Nokea
Identify the mismatched receptor: ligand pair
- A. NOD2: peptidoglycan
- B. TLR9: CpG DNA
- C. TLR5: dsRNA
- D. RIG-I: viral RNA
Correct Answer: C
Rationale: TLR5 recognizes flagellin, not dsRNA. This is why choice C is the correct answer. NOD2 binds to peptidoglycan (A), TLR9 binds to CpG DNA (B), and RIG-I recognizes viral RNA (D). Each receptor has specificity for a different ligand, making choice C the mismatched pair.
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What is the lag phase of the primary antibody response?
- A. 1-3 days
- B. 5-10 days
- C. 10-15 days
- D. No lag phase
Correct Answer: B
Rationale: The lag phase of the primary antibody response refers to the time it takes for the immune system to generate specific antibodies after initial exposure to an antigen. The correct answer is B (5-10 days) because during this period, B cells are activated, undergo proliferation, differentiate into plasma cells, and start producing antibodies. This process takes time as the immune system needs to recognize the antigen, mount a response, and produce sufficient antibodies. Option A (1-3 days) is too short for the full activation and differentiation of B cells. Option C (10-15 days) is too long for the typical lag phase duration. Option D (No lag phase) is incorrect because there is always a lag phase before the peak antibody production in the primary immune response.
A patient with systemic lupus erythematosus (SLE) is admitted to the hospital for evaluation and management of acute joint inflammation. Which information obtained in the admission laboratory testing concerns you most?
- A. The blood urea nitrogen (BUN) level is elevated.
- B. The C-reactive protein (CRP) level is increased.
- C. The anti-nuclear antibody (ANA) test is positive.
- D. The lupus erythematosus (LE) cell prep is positive.
Correct Answer: A
Rationale: An elevated BUN level may indicate kidney involvement which is a serious complication of SLE. The other findings are expected in SLE and do not indicate an urgent problem. CRP is a marker of inflammation and positive ANA and LE cell prep are diagnostic of SLE but do not indicate acute complications.
The nurse notes that a patient's eosinophil level is elevated. For which health problem should the nurse plan care for this patient?
- A. Cancer
- B. Allergic reactions
- C. Acute viral infections
- D. Autoimmune diseases
Correct Answer: B
Rationale: The elevated eosinophil level indicates an allergic reaction. Eosinophils are white blood cells involved in allergic responses. They increase in response to allergens. Allergic reactions involve the immune system's response to harmless substances, triggering the release of eosinophils. Cancer, acute viral infections, and autoimmune diseases typically do not directly cause eosinophil elevation. Therefore, the correct answer is B (Allergic reactions).
Patients with septic shock are treated, among other drugs, with activated protein C. The purpose of this treatment is to
- A. Dampen the cytokine storm
- B. Raise the blood pressure
- C. Resolve DIC (disseminated intravascular coagulation)
- D. Boost the immune response
Correct Answer: C
Rationale: The correct answer is C: Resolve DIC. Activated protein C is used in septic shock to address the coagulopathy associated with DIC, a common complication. Activated protein C inhibits clotting factors and promotes fibrinolysis, helping to restore normal coagulation function. This treatment does not directly dampen the cytokine storm (choice A), raise blood pressure (choice B), or boost the immune response (choice D) in septic shock patients. It specifically targets the coagulation abnormalities seen in DIC, making choice C the most appropriate answer.
What type of cells do natural killer (NK) cells target?
- A. Bacterial cells
- B. Virus-infected and cancerous cells
- C. Plasma cells
- D. Self-antigens
Correct Answer: B
Rationale: Natural killer (NK) cells target virus-infected and cancerous cells because they have the ability to recognize abnormal cells through activating receptors. These cells can identify changes in surface markers associated with viral infection or cancer, leading to their destruction. NK cells do not target bacterial cells (choice A), plasma cells (choice C), or self-antigens (choice D) as these are not typically recognized as threats by the immune system. NK cells play a crucial role in immune surveillance against abnormal cells, making choice B the correct answer.