Chapter 17 (Unit 4 Exam)

Question 1

Primary immunodeficiencies are ________, whereas secondary immunodeficiencies ________.

Options:
A) Always genetic; result from disease or environmental factors
B) Caused by aging; are present at birth
C) Acquired later in life; are genetic disorders
D) Less serious; are often life-threatening

Answer 1

A) Always genetic; result from disease or environmental factors

Explanation: Primary immunodeficiencies are typically genetic and present from birth, affecting the development and/or function of the immune system. Secondary immunodeficiencies are acquired later in life due to factors such as infections (e.g., HIV), malnutrition, or chemotherapy.

Question 2

Severe Combined Immunodeficiency (SCID) is a primary immunodeficiency characterized by a lack of functional ________ and _________.

Answer 2

B and T lymphocytes

Explanation: SCID is a severe disorder where both the B and T cell arms of the adaptive immune system are nonfunctional, leading to a highly compromised immune system. It is treated with bone marrow transplants or gene therapy.

Question 3

In acute post-streptococcal glomerulonephritis, antibodies and __________ contribute to inflammation in the glomeruli of the kidneys.

Answer 3

neutrophils

Explanation: After a streptococcal infection, the immune system produces antibodies that can form complexes with streptococcal antigens, which then deposit in the glomeruli. Neutrophils respond to these complexes, and their enzymes can damage the kidney’s filtering structures.

Question 4

The most influential set of antigens determining blood transfusion reactions is the __________ system.

Answer 4

ABO

Explanation: The ABO blood group system is the most significant in transfusion medicine as it determines how recipients will react to blood based on the presence of A and B antigens on red blood cells.

Question 5

Which event represents the process of releasing chemical mediators?

Multiple Choice
A) Degranulation
B) Prostaglandins causing vasodilation and increased vascular permeability
C) Binding of allergen to adjacent IgE binding sites on mast cells and basophils
D) Binding of IgE by the Fc region to mast cells and basophils
E) Histamine acting on smooth muscle

Answer 5

A) Degranulation

Question 6

Match the description to the correct term to test your understanding of the different sources of graft material.

1) Xenograft
2) Allograft
3) Autograft
4) Isograft

A) Tissue transplanted from one site to another on your own body
B) Tissue transplant from an identical twin
C) Exchange between genetically different individuals belonging to the same species
D) Tissue transplant between individuals of different species

Answer 6

1) Xenograft
D) Tissue transplant between individuals of different species

2) Allograft
C) Exchange between genetically different individuals belonging to the same species

3) Autograft
A) Tissue transplanted from one site to another on your own body

4) Isograft
B) Tissue transplant from an identical twin

Explanation: Tissue transplanted from one site on an individual’s body to another site on his or her body is known as an autograft. In an isograft, tissue from an identical twin is used. Allograft, the most common type of grafts, are exchanges between genetically different individuals belonging to the same species (two humans). A xenograft is a tissue exchange between individuals of different species.

Question 7

What is immunopathology and what are the two major categories of immune dysfunction?

Options:
A) The study of vaccines, categorized into autoimmune diseases and hypersensitivities.
B) The study of immune responses, categorized into immunodeficiency and autoimmunity.
C) The study of healthy immune functions, categorized into immunodeficiency and allergies.
D) The study of diseases caused by the immune system, categorized into hypersensitivities and immunodeficiencies.

Answer 7

D) The study of diseases caused by the immune system, categorized into hypersensitivities and immunodeficiencies.

Explanation: Immunopathology is the study of diseases that result from dysfunction in the immune system, such as overreactions (hypersensitivities) or inadequate responses (immunodeficiencies).

Question 8

Autoimmune diseases involve an abnormal attack against self-antigens and can involve Type II, Type III, and Type IV hypersensitivities.

A) True
B) False

Answer 8

A) True

Explanation: Autoimmune diseases occur when the immune system mistakenly targets the body’s own tissues, involving various types of hypersensitivity reactions depending on the disease’s nature and the immune components involved.

Question 9

The hygiene hypothesis suggests that

Multiple Choice

A) there are still too many microorganisms in the environment.
B) we may need more contact with microbes as our systems mature.
C) we may need more contact with antimicrobials as our systems mature.
D) there are not enough microbes on farms.

Answer 9

B) we may need more contact with microbes as our systems mature.

Question 10

Primary immunodeficiencies are always genetic and present from birth, whereas secondary immunodeficiencies are acquired after birth due to factors like infections or chemotherapy.

A) True
B) False

Answer 10

A) True

Explanation: Primary immunodeficiencies are congenital and often have a genetic basis, while secondary immunodeficiencies occur due to various acquired causes, including infections, malnutrition, or medical treatments like chemotherapy and radiation.

Question 11

In contact dermatitis, a common Type IV hypersensitivity reaction, the response is mediated by _______ cells which can take 2-3 days to develop symptoms.

Answer 11

T

Explanation: Contact dermatitis is a delayed hypersensitivity reaction mediated by T cells, typically manifesting 2-3 days after exposure to the antigen .

Question 12

What is the most recognized infection-induced immunodeficiency disease, characterized by the infection of T helper cells, monocytes, macrophages, and APCs with a specific virus?

Options:
A) Severe Combined Immunodeficiency (SCID)
B) Common Variable Immunodeficiency (CVID)
C) Acquired Immunodeficiency Syndrome (AIDS)
D) DiGeorge Syndrome

Answer 12

C) Acquired Immunodeficiency Syndrome (AIDS)

Explanation: AIDS is the most recognized infection-induced immunodeficiency disease caused by Human Immunodeficiency Virus (HIV) infection, leading to the depletion of T helper cells and impairment of immune responses, allowing for cancers and opportunistic infections to develop.

Question 13

An individual with blood type O- could donate to any of thee four patients because:

Multiple Choice
A) the recipient has no antibodies against O antigen.
B) blood type O- carries no antibodies against A, B or the Rhesus factor.
C) blood type O- has no blood group antigens to react with the recipient’s antibodies.

Answer 13

C) blood type O- has no blood group antigens to react with the recipient’s antibodies.

Question 14

The four major categories of hypersensitivity reactions are Type I (immediate), Type II (__ ), Type III (immune complex-mediated), and Type IV ( __).

Answer 14

Cytotoxic, Delayed

Explanation: Type II hypersensitivity reactions are cytotoxic, meaning they lead to the destruction of the host cell. Type IV reactions are delayed-type hypersensitivities, which typically take more than 12 hours to develop

Question 15

The Rh factor does not affect pregnancy and is irrelevant to fetal health.

A) True
B) False

Answer 15

B) False

Explanation: The Rh factor can play a critical role in pregnancy. If an Rh-negative mother carries an Rh-positive fetus, her immune system may recognize the fetus’s Rh factor as foreign and produce antibodies against it, potentially leading to hemolytic disease of the newborn. Rhogam shots are given to prevent this immunization and disease.

Question 16

The ABO blood group system is based on __________, and the blood type that is considered a “universal donor” is __________.

Options:
A) The presence of specific antigens on the cell surface, Type O
B) The presence of antibodies in the plasma, Type AB
C) Blood cell count, Type A
D) Plasma proteins, Type B

Answer 16

A) The presence of specific antigens on the cell surface, Type O

Explanation: The ABO blood group system is determined by the presence of antigens on the surface of red blood cells. Type O blood lacks these antigens and is considered the “universal donor” because it can be donated to individuals of any ABO blood type.

Question 17

The three immune components causing cell lysis in type II hypersensitivity reactions include antibodies, complement proteins, and __________.

Answer 17

phagocytes

Explanation: In type II hypersensitivity reactions, antibodies bind to antigens on the surface of target cells. This binding can activate the complement system leading to cell lysis or opsonization, which in turn leads to phagocytosis.

Question 18

Symptoms of anaphylaxis may include:

Options:
A) Mild itching and a small rash
B) Swelling of the throat, difficulty breathing, and a drop in blood pressure
C) Increased heart rate only
D) Nausea without other physical symptoms

Answer 18

B) Swelling of the throat, difficulty breathing, and a drop in blood pressure

Explanation: Anaphylaxis is a severe allergic reaction that is rapid in onset and may cause death. Symptoms include swelling of the throat (angioedema), difficulty breathing, a significant drop in blood pressure, and can lead to anaphylactic shock.

Question 19

Three conditions caused by IgE-mediated allergic reactions include __________, asthma, and allergic rhinitis.

Answer 19

atopic dermatitis

Explanation: Atopic dermatitis, asthma, and allergic rhinitis (hay fever) are common conditions resulting from IgE-mediated allergic responses. These conditions are characterized by excessive activation of the immune system in response to environmental antigens.

Question 20

Which antibodies are involved in complement-mediated cell destruction in Type II hypersensitivities?

Options:
A) IgE and IgD
B) IgA and IgM
C) IgG and IgM
D) IgE and IgA

Answer 20

C) IgG and IgM

Explanation: In Type II hypersensitivities, such as those that occur in blood group incompatibility, IgG and IgM antibodies target cells and can activate the complement system, leading to cell lysis.

Question 21

Type III hypersensitivity reactions differ from Type II because they:

Options:
A) Involve antibodies binding directly to cell surfaces.
B) Result in the formation of immune complexes in the blood or tissues.
C) Are immediate hypersensitivity reactions.
D) Do not involve the immune system.

Answer 21

B) Result in the formation of immune complexes in the blood or tissues.

Explanation: While Type II hypersensitivity involves antibodies that react to cell surface antigens, leading to cell lysis or phagocytosis, Type III hypersensitivity involves the formation of antibody-antigen complexes (immune complexes) that can deposit in various tissues, leading to an inflammatory response and tissue damage.

Question 22

All of the following can result in acquired immune deficiency except

Multiple Choice
A) enzyme deficiency.
B) bacterial infection.
C) radiation treatment.
D) malnutrition.
E) stress.

Answer 22

A) enzyme deficiency.

Question 23

Severe Combined Immunodeficiency (SCID) is characterized by:

Options:
A) A dysfunction of the T lymphocytes only.
B) A dysfunction of both B and T lymphocyte systems.
C) Only an absence of lymphocyte stem cells in the bone marrow.
D) Only dysfunction of B cells later in development.

Answer 23

B) A dysfunction of both B and T lymphocyte systems.

Explanation: SCID involves serious defects in both the B cell and T cell arms of the immune system, which can be due to the complete absence of lymphocyte stem cells or dysfunction at a later stage of development.

Question 24

Severe combined immunodeficiency (SCID) is a primary immunodeficiency characterized by the absence of functional T cells and B cells, and current therapeutic approaches include __________ and gene therapy.

Answer 24

bone marrow transplants

Explanation: SCID is a life-threatening condition usually detected soon after birth, and it involves a severely compromised immune system due to the dysfunction or absence of T cells and B cells. Bone marrow transplants can replace the defective immune cells with healthy ones, and gene therapy aims to correct the genetic defects causing the disorder.

Question 25

Four classes of grafts include autografts, isografts, allografts, and __________. Host versus graft disease occurs when the host’s immune system attacks the graft, and graft versus host disease develops when the grafted tissue contains immune cells that attack the host.

Answer 25

xenografts

Explanation: Autografts are from the same individual’s body; isografts are between identical twins; allografts are between non-identical individuals of the same species; and xenografts are from a different species.

Question 26

To prevent or short-circuit Type I allergic reactions, one can use antihistamines, corticosteroids, and allergen immunotherapy.

A) True
B) False

Answer 26

A) True

Explanation: Type I allergic reactions can be managed or prevented using antihistamines, which block histamine receptors; corticosteroids, which reduce inflammation; and allergen immunotherapy, which gradually desensitizes the immune system to the allergen.

Question 27

The initial encounter with an allergen is called the _________blank dose.

Multiple Choice
A) provocative
B) hypersensitivity
C) desensitizing
D) sensitizing
E) allergic

Answer 27

D) sensitizing

Question 28

Match the statement to the correct hypersensitivity reaction to test your understanding of overreactions to antigens.

1) Type III
2) Type IV
3) Type I
4) Type II

A) Includes anaphylaxis, a systemic fatal reaction with airway obstruction and respiratory collapse
B) Involves complement assisted lysis of cells coated with antibodies which often results in autoimmune reactions
C) Immune complexes form and become lodged in various basement
D) T cell-mediated delayed hypersensitivity reactions including contact dermatitis and graft rejection reactions

Answer 28

1) Type III
C) Immune complexes form and become lodged in various basement

2) Type IV
D) T cell-mediated delayed hypersensitivity reactions including contact dermatitis and graft rejection reactions

3) Type I
A) Includes anaphylaxis, a systemic fatal reaction with airway obstruction and respiratory collapse

4) Type II
B) Involves complement assisted lysis of cells coated with antibodies which often results in autoimmune reactions

Question 29

Two methods for diagnosing allergies include skin prick tests and __________ assays.

Answer 29

serum IgE

Explanation: Allergies can be diagnosed through skin prick tests, which expose the skin to potential allergens to observe reactions, and serum IgE assays, which measure the level of IgE antibodies in the blood in response to specific allergens.

Question 30

Genetic factors play no role in allergy development, with environmental factors being the sole contributors.

A) True
B) False

Answer 30

B) False

Explanation: Both genetic and environmental factors influence allergy development. Genetic predisposition can play a significant role in the likelihood of developing allergies, and environmental factors can trigger or exacerbate these reactions.

Question 31

Which of the following is not a common autoimmune disease?

Options:
A) Systemic Lupus Erythematosus (SLE)
B) Rheumatoid Arthritis
C) Type I Diabetes
D) Polycythemia Vera

Answer 31

D) Polycythemia Vera

Explanation: Polycythemia Vera is a type of blood cancer that causes the bone marrow to make too many red blood cells and is not an autoimmune disease. SLE, Rheumatoid Arthritis, and Type I Diabetes are all autoimmune diseases.

Question 32

Hemolytic disease of the newborn can occur when an Rh-________ mother is carrying an Rh-________ fetus, which can be prevented with Rhogam shots.

Answer 32

negative, positive

Explanation: Hemolytic disease of the newborn may develop if an Rh-negative mother becomes sensitized to Rh-positive fetal blood cells. Rhogam shots prevent the mother’s immune system from attacking the Rh-positive cells of the fetus.

Question 33

A systemic, sometimes fatal, reaction with airway obstruction and circulatory collapse is:

Multiple Choice
A) delayed.
B) T-cell-mediated.
C) antibody-mediated.
D) systemic anaphylaxis.
E) atopic.

Answer 33

D) systemic anaphylaxis.

Question 34

The universal donor blood type is AB.

A) True
B) False

Answer 34

B) False

Explanation: The universal donor blood type is O because it lacks A and B antigens, thus it does not cause agglutination when transfused into individuals with different blood types.

Question 35

Three autoimmune diseases include type 1 diabetes, rheumatoid arthritis, and __________, each having unique immunologic features like the destruction of specific tissues or the presence of characteristic autoantibodies.

Answer 35

systemic lupus erythematosus (SLE)

Explanation: In type 1 diabetes, the immune system destroys insulin-producing beta cells. Rheumatoid arthritis is characterized by an attack on joint tissues, and SLE is known for widespread inflammation and autoantibodies against a variety of tissues.

Question 36

Identify a type IV hypersensitivity reaction and the role of T cells in it:

Options:
A) Hay fever, with T cells producing antibodies.
B) Contact dermatitis, with T cells mediating the delayed response.
C) Hemolytic anemia, with T cells lysing blood cells.
D) Serum sickness, with T cells forming immune complexes.

Answer 36

B) Contact dermatitis, with T cells mediating the delayed response.

Explanation: Contact dermatitis, such as a reaction to poison ivy, is a classic example of a type IV hypersensitivity reaction. It is cell-mediated with T cells responding to the antigen, leading to a delayed reaction that results in skin inflammation.

Question 37

What are the steps involved in a Type I allergic response?

Options:
A) Sensitization, activation, degranulation, and inflammation
B) Activation, infection, response, and recovery
C) Exposure, recognition, replication, and memory formation
D) Sensitization, mutation, replication, and cytokine release

Answer 37

A) Sensitization, activation, degranulation, and inflammation

Explanation: A Type I allergic response begins with sensitization when an individual is first exposed to an allergen. Upon subsequent exposures, mast cells and basophils are activated, leading to degranulation and the release of inflammatory mediators.

Question 38

Hemolytic disease of the newborn can occur when an Rh-negative mother carries an Rh-________ fetus and can be prevented by administering __________ shots.

Answer 38

positive, Rhogam

Explanation: Hemolytic disease of the newborn happens when an Rh-negative mother’s immune system attacks the red blood cells of an Rh-positive fetus. Rhogam shots are given to prevent the mother’s immune system from becoming sensitized to Rh-positive cells .

Question 39

Which of the following is a proposed explanation for the origin of autoimmunity?

Options:
A) Molecular mimicry, where antigens resemble self-antigens.
B) Hygiene hypothesis, suggesting a lack of early childhood exposure to infectious agents.
C) Both A and B.
D) Neither A nor B.

Answer 39

C) Both A and B.

Explanation: Autoimmunity can result from molecular mimicry, where foreign antigens closely resemble self-antigens, causing the immune system to launch an attack that also targets the body’s own tissues. The hygiene hypothesis suggests that a lack of exposure to infections in early childhood may lead to an improperly trained immune system, which may mistakenly target the body’s own cells.