Deck 10: Autoimmunitysystemic

Question 1

Which antibody would you expect to be involved in the disease in question 5?

A)anti-dsDNA
B)antitopoisomerase
C)anti-SCL-70
D)anti-SS-A and anti SS-B
E)B and C

Answer 1

anti-SS-A and anti SS-B

Question 2

What percentage of the SLE patients is positive for antinuclear antibodies

A)100
B)95
C)20
D)15

Answer 2

95

Question 3

SLE is associated with
a.increased clearance of dead and dying cells
b.decreased clearance of dead and dying cells
c.high titers of rheumatoid factor
d.excess complement concentrations

Answer 3

decreased clearance of dead and dying cells

Question 4

What would the diagnosis of the patient in questions 5 and 6 be?

A)SLE
B)rheumatoid factor
C)Crohn's disease
D)celiac disease
E)Sjögren's syndrome

Question 5

Which of the following is used for testing the specificity of the antibody in a patient suspected of having SLE?
a.ANA testing on HEP-2 cells
b.ELISA testing
c.testing on Crithidia luciliae
d.all of the above
e.A and B

Question 6

Antibodies to cyclic citrullinated peptides

A)recognize antigens that contain an arginyl converted to a cyclic citrullyl
B)have a high specificity for the diagnosis of SLE
C)have a high specificity for the diagnosis of autoimmune hepatitis
D)have a high specificity for the diagnosis of rheumatoid arthritis
E)A and D

Question 7

Monoclonal antibodies are used in the treatment of some autoimmune diseases including Crohn's and rheumatoid arthritis. This therapeutic antibody reacts with

A)TGF-beta
B)TNF-alpha
C)IL-2
D)IL-6

Question 8

Autoimmunity can be

A)infection associated because of a cross-reactive epitope
B)environmentally associated
C)trauma associated
D)A and B
E)all of the above

Question 9

SLE is

A)related to a single gene mutation
B)made worse by exposure to sunlight
C)due to inflammation caused by circulating immune complexes
D)B and C
E)all of the above

Question 10

Autoimmunity

A)involves genetics
B)can sometimes be gender associated
C)can be hormone associated
D)B and C
E)all of the above

Question 11

A patient comes into the clinic with dry eyes and dry mouth but no joint pain. Which pattern of ANA staining would you expect?
a.peripheral
b.nucleolar
c.speckled
d.homogeneous

Question 12

Serum from CREST subset of systemic sclerosis in ANA testing shows

A)centromere staining
B)speckled staining
C)rim staining
D)homogeneous staining

Question 13

Antibody to cyclic citrullinated peptide (CCP) is diagnostic for

A)SLE
B)rheumatoid arthritis
C)Sjögren's syndrome
D)mixed connective tissue disease
E)all of the above

Question 14

Antibody to which of the following cytokines can be used to treat rheumatoid arthritis.

A)IL2
B)GM-CSF
C)TGF-beta
D)TNF-alpha

Question 15

Although some patients with other types of SLE have antibody to this nuclear antigen, the fact that 95% of patients with drug-induced Lupus have antibody to this particular antigen can be helpful if drug-induced lupus is suspected. The antigen is
a.Smith antigen
b.RNP
c.dsDNA
d.histones
e.none of the above

Question 16

Antibody to one of the nuclear antigens listed below, although it is in only about 10-25% of SLE patients, has such a high specificity that it is still used to aid in diagnosis. This antigen is
a.RNP
b.Sm
c.ds DNA
d.histones

Question 17

A patient comes into the clinic with a skin condition called scleroderma. Of the following, which pattern of ANA staining would you expect?

A)centromere
B)peripheral
C)nucleolar
D)homogeneous

Question 18

Apoptosis is related to SLE because

A)the slow cleanup of apoptotic debris may lead to SLE
B)lymphocytes that are self-reactive may not kill themselves
C)cellular debris can lead to polyclonal activation of B cells
D)all of the above

Question 19

Central tolerance

A)involves regulatory T cells
B)negative selection
C)positive selection
D)A and B
E)B and C

Question 20

An ANA that yields a speckled result requires a subsequent assay because any of the following antigens could be involved

A)dsDNA, nucleolus RNA, kinetochore
B)RNP, ds DNA
C)Sm, SS-A, SS-B, SCL-70, RNP
D)RNP, nucleolar RNA, dsDNA,

Question 21

A pannus is

A)an area of continuous inflammation in the joint of someone with arthritis
B)an area of inflammation in the kidney of someone with antidouble-stranded DNA
C)reaction with Crithidia luciliae
D)none of the above

Question 22

In SLE,

A)smaller joints are more affected than larger joints
B)larger joints are more affected than smaller joints
C)a swelling appears in the neck
D)the patient has difficulty holding eyelids open

Question 23

The specificity of the ANA test for SLE is

A)high; no other individuals have this antibody
B)high except for patients who have rheumatoid arthritis
C)low; other people have this antibody
D)high if used in conjunction with anti-CCP

Question 24

In the latex agglutination assay for rheumatoid factor, the antigen coated on the latex beads is

A)CCP
B)IgG with the Fc facing in
C)IgG with the Fc facing out
D)CCP and IgG with the Fc facing out

Question 25

Anti-CCP antibodies

A)are seen in all cases of rheumatoid arthritis and in people with chronic infections
B)are seen in about 70% of cases of rheumatoid arthritis and are rarely seen in others
C)are seen in all cases of rheumatoid arthritis and are rarely seen in others
D)are found only in patients with rheumatoid arthritis and patients with Lyme disease

Question 26

Antitopoisomerase antibody is the same as

A)anti-SS-A
B)anti SS-B
C)antihistones
D)anti-Scl-70