An HIV positive intravenous drag user is suspected of having active tuberculosis
ID: 944215 • Letter: A
Question
An HIV positive intravenous drag user is suspected of having active tuberculosis, and a tuberculin (Mantoux) intradermal skin test is performed. After 48 hours, 10 cm of induration is observed. Which of the following are involved in this form of hypersensitivity reaction? B cells and antibodies Basophils and IgF. Immune complexes and complement Plasma cells and IgM T cells A client experiences an anaphylactic reaction after taking the first dose of a newly prescribed antibiotic. The client history reveals that the client had taken the antibiotic once before without a problem. The nurse's explanation to the client will be based on what knowledge of hypersensitivity response? A histamine precursor causes anaphylaxis and a life-threatening situation. IgE antibodies destroy mast cells, releasing substanccs that causc hypotension and vascular collapse. Cell-mediated response, or delayed hypersensitivity, is caused by sensitized T lymphocytes and can lead to tissue injury. Massive numbers of red blood cells are lysed because of an incompatibility with the medication that requires discontinuing the medication. A female client who has recently been diagnosed with type 1 diabetes mellitus (DM) asks the nurse how she developed this because no one in her family is a diabetic, The nurse s best response is. "DM is an autoimmune disease characterized by: Failure of the immune system to recognize self. Kxacerbations and remissions. Accelerated production of killer T-cclls. Immunosuppression and altered cortisol levels.Explanation / Answer
Answer 5) e. T- cells
Tuberculin test is an example of type IV hypersensitivity reaction. Type IV hypersensitivity is often called delayed type hypersensitivity as the reaction takes two to three days to develop. Unlike the other types, it is not antibody mediated but rather is a type of cell-mediated response. Cell-mediated immunity is an immune response that does not involve antibodies, but rather involves the activation of phagocytes, natural killer cells (NK), antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. A classic example of delayed type IV hypersensitivity is the Mantoux tuberculin test in which skin induration indicates exposure to tuberculosis. Other examples include: temporal arteritis, Hashimoto's thyroiditis, symptoms of leprosy, symptoms of tuberculosis, coeliac disease, graft-versus-host disease and chronic transplant rejection. In this Mantoux test the reaction is read by measuring diameter of induration across the forearm in millimetres. (Source: Boundless. “Type IV (Delayed Cell-Mediated) Reactions.” Boundless Microbiology. Boundless, 21 Jul. 2015. Retrieved 29 Feb. 2016)
Answer 6) b. IgE antibodies destroy mast cells releasing substance that causes hypotension and vascular collapse
This is an example of type I hypersensitivity reaction. Type I hypersensitivity (or immediate hypersensitivity) is an allergic reaction provoked by reexposure to a specific type of antigen referred to as an allergen. This is one of the more common types of allergies and there is a hereditary predisposition for anaphylactic reactions. The process itself involves B cells, mast cells and basophils. It appears that these individuals mount a vigorous immune defence against something that is not harmful, whereas the healthy immune system would not react so strongly. During the first exposure to allergen, contact is made with B cells that differentiate and produce IgE antibody. The IgE against the allergen is released into the bloodstream and eventually binds to Fc receptors on mast cells and basophils. The mast cells are now sensitized, laying in wait for the second exposure. Upon contact with allergen a second time, it now attaches to IgE present on mast cells causing degranulation. On the cellular level, the granules present in the cytoplasm migrate to the cellular membrane and spill out their contents into the surrounding area. This results in the release of histamine, slow reacting substance of anaphylaxis (SRS-A), heparin, prostaglandins, platelet-activation factor (PAF), eosinophil chemotactic factor of anaphylaxis and proteolytic enzymes. These cocktails of proteins are the mediators of inflammation and they trigger a number of physiological responses including smooth muscle contraction, an increase in vascular permeability and mucous secretion.
Answer 7) a) A failure of immune system to recognize it self
Diabetes mellitus type 1 (also known as type 1 diabetes, or T1D; formerly insulin-dependent diabetes or juvenile diabetes) is a form of diabetes mellitus that results from the autoimmune destruction of the insulin-producing beta cells in the pancreas. It involves auto reactive CD4+ T helper cells and CD8+ T cells, autoantibody-producing B cells and activation of the innate immune system. The subsequent lack of insulin leads to increased blood and urine glucose. The classical symptoms are polyuria (frequent urination), polydipsia (increased thirst), polyphagia (increased hunger) and weight loss. Type 1 diabetes can be distinguished from type 2 by autoantibody testing. The C-peptide assay, which measures endogenous insulin production, can also be used.