Quiz Questions for Exam 3 Flashcards
What is the target of the autoimmune response that leads to multiple sclerosis?
A. Thryoid stimulating hormone
B. Beta - islet cells
C. Myelin
D. Nucleic Acid
C. Myelin
Active systemic lupus erythematosus is characterized by:
A. HLA - DR antigens expressed on thyroid epithelial cells
B. Presence of dsDNA antibodies
C. Absence of immune complexes
D. Increase in cells lining the synovial membrane
B. Presence of dsDNA antibodies
Which of the following is an immune privileged site?
A. Testes
B. Adrenal gland
C. appendix
D. Lung
E. Thyroid
A. testes
An IgM specific for IgG is referred to as:
A. Rheumatoid factor
B. Cause of rheumatoid arthritis
C. Arthus body
D. Hemolytic agent of anemia
A. Rheumatoid factor
An autoimmune disease characterized by pain and progressive destruction of the joints, weight loss, morning stiffness, and presence of an antibody directed against IgG best described:
A. Hemolytic anemia
B. Rheumatoid arthritis
C. Graves disease
D. Diabetes mellitus
E. Lupus
B. Rheumatoid arthritis
The purified protein derivative reaction to determine exposure to tuberculosis is based on which of the follow?
A. A sensitized T - cell response
B. formation of antigen - antibody complexes
C. A type II hypersensitivity reaction
D. An immune mediated hypersensitivity reaction
A. A sensitized T - cell response
Type I hypersensitivity involves:
A. A kidney membrane antigen and specific antibody
B. IgE binding to mast cells and basophils
C. Phagocytic cell degranulation and proteolytic enzyme activity
D. Natural killer cell activation
B. IgE binding to mast cells and basophils
Which of the following occurs in hemolytic disease of the newborn?
A. The Rh+ mother is exposed to Rh- baby cells
B. IgE builds up on the mothers cells
C. The baby must be Rh-
D. The Rh- mother is exposed to the Rh+ baby cells
D. The Rh- mother is exposed to the Rh+ baby cells
Hypersensitivities to poison ivy and nickel are:
A. Macrophage and T - cell responses to haptens
B. IgE responses to hapten
C. Mediated by eosinophils
D. Mediated by IgG and IgM antibodies
A. Macrophage and T - Cell responses to haptens
All of the hypersensitivity responses have which of the following in common?
A. Asymptomatic sensitization phase
B. activation of macrophage against a pathogen
C. Release of histamine
D. Involvement of antibody
A. Asymptomatic sensitization phase
A 54 - year old woman presents to her optometrist complaining that she has been having difficulty focusing on objects near and far. Her vision problems are getting progressively worse. She also thinks that her eyelids are drooping, and she is thinking of getting plastic surgery to “put them back up:. The optometrist cannot find a good reason for her vision problems but is able to fit her with glasses and recommends that she sees a rheumatologist, as this would be consistent with myasthenia gravis. What autoantibody would you recommend be tested for in this patient?
A. Antibody to the acetylcholine receptor
B. Antibody to myelin basic protein
C. Antibody to basement membrane antigens
D. Anti-neutrophilis cytoplasmic antibodies (ANCAs)
A. Antibody to acetylcholine receptor
Antibodies to cyclic proteins (anti-CPP) are specific diagnostic indicators for:
A. Rheumatoid arthritis
B. Graves disease
Diabetes mellitus
D. Multiple sclerosis
A. Rheumatoid arthritis
An 30 year old clinical laboratory science student complains of being tired but is not able to sleep. The women also states that she has without reason have increased nervousness/anxiety. She has also lost 20 pounds over the past 2 months without trying. The woman’s pulse and blood pressure are elevated, and her eyes seem to be bulging. Her CBC is normal. Her thyroid stimulating hormone is decreased, however her thyroid hormones are elevated. This woman most likely has:
A. Reiters syndrome
B. Graves Disease
Diabetes mellitus
D. Myasthenia gravis
B. Graves disease
A 56 year old woman presents to her physician complaining of weight gain and joint problems. She is increasingly having difficulty walking up stairs and manipulating her fingers. Fingers in both hands as well as knees on both legs are equally painful and stiff. The symptoms have been getting progressively worse over the past 6 months. Rheumatoid factor is elevated and ANA is not detected. Complement levels in her joints are decreased. The woman most likely has:
A. Insulin dependent diabetes mellitus
B. Systemic lupus erythematosus
C. Rheumatoid arthritis
D. Myasthenia gravis
E. Graves Disease
C. Rheumatoid arthritis
Complement is responsible for tissue damage in which of the following reactions (Choose all correct answers):
A. Type III hypersensitivity
B. Immediate hypersensitivity
C. Delayed - type hypersensitivity
D. Type II hypersensitivity
E. Anaphylaxis
A. Type III hypersensitivity
and
D. Type II hypersensitivity
An Exaggerated reaciton directed against an antigen that is harmless is called:
A. Hypersensitivity
B. Passive cutaneous analphylaxis
C. Atopy
D. Immune complex disease
A. Hypersensitivity
Immune injury resulting from the localization of immune complexes in blood vessels and tissues described which hypersensitivity reaction?
A. IV
B. I
C. III
D. II
C. III
A 5 year old girl was rushed to the mergency department because she was having trouble breathing. She had been playing at the park when she fell down and her face and neck started to swell up. One of her friends thought she may have been stung by a bee because a bee was flying around them, shortly before the girl fell to the ground she had screamed. The girl had a large red bump on her cheek. This girl likely has:
A. Brutons hypogammaglobinemia
B. Type I diabetes
C. Type IV hypersensitivity
D. Type I hypersensitivity
D. Type I hypersensitivity
Type I hypersensitivity involves:
A. A kidney membrane
B. IgE binding to mast cells and basophils
C. Phagocytic cell degranulation and proteolytic enzyme activity
D. Natural Killer cell activation
B. IgE binding to mast cells and basophils
Autoimmune hemolytic anemia targets which cells or tissues?
A. White Blood cells
B. Liver
C. Red Blood Cells
D. Platelets
E. Connective Tissue
C. Red blood cells
A 35 year old female experiences difficulty in walking and her hands and feet are numb from time to time. Suspecting a disease involving the central nervous system, her physician orders an MRI. The MRI reveals leisons on the myelin sheath. What is the most likely disease?
A. Multiple sclerosis
B. Rheumatoid arthritis
C. Graves Disease
D. Myasthenia gravis
A. Multiple sclerosis
Central Tolerance in which lymphocytes learn to distinguish between self - antigens and foreign antigens, take place in the thymus and:
A. Liver
B. Lymph nodes
C. Spleen
D. Bone marrow
D. Bone Marrow
Which mechanism is involved in peripheral tolerance to self antigen?
A. Positive Selection
B. Lack of co - stimulatory signals from antigen - presenting cells
C. Negative selection
B. Lack of co - stimulatory signals from antigen - presenting cells
The normal activity of a type I hypersensitivity response is protection primarily against which of the following?
A. Parasites
B. Viruses
C. Fungi
D. Bacteria
A. Parasites
A pregnant Rh - negative woman is concerned of possible hemolytic disease in her newborn and in future children. The best approach to avoid this problem is:
A. Administer RhoGam to the first newborn
B. Administer RhoGam to each newborn
C. Administer RhoGam to the mother for all pregnancies
D. Not to administer RhoGam
C. Administer RhoGam to the mother for all pregnancies
Reaction to poison Ivy is which type of hypersensitivity?
A. III
B. I
C. II
D. IV
D. IV
In which of the following autoimmune diseases are antibodies to acetylcholine receptors produced, thereby blocking the signal to muscles?
A. Sjogren’s Syndrome
B. Myasthenia Gravis
C. Multiple sclerosis
D. Systemic lupus erythematosus
E. Autoimmune hemolytic anemia
B. Myasthenia Gravis
The flourescent antinuclear antibody test for lupus is an example of which of the following?
A. Indirect fluorescence testing
B. Flow cytometry
C. Direct fluorescence testing
D. Completitive immunoassay
A. Indirect fluorescence testing
Active systemic lupus erythematosus is characterized by:
A. Increase in cells lining the synovial membrane
B. HLA - DR antigens expressed on thyroid epithelial cells
C. Presence of ds - DNA antibodies
D. Absence of immune complexes
C. Presence of ds - DNA antibodies
Anaphylactic reactions are mediated by:
A. Natural killer cells
B. Lymphocytes
C. Mast cells
D. Macrophages
C. Mast cells
Which isotype of immunoglobulin is inolved in a type I hypersensitivity?
A. IgA
B. IgG
C. IgE
D. IgD
E. IgM
C. IgE
Which of the following is considered a systemic autoimmune disease?
A. Multiple sclerosis
B. Systemic Lupus erythematosus
C. Myasthenia gravis
D. Graves disease
B. systemic lupus erythematosus
The principle difference between type II and type III hypersensitivity reaction is:
A. Whether the antigen is cellular or soluble
B. Involvement of helper T cells and macrophages
C. The isotype of the antibody involved
D. Complement - mediated lysis of host cells
A. Whether the antigen is cellular or soluble
The purified protein derivative reaction to determine exposure to tuberculosis is based on which of the following?
A. A type II hypersenitive reaction
B. Formation of antigen - antibody complexes
C. An immediate hypersensitivity reaction
D. A sensitized T cell response
D. A sensitized T cell response
Immune injury resulting from the localization of immune complexes in blood vessels and tissues describes which type of hypersensitivity?
A. IV
B. III
C. II
D. I
B. III
In the rheumatoid factor test, what is being detected?
A. Antithyroglobulin antibody
B. Antinuclear antibody
C. IgG directed against IgM IgM
D. Directed against IgG
D. Directed against IgG
Antibodies to cyclic citrullinated proteins (anti - CPP) are specific diagnostic indicators for:
A. Multiple sclerosis
B. Rheumatoid arthritis
C. Graves disease
D. Diabetes mellitus
B. Rheumatoid arthritis
A 6-month-old baby has suffered from recurrent bacterial infections. Flow cytometry results indicate a lack of B cells but the presence of normally functioning T cells. Which is the most likely diagnosis?
a. DiGeorge syndrome
b. Bruton’s tyrosine kinase deficiency
c. Selective IgA immunodeficiency
d. Severe combined immunodeficiency
B. Bruton’s tyrosine kinase deficiency
A 7-month-old boy is seen by a specialist because of hypocalcemia, viral pneumonia, a history significant for recurrent diarrhea, and oral candidiasis. An x-ray reveals the lack of a thymic shadow. A likely diagnosis for this boy is:
a. Bare lymphocyte syndrome I.
b. ataxia telangiectasia.
c. bare lymphocyte syndrome II.
d. DiGeorge anomaly.
D. DiGeorge anomaly
A 9-month-old boy is suspected of having an immune deficiency because he had many recurrent infections with Streptococcus pneumoniae. Laboratory tests reveal a normal percentage of T cells and T-cell subsets but a lack of mature B cells and immunoglobulins. This boy most likely has:
a. chronic granulomatous disease.
b. DiGeorge anomaly.
c. X-linked agammaglobulinemia.
d. Bare lymphocyte syndrome II.
C. X - Linked agammaglobulinemia
A child suspected of having an inherited humoral immunodeficiency disease is given a diphtheria/tetanus vaccine. Two weeks after the immunization, his level of antibody to the specific antigens is measured. Which result is expected for this patient if he does have this deficiency?
a. An increase in IgG-specific antibody but not IgM-specific antibody
b. No change in the level of specific antibody
c. Increased levels of nonspecific antibody
d. Increased levels of specific antibody
B. No change in the level of specific antibody
A nitroblue tetrazolium test shows little color in cells observed under a microscope. What disease does this finding correlate with?
a. Bruton’s tyrosine kinase deficiency
b. Transient hypogammaglobulinemia
c. Wiskott-Aldrich syndrome
d. Chronic granulomatous disease
e. Ataxia telangiectasia
D. Chronic granulomatous disease
A patient has a monoclonal serum band. Which of the following additional criteria would support a diagnosis of multiple myeloma?
a. Increased abnormal plasma cells in bone marrow or monoclonality of plasma cells
b. Nose bleeds or bruising
c. Presence of Reed-Sternberg cells
d. Recurrent infections
A. Increased abnormal plasma cells i bone marrow or monoclonality of plasma cells
A patient’s immunofixation electrophoresis shows excessive amounts of free monoclonal light chains. These light chains are referred to as:
a. Bence Jones proteins.
b. precipitated immunoglobulin A.
c. alpha-1 antitrypsin.
d. albumin
A. Bence Jones proteins
A transplant patient on a follow-up visit to his physician is noted to have progressive fibrosis and scarring with narrowing of the vessels leading to the transplanted organ. What type of rejection is occurring?
a. Acute
b. Accelerated
c. Chronic
d. Hyperacute
C. Chronic
A transplantation patient suffers an organ rejection within hours after the procedure. What type of rejection occurred?
a. Hyperacute
b. Chronic
c. Acute
d. Graft-versus-host disease
A. Hyperacute
Decreased CD3-positive lymphocytes and a lack of responsiveness to phytohemagglutinin in the circulation are typically associated with:
a. DiGeorge anomaly.
b. transient hypogammaglobulinemia.
c. chronic granulomatous disease.
d. inflammation.
A. DiGeorge anomaly
If a patient suffers with an increased susceptibility to septicemias by Neisseria sp., but not other bacteria. Which of the following complement activities is most likely deficient in this patient?
a. Mast cell degranulation
b. Enhancing phagocytosis
c. Recruitment of neutrophils
d. Formation of membrane attack complex
D. Formation of membrane attack complex
In a patient who is exhibiting signs of graft-versus-host disease, which cell type is most likely responsible for the reaction?
a. T cells
b. B cells
c. Eosinophils
d. Macrophages
A. T cells
In indirect allorecognition, the host’s T helper cells recognize foreign protein and uptake, process, and present it to recipient antigen-presenting cells (APCs).
a. True
b. False
B. False
In direct allorecognition, the recipient T cells bind and respond directly to foreign HLA proteins.
a. True
b. False
A. True
Patients with recombinase activating gene 1 (RAG-1) or RAG-2 deficiencies have decreased numbers of:
a. monocytes.
b. lymphocytes.
c. Granulocytes
d. all of the other answers are true
B. Lymphocytes
Serum samples from day 1 and day 4 were collected from a patient showing signs of disease. The serum samples were assayed for IgG titer against a potential pathogen consistent with the patient’s clinical signs. The titers for the first sample was 16 while the second sample was 32.
a. Need a sample taken later as the two samples assayed may have been collected too close together
b. The patient is immune to the pathogen as the antibody levels are high enough to resist infection
c. No answer text provided.
A. Need a sample taken later as the two samples assayed may have been collect too close together
Suppose a mother and her child possess the following HLA haplotypes:
Mother:
A28 B17 Cw4 Dw3
A30 B21 Cw2 Dw10
Child:
A3 B8 Cw6 Dw7
A28 B17 Cw4 Dw3
Paternity testing was performed. Three potential fathers were HLA typed and found to contain the following haplotypes:
Father 1:
A30 B21 Cw2 Dw10
A1 B2 Cw5 Dw9
Father 2:
A3 B8 Cw6 Dw7
A8 B9 Cw1 Dw8
Father 3:
A3 B8 Cw5 Dw4
A2 B1 Cw6 Dw7
Which of the following statements is true?
a. The true father may be Father 1 only.
b. The true father may be Father 1 or Father 2.
c. The true father may be Father 2 only.
d. The true father may be Father 2 or Father 3.
D. The true father may be father 2 or father 3
The accumulation of immune complexes in renal glomeruli or joints (lupus-like syndromes) can be caused by a deficiency in the complement component:
a. Factor B
b. C5.
c. C2.
d. properdin.
C. C2
The basic difference between a leukemia and lymphoma is the
a. typical age of patients.
b. migration pattern of cells.
c. stage of cell differentiation of proliferating cell.
B. Migration pattern of cells
The most serious impairment of opsonization and antimicrobial defense is caused by a deficiency in complement component:
a. C1q
b. C5
c. factor B
d. C3
D. C3
Which is true of selective IgA deficiency?
a. Patients may develop an anti-IgA antibody.
b. It is very rare.
c. It is invariably fatal.
d. It mainly occurs in older adults.
A. Patients may develop an anti-IgA antibody
Which of the following diseases is characterized by skin involvement?
a. Multiple myeloma
b. Hairy cell leukemia
c. Hodgkin’s disease
d. Sézary syndrome
D. Sézary syndrome
Which of the following findings is a diagnostic criterion for monoclonal gammopathy of undetermined significance?
a. Presence of CRAB features
b. Serum monoclonal protein greater than 3 g/dL
c. Increased calcium in the blood
d. Plasma cell count lower than 10% of total cells in bone marrow
D. Plasma cell count lower than 10% of total cells in bone marrow
Which of the following is characteristic of an acute graft-versus-host disease episode?
a. The reaction involves the skin, gastrointestinal (GI) tract, and liver.
b. The reaction involves the recipient’s bone marrow.
c. The reaction occurs within 100 days of the transplant.
d. The reaction produces a fibrous condition of the mouth and eyes.
A. The reaction involves the skin, gastrointestinal (GI) tract, and liver.
Which of the following statements about severe combined immunodeficiency is true?
a. It occurs only in males.
b. It is accompanied by hypergammaglobulinemia.
c. Patients can be vaccinated with live virus.
d. It may be associated with a signal transduction defect.
D. It may be associated with a signal transduction defect.
Which type of gene is required for cell growth and division but can cause malignant transformation when altered?
a. Anti-tumor gene
b. Tumor suppressor gene
c. Proto-oncogene
d. Immunoglobulin gene
C. Proto-oncogene
Your otherwise healthy Caucasian patient has recurrent sinopulmonary infections and diarrhea. You find there is an isolated antibody deficiency. This rather common immunodeficiency disorder is most likely to be:
a. IgA
b. IgM
c. IgG
d. IgE
A. IgA
