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Principles of Pharmacology and Immunology (PPI) > Quiz 1 Exam 4 > Flashcards

Quiz 1 Exam 4 Flashcards

Innate and adaptive immunity + Immune disorders

1
Q

What are the two types of immunity in the body?

A

Nonspecific/innate and specific/adaptive immunity

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2
Q

What is the main response when nonspecific/innate immunity is triggered?

A

Inflammation

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3
Q

What are the main inflammatory mediators?

A

Small chemicals not encoded in the genes, prostaglandins, leukotrienes, histamine, and bradykinin.

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4
Q

What are cytokines?

A

These are small protein signalling molecules with the job of inter-cell communication. These cells tell the immune system to activate either the humoral or cellular response.

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5
Q

What are the 3 types of cytokines?

A

Interleukins, tumor necrosis factor, and chemokines

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6
Q

How do inflammatory mediators and cytokines act and where?

A

They act through conventional receptors initiating 2nd messenger systems. They act in damaged tissue.

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7
Q

What cell type is the source of histamine as an inflammatory mediator?

A

Mast cell

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8
Q

What do mast cell bind to?

A

IgE

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9
Q

How are mast cells activated to release their granule contents?

A

Once bound, calcium enters the cell and cAMP is made triggering the granules to release their contents.

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10
Q

What are the two main eicosanoids?

A

Leukotrienes and prostaglandins

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11
Q

What pathway makes leukotrienes from arachidonic acid?

A

Lypoxygenase pathway

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12
Q

What pathway makes prostaglandins from arachidonic acid?

A

Cyclooxygenase pathway

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13
Q

Where are leukotrienes typically located?

A

Mucus membranes

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14
Q

Where are prostaglandins typically located?

A

Systemic circulation

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15
Q

What are the two types of immune responses?

A

Humoral and cellular responses

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16
Q

When is the humoral response in the immune system activated?

A

Bacterial and extracellular pathogens.

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17
Q

Is the humoral response slow or rapid?

A

Rapid (24-48hr)

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18
Q

What molecule induces the humoral response and what are the effectors?

A

TH2 cytokines induce it while B-lymphocytes and antibodies are the effectors

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19
Q

When is the cellular response in the immune system activated?

A

Intracellular and viral infections

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20
Q

Is the cellular response slow or fast?

A

Slow (72h)

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21
Q

What molecule induces the cellular response and what are the effectors?

A

TH1 cytokines induce it while T-lymphocytes and natural killer cells are the effectors.

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22
Q

___________ determines the prevalence of a cellular or a humoral immune response.

A

Cytokines

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23
Q

Cytokines bind to ___________ receptors on the cell surface.

A

Tyrosine kinase (specifically Jak/STAT)

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24
Q

Cytokines initiate jak/STAT pathway to act as a ___________ factor.

A

Transcription

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25
Q

Interleukin-1 (IL1), a type of cytokine, activates what 4 things?

A
  1. Monocytes/ macrophages to induce inflammation
  2. Fibroblast proliferation for synovial pannus formation
  3. Chondrocytes for cartilage breakdown
  4. Osteoclasts for bone reabsorption
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26
Q

TNF-a, a type of cytokine, activates ____________ __________ in osteoarthritis to induce bone changes and cartilage degradation.

A

Synovial fibroblasts

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27
Q

How do TNF-a and IL1 act in arthritis?

A

Increased levels of TNF-a and IL1, cytokines, activate the immune response in the joints leading to damage in the pannus area.

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28
Q

What are chemokines?

A

These are small cytokines responsbile for directional cell migration. These direct immune cells to the site of damage.

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29
Q

Chemokines bind to __________ receptors.

A

G-protein. This is different than all the other cytokines.

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30
Q

What are the 6 main drug classes that target inflammation in the body?

A
  1. Antihistamines
  2. Acetaminophen (Tylenol)
  3. NSAIDS
  4. DMARDS (Disease-modifying antirheumatic drugs)
  5. Anti-proliferative drugs
  6. Steroids
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31
Q

What is the MOA of antihistamines?

A

Block histamine H1 receptors in the mucus membranes.

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32
Q

What is the MOA of acetaminophen (Tylenol)?

A

Inhibits prostaglandin synthesis in CNS.

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33
Q

What is the MOA of the NSAIDs?

A

Inhibits COX1, COX2, and NF-KB in the CNS and PNS.

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34
Q

What is the MOA of DMARDs?

A

Immune modulators

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35
Q

Histamine mediates __________ responses.

A

Allergic/anaphylactic

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36
Q

What is the biggest difference in 1st and 2nd generation antihistamines?

A

1st generation antihistamines like diphenhydramine and chlorpheniramine induce severe drowsiness while 2nd generations like cetirizine and loratadine are do not do that.

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37
Q

Why do 1st generation antihistamines make you more tired than 2nd generation antihistamines?

A

1st generation can enter the CNS and block H1 receptors there while 2nd generation only block H1 in the PNS.

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38
Q

What is the drug Azelastine (Astelin) used for?

A

This is an intranasal H1 receptor antagonist used for seasonal allergic rhinitis.

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39
Q

What are the 2 main side effects of Azelastine?

A

Bitter taste in mouth and nasal burning

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40
Q

What was the original NSAID?

A

Salicylate (Aspirin)

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41
Q

For the NSAIDs that end in -coxib, what is their MOA?

A

These NSAIDs are COX2 inhibitors only. The other NSAIDs like ibuprofen (Advil), diclofenac, naproxen, etc inhibit COX1 and COX2

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42
Q

What is different between the NSAIDs and Acetaminophen?

A

NSAIDs act peripherally while acetaminophen acts in the CNS.

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43
Q

What is a potential side effects associated with NSAID use?

A

Stomach lining damage

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44
Q

Selective COX2 inhibitors (-coxib) are associated with an increased risk of _________ and ________ due to COX-2 inhibitors disrupting the balance of prostaglandins, leading to increased clotting (via platelet aggregation) and blood vessel constriction.

A

Increased blood coagulation and elevated risk for a heart attack

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45
Q

What are the main uses for NSAIDs?

A

Pain relief, antipyretic, and antiplatelet (aspirin, aleve which are COX1 and 2 inhibitors)

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46
Q

What is unique about acetaminophen (tylonel)?

A

It only blocks COX1 and COX2 in the CNS. It also does not cause peptic ulcers and has no effect on bleeding.

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47
Q

What are the functions of the immune system?

A
  1. Distinguishing between self and non-self with the help of HLA and MHC markers
  2. Recognize and destroy antigen via nonspecific and specific immunity
  3. Promote repair of damaged tissues
  4. Surveillance
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48
Q

What are the 3 characteristics of nonspecific/innate immunity?

A

Immediate, limited duration, and lacks memory

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49
Q

What are the 3 characteristics of specific/adaptive immunity?

A

Slower, immunogen (antigen) specific, and memory

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50
Q

What are the main cells involved in the nonspecific/innate immune response?

A

Macrophages, Natural killer cells, Neutrophils, eosinophils, basophils, and monocytes.

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51
Q

What are the cell types involved in the specific/adaptive immune response?

A

Suppressor T cells, Helper T cells, Memory T cells, Cytotoxic T cells, B cell, Memory B cell, plasma cell

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52
Q

What organ is the largest mass of lymphatic tissue?

A

Spleen

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53
Q

What are the main functions of the lymphatic system?

A
  1. Drain excess interstitial fluid
  2. Transport dietary lipids from GIT to blood
  3. Protect against invasion through immune responses
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54
Q

What are the primary lymphoid organs?

A

The primary organs are where stem cells divide and become immunocompetent (educated).

  1. Red bone marrow
  2. Thymus gland (where pre-T cells from the bone marrow mature)
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55
Q

What are the main secondary lymphoid organs?

A

This is where the immune response occur.

  1. Lymph nodes
  2. Spleen
  3. Lymphatic nodules
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56
Q

What are the two main groups of leukocytes?

A

Granulocytes and non-granulocytes

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57
Q

What are the 3 types of granulocytes?

A

Basophils, Eosinophils, and Neutrophils

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58
Q

What are the other names for neutrophils?

A

Polymorphonuclear leukocytes, PMNS, and polys

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59
Q

Which granulocyte is at the highest concentration?

A

Neutrophils at 50-70%

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60
Q

What are the 2 main types of non-granulocytes?

A
  1. Monocytes (blood) and macrophages (tissue)
  2. Lymphocytes (B cells, T cells, and NK cell)
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61
Q

What are the two cells types most important in antigen presentation?

A

Macrophages and dendritic cells

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62
Q

What is a main function of a macrophage?

A

Antigen presentation and phagocytosis and activation of bactericidal mechanisms.

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63
Q

What is the main function of dendritic cells?

A

Antigen presentation and antigen uptake in peripheral sites.

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64
Q

What is the main function of neutrophils?

A

Phagocytosis and activation of bactericidal mechanisms.

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65
Q

What is the main function of the mast cells?

A

Mast cells are basophils but in the tissue and not the blood. Mast cells function to release granules containing histamine and other active ingredients.

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66
Q

What is the main function of basophils?

A

Basophils are mast cells but in the blood and not the tissue. Basophils functions to promote allergic response and augmentation of anti-parasitic immunity. Mainly respond in allergic reactions though.

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67
Q

What is the main function of eosinophils?

A

They kill antibody coated parasites.

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68
Q

What is the function of natural killer cells?

A

NK cells release lytic granules that kill some virus-infected cells and tumors.

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69
Q

What is clonal selection theory?

A

This is when a specific lymphocyte is cloned that is reactive to a certain antigen. This allows the body to respond to better get rid of the antigen.

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70
Q

The 2011 Nobel Prizes in Medicine were awarded, in part, for immune funtion discoveries involving?

A. Antigenic mimicry
B. T help cell function
C. Toll-like receptors
D. Immunoglobulin structure and function
E. Complement deficiences

A

C. Toll-like receptors

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71
Q

The single largest mass of lymphatic tissue in the body which is rich in B cells and is a major site of removal of worn out blood cells is what organ?

A

Spleen

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72
Q

The major lymphatic ducts eventually return lymph back to the systemic circulation at the junction between which two things?

A. Subclavian and internal jugular veins
B. Inferior vena cava and iliac veins
C. Great saphenous and femoral veins
D. Right and left testicular veins
E. Dorsal metatarsal and rectal veins

A

A. Subclavian and internal jugular veins

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73
Q

Which of the following would NOT be considered a component of nonspecific immunity?
A. Gastric juice, mucus, saliva and vaginal secretions
B. Phagocytosis by neutrophils
C. Complement activation
D. B cell/plasma cell production of immunoglobulin
E. Cell lysis by natural killer cells

A

D. B cell/Plasma cell production of immunoglobulin. This is apart of the specific/adaptive immune response.

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74
Q

Which of the following is generally NOT a result of complement activation?

A. Neutrophil chemotaxis
B. Decreased vascular permeability
C. Opsonization of microbes
D. Formation of a membrane attack complex with resultant cytolysis
E. Release of histamine from mast cells

A

B. Decreased vascular permeability. As a result of complement activation, increased vascular permeability occurs.

There is chemotactic attraction of phagocytes which includes neutrophils, there is opsonization which is phagocytosis of microbes, it forms the MAC complex to make a hole and kill it, and C3a activates mast cells which release histamine to trigger inflammation to increase blood vessel permeability!

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75
Q

T or F: The removal of potentially self-reactive immature lymphocytes occurs by clonal deletion.

A

True. The body removes immature lymphocytes that react to self-antigens

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76
Q

What is hematopoiesis?

A

This is the process of creating new blood cells from stem cells.

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77
Q

Which of the following is NOT true concerning cytokines?

A. Cytokines are soluble chemical mediators involved in cell-to-cell communication
B. Major functions of IL-1 and IL-2 include stimulation and activation of T and B cells
C. Interleukins, monokines, lymphokines, interferons and colony-stimulating factors are specific examples of cytokines
D. There are several examples of FDA-approved drug products that are actually cytokines, cytokine antagonists or colony-stimulating factors.
E. Increased cytokine production is always associated with improved immune function

A

E. Increased cytokine production is always associated with improved immunity.

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78
Q

______ and ______ cytokines direct pluripotent stem cells to make myeloid stem cells. This will in turn make all blood cells except for B and T cells.

A

IL1 and IL3

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79
Q

_______ and ______ cytokines direct pluripotent stem cells to make lymphocyte stem cells which will become B and T cells.

A

IL1 and IL7

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80
Q

What does the colony stimulating factor (CSF), erythropoietin do?

A

Stimulates red blood cell growth.

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81
Q

What does the colony stimulating factor (CSF), G-CSF, do?

A

It stimulates granulocyte growth (neutrophils, basophils, and eosinophils)

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82
Q

What does the colony stimulating factor (CSF), M-CSF, do?

A

It stimulates monocyte-macrophage growth and differentiation.

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83
Q

What does the colony stimulating factor (CSF), GM-CSF, do?

A

It stimulates granulocyte and macrophage growth and differentiation.

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84
Q

____________ infections result in an _________ response.

A

Extracellular (bacterial)
Antibody

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85
Q

What type of cell makes antibodies?

A

B cells! They become big plasma cells and those guys pump out the antibodies.

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86
Q

The antibody response from B cells is helped by which cell type?

A

T helper cells

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87
Q

What is the surface marker on T helper cells?

A

CD4

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88
Q

T helper cells recognize ___________ on the surface of other cells like macrophages and B cells.

A

MHC class II

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89
Q

_______ infections result in a ________ ___ cell response.

A

Viral (Intracellular)
Cytotoxic T

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90
Q

Cytotoxic T cell recognizes has ______ on its cell surface.

A

CD8

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91
Q

Cytotoxic T cells (CD8+) recognize complex of viral peptides with MHC class _____ and kills the infected cell.

A

I

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92
Q

What is the role of interferons?

A

Interferons are apart of innate immunity. They protect uninfected host cells from viral infections if they are close to an infected cell.

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93
Q

Helper T lymphocytes are the primary target of the Human Immunodeficiency Virus (HIV), the causative organism of the Acquired Immunodeficiency Syndrome (AIDS). Infection usually results in cellular apoptosis and/or lysis. As a result, which would you expect to be severely depleted in a patient with long-standing AIDS?

A. CD4 + cells
B. CD8+ cells
C. IL-1
D. TNF-alpha
E. All would be severely decreased

A

A. CD4+ cells. T helper cells express CD4 on their cell surface so killing these would reduce the number of this cell type.

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94
Q

What is the complement system?

A

This is part of the both specific and nonspecific immunity. It is around 25 proteins that help the antibodies destroy bacteria.

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95
Q

What is the goal of the complement system?

A
  1. Increase vascular permeability (helps get immune cells to where they need to be)
  2. Enhance phagocytosis (opsonization)
  3. Creates cell lysis-membrane attack complex (MAC) (punches hole in cell membrane and makes it die)
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96
Q

T or F: There is only one way for an organism to activate the complement cascade?

A

False. There are many ways.

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97
Q

What are toll-like receptors?

A

These are signalling receptors for Pathogen-associated Molecular Patterns (PAMPs). Once bound, they initiate cascade events that signal to nucleus to produce a cytokine cocktail.

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98
Q

T or F: TLRs are not specific for certain pathogens but exhibit polymorphisms and bridge the gap between innate and adaptive immunity.

A

False. TLRs are specific for certain pathogens however they do have polymorphisms and bridge the gap between innate and adaptive immunity.

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99
Q

What are the two most important inflammatory cytokines?

A

IL1 and TNFa

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100
Q
  1. Which of the following statements concerning helper T cells are true?

I. Recognize MHC class II self antigens via their CD8 molecule
II. Lyse virus-infected and malignant cells by secreting perforin
III. Have a regulatory and inducer role in coordinating the specific B and T cell responses

A. I only
B. III only
C. I and II only
D. II and III only
E. I, II and III

A

D. II and III only

These recognize MHC class II via their CD4 molecule not CD8.

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101
Q
  1. Toll-like receptors (TLRs)…

I. Serve as signaling receptors for Pathogen-Associated Molecular Patterns
II. When activated induce cytokine production which is very organism-specific
III. Contribute to “bridge” nonspecific and specific immunity

A. I only
B. III only
C. I and II only
D. II and III only
E. I, II and III

A

E. I, II, and III. TLRs do all of the above

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102
Q
  1. The major difference between interstitial fluid and lymph is:

A. The protein content
B. The location
C. The color
D. The taste
E. The cost

A

B. The location.

Interstitial fluid is the fluid that surrounds and bathes the cells in tissues. It leaks out of capillaries and carries nutrients, waste, and other substances. Lymph is essentially interstitial fluid that has entered the lymphatic vessels. It is transported through the lymphatic system, eventually draining back into the bloodstream.

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103
Q
  1. Which statements concerning specific (adaptive) immunity are true?

I. Specific immunity primarily involves B and T lymphocytes
II. Specific immunity takes somewhat longer to initially develop as compared to nonspecific immunity
III. Specific immunity usually results in life-long protection as a result of immunologic memory

A. I only
B. III only
C. I and II only
D. II and III only
E. I, II and III

A

E. I, II, and III. Specific/adaptive immunity does all those things.

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104
Q
  1. Toll Like receptors on immune cells such as macrophages and dendritic cells recognize specific foreign antigens through identification of:

a. Pathogen associated molecular patterns
b. T cell receptors
c. Interferon gamma release
d. Antigenic mimicry

A

A. PAMPs

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105
Q

T or F: Cytokines secreted from activated macrophages like IL-1B, IL6, and TNFa play no role in fever production, neutrophil mobilization, or migration of dendritic cells to lymph nodes.

A

False! These cytokines do all those things and more!

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106
Q

In nonspecific immunity, there are cells that are phagocytic and cells that are not. What are the two types of innate immune cells are phagocytic?

A
  1. Neutrophils (poly, PMNs, polymorphonuclear granulocytes)
  2. Monocytes-macrophages
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107
Q

In nonspecific immunity, there are cells that are phagocytic and cells that are not. What is the cell in innate immunity that is not phagocytic?

A

Natural killer cells

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108
Q
  1. Which of the following cell types is associated with immune surveillance and elimination of potentially early tumor cells or virus-infected cells?

a. Plasma cells
b. Neutrophils
c. NK cells
d. Dendritic cells
e. Th1 cells

A

C. NK cells (natural killer cells)

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109
Q
  1. Which of the following are characteristics of adaptive immunity?
    Select all the apply.

a. Interaction with APCs and specific T cell receptors
b. Cytokine co-stimulation and T cell proliferation
c. Phagocytosis by neutrophils
d. Formation of B cells
e. Formation of T and B memory cells
f. Phagolysosome formation

A

A, B, D, and E

Adaptive is all about B and T cells!

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110
Q
  1. Secondary lymphoid organs consist of (select all that apply):

a. Red bone marrow
b. Tonsils
c. Lymph nodes
d. Lymph nodule
e. Thymus gland
f. Spleen

A

B, C, D, and F

Red bone marrow and the thymus gland are part of the primary lymphoid organs.

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111
Q

The main area for return of lymph back to the venous blood is the:

a. Right thoracic duct
b. Left thoracic duct
c. Left lumbar trunk
d. Intestinal trunk
e. Pulmonary duct

A

Left thoracic duct

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112
Q

It is called a monocyte when it is in the _________ and a macrophage when it is in the ________.

A

Blood
Tissue

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113
Q

How do monocytes/macrophages get to a site of injury?

A

They bind to adhesion molecules on the vascular endothelium and receive a chemokine signal. They migrate into the tissue and enter the site of infection.

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114
Q

What does a viral-infected host cell release?

A

Interferon alpha and beta (IFNa and IFNb)

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115
Q

What is the definition of an immunogen or antigen?

A

This is a substance that can induce a detectable immune response whether it be a humoral or cellular response.

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116
Q

What is a requirement for immunogenicity (immune response to be had)?

A

The body most recognize something as foreign through the use of antigenic determinants called epitopes.

117
Q

What is the humoral response in specific/adaptive immunity?

A

B lymphocytes producing antibodies

118
Q

What is the cellular response in specific/adaptive immunity?

A

T cells using cytotoxic T cells.

119
Q

What are the 5 main characteristics of specific/adaptive immunity?

A
  1. Immunogenicity and antigen specificity
  2. Specificity and diversity through B and T cells
  3. Origin and development of B and T cells
  4. Clonal expansion (of each antibody and T cell)
  5. Memory cells
120
Q

Cellular/cell mediated immunity with cytotoxic T cells is directed towards __________ pathogens.

A

Intracellular

121
Q

Antibody-mediated immunity is directed against _________ pathogens.

A

Extracellular

122
Q

What is the function of cytotoxic T cells?

A

These are work for intracellular pathogens. They lyse the antigens.

123
Q

Which of the following is the predominant cytokine secreted by T helper cells that functions to stimulate activation and clonal expansion of T cells, B cells and NK cells?

A. CD4
B. IL-2
C. Healiotropin
D. TNF-alpha
E. Erythropoietin

A

B. IL-2. Interleukin 2 is a type of cytokine secreted from helper T cells that stimulates proliferation (clonal expansion) and differentiation of T cells, B cells, and NK cells.

124
Q

How does a macrophage present an antigen?

A
  1. Macrophage contacts with either A) just the antigen, B) Antigen/ Antibody complex or C) Antigen/antibody complex coated with complement (makes it yummy for macrophage)
  2. Macrophage engulfs it and degrades it with lysozymes
  3. Macrophage then presents whole antigen or part of it on its surface. The antigen is close to the MHC class II self-antigen.
125
Q

Are MHC class I or class II present on all cell types?

A

MHC class I is present on all cell types in the body while MHC class II is only present on antigen-presenting cells.

126
Q

What are the two cells that are crucial antigen-presenting cells?

A

Macrophages and dendritic cells

127
Q

T or F: All cells can engulf and present antigens to the immune system cells.

A

True! All cells can do this. The only difference is that normal cells will present the antigen with MHC class I while antigen-presenting specific cells will present the antigen with MHC class II.

128
Q

What are the two main cytokines that macrophages secrete?

A

IL-1 and TNFa

129
Q

What is the main function of interleukin-1?

A

To stimulate and activate T and B cells. A macrophage will present itself with antigen to T or B cell and secrete IL1 to activate them.

130
Q

What is the function of TNFa?

A

It functions to increases the killing ability of neutrophils and macrophages.

131
Q
  1. When you acquire a viral respiratory illness such as the common cold, which important chemical mediator is released from your virus-infected body cells and serves to communicate with nearby cells increasing their resistance to becoming infected (thus limiting the viral spread)?

A. Interferon
B. G-CSF
C. Lysozyme
D. TLR-4

A

A. Interferon

Interferons are apart of innate immunity. They protect uninfected host cells from viral infections if they are close to an infected cell.

132
Q

What is the effector cell for T lymphocytes?

A

Cytotoxic T cells and memory T cells

133
Q

What is the function of cytotoxic T cells?

A

They kill intracellular pathogens by punching holes in them.

134
Q

What activates the helper T cells?

A

Antigen-presenting cells expressing antigens on their surface bound to MHC class II which then secrete TNFa and IL1 to activate the inactive T helper cell.

135
Q

What is the function of helper T cells?

A

They help B cells produce antibodies and help phagocytes destroy pathogens. There are several subtypes of T helper cells including Th1, Th2, and Th17.

136
Q

T or F: T helper cells kill pathogens.

A

False. T helper cells do not kill anything. They coordinate the response towards the antigen through cytokine secretion.

137
Q

T or F: The primary difference between the white pulp and red pulp areas of the spleen is the absence or presence of red blood cells.

A

True

138
Q

Which cell types are found in a lymph node? Select all that apply.

a. Dendritic cells
b. Macrophages
c. B cells
d. T cells
e. Plasma cells
f. Neutrophils
g. Basophils

A

A, B, C, D, and E
Neutrophils and Basophils are circulating in the blood stream.

139
Q

How are the subtypes of T helper cells categorized?

A

They are categorized by the type of cytokine that secrete.

140
Q

Once a T helper cell is active, what is one of the most important cytokines it can secrete?

A

IL2

141
Q

T helper cells secrete many different types of cytokines. What are the 3 most important ones discussed in class?

A

A. Interleukin-2 (IL2)
B. Interferon gamma
C. Interleukins 4, 5, and 6

142
Q

What is the main function of interleukin 2?

A

It is secreted by T helper cells and stimulates the proliferation (clonal expansion) and differentiation of T cells, B cells, and NK cells. It also enhances cytotoxicity of cytotoxic T cells.

143
Q

What is the function of interferon gamma?

A

This is secreted from T helper cells. It activates NK cells to kill viruses and tumors and activates macrophages.

144
Q

What is the function of interleukins 4, 5, and 6?

A

These are secreted from T helper cells. They are involved in the activation, growth, and differentiation of B cells.

145
Q

What are the functions of B lymphocytes?

A

They stimulate the humoral arm of the immune system and it results in the activation of B lymphocytes and production of immunoglobulins/ antibodies.

146
Q

How do B cells become activated?

A
  1. Antigen binds to B cell to activate it via the epitopes.
  2. Helper T cell secretes IL 4, 5, and 6
  3. These cytokines allow for clonal selection of the B cells
  4. B cells become plasma cells and produce antibodies for that antigen
147
Q

The epitope on the antigen binds to the ________ end of the antibody.

A

Fab region

148
Q

What are the two most important immunoglobulins/ antibodies in protecting the host from foreign invaders?

A

IgG and IgM

149
Q

The complement proteins bind to what part of the antibody?

A

Fc region

150
Q

Is IgG or IgM better at activating the complement?

A

IgM is better at activating the complement as it has 5 complement binding domains compared to IgG having only one.

151
Q

Which immunoglobulin is the major one produced in the secondary response to an antigen?

A

IgG. B memory cells are mostly making IgG antibodies.

152
Q

What is the only class of immunoglobulins that can cross the placental barrier?

A

IgG

153
Q

What immunoglobulin is the major one produced in the primary response to an antigen?

A

IgM

154
Q

What immunoglobulin is involved in allergies and anaphylaxis?

A

IgE

155
Q

What are the main functional characteristics of the immunoglobulin IgG?

A

It neutralizes the toxin, activates the complement, and does opsonization of phagocytosis. It is the major immunoglobulin produced with the secondary response to an antigen.

156
Q

What is natural immunity?

A

This is when a person contracts a pathogen from a typical source like contaminated hands, sneezing, etc.

157
Q

What is artificial immunity?

A

This is when a person gains immunity due to a vaccine.

158
Q

What is active immunity?

A

This is when the patient has the illness and presents with symptoms of it.

159
Q

What is passive immunity?

A

This is when antibodies for something is given and the body has immunity to it but not response it given.

160
Q

What is an example of naturally acquired passive immunity?

A

This could be the transfer of IgG antibodies from mother to fetus.

161
Q

What is an example of artificially acquired active immunity?

A

Antigen given in vaccine and triggers an immune response.

162
Q

Which of the following is an attribute of the immunoglobulin IgM?

A. Is associated with anaphylaxis (severe allergic reaction)
B. Is the earliest formed antibody following a primary (first) exposure to an antigen
C. Is the main antibody associated with the “memory” response to an antigen
D. All of the above are attributes
E. None of the above are attributes

A

B. IgM is the earliest formed antibody following a primary exposure to an antigen.

163
Q

All pharmacy students are required to receive the hepatitis B subunit vaccine series (3 injections) upon entry to school. The 2nd and 3rd injections are intended to “boost” the immune response by increasing the protective levels of:

A. IgG
B. IgM
C. G-CSF
D. Neutrophils
E. Antigen presenting cells

A

A. IgG

164
Q

Non-steroidal anti-inflammatory drugs (NSAIDs) and related drugs most act through inhibiting cyclooxygenases at the site of inflammation. They uniformly suppress fever and pain. Some members of this class of drugs have unique functions. What statement is correct?

A

Acetaminophen has no effect on bleeding and is suitable for pain after surgery.

165
Q

Which of the following is correct: Anakinra (Kineret) is….

A

a recombinant form of an endogenous protein

166
Q

Steroids are a group of endogenous hormones that may also have important drug functions. Which of the following statements about steroids is correct?

A

The adrenal glands usually produce about 20 milligrams of cortisol per day

167
Q

Which of the following is an antimetabolite drug?

A

mycophenolate sodium

168
Q

Humoral immunity is for ________ pathogens while cellular immunity is for _______ pathogens.

A

External
Internal

169
Q

What is clonal selection theory?

A

Virgin B cells are called into action and antigen binds to B lymphocyte. They proliferate and form plasma cells which release antibodies and memory B cells are made for that antigen. Years later if that antigen returns, the body can clone the memory B cells and antibodies to fight infection even faster.

170
Q

What happens to plasma cells once the danger of infection is over?

A

Apoptosis

171
Q

The antibody/immunoglobulin IgA is only present is the _____________.

A

Mucosal areas

172
Q

What is the function of IgD?

A

This is an antibody that is on B cells and has not been exposed to any antigens yet. It acitvates basophils and mast cells to make antimicrobial factors.

173
Q

Which antibody gives passive immunity to a fetus?

A

IgG

174
Q

The CDR-grafted antibody/humanized is _____% human.

A

90%

175
Q

The chimeric antibody is _____% human.

A

70%

176
Q

Chimeric monoclonal antibody has the source letter of….

A

xi

177
Q

Humanized monoclonal antibody has the source letters of…

A

Zu

178
Q

What are the main 3 things that occur when giving antibody drugs?

A
  1. Neutralize target
  2. Can induce antibody dependent cellular cytotoxicity
  3. Can induce complement-dependent killing
179
Q

What are the 3 manifestations of arthritis?

A
  1. Gouty arthritis
  2. Osteoarthritis
  3. Rheumatoid arthritis
180
Q

What are the causes and contributors to the onset of rheumatoid arthritis?

A

It is idiopathic so it is unknown what triggers it. The contributors include prostaglandins, interleukin-1, and TNFa. They attack the synovial membranes at the joints.

181
Q

What is the first line drug treatment for rheumatoid arthritis?

A

NSAIDS

182
Q

What is the second line drug treatment for rheumetoid arthritis?

A

DMARDS (disease modifying anti-rheumatic drugs). These drugs target the cytokines.

183
Q

What do DMARDS target?

A

Cytokines

184
Q

What is the 3rd line treatment for rheumatoid arthritis?

A

Steroids and antiproliferative agents. These are only used as a last resort.

185
Q

What are the two DMARD drug used in rheumatoid arthritis that scout TNFa and bind it before it can reach its receptor?

A

Infliximab (Remicade) and Adalimumab (Humira)

186
Q

What are the two most common adverse effects of using any sort of TNFa inhibitor like Infliximab or Adalimumab?

A

Immunosuppression and nerve demyelination

187
Q

What is the MOA of etanercept (Enbrel)?

A

This drug mimics the TNFa receptor. It acts as a ‘fake’ receptor for TNFa in the blood so it binds to the drug molecule instead of the actual receptor.

188
Q

What are the adverse effects of etancercept?

A

Immunosuppression and nerve demylienation

189
Q

What is the MOA of the drug Anakinra (Kineret)?

A

This is a recombinant form of the endogenous interleukin-1 receptor antagonist. It binds the IL-1 receptor and inhibit it.

190
Q

What is an example of antibody-mediated neutraliztion?

A

Herceptin binding to HER2 and prevents it from forming a dimer which stops the downstream growth signals.

191
Q

What is an example of antibody-dependent cell-mediated cytotoxicity?

A

Antibodies bind the antigens on the surface of the target cells. The natural killers cells see the cell-bound antibodies and cross-link which triggers degranulation into the lytic synapse. This cause cell death by apoptosis.

192
Q

In antibody-dependent cell-mediated cytotoxicity (ADCC), what cell type is doing the actual killing?

A

Natural killer cell

193
Q

What are the three ways in which antibodies work?

A
  1. Neutralization (herceptin example)
  2. antibody-dependent cell-mediated cytotoxicity (ADCC)
  3. Complement-mediated cell killing (CMCK)
194
Q

The display of antigen in specialized surface structures (MHC and HLA) of antigen-presenting cells is the key to triggering ____________ immunity.

A

Adaptive/specific

195
Q

What are the steps of antigen presentation and B cell activation?

A
  1. Macrophage eats ups pathogen, digests it, and presents those as antigens on its surface
  2. T helper cells binds to macrophage and becomes activated
  3. The activated T helper cells binds a B cell to activate it
  4. The activated B cells can now turn into plasma cells and are released into the blood while othern B cells become memory cells.
  5. Plasma cells secrete antibodies specific to the beginning antigen to fight those pathogens
196
Q

Why do we have B memory cells?

A

If the pathogen comes back, the body can make the immune response much faster as it already has the antibodies for it.

197
Q

T or F: initiation of the wrong immune response compromises the host defense

A

True

198
Q

B cells are the ________ of humoral immunity while _________ pathogens are the inducers of humoral immunity.

A

effectors
inducers

199
Q

What are the 3 genetic determinants for the immune system?

A
  1. Genetic predisposition in the host (polymorphisms in receptors change how we respond to pathogens)
  2. Pathogen genomics (virulence and anti-infective resistance)
  3. Host-pathogen interactions
200
Q

What type of immune response against H.Pylori may lead to stomach cancer?

A

Inflammatory response generated by the innate/nonspecific immune system and it is mainly a cellular, not humoral, response. We want a humoral response though to reduce the risk for cancer.

201
Q

CD8 T cells (effector and cytotoxic T cells) interact with all cells and scan ____________ to determine if issues are present.

A

MHC class 1

202
Q

CD4 T cells (helper T cells) interact with ___________ and can activate either the cellular or humoral immunity.

A

MHC class II

203
Q

Ligation/engagement of the T-cell antigen receptor is needed for a response, but it is still not sufficient. This means there must be simultaneous binding via costimulatory receptors for activation. With this is mind, if the T cell receptor is only activated, what will the response be?

A

There will be no response.

204
Q

Ligation/engagement of the T-cell antigen receptor is needed for a response, but it is still not sufficient. This means there must be simultaneous binding via costimulatory receptors for activation. With this in mind, if the T cell is activated and costimulated, what will the response be?

A

T-cell activation

205
Q

Ligation/engagement of the T-cell antigen receptor is needed for a response, but it is still not sufficient. This means there must be simultaneous binding via costimulatory receptors for activation. With this in mind, if the T cell is activated and checkpointed, what will the response be?

A

No response as checkpoints pull the plug on any activation.

206
Q

What is the main activating co regulator for T cell?

A

CD28

207
Q

What is the main inhibitory co-receptor for T cells?

A

CTLA-4

208
Q

What are checkpoint inhibitor drugs?

A

These drugs disable the breaks on the immune system therefore increasing the immune response.

209
Q

Natural killers cells are cytotoxic T lymphocytes critical to the _________ immune system.

A

innate

210
Q

T or F: Natural killer cells need activation by antibodies or MHC molecules to respond to viral-infected or tumor infected cells.

A

False. Natural killer cells can respond without activation.

211
Q

What were the four types of antimetabolite drugs discussed?

A
  1. Methotrexate
  2. Mycophenolate mofetil
  3. Mycophenolate sodium
  4. Leflumomide
212
Q

What is the MOA of the antimetabolite drugs

A

They inhibit dehydrogenase enzymes in lymphocytes therefore decreasing T and B cell proliferation. Overall they suppress the proliferation of the immune system.

213
Q

What are the FDA black box warnings for methotrexate?

A

Bone marrow suppression, hepatotoxicity, lung and renal damage. Side effects include GIT upset and immunosuppresion

214
Q

What are the 3 main uses of methotrexate?

A
  1. Asthma
  2. Psoriasis
  3. Rheumatoid arthritis
215
Q

What are the main uses for the antimetabolites Mycophenolate mofetil and Mycophenolate sodium?

A

Organ transplant

216
Q

What is the main use for the antimetabolite Leflunomide?

A

Rheumatoid arthritis

217
Q

Non-steroidal anti-inflammatory drugs (NSAIDs) and related drugs most act through inhibiting cyclooxygenases at the site of inflammation. They uniformly suppress fever and pain. Some members of this class of drugs have unique functions. Which of the following statements is correct?

A

Acetaminophen (Tylenol) has no effect on bleeding and is suitable for pain after surgery

218
Q

Which of the following is correct: Anakinra (Kineret) is

A

a recombinant form of an endogenous protein

219
Q

Steroids are a group of endogenous hormones that may also have important drug functions. Which of the following statements about steroids is correct?

A

the adrenal glands usually produce about 20 milligrams of cortisol per day

220
Q

What are the broad function of cortisol?

A

Blocks production of inflammatory mediators like prostaglandins and impedes the function of while blood cells. Glucocorticosteroids are potent immunosuppressive drugs.

221
Q

What is the drug Prednisone?

A

This is a synthetic prodrug corticosteroid that is activating to prednisone in the liver.

222
Q

After 2 weeks on any steroid, ________ is mandatory as the body is no longer making its own cortisol from the adrenals.

A

Tapering

223
Q

What happens if tapering in not done after taking steriods?

A

It can result in an adrenal crisis and/or steroid withdrawal syndrome.

224
Q

Inducers of cellular immunity are what 3 things?

A
  1. Intracellular pathogens
  2. MHC mismatched cells
  3. Foreign bodies
225
Q

What are the two effectors of cellular immunity?

A
  1. T cells
  2. NK cells`
226
Q

There are more than _________ primary (born with) immunodeficiency diseases recognized by WHO.

A

350

227
Q

Primary immunodeficiency disorders are classified into 6 groups, what are they?

A
  1. B cells deficiencies
  2. T cell deficiencies
  3. Combination of B and T cell deficiencies
  4. Defective phagocytes
  5. Complement deficiencies
  6. Unknown
228
Q

What are 3 ways the immune system can be boosted?

A
  1. Immunoglobulin therapy
  2. Interferon-gamma therapy
  3. Growth factor
  4. Stem cell transplant
229
Q

How are acquired immunodeficiency diseases typically brought on?

A

They are triggered by external sources

230
Q

What are the function of chemokines?

A

These are a type of cytokine that induce directional cell migration.

231
Q

Which of the following statements is/are true concerning lymph nodes? Select all that apply.

a.Where most of the antigen recognition, processing and presentation takes place
b.There are approximately 600 located throughout the body
c.Where worn out red blood cells are removed/digested
d.Where the majority of granuloctyes reside
e.They have more afferent vessels that efferent vessels
f.Where pre-Tcells mature

A

A, B, and E

Antigen recognition, processing, presentation occurs at the lymph nodes, there are about 600 in the body, and they have more afferent than efferent vessels.

232
Q

Where do preT-cells mature?

A

Thymus

233
Q

Which of the following cells are granulocytes?

a. Basophil
b. Eosinophil
c. NK cell
d. Monocyte/macrophage
e. Neutrophil
f. T cell
g. B cell

A

A, B, and E

234
Q

Which of the following cells are leukocytes?

a. Basophil
b. Eosinophil
c. NK cell
d. Monocyte/macrophage
e. Neutrophil
f. T cell
g. B cell

A

C, F, and G

NK cells, T and B cells

235
Q

Which are considered the primary antigen presenting cells?

a. Neutrophils
b. Basophils
c. Eosinophils
d. Dendritic cells
e. Macrophages

A

D and E

Dendritic and macrophages

236
Q

Which of the following statements is/are true concerning the clonal selection theory? Select all that are true.

a.Each lymphocyte bears a single receptor of unique specificity
b.Interaction with a foreign epitope results in high-affinity binding and lymphocyte activation
c.Activated cells that proliferate have clonal specificity identical to the parent cell
d.Cells with receptors similar to self-molecules are deleted during early lymphoid development

A

All are true!

237
Q

Which of the following colony-stimulating factors is most broad in terms of its activity on various cell types?

a. M-CSF
b. G-CSF
c. GM-CSF
d. Erythropoietin

A

C. GM-CSF

Erythropoietin is only red blood cell growth while GM-CSF is granulocyte and macrophage growth and differentiation.

238
Q

Which of the following is a characteristic of cytokines?

a) Small chemicals not encoded in genes
b) Gene-encoded proteins that facilitate intercellular communication
c) Lipid-derived molecules targeting damaged tissues
d) DNA sequences regulating immune cell transcription

A

B. Gene-encoded proteins that facilitate intercellular communcation

239
Q

What is the main role of chemokines?

a) Inhibit inflammatory pathways
b) Enhance histamine release from mast cells
c) Induce directional migration of leukocytes
d) Suppress cytokine production

A

C. Induce directional migration of leukocytes

240
Q

What are the two broad groups of soluble mediators of the immune system?

A

Inflammatory mediators and cytokines. Inflammatory mediators include the prostaglandins, leukotrienes, and histamines and bradykinin. Cytokines include the interleukins, TNFs, and chemokines

241
Q

Which histamine receptor is primarily involved in gastric acid secretion?

a) H1
b) H2
c) H3
d) H4

A

B. H2

242
Q

What is the primary immunoglobulin found in mucosal areas?

a) IgA
b) IgD
c) IgE
d) IgG

A

A. IgA

243
Q

Which immunoglobulin is involved in the early stages of humoral immunity?

a) IgA
b) IgM
c) IgD
d) IgE

A

B. IgM

244
Q

What is the main mechanism of monoclonal antibody therapies like rituximab?

a) Enhancing TNF-α activity
b) Neutralizing specific targets like CD20
c) Increasing production of IgM antibodies
d) Inhibiting T-cell receptors

A

B. Neutralizing specific targets like CD20

245
Q

Which therapeutic drug neutralizes TNF-α in rheumatoid arthritis?

a) Anakinra
b) Infliximab
c) Cetirizumab
d) Loratadine

A

B. Infliximab

246
Q

Which cells are the primary effectors of humoral immunity?

a) T-helper cells
b) B cells
c) Macrophages
d) Natural killer cells

A

B. B cells

247
Q

What type of immune response is most effective against intracellular pathogens?

a) Humoral immunity
b) Cellular immunity
c) Innate immunity
d) Complement-mediated immunity

A

B. Cellular immunity

248
Q

What is the key trigger for the adaptive immune response?

a) Production of cytokines
b) Antigen presentation via MHC molecules
c) Activation of complement proteins
d) Secretion of chemokines

A

B. Antigen presentation via MHC molecules

249
Q

Which type of MHC molecule is expressed on all nucleated cells?

a) MHC I
b) MHC II
c) MHC III
d) MHC IV

A

A. MHC class I

250
Q

Which of the following cytokines is primarily secreted by macrophages and induces changes via phosphorylation?

a) Interleukin-2 (IL-2)
b) Tumor Necrosis Factor-α (TNF-α)
c) Chemokine (CXC)
d) Prostaglandin E2 (PGE2)

A

B. Tumor Necrosis Factor a

251
Q

Which of the following is NOT a role of eicosanoids in the body?

a) Inflammatory responses
b) Cardiovascular regulation
c) Nervous system signaling
d) Reproductive system processes

A

C. Nervous system signalling

252
Q

What distinguishes cytokines from small chemical mediators of inflammation?

a) Cytokines act exclusively on immune cells.
b) Cytokines are gene-encoded proteins, while small mediators are not.
c) Cytokines function only in chronic inflammation.
d) Small mediators lack receptors, while cytokines do not.

A

B. Cytokines are gene-encoded while small mediators are not

253
Q

Which cytokine family is closely linked to cartilage degradation in osteoarthritis?

a) Interferons
b) Tumor Necrosis Factor (TNF)
c) Transforming Growth Factor (TGF)
d) Interleukins-17 (IL-17)

A

B. TNFa and IL1

254
Q

What is the primary mechanism of chemokine action?

a) Enzymatic cleavage of target proteins
b) Binding to 7-transmembrane G-protein coupled receptors
c) Blocking the action of inflammatory cytokines
d) Directly lysing bacterial membranes

A

B. Binding to 7-transmembrane GPCR`

255
Q

Which inflammatory mediator is responsible for bronchoconstriction and vasodilation in allergic reactions?

a) Leukotrienes
b) Prostaglandins
c) Histamine
d) Bradykinin

A

C. Histamine

256
Q

What is the role of the H4 histamine receptor?

a) Stimulating gastric acid secretion
b) Inducing chemotaxis of immune cells
c) Reducing neurotransmitter release
d) Mediating pain and itching responses

A

B. Inducing chemotaxis of immune cells

257
Q

Why are selective COX-2 inhibitors preferred over non-selective NSAIDs for chronic inflammatory diseases?

a) They enhance platelet aggregation and reduce the risk of bleeding.
b) They avoid COX-1 inhibition, reducing gastroduodenal erosion.
c) They activate cytokine receptors, increasing anti-inflammatory cytokine output.
d) They are metabolized via histamine receptors, reducing systemic side effects.

A

B.

258
Q

Which characteristic of TNF-α contributes to its role in arthritis progression?

a) Its ability to induce cartilage degradation via interleukin-8.
b) Its direct activation of synovial fibroblasts to produce histamine.
c) Its suppression of chemokine activity, leading to immune evasion.
d) Its inability to bind to receptor-ligand complexes in osteoarthritic tissues.

A

A

259
Q

What differentiates interleukin-1 (IL-1) from most other cytokines?

a) IL-1 exclusively mediates anti-inflammatory responses.
b) IL-1 requires a receptor antagonist to regulate its activity.
c) IL-1 binds directly to chemokine receptors for signal transduction.
d) IL-1 secretion is primarily controlled by the activation of COX enzymes.

A

b) IL-1 requires a receptor antagonist to regulate its activity

260
Q

How does the interaction between IL-1 and TNF-α amplify inflammatory responses?

a) By directly inducing leukotriene synthesis in macrophages.
b) By synergistically promoting PGE2 and IL-6 production in synovial fibroblasts.
c) By antagonizing COX-2 activity, increasing vasodilation.
d) By upregulating H1 histamine receptor expression in endothelial cells.

A

B

261
Q
  1. Which of the following would be anticipated effects of G-CSF administration to a patient? Select all that apply.

a.Enhanced number of PMNs
b.Enhanced chemotaxis
c.Enhanced phagocytic activity
d.Enhanced oxidative metabolism
e.Enhanced apoptosis

A

A, B, C, and D

262
Q

What are the 5 main functions of CSFs, specifically GM-GSF?

A
  1. Increase # of PMNs and monocyte-macrophages
  2. Enhance chemotaxis (draw macrophages and neutrophils to area of infection/antigen
  3. Enhance phagocytosis
  4. Enhance oxidative metabolism
  5. Prolong cell survival
263
Q

Streptococcus pneumoniae is the most common extracellular bacterial pathogen associated with respiratory infections. Which two of the following immune responses would you expect to predominate in the control and eradication of this type of infection? Select all that apply.

a. Antibody production
b. Cytotoxic T cell production
c. NK cell production
d. Neutrophil phagocytosis
e. T helper cell production

A

A and D

Antibodies and Neutrophil Phagocytosis

264
Q

Influenza Type A is one of the most common viruses causing respiratory illness during the winter months. Which two of the following immune responses would you expect to predominate in the control and eradication of this type of intracellular infection? Select all that apply.

a. Antibody production
b. Cytotoxic T cell production
c. NK cell production
d. Neutrophil phagocytosis
e. T helper cell production

A

B and C

Cytotoxic T cells and NK cells. Cells infected by viruses are recognized by cytotoxic T cells. NK cells are the second line of clean up and killing in viral infected cells.

265
Q

Virus infected body cells possessing ________ self antigens recognize _____________ cells via their CD8 receptor.

a. MHC-I, T helper cells
b. MHC-I, Cytotoxic T cells
c. MHC-II, T helper cells
d. MHC-II, Cytotoxic T cells

A

B. Viral infected cells have MHC class I self-antigens that have broken down some virus and presented it on that MHC class I and CD8+ cells like cytotoxic T cells recognize it.

266
Q

Macrophages bearing _______ self antigens present foreign epitopes to __________ via their CD4 receptor.

a. MHC-I, T helper cells
b. MHC-I, Cytotoxic T cells
c. MHC-II, T helper cells
d. MHC-II, Cytotoxic T cells

A

C. MHC class II presents to T helper cells. Remember the epitopes are foreign antigenic determinants.

267
Q

Which antimicrobial proteins and cell types are associated with nonspecific (innate) resistance? Select all that apply.

a. Interferons
b. Complement
c. Neutrophils
d. NK cells
e. B cells
f. Cytotoxic T cells

A

A, B, C, and D

268
Q

What are interferons?

A
269
Q

Activation of complement proteins C5-C9 is associated with:

a. Enhanced chemotaxis
b. Enhanced opsonophagocytosis
c. Enhanced cytolysis
d. Enhanced vasodilation
e. Enhanced mast cell degranulation

A

C. enhanced cytolysis

C5-C9 complement proteins burst the microbe by forming a channel in it while the C3 complement proteins work to increase inflammation through increasing vascular permeability and chemotactic attraction of phagocytes. C3 also enhances phagocytosis.

270
Q

Which of the following is true concerning toll-like receptors? Select all that apply.

a.They are pathogen specific recognizing pathogen-associated molecular patterns
b.They result in a pathogen-specific cytokine response to signal other cell types
c.They exhibit polymorphisms
d.They participate in both the innate and adaptive immune response

A

All of them!

271
Q

What are toll-like receptors?

A

TLRs are signalling receptors for Pathogen-Associated Molecular Patterns (PAMPs). PAMPs on pathogens interact with the TLRs to initiate a cascade of events that results in a signal to the nucleus to produce various cytokines.

272
Q

Which three pro-inflammatory cytokines are most associated with release from macrophages resulting in early inflammation, fever production and the acute phase response to infection? Select the best answer.

a. IL-1, IL-2, IL-3
b. IL-2, IL-6, IL-12
c. IL-1, IL-6, TNF
d. TNF, IL-8, IL-10
e. IL-5, IL-5, IL-6

A

C. IL1, IL6, and TNF

273
Q

Patients who receive a transplanted organ are often given steroids to prevent rejection. What is the mechanism by which steroids suppress the immune response? Select the best answer.

a.They inhibit IL-1 which blocks activation of cytotoxic T cells
b.They inhibit TNF-alpha which blocks activation of B cells
c.They inhibit IL-2 which blocks activation of helper T cells
d.They promote IL-10 production which activates an anti-inflammatory response
e.They promote IL-2 production which blocks activation of NK cells

A

A. Steroids inhibit IL-1 which blocks the activation of cytotoxic T cells

274
Q

Which T helper cell subset is associated with activation of neutrophils to respond to extracellular pathogens but can also play a role in the development of autoimmune disease?

a. Th1
b. Th2
c. Th4
d. Th17

A

D. Th17

275
Q

Which T helper cell subset is associated with the activation of macrophages to respond to intracellular pathogens but can also play a role in autoimmunity and chronic inflammation?

a. Th1
b. Th2
c. Th4
d. Th17

A

A. Th1

276
Q

Which T helper cell subset is associated with the activation of eosinophils to respond to parasites and can also play a role in allergies?

a. Th1
b. Th2
c. Th4
d. Th17

A

B. Th2

277
Q

Which cytokine is the most important at stimulating the activation, proliferation and clonal expansion of helper T cells, B cells and NK cells?

a. IL-1
b. IL-2
c. IL-6
d. TNF
e. IFN

A

B. IL-2. IL2 is secreted from T helper cells and stimulates the proliferation/clonal expansion and differentiation of T cells, B cells, and NK cells. IL1 on the other hand is secreted by macrophages and function to stimulate/activate T and B cells.

278
Q

Which of the following statements is/are true? Select all that apply.

a.Infected body cells result in activation of cytotoxic T cells which release granzymes that cause the infected cell to undergo apoptosis
b.Infected body cells result in activation of cytotoxic T cells which release perforins that caused cytolysis of the infected cell
c.Infected body cells result in activation of cytotoxic T cells which release granulysin which destroys the microbe
d.Infected body cells result in activation of T helper cells which release IL-2 and interferon which upregulate NK cell activation with resultant cell lysis

A

All of the above!

279
Q

The most efficient antibody subtype at activating complement via the Fc region is:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

E. IgM.

IgM is best at activating complement as it has 5 binding domains.

280
Q

The antibody subtype that crosses the placenta and provides protection to the fetus during pregnancy is:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

D. IgG

281
Q

The antibody subtype found in breast milk that provides protection by interfering with microbial adherence to mucus membranes is:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

A. IgA

282
Q

The antibody subtype found on the surface of basophils and mast cells responsible for allergic responses is:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

C. IgE

283
Q

The antibody subtype found on B memory cells responsible for neutralization of antigens and the primary antibody of the secondary immune response is:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

D. IgG

284
Q

The primary antibody initially produced in response to a newly encountered antigen is:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

E. IgM

285
Q

A patient with a parasitic worm (helminth) infection is likely to have an increase in:

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

C. IgE

286
Q

Your body’s response to getting infected with a strain of SARS-CoV-2 (Covid) is an example of:

a. Naturally-acquired passive immunity
b. Naturally-acquired active immunity
c. Artificially-acquired passive immunity
d. Artificially-acquired active immunity

A

B. Naturally-acquired active immunity

287
Q

The protection afforded to a pregnant mother by receiving the Covid vaccine is best described as:

a. Naturally-acquired passive immunity
b. Naturally-acquired active immunity
c. Artificially-acquired passive immunity
d. Artificially-acquired active immunity

A

D. Artificially-acquired active immunity

288
Q

The protection afforded to the unborn fetus during pregnancy following the mother’s receipt of the Covid vaccine is best described as:

a. Naturally-acquired passive immunity
b. Naturally-acquired active immunity
c. Artificially-acquired passive immunity
d. Artificially-acquired active immunity

A

A. Naturally-acquired passive immunity

289
Q

The protection afforded to a child receiving rabies immune globulin following a dog bite is best described as:

a. Naturally-acquired passive immunity
b. Naturally-acquired active immunity
c. Artificially-acquired passive immunity
d. Artificially-acquired active immunity

A

C. Artificially-acquired passive immunity

Principles of Pharmacology and Immunology (PPI) (7 decks)

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