HIS 2016-2017 MCQ - Flashcards
Q1. A patient suffering from dehydration is given an infusion of isotonic saline. What effect will the introduction of this solution have on the body’s fluids?
increase ECF (extracellular fluid) volume while decreasing ECF osmolarity
increase ECF volume without altering ECF osmolarity
increase ICF (intracellular fluid) volume without altering ECF osmolarity
increase ECF volume while increasing ECF osmolarity
increase ICF volume without altering ICF osmolarity
A. Increase ECF volume without altering ECF osmolarity
Q2. A 16-year-old girl presents to the Emergency department after fainting in school. Her mother informs the doctor that she suffers from fatigue, breathlessness and menorrhagia (heavy, regular menstruation). Her physical examination is notable for pallor. Following analysis of her full blood count and blood film, the girl is diagnosed with iron deficiency anaemia. In terms of haemoglobin levels and red blood cell size, how would you best describe her anaemia?
Hyperchromic, macrocytic
Hyperchromic, microcytic
Hypochromic, microcytic
Hypochromic, normocytic
Normochromic, microcytic
C. Hypochromic, microcytic
Q3. Prior to performing a blood transfusion, blood grouping of the donor’s blood is determined. The illustration below highlights the results of this blood group analysis. What is the blood group of the donor?
A Rhesus negative
A Rhesus positive
AB Rhesus positive
B Rhesus negative
B Rhesus positive
B. A rhesus positive
Q4. A man goes to his GP after a scratch on his leg has become painful and swollen. The GP diagnoses a bacterial infection. What cells of the immune system use a process of phagocytosis to engulf bacteria?
Eosinophils
Macrophages
Mast cells
Secretory cells
T cells
B. Macrophages
Q5. Approximately 60 minutes after being bitten by an insect, a 45-year-old woman noticed localised swelling, itching and redness to the affected area. A likely contributor to this reaction is histamine, released by mast cells in an acute inflammatory response. What is the main role of histamine in this case?
It acts as a chemoattractant
It causes constriction of blood vessels
It increases the permeability of blood vessels
It activates neutrophils
It mediates direct killing of a microbe
C. It increases the permeability of blood vessels
Q6. A 26-year-old man presented to the Emergency Department of a hospital with severe swelling to his face mainly around the lips. There was no itching and no evidence of hives. The doctor suspected anaphylaxis but adrenaline failed to have a significant effect. Based on a family history of similar events, hereditary angioedema was considered more likely. What defect in the immune system contributes to this disease?
Complement disorder
Cytokine deficiency
Defects in antigen presentation
MHC deficiency
Phagocyte disorder
A. Complement disorder - hereditary angioedema - overactivation due to a lack of complement inhibitors.
Q7. Where do precursor T cells develop into fully competent but not yet activated T cells?
Bone marrow
Lymph nodes
Peripheral tissue
Spleen
Thymus
E. Thymus -
Q8. A 15-month-old girl was admitted to hospital with diarrhoea, vomiting, dehydration and abdominal pain. She was also noted to have significant weight loss, irritability and a distended stomach over the last 3 months. Clinical presentation, serologic testing and biopsy analysis confirmed coeliac disease. What antibody isotype would be highly elevated in the serology result?
IgA
IgD
IgE
IgG
IgM
D. IgG
Q9. Following a trip to East Asia, and the consumption of unwashed vegetables there, a 32-year-old man developed intestinal symptoms consistent with an extracellular helminth (worm) infection. What subset of helper T cells drives the immune response responsible for clearing worm infections?
Th0
Th1
Th2
Th17
Treg
C. Th2
Q10. It is flu season, and a media campaign has been launched to advise vulnerable groups of society to get the flu vaccine. What cytokine is primarily associated with the immune response to viral infection, via functions including the following: shutting down viral replication, activating cytotoxic T cells, activating antigen-presenting cells and up regulating Class I MHC?
Interferon alpha
Interleukin 1 beta
Interleukin 2
Interleukin 8
Tumour necrosis factor alpha
B. interleukin 1 beta
Q11. A woman presents to her general practitioner with symptoms including persistent skin rashes, joint pain, oedema and chronic fatigue. Based on a combination of physical exam, history and lab tests, the autoimmune disease systemic lupus erythematosus is diagnosed. The patient later develops severe kidney inflammation (lupus nephritis) as a consequence of immune complex deposition in the kidneys. What type of hypersensitivity reaction involves immune complex deposition in tissues or organs?
Immediate hypersensitivity
Type I
Type II
Type III
Type IV
C. Type 3
Q12. A new immunotherapy for cancer is being tested in a Phase II clinical trial in combination with the standard-of-care cytotoxic drugs. Part of the acquired (specific) immune response towards clearing tumour cells mimics the way in which virally infected cells are disposed of. What cell type and immune mediator combination is commonly used by both the anti-tumour and anti-viral immune response?
Cytotoxic T lymphocytes / perforin
Helper T lymphocytes / complement
Helper T lymphocytes / granzyme
Natural killer cells / interleukin-1 beta
Neutrophil / defensins
D. Natural Killer Cells/Interleukin 1 beta
Q14. A 40-year-old man is admitted with a chest infection, which is subsequently identified as Pneumocystis jiroveci pneumonia. He was diagnosed with HIV 8 years earlier and had been treated with a combination of a nucleoside and non-nucleoside reverse transcriptase inhibitor as well as a protease inhibitor. A decision is taken to start treatment with maraviroc.
What test must be performed before using maraviroc?
CD4+ cell count
CD8+ cell count
Liver function test
Renal function test
Viral tropism test
Viral tropism test
Q13. A surgical patient developed a methicillin-resistant Staphylococcus aureus infection and was started on a combination of linezolid and daptomycin and subsequently improved. What is the mechanism of action of daptomycin?
Cell depolarization
Inhibition of cell wall synthesis
Inhibition of DNA synthesis
Inhibition of ribosomal complex formation
Inhibition of RNA synthesis
A . Cell depolarization
Q15. A liver transplant patient is started on tacrolimus to prevent organ rejection. How does tacrolimus prevent organ rejection?
It inhibits IL-2 production
It inhibits IL-2 signalling
It inhibits lymphocyte entry to blood stream
It inhibits nucleotide synthesis
It is cytotoxic to dividing cells
It inhibits IL-2 production
Questions 22-23
A 24-year-old man with poor English, presented to the emergency department with excessive and prolonged bleeding from an accidental domestic knife cut while chopping vegetables. His poor command of English prevented any detailed family history from being taken. A coagulation screen was requested and the results, shown in the table below, demonstrated that he appeared to suffer from a bleeding disorder. What type of blood sample is used to assess blood coagulation?
A blood sample collected from the bleeding wound
A blood sample collected in a vaccutainer containing heparin as the anticoagulant
A blood sample collected in a vaccutainer containing sodium citrate as the anticoagulant
A blood sample collected in a vaccutainer containing no anticoagulant
A serum sample obtained after centrifugation of the clotted blood
Q23. What is the likely cause of the bleeding disorder in this patient?
Deficiency of Factor VIII or Factor IX
Deficiency of Factor VII
Deficiency of Prothrombin, fibrinogen or Factor X
Incorrectly synthesised Factors II, VII, IX and X
Presence of an inhibitor of Prothrombin, Fibrinogen or Factor X
c. A blood sample collected in a vaccutainer containing sodium citrate as the anticoagulant?
Q25. A 23-year-old suffering with sneezing, nasal congestion and red watery eyes is diagnosed with allergic rhinitis (hay fever). Analysis of this patient’s blood after staining with haematoxylin and eosin revealed increased levels of the leukocyte indicated by an arrow in the photomicrograph below. What is this cell type called?
Eosinophil
Erythrocyte
Lymphocyte
Monocyte
Neutrophil
E. Eosinophil
