Immunoglobulins and Hypersensitivity
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Questions and Answers

A patient experiences a severe allergic reaction after a bee sting. Which type of hypersensitivity reaction is most likely responsible for this immediate response?

  • Type 1: IgE-mediated (correct)
  • Type 2: Antibody-mediated
  • Type 3: Immune complex-mediated
  • Type 4: Delayed hypersensitivity

Which immunoglobulin is primarily involved in protecting mucous membranes?

  • IgM
  • IgG
  • IgA (correct)
  • IgE

In a Type 3 hypersensitivity reaction, such as systemic lupus erythematosus, what is the primary mechanism of tissue damage?

  • Direct T-cell cytotoxicity
  • IgG/IgM binding to cell surfaces followed by phagocytosis
  • Deposition of insoluble antigen-antibody complexes leading to inflammation (correct)
  • Immediate mast cell degranulation and histamine release

Why does a Type 4 hypersensitivity reaction take 24-72 hours to manifest?

<p>T-cells need time to migrate and elicit an immune response (C)</p> Signup and view all the answers

Which of the following hypersensitivity reactions involves the activation of the complement system leading to cell damage?

<p>Type 2 (B)</p> Signup and view all the answers

A patient with a spinal cord injury at the T5 level presents with hypotension and bradycardia. Which type of shock is the MOST likely cause?

<p>Neurogenic shock (D)</p> Signup and view all the answers

Which of the following mechanisms is the PRIMARY cause of decreased blood pressure in anaphylactic shock?

<p>Systemic vasodilation caused by histamine release (A)</p> Signup and view all the answers

A patient with a severe infection develops septic shock. The patient's blood pressure is decreasing. Which of the following best explains why this might be happening?

<p>Massive vasodilation and the body's inability to compensate (A)</p> Signup and view all the answers

A patient experiencing a large blood loss is at risk of hypovolemic shock. Which compensatory mechanism would be LEAST effective in maintaining blood pressure?

<p>Profound vasodilation (C)</p> Signup and view all the answers

A patient presents with hypotension, increased heart rate, and increased respiratory rate. Further examination reveals a tension pneumothorax. Which type of shock is the patient MOST likely experiencing?

<p>Obstructive shock (A)</p> Signup and view all the answers

A patient presents with muscle weakness and EKG changes showing flattened T waves. Which of the following electrolyte imbalances is MOST likely the cause?

<p>Hypokalemia (B)</p> Signup and view all the answers

Which of the following conditions would MOST likely result in a shift of $K^+$ from the intracellular fluid (ICF) to the extracellular fluid (ECF), potentially leading to hyperkalemia?

<p>Metabolic acidosis (C)</p> Signup and view all the answers

Impaired kidney function can lead to hyperkalemia due to which of the following mechanisms?

<p>Decreased potassium excretion (B)</p> Signup and view all the answers

A patient's lab results show tall, peaked T waves on their ECG. Which electrolyte imbalance is MOST likely indicated by this finding?

<p>Hyperkalemia (D)</p> Signup and view all the answers

Which of the factors below contributes to hypomagnesemia by inhibiting magnesium absorption in the GI tract?

<p>Phytic acid (C)</p> Signup and view all the answers

A patient with heart failure is admitted with euvolemic hyponatremia. Which of the following mechanisms BEST explains the development of hyponatremia in this patient?

<p>Retention of excess fluid diluting the sodium concentration in the extracellular fluid. (C)</p> Signup and view all the answers

A patient is admitted with hypernatremia and clinical signs of dehydration. Which of the following physiological responses would the body INITIALLY employ to compensate for this imbalance?

<p>Increased ADH secretion to promote water retention by the kidneys. (A)</p> Signup and view all the answers

A patient presents with confusion, lethargy, and muscle twitching. Lab results reveal a serum sodium level of 118 mEq/L. Which of the following mechanisms is MOST directly responsible for the neurological symptoms observed in this patient?

<p>Fluid shift into neurons causing cellular swelling and increased intracranial pressure. (D)</p> Signup and view all the answers

A patient with a history of diabetes insipidus is admitted with a serum sodium level of 155 mEq/L. Which mechanism is MOST likely contributing to the patient's hypernatremia?

<p>Inadequate secretion of ADH leading to impaired water reabsorption in the kidneys. (D)</p> Signup and view all the answers

A patient is receiving a continuous infusion of 3% hypertonic saline to treat severe symptomatic hyponatremia. Which of the following BEST describes the expected fluid shift resulting from this treatment?

<p>Fluid shift from the intracellular space (ICF) to the extracellular space (ECF). (A)</p> Signup and view all the answers

Which of the subsequent processes exemplifies the complement system's role in aiding the first line of defense?

<p>Promoting bacterial aggregation to enhance phagocytosis. (B)</p> Signup and view all the answers

During hypovolemic shock, the body initiates several compensatory mechanisms. Which of the following is a counterproductive response that exacerbates the condition if hypoperfusion continues?

<p>Vasodilation in the kidneys leading to urine output. (B)</p> Signup and view all the answers

A patient in shock exhibits an increased cardiac preload. What negative consequence can arise from this condition?

<p>Excess fluid in the ventricles that the heart is unable to effectively pump. (C)</p> Signup and view all the answers

If the body's compensatory mechanisms for shock fail, leading to hypoxia and hypercapnia, what is the MOST likely subsequent central nervous system (CNS) response?

<p>Seizures, stupor, and coma. (D)</p> Signup and view all the answers

During the initial compensation stage for decreased oxygen levels ($\text{O}_2$), the body responds by hyperventilating. What is the primary purpose of this action?

<p>To decrease $\text{CO}_2$ to increase the partial pressure of $\text{O}_2$. (B)</p> Signup and view all the answers

Flashcards

IgG

Most abundant immunoglobulin, crosses the placenta, and activates the complement system.

IgA

Immunoglobulin found in secretions (saliva, tears, mucus); protects mucous membranes.

IgM

Immunoglobulin associated with initial response to antigens and blood typing.

Type 1 Hypersensitivity

Hypersensitivity where IgE antibodies bind to mast cells and basophils.

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Type 4 Hypersensitivity

Hypersensitivity that is a delayed T-cell mediated reaction.

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Shock (General)

A syndrome characterized by decreased blood pressure, not a disease itself.

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Anaphylactic Shock

Shock due to severe allergic reaction causing vasodilation and low blood pressure.

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Neurogenic Shock

Shock resulting from spinal injury, leading to loss of autonomic function and low blood pressure.

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Septic Shock

Shock caused by infection in the bloodstream, resulting in low blood pressure.

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Cardiogenic Shock

Shock due to the heart's inability to pump enough blood to meet the body's oxygen needs.

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Hypokalemia

Low potassium levels in the extracellular fluid (ECF).

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Hyperkalemia

High potassium levels in the extracellular fluid (ECF).

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Metabolic Acidosis and Potassium

Potassium shifts from ICF to ECF due to increased acidity in the blood.

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Cellular Injury and Potassium

Potassium shifts from ICF to ECF due to cellular damage.

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Hypomagnesemia

Low magnesium levels in the body.

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Hyponatremia Definition

Sodium concentration below 135-145 mEq/L.

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Hypovolemic Hyponatremia

Renal/external fluid loss combined with elevated ADH, causing sodium deficit.

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Euvolemic Hyponatremia

Excess fluid dilutes sodium levels, while total volume increases without change in ECF sodium.

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Hypervolemic Hyponatremia

Total volume increases more than sodium, causing fluid shift into cells.

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Hypernatremia Definition

Sodium concentration above 145 mEq/L.

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Complement System

A part of the immune system that enhances (complements) the ability of antibodies and phagocytic cells to clear microbes and damaged cells, promote inflammation, and attack the pathogen's cell membrane.

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Complement System Actions

Bacterial aggregation enhances phagocytosis; vasodilation increases vessel permeability, causing redness, swelling & inflammation.

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ICF to ECF Shift Effects

Fluid shift from ICF to ECF causing low blood volume and low blood pressure & leads to vasoconstriction, increased HR and vasodilation in kidneys.

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Compensation for Decreased $O_2$

Decreased oxygen leads to increased ventilation to eliminate $CO_2$ to compensate.

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Uncompensated Hypoxia/Hypercapnia

Hypoxia and hypercapnia lead to central nervous system failure (seizures, stupor, coma).

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Description

Overview of immunoglobulins including IgG, IgA, IgM and IgE and their functions. Focus on hypersensitivity reactions: Type 1 (IgE mediated allergy), Type 2 (antibody-mediated autoimmunity), and Type 3 (immune complex-mediated).

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