Chapter 17 allergies etc. Flashcards
(92 cards)
1
Q
The initial work on anaphylaxis was done by
A. Watson and Crick.
B. Pasteur.
C. Fleming.
D. Richet and Portier.
A
D. Richet and Portier.
2
Q
If the immune system responds inadequately to antigenic stimulation, this is termed
A. hypersensitivity.
B. autoimmunity.
C. cell-mediated immunity.
D. immunodeficiency.
A
D. immunodeficiency.
3
Q
The immunoglobulin associated with Type I hypersensitivity is
A. IgG.
B. IgA.
C. IgM.
D. IgE.
E. IgD.
A
D. IgE.
4
Q
IgE molecules involved in hypersensitivity reactions have become attached to
A. neutrophils.
B. mast cells.
C. B cells.
D. macrophages.
E. mast cells AND B cells.
A
B. mast cells.
5
Q
To produce an allergic reaction in Type I hypersensitivity, the antigen
A. must bind to mast cells.
B. must bind to free IgE molecules.
C. must bind to IgE on mast cells.
D. must crosslink two IgE molecules on mast cells.
A
D. must crosslink two IgE molecules on mast cells.
6
Q
During a Type I hypersensitivity reaction, the mast cells
A. become phagocytic.
B. release IgE antibodies.
C. degranulate.
D. immediately release histamine.
E. degranulate AND immediately release histamine.
A
E. degranulate AND immediately release histamine.
7
Q
Urticaria is characterized by
A. living in Utica.
B. wheal and flare.
C. asthma.
D. inflammation.
A
B. wheal and flare.
8
Q
Generalized anaphylaxis is generally characterized by
A. wheal and flare.
B. inflammation.
C. shock.
D. rash.
A
C. shock.
9
Q
Most cases of generalized anaphylaxis are a result of
A. fire ant stings.
B. aspirin.
C. bananas.
D. peanuts, bee stings or penicillin injections.
A
D. peanuts, bee stings or penicillin injections.
10
Q
Desensitization
A. stimulates an increase in IgG.
B. reduces the number of mast cells.
C. increases the number of basophil cells.
D. is a treatment for hypersensitivity reactions.
E. stimulates an increase in IgG AND is a treatment for hypersensitivity reactions.
A
E. stimulates an increase in IgG AND is a treatment for hypersensitivity reactions.
11
Q
The hypersensitivity treatment that stimulates an increase of IgG and T suppressor cells and a decrease in IgE is known as
A. desensitization.
B. immunity.
C. sensitization.
D. exposure.
E. anaphylaxis.
A
A. desensitization.
12
Q
Recombinant human monoclonal antibody (rhuMAb)
A. appears promising as a treatment for asthma.
B. decreases the levels of IgG.
C. uses an engineered form of an IgG molecule.
D. promotes crosslinking between IgE molecules on the mast cells.
E. appears promising as a treatment for asthma AND uses an engineered form of an IgG molecule.
A
E. appears promising as a treatment for asthma AND uses an engineered form of an IgG molecule.
13
Q
The type of hypersensitivity expressed with the lysing of red blood cells is
A. Type I.
B. Type II.
C. Type III.
D. Type IV.
E. Type V.
A
B. Type II.
14
Q
A transfusion reaction primarily involves
A. leukocytes.
B. phagocytes.
C. platelets.
D. erythrocytes.
A
D. erythrocytes.
15
Q
The natural antibodies in serum that react with A or B polysaccharide antigens are mostly of the class
A. IgG.
B. IgE.
C. IgM.
D. IgD.
E. IgA.
A
C. IgM.
16
Q
Anti-A and anti-B antibodies
A. are considered natural antibodies.
B. are present at birth.
C. are typically IgM.
D. easily cross the placenta.
E. are considered natural antibodies AND are typically IgM.
A
E. are considered natural antibodies AND are typically IgM.
17
Q
Regarding a mismatch of either the Rh antigen or the AB antigen, both
A. result in destruction of red blood cells.
B. utilize complement to destroy red blood cells.
C. utilize antibody-dependent cellular cytotoxicity to destroy the red blood cells.
D. result in destruction of only leukocytes.
A
A. result in destruction of red blood cells.
18
Q
Antibodies that have arisen in the blood plasma without any obvious or deliberate stimulus are called
A. natural.
B. acquired.
C. injurious.
D. active.
A
A. natural.
19
Q
Hemolytic disease of the newborn
A. may not manifest itself fully until after birth.
B. is due to the action of IgM.
C. is due to the action of IgE.
D. is a Type I hypersensitivity reaction.
E. may not manifest itself fully until after birth AND is due to the action of IgE.
A
A. may not manifest itself fully until after birth.
20
Q
The cell type responsible for Type II hypersensitivity is the
A. mast cell.
B. B cell.
C. macrophage.
D. platelet.
E. neutrophils.
A
B. B cell.
21
Q
Immune complexes
A. consist of antigen-antibody bound together.
B. are usually cleared rapidly from the body.
C. bind to Fc receptors on cells.
D. are involved in Type III hypersensitivity reactions.
E. All of the choices are correct.
A
E. All of the choices are correct.
22
Q
Localized injury or death of tissue resulting from repeated injections of an antigen into a person with high levels of circulating specific antibody is known as
A. farmer’s lung.
B. German measles.
C. serum sickness.
D. an Arthus reaction.
A
D. an Arthus reaction.
23
Q
Arthus reactions and serum sickness are examples of _________ hypersensitivity.
A. type I
B. type II
C. type III
D. type IV
E. type V
A
C. type III
24
Q
Which of the following disease states is not among those caused by immune complexes?
A. farmer’s lung
B. serum sickness
C. hay fever
D. glomerulonephritis
A
C. hay fever
25
Delayed hypersensitivity is also known as ___________ hypersensitivity.
A. type I
B. type II
C. type III
D. type IV
E. type V
D. type IV
26
Delayed type hypersensitivity primarily involves
A. erythrocytes.
B. B cells.
C. T cells.
D. mast cells.
C. T cells.
27
Type IV hypersensitivity reactions typically peak within
A. minutes.
B. hours.
C. 12 hours.
D. 2-3 days.
D. 2-3 days.
28
Which of the following is associated with contact dermatitis?
A. poison ivy
B. latex
C. tuberculin skin test
D. hay fever
E. poison ivy, latex AND tuberculin skin test
E. poison ivy, latex AND tuberculin skin test
29
The redness and induration found after a tuberculin skin test involve the action of
A. sensitized T cells.
B. IgE.
C. complement.
D. basophil cells.
A. sensitized T cells.
30
Patch tests are used to detect
A. hives.
B. serum sickness.
C. immune complexes.
D. contact hypersensitivity.
D. contact hypersensitivity.
31
Which of the following have been an effective immunosuppressant for use in transplantation?
A. amphotericin B and cyclosporin A
B. FK506 and cephalosporin
C. cyclosporin A and tacrolimus
D. cephalosporin and amphotericin B
E. FK506 and amphotericin B
C. cyclosporin A and tacrolimus
32
Graft-versus-host disease is primarily a
A. Type I reaction.
B. Type II reaction.
C. Type III reaction.
D. Type IV reaction.
E. Type V reaction.
D. Type IV reaction.
33
The tissue antigens most involved in graft rejection involve
A. Rh.
B. ABO.
C. MHC.
D. MLB.
C. MHC.
34
Killing of graft cells occurs through a complex series of mechanisms including
A. sensitized T cytotoxic cells.
B. NK cells.
C. erythrocytic cells.
D. basophilic cells.
E. sensitized T cytotoxic cells AND NK cells.
E. sensitized T cytotoxic cells AND NK cells.
35
Cyclosporin A
A. is a relatively general immunosuppressive agent.
B. suppresses T cell proliferation.
C. activates macrophages.
D. stimulates antibody production.
E. is a relatively general immunosuppressive agent AND suppresses T cell proliferation.
B. suppresses T cell proliferation.
36
Immunosuppressive drugs
A. are only needed during the first week after transplantation.
B. are only needed for the first year after transplantation.
C. are needed indefinitely after transplantation.
D. are needed for transplants between identical twins.
E. are needed indefinitely after transplantation AND are needed for transplants between identical twins.
C. are needed indefinitely after transplantation.
37
Allografts
A. are normally rejected within hours.
B. are normally rejected within 10-14 days.
C. are grafts between non-identical members of the same species.
D. would include the fetus.
E. are normally rejected within 10-14 days, are grafts between non-identical members of the same species AND would include the fetus.
E. are normally rejected within 10-14 days, are grafts between non-identical members of the same species AND would include the fetus.
38
Immunologically privileged sites include the
A. brain.
B. eyes.
C. testes.
D. kidney.
E. brain, eyes AND testes.
E. brain, eyes AND testes.
39
The fetus is not rejected because
A. it is too small.
B. it is in an immunologically privileged site.
C. the father is immunosuppressed.
D. it has no antigens.
E. it is in an immunologically privileged site AND the father is immunosuppressed.
B. it is in an immunologically privileged site.
40
Which of the following primary immunodeficiencies is the most common?
A. severe combined immunodeficiency
B. selective IgA deficiency
C. agammaglobulinemia
D. Di George's syndrome
B. selective IgA deficiency
41
If the thymus fails to develop
A. functional T cells are absent.
B. functional B cells are absent.
C. Di George's syndrome exists.
D. complement deficiencies exist.
E. functional T cells are absent AND Di George's syndrome exists.
E. functional T cells are absent AND Di George's syndrome exists.
42
If a patient lacks B cells, the resulting disease is
A. SCID.
B. AIDS.
C. Di George's syndrome.
D. agammaglobulinemia.
D. agammaglobulinemia.
43
Defects in bone marrow stem cells result in a condition known as
A. SCID.
B. AIDS.
C. Di George's syndrome.
D. Chediak-Higashi disease.
A. SCID.
44
A defect in which of the following systems leads to granulomatous disease?
A. lymphatic system
B. circulatory system
C. oxidase system
D. Golgi system
C. oxidase system
45
The condition that results from ineffective digestion after phagocytosis is
A. AIDS.
B. Chediak-Higashi disease.
C. Di George's syndrome.
D. agammaglobulinemia.
B. Chediak-Higashi disease.
46
Secondary immunodeficiency disease is not the result of
A. genetic defects.
B. malignancies.
C. advanced age.
D. malnutrition.
A. genetic defects.
47
HIV
A. appears to cause AIDS.
B. is an RNA virus.
C. destroys T helper cells.
D. makes the patient vulnerable to infections, especially those caused by opportunists.
E. All of the choices are correct.
E. All of the choices are correct.
48
If the body recognizes parts of itself as being foreign, this is termed
A. immunodeficiency disease.
B. agammaglobulinemia.
C. autoimmune disease.
D. AIDS.
C. autoimmune disease.
49
Myasthenia gravis is an example of an autoimmune disease that involves
A. sensitized T cells.
B. cytotoxic T cells.
C. antibodies.
D. IgD.
C. antibodies.
50
Insulin-dependent diabetes mellitus is an example of an autoimmune disease that involves
A. sensitized T cells.
B. cytotoxic T cells.
C. antibodies.
D. IgD.
B. cytotoxic T cells.
51
Gene therapy technology
A. may be used to generate cells for transplantation.
B. may overcome graft rejection.
C. may treat cancer.
D. may down-regulate the immune response.
E. may overcome graft rejections AND may treat cancer.
E. may overcome graft rejections AND may treat cancer
52
Stem cells
A. have an almost unlimited capacity to divide.
B. can differentiate into different tissues.
C. may be used to test the effects of drugs on human cells.
D. come from fetal material.
E. All of the above
E. All of the above
53
First exposure to an allergen results in a violent hypersensitivity reaction.
FALSE
54
Generalized anaphylaxis may be quickly controlled with the use of antihistamines.
FALSE
55
Anaphylaxis is the name given to allergic reactions caused by IgE-mediated release of mast cell granules.
TRUE
56
Allergic rhinitis and hives may both respond to antihistamines.
TRUE
57
Type O blood is missing both anti-A and anti-B antibodies
TRUE
58
Anti-A and anti-B antibodies are natural antibodies and are present at birth.
FALSE
59
Mismatch of either the Rh antigen or the AB antigen results in lysis of red blood cells by complement.
FALSE
60
Anti-Rh antibodies may not cross the placenta.
FALSE
61
MHC plays a pivotal role in transplant rejection
TRUE
62
A lack of T cells makes one more vulnerable to intracellular parasites.
TRUE
63
Why do Rh-negative but not Rh-positive mothers sometimes have babies with hemolytic disease of the newborn?
A. This disease results when an Rh-negative mother's immune system is primed multiple times to produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-positive, she won't produce any anti-Rh antibodies at all.
B. Rh-positive mothers produce IgM antibody, not IgG. This antibody can't cross the placenta, so it can't cause hemolytic disease of the newborn.
C. Rh-positive mothers will receive a preventative shot from their physician prior to conception. This will provide the protection the fetus needs AFTER conception to avoid the disease.
D. Rh-negativity is also associated with hyperproduction of antibodies. As such, Rh-negative mothers are more likely than Rh-positive mothers to produce the antibodies needed to produce this disease.
A. This disease results when an Rh-negative mother's immune system is primed multiple times to produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-positive, she won't produce any anti-Rh antibodies at all.
64
What is NOT a reason that the kidneys are particularly prone to damage caused by immune complexes?
A. Kidney blood vessel wall cells have receptors for antibodies on them, which makes them soak up antibodies (or in this case, immune complexes) from the bloodstream. This blocks the kidneys up and causes them to malfunction and become damaged.
B. Blood is pushed through the kidneys at a very high pressure-any blockage of the vessels (such as what might be caused by immune complex deposits) can lead to ruptures/inflammation and damage.
C. While blood vessel walls do NOT have receptors for antibodies, large immune complexes forced through small diameter vessels can become embedded within them. This can trigger complement system inflammation and cell destruction.
D. Trapped immune complexes that initiate inflammation can attract neutrophils. The neutrophils degranulate in the area of the immune complexes, leading to cell/tissue destruction.
A. Kidney blood vessel wall cells have receptors for antibodies on them, which makes them soak up antibodies (or in this case, immune complexes) from the bloodstream. This blocks the kidneys up and causes them to malfunction and become damaged.
65
In the tuberculin skin test, what would be the most likely reason why a positive test would NOT necessarily indicate an infection in progress in a patient in the United States?
A. False positives occur all the time. This might simply be an example of that.
B. The TB skin test is a measure of reactivation of memory T cells. The memory T cells would be formed either during an active infection or would be remnants of a prior infection that may be cleared. Since the memory of the response persists, the test still shows positive, even though the patient is cleared of actual infection.
C. Each person in the US receives the BCG tuberculosis vaccine. This is an attenuated mycobacterium vaccine. The response to this vaccine makes us positive for the TB skin test, even though we may not have actually had a TB infection at any point in our lives.
D. This is a trick question-a positive TB skin test ALWAYS indicates a current, active infection.
B. The TB skin test is a measure of reactivation of memory T cells. The memory T cells would be formed either during an active infection or would be remnants of a prior infection that may be cleared. Since the memory of the response persists, the test still shows positive, even though the patient is cleared of actual infection.
66
If a patient received a kidney transplant that was matched well across each of the major histocompatibility complex (MHC) molecules, but they stopped taking their anti-rejection drugs, what would happen and why?
A. Nothing-the transplant is matched, so the patient doesn't need the drugs to prevent rejection. The new organ should be seen by the recipient's immune system as 'self.'
B. The organ will be rejected very quickly, as allografts (tissue from the same species, but a different individual) are seen by the recipient's immune system as 'foreign,' and are quickly attacked.
C. The organ will be rejected, but it will be a gradual process since it was matched well. There are a number of other proteins that cannot be matched between donors, so the graft will still be viewed as 'foreign' by the recipient's immune system, and will still be attacked. The attack will just be a slower and lengthier process.
D. Nothing-since the transplant was accepted for so long with the anti-rejection drugs, the person's immune system has had the time to become accustomed to it and now views the graft as 'self.' It will not be attacked.
C. The organ will be rejected, but it will be a gradual process since it was matched well. There are a number of other proteins that cannot be matched between donors, so the graft will still be viewed as 'foreign' by the recipient's immune system, and will still be attacked. The attack will just be a slower and lengthier process.
67
What might be an advantage to using an individual's own stem cells instead of pancreatic cell allografts to treat Type I diabetes?
A. Stem cells can disable the immune responses that led to the diabetes state in the first place.
B. This process should be far cheaper than the surgical intervention needed for the allograft.
C. You can't do this-stem cell research is still theoretical, not approved by the FDA, and is currently illegal in the US. As such, there is no advantage.
D. If you were able to use a person's own cells, it would be considered an autograft rather than an allograft. As such, there should be no HLA/MHC matching required, and no long-term anti-rejection drugs needed.
D. If you were able to use a person's own cells, it would be considered an autograft rather than an allograft. As such, there should be no HLA/MHC matching required, and no long-term anti-rejection drugs needed.
68
Multiple myeloma is a plasma cell tumor in which a clone of malignant plasma cells produces large amounts of immunoglobulin. With all this excess immunoglobulin, how can a person with multiple myeloma be immunodeficient?
A. All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter.
B. The multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.
C. The massive overproduction of immunoglobulin impairs the kidneys, preventing production of the correct hormones from the kidneys to balance immune system cell production from the bone marrow.
D. Through a negative feedback loop, the large amount of immunoglobulin tricks the immune system into thinking it's making a strong response that is needed. As such, it shuts down production of other responses that might truly BE needed to fight off a pathogen.
E. All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter AND the multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.
E. All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter AND the multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.
69
```
Charles Richet received the Nobel Prize in 1913 for his discovery of
A) prophylaxis.
B) immunity.
C) immunodeficiency.
D) hypersensitivity.
E) autoimmunity
```
D. hypersensitivity
70
Which of the following sets of terms is mismatched?
A) autoimmune disease - target self-antigens
B) hypersensitivity - immunity that causes tissue damage
C) immunodeficiency - inadequate immunity
D) anaphylaxis - prevention of disease
E) shock (--) hypoxia from low blood pressure
D) anaphylaxis - prevention of disease
71
```
Which of the following is not a type of hypersensitivity?
A) cytotoxic
B) delayed cell-mediated
C) immediate IgE-mediated
D) immune complex-mediated
E) humoral
```
E) humoral
72
```
Which of the following is NOT a typical symptom of Type I hypersensitivity?
A) asthma
B) anaphylatic shock
C) hives
D) kidney damage
E) rhinitis
```
D) kidney damage
73
Which of the following statements about generalized anaphylaxis is FALSE?
A) It is an IgE-mediated allergy.
B) Prevention involves injecting the person with the antigen.
C) It may be fatal in minutes.
D) Most cases are caused by peanuts, bee stings, and penicillin injections.
E) All of these choices are correct.
B) Prevention involves injecting the person with the antigen.
74
Which of the following statements about Type II hypersensitivity is FALSE?
A) It causes transfusion reactions.
B) It causes hemolytic disease of the newborn.
C) Cells are destroyed by complement-fixing antibodies or antibody-dependent cellular cytoxicity.
D) IgE, IgG, and IgM are involved.
E) All of these choices are correct.
D) IgE, IgG, and IgM are involved.
75
```
The tuberculin skin test is based on
A) Type I hypersensitivity.
B) Type II hypersensitivity.
C) Type III hypersensitivity.
D) Type IV hypersensitivity.
```
C) Type III hypersensitivity.
76
Which of the following diseases does NOT result from immune complex-mediated hypersensitivity?
A) Arthus reaction
B) contact dermatitis
C) disseminated intravascular coagulation
D) glomerulonephritis
E) serum sickness
B) contact dermatitis
77
```
DiGeorge syndrome involves a deficiency in:
A) B cells making IgA.
B) bone marrow stem cells.
C) early B cells.
D) phagocytes.
E) T cells.
```
E) T cells.
78
Which of the following statements about immunodeficiencies is FALSE?
A) Primary immunodeficiency results from genetic or developmental problems.
B) Secondary immunodeficiency results from infection or environmental influences.
C) Children with DiGeorge's Syndrome have no T cells.
D) Selective IgA deficiency is the most common primary immunodeficiency.
E) All of these choices are correct.
E) All of these choices are correct.
79
```
Which of the following is associated with the “bubble boy disease”?
A) chronic granulomatous
B) Chediak-Higashi
C) monoclonal gammopathy
D) severe combined immunodeficiency
E) none of these
```
D) severe combined immunodeficiency
80
```
Which of the following is a possible cause of secondary immunodeficiency in humans?
A) HIV infection
B) age
C) malignancies
D) malnutrition
E) All of these choices are correct.
```
E) All of these choices are correct.
81
```
Which of the following is not an autoimmune disease?
A) lupus erythematosus
B) myasthenia gravis
C) insulin-dependent diabetes
D) rheumatoid arthritis
E) osteoarthritis
```
E) osteoarthritis
82
```
Chediak-Higashi disease involves a deficiency in:
A) B cells.
B) phagocytes.
C) T-cells.
D) bone marrow stem cells.
E) early B-cells.
```
B) phagocytes.
83
Which of the following statements about stem cells is FALSE?
A) Stem cells are derived from early stage embryos.
B) Stem cells have an almost unlimited capacity to divide.
C) Stem cells can differentiate into most types of tissue in the body.
D) Stem cells have the potential to repair damaged neurons.
E) Stem cells can be found in every organ until adolescence.
E) Stem cells can be found in every organ until adolescence.
84
```
People with blood type ____ are potentially able to donate blood to anyone.
A) A
B) B
C) AB
D) O
E) A-negative
```
D) O
85
```
People with blood type ____ are only able to donate blood to people with the same type of blood.
A) A
B) B
C) AB
D) O
E) None of these choices are correct.
```
C) AB
86
```
Which type of hypersensitivity does NOT cause a skin reaction?
A) Type I
B) Type II
C) Type III
D) Type IV
E) All of these choices are correct.
Feedback: Correct!
```
B) Type II
87
What is the best explanation for the fact that many herbal remedies for allergies actually make a person more hypersensitive?
A) Herbs inhibit neutrophils.
B) Herbs inhibit basophils.
C) Herbs are known to contain many allergens.
D) IgM is stimulated by herbs.
E) NK cells are stimulated by herbs.
C) Herbs are known to contain many allergens.
88
Twenty-two female tourists visiting Indonesia broke out with severe blisters and rashes mostly on the ear lobes, fingers, and lips. Eighteen of these people had smaller patches of blisters on various other body parts. Which of the following is the most likely explanation for this outbreak of problems?
A) Contact hypersensitivity from soup cups made out of coconut shells.
B) Contact hypersensitivity from earrings made of cashew husks.
C) Delayed hypersensitivity due to fungi in the environment.
D) Allergic rhinitis from pollen of tropical plants.
B) Contact hypersensitivity from earrings made of cashew husks.
89
```
Emergency room personnel know that antihistamines are mostly useful when treating patients with the following type(s) of hypersensitivity:
A) Type I
B) Type II
C) Type III
D) Type IV
E) Types I and III
```
A) Type I
90
Patients receiving organ transplants are more likely than other hospital patients to get regular bouts of respiratory and skin infections. What is the best explanation for this observation?
A) Bacteria and viruses from the donor are usually residing on the transplanted organs.
B) Transplant recipients develop immunosuppression after the surgery.
C) Blood given during the surgery overworks the immune system.
D) Autoimmune attack of the organs leaves little time for the immune system to fight disease.
E) Antirejection drugs weaken the immune system.
E) Antirejection drugs weaken the immune system.
91
Some scientists believe that certain pollutants such as ozone are capable of inducing autoimmune disease in people. What would be the most accurate rationale for their concern?
A) Ozone alters cellular proteins, making them subject to autoantibody attack.
B) Ozone is chemically similar to other body chemicals, causing the formation of autoantibodies.
C) Ozone causes so much cell damage that the body produces autoantibodies.
D) Ozone is a hapten and thus stimulates autoantibody production.
E) Ozone binds to DNA and thus stimulates autoantibody production.
A) Ozone alters cellular proteins, making them subject to autoantibody attack.
92
```
Which type of hypersensitivity does NOT involve antibodies?
A) Type I
B) Type II
C) Type III
D) Type IV
E) None of these choices are correct.
```
D) Type IV
