Patho: Exam 2 Review

A 19-year-old college student arrives at the campus clinic minutes after eating a packaged trail mix at a study group. She reports sudden itching, flushing, and “throat tightness.” Vitals: T 98.7°F, HR 124, BP 86/54, RR 26 with audible wheeze, SpO₂ 93% RA. The exam shows perioral swelling, diffuse urticaria over the chest and arms, and mild abdominal cramping. She is anxious and speaking in short phrases. Nurses note the rapid progression of symptoms in the waiting area.

Which type of hypersensitivity reaction is this?

-Which is the predominant antibody causing the reaction?

-Based on the manifestations, is this a local or systemic reaction? Why?

-What cellular process causes this reaction?

Type 1, systemic because there are multiple different reactions in different areas of the body, anaphylaxis

A 28-year-old graduate student presents with perioral tingling, intermittent hand cramping, and lightheadedness. She has had limited sun exposure and a restrictive diet. Exam: positive Trousseau’s sign, mild diffuse hyperreflexia; lungs clear. ECG shows a prolonged QT interval.

-What type of electrolyte disorder does this patient most likely have?

-Which signs and symptoms confirm this disorder?

-Why would the electrolyte disorder in this case cause these specific symptoms?

-Why would limited sun exposure and a restrictive diet contribute to this disorder?

hypolcalcemia, vitamin d is gotten through sun exposure and if he isnt intaking calcium in his diet through milk, etc.

A 68-year-old woman with severe osteoarthritis is brought in for progressive drowsiness and morning headaches. She recently increased her prescribed opioid dose for pain control. Vitals: T 98.6°F, HR 88, BP 134/78, respirations are slow and shallow. Oxygen levels are normal. She is arousable but sluggish; pupils are midsize and reactive. Lungs are clear; no focal neurologic deficits. Nurses report that when she dozes off, her breathing slows further.

-What is the most likely acid-base imbalance based on the information presented?

-What information likely confirms this imbalance?

-What would the renal system do to compensate for this imbalance?

respiratory acidosis; drowsy, shallow breathing; produce/reabsorb more bicarbonate 

A 24-year-old woman presents with 2 months of intermittent low-grade fever, profound fatigue, and aching in both wrists and knees. She notes a rash across the cheeks that worsens after weekend sun exposure. Exam reveals a symmetric, non-erosive polyarthralgia and an erythematous malar (“butterfly”) facial rash without pustules. No focal lung findings; mild ankle edema. She denies new medications.

-What type of hypersensitivity reaction is this?

-Which exemplar disease is this demonstrating? How do you know?

-How is the immune process leading to damage?

Type 3; lupus antibody antigen combination getting stuck in areas it shouldn’t be (ie, the joints) and that creates the inflammatory process

In the chain of infection, a reservoir could be soil, water, inanimate object, a human or an animal.

True

Which electrolyte imbalance is likely to cause uncontrolled or involuntary muscular contractions of the vocal folds?

hypocalcemia

Why are patients with HIV prone to unusual infections and a weakened immune system?

They have a loss of T cells that weakens both humoral and cellular defense

An immune reaction against antigens from another individual of the same species, usually used in the context of maternal-fetal incompatibility.

isoimmune

A pt with SLE develops SOB and is found to have reduced kidney function on labs. Which mechanism best explains how chronic inflammation contributes?

chronic immune activation causes ongoing tissue injury and fibrosis in the kidney

Which type of hypersensitivity reaction is T-cell mediated and there is cytokine release?

type IV

True or False? During a transfusion reaction, RBC destruction can release bilirubin.

true

Which hormone promotes renal reabsorption of sodium and water to support intravascular volume?

aldosterone

Antinuclear antibodies (ANA) are autoantibodies that are seen in type III immune complex manifestations.

true

The hormone that lowers serum calcium by inhibiting bone resorption is:

calcitonin

Tingling or “pins and needles” sensations in hands or around the mouth would be documented as:

parasthesias

A substance that donates protons and raises hydrogen ion concentration is a(n):

acid

 In the body, the primary volatile component produced by metabolism that influences acid–base status is:

carbon dioxide

An exaggerated immune response to a typically harmless antigen is termed:

hypersensitivity

A reaction in which antibodies target cells leading to their destruction is characteristic of a:

cytotoxic reaction

Recurrent oral thrush and Pneumocystis infection in a patient with low CD4+ count most strongly indicates:

opportunistic infection

The T-lymphocyte subset that coordinates immune responses via cytokine signaling is:

CD4 and T helper cells

A 20 year old had recurrent bacterial sinusitis due to low IgG and IgA. Which yupe of immunity is primarily deficient?

humoral

Which electrolyte is most critical for resting membrane potential in excitable cells

potassium

Chain of Infection: Which is missing: agent→ reservoir→ protal of exit→ mode of transmission→ portal of exit→ _____

susceptable host

A patient with hemolytic anemia from anti-RBV antibodies exemplifies which hypersensitivity?

type II

Renal compensation for a chronic respiratory disorder primarily adjusts

Bicarbonate

A stident identifies a vehicle-borne outbreak sourse. Whoch example fits best?

Hep C from shared needles

Which lab combo best supports humoral immunodeficiency?

low IgG/IgA

Hypernatremia most often reflects:

water deficit relative to sodium

In metablolic alkalosis from vomiting, which compensation occurs?

hypoventilation

Latex contact dermatitis appearing two days after

delayed T cell reaction

A patient exposed 48 hours ago to a pathogen has no symptoms. Which infection stagebest explains this.

Incubation

Which buffer system is the major component in the blood

Bicarbonate- carbonic acid

Primary hyperparathyroidism typically causes

hypocalcemia

A 72 year old with confision after a fall is noted to have alow Na low serum osm and high urin osm. What is the cause?

SIADH

A student forgets hand hygiene between patients. What link in the infection chain becomes broken?

transmissipon

What hormone is secreted in the thirst mechanism?

ADH