Immuno Set 10 Flashcards
During an infection with Streptococcus pyogenes, an individual generated sufficiently high levels of lgM and lgG antibodies against a S. pyogenes antigen with structural similarity with molecules on the heart that cardiac damage was caused. In this example, the microbe contributed to autoimmunity via which of the following process?
A. anergy B. central tolerance C. epitope spreading D. loss of suppression E. molecular mimicry
E. molecular mimicry
An individual normally does not make an immune response to a self-protein because of which of the following?
A. Self-proteins cannot be processed into peptides. B. Peptides from self-proteins cannot bind to MHC class I molecules. C. Peptides from self-proteins cannot bind to MHC class II molecules. D. Lymphocytes that express a receptor reactive to a self-protein are inactivated by deletion, anergy, or receptor editing. E. Developing lymphocytes cannot rearrange V genes required to produce a receptor for self-proteins.
D. Lymphocytes that express a receptor reactive to a self-protein are inactivated by
deletion, anergy, or receptor editing.
Which of the following autoimmune diseases has been proven to be due to a single gene defect?
A. systemic lupus erythematosus B. autoimmune lymphoproliferative syndrome (ALPS) C. multiple sclerosis D. rheumatoid arthritis E. Hashimoto’s thyroiditis
B. autoimmune lymphoproliferative syndrome (ALPS)
In which of the following diseases do TH1 CD4+ cells and cytotoxic CD8+ T cells contribute to the pathology?
A. myasthenia gravis B. systemic lupus erythematosus C. Graves’ disease D. autoimmune hemolytic anemia E. type I diabetes mellitus
E. type I diabetes mellitus
A 22-year-old woman has an erythematous rash on the malar eminences of her face that gets worse when she goes out in the sun. She has lost about 10 pounds, complains of generalized joint pain, and feels tired much of the time. Physical examination is normal except for the rash. Laboratory tests reveal a WBC count of 5500 (normal). Urinalysis shows elevated levels of protein in the urine but no RBCs, WBCs, or bacteria. Which one of the following is the most likely laboratory finding in this disease?
A. decreased number of cytotoxic (CD8+) T cells
B. low level of C1 inhibitor
C. high levels of antibodies to double-stranded DNA
D. increased number of cytotoxic T cells
E. low microbicidal activity of neutrophils
C. high levels of antibodies to double-stranded DNA
Blocking any of the following processes can result in peripheral tolerance in mature T cells except which of the following?
A. the interaction of co-stimulatory molecules on T cells with their ligands on APCs
B. intracellular signal transduction mechanisms
C. negative selection of thymocytes
D. activation of the IL-2 gene
E. the binding of antigen with MHC molecules
C. negative selection of thymocytes
A 30-year-old woman with a previous history of rheumatic fever has recently developed a heart murmur. The most likely cause of his disease is which of the following?
A. circulating rheumatoid factor
B. molecular mimicry of a streptococcal antigen and cardiac myosin
C. common variable immune deficiency
D. a congenital abnormality
B. molecular mimicry of a streptococcal antigen and cardiac myosin
A previously healthy 1 2-year-old female lost 8 pounds over the past several weeks without dieting. Her parents are concerned about this weight loss and believe that she has an eating disorder. The patient’s history reveals polydipsia (excessive thirst), polyuria (excessive urination), and nocturia (need to arise during the night for urination) over the last several weeks. A fasting blood glucose of 460 mg/dl is obtained (reference range: 70 to 100 mg/dl). The patient is diagnosed with an autoimmune disease. On the basis of these findings, which of the following conditions was most likely diagnosed in this patient?
A. Anorexia nervosa B. Hyperthyroidism C. Nephrolithiasis (kidney stones) D. Type 1 diabetes mellitus E. Urinary tract infection
D. Type 1 diabetes mellitus
A previously healthy 65-year-old female presents with complaints of frequent bowel movements, weight loss, and nervousness. Her physical examination was remarkable for slight exophthalmos (protrusion of the eyeball) and atrial fibrillation (abnormal heart rhythm). Laboratory findings supported a diagnosis of G raves disease. Which of the following tissues/organs will be most affected by the ensuing immune reactions?
A. Connective tissue B. Joints of lower extremities C. Heart valves D. Kidneys E. Thyroid gland
E. Thyroid gland
A 35-year-old male presents with symptoms of fatigue, paresthesia (numbness and tingling) of his arms and legs, and occasional blurred vision of 2 months’ duration. Tests reveal several areas of demyelination within the central nervous system. Diagnosis of which of the following conditions is supported by these findings?
A. Ankylosing spondylitis B. Hashimoto thyroiditis C. Multiple sclerosis D. Reactive arthritis E. Systemic lupus erythematosus
C. Multiple sclerosis
A 30-year-old female presents with fatigue, weight loss, arthritis of her hands, and a malar (“butterfly”) rash. Blood tests reveal decreased hemoglobin and the presence of antinuclear antibodies. These findings support which of the following diagnoses paired with its underlying immunologic process?
A. Grave’s disease: autoantibodies to thyroid-stimulating hormone receptor
B. Myasthenia gravis: autoimmunity associated with HLA gene DR3
C. Reiter syndrome: immune-mediated destruction associated with HLA gene B27
D. Rheumatoid arthritis: immune deficiency associated with HLA gene DR4
E. Systemic lupus erythematosus: autoantibodies to chromosomal proteins
E. Systemic lupus erythematosus: autoantibodies to chromosomal proteins
A 55-year-old female presents with complaints of pain and stiffness in her hands and wrists that occurs mainly in the morning. Examination reveals tenderness and swelling in both wrists and hands. Testing reveals the presence of rheumatoid factor. The patient is diagnosed with rheumatoid arthritis. Resulting tissue injury that will likely occur in this patient will result from which of the following?
A. Type IV hypersensitivity B. both type II and type III hypersensitivity C. lgE-mediated immune responses only D. self-tolerance E. type II hypersensitivity only
A. Type IV hypersensitivity
A 47-year-old-male has a history of end-stage renal failure and required a kidney transplant. Approximately 4 weeks after receiving his transplanted kidney, he developed oliguria (decreased production of urine), fever, hypertension, and pain or tenderness over the allograft. On the basis of these findings, which of the most likely underlying immunological process?
A. autoimmunity B. acute rejection C. chronic rejection D. hyperacute rejection E. peripheral tolerance
B. acute rejection
A 20-year-old woman presents with right lower abdominal cramp-type pain associated with diarrhea and weight loss. Blood tests reveal a low hemoglobin level and high white blood cell counts. She is diagnosed with Crohn disease. The tissue that is most affected in this autoimmune disease is which of the following?
A. connective tissue B. erythrocytes C. pancreatic cells D. the small intestine E. the thyroid
D. the small intestine
Bill is a 30-year-old man who presents with lower right quadrant abdominal pain, a 10-pound weight loss over the past month, fever, and nonbloody diarrhea. Barium enema contrast imaging indicates mucosal swelling of the wall of the ileum and ascending colon. A biopsy of the colon shows the presence of transmural granulomatous inflammation. Laboratory tests indicate mild anemia, leukocytosis, and decreased total serum protein and albumin, which suggest anorexia. Which of the following therapies would be expected to be most beneficial in treating this condition?
A. Plasmapheresis B. Anti-tumor necrosis factor (TNF)-α C. Recombinant C1 Inh D. Appendectomy E. Antifungal agents
B. Anti-tumor necrosis factor (TNF)-α
