Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 15- Disorders of the Immune Response
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | After years of going to different physicians with vague symptoms, a 55-year-old client with a history of Hodgkin disease has been diagnosed with a secondary immunodeficiency syndrome. The client asks the nurse what this means. The nurse knows from the following list of characteristics that secondary immunodeficiency disorders: Select all that apply. | |
| A) | may be inherited as a sex-linked trait. | |
| B) | usually develop later in life. | |
| C) | may be a result of chemotherapy being used to treat a cancer. | |
| D) | can result from frequent recurring Staphylococcus aureus infections. | |
| E) | can occur in a chronic obstructive pulmonary disease patient taking corticosteroids daily. | |
| Ans: | B, C, E | |
| Feedback: | ||
| Secondary immunodeficiency disorders develop later in life as a result of other pathophysiologic states such as malnutrition, disseminated cancers, infection of the cells of the immune system, and treatment with immunosuppressive drugs, such as chemotherapeutic agents. Primary disorders may be congenital or inherited as sex-linked, autosomal dominant, or autosomal recessive traits. Humoral (B-cell) immunodeficiencies are primarily associated with recurrent infections like Staphylococcus aureus. | ||
| 2. | A 2-year-old girl has had repeated ear and upper respiratory infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child’s recurrent infections? | |
| A) | The child’s immune system is unable to synthesize adequate immunoglobulin on its own. | |
| B) | The child had a congenital absence of IgG antibodies that her body is only slowly beginning to produce independently. | |
| C) | The child was born with IgA and IgM antibodies, suggesting intrauterine infection. | |
| D) | The child lacks the antigen-presenting cells integral to normal B-cell antibody production. | |
| Ans: | A | |
| Feedback: | ||
| Transient hypogammaglobulinemia of infancy is characterized by inadequate communication between B and T cells. IgG would be inherited through placental blood, and an intrauterine infection is neither causative or nor synonymous with transient hypogammaglobulinemia of infancy. The diagnosis does not include a lack of antigen-presenting cells. | ||
| 3. | A nurse is providing care for a 17-year-old boy who has experienced recurrent sinus and chest infections throughout his life and presently has enlarged tonsils and lymph nodes. Blood work indicated normal levels of B cells and free immunoglobulins but a lack of differentiation into normal plasma cells. The boy is currently receiving intravenous immunoglobulin (IVIG) therapy. What is the boy’s most likely diagnosis? | |
| A) | X-linked hypogammaglobulinemia | |
| B) | Transient hypoglobulinemia | |
| C) | Common variable immunodeficiency | |
| D) | IgG subclass deficiency | |
| Ans: | C | |
| Feedback: | ||
| The lack of a terminal differentiation from B cells into plasma cells is the hallmark of common variable immunodeficiency. Recurrent infections, enlarged lymph nodes and tonsils, and IVIG therapy are also commonly associated. | ||
| 4. | Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow? | |
| A) | A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use | |
| B) | A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM | |
| C) | A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells | |
| D) | A 9-year-old girl who has a diagnosis of IgA deficiency | |
| Ans: | B | |
| Feedback: | ||
| Decreased IgA, IgE, and IgG with increased IgM levels are characteristic of X-linked immunodeficiency with hyper-IgM, a primary cell-mediated immunodeficiency that would respond to thymic tissue transplantation and MHC-compatible bone marrow. Low IgG levels secondary to phenytoin use, X-linked hypogammaglobulinemia, and selective IgA deficiency are unlikely to be treated with the T-cell–focused treatments like thymic tissue transplantation and MHC-compatible bone marrow. | ||
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