Question 1

Anti-Rh antibodies are used to treat:&#10;A) Serum sickness&#10;B) Kawasaki disease&#10;C) Erythroblastosis fetalis&#10;D) Idiopathic thrombocytopenic purpura (ITP)

Accepted Answer

Erythroblastosis fetalis, also known as hemolytic disease of the newborn, occurs when an Rh-negative mother is pregnant with a child who is Rh-positive. This incompatibility leads to production of anti-Rh antibodies in the mother when she is exposed to fetal red blood cells (RBCs), such as during trauma or during delivery. If the exchange occurs during trauma, then the antibodies can cross the placenta and destroy fetal RBCs, leading to severe anemia. If the exchange of blood occurs during delivery, then subsequent pregnancies are at risk for erythroblastosis fetalis. The anti-Rh antibody can be administered to the mother in sufficient quantities to coat all of the fetal RBCs that are circulating in the mother. As a result, the mother's immune system does not recognize the Rh-positive fetal RBCs and does not mount an immune response.

Question 2

Low platelet count and antibodies to platelets are signs of:&#10;A) Serum sickness&#10;B) Kawasaki disease&#10;C) Erythroblastosis fetalis&#10;D) Idiopathic thrombocytopenic purpura (ITP)

Accepted Answer

Patients with ITP develop autoantibodies to platelets, leading to early destruction of platelets and low platelet counts. These patients are usually children, and ITP often follows a viral infection in these children. One treatment option for these patients is the administration of intravenous immunoglobulin (IVIG).

Question 3

A monoclonal antibody used as a drug has a name that ends in what suffix?&#10;A) U&#10;B) Ab&#10;C) Mab&#10;D) Imm

Accepted Answer

Monoclonal antibodies that are used as pharmaceutical agents all have generic names that end in -mab, such as adalimumab. Additionally, the syllables before the suffix indicate the origin (human, humanized, etc.) and the target (tumor, immune system, etc.).

Question 4

The main pathological target for autoantibodies found in patients with Kawasaki disease is:&#10;A) Skin&#10;B) Kidneys&#10;C) Platelets&#10;D) Vascular endothelial cells

Accepted Answer

Patients with Kawasaki disease develop autoantibodies to vascular endothelial cells and cardiac myosin, leading to the main areas of damage occurring in the peripheral and coronary arteries and the heart.

Question 5

Radiolabeled antibodies to CD20, including tositumomab labeled with iodine-131, are frequently used to treat which disorder?&#10;A) Multiple myeloma&#10;B) Rheumatoid arthritis&#10;C) Non-Hodgkin's lymphoma&#10;D) Human immunodeficiency virus (HIV)

Accepted Answer

Most non-Hodgkin's lymphomas are B cell lymphomas, and these cells are frequently positive for the CD20 marker. The radiolabeled anti-CD20 antibody will target the marker to cause an immune response, but will also target the radioactivity to the tumor cell, having the duel effect of damaging the tumor cell and reducing damage to healthy cells.

Question 6

Bispecific antibodies can react with:&#10;A) Two different antigens&#10;B) Two of the same antigen&#10;C) Antigen and T cell or NK cell&#10;D) Four different antigens on the same cell

Accepted Answer

Heavy and light chains of one monoclonal antibody with a certain specificity are combined with heavy and light chains of a monoclonal antibody with a different specificity to form bispecific antibodies that can react with two different antigens.

Question 7

Hybridomas are fusion cells composed of:&#10;A) B cells and T cells&#10;B) Two different myeloma cells&#10;C) Splenic B cells and myeloma cells&#10;D) Lymph node B cells and splenic B cells

Accepted Answer

Hybridomas are fusion cells made up of B cells from the spleen of a mouse that had previously been exposed to antigen. Those B cells are fused with immortal myeloma cells to produce a fusion cell that can grow indefinitely and can produce antibody to a specific antigen.

Question 8

Which of the following is an example of active immunity?&#10;A) Antibody used therapeutically to treat lymphoma&#10;B) Immunity to pneumococcal infection after exposure to the organism&#10;C) Immunity acquired in a child by passage of antibodies from the mother's milk&#10;D) Administration of pooled immunoglobulins from patients that had recovered from cytomegalovirus (CMV) to patients that currently have the disease

Accepted Answer

Active immunity occurs when a person is exposed to an organism, through either communicable acquisition or vaccination, and the immune system forms memory cells against that pathogen. Those memory cells will produce a faster, stronger secondary response if the person is exposed to that organism again in the future. In this case the person acquired a pneumococcal infection and developed immunity caused by exposure to the community-acquired bacteria. The other choices were all examples of passive immunity, in which case the patient does not acquire long-term immunity - the immunity lasts only as long as the transferred antibodies remain in the system before natural degradation takes place.

Question 9

A serious potential side effect of using antiserum therapy is the development of immune complexes that can lead to serious damage in the:&#10;A) Brain&#10;B) Lungs&#10;C) Muscles&#10;D) Kidneys

Accepted Answer

The antibody in the antiserum binds to the antigen and forms immune complexes that can become trapped in the glomerulus and can cause significant damage to the kidneys. Immune complexes can also cause damage to the vascular system throughout the body, but the complexes are too large to move through the vascular endothelial cells, so they are unlikely to cause damage to the brain, lung, or muscle tissue, and the damage is limited to the vessels.

Question 10

Chimeric antibodies are a combination of:&#10;A) Murine and yeast genes&#10;B) Human and yeast genes&#10;C) Human and murine genes&#10;D) Murine genes from two different sources

Accepted Answer

Chimeric antibodies combine murine genes coding for the variable regions of the heavy and light chains with human genes coding for the constant regions of the heavy and light chains.

Deck 13: Antibodies and in Vivo Therapy