Immune Dysfunction (Mordecai) Exam III Flashcards
What is the primary function of the human immune system?
A) To aid in digestion
B) To repair tissues
C) To protect the host
D) To regulate metabolism
C) To protect the host against micro-organisms
Slide 2
The human immune system is divided into which of the following types of immunity? (Select 2)
A) Innate immunity
B) Passive immunity
C) Aquired immunity
D) Humoral immunity
A) Innate immunity,
C) Acquired immunity aka Adaptive
Slide 2
Innate immunity differs from adaptive immunity in which of the following ways?
A) It takes longer to activate and responds specifically
B) It provides long-lasting memory
C) It responds rapidly and non-specifically
D) It requires prior exposure to pathogens
C) It responds rapidly and non-specifically
slide 3
Innate immunity recognizes ____ pathogens and it does not require a prior exposure.
A) Specific
B) Common
C) Unique
D) Limited
B) Common
Slide 3
The innate immune system has the following properties: (Select 3)
A) No long-lasting immunity
B) Slow activation
C) No immunological memory
D) Highly specific to pathogens
E) Responds identically to repeated infections
F) Capable of immunological memory
A) No long-lasting immunity
C) No immunological memory - No antibodies are formed.
E) Responds identically to repeated infections
slide 3
Which of the following is an example of a non-cellular element of innate immunity?
A) Neutrophils
B) Natural Killer (NK) cells
C) Complement proteins
D) Macrophages
C) Complement proteins
Mordecai - non-immune cell elements which are more structural things like…complement proteins
slide 4
The non-cellular elements of innate immunity include: (Select 3)
A) Acute phase proteins
B) Epithelial membranes
C) Natural Killer (NK) cells
D) Mucous membranes
E) Neutrophils
A) Acute phase proteins
B) Epithelial membranes
D) Mucous membranes
Slide 4
Which type of cellular element in the innate immunity responds the fastest to infection?
A) Macrophages
B) Monocytes
C) Neutrophils
D) Natural Killer (NK) cells
C) Neutrophils
Cells at Work.. great anime.
Slide 4
Macrophages are part of the cellular elements of the innate immune system and provide:
A) A fast but short-lived response
B) A slower but sustained response
C) No response unless activated by T-cells
D) Only non-specific responses
B) A slower but sustained response
slide 4
Which of the following are considered cellular elements of innate immunity? (Select 2)
A) NK Cells
B) Epithelial and mucous membranes
C) Monocytes
D) Microphages
E) Complement
A) NK Cells - natural killer
C) Monocytes,
Slide 4
What is the common origin of all blood cells, including both myeloid and lymphoid lineages?
A) T-cell progenitor
B) Homeotopoietic stem cell
C) Common myeloid progenitor
D) Granulocyte-monocyte progenitor
E) Hematopoietic stem cell
E) Hematopoietic stem cell
Slide 4
Which of the following cells are derived from the common myeloid progenitor? (Select 4)
A) Megakaryocyte
B) Cytotoxic T-cells
C) Erythrocytes
D) Eosinophil progenitor
E) B-cells
F) Basophil progenitor
A) Megakaryocyte
C) Erythrocytes
D) Eosinophil progenitor
F) Basophil progenitor
and Granulocyte-monocyte progenitor
Slide 4
Which of the following cells originate from the common lymphoid progenitor? (Select 3)
A) T-cell progenitor
B) Natural Killer cells
C) Platelets
D) B-cells progenitor
E) Basophils
A) T-cell progenitor
B) Natural Killer (NK) cells,
D) B-cells progenitor
Slide 4
What does the granulocyte-monocyte progenitor create? (Select 2)
A) Monocytes
B) Dendritic cells
C) Platelets
D) Eosinophils
E) Mast cells
F) Neutrophils
A) Monocytes,
F) Neutrophils
Slide 4
Platelets are derived from which of the following?
A) Monocytes
B) Eosinophils
C) Neutrophils
D) Megakaryocytes
D) Megakaryocytes
Slide 4
Which of the following cells are derived from the Monocytes? (Select 2)
A) Basophils
B) Helper T-cells
C) Dendritic cells
D) Macrophages
E) Natural Killer (NK) cells
C) Dendritic Cells
D) Macrophages
Slide 4
True or False
Erythrocytes are also known as Red Blood Cells
True
slide 4
Which of the following cells originate from the Basophil progenitor? (Select 2)
A) Mast cells
B) Eosinophils
C) Helper T-cells
D) Basophils
E) Cytotoxic T-cells
A) Mast cells
D) Basophils
Slide 4
The complement system plays a role in which of the following types of immunity?
A) Innate immunity only
B) Adaptive immunity only
C) Both innate and adaptive immunity
D) Neither innate nor adaptive immunity
C) Both innate and adaptive immunity
Slide 5
Which of the following is one of the primary functions of the complement system?
A) Producing antibodies
B) Marking pathogens for destruction
C) Directly killing pathogens without any immune cell involvement
D) Providing long-term memory of pathogens
B) Marking pathogens for destruction
Slide 5
The complement system consists of over ____ plasma and cell surface proteins, most of which are produced in the ____.
A) 20; bone marrow
B) 50; spleen
C) 30; liver
D) 15; spleen
E) 40; liver
C) 30; liver
Slide 5
One of the primary functions of the complement system is to augment ____ and ____ to help clear pathogens from the body.
A) phagocytes; antibodies
B) T-cells; natural killer cells
C) enzymes; hormones
D) mast cells; basophils
A) phagocytes; antibodies
Slide 5
The complement system can be activated by ____ in the classical pathway or by ____ in the alternative pathway.
A) T-cells or B-cells
B) Antigens or antibodies
C) Compliment 1 or compliment 3
D) Neutrophils or macrophages
C) C1; C3
Usually Compliment 1 in the classical pathway
Slide 5
Which of the following are NOT a characteristic of neutrophils?
A) Most numerous white blood cells
B) Migrate rapidly during bacterial infections
C) Have a half-life of 24 hours
D) Sensitive to acidic environments of infection
E) Become purulent exudate
C) Have a half-life of 24 hours
slide 6
Neutrophils release ____ and engage in ____ during bacterial infections.
A) cytokines; phagocytosis
B) antibodies; exocytosis
C) histamines; antigen presentation
D) interferons; cytokines
A) cytokines; phagocytosis
Slide 6
Neutrophils are the most numerous of the WBCs with a half-life of approximately ____ hours.
A) 6
B) 8
C) 12
D) 16
A) 6
Slide 6
Monocytes are known as the largest of which type of cells?
A) Platelets
B) White blood cells
C) Red blood cells
D) Lymphocytes
B) White blood cells
Slide 7
Matching
Match the type of monocyte with where they become macrophages in the body
Langerhans → c) Epidermis (Skin)
Kupffer → a) Liver
Alveolar cells → d) Lung
Microglia → b) Central Nervous System (CNS)
Slide 7
After neutrophils mobilize to a site of infection, macrophages follow and persist at sites of ____ infection, where they engage in phagocytic destruction and produce ____.
A) chronic; NO and cytokines
B) acute; histamines and cytokines
C) acute; histamines and antibodies
D) chronic; NO and histamines
A) chronic; NO and cytokines
M - lncrease in NO leads to vasodilation which then further helps the immune system by opening up the blood vessels and help our immune cells to the target of area where they need to perform their functions. Macrophages persist and have that slow sustained response that can last for days.
Slide 7
Which of the following is true about basophils?
A) They are the most numerous white blood cells
B) They are the least common blood granulocytes
C) They primarily reside in connective tissue
D) They do not play a role in allergies
B) They are the least common blood granulocytes
Slide 8
Mast cells are typically found in which location?
A) Circulating in the bloodstream
B) In connective tissue
C) In lymph nodes
D) Inside the liver
B) In connective tissue near blood vessels
Slide 8
What role do both basophils and mast cells play in the body?
A) They directly attack bacteria
B) They produce antibodies
C) They initiate hypersensitivity reactions
D) They destroy viruses
C) They initiate hypersensitivity reactions
M - Type 1 hypersensitivity reaction… like asthma or an acute allergic response is a hypersensitivity reaction.
Slide 8
Both basophils and mast cells express high-affinity receptors for ____, which are involved in allergic responses.
A) IgG
B) IgA
C) IgE
D) IgM
C) IgE
Slide 8
Which substances are released by mast cells and basophils during an allergic response? (Select 4)
A) Histamine
B) Leukotrienes
C) Cytokines
D) Cortisol
E) Platelets
F) Prostaglandins
A) Histamine
B) Leukotrienes
C) Cytokines
F) Prostaglandins
Slide 8
True or False
Mast Cells and Eosinophils stimulate smooth muscle contraction
False
Mast cells and Basophils stimulate smooth muscle contraction
M - They cause broncoconstriction and that’s why we have difficulty breathing with some of these allergic responses.
Slide 8
Which of the following are functions of mast cells? (Select 2)
A) Stimulate skeletal muscle contraction
B) Play a major role in asthma and eczema
C) Act as the first responders to bacterial infections
D) Reside primarily in the bloodstream
E) Release histamine
B) Play a major role in asthma and eczema
E) Release histamine and other inflammatory mediators
slide 8
Where are eosinophils most heavily concentrated in the body?
A) Central nervous system
B) Lymph nodes
C) Gastrointestinal mucosa
D) Skin
C) Gastrointestinal mucosa
slide 9
What is one of the primary roles of eosinophils?
A) Phagocytosis of bacteria
B) Protection against parasites
C) Initiating hypersensitivity reactions
D) Producing antibodies
B) Protection against parasites
Slide 9
In addition to protecting against parasites, eosinophils also degrade inflammation caused by ____.
A) neutrophils
B) basophils
C) mast cells
D) lymphocytes
C) mast cells
M - Eosinophils will degrade mast cell inflammatory mediators… like histamine, leukotrienes, cytokines and prostaglandins.
Slide 9
Adaptive immunity is found in which of the following organisms?
A) Vertebrates only
B) Invertebrates only
C) Arthropods only
D) Plants and fungi
A) Vertebrates only
Slide 10
Adaptive immunity is derived from ____ stem cells which then turn into the common _______ progenitor.
A) hematopoietic; lymphoid
B) pluripotent; myeloid
C) mesenchymal; T-cell
D) endothelial; lymphoid
A) hematopoietic; lymphoid
Slide 10
What is one of the key characteristics of adaptive immunity compared to innate immunity?
A) Immediate activation upon infection
B) Lack of memory
C) Delayed onset of activation
D) Non-specific response to pathogens
C) Delayed onset of activation
slide 10
The adaptive immune system has a delayed onset of activation but is capable of ____ and ____.
A) immediate response; phagocytosis
B) nonspecific response; inflammation
C) cytokine release; mast cell activation
D) memory; specific antigen response
D) memory; specific antigen response
Slide 10
True or False
Vaccinations have active memory like adaptive immunity
True
Slide 10
Which of the following are functions of B cells in the humoral component of adaptive immunity? (Select 3)
A) Produce antibodies
B) Activate IgG
C) Bind to foreign proteins of bacteria and viruses
D) Release histamines
E) Bind to foreign proteins of tumors
A) Produce antibodies - IgA, IgE,IgM
C) Bind to foreign proteins of bacteria, viruses
E) Bind to foreign proteins of tumors
Slide 11
As part of the Cellular component of adaptive immunity, where do T cells (helper and cytotoxic) originate in the body, and where do they mature?
A) Originate in the thymus, mature in the bone marrow
B) Originate and mature in the thymus
C) Originate in the bone marrow, mature in the thymus
D) Originate in the lymph nodes, mature in the spleen
C) Originate in the bone marrow, mature in the thymus
Slide 11
Which of the following are produced by T cells as part of the cellular component of adaptive immunity? Select 2
A) Antibodies
B) Interferon
C) Histamines
D) Complement proteins
E) Cytokines
F) Interleukin
B) Interferon
F) Interleukin
Slide 11
Which of the following are roles of T cells in the cellular component of adaptive immunity? (Select 3)
A) Activate IgE
B) Respond to infections
C) Initiate allergic reactions
D) Play a role in chronic inflammation
E) Bind directly to viruses and tumors via antibodies
F) Activate IgA
A) Activate IgE
B) Respond to infections
D) Play a role in chronic inflammation
slide 11
Active immunity involves the deliberate administration of a ____, such as through a vaccine, to initiate an immune response.
A) pathogen
B) antibody
C) cell
D) protein
A) pathogen
Vaccines can be live, inactivated, recombinant (lab made)
Slide 12
In active immunity, repeated exposure to the same pathogen results in a ____ immune response
A) weaker
B) quicker
C) slower
D) delayed
B) quicker
M - occurs due to environmental pathogen exposure or pathogens that are deliberately administered to induce antibody formation.
slide 12
Which of the following are examples of passive immunity? (Select 3)
A) Maternal IgA antibodies passed via breast milk
B) Vaccination with a live pathogen
C) Receiving antibodies from another individual
D) Immunity lasting a few weeks to months
E) Production of antibodies after vaccination
F) Someone sneezes in your face
A) Maternal IgA antibodies passed via breast milk
C) Receiving antibodies from another individual,
D) Immunity lasting a few weeks to months
Slide 12
True or False
Immunoglobins like IVIG are a type of passive immunity given to patients that are immunocompromised to help fight off infection.
True
M - immunoglobins like IVIG are given to help patients that are immunocompromised fight off infection. They are from donated plasma and the immunoglobins are isolated and then given as a treatment for various autoimmune diseases and other comorbidities.
Slide 12
The immune response, Neutropenia, is characterized by an ____________ number of neutrophils.
A) Excessive
B) Misdirection
C) Inadequate
D) Exaggerated
C) Inadequate
Slide 13
Matching
Match the Category of Immune Response with its Example
- Inadequate → c) Neutropenia (low white blood cell count)
- Excessive (exaggerated immune response) → a) Asthma, hives, or anaphylaxis…Type 1 - overeacting to an antigen
- Misdirection → b) Autoimmune disorders - Antibodies are formed against the body’s natural receptors or ligands that aren’t necessarily harmful
Slide 13
During a hypersensitivity reaction, the immune system mounts an altered response involving both ____ cells and ____.
A) B; mast cells
B) T; antibodies
C) red blood; B-cells
D) platelets; cytokines
B) T; antibodies
Slide 14
What is a necessary condition for hypersensitivity reactions to occur?
A) Direct bacterial infection
B) Excessive neutrophil production
C) Immunosuppression
D) Prior sensitization to an antigen
D) Prior sensitization to an antigen
Grass, latex, gluten, nuts, medications
Yellow guy is Cedar Pollen “antigen”
Slide 14
Hypersensitivity reactions can result in a response that ranges from ____ to ____.
A) uncomfortable; moderate
B) comfortable; severe
C) uncomfortable; fatal
D) pleasant; fatal
C) uncomfortable; fatal
Slide 14
Which of the following drugs are common triggers for hypersensitivity reactions? (Select 3)
A) NSAIDs
B) Antibiotics
C) Proton pump inhibitors
D) Antihistamines
E) Analgesics
A) NSAIDs
B) Antibiotics
C) Proton pump inhibitors (PPIs)
Slide 14
True or False
Antibiotics are the #1 drug that causes allergic reactions under anesthesia
False
M - NMBD are the #1 drug that causes allergic reactions under anesthesia.. rocuronium
Slide 14
Which of the following is another name for a Type I allergic response?
A) Delayed hypersensitivity
B) Cytotoxic hypersensitivity
C) Immediate hypersensitivity
D) Immune complex-mediated hypersensitivity
C) Immediate hypersensitivity
Slide 15
During a Type I allergic response, ____ cells stimulate ____ cells, leading to the production of IgE antibodies.
A) B; T
B) Mast; B
C) Plasma; B
D) T; B
D) T; B
M - that immediate hypersensitivity response that is mediated by the T cells stimulating the B cells and then Ige antibodies are produced immediately
Slide 15
What happens during the second exposure to an antigen in a Type I allergic response?
A) IgG antibodies are produced
B) Antigen releases calcium
C) T cells produce cytokines to kill the antigen
D) Antibodies directly attack the antigen
B) Antigen releases calcium
Slide 15
During a Type I allergic response, the release of calcium triggers the release of which of the following substances? (Select 4)
A) Histamine
B) Heparin
C) Interleukins
D) Interferon
E) Prostaglandins
F) Inflammatory mediators
G) Cytokines
A) Histamine
B) Heparin
E) Prostaglandins
F) Inflammatory mediators
Slide 15
Histamine released during a Type I allergic response can trigger which of the following effects? (Select 3)
A) Bronchoconstriction
B) Increased vascular permeability
C) Vasodilation
D) Decreased gastric acid production
E) Smooth muscle relaxation
F) Decrease vascular permeability
A) Bronchoconstriction
B) Increased vascular permeability
C) Vasodilation
and gastric acid secretion
Slide 15
Which of the following treatments are used to prevent or manage the effects of histamine during a Type I allergic response? (Select 4)
A) Antihistamines
B) Cromolyn sodium
C) Bronchodilators
D) COX pathway inhibitors
E) Antibiotics
A) Antihistamines
B) Cromolyn sodium
C) Bronchodilators
D) COX pathway inhibitors
Diagnostic testing
Slide 16
Which immune components are involved in a Type II allergic response?
A) IgG, IgM, and complement
B) IgE, IgM and mast cells
C) IgE, T cells and complement
D) Antigen-presenting cells, mast cells and dendritic cells
A) IgG, IgM, and complement mediated
- Activate B cells to produce antibodies
slide 17
What mediates a Type IV allergic response? Select 3
A) IgG antibodies
B) B lymphocytes
C) T lymphocytes
D) IgE antibodies
E) Monocytes
F) Macrophages
C) T lymphocytes
E) Monocytes
F) Macrophages
Slide19
Treatments for Type IV allergic responses include which of the following? (Select 2)
A) Anti-inflammatories
B) Immunosuppressives
C) Antivirals
D) Antibiotics
E) Antihistamines
A) Anti-inflammatories
B) Immunosuppressives
Slide 19
What triggers the antigen-antibody reaction in anaphylaxis?
A) First exposure to an antigen
B) Subsequent exposure to an antigen
C) A bacterial infection
D) A viral infection
B) Subsequent exposure to an antigen
Antigen-antibody reaction
Slide 22
During anaphylaxis, which cells degranulate and release histamine and other mediators?
A) B cells and T cells
B) Neutrophils and macrophages
C) Mast cells and basophils
D) Dendritic cells and eosinophils
C) Mast cells and basophils
Slide 22
Which mediators are released during the degranulation of mast cells and basophils in anaphylaxis? (Select 5)
A) Histamine
B) Leukotrienes
C) Prostaglandins
D) Eosinophils
E) Platelet-activating factor
F) Von Willebrand factor
A) Histamine
B) Leukotrienes
C) Prostaglandins
D) Eosinophil/neutrophils
E) Platelet-activating factor
and Chemotatic factor
Slide 22
Anaphylaxis can result in significant fluid loss, with up to ____ of intravascular fluid extravasating into surrounding tissues.
A) 5%
B) 30%
C) 50%
D) 73%
C) 50%
M - lifetime prevalence of anaphylaxis is 5%, but different sources show different numbers. So don’t hang your hat on that 5%.
I think that’s a very high
Slide 22
Which of the following statements are true regarding anaphylactic response skin testing after an episode of anaphylaxis? (Select 2 that apply.)
A. Skin testing is typically done 6 weeks after the initial reaction.
B. Skin testing is done immediately after the reaction to confirm diagnosis.
C. The skin test looks for a wheal and flare response.
D. Skin testing is usually done 2 weeks after the initial reaction.
E. Skin testing is done 6 months after the initial reaction.
A. Skin testing is typically done 6 weeks after the initial reaction
C. The skin test looks for a wheal and flare response
Slide 25
Match each blood type with the correct antibodies present in the plasma:
Type A
Type B
Type AB
Type O
A. Anti-A and Anti-B antibodies
B. Anti-A antibodies
C. Anti-B antibodies
D. No antibodies
Type A → C. Anti-B antibodies
(A antigen)
Type B → B. Anti-A antibodies
(B Antigen)
Type AB → D. No antibodies
(A and B antigen)
Type O → A. Anti-A and Anti-B antibodies
(No antigen)
Slide 29
Match the blood type with the appropriate transfusion compatibility for red blood cell transfusion:
Type A
Type B
Type AB
Type O
A. Can receive red blood cells from A, AB, B, and O (universal recipient)
B. Can only receive red blood cells from O (universal donor)
C. Can receive red blood cells from B or O
D. Can receive red blood cells from A or O
Type A → D. Can receive red blood cells from A or O
Type B → C. Can receive red blood cells from B or O
Type AB → A. Can receive red blood cells from A, AB, B, and O (universal recipient)
Type O → B. Can only receive red blood cells from O (universal donor)
Slide 29
Which of the following statements accurately describe angioedema? (Select 4 that apply.)
A. Angioedema involves profound, extreme swelling of tissues.
B. Angioedema can affect the face, airway, and upper respiratory tract.
C. Angioedema is only caused by allergic reactions and never has an idiopathic origin.
D. Angioedema can involve the legs, hands, and other parts of the body.
E. Angioedema can be caused by severe anaphylaxis or occur for idiopathic reasons.
A. Angioedema involves profound, extreme swelling of tissues
B. Angioedema can affect the face, airway, and upper respiratory tract
D. Angioedema can involve the legs, hands, and other parts of the body
E. Angioedema can be caused by severe anaphylaxis or occur for idiopathic reasons
Slide 32
Fill-in-the-Blank Multiple Choice Question
If your patient has a compromised immune system, they are far more likely to be susceptible to __, __, and even certain __.
A. bacterial infections; viruses; cancers
B. allergies; autoimmune diseases; mental disorders
C. dehydration; fractures; muscle spasms
D. hypertension; diabetes; thyroid conditions
A. bacterial infections; viruses; cancers
Mordecai: if your patient has a compromised immune system, they’re going to be far more likely to be susceptible to bacterial infections, viruses, and even certain cancers. Herpes is associated.
What else? they’re more likely to need airway management and more likely to have complicated Airways because of their repeated respiratory infections.
Slide 39
Which of the following signs and symptoms characterize scleroderma? (Select 3 that apply.)
A. Inflammation
B. Vascular sclerosis
C. Fibrosis of the skin and viscera
D. Joint pain and fever
E. Abdominal pain and vomiting
A. Inflammation
B. Vascular sclerosis
C. Fibrosis of the skin and viscera
Slide 43
