The document provides an extensive overview of various medical and immunological topics, including the characteristics of gills in underwater breathing beings, the immune response to cancer and infections, the impact of genetics on diseases like HIV, and the necessity of aseptic techniques during specimen collection. It also explores specific case studies, vaccine responses, and treatment strategies for conditions like chronic lymphocytic leukemia and type I diabetes. Overall, it emphasizes the complexities of host defense mechanisms, pathogenic interactions, and public health strategies.

1. Template for Models of Practice Assignment
Model Characteristics for the
Model of Practice for Underwater Breathing
Application to Your Advanced Practice Role
Characteristic 1: Human beings who breathe underwater have
gills.
Because patients with gills cannot be intubated, adaptations
must be made in the equipment used when anesthetizing these
patients.
Chapter 15
1.Explain the two main features that characterize the third line
of host defense mechanisms.
2.Chronic lymphocytic leukemia (CLL) leads to the production
of cancerous B cells, and treatment often involves bone marrow
transplantation. Based upon your knowledge of lymphocyte

2. development, explain how this procedure can lead to therapeutic
effects in some patients.
3.Recently, scientists have been experimenting with using IRA-
B cells as a treatment for hospitalized patients in an attempt to
prevent them from getting septic infections. Speculate on what
the principle behind this might be.
4.Provide an explanation to refute the following statement:
Humans would never develop natural immunity to a novel
biological agent created in a laboratory.
5. a.Explain how the anamnestic response is triggered by
vaccination. b.Conduct additional research and discuss one
current example illustrating how lack of herd immunity within a
population has led to localized disease outbreaks in the United
States.
Chapter 16
1.Conduct additional research and discuss examples that
illustrate how cancer can be both a cause of immune
dysfunction and an effect of this process.
2.Summarize the roles of the microbiome and genetics in the
development of type I allergic reactions. Discuss how probiotics
or gene therapy could be used to alter an individual’s allergic
response to antigen.
3. a.Draw a diagram illustrating whether or not each of the
following transfusions would be immunologically compatible.
Type A donor into a type B recipient Type B donor into a type
AB recipient Type O– donor into a type O+ recipient b.Explain
how xenotransplantation might be successful in light of the
immune system’s robust ability to recognize foreign antigen.

3. 4.Summarize the role of the immune system in the development
of type I diabetes. Propose a strategy that could be used to
protect young children from developing an autoimmune
reaction, and subsequently type I diabetes, after a viral
infection.
5.A patient in your unit exhibits frequent bouts of microbial
infections and is found to produce extremely low levels of IgG
and IgM antibodies. Your colleague suggests that the patient
receive numerous vaccinations against a broad spectrum of
common pathogens; you disagree. Why? Explain another
treatment that may be beneficial to this patient.
Chapter 17
1.Explain why specimens should be taken aseptically, even
when nonsterile sites are being sampled and selective media are
to be used, and explain why speed is important in the clinical
testing process.
2.In the middle of an outbreak of measles (an infection that is
highly communicable), a public health department is using
immunologic testing to determine whether sick children have
measles or not. If the children test positive, they are
quarantined at home, and their contacts are counseled to update
their MMR vaccine. In this situation, would you prefer to use a
diagnostic test that is highly specific or one that is highly
sensitive? Justify your answer.
3.Explain which type of ELISA can be used to determine an
individual’s past exposure to a pathogen.
4.You are working at a health clinic, and a woman enters,
suspecting that she was exposed to HIV two nights ago.
a.Discuss whether or not she can be tested for HIV infection at
this point. b.Summarize how you would respond to this patient,
providing her with appropriate information regarding testing for

4. HIV infection.
5.Compare and contrast the process of restriction analysis used
in traditional DNA fingerprinting with the procedure used in
pulse-field gel electrophoresis.
Chapter 18
1.A young boy was at the playground when he felt a sharp pain
on his leg. Upon inspection, his mother realized he had been
stung by a bee. They went home and she carefully removed the
stinger and washed the site well. Within a week, the site became
swollen and painful; a red line appeared at the site, trailing up
his leg.
a.Explain what condition the young boy appears to be suffering
from and the most likely causative agent involved.
b.Discuss how the microbe may have gained access to the portal
of entry.
2.A farmer working on a piece of machinery gets his shirtsleeve
caught in a moving piece of the equipment. His shirt is sliced,
and a sharp blade covered in mud slices through his upper arm.
He attempts to control the bleeding and immediately seeks
medical attention. After 3 days, he develops a fever and his arm
becomes extremely swollen and painful. Pulling back the
bandages, he finds that the wound has become blackened and is
leaking a bloody fluid. Microscopic analysis of the fluid reveals
the presence of gram-positive bacilli.
a.Discuss what condition the patient is suffering from and the
likely causative agent of this infection.
b.Explain how the patient contracted this pathogenic microbe
and what virulence factors contributed to the pathogenesis seen
at the wound site.
c.In addition to antibiotics, the physician prescribes hyperbaric
therapy. Describe what this treatment involves and how it could
be therapeutic to this patient.

5. 3. a.Conduct additional research, and discuss whether “pox
parties” represent a safe method of developing immunity to
varicella zoster virus.
b.Provide evidence in support of or refuting the following
statement: Shingles develops when you are reinfected with
varicella zoster virus later on in life.
4.Smallpox has a rich history—from prompting the first vaccine
to potential use as a bioterrorism agent. Given what you know
about the etiology of the disease and the current state of the
world’s immunity to smallpox, discuss how effective (or
ineffective) a smallpox biological weapon could be against a
human population.
5.Your coworker says that her spouse is in the hospital for
elective surgery and his recovery is complicated by two
infections: He has chicken pox all over the upper half of his
body, and shingles on his legs. What questions will you ask for
clarification?
Chapter 19
1. a.Explain why the nervous system is described as
“immunologically privileged,” and discuss whether this
provides a beneficial or disadvantageous effect in this system.
b.Discuss the defenses a pathogen encounters as it attempts to
gain entry into the nervous system.
2.Conduct research and summarize the causative agent and
mode of transmission behind the multistate meningitis outbreak
linked to steroid injections that occurred in 2012. How did
improper physical and chemical control methods play a major
role in this outbreak? Did portal of entry play any role?
3.Chronic wasting disease (CWD) is a transmissible spongiform
encephalopathy affecting white-tailed deer and elk. In 2005,
venison from a deer testing positive for CWD was served during

6. an annual wild-game dinner in the town of Verona in upstate
New York. Based upon your knowledge of vCJD and related
spongiform encephalopathies and any additional research you
conduct, discuss whether any of the attendees are at risk for
developing disease in the future.
4.As you learned in section 8.3, many types of fruits and
vegetables can be fermented into alcoholic beverages. Such was
the case recently when prisoners in Utah attempted to make an
illegal beverage called “pruno”; however, someone added a
weeks-old baked potato to the mix, letting a microbe into the
party who was clearly uninvited. Consumers of the pruno began
to develop difficulty swallowing, vomiting, double vision, and
muscle weakness; three required ventilation therapy. No deaths
were attributed to the contaminated beverage.
a.What disease were the prisoners suffering from, and what was
the causative agent involved?
b.Based upon your knowledge of this disease, what form of
treatment was used to successfully avoid the worst outcomes of
the disease in these patients?
5.In August 2011, a soldier from Fort Drum in Watertown, New
York, tested positive for rabies; he died less than 3 weeks later.
Further investigation revealed that he actually became infected
when he was bitten by a dog in January of the same year while
stationed in Afghanistan. Discuss any risks the soldier posed to
his platoon, explaining whether or not this fatal outcome could
have been avoided.
Chapter 20
1.Explain why cases of dengue fever have been observed
beyond endemic regions of the world today. Discuss whether or
not completely eradicating mosquito (vector) populations from
disease-ridden areas is advisable.
2. a.Discuss whether or

7. not genetics plays a role in HIV infection, providing at least one
example to illustrate your position.
b.Provide evidence in support of or refuting the following
statement: An HIV-positive individual will always harbor the
virus even if no viral load is detectable by PCR or other
methods.
3.Explain why over the years the incidence of HIV infection has
declined in the United States while the prevalence of AIDS has
increased.
4. a.Compare and contrast various characteristics of
hemorrhagic and nonhemorrhagic fever diseases.
b.Provide an explanation for the observed increase in incidence
of these zoonotic infections around the world today.
5.Several pathogens in this chapter are listed as Category A
bioweapons by the Centers for Disease Control and Prevention
(CDC). What characteristics of the pathogens in this chapter
make them suited for mass infection with high mortality?