Pathophysiological Mechanism of Disease, Altered immune Response, Autoimmune Diseases | Mock Test | Staff Nurse | Guides Academy

Pathophysiological mechanism of disease, altered immune response, autoimmune diseases

Time: 15:00

A nurse in a community health setting identifies a child with edema, a swollen abdomen, and sparse, brittle hair, despite not appearing severely underweight. These are classic signs of which form of Protein-Energy Malnutrition (PEM) prevalent in India?

[a] Marasmus.

[b] Nutritional Stunting.

[c] Kwashiorkor.

[d] Iron Deficiency Anemia.

A patient presents with a localized infection displaying redness (rubor), swelling (tumor), heat (calor), and pain (dolor). These cardinal signs of inflammation are primarily initiated by which pathophysiological process?

[a] Fibroblast proliferation and scar formation.

[b] Vasodilation and increased vascular permeability.

[c] Systemic release of pyrogens causing fever.

[d] Phagocytosis of pathogens by lymphocytes.

A patient experiences a severe, life-threatening anaphylactic reaction after a bee sting. This Type I hypersensitivity reaction is mediated by the binding of the allergen to which immunoglobulin on the surface of mast cells?

[a] IgG.

[b] IgA.

[c] IgM.

[d] IgE.

In Myasthenia Gravis, progressive muscle weakness is caused by an autoimmune attack on which specific target at the neuromuscular junction?

[a] Myelin sheath of motor neurons.

[b] Calcium channels in the presynaptic terminal.

[c] Acetylcholine receptors on the muscle cell membrane.

[d] The enzyme acetylcholinesterase.

A nurse is reviewing the ECG of a patient with chronic renal failure. The nurse observes tall, peaked T-waves. This finding is a classic sign of which electrolyte imbalance?

[a] Hyperkalemia.

[b] Hypokalemia.

[c] Hyponatremia.

[d] Hypercalcemia.

The induration and erythema seen 48-72 hours after a Mantoux test (tuberculin skin test) is a classic example of which type of hypersensitivity reaction?

[a] Type I (Anaphylactic).

[b] Type II (Cytotoxic).

[c] Type III (Immune Complex).

[d] Type IV (Delayed-type/Cell-mediated).

A patient diagnosed with Systemic Lupus Erythematosus (SLE) presents with a characteristic "butterfly rash" on her face. This autoimmune disease is primarily characterized by the production of:

[a] Antibodies against thyroid-stimulating hormone receptors.

[b] Antinuclear antibodies (ANAs) against self-DNA and proteins.

[c] IgE antibodies against common environmental allergens.

[d] Rheumatoid factor (RF) targeting the synovial joints.

A patient in the intensive care unit with a severe bacterial infection develops hypotension, tachycardia, and a high fever. Unlike other forms of shock, the early stage of septic shock is often characterized by what paradoxical finding?

[a] Extreme vasoconstriction and cold, clammy skin.

[b] Profound bradycardia due to vagal stimulation.

[c] Peripheral vasodilation causing warm, flushed skin.

[d] A significantly decreased cardiac output.

The progressive failure of the immune system in Acquired Immunodeficiency Syndrome (AIDS) is a direct result of the Human Immunodeficiency Virus (HIV) targeting and destroying which crucial immune cells?

[a] B-lymphocytes.

[b] Neutrophils.

[c] Natural Killer (NK) cells.

[d] CD4+ T-helper lymphocytes.

In the pathophysiology of Rheumatoid Arthritis, the inflammation of the synovial membrane leads to the formation of an abnormal layer of fibrovascular tissue called pannus. What is the primary destructive action of pannus?

[a] It secretes excess synovial fluid, causing swelling.

[b] It erodes the articular cartilage and underlying bone.

[c] It calcifies, leading to joint fusion (ankylosis).

[d] It triggers a systemic febrile response.

A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted with increased dyspnea. Arterial Blood Gas (ABG) analysis shows pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L. These values indicate which acid-base imbalance?

[a] Metabolic Acidosis.

[b] Respiratory Alkalosis.

[c] Respiratory Acidosis.

[d] Metabolic Alkalosis.

An acute hemolytic transfusion reaction, where a patient receives ABO-incompatible blood, is a classic example of which type of hypersensitivity?

[a] Type I.

[b] Type II.

[c] Type III.

[d] Type IV.

The underlying pathophysiological mechanism of Multiple Sclerosis (MS) involves an autoimmune-mediated attack that results in:

[a] Destruction of acetylcholine receptors at the neuromuscular junction.

[b] Inflammation and destruction of peripheral nerve myelin.

[c] Demyelination and plaque formation in the central nervous system.

[d] Deposition of amyloid plaques in the brain parenchyma.

What is the term for the process of programmed cell death, a normal physiological process that eliminates unwanted or damaged cells without causing an inflammatory response?

[a] Apoptosis.

[b] Necrosis.

[c] Atrophy.

[d] Dysplasia.

A kidney transplant recipient develops immediate graft failure on the operating table. This hyperacute rejection is caused by which immune mechanism?

[a] T-cell mediated attack on the graft tissue.

[b] Pre-existing recipient antibodies against donor antigens.

[c] Deposition of new immune complexes in the graft vessels.

[d] A slow, fibrotic process that occludes graft vessels over years.

Graves' disease is an autoimmune disorder that causes hyperthyroidism. What is the pathophysiological mechanism responsible for the excessive thyroid hormone production?

[a] Autoimmune destruction of the thyroid gland, releasing stored hormones.

[b] A benign tumor in the pituitary gland secreting excess TSH.

[c] Inflammation of the thyroid gland (thyroiditis).

[d] Autoantibodies that mimic TSH and stimulate thyroid hormone synthesis.

A patient with end-stage liver disease develops ascites and peripheral edema. The primary pathophysiological reason for this fluid shift is:

[a] Increased capillary hydrostatic pressure.

[b] Decreased plasma oncotic pressure due to hypoalbuminemia.

[c] Obstruction of lymphatic drainage.

[d] Increased capillary permeability due to inflammation.

Which class of immunoglobulin is unique in its ability to cross the placental barrier, thereby providing passive immunity to the fetus and newborn?

[a] IgA.

[b] IgM.

[c] IgG.

[d] IgE.

A patient is diagnosed with Guillain-Barré Syndrome (GBS) following a viral infection. The nurse should be most alert for which characteristic clinical manifestation?

[a] A descending paralysis starting from the head and neck.

[b] Chronic, progressive muscle weakness over many years.

[c] Spastic paralysis with hyperactive deep tendon reflexes.

[d] An ascending, symmetrical paralysis starting from the lower extremities.

A large, open, contaminated wound, such as a pressure ulcer, heals by which process that involves significant granulation tissue formation and scarring?

[a] Primary intention.

[b] Secondary intention.

[c] Tertiary intention.

[d] Remodeling phase.

Systemic reactions like serum sickness or diseases such as post-streptococcal glomerulonephritis are caused by the deposition of antigen-antibody complexes in tissues. This represents which type of hypersensitivity reaction?

[a] Type I.

[b] Type II.

[c] Type III.

[d] Type IV.

Hashimoto's thyroiditis is the most common cause of hypothyroidism in iodine-sufficient areas. The pathophysiology involves:

[a] Autoimmune destruction of thyroid follicular cells.

[b] Antibodies that block TSH receptors.

[c] Insufficient dietary intake of iodine.

[d] A congenital absence of the thyroid gland.

A patient with a spinal cord injury at the thoracic level develops neurogenic shock. The hallmark physiological alteration responsible for the hypotension and bradycardia seen in this condition is:

[a] Massive fluid loss from the vascular space.

[b] Release of inflammatory mediators causing vasodilation.

[c] Loss of sympathetic nervous system tone.

[d] Pump failure due to direct cardiac injury.

Pernicious anemia is a megaloblastic anemia caused by an autoimmune process that leads to a deficiency of which essential substance for Vitamin B12 absorption?

[a] Pepsin.

[b] Gastrin.

[c] Intrinsic factor.

[d] Hydrochloric acid.

In the initial phase of the acute inflammatory response to bacterial infection, which leukocyte is the first to arrive at the site of injury and is responsible for phagocytosis?

[a] Monocytes.

[b] Eosinophils.

[c] Lymphocytes.

[d] Neutrophils.