Deck 17: Immunologic Disorders

Question 1

To produce an allergic reaction in Type I hypersensitivity, the antigen

A) must bind to mast cells.
B) must bind to free IgE molecules.
C) must bind to IgE on mast cells.
D) must crosslink two IgE molecules on mast cells.

Answer 1

D

Question 2

The type of hypersensitivity expressed with the lysing of red blood cells is

A) Type I.
B) Type II.
C) Type III.
D) Type IV.
E) Type V.

Answer 2

B

Question 3

Regarding a mismatch of either the Rh antigen or the AB antigen, both

A) result in destruction of red blood cells.
B) utilize complement to destroy red blood cells.
C) utilize antibody-dependent cellular cytotoxicity to destroy the red blood cells.
D) result in destruction of only leukocytes.

Answer 3

A

Question 4

Hemolytic disease of the newborn

A) may not manifest itself fully until after birth.
B) is due to the action of IgM.
C) is due to the action of IgE.
D) is a Type I hypersensitivity reaction.
E) may not manifest itself fully until after birth AND is due to the action of IgE.

Question 5

During a Type I hypersensitivity reaction, the mast cells

A) become phagocytic.
B) release IgE antibodies.
C) degranulate.
D) immediately release histamine.
E) degranulate AND immediately release histamine.

Question 6

Recombinant human monoclonal antibody (rhuMAb)

A) appears promising as a treatment for asthma.
B) decreases the levels of IgG.
C) uses an engineered form of an IgG molecule.
D) promotes crosslinking between IgE molecules on the mast cells.
E) appears promising as a treatment for asthma AND uses an engineered form of an IgG molecule.

Question 7

IgE molecules involved in hypersensitivity reactions have become attached to

A) neutrophils.
B) mast cells.
C) B cells.
D) macrophages.
E) mast cells AND B cells.

Question 8

The immunoglobulin associated with Type I hypersensitivity is

A) IgG.
B) IgA.
C) IgM.
D) IgE.
E) IgD.

Question 9

Anti-A and anti-B antibodies

A) are considered natural antibodies.
B) are present at birth.
C) are typically IgM.
D) easily cross the placenta.
E) are considered natural antibodies AND are typically IgM.

Question 10

If the immune system responds inadequately to antigenic stimulation, this is termed

A) hypersensitivity.
B) autoimmunity.
C) cell-mediated immunity.
D) immunodeficiency.

Question 11

The cell type responsible for Type II hypersensitivity is the

A) mast cell.
B) B cell.
C) macrophage.
D) platelet.
E) neutrophils.

Question 12

Desensitization

A) stimulates an increase in IgG.
B) reduces the number of mast cells.
C) increases the number of basophil cells.
D) is a treatment for hypersensitivity reactions.
E) stimulates an increase in IgG AND is a treatment for hypersensitivity reactions.

Question 13

The hypersensitivity treatment that stimulates an increase of IgG and T suppressor cells and a decrease in IgE is known as

A) desensitization.
B) immunity.
C) sensitization.
D) exposure.
E) anaphylaxis.

Question 14

Antibodies that have arisen in the blood plasma without any obvious or deliberate stimulus are called

A) natural.
B) acquired.
C) injurious.
D) active.

Question 15

A transfusion reaction primarily involves

A) leukocytes.
B) phagocytes.
C) platelets.
D) erythrocytes.

Question 16

Most cases of generalized anaphylaxis are a result of

A) fire ant stings.
B) aspirin.
C) bananas.
D) peanuts, bee stings or penicillin injections.

Question 17

The initial work on anaphylaxis was done by

A) Watson and Crick.
B) Pasteur.
C) Fleming.
D) Richet and Portier.

Question 18

Generalized anaphylaxis is generally characterized by

A) wheal and flare.
B) inflammation.
C) shock.
D) rash.

Question 19

The natural antibodies in serum that react with A or B polysaccharide antigens are mostly of the class

A) IgG.
B) IgE.
C) IgM.
D) IgD.
E) IgA.

Question 20

Urticaria is characterized by

A) living in Utica.
B) wheal and flare.
C) asthma.
D) inflammation.

Question 21

Which of the following is associated with contact dermatitis?

A) poison ivy
B) latex
C) tuberculin skin test
D) hay fever
E) poison ivy, latex AND tuberculin skin test

Question 22

Which of the following primary immunodeficiencies is the most common?

A) severe combined immunodeficiency
B) selective IgA deficiency
C) agammaglobulinemia
D) Di George's syndrome

Question 23

Killing of graft cells occurs through a complex series of mechanisms including

A) sensitized T cytotoxic cells.
B) NK cells.
C) erythrocytic cells.
D) basophilic cells.
E) sensitized T cytotoxic cells AND NK cells.

Question 24

Cyclosporin A

A) is a relatively general immunosuppressive agent.
B) suppresses T cell proliferation.
C) activates macrophages.
D) stimulates antibody production.
E) is a relatively general immunosuppressive agent AND suppresses T cell proliferation.

Question 25

Immunosuppressive drugs

A) are only needed during the first week after transplantation.
B) are only needed for the first year after transplantation.
C) are needed indefinitely after transplantation.
D) are needed for transplants between identical twins.
E) are needed indefinitely after transplantation AND are needed for transplants between identical twins.

Question 26

Which of the following have been an effective immunosuppressant for use in transplantation?

A) amphotericin B and cyclosporin A
B) FK506 and cephalosporin
C) cyclosporin A and tacrolimus
D) cephalosporin and amphotericin B
E) FK506 and amphotericin B

Question 27

Delayed hypersensitivity is also known as ___________ hypersensitivity.

A) type I
B) type II
C) type III
D) type IV
E) type V

Question 28

Which of the following disease states is not among those caused by immune complexes?

A) farmer's lung
B) serum sickness
C) hay fever
D) glomerulonephritis

Question 29

Immunologically privileged sites include the

A) brain.
B) eyes.
C) testes.
D) kidney.
E) brain, eyes AND testes.

Question 30

Immune complexes

A) consist of antigen-antibody bound together.
B) are usually cleared rapidly from the body.
C) bind to Fc receptors on cells.
D) are involved in Type III hypersensitivity reactions.
E) All of the choices are correct.

Question 31

Type IV hypersensitivity reactions typically peak within

A) minutes.
B) hours.
C) 12 hours.
D) 2-3 days.

Question 32

The fetus is not rejected because

A) it is too small.
B) it is in an immunologically privileged site.
C) the father is immunosuppressed.
D) it has no antigens.
E) it is in an immunologically privileged site AND the father is immunosuppressed.

Question 33

Arthus reactions and serum sickness are examples of _________ hypersensitivity.

A) type I
B) type II
C) type III
D) type IV
E) type V

Question 34

The redness and induration found after a tuberculin skin test involve the action of

A) sensitized T cells.
B) IgE.
C) complement.
D) basophil cells.

Question 35

Graft-versus-host disease is primarily a

A) Type I reaction.
B) Type II reaction.
C) Type III reaction.
D) Type IV reaction.
E) Type V reaction.

Question 36

Allografts

A) are normally rejected within hours.
B) are normally rejected within 10-14 days.
C) are grafts between non-identical members of the same species.
D) would include the fetus.
E) are normally rejected within 10-14 days, are grafts between non-identical members of the same species AND would include the fetus.

Question 37

Patch tests are used to detect

A) hives.
B) serum sickness.
C) immune complexes.
D) contact hypersensitivity.

Question 38

The tissue antigens most involved in graft rejection involve

A) Rh.
B) ABO.
C) MHC.
D) MLB.

Question 39

Delayed type hypersensitivity primarily involves

A) erythrocytes.
B) B cells.
C) T cells.
D) mast cells.

Question 40

Localized injury or death of tissue resulting from repeated injections of an antigen into a person with high levels of circulating specific antibody is known as

A) farmer's lung.
B) German measles.
C) serum sickness.
D) an Arthus reaction.

Question 41

Secondary immunodeficiency disease is not the result of

A) genetic defects.
B) malignancies.
C) advanced age.
D) malnutrition.

Question 42

The condition that results from ineffective digestion after phagocytosis is

A) AIDS.
B) Chediak-Higashi disease.
C) Di George's syndrome.
D) agammaglobulinemia.

Question 43

Anaphylaxis is the name given to allergic reactions caused by IgE-mediated release of mast cell granules.

Question 44

Type O blood is missing both anti-A and anti-B antibodies.

Question 45

Gene therapy technology

A) may be used to generate cells for transplantation.
B) may overcome graft rejection.
C) may treat cancer.
D) may down-regulate the immune response.
E) may overcome graft rejections AND may treat cancer.

Question 46

Allergic rhinitis and hives may both respond to antihistamines.

Question 47

Insulin-dependent diabetes mellitus is an example of an autoimmune disease that involves

A) sensitized T cells.
B) cytotoxic T cells.
C) antibodies.
D) IgD.

Question 48

If a patient lacks B cells, the resulting disease is

A) SCID.
B) AIDS.
C) Di George's syndrome.
D) agammaglobulinemia.

Question 49

Myasthenia gravis is an example of an autoimmune disease that involves

A) sensitized T cells.
B) cytotoxic T cells.
C) antibodies.
D) IgD.

Question 50

Defects in bone marrow stem cells result in a condition known as

A) SCID.
B) AIDS.
C) Di George's syndrome.
D) Chediak-Higashi disease.

Question 51

First exposure to an allergen results in a violent hypersensitivity reaction.

Question 52

Generalized anaphylaxis may be quickly controlled with the use of antihistamines.

Question 53

A defect in which of the following systems leads to granulomatous disease?

A) lymphatic system
B) circulatory system
C) oxidase system
D) Golgi system

Question 54

Mismatch of either the Rh antigen or the AB antigen results in lysis of red blood cells by complement.

Question 55

Stem cells

A) have an almost unlimited capacity to divide.
B) can differentiate into different tissues.
C) may be used to test the effects of drugs on human cells.
D) come from fetal material.
E) All of the above

Question 56

Anti-A and anti-B antibodies are natural antibodies and are present at birth.

Question 57

Anti-Rh antibodies may not cross the placenta.

Question 58

If the body recognizes parts of itself as being foreign, this is termed

A) immunodeficiency disease.
B) agammaglobulinemia.
C) autoimmune disease.
D) AIDS.

Question 59

HIV

A) appears to cause AIDS.
B) is an RNA virus.
C) destroys T helper cells.
D) makes the patient vulnerable to infections, especially those caused by opportunists.
E) All of the choices are correct.

Question 60

If the thymus fails to develop

A) functional T cells are absent.
B) functional B cells are absent.
C) Di George's syndrome exists.
D) complement deficiencies exist.
E) functional T cells are absent AND Di George's syndrome exists.

Question 61

Why do Rh-negative but not Rh-positive mothers sometimes have babies with hemolytic disease of the newborn?

A) This disease results when an Rh-negative mother's immune system is primed multiple times to produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-positive, she won't produce any anti-Rh antibodies at all.
B) Rh-positive mothers produce IgM antibody, not IgG. This antibody can't cross the placenta, so it can't cause hemolytic disease of the newborn.
C) Rh-positive mothers will receive a preventative shot from their physician prior to conception. This will provide the protection the fetus needs AFTER conception to avoid the disease.
D) Rh-negativity is also associated with hyperproduction of antibodies. As such, Rh-negative mothers are more likely than Rh-positive mothers to produce the antibodies needed to produce this disease.

Question 62

MHC plays a pivotal role in transplant rejection.

Question 63

What is NOT a reason that the kidneys are particularly prone to damage caused by immune complexes?

A) Kidney blood vessel wall cells have receptors for antibodies on them, which makes them soak up antibodies (or in this case, immune complexes) from the bloodstream. This blocks the kidneys up and causes them to malfunction and become damaged.
B) Blood is pushed through the kidneys at a very high pressure-any blockage of the vessels (such as what might be caused by immune complex deposits) can lead to ruptures/inflammation and damage.
C) While blood vessel walls do NOT have receptors for antibodies, large immune complexes forced through small diameter vessels can become embedded within them. This can trigger complement system inflammation and cell destruction.
D) Trapped immune complexes that initiate inflammation can attract neutrophils. The neutrophils degranulate in the area of the immune complexes, leading to cell/tissue destruction.

Question 64

Multiple myeloma is a plasma cell tumor in which a clone of malignant plasma cells produces large amounts of immunoglobulin. With all this excess immunoglobulin, how can a person with multiple myeloma be immunodeficient?

A) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter.
B) The multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.
C) The massive overproduction of immunoglobulin impairs the kidneys, preventing production of the correct hormones from the kidneys to balance immune system cell production from the bone marrow.
D) Through a negative feedback loop, the large amount of immunoglobulin tricks the immune system into thinking it's making a strong response that is needed. As such, it shuts down production of other responses that might truly BE needed to fight off a pathogen.
E) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter AND the multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.

Question 65

If a patient received a kidney transplant that was matched well across each of the major histocompatibility complex (MHC) molecules, but they stopped taking their anti-rejection drugs, what would happen and why?

A) Nothing-the transplant is matched, so the patient doesn't need the drugs to prevent rejection. The new organ should be seen by the recipient's immune system as 'self.'
B) The organ will be rejected very quickly, as allografts (tissue from the same species, but a different individual) are seen by the recipient's immune system as 'foreign,' and are quickly attacked.
C) The organ will be rejected, but it will be a gradual process since it was matched well. There are a number of other proteins that cannot be matched between donors, so the graft will still be viewed as 'foreign' by the recipient's immune system, and will still be attacked. The attack will just be a slower and lengthier process.
D) Nothing-since the transplant was accepted for so long with the anti-rejection drugs, the person's immune system has had the time to become accustomed to it and now views the graft as 'self.' It will not be attacked.

Question 66

A lack of T cells makes one more vulnerable to intracellular parasites.

Question 67

In the tuberculin skin test, what would be the most likely reason why a positive test would NOT necessarily indicate an infection in progress in a patient in the United States?

A) False positives occur all the time. This might simply be an example of that.
B) The TB skin test is a measure of reactivation of memory T cells. The memory T cells would be formed either during an active infection or would be remnants of a prior infection that may be cleared. Since the memory of the response persists, the test still shows positive, even though the patient is cleared of actual infection.
C) Each person in the US receives the BCG tuberculosis vaccine. This is an attenuated mycobacterium vaccine. The response to this vaccine makes us positive for the TB skin test, even though we may not have actually had a TB infection at any point in our lives.
D) This is a trick question-a positive TB skin test ALWAYS indicates a current, active infection.

Question 68

What might be an advantage to using an individual's own stem cells instead of pancreatic cell allografts to treat Type I diabetes?

A) Stem cells can disable the immune responses that led to the diabetes state in the first place.
B) This process should be far cheaper than the surgical intervention needed for the allograft.
C) You can't do this-stem cell research is still theoretical, not approved by the FDA, and is currently illegal in the US. As such, there is no advantage.
D) If you were able to use a person's own cells, it would be considered an autograft rather than an allograft. As such, there should be no HLA/MHC matching required, and no long-term anti-rejection drugs needed.