HLTH module 3 questions

Question 1

Host-versus-graft disease refers to:

Answer 1

transplant rejection by the recipient’s immune system

Question 2

During a talk you are giving to high school students on allergic reactions, you explain that there are a number of types of hypersensitivity reactions. The most commonly known, immediate allergic reaction, where free antigens cross link the IgE on mast cells and basophils, is which one of the following?

Answer 2

type I

Question 3

A broad-spectrum bactericidal agent would be expected to:

Answer 3

destroy many gram-negative and gram-positive bacteria

Question 4

While vacationing in a tropical country, you develop diarrhea, which is accompanied by nausea and vomiting. You suspect you ingested an organism from the drinking water. What is the most likely organism causing your illness?

Answer 4

E coli

Question 5

Immunodeficiencies may result in an increased risk of infections by normally harmless microorganisms. These infections are referred to as:

Answer 5

opportunistic

Question 6

You are asked to see a 19-year-old girl who became intoxicated at a party and had unprotected sex with a man she did not know. She is concerned about contracting a sexually transmissible disease, especially HIV. Which one of the following changes in her blood will occur if she has contracted HIV?

Answer 6

Decrease in CD4+ T helper cells

Question 7

During your immunology rotation, you see a patient who was recently diagnosed with chronic granulomatous disease. You realize that this condition can lead to immunodeficiency through which one of the following processes?

Answer 7

neutropenia

Question 8

The most common clinical condition associated with a cytokine storm is:

Answer 8

acute respiratory distress syndrome

Question 9

During a rotation at a wound care clinic, one of your patients is interested in learning more about the healing process. He is recovering from a severe leg laceration sustained in an ATV accident. He has been reading on the Internet about healing and asks you about the role of macrophages. He understands that they have a primary role in the initial response to infections but can’t remember how the body develops macrophages. You tell him that they originate from which of the following cells?

Answer 9

monocytes

Question 10

You have just finished assessing a patient who presented to the ER; the patient has a high fever, cough, and shortness of breath. You suspect a bacterial pneumonia and have sent him for blood work and a chest X-ray. If you are correct, you are expecting to see an elevation in his white blood cell count. This elevation would be primarily due to an elevation of which one of the following?

Answer 10

neutrophils

Question 11

neutrophils are…

Answer 11

are phagocytic cells

Question 12

Which cells are required to process and present antigens from foreign material as the initial step in the immune response?

Answer 12

macrophages

Question 13

Humoral immunity is mediated by:

Answer 13

B lymphocytes

Question 14

During your endocrinology rotation, you are asked to see a patient recently diagnosed with rheumatoid arthritis. As you are heading in to see her, you recall that rheumatoid arthritis involves the formation of immune complexes and represents which one of the following types of hypersensitivity reactions?

Answer 14

type III

Question 15

The role of memory cells is to:

Answer 15

Recognize an antigen and stimulate the immune response

Question 16

During a case discussion with your peers on autoimmune disorders, you are told about a patient with a chronic inflammatory disorder that is characterized by a butterfly rash on the cheeks and nose, arthralgias and polyarthritis, and glomerulonephritis. Before you are told about some of the other ailments that can be associated with this condition, you recognize it as a case of:

Answer 16

systemic lupus erythematosus

Question 17

The type of antibody found in mucous membranes is:

Answer 17

IgA

Question 18

When an infectious disease is occurring globally at a higher rate than usual, it may be designated as:

Answer 18

pandemic

Question 19

A 38-year-old male presents to your clinic, with persistent abdominal pain. This pain has a burning quality, is located in his epigastric area, and worsens approximately 15–30 minutes after eating. He has had the pain on and off for over three months. Antacids do not help. He works as an accountant and has been under considerable stress recently. You suspect peptic ulcer disease and test him for Helicobacter pylori. The test comes back positive. Which one of the following toxins is associated with H. pylori?

Answer 19

urease

Question 20

A 23-year-old female presents to your clinic, with a three-day history of fever, chills, malaise, and generalized body aches. Initially, she had a slight runny nose and was coughing, but her symptoms have since rapidly progressed to involve fever and chills. On examination, her temperature is 102.3° F (39° C), and she is tachycardic. Her oral pharynx is slightly erythematous and without exudate. Her lungs are clear to auscultation. Her periphery is cool, but pulses and capillary refill are adequate. What is the most likely diagnosis in this case?

Answer 20

influenza

Question 21

IgG is transferred from mother to fetus across the placenta is referred to as:

Answer 21

passive natural immunity

Question 22

How do antiviral drugs act?

Answer 22

they reduce the rate of viral infection

Question 23

A 38-year-old male presents to your clinic, with persistent abdominal pain. This pain has a burning quality, is located in his epigastric area, and worsens approximately 15–30 minutes after eating. He has had the pain on and off for over three months. Antacids do not help. He works as an accountant and has been under considerable stress recently. You suspect peptic ulcer disease and test him for Helicobacter pylori. The test comes back positive. Which of the following is the best treatment for H. pylori?

Answer 23

Omeprazole, amoxicillin and clarithromycin

Question 24

The term nosocomial infection means:

Answer 24

Acquired in hospital or medical facility

Question 25

During your neonatal rotation you notice a whitish material in an infant’s mouth. You gently scrape it with a wooden spatula, but it does not come off. You realize this is most likely an infection of candida albicans. This organism is best described as a:

Answer 25

fungus

Question 26

You have just finished assessing a patient who presented to the ER; the patient has a high fever, cough, malaise, and body aches. You suspect that he has the flu, but want to rule out a more serious concern, so you have sent him for blood work and a chest X-ray. If you are correct and this patient has a significant viral infection, you are expecting to see an elevation in his white blood cell count. This elevation would be primarily due to an elevation of which one of the following?

Answer 26

lymphocytes

Question 27

During grand rounds at the hospital, you hear about an unusual case of Creutzfeldt-Jakob disease. Which one of the following organisms is involved in the initial infection in this condition?

Answer 27

prion

Question 28

A 23-year-old female presents to your clinic, with a three-day history of fever, chills, malaise, and generalized body aches. Initially, she had a slight runny nose and was coughing initially, but her symptoms have since rapidly progressed to involve fever and chills. On examination, her temperature is 102.3° F (39° C), and she is tachycardic. Her oral pharynx is slightly erythematous and without exudate. Her lungs are clear to auscultation. Her periphery is cool, but her pulse and capillary refill are adequate. You confirm influenza B. The best treatment for this condition is:

Answer 28

supportive therapy

Question 29

A 23-year-old female presents to your clinic, with a three-day history of fever, chills, malaise, and generalized body aches. Initially, she had a slight runny nose and was coughing, but her symptoms have since rapidly progressed to involve fever and chills. On examination, her temperature is 102.3° F (39° C), and she is tachycardic. Her oral pharynx is slightly erythematous and without exudate. Her lungs are clear to auscultation. Her periphery is cool, but her pulse and capillary refill are adequate. You suspect influenza. The best method for confirming this diagnosis is:

Answer 29

antigen detection

Question 30

During a case discussion on autoimmune disorders with your peers, you are told about a 10-year-old patient who, a few weeks after having a sore throat, developed a fever, pain in his hips and knees, and a rash that began on his trunk and disseminated outwards. Before you are told about some of the other ailments that can be associated with this condition, you recognize it as a case of:

Answer 30

rheumatic fever

Question 31

As you prepare for a medical mission trip to a third-world nation, you review various causes of dysentery. As you read about Entamoeba histolytica, you are reminded that it represents which one of the following types of organisms?

Answer 31

protozoa

Question 32

A 23-year-old male comes to your clinic, complaining of cough and chest pain. His cough has been intermittent but progressive over the past six days. The chest pain is sharp and associated with coughing. He denies shortness of breath, but thinks he may have a low grade fever. After a thorough history and physical examination, you are concerned he may have atypical (“walking”) pneumonia. The chest x-ray is consistent with right lower lobe pneumonia. Culture reveals small organisms that have no cell wall and are therefore in multiple different shapes. The most likely infecting organism is:

Answer 32

Mycoplasma pneumoniae

Question 33

During a talk you are giving to high school students on allergic reactions, you explain the role of histamine. You explain how histamine is released from which of the following cells?

Answer 33

mast cells

Question 34

Which of the following is a local sign of infection?

Answer 34

pain, redness, and swelling

Question 35

While vacationing in a tropical country, you develop diarrhea, which is accompanied by nausea and vomiting. You suspect that you ingested an organism from the drinking water. For this to have happened, the organism would have had to get past the primary defense in the stomach. Which one of the following is this primary defense?

Answer 35

hydrochloric acid

Question 36

During your hematology rotation, you see a patient who was recently diagnosed with sickle cell disease. You realize that this condition can lead to immunodeficiency through which one of the following processes:

Answer 36

asplenia

Question 37

Maturation of B lymphocytes takes place in the:

Answer 37

bone marrow

Question 38

While on a locum, you are asked to see a man who became sick five days ago after returning home from a week-long hiking trip. He initially developed nausea and vomiting but has now developed a fever, maculopapular rash with some petechiae, and increasing abdominal pain. He reports that he was bitten by a tick while on his hike. You are concerned that he may have Rocky Mountain spotted fever. This is a condition involving which one of the following organisms?

Answer 38

gram-negative bacteria

Question 39

During your ICU rotation, you admit a 46-year-old man who has a severe head injury, following a motor vehicle accident. He is placed on a mechanical ventilator to support respiration. On the eighth day post-admission, he develops a fever, his ventilator requirements change, and an X-ray reveals evidence of pneumonia. You get blood and lower respiratory secretion samples for culture and begin empirical antibiotic therapy. Which one of the following is the most likely organism causing the pneumonia?

Answer 39

Klebsiella pneumoniae

Question 40

A secondary immune response differs from the primary immune response in that:

Answer 40

it is more rapid than the primary response and results in higher antibody levels.

Question 41

Which type of immunity is provided by a vaccination?

Answer 41

active artificial

Question 42

When an allergen binds with IgE antibodies on mast cells, resulting in release of chemical mediators, this reaction is called:

Answer 42

type I hypersensitivity reaction

Question 43

Which statement applies to contact dermatitis?

Answer 43

a type IV reaction occurs in affected areas

Question 44

Following a positive HIV antibodies blood test and ELISA test, what is the test commonly used for confirmation?

Answer 44

western blot test

Question 45

Incompatible blood transfusions result in:

Answer 45

hemolysis of RBCs

Question 46

Systemic lupus erythematosus is caused by:

Answer 46

immune complex deposits of antinuclear antibodies

Question 47

Distinguishing clinical features of systemic lupus erythematosus include:

Answer 47

inflammation of multiple organs

Question 48

A diagnosis of HIV positive means that:

Answer 48

the virus and antibodies are present in the blood

Question 49

HIV infection impairs:

Answer 49

both humoral and cell-mediated

Question 50

Serious infections frequently occurring in patients with AIDS include:

Answer 50

tuberculosis and pneumocystis carinii pneumonia

Question 51

Which of the following statements does NOT apply to major histocompatibility complex (MHC) proteins or molecules?

Answer 51

All members of a family have identical MHCs.

Question 52

In your clinic, you see a patient whom you diagnosed with walking pneumonia two weeks ago. At that time, you prescribed a 10-day course of antibiotics. The patient reports that he felt much better after two or three days and was back to his normal health by day five, after which he stopped his antibiotics, as they had been nauseating him. He now complains that he has had a fever and worsening cough over the past 36 hours. Of the following, which one has most likely contributed to this patient’s recent worsening symptoms?

Answer 52

discontinuance of the prescription

Question 53

You have applied for a position in a new hospital and are required to take a Mantoux skin test for tuberculosis. You realize that this test, when positive, represents which one of the following types of hypersensitivity reactions?

Answer 53

type IV

Question 54

During your immunology rotation, you meet a 19-year-old male patient who has HIV. He is interested in learning more about the immune system and has been reading on the Internet. He says that the information is confusing, and asks you where T-lymphocytes come from. You explain that they arise from stem cells but differentiate into T-lymphocytes in-which of the following organs?

Answer 54

thymus

Question 55

While working in a pediatric clinic, you are asked to see a 2-month old infant born at 39 weeks’ gestation to an HIV-positive mother. Serology testing during this visit includes positive test results, using ELISA, Western Blot, and viral culture. Based on these findings, what is the best description of the infant’s HIV status?

Answer 55

HIV positive

Question 56

While vacationing in a tropical country, you develop diarrhea, which is accompanied by nausea and vomiting. You suspect that you ingested an organism from the drinking water. You are having three to five loose bowel motions per day and two to three episodes of vomiting your stomach contents per day. You are able to keep small amounts of fluid down. What is the best initial treatment for your condition?

Answer 56

adequate fluid

Question 57

A 23-year-old female presents to your clinic, with a three-day history of fever, chills, malaise, and generalized body aches. Initially, she had a slight runny nose and was coughing, but her symptoms have since rapidly progressed to involve fever and chills. On examination, her temperature is 102.3° F (39° C), and she is tachycardic. Her oral pharynx is slightly erythematous and without exudate. Her lungs are clear to auscultation. Her periphery is cool, but her pulse and capillary refill are adequate. You suspect influenza. The best method for confirming this diagnosis is:

Answer 57

antigen detection

Question 58

An autoimmune disease is:

Answer 58

Failure of the immune system to distinguish self from non-self.

Question 59

The “incubation period” refers to the time period between:

Answer 59

Entry of the pathogen into the body and the first signs of infectious disease.

Question 60

You have applied for a position in a new hospital and are required to take a Mantoux skin test for tuberculosis. You realize that this test, when positive, represents which one of the following types of hypersensitivity reactions?

Answer 60

type IV