Which of the following is a systemic sign of infection?
Pain
Erythema
Swelling
Fatigue
Which of the following does NOT directly determine the virulence of a microbe?
Whether its gram positive or negative
Invasive qualities
Ability to mutate
Production of toxins
The widespread necrosis of respiratory mucosa caused by an influenza infection often gives rise to:
Subclinical infections
Primary infections
Secondary infections
Tertiary infections
Which of the following bodily fluids would you expect to be sterile?
Blood
Vaginal discharge
Faeces
Sputum
That time during an infection when the infected person may experience a headache or fatigue and senses he or she is “coming down with something” is referred to as which of the following?
Subclinical
Acute
Prodromal
Incubation
Which of the following is a local sign of infection?
Fever and leukocytosis
Headache and anorexia
Nausea, weight loss, and fatigue
Pain, erythema, and swelling
What are culture and sensitivity tests used for?
To provide a specific medium that supports maximum microbial growth
To provide living host cells for microbes requiring such for replication
To identify the causative microbe and the effective antimicrobial agent for it
To determine the type of microbe present in a specimen
What does leukocytosis frequently indicate?
Presence of viral infection
Presence of bacterial infection
Bone marrow damage
Immunosuppression
Secondary immune deficiencies occur because of:
Lack of protein in the diet
Long term use of prednisone
Stressful job
All answers are correct
A common symptom of individuals with immunodeficiency is:
Anaemia
Recurrent infections
Lots of allergies
Auto antibody production
Primary immune deficiencies occur because of:
bad nutrition
a genetic defect
recurrent infections
chronic diseases affecting the immune system
Immunodeficiencies may result in an increased risk of infections by normally harmless microorganisms. These infections are referred to as:
transient
pathogenic
opportunistic
virulent
Which of the following is an effect of cytokines? They:
increase the rate of mitosis in tumors.
cause immediate pain.
activate and stimulate proliferation of B and T lymphocytes.
destroy antigens quickly.
An incompatible blood transfusion is an example of this type of hypersensitivity reaction:
Type IV
Type III
Type II
Type I
Reaction to latex gloves (in most cases) is an example of what type of hypersensitivity reaction:
In this type of reaction, the antigen and antibody combine forming an immune complex which then can get deposited into tissue for example the kidneys.
A bee sting that causes a person to go into anaphylactic shock is an example of this type of hypersensitivity reaction:
The first line of defense which changes very little during our lifetime is called
Passive immunity
Active immunity
Adaptive immune response
Innate immune response
Humoral immunity is mediated by:
T lymphocytes (T cells).
B lymphocytes (B cells).
natural killer cells.
neutrophils.
Which white blood cells are responsible for adaptive immunity:
Monocytes
Eosinophils
Neutrophils
Lymphocytes
A molecule that will stimulate the adaptive immune response:
Antigen
Pathogen
Immunoglobulin
Antibody
Neutrophils:
produce histamine.
produce antibodies.
are elevated during an allergic response.
are phagocyte cells.
The role of memory cells is to:
change into an antibody-secreting cell following activation.
immediately secrete antibodies following the first exposure to antigen.
recognize the antigen and stimulate the immune response.
bind complement to the antibody.
Natural killer cells
T cells
B cells
The most abundant, actively motile, phagocytic leukocyte is the:
Neutrophil
Monocyte
Basophil
Macrophage
Which cells are required to process and present antigens from foreign material as the initial step in the immune response?
T-helper cells
Macrophages
The immunoglobulin that is found in tears and saliva is:
IgB
IgA
IgM
IgG
Exposure to peanuts where the person goes into anaphylactic shock is an example of this type of hypersensitivity reaction:
A common primary target for most immunosuppressant drugs is:
B cell activation
All cytokines
T cell activation
An autoimmune disease is:
an abnormal response to ingested food and drugs
failure of the immune system to distinguish self from nonself
an extreme response to normally harmless material in the environment
excessive formation of antibodies following exposure to foreign material
When an allergen binds with IgE antibodies on mast cells, resulting in release of chemical mediators, this reaction is called:
Delay hypersensitivity
Cytotoxic hypersensitivity
Immune complex hypersensitivity
Type 1 hypersensitivity
Autoimmunity arises when a breakdown in 'self-
Specificity
Immunity
Memory
Tolerance
A 22-year-old prostitute was recently diagnosed with HIV. A decrease in which of the following cell types would be expected to accompany this virus?
CD8 T cells
T memory cells
CD4 T cells
A genetic defect
HIV
Excessive emotional stress
Lack of vitamin C
A 30-year-old male was diagnosed with HIV. Which of the following treatments would be effective?
ribavirin
reverse transcriptase inhibitors
cell wall synthesis inhibitors
inhibitors of metabolism
Which type of immunity is provided by a vaccination?
Passive natural
Active artificial
Active natural
Passive artificial
Which of the following is NOT a cause of immunodeficiency?
Hypoplasia of the thymus
Immunosuppresive agents
Atrophy of lymph nodes
Delayed hypersensitivity
All of the following are factors that promote healing EXCEPT:
Effective circulation
Advanced age
Good nutrition: protein, vitamins A & C
A clean, undisturbed wound
A raised thickened scar that grows beyond the wound margin is
Keloid scar
Epithelialisation
Ulcer
Hypertrophic scar
The purpose of inflammation include all the following except:
Eliminate/neutralise injurious agent
To remove body toxins
Localise injury and prevent further damage
Clean-up tissue for healing
The first phagocytic cell(s) to enter a site of injury are:
Systemic manifestations of inflammation include all EXCEPT:
Pyrexia
Malaise
Regional swelling
Anorexia
Pathophysiology may be defined as the study of:
Disease patterns
Disease causes
How disease develop and alter body function
A collection of signs and symptoms
Glucocorticoids are produced by
The hypothalamus
The spleen
The thymus glands
The adrenal glands
The mechanism of action of glucocorticoids include all of the following except:
Inhibit of helper T cells
Prevent the synthesis of arachidonic acid
Increase production of antibodies
Inhibit protein synthesis of chemical mediators
Which of the following effects is NOT one typically associated with glucocorticoids?
Reduced prostaglandin sythesis
Stimulation of fat and protein break down
Reduced bone density
Increased sodium and water retention
Patients taking glucocorticoids for long periods of time are likely to develop all of the following
Opportunistic infections
Decreased bone density
Increased leukocyte production
Wasting skeletal muscle
Which of the following drugs relieves fever and some types of pain but is NOT an anti-inflammatory agent?
Paracetamol
Prednisone
Asprin
Ibuprofen
Drugs that have anti-inflammatory, analgesic, and antipyretic activities include: 1. COX-2 inhibitors (NSAIDs). 2. glucocorticoids (e.g., prednisone). 3. ibuprofen (NSAID). 4. paracetamol. 5. aspirin.
1,2
2,4
1,3,5
1,4,5
All of the following are correct statements regarding wound healing EXCEPT:
Resolution occurs where there is minimal tissue damage and the cells can recover.
Regeneration occurs where the cells are capable of mitosis.
Granulation tissue forms a permanent replacement for damaged tissue.
Scar tissue forms where the surrounding cells are incapable of mitosis
Which of the following factors generally WOULD NOT delay wound healing?
Poor nutrition
Adequate serum levels of Vitamins A & C
Hypoxia
exudates are thick, yellow/green and typically indicates a bacterial infection
Serous
Fibrinous
Purulent
Haemorrhagic
Chemical mediators released during inflammatory response include:
Albumin and fibrinogen
Growth factors and cell enzymes
Histamine and prostaglandins
Macrophages and neutrophils
Aetiology is defined as the study of the:
causes of a disease
course of a disease
expected complications of a disease
manifestations of a disease
Identify the proper sequence in the healing process
1)A blood clot forms; 2) granulation tissue grows into the gap; 3) new blood vessels develop; 4) phagocytosis of foreign material and cell debris occurs; 5) and collagen fibers form a tight, strong scar.
1)Foreign material and cell debris are removed by phagocytes; 2) a blood clot forms; 3) granulation tissue grows into the gap; 4) new blood vessels form; 5) and collagen fibers grow and cross-link.
1) A blood clot forms; 2) phagocytes remove foreign material and cell debris; 3) granulation tissue grows into the gap; 4) new blood vessels form; 5) and collagen fibers promote formation of a tight, strong scar.
1) Collagen fibers form in the damaged area; 2) a blood clot forms; 3) granulation tissue grows into the gap; 4) angiogenesis takes place; 5) and foreign material and cell debris are removed by phagocytes.
To which of the following does the term apoptosis refer?
Unplanned death of a group of cells
Preprogrammed cell self-destruction
Increase rate of mitosis of cells
Necrotic tissue invaded by bacteria
A patient is on a high dose of glucocorticoids to treat lupus. Which of the following blood tests would a nurse be most concerned about?
Blood glucose
Liver enzymes
Clotting time
pH
A patient with type 1 diabetes was prescribed a glucocorticoid for chronic obstructive pulmonary disease. Which will the nurse expect in the treatment plan?
A decrease in the amount of insulin needed
An increase in the amount of insulin needed
No change in the amount of insulin needed
An increase in the need for carbohydrates
Inflammation is a non-specific response to:
Any injury to vascularised tissue
Cold temperatures
Micro-organisms only
Foreign material only
Histamines are produced from ? and cause ?.
Plasma proteins; increased platelet aggregation
Mast cells; vasodilation and increased capillary permeability
All cell membranes; pain
Platelets; attraction of neurophils
A broad-spectrum bactericidal agent would be expected to:
reduce the replication of many bacteria.
reduce the growth of many gram-positive and gram-negative bacteria
destroy many gram-positive and gram-negative bacteria
destroy all pathogenic microbes
Bacterial mutation means that:
pathogens become nonpathogens
the host's immune response to that bacteria is strengthened
the bacteria survives adverse conditions but can no longer replicate
its genetic information has changed
Pathogenicity:
is the capacity of microbes to cause disease/infection
is the size of a specific microbe
is the presence of toxins in the blood
is the presence of viruses in the blood
Exotoxins:
are very heat tolerant
may cause fever and fatigue
can disrupt cellular metabolic and signalling processes causing widespread damage
can be incorporated into the structure of the cell membrane as liposaccharides
Gram negative bacteria have
A thick peptidoglycan layer cell wall
A thin peptidoglycan cell wall sandwiched between an inner cytoplasmic cell membrane and a bacterial outer membrane.
No cell wall only a thick cell membrane
require oxygen as a source of energy and therefore for growth.
Protozoa:
are multicellular organisms
have intricate life cycles including egg, larvae and adults stages
replicate asexually by cell division
all of the answers are correct
Opportunistic infections are:
An infection by a non-pathogenic organism that has become pathogenic
The capacity of microbes to cause disease
Presence and multiplication of micro-organisms that is not yet causing disease
An organism participating in a symbiotic relationship with the host
What is a eukaryotic organism, that contains both a cell wall and cell membrane. When they cause an infection it is termed mycosis
Fungi
Virus
Bacteria
Protozoa
Which of the following factors would NOT increase the virulence of a specific microbe?
Secretion of endotoxins
Presence of a bacterial capsule
Secretion of enzymes
Size of the micro-organism
Triazole as an antifungal agent works by:
Disrupt the synthesis of its cell membrane
Disrupt DNA replication
Disrupt the synthesis of its cell wall
Inhibit hydrogen peroxide metabolism
An antimicrobial agent with a narrow spectrum of activity reflects a drug that has:
only a weak antibiotic action.
effectiveness against a relatively small variety of microbes.
a low potency.
a narrow margin of safety.
Which of the following signs would best indicate a bacterial infection (in comparison to a viral infection)?
The presence of pain
The presence of purelent exudate.
The presence of a serous exudate.
The presence of swelling.
During which period is the infectious disease fully developed?
Aggresive
The structure of a virus includes:
a cell wall and membrane
metabolic enzymes and a cell wall
a protein coat and either DNA or RNA
a slime capsule and cilia
Bacteria:
require host cells in order to replicate
are prokaryotes
may cause mycosis
are contained within a capsid
Which of the following mechanisms is NOT one of the four typical mechanisms of action of antibiotic agents
Affect bacterial folic acid synthesis
Inhibit bacterial DNA synthesis
Disrupt bacterial meiosis
Disrupt cell wall synthesis
Which of the following clinical manifestations is not one typically associated with anaphylaxis
Pruritus
Hypertension
Stridor
Syncopy
Primary immune deficiencies occur as a result of:
A genetic defect affecting immune cell number
Human immunodeficiency virus
An example of a live attenuated vaccine includes:
Polio
Rabies
DPT
Rubella
The main property of the adaptive immune response for immunity to previously encountered infections is:
Antigen specificity
Diversity
Self/non-self recognition
The role of memory cells is to
recognize the antigen and stimulate an immune response.
activate the hippocampus in the CNS
White blood cells responsible for adaptive immunity:
Mast cells
Blocking cytokines
Suppressing B cell activation
Suppressing T cell activity
Suppressing macrophages
Some common treatments for immunodeficiency may include marrow or thymus transplants and:
Hyperbaric treatments
Blood transfusions and narrow spectrum antibiotics
Prophylactic antibiotics and cytokine stimulants
Antibiotics and radiation therapy
Interferons work by:
Suppress viral replication in infected cells
Stimulates cytokine production
Inhibit macrophage activity
Inducing fever
The immune system identifies foreign organisms via the recognition of surface:
antigens
cytokines
interferons
antibodies
Type 1 diabetes mellitus is associated with a:
Type III hypersensitivity reaction
Type II hypersensitivity reaction
Type IV hypersensitivity reaction
Type I hypersensitivity reaction
Systemic lupus erythematosus is caused by:
development of an immune-deficient state.
a chronic allergic condition.
immune complex deposits of anti DNA/RNA antibodies.
a deficiency of T lymphocytes.
The type of white blood cells that contains chemical mediators and plays an important part in allergic inflammatory responses is the:
The common local effects of an expanding tumour mass include: 1. obstruction of a tube or duct. 2. anemia and weight loss. 3. cell necrosis and ulceration. 4. tumour markers in the circulation.
1,3
1,2,3,4
Which of the following does paraneoplastic syndrome refer to?
The decreased resistance to infection resulting from malignant tumors
The effects of substances such as hormones secreted by the tumor cells
The effects of multiple metastatic tumors
Severe weight loss and cachexia associated with advanced cancer
Ultraviolet light is considered a carcinogen because:
It produces a carcinogenic enzyme in skin cells
It introduces errors into DNA (genes)
It directly prevents telomere shortening
It directly prevents DNA repair
First line treatment for testicular cancer always involves
nodulectomy
chemotherapy
radiation
orchidectomy
Staging systems used to classify a malignant tumour at the time of diagnosis are based on which of the following factors?
Size, encapsulated or non-encapsulated, invasion into neighboring tissue
Size of the tumour, involvement of lymph nodes, metastases
Location of tumour, size, type of cellular abnormality
Type of cellular abnormality, size of secondary tumours, location/tissue affected
Why is a patient with prostate cancer prescribed an estrogen?
To soften prostatic tissue
To decrease the rate of replication for malignant cells
To achieve hormonal balance
To suppress prostate gland function
Seeding refers to:
Spread of cancer cells in body cavities/membranes
Spread of cancer cells into the nearest lymph node
Local spread of cancer cells within a tissue
Spread of cancer cells to distant sites in the body by blood or lymph
