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The nurse is caring for a patient with an infection. Which immunoglobulin should the nurse understand is produced first when an infection occurs?
- A. IgD
- B. IgE
- C. IgG
- D. IgM
Correct Answer: D
Rationale: Step-by-step rationale for why IgM is the correct answer:
1. IgM is the first immunoglobulin produced in response to an infection.
2. It is the largest immunoglobulin and is effective in agglutinating pathogens.
3. IgM activates the complement system to enhance immune response.
4. IgG is produced later in the immune response and provides long-term immunity.
5. IgD and IgE have specific roles but are not the initial immunoglobulins produced in response to infection.
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Severe combined immunodeficiency (SCID) is a disease caused by:
- A. Infection with human immunodeficiency virus
- B. One of several inherited genetic mutations
- C. Deficiency of both innate and adaptive immune components
- D. Deficiency of hematopoietic stem cells
Correct Answer: B
Rationale: Step 1: SCID is a genetic disorder affecting the immune system.
Step 2: Inherited genetic mutations cause abnormalities in immune cells.
Step 3: These mutations lead to severe deficiencies in immune function.
Step 4: Choice B accurately reflects the genetic basis of SCID.
Summary: Choice A is incorrect because SCID is not caused by HIV. Choice C is incorrect as it oversimplifies the immune deficiencies in SCID. Choice D is incorrect because SCID primarily affects immune cells, not stem cells.
What are the three main principles of adaptive immunity?
- A. Respond, Replace, Repair
- B. Recognize, Respond, Remember
- C. Resist, Retain, Recruit
- D. React, Replicate, Restore
Correct Answer: B
Rationale: The three main principles of adaptive immunity are Recognize, Respond, Remember.
1. Recognize: Immune system identifies specific pathogens through antigen recognition.
2. Respond: Immune response is triggered to eliminate the pathogen.
3. Remember: Immune system forms memory cells for faster and stronger response upon re-exposure.
Other options are incorrect:
A: Respond, Replace, Repair - Incorrect as it does not reflect the key processes of adaptive immunity.
C: Resist, Retain, Recruit - Incorrect as these terms do not accurately describe the adaptive immune response.
D: React, Replicate, Restore - Incorrect as it does not encompass the essential principles of adaptive immunity.
Choose the correct sequence in an allergic reaction.
- A. Allergen → mast cells → histamine → B cells → IgE antibodies
- B. Allergen → IgE antibodies → B cells → histamine → mast cells
- C. Allergen → B cells → IgE antibodies → mast cells → histamine
- D. Allergen → histamine → mast cells → IgE antibodies → B cells
Correct Answer: C
Rationale: Rationale for Answer C:
1. Allergen exposure triggers B cells to produce IgE antibodies specific to the allergen.
2. IgE antibodies bind to mast cells sensitizing them.
3. Upon re-exposure to allergen, allergen binds to IgE on mast cells.
4. This triggers release of histamine and other chemicals causing allergic symptoms.
Summary:
- Choice A: Incorrect because B cells do not produce IgE antibodies before allergen exposure.
- Choice B: Incorrect because IgE antibodies are produced by B cells, not the other way around.
- Choice D: Incorrect because histamine is released after allergen binds to IgE on sensitized mast cells.
A patient with wheezing and coughing caused by an allergic reaction to penicillin is admitted to the emergency department (ED). Which of these medications do you anticipate administering first?
- A. methylprednisolone (Solu-Medrol) 100 mg IV
- B. cromolyn sodium (Intal) 20 mg per nebulizer
- C. albuterol (Proventil) 0.5 mL per nebulizer
- D. aminophylline 500 mg IV over 20 minutes
Correct Answer: C
Rationale: Albuterol is a bronchodilator that acts quickly to relieve wheezing and coughing caused by bronchospasm. It is the first-line treatment for acute allergic reactions affecting the airways. The other medications may be used as adjuncts but are not as immediately effective in relieving bronchospasm.
Compared to antibodies produced in a primary response to a given antigen, the antibodies produced in a memory response are typically:
- A. More likely to be IgM
- B. More likely to be IgG, IgA and/or IgE
- C. Of lower affinity
- D. Two of these responses are correct
Correct Answer: B
Rationale: Step 1: Memory response produces antibodies of higher affinity due to affinity maturation.
Step 2: Memory response involves class switching, leading to production of IgG, IgA, and IgE.
Step 3: IgM is predominant in primary response, but memory response shifts towards other classes.
Summary: Choice B is correct as memory response produces antibodies of higher affinity and different classes. Choices A and C are incorrect as memory response does not typically result in more IgM or lower affinity antibodies. Choice D is incorrect as only choice B is accurate.