Clinical immunology Flashcards
Which is NOT a side-effect of chronic steroid therapy?
A) Hypertension
B) Myopathy
C) Hyperpotassemia
D) Cataract
E) Glaucoma
C) Hyperpotassemia
Which autoantibody is NOT specific for poly-dermatomyositis?
A) Anti-Ku
B) Anti-Mi2
C) Anti-SRP
D) Anti-Sm
E) Anti-Jo1
D) Anti-Sm
Which immunosuppressive agent MAY NOT be used for SLE therapy?
A) Cyclophosphamide
B) Methotrexate
C) Belimumab
D) Adalimumab
E) Azathioprine
D) Adalimumab
Which is NOT a complication of systemic sclerosis?
A) Diffuse pulmonary fibrosis
B) Honeydew melon stomach
C) Esophageal stricture
D) Pulmonary hypertension
E) Fingertip-ulcer
B) Honeydew melon stomach
Which is NOT an ANCA-associated vasculitis?
A) Polyarteritis nodosa
B) Churg-Strauss syndrome
C) Granulomatous vasculitis
D) Microscopic polyangiitis
E) Wegener granulomatosis
A) Polyarteritis nodosa
Which antibody is specific for Antiphospholipid syndrome?
A) Anti-apexin V.
B) Anti-beta2-microglobulin I.
C) Anti-beta2-glycoprotein I
D) Anti-cardiotliptin
E) Anti-lupus anticoagulant
C) Anti-beta2-glycoprotein I
Which autoantibody is specific for MCTD?
A) Anti-PM-Scl
B) Anti-U1 RNP
C) ANCA
D) Anti-SS-A
E) Anti-dsDNA
B) Anti-U1 RNP
Which is true about immunofluorescent staining of antinuclear antibody?
A) The staining is nucleolar in SLE
B) The staining is homogenous in MCTD
C) The staining is nucleolar in systemic sclerosis
D) The staining is homogenous in RA
E) The staining is against centromer in myositis
C) The staining is nucleolar in systemic sclerosis
Which is NOT a polysystemic autoimmune disease?
A) Polymyositis
B) Systemic sclerosis
C) Sclerosis multiplex
D) Sjögren’s syndrome
E) MCTD
C) Sclerosis multiplex
Which statement is NOT typical in systemic autoimmune diseases?
A) Familiar aggregation
B) Sometimes medicines or chemicals can trigger them
C) Antinuclear autoantibodies are frequent
D) Males are affected mainly
E) The disease can worsen or improve during pregnancy
D) Males are affected mainly
Which genetic constellation is typical in autoimmune diseases?
A) HLA-DQ2-DR4
B) HLA-A1-B8-DR3
C) HLA-A8-B27-DR4
D) HLA-B7-B27-DR3
E) HLA-A1-B7-DR4
B) HLA-A1-B8-DR3
Which of the following is the most frequently occurring systemic autoimmune disease?
A) SLE
B) Polymyositis
C) Systemic sclerosis
D) MCTD
E) Sjögren’s syndrome
E) Sjögren’s syndrome
Which autoimmune disease is NOT commonly associated with B-cell lymphoma?
A) SLE
B) Systemic sclerosis
C) Rheumatoid arthritis
D) Polymyositis
E) Sjögren’s syndrome
D) Polymyositis
Which is NOT a symptom of antiphospholipid syndrome?
A) Habitual abortion
B) Frequent migraine
C) Thrombocytosis
D) Increased risk of thromboembolism
E) Livedo reticularis
C) Thrombocytosis
Which medicine DO NOT causes SLE?
A) Etanercept
B) Procainamide
C) Infliximab
D) Hydralazine
E) Rituximab
E) Rituximab
In what percent of patients with undifferentiated autoimmune diseases (NDC) develops definitive autoimmune disease?
A) 5-10 %
B) 15-20 %
C) 30-40 %
D) 50-60 %
E) 70-80 %
D) 50-60 %
In which case can be NDC diagnosed?
A) In the presence of three typical clinical symptoms
B) In the presence of one typical clinical symptom and two autoantibody positivity’s
C) In the presence of two clinical symptoms and two autoantibodies
D) In the presence of two clinical symptoms and one autoantibody
E) In the presence of one clinical symptom and three typical autoantibodies
D) In the presence of two clinical symptoms and one autoantibody
Which process is NOT typical in the pathogenesis of SLE?
A) DNA repair disorder
B) DNA methylation
C) Tissue citrullination
D) Increased B-cell activity
E) Decreased regulatory T-cell activity
C) Tissue citrullination
Which biological therapy is appropriate for the therapy of SLE?
A) Etanercept
B) Infliximab
C) Belimumab
D) Adalimumab
E) Tocilizumab
C) Belimumab
Accelerated atherosclerosis and increased cardiovascular mortality are NOT typical in which disease?
A) Rheumatoid arthritis
B) SLE
C) Sjögren’s syndrome
D) Antiphospholipid syndrome
E) Systemic sclerosis
C) Sjögren’s syndrome
Which is NOT a real histological type of lupus nephritis?
A) Diffuse lupus nephritis
B) Sclerotizing glomerulonephritis
C) Membranous lupus nephritis
D) Mesangial proliferative lupus nephritis
E) Focal minimal lupus nephritis
E) Focal minimal lupus nephritis
Which is NOT a typical cause of death in SLE?
A) Cardiovascular disease
B) Kidney failure
C) Central nervous system lupus
D) Pulmonary fibrosis
E) Secondary tumors
D) Pulmonary fibrosis
Which pathogenetic process DOES NOT plays a role in the development of systemic sclerosis?
A) Microvascular disorders
B) Immunopathological disorders
C) Tissue citrullination
D) Collagen deposition in the organs
E) Macrovascular disorders
C) Tissue citrullination
Against which antigen is oriented Anti-Scl70 in scleroderma?
A) RNA polymerase I
B) DNA polymerase I
C) DNA topoisomerase III
D) RNA polymerase III
E) DNA topoisomerase I
E) DNA topoisomerase I
Which is NOT a diagnostic criterion of systemic sclerosis?
A) Sclerodactylia
B) Paroxysmal scleroderma
C) Star-shaped scars on the fingertips
D) Bibasilar pulmonary fibrosis
E) Esophageal dismotility
E) Esophageal dismotility
Which medicine is NOT appropriate for treating the vascular symptoms of systemic sclerosis?
A) Nitroglycerin
B) Calcium antagonists
C) Angiotensin II receptor antagonists
D) Beta receptor blockers
E) Sildenafil
D) Beta receptor blockers
Which is NOT among the clinic pathological subtypes of inflammatory muscle diseases?
A) Adult polymyositis
B) Tumor-associated myositis
C) Juvenile poly-dermatomyositis
D) Inclusion body myositis
E) Ossification myositis
E) Ossification myositis
Which is NOT among the diagnostic criteria of inflammatory muscular diseases according to Bohan and Peter?
A) Elevated levels of CK and LDH enzymes
B) Intensifying weakness of distal muscles
C) Positive muscle biopsy with inflammation, necrosis
D) EMG disorders
E) Skin symptoms specific for dermatomyositis
B) Intensifying weakness of distal muscles
Which is NOT among the American-European Consensus Criteria for Sjögren’s syndrome?
A) Anti-fodrin antibody
B) Anti-SS-A and/or anti-SS-B antibody
C) Positive Rose-Bengal test
D) Schirmer-test <5 mm/5 min
E) Positive salivary gland scintigraphy
A) Anti-fodrin antibody
Which agent is NOT appropriate for treating glandular symptoms of Sjögren’s syndrome?
A) N-acetylcysteine
B) Tear point occlusion
C) Methylcellulose containing artificial tear
D) Infliximab
E) Pilocarpine
D) Infliximab
Which disease is NOT an element of MCTD?
A) Rheumatoid arthritis
B) NDC
C) Polymyositis
D) SLE
E) Systemic sclerosis
B) NDC
Which disease constitutes diagnostic criteria for MCTD according to Alarcon-Segovia?
A) Pulmonary fibrosis
B) Swelling of the back of the hand
C) Pulmonary arterial hypertension
D) Esophageal dismotility
E) Swelling of the fingers
B) Swelling of the back of the hand
Which systemic vasculitis affects the medium-sized vessels?
A) Churg-Strauss syndrome
B) Takayasu arteritis
C) Kawasaki disease
D) Cryoglobulinemic vasculitis
E) Polymyalgia rheumatica
C) Kawasaki disease
Histopathological forms of lupus nephritis:
1) Focal lupus nephritis
2) Membranous lupus nephritis
3) Sclerotizing glomerulonephritis
4) Minimal mesangial nephritis
5) Diffuse lupus nephritis
A) 1. and 3. are correct
B) 2. and 4. are correct
C) only 5. is correct
D) 1., 3. and 5. are correct
E) all answers are correct
E) all answers are correct
Classification criteria of SLE:
1) Iron deficiency anemia
2) ANA positivity
3) Anti-ENA antibody
4) Leukopenia <4G/l
5) Lymphocytosis
A) answers 1 and 3 are correct
B) answers 2 and 4 are correct
C) only answer 5 is correct
D) answers 1, 3 and 5 are correct
E) all of the answers are correct
B) answers 2 and 4 are correct
Diagnostic criteria of Sjögren’s syndrome according to the American-European Consensus system:
1) Recurrent foreign body sensation in the eyes
2) Positive ultrasound of salivary glands
3) Dry eyes for more than 3 months
4) Schirmer-test <3mm/3min
5) Positive sialography
A) 1. and 3. answers are correct
B) 2. and 4. answers are correct
C) only 5. answer is correct
D) 1., 3. and 5. answers are correct
E) all of the answers are correct
D) 1., 3. and 5. answers are correct
B-cell inhibitor appropriate for therapy of SLE:
1) Rituximab
2) Tocilizumab
3) Certolizumab pegol
4) Infliximab
5) Belimumab
A) 1. and 3. are correct
B) 2. and 4. are correct
C) only 5. is correct
D) 1., 3. and 5. are correct
E) all answers are correct
C) only 5. is correct
Classification criteria of Henoch-Schönlein purpura:
1) Palpable purpura
2) ANCA positivity
3) Abdominal angina
4) Lymphocytes in the wall of small vessels
5) Age <21 years at the beginning of the disease
A) 1. and 3. are correct
B) 2. and 4. are correct
C) only 5. is correct
D) 1., 3. and 5. are correct
E) all answers are correct
D) 1., 3. and 5. are correct
Which is true?
1) Wegener-granulomatosis is a vasculitis affecting the small vessels
2) Polyarteritis nodosa is an ANCA-associated vasculitis
3) Microscopic polyangiitis is an ANCA-associated vasculitis
4) Takayasu-arteritis affects the medium-sized vessels
5) Churg-Strauss syndrome is not ANCA-associated
A) 1. and 3. are correct
B) 2. and 4. are correct
C) only 5. is correct
D) 1., 3. and 5. are correct
E) all answers are correct
A) 1. and 3. are correct
Appropriate medicines for therapy of ANCA-associated vasculitides:
1) Cyclophosphamide
2) Azathioprine
3) Sulfamethoxazole
4) Methotrexate
5) Rituximab
A) 1. and 3. are correct
B) 2. and 4. are correct
C) only 5. is correct
D) 1., 3. and 5. are correct
E) all answers are correct
E) all answers are correct
Organ symptoms of systemic sclerosis:
1) Pulmonary arterial hypertension
2) Apical pulmonary fibrosis
3) Watermelon-stomach
4) Discoid skin symptoms
5) Subcutaneous calcinosis
A) 1. and 3. are correct
B) 2. and 4. are correct
C) only 5. is correct
D) 1., 3. and 5. are correct
E) all answers are correct
D) 1., 3. and 5. are correct
