Final Exam Review Questions Flashcards
A seventeen-year-old patient presents with acute cutaneous lupus erythematosus (SCLE) diagnosed at the age of 15 years old. Prior laboratory measurements showed no detectable C4 proteins, serum C3 levels were lower (77 mg/dL) and C1q inhibitor levels were normal. Which complement activities would be inhibited in this patients?
A. Completion of the classic pathway to the splitting of C3
B. Formation of C3b for opsonization
C. Formation of C5 convertase via the alternative pathway
D. Formation of C5a for chemotactic attractant for neutrophils
E. Formation of the membrane attack complex
A. Completion of the classic pathway to the splitting of C3
A patient admitted in hospital who has a severe bacterial infections. He is found to be deficient in C3 component of complement. Which of the complement associated event would still be present in this patient?
a. Hemolysis
b. Chemotaxis
c. Opsonization
d. Hereditary angioneurotic edema
e. Bacteriolysis
d. Hereditary angioneurotic edema
A 77-year-old woman with dysuria for 1 week now has a fever. On examination, she has a temperature of 37.9°C, pulse of 103/min, and blood pressure of 80/40 mm Hg. There is right flank pain. A urinalysis shows numerous white blood cells. Her plasma lactate is increased. Urine culture and blood culture grow Escherichia coli. Which of the following is most likely mediating her cardiovascular collapse through attachment to Toll-like cell receptors? A. Complement C3b B. Lipopolysaccharide C. Nitric oxide D. Platelet-activating factor E. Toxic shock syndrome toxin-1 F. Tumor necrosis factor
B. Lipopolysaccharide
Cytokine storms are associated with a wide variety of infectious and noninfectious diseases. Which of the following immunosuppressive drugs functions by transcriptional inhibition of pro-inflammatory genes? A. Cyclosporine A B. Corticosteroids C. Tacrolimus D. Anti-CD3 (OKT3) antibodies E. Anti-CD25 antibodies
B. Corticosteroids
A 55-year-old man with multiple primary liver abscesses caused by Escherichia coli and anaerobic bacteria has fever and shaking chills. Which of the following is the most likely cause of these symptoms?
A. Associated abscess in the hypothalamus
B. Hypothalamic response to leukocytosis
C. Leukocyte inflammation of the hypothalamus
D. Release of fragments of damaged hepatocytes into the circulation
E. Release of leukocyte cytokines into the circulation
E. Release of leukocyte cytokines into the circulation
A 77-year-old man is admitted to the intensive care unit (ICU) of a university hospital from the operating room. Earlier the same day, he had presented to the emergency department with abdominal pain. In the emergency department, he was drowsy and confused when roused and was peripherally cold with cyanosis. The systemic arterial blood pressure was 75/50 mm Hg, and the heart rate was 125 beats per minute. Which of the following is thought to be a major contributor to the septic shock? A. Clathrin B. Histamine C. Interferon D. Interleukin 2 E. Tumor necrosis factor
E. Tumor necrosis factor
A 24-year-old Caucasian male is admitted to the hospital with a one-week history of fever, cough, and chest pain. Lung auscultation reveals crackles over the right lower lung lobe. When placed in an upright glass tube, his anticoagulated red blood cells sedimented at an increased rate of 35 mm per hour. This finding is most likely related to the action of which of the following substances? A. Bradykinin B. Leukotriene B4 C. Erythropoietin D. IL-6 E. Platelet activating factor F. Thromboxane A2
D. IL-6
A 68 year old female with no history of perianal abscess was examined in the Emergency Department of the hospital verbalizing complaints of swelling and tenderness in the left inguinal area. Physical examination revealed abscess of the left labial area. The patient was admitted to the hospital and surgical incision and drainage was performed by the physician. Which one of the listed cytokines is most important in formation of an abscess? A. TNF B. IL-1 C. IL-6 D. IL-8 E. IL-12
D. IL-8
A polypeptide fragment of a large viral antigen is isolated in the laboratory and injected into health volunteers. Researchers find that individuals with particular HLA haplotype do not mount an Ab response to the antigen. Which of the following processes is most likely failing to occur in these subjects?
A. Antigen recognition by T lymphocytes
B. Antigen recognition by B lymphocytes
C. Antigen presentation by macrophages
D. Antigen independent B lymphocyte proliferation
E. Negative selection of T lymphocytes.
A. Antigen recognition by T lymphocytes
Class diversity of immunoglobulin molecules is determined by:
A. V,J rearrangements of the DNA coding for variable N terminus of light chain
B. V,D,J rearrangements of the DNA coding for variable N
terminus of heavy chain
C. Alternate splicing of segment of RNA coding for the carboxyl terminus of the heavy chain
D. N-nucleotide addition
E. A,B,C,D
C. Alternate splicing of segment of RNA coding for the carboxyl terminus of the heavy chain
A healthy one year old is given an antigen. The immune response shows increasing IgM and no rise in IgG during the next 2 months. Which of the following types of antigens was mostly likely given?
a. bacterial polysaccharide
b. live attenuated measles
c. polio
d. tetanus toxoid
e. unconjugated hapten
a. bacterial polysaccharide
You are asked to see a 4-year-old boy who has extremely elevated white blood cell counts, with a profound lymphocytosis. Biopsy of his cervical LN reveals extreme hypocellularity in both cortical and paracortical areas. Absence of which of the following leukocyte surface molecules could result in this clinical picture?
A. Immunoglobulin family cell adhesion molecules
B. Integrins
C. L-selectins
D. Chemokines
E. Addressins
C. L-selectins
A 34-year-old female is in need of a blood transfusion because of blood loss due to a road accident. Her blood group is B. Which of the following is a permissible match for the patient? A. A or B B. B or AB C. AB or A D. A or O E. B or O
E. B or O
A 42 YO man needs a kidney allograft. His lymphocytes are examined by the mixed lymphocyte reaction with killed stimulator cells from himself & from each of 5 prospective donors. A donor with which of the following thymidine incorporation (cpm) will be most compatible? (the patient has a thymidine value of 425/cpm)
a. 312
b. 1542
c. 2505
d. 15,389
e. 27,482
a. 312
A 40-year-old man with chronic myelogenous leukemia undergoes high- dose chemotherapy and bone marrow transplantation from an unrelated donor. Six weeks after the transplant he has good recovery of hematopoiesis but develops diarrhea, a generalized cutaneous rash, and jaundice. Which of the following cell types most likely underlies these signs? A. B lymphocytes B. Eosinophils C. Mast cells D. Neutrophils E. T lymphocytes
E. T lymphocytes