma. Which immunoglobulin is primarily involved in this type I hypersensitivity reaction?
A patient presents with a history of exercise-induced asthma. Which immunoglobulin is primarily involved in this type I hypersensitivity reaction?
A patient describes having painful, enlarged lymph nodes that are tender to the touch. What is the most likely cause?
A patient describes having painful, enlarged lymph nodes that are tender to the touch. What is the most likely cause?
Which of the following is a true statement about active immunity?
Which of the following is a true statement about active immunity?
A patient is starting recombinant DNA technology. What should the nurse include in patient education?
A patient is starting recombinant DNA technology. What should the nurse include in patient education?
Following a bee sting; a patient begins to exhibit signs of anaphylactic shock, including wheezing, throat closing, and hypotension. Which immediate therapeutic measure is most critical?
Following a bee sting; a patient begins to exhibit signs of anaphylactic shock, including wheezing, throat closing, and hypotension. Which immediate therapeutic measure is most critical?
Which of the following is a normal finding of a functioning immune system?
Which of the following is a normal finding of a functioning immune system?
In humoral immunity, how do antibodies contribute to the destruction of pathogens?
In humoral immunity, how do antibodies contribute to the destruction of pathogens?
A patient is prescribed a medication that is known to suppress the bone marrow. Which lab value should the nurse monitor most closely:
A patient is prescribed a medication that is known to suppress the bone marrow. Which lab value should the nurse monitor most closely:
A researcher is investigating the primary immune response to a novel viral pathogen. If they analyze serum samples shortly after infection, which immunoglobulin class would they expect to be most prominently elevated during this initial phase?
A researcher is investigating the primary immune response to a novel viral pathogen. If they analyze serum samples shortly after infection, which immunoglobulin class would they expect to be most prominently elevated during this initial phase?
A patient with a history of recurrent respiratory infections shows significantly reduced levels of IgA in mucosal secretions but normal serum IgA levels. Which of the following mechanisms is most likely responsible for this selective IgA deficiency in mucosal tissues?
A patient with a history of recurrent respiratory infections shows significantly reduced levels of IgA in mucosal secretions but normal serum IgA levels. Which of the following mechanisms is most likely responsible for this selective IgA deficiency in mucosal tissues?
In a patient undergoing a hematopoietic stem cell transplant, which component of the immune system is expected to recover first and provide initial defense against opportunistic infections in the early post-transplant period?
In a patient undergoing a hematopoietic stem cell transplant, which component of the immune system is expected to recover first and provide initial defense against opportunistic infections in the early post-transplant period?
An elderly patient with a history of shingles (herpes zoster) infection many years ago is considering receiving the recombinant zoster vaccine (RZV). What is the primary immunological rationale for recommending RZV to this patient, despite prior infection?
An elderly patient with a history of shingles (herpes zoster) infection many years ago is considering receiving the recombinant zoster vaccine (RZV). What is the primary immunological rationale for recommending RZV to this patient, despite prior infection?
A patient with rheumatoid arthritis is treated with a TNF-alpha inhibitor, a type of monoclonal antibody. What is the most direct mechanism by which this therapy alleviates symptoms and slows disease progression in rheumatoid arthritis?
A patient with rheumatoid arthritis is treated with a TNF-alpha inhibitor, a type of monoclonal antibody. What is the most direct mechanism by which this therapy alleviates symptoms and slows disease progression in rheumatoid arthritis?
During an anaphylactic reaction to peanuts, a patient receives an epinephrine auto-injector. Which of the following physiological effects of epinephrine is most critical in reversing the life-threatening symptoms of anaphylaxis?
During an anaphylactic reaction to peanuts, a patient receives an epinephrine auto-injector. Which of the following physiological effects of epinephrine is most critical in reversing the life-threatening symptoms of anaphylaxis?
A patient with suspected autoimmune hemolytic anemia has a positive direct Coombs test. This test detects antibodies and complement proteins bound to the patient's red blood cells (RBCs). What is the most likely mechanism by which these antibodies lead to RBC destruction in this condition?
A patient with suspected autoimmune hemolytic anemia has a positive direct Coombs test. This test detects antibodies and complement proteins bound to the patient's red blood cells (RBCs). What is the most likely mechanism by which these antibodies lead to RBC destruction in this condition?
A researcher is studying the role of microbiota in immune system development. In germ-free animals (raised without any microbiota), which of the following immunological characteristics would be most expected compared to animals with normal microbiota?
A researcher is studying the role of microbiota in immune system development. In germ-free animals (raised without any microbiota), which of the following immunological characteristics would be most expected compared to animals with normal microbiota?
A patient with a history of allergic rhinitis is considering sublingual immunotherapy (SLIT). What is the primary mechanism through which SLIT is thought to reduce allergic symptoms over time?
A patient with a history of allergic rhinitis is considering sublingual immunotherapy (SLIT). What is the primary mechanism through which SLIT is thought to reduce allergic symptoms over time?
A patient undergoing chemotherapy for cancer develops neutropenia. Which of the following best describes the primary immunological consequence of neutropenia that places the patient at high risk for infection?
A patient undergoing chemotherapy for cancer develops neutropenia. Which of the following best describes the primary immunological consequence of neutropenia that places the patient at high risk for infection?
A patient with a known history of anaphylaxis to bee stings is stung by a bee. After self-administering epinephrine, the patient's symptoms initially improve, but then recur several hours later. What is the most appropriate explanation for this 'biphasic anaphylactic reaction'?
A patient with a known history of anaphylaxis to bee stings is stung by a bee. After self-administering epinephrine, the patient's symptoms initially improve, but then recur several hours later. What is the most appropriate explanation for this 'biphasic anaphylactic reaction'?
A patient with systemic lupus erythematosus (SLE) develops glomerulonephritis. Which type of hypersensitivity reaction is primarily responsible for the renal damage in lupus nephritis?
A patient with systemic lupus erythematosus (SLE) develops glomerulonephritis. Which type of hypersensitivity reaction is primarily responsible for the renal damage in lupus nephritis?
In the context of organ transplantation, which type of T cells plays a central role in the rejection of a transplanted organ by directly destroying graft cells?
In the context of organ transplantation, which type of T cells plays a central role in the rejection of a transplanted organ by directly destroying graft cells?
A patient with HIV infection has a CD4+ T cell count below 200 cells/µL. This level of CD4+ T cell depletion is most directly associated with increased susceptibility to which category of infections?
A patient with HIV infection has a CD4+ T cell count below 200 cells/µL. This level of CD4+ T cell depletion is most directly associated with increased susceptibility to which category of infections?
Which of the following mechanisms represents the primary role of complement proteins in enhancing humoral immunity?
Which of the following mechanisms represents the primary role of complement proteins in enhancing humoral immunity?
A patient is diagnosed with a genetic defect that impairs the development of mature B lymphocytes but leaves T lymphocyte development intact. Which aspect of the immune response would be most significantly compromised in this patient?
A patient is diagnosed with a genetic defect that impairs the development of mature B lymphocytes but leaves T lymphocyte development intact. Which aspect of the immune response would be most significantly compromised in this patient?
Interferon-alpha is often used in the treatment of certain viral infections and cancers. What is the primary mechanism by which interferon-alpha exerts its antiviral and antitumor effects?
Interferon-alpha is often used in the treatment of certain viral infections and cancers. What is the primary mechanism by which interferon-alpha exerts its antiviral and antitumor effects?
An elderly patient is described as experiencing immunosenescence. Which of the following immunological changes is most characteristic of immunosenescence and contributes to increased susceptibility to infections in older adults?
An elderly patient is described as experiencing immunosenescence. Which of the following immunological changes is most characteristic of immunosenescence and contributes to increased susceptibility to infections in older adults?
A patient with a latex allergy is advised to avoid certain cross-reactive foods. Which of the following food groups is known to have the highest degree of cross-reactivity with latex allergens?
A patient with a latex allergy is advised to avoid certain cross-reactive foods. Which of the following food groups is known to have the highest degree of cross-reactivity with latex allergens?
Following a splenectomy, a patient is at increased risk for overwhelming post-splenectomy infection (OPSI), particularly from encapsulated bacteria. What is the primary immunological function of the spleen that, when lost, leads to this increased susceptibility?
Following a splenectomy, a patient is at increased risk for overwhelming post-splenectomy infection (OPSI), particularly from encapsulated bacteria. What is the primary immunological function of the spleen that, when lost, leads to this increased susceptibility?
A patient with suspected allergic bronchopulmonary aspergillosis (ABPA) has elevated levels of IgE and eosinophilia, and skin testing is positive for Aspergillus. Which type of hypersensitivity reaction is primarily involved in the pathogenesis of ABPA?
A patient with suspected allergic bronchopulmonary aspergillosis (ABPA) has elevated levels of IgE and eosinophilia, and skin testing is positive for Aspergillus. Which type of hypersensitivity reaction is primarily involved in the pathogenesis of ABPA?
In a patient with multiple sclerosis (MS), an autoimmune disease affecting the central nervous system, the pathological process primarily involves the destruction of the myelin sheath surrounding nerve fibers. Which type of immune cells are considered to be the main effectors in this myelin destruction in MS?
In a patient with multiple sclerosis (MS), an autoimmune disease affecting the central nervous system, the pathological process primarily involves the destruction of the myelin sheath surrounding nerve fibers. Which type of immune cells are considered to be the main effectors in this myelin destruction in MS?
A patient is undergoing a Mantoux test (tuberculin skin test). A positive result, indicated by induration, is primarily mediated by which type of immune response?
A patient is undergoing a Mantoux test (tuberculin skin test). A positive result, indicated by induration, is primarily mediated by which type of immune response?
A patient who received a kidney transplant develops acute graft rejection. Which class of HLA (human leukocyte antigen) molecules on the donor kidney cells is primarily recognized by the recipient's T cytotoxic cells to initiate this rejection response?
A patient who received a kidney transplant develops acute graft rejection. Which class of HLA (human leukocyte antigen) molecules on the donor kidney cells is primarily recognized by the recipient's T cytotoxic cells to initiate this rejection response?
A patient is diagnosed with severe combined immunodeficiency (SCID), a genetic disorder characterized by defects in both T and B lymphocyte development. Which of the following is the most significant clinical manifestation of SCID in early infancy?
A patient is diagnosed with severe combined immunodeficiency (SCID), a genetic disorder characterized by defects in both T and B lymphocyte development. Which of the following is the most significant clinical manifestation of SCID in early infancy?
Which of the following is the primary mechanism of action of antihistamines like diphenhydramine (Benadryl) in alleviating the symptoms of allergic reactions?
Which of the following is the primary mechanism of action of antihistamines like diphenhydramine (Benadryl) in alleviating the symptoms of allergic reactions?
A patient is prescribed corticosteroids for the treatment of an autoimmune disorder. What is the broad mechanism by which corticosteroids suppress the immune system and reduce inflammation?
A patient is prescribed corticosteroids for the treatment of an autoimmune disorder. What is the broad mechanism by which corticosteroids suppress the immune system and reduce inflammation?
During a blood transfusion, a patient develops a hemolytic transfusion reaction due to ABO blood group incompatibility. Which type of hypersensitivity reaction is responsible for this acute hemolytic reaction?
During a blood transfusion, a patient develops a hemolytic transfusion reaction due to ABO blood group incompatibility. Which type of hypersensitivity reaction is responsible for this acute hemolytic reaction?
Which of the following statements accurately describes the concept of 'active immunity'?
Which of the following statements accurately describes the concept of 'active immunity'?
A patient presents with symptoms suggestive of an immune disorder. An antinuclear antibody (ANA) test is ordered. What is the primary purpose of the ANA test in the diagnostic workup of autoimmune diseases?
A patient presents with symptoms suggestive of an immune disorder. An antinuclear antibody (ANA) test is ordered. What is the primary purpose of the ANA test in the diagnostic workup of autoimmune diseases?
Natural killer (NK) cells are a component of the innate immune system. How do NK cells primarily recognize and eliminate target cells, such as virus-infected cells or tumor cells?
Natural killer (NK) cells are a component of the innate immune system. How do NK cells primarily recognize and eliminate target cells, such as virus-infected cells or tumor cells?
A patient is undergoing a lymph node biopsy. What is the most critical nursing intervention immediately following this procedure to monitor for potential complications?
A patient is undergoing a lymph node biopsy. What is the most critical nursing intervention immediately following this procedure to monitor for potential complications?
In humoral immunity, antibodies contribute to pathogen destruction through various mechanisms. Which of the following is NOT a primary mechanism by which antibodies eliminate pathogens?
In humoral immunity, antibodies contribute to pathogen destruction through various mechanisms. Which of the following is NOT a primary mechanism by which antibodies eliminate pathogens?
A patient is prescribed a medication known to cause bone marrow suppression. Which of the following laboratory values should the nurse prioritize monitoring to detect early signs of bone marrow suppression?
A patient is prescribed a medication known to cause bone marrow suppression. Which of the following laboratory values should the nurse prioritize monitoring to detect early signs of bone marrow suppression?
A patient with a history of exercise-induced asthma experiences bronchospasm during physical activity. Which immunoglobulin class is primarily involved in mediating this type I hypersensitivity reaction in exercise-induced asthma?
A patient with a history of exercise-induced asthma experiences bronchospasm during physical activity. Which immunoglobulin class is primarily involved in mediating this type I hypersensitivity reaction in exercise-induced asthma?
A patient presents with painful, enlarged lymph nodes that are tender to palpation in the cervical region, along with fever and sore throat. What is the most likely primary cause of these tender and enlarged lymph nodes in this clinical scenario?
A patient presents with painful, enlarged lymph nodes that are tender to palpation in the cervical region, along with fever and sore throat. What is the most likely primary cause of these tender and enlarged lymph nodes in this clinical scenario?
Recombinant DNA technology is being explored for therapeutic purposes in various immune disorders. What is the fundamental principle behind using recombinant DNA technology to treat genetic immune deficiencies?
Recombinant DNA technology is being explored for therapeutic purposes in various immune disorders. What is the fundamental principle behind using recombinant DNA technology to treat genetic immune deficiencies?
A researcher is investigating potential interventions to enhance the effects of a vaccine in an elderly population. Which strategy is most likely to improve the immune response to a novel vaccine in older adults experiencing immunosenescence?
A researcher is investigating potential interventions to enhance the effects of a vaccine in an elderly population. Which strategy is most likely to improve the immune response to a novel vaccine in older adults experiencing immunosenescence?
A patient with a history of recurrent infections and a suspected B-cell deficiency undergoes immunoglobulin subclass analysis. The results reveal a selective IgA deficiency with normal levels of other immunoglobulin isotypes. Which of the following mechanisms is most likely responsible for this isolated IgA deficiency?
A patient with a history of recurrent infections and a suspected B-cell deficiency undergoes immunoglobulin subclass analysis. The results reveal a selective IgA deficiency with normal levels of other immunoglobulin isotypes. Which of the following mechanisms is most likely responsible for this isolated IgA deficiency?
A researcher is investigating novel therapeutic targets to enhance cell-mediated immunity against intracellular pathogens. Which of the following strategies would be most effective in boosting the ability of cytotoxic T lymphocytes (CTLs) to eliminate infected cells?
A researcher is investigating novel therapeutic targets to enhance cell-mediated immunity against intracellular pathogens. Which of the following strategies would be most effective in boosting the ability of cytotoxic T lymphocytes (CTLs) to eliminate infected cells?
A patient with rheumatoid arthritis is being treated with a novel biologic agent that targets and inhibits the co-stimulatory molecule CD28 on T cells. What is the primary mechanism by which this drug modulates the immune response in rheumatoid arthritis?
A patient with rheumatoid arthritis is being treated with a novel biologic agent that targets and inhibits the co-stimulatory molecule CD28 on T cells. What is the primary mechanism by which this drug modulates the immune response in rheumatoid arthritis?
A patient undergoing hematopoietic stem cell transplantation (HSCT) experiences prolonged neutropenia post-transplant. Which strategy is most crucial to prevent life-threatening opportunistic infections during this period?
A patient undergoing hematopoietic stem cell transplantation (HSCT) experiences prolonged neutropenia post-transplant. Which strategy is most crucial to prevent life-threatening opportunistic infections during this period?
A patient with a history of severe combined immunodeficiency (SCID) is awaiting hematopoietic stem cell transplantation. Which of the following pre-transplant conditioning regimens is most critical to ensure successful engraftment and immune reconstitution?
A patient with a history of severe combined immunodeficiency (SCID) is awaiting hematopoietic stem cell transplantation. Which of the following pre-transplant conditioning regimens is most critical to ensure successful engraftment and immune reconstitution?
A patient with relapsing-remitting multiple sclerosis (MS) is being treated with a disease-modifying therapy that targets and inhibits the migration of lymphocytes into the central nervous system (CNS). Which of the following mechanisms is most likely responsible for the therapeutic effect of this drug?
A patient with relapsing-remitting multiple sclerosis (MS) is being treated with a disease-modifying therapy that targets and inhibits the migration of lymphocytes into the central nervous system (CNS). Which of the following mechanisms is most likely responsible for the therapeutic effect of this drug?
A patient with a known history of anaphylaxis to bee stings is stung while gardening. After self-administering epinephrine, the patient's symptoms initially improve, but several hours later, they experience a recurrence of severe symptoms. What is the most appropriate next step in managing this 'biphasic anaphylactic reaction'?
A patient with a known history of anaphylaxis to bee stings is stung while gardening. After self-administering epinephrine, the patient's symptoms initially improve, but several hours later, they experience a recurrence of severe symptoms. What is the most appropriate next step in managing this 'biphasic anaphylactic reaction'?
A patient with eosinophilic asthma is being treated with a monoclonal antibody that targets interleukin-5 (IL-5). What is the primary mechanism by which this therapy reduces asthma exacerbations?
A patient with eosinophilic asthma is being treated with a monoclonal antibody that targets interleukin-5 (IL-5). What is the primary mechanism by which this therapy reduces asthma exacerbations?
A patient with a history of recurrent fungal infections and chronic granulomatous disease (CGD) has a mutation affecting the NADPH oxidase enzyme complex in phagocytes. Which of the following is the most direct consequence of this genetic defect on the patient's immune function?
A patient with a history of recurrent fungal infections and chronic granulomatous disease (CGD) has a mutation affecting the NADPH oxidase enzyme complex in phagocytes. Which of the following is the most direct consequence of this genetic defect on the patient's immune function?
A patient with a history of multiple severe infections since infancy is diagnosed with a defect in the common gamma chain (γc) cytokine receptor subunit. This defect most directly impairs signaling downstream of which group of interleukins, leading to the patient's immunodeficiency?
A patient with a history of multiple severe infections since infancy is diagnosed with a defect in the common gamma chain (γc) cytokine receptor subunit. This defect most directly impairs signaling downstream of which group of interleukins, leading to the patient's immunodeficiency?
A patient with a history of chronic hepatitis B virus (HBV) infection is being considered for therapy with interferon-alpha. What is the primary mechanism by which interferon-alpha exerts its antiviral effects in this patient?
A patient with a history of chronic hepatitis B virus (HBV) infection is being considered for therapy with interferon-alpha. What is the primary mechanism by which interferon-alpha exerts its antiviral effects in this patient?
A patient with systemic lupus erythematosus (SLE) develops lupus nephritis. Which of the following mechanisms is primarily responsible for the glomerular damage observed in this condition?
A patient with systemic lupus erythematosus (SLE) develops lupus nephritis. Which of the following mechanisms is primarily responsible for the glomerular damage observed in this condition?
A researcher is studying the role of the gut microbiota in the development of immune tolerance. Which of the following mechanisms is most critical in maintaining immune homeostasis in the gut?
A researcher is studying the role of the gut microbiota in the development of immune tolerance. Which of the following mechanisms is most critical in maintaining immune homeostasis in the gut?
A patient with a genetic defect affecting the expression of MHC class II molecules has impaired activation of which specific T cell population, leading to a compromised immune response?
A patient with a genetic defect affecting the expression of MHC class II molecules has impaired activation of which specific T cell population, leading to a compromised immune response?
A patient with a history of asthma and allergic rhinitis is undergoing skin prick testing. A positive reaction to a specific allergen is characterized by wheal and flare formation. Which of the following mediators released from mast cells is primarily responsible for the immediate wheal formation?
A patient with a history of asthma and allergic rhinitis is undergoing skin prick testing. A positive reaction to a specific allergen is characterized by wheal and flare formation. Which of the following mediators released from mast cells is primarily responsible for the immediate wheal formation?
A researcher is developing a novel vaccine strategy that aims to induce long-lived immunity against a rapidly mutating virus. Which approach is most likely to generate broadly neutralizing antibodies that can provide protection against multiple viral variants?
A researcher is developing a novel vaccine strategy that aims to induce long-lived immunity against a rapidly mutating virus. Which approach is most likely to generate broadly neutralizing antibodies that can provide protection against multiple viral variants?
A patient with a history of organ transplantation is on chronic immunosuppressive therapy. Which of the following strategies is most effective in minimizing the risk of opportunistic infections while preventing graft rejection?
A patient with a history of organ transplantation is on chronic immunosuppressive therapy. Which of the following strategies is most effective in minimizing the risk of opportunistic infections while preventing graft rejection?
A patient with a history of autoimmune disease is prescribed tumor necrosis factor (TNF) inhibitors. What potential adverse effect is most important for the nurse to monitor?
A patient with a history of autoimmune disease is prescribed tumor necrosis factor (TNF) inhibitors. What potential adverse effect is most important for the nurse to monitor?
A previously healthy young adult is infected with a novel strain of influenza virus. During the initial immune response, which type of antibody would be expected to play the most significant role in neutralizing the virus and preventing it from infecting host cells?
A previously healthy young adult is infected with a novel strain of influenza virus. During the initial immune response, which type of antibody would be expected to play the most significant role in neutralizing the virus and preventing it from infecting host cells?
Flashcards
Immunity
Immunity
The ability to destroy pathogens or foreign material and prevent infectious disease.
Antigens
Antigens
Chemical markers identifying cells as "self" or foreign.
Natural Killer (NK) Cells
Natural Killer (NK) Cells
Destroy foreign cells, including tumors and infected cells.
Antibodies
Antibodies
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Cell-Mediated Immunity
Cell-Mediated Immunity
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Humoral Immunity
Humoral Immunity
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Vaccine
Vaccine
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Neutralize Viruses
Neutralize Viruses
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Interferon
Interferon
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Passive Immunity
Passive Immunity
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Active Immunity
Active Immunity
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Immunosenescence
Immunosenescence
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Microbiota
Microbiota
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Pericardial Friction Rub
Pericardial Friction Rub
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C-Reactive Protein (CRP)
C-Reactive Protein (CRP)
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Biopsy
Biopsy
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Allergies
Allergies
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Allergen Immunotherapy
Allergen Immunotherapy
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Monoclonal Antibodies
Monoclonal Antibodies
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Recombinant DNA Technology
Recombinant DNA Technology
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Study Notes
- Immunity is the body's ability to destroy pathogens or foreign material and prevent infectious diseases.
- The immune system can target foreign microorganisms, mutated cells, transplanted organs, or mistakenly react to self (autoimmune disease) or harmless substances (allergic reaction).
- The immune system includes lymphoid organs and tissues, lymphocytes and other white blood cells (WBCs), and chemicals that activate cells to destroy foreign antigens.
- Lymphoid organs include lymphatic vessels, lymph nodes, nodules, the spleen, red bone marrow, and the thymus.
- Lymph flows through lymph nodes, where pathogens are filtered and destroyed, with high concentrations in the cervical, axillary, and inguinal areas.
Antigens
- Antigens are chemical markers that identify cells as "self" or "foreign."
- Human cells have major histocompatibility complex antigens (human leukocyte antigens) that identify them as "self."
- Foreign antigens are destroyed by the immune system.
Lymphocytes
- Lymphocytes include natural killer (NK) cells, T cells, and B cells, each with different functions.
- NK cells patrol the body and quickly destroy foreign cells, altered self-cells (tumors), and infected cells by releasing perforins and granzymes, causing cytolysis.
- T cells and B cells are involved in specific immune responses, programmed to respond to specific foreign antigens.
- T cells mature in the thymus and migrate to lymphatic tissues.
- B cells mature in the bone marrow and migrate directly to lymphatic tissue.
- When activated, T cells directly attack, while B cells become plasma cells that release antibodies.
Antibodies
- Antibodies are glycoproteins (immunoglobulins) produced by plasma cells to respond to foreign antigens, labeling them for destruction.
- Each antibody is specific to one antigen.
- B cells produce millions of different antibodies.
- The five classes of human antibodies are IgG, IgA, IgM, IgD, and IgE, each with specific functions.
Mechanisms of Immunity
- The two mechanisms of immunity are cell-mediated immunity (T cells) and humoral immunity (B cells).
- A pathogen invasion often triggers both mechanisms.
Cell-Mediated Immunity
- Cell-mediated immunity is effective against intracellular pathogens, malignant cells, and foreign tissue grafts.
- T-cell response involves cytotoxic T cells (attack altered cells), helper T cells (assist), and memory T cells (retain knowledge of the pathogen).
Humoral Immunity
- Humoral immunity (antibody-mediated immunity) involves antibody production and is effective against extracellular pathogens.
- Antibodies produced by plasma cells circulate and bind to antigens, forming an antigen-antibody complex that immobilizes the pathogen.
- The complex is then labeled for phagocytosis by macrophages or neutrophils and activates the complement cascade.
- Complement is a group of plasma proteins activated by pathogens or antigen-antibody complexes, resulting in cell lysis and attraction of macrophages.
Antibody Responses
- The first exposure to an antigen stimulates slow antibody production.
- Subsequent exposures trigger rapid production of large amounts of antibodies due to memory cells, often preventing illness, which is the basis for vaccine protection.
- Vaccines contain non-pathogenic antigens that stimulate antibody and memory cell formation.
- Antibodies can neutralize viruses by attaching to them, preventing cell entry and leading to phagocytosis.
- Interferon protects surrounding cells from viral replication.
- During allergic responses, IgE antibodies on mast cells bind to allergens, releasing histamine and causing inflammation.
- Anaphylactic shock involves loss of plasma from capillaries and a sudden drop in blood pressure.
Types of Immunity
- Passive immunity involves obtaining antibodies from another source.
- Naturally acquired passive immunity includes placental transmission and breast milk.
- Artificially acquired passive immunity involves injection of preformed antibodies, like after hepatitis B exposure.
- Passive immunity is temporary.
- Active immunity means the person produces their own antibodies.
- Naturally acquired active immunity occurs after recovering from an infection.
- Artificially acquired active immunity occurs through vaccination.
- The duration of active immunity depends on the disease or vaccine.
Aging and the Immune System
- Immunosenescence refers to the decline in immune system function in older adults, including decreased production of new immune cells, reduced efficiency, and lessened response to vaccines.
- Lifestyle factors, medications, and repeated exposures contribute to immunosenescence.
- Older adults are more susceptible to infections, autoimmune disorders, and cancer.
- Maintaining a healthy lifestyle can promote immune health.
Microbiota and the Immune System
- Microbiota is a collection of microbes living in or on the body, essential for immune system function.
- Microbiome refers to the genes within these microbes.
- Microbes affect metabolic pathways providing nutrients and lack of diversity may contribute to anorexia, cardiovascular disease, depression, irritable bowel syndrome, and immune disorders.
Effects of Aging on the Immune System
- Immunosenescence is a decline in immune system function.
- The thymus decreases in size, increasing production of immature T cells, leading to a decline in response to antigens.
- Recommended age-appropriate immunizations for older adults include:
- Herpes zoster (shingles) vaccine (Shingrix preferred) for those 50 or older, or Zostavax for those 60 or older.
- Annual influenza vaccine (plus H1N1 if recommended) in October/November.
- PCV13 followed by PPSV23 at least 1 year later.
- Tetanus and diphtheria booster every 10 years.
Immune System Data Collection
- Disorders affect every system, requiring head-to-toe data collection and patient history.
Subjective Data
- Collected using the WHAT’S UP? format, including family history.
- Systemic lupus erythematosus (SLE) affects more women, particularly Black, Asian American, Hispanic/Latino, American Indian, and Pacific Islander women.
- Atopic disorders (allergic rhinitis, asthma) and autoimmune disorders (ankylosing spondylitis) may be familial or have genetic predispositions.
- Key questions include:
- Birthplace; cultural and ethnic background.
- Current and past living locations to assess environmental exposures.
- Occupation, including exposure to hazardous chemicals or radiation.
- Risky behaviors, such as IV drug use or unprotected sex, increasing risk for HIV.
- Allergies to medications, latex, foods, stinging insects, or environmental allergens.
- Family history of allergies.
- Medications, herbs, and supplements taken.
- Past and current medical conditions.
- Surgeries, especially involving immune organs like the thymus or spleen.
- Coping mechanisms and support systems to assess stress management.
Objective Data
- Physical data collection includes general appearance, facial expression, hearing, vision, posture, gait, skin, and nailbeds.
- Rashes should be examined for size, shape, location, texture, drainage, and pruritus.
- Enlarged lymph nodes should be assessed for location, size, shape, tenderness, temperature, consistency, mobility, symmetry, and pulsation.
- Abnormal Findings:
- Heart Sounds:
- Pericardial friction rub: Rheumatoid arthritis or SLE.
- Lung Sounds:
- Pneumocystis jiroveci pneumonia: Crackles with dry cough.
- Rheumatoid arthritis, SLE: Pleural effusion, friction rub.
- Allergic reaction: Wheezing.
- Lymph Nodes:
- Inflammation, infection: Painful, enlarged lymph nodes.
- Cancer: Enlarged, painless, firm, fixed lymph nodes.
- Gastrointestinal:
- Irritable bowel syndrome: Diarrhea or constipation.
- Musculoskeletal:
- Rheumatoid arthritis: Swollen, painful joints, limited range of motion.
- Multiple sclerosis: Decreased strength and coordination.
- Myasthenia gravis: Loss of strength and endurance.
- Neurologic:
- Late-stage SLE or AIDS: Confusion, lethargy.
- Multiple sclerosis or myasthenia gravis: Muscle weakness.
- Renal:
- SLE or serum sickness: Urine output less than 30 mL/hour, protein in urine, edema.
- Glomerulonephritis, transfusion reaction: Hematuria, flank pain, oliguria.
- Skin:
- SLE: “Butterfly rash”.
- Hashimoto thyroiditis: Onycholysis.
- Kaposi sarcoma: Painless purple lesions.
- Allergic reaction: Rash, erythema, urticaria, pruritus, pustules.
- Heart Sounds:
Diagnostic Tests for the Immune System
- Most Common Blood Tests: Used for allergic, autoimmune, or immune disorders.
- Common Noninvasive and Invasive Procedures: Used for immune disorders.
- Chest X-Ray, MRI, CT Scans: Can also be used.
Gene Testing
- Can identify diseases, predispositions, and enzyme deficiencies that alter the immune response.
Laboratory Tests for the Immune System
- Red Blood Cell (RBC) Count:
- Adult male: 4.21–5.81 × 106 cells/microL
- Adult female: 3.61–5.11 × 106 cells/microL
- Decreased in anemia.
- Differential:
- MCV (Adult male: 77–97 fL; Adult female: 78–98 fL)
- MCH (Adult: 26–34 pg/cell)
- MCHC (32–36 g/dL)
- RDWCV (11.6–14.8)
- RDWSD (38–48)
- Helps determine the cause of anemia.
- White Blood Cell (WBC) Count:
- Adult: 4.5–11.1 × 103/microL3
- Increased with immunosuppression and infection.
- Differential:
- Neutrophils (40–75%)
- Lymphocytes (12–44%)
- Monocytes (4–9%)
- Eosinophils (0–5.5%)
- Basophils (0–1%)
- Eosinophils elevate with type I hypersensitivity reactions.
- Erythrocyte Sedimentation Rate (ESR):
- Male under 50: 0–15 mm/hr
- Female under 50: 0–25 mm/hr
- Male 50 and over: 0–20 mm/hr
- Female 50 and over: 0–30 mm/hr
- False negative if steroids or NSAIDs are taken.
- Rheumatoid Factor (RF):
- Less than 14 IU/mL (may be elevated in older adults)
- Increased in rheumatoid arthritis, SLE, leukemia, tuberculosis, and older age.
- Antinuclear Antibody (ANA)/Anti-ds DNA:
- Negative: Less than 5 IU
- Indeterminate: 5–9 IU
- Positive: 9 IU
- Strongly associated with SLE; also indicates leukemia, scleroderma, and rheumatoid arthritis.
- Complement:
- Total (CH50 31–60 units/mL)
- C3 (83–177 mg/dL)
- C4 (12–36 mg/dL)
- Deficiencies seen in SLE.
- C-Reactive Protein (CRP):
- Less than 10 mg/L
- Increased in rheumatoid arthritis, cancer, and SLE; suppressed by aspirin and steroids.
- Antigen/Antibody Combination Immunoassay:
- Negative
- Detects HIV-1 and HIV-2 antibodies and HIV-1 p24 antigen.
- Antibody Differentiation Immunoassay:
- Negative
- Differentiates between HIV-1 and HIV-2 antibodies.
- Nucleic Acid Test:
- Positive HIV-1
- Confirmation test for HIV-1 if antigen/antibody combination immunoassay is positive but antibody differentiation immunoassay is nonreactive or inconclusive.
- Immunoglobulin Assay or Electrophoresis:
- IgG (650–1600 mg/dL)
- IgM (50–300 mg/dL)
- IgA (40–350 mg/dL)
- IgE (Less than 160 units/L)
- IgD (Less than 15 mg/dL)
- Abnormal levels indicate various infections, liver diseases, and immune disorders.
- Radioallergosorbent Test (RAST): A viable alternative to skin testing is the patient has multiple allergies.
- CD4 Count:
- Percentage: 28%–51%
- Count: 332–1642 cells/microL
- Guides antiretroviral therapy.
- CD8 Count:
- Percentage: 12%–38%
- Count: 170–811 cells/microL
- Increased in viral infections, decreased in SLE.
Diagnostic Procedures for the Immune System
- Gene Testing:
- A sample of DNA is examined for genetic disorders. Abnormal findings may confirm a diagnosis or indicate risk.
- Nursing Management: Identify patient support systems and provide counseling referral.
- Biopsy:
- Tissue is examined microscopically to confirm a diagnosis or evaluate treatment for cancers, lymphomas, leukemias, and transplant rejections.
- Nursing Management: Ensure informed consent, monitor vital signs and site for bleeding.
- Skin Testing:
- Testing is done for Candida, tetanus, tuberculosis (PPD), or specific allergens.
- If erythema or induration occurs, the test is positive, indicating exposure.
- Nursing Management: Ask if patients have any allergies and the type of reaction or symptoms that occur.
Therapeutic Measures for the Immune System
- Allergies:
- Medical identification jewelry is essential.
- Verify allergies before giving medications or foods.
- Allergen Exposure Treatment:
- Epinephrine auto-injector (EpiPen): Must be carried, checked for discoloration and expiration.
- Antihistamines (diphenhydramine)
- Obtain emergency medical care immediately after using epinephrine auto-injector.
- Immunotherapy:
- Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) aim to desensitize.
- SCIT:
- Inject small amounts of allergen extract, gradually increasing the concentration.
- Anaphylactic reactions can occur; HCP and emergency equipment should be available.
- SLIT:
- Use tablets or drops containing allergen extracts placed under the tongue.
- Effective in dust-mite allergy-related asthma.
- Significantly lower anaphylactic event occurrence than SCIT.
- Medications:
- Antibiotics, antihistamines, antivirals, corticosteroids, decongestants, epinephrine, H2 blockers, hormone therapy, immunosuppressants, interferon, leukotriene antagonists, and mast cell stabilizers.
- Surgical Management:
- Splenectomy may be needed, increasing the risk of infection.
- Monoclonal Antibodies:
- Used for transplant rejections and cancer.
- Recombinant DNA Technology:
- Replaces abnormal genes with normal genes, injected into patients to cure disorders.
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