Questions 1-3 refer to this scenario: A man presents to an ER with a large laceration sustained at a construction site a few hours before. The area around the laceration is erythematous, painful, and swollen.
1. The erythema and swelling can be explained at a cellular level by all the following EX...
questions 1 3 refer to this scenario a man presents to an er with a large laceration sustained at a construction site a few hours before the area aro
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NURS 3365 BB ASSIGNMENT
3 answers and rationaleS
(Includes Mechanisms of Defense & Alterations;
Infection)
Questions 1-3 refer to this scenario: A man presents to an ER with a large
laceration sustained at a construction site a few hours before. The area around
the laceration is erythematous, painful, and swollen.
1. The erythema and swelling can be explained at a cellular level by all the
following EXCEPT
a. mast cell degranulation and release of histamine. True (see concept map)
b. pro-inflammatory prostaglandins released. True
c. increased vasomotor tone (tightening) of the capillaries in the area.
False statement, so this is the CORRECT answer. Any inflammatory
response involves some degree of DECREASED vasomotor tone—ie,
capillaries in the area must VASODILATE (relax, have less tone) in
order for substances to “ooze out”-- leak out of the blood to go
“help” healing in the tissue. So usually we equate “dilation and
leakage” with inflammation. This is why you often see swelling
with inflammation—the swelling is caused by the dilated blood
vessels and accumulation of leakage.
d. local reaction to acute phase reactants. True
2. The patient is given a TIG (tetanus immunoglobulin) injection because the
wound is high risk for tetanus
exposure and he doesn’t remember ever having a tetanus vaccination.
The purpose of the TIG is to
a. prevent any tetanus bacteria from activating the inflammatory system.
Wrong—inflammation will be activated as soon as any cell in the body is irritated and/or injured. Giving
antibodies (immunoglobulins)– the “IG” in TIG—doesn’t prevent inflammation.
b. introduce tetanus bacteria so that the immunocyte system can
create antibodies to tetanus. Wrong—TIG is antibodies, not the microbe itself.
c. give the patient natural active acquired immunity. Wrong—the word “natural”
implies that a person contracted tetanus (HAD the disease) and created their own antibodies as a result of the
active disease.
d. provide tetanus antibodies to fight any tetanus bacteria that might be
present. CORRECT
—just in case this person’s body was invaded by a tetanus
bacteria, giving them antibodies NOW will help them fight
the microbe NOW. This is called conferring artificial passive
acquired immunity.
3. The patient (should or should not) be instructed to also get a
tetanus vaccination, because .
a. should: he needs protection against future tetanus exposure.
CORRECT : passive immunity (when you DON’T make the
antibodies in your own body, but are given them) is very short-
lived. The antibodies that are GIVEN to you, that you DON’T create
on your own, will disintegrate within a few weeks. So you WILL
need a vaccination, which confers artificial ACTIVE immunity—
having a weak tetanus injected in you will make you create your
OWN antibodies, which are long-lived.
b. should: the vaccination will provide additional passive immunity.
Wrong—see above (vaccination and PASSIVE shouldn’t be in the same sentence;
vACcination = ACtive)
c. should not: the TIG is enough, as it will provide long term active acquired
immunity
Wrong—see above
d. should not: the vaccine will do nothing for the current exposure. Wrong—see
above. Look at this answer closely. The last part is true. A vaccination WILL NOT help a person
RIGHT NOW, because creating your antibodies takes time. But the question asked should he go
ahead and get a vaccination? Yes, he should. No, it won’t help him NOW, but it will help him if he
ever gets a tetanus microbe inside his body in the future—his antibodies can THEN kill the microbe
swiftly.
,4. A microbe invades the body for the first time. Which statement is
most likely about the processes that follow?
a. Plasma cells (a type of B-lymphocyte) will immediately secrete T-
cells specific to that microbe. Wrong. Plasma cells secrete antibodies, not T-
cells.
b. CD4 cells will introduce remnants of the microbe to the plasma
cells, which directly phagocytize the remnants. Wrong— plasma cells are not
phagocytes. They are a form of B lymphocyte.
c. Antigens will be created from the memory cells of immunocytes. Wrong
—doesn’t make sense. Don’t
, confuse the word antigen with the word antibody.
d. Immunocytes will begin the process of developing memory to that
microbe. Correct— During the inflammatory process, if a microbe is
involved, the T-cells and/or B-cells are “called in” and begin to
develop microbe-specific memory. Especially let’s focus on the
antibodies… the Bcells will begin the memory process, and as a
result, antibodies that are specific to that particular microbe will
be formed and will be on hand for the next time the body “sees”
that microbe. (Tcells do similar process, but don’t create
antibodies.)
5. A patient has a systemic inflammation. All the following are likely associated
with his condition
EXCEPT
a. increased acute phase reactants. True – acute phase reactants have the job of
increasing inflammation as needed—“fuel on the fire”; especially they increase circulating in the
blood when there is a systemic inflammation.
b. lab results showing a high C-reactive protein (CRP). True—CRP is one of the acute phase
reactants.
c. lab results showing leukopenia. False, so this is CORRECT answer.
During systemic inflammation, leukocytes will increase in
number so as to participate in the various parts of the
inflammatory response, especially neutrophils, which act as
phagocytes (see concept map). So leukocytosis and neutrophilia
are part of inflammation, not leukopenia (PENIA= “lower
numbers than normal”).
d. increased pro-inflammatory prostaglandins. True – remember that prostaglandins
have two subcategories—the duty of INCREASING inflammation is called “pro-inflammatory.”
The other types of prostaglandins are “protective”—they bolster certain aspects of body
function
6. A baby who has received immunoglobulins against the “XYZ” virus via its
mother’s milk now has
a. natural active acquired immunity. Wrong—an example of this is getting chicken pox.
b. natural passive acquired immunity. Correct—natural (from mom);
passive = baby did NOT make its own antibodies.
c. passive innate immunity. Wrong—mixed up terms. Remember that when we are talking
about immunoglobulins, we are automatically thinking of the third line of defense – ACQUIRED
immunity, not innate. (Innate involves first and second line of defense)
d. active innate immunity. Wrong—see above about acquired vs innate.
7. The baby in the previous question will .
a. have lifelong immunity to the XYZ virus because of receiving the
immunoglobulins that are specific to that particular microbe. Wrong—can’t
get lifelong immunity from receiving SOMEONE ELSE’s antibodies.
b. develop temporary immunity to the XYZ virus due to receiving Mom’s
antibodies that are specific to that particular microbe. Correct—
passive acquired immunity is ok for right NOW, but the antibodies
will disintegrate within a short time—hence “temporary.”
c. now have complete 2nd line of defense protection, having received it in
the breast milk. Wrong— remember that when we are talking about immunoglobulins, we
are automatically thinking of the third line of defense
d. develop alphabetophobia due overdose of anti-XYZ immunoglobulins.
8. A person starts Jazzercise for the first time and becomes very sore
all over. The most appropriate self-treatment for this person is to
, because .
a. take an NSAID such as Aleve : it powerfully suppresses phospholipase
enzymes in the arachidonic pathway. Wrong—steroids suppress phospholipase.
NSAID are non-steroidal antiinflammatories that work further down in the arachidonic
pathway. See page 19 of RRD.
b. take an NSAID such as Advil : it is an effective suppressor of
certain levels of pro- inflammatory prostaglandin activity.
Correct
c. go in for a CRP test: it will determine the degree of pain. Wrong --CRP is an
acute phase reactant that will increase when you have an inflammation but it is very non-
specific—you can’t judge degree of pain by that (besides that, FYI—everyone’s pain is different—
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