Deck 46: Immunopharmacology

Question 1

Differentiate between interferon,interleukin-2,and colony stimulating factors,and select the true statement related to their use.

A) Interleukin-2 is a chemical mediator involved in the immune attack on infectious organisms and other foreign substances. The CSFs function to stimulate B-cell production of antibodies and killer T-cell activity. The interferons stimulate the bone marrow to increase the production of macrophages and granulocytes.
B) The interferons are chemical mediators involved in the immune attack on infectious organisms and other foreign substances. Interleukin-2 functions to stimulate B-cell production of antibodies and killer T-cell activity. The CSFs stimulate the bone marrow to increase the production of macrophages and granulocytes.
C) Interleukin-2 is a chemical mediator involved in the immune attack on infectious organisms and other foreign substances. Interferons function to stimulate B-cell production of antibodies and killer T-cell activity. The CSFs stimulate the bone marrow to increase the production of macrophages and granulocytes.
D) The CSFs are chemical mediators involved in the immune attack on infectious organisms and other foreign substances. Interferons function to stimulate B-cell production of antibodies and killer T-cell activity. Interleukin-2 stimulates the bone marrow to increase the production of macrophages and granulocytes.

Answer 1

The interferons are chemical mediators involved in the immune attack on infectious organisms and other foreign substances. Interleukin-2 functions to stimulate B-cell production of antibodies and killer T-cell activity. The CSFs stimulate the bone marrow to increase the production of macrophages and granulocytes.

Question 2

Using the steps in the immune response,select the true statement about macrophages and their role in the immune response process.

A) Macrophages release interleukins that activate the T-cells.
B) Macrophages are classified as antigen-presenting cells.
C) Macrophages kill cells that are infected with foreign organisms.
D) Macrophages produce immunoglobulins or antibodies.

Answer 2

Macrophages are classified as antigen-presenting cells.

Question 3

Select the false statement about memory cells and their role in the immune response process in the body.

A) Memory cells are produced by receiving vaccinations for the childhood diseases.
B) Some B-cells and T-cells are referred to as memory cells.
C) Memory cells are lymphocytes that inhibit the activity of the immune system when the immune response is no longer needed.
D) Memory cells remain in the body for many years and can quickly become reactivated to produce an immune response against an organism that previously infected the body.

Answer 3

Memory cells are lymphocytes that inhibit the activity of the immune system when the immune response is no longer needed.

Question 4

Select the false statement about lymphopenia's effect on the immune response following administration of immunosuppressive drugs like the corticosteroids.

A) The immunosuppressive effect (lymphopenia) occurs 4 to 6 hours following
B) drug administration and significantly reduces the number of circulating lymphocytes in the blood.
C) Lymphopenia decreases the ability of lymphocytes to initiate and participate in an immune response.
D) Corticosteroids increase the amount of lymphoid tissue and cells in the lymph nodes and spleen.
E) None of these are false.

Question 5

Identify the role of helper T-cell lymphocytes in regulating the activity of the immune system.

A) The function of helper T-cells is to recognize the foreign antigens presented to them by macrophages and other antigen-presenting cells.
B) Helper T-cell lymphocytes are scavenger cells that engulf and digest infectious organisms and foreign substances.
C) Helper T-cell lymphocytes function as antigen-presenting cells.
D) All of these are correct.

Question 6

Select the true statement related to the alkylating drug cyclosporine (Sandimmune).

A) Cyclosporine is a cytotoxic drug agent produced by a fungus.
B) Cyclosporine inhibits the production of interleukin-1.
C) Cyclosporine inhibits the production of interleukin-2.
D) Cyclosporine is a polypeptide metabolite produced by an algae.

Question 7

Differentiate between tacrolimus (Prograf) and cyclosporine (Sandimmune),and select the true statement.

A) Tacrolimus is a macrolide antibiotic that has a similar mechanism of action as cyclosporine-to inhibit T-cell lymphocyte activity.
B) Cyclosporine is more potent than tacrolimus and is primarily used in organ transplantation to prevent rejection.
C) Tacrolimus and cyclosporine stimulate the production of interleukin-2, a chemical mediator necessary for the growth and multiplication of T-cells.
D) None of these are correct.

Question 8

Summarize the clinical indications for the use of mycophenolate mofetil (CellCept).

A) Mycophenolate mofetil is used in the treatment of Crohn's disease.
B) Mycophenolate mofetil is used in the treatment of rheumatoid arthritis.
C) Mycophenolate mofetil is used in renal organ transplantation to prevent rejection.
D) Mycophenolate mofetil is used to control immune-based diseases such as lupus erythematosus.

Question 9

Explain the main immunosuppressive effect of the corticosteroids.

A) The main immunosuppressive effect of the corticosteroids is to inhibit the synthesis of purine nucleotides that are required for the synthesis of deoxyribonucleic acid (DNA) and for cell growth and reproduction.
B) The main immunosuppressive effect of the corticosteroids is to kill and suppress the function of lymphocytes.
C) The main immunosuppressive effect of the corticosteroids is to cause lymphocytes in the blood to be redistributed into the bone marrow.
D) All of these are correct.

Question 10

Using the adverse-effects profile of infliximab (Remicade),educate a patient who is considering the use of the drug.

A) Administration of infliximab is associated with an infusion reaction that can include tremors and seizures.
B) Administration of infliximab is associated with an infusion reaction that can include hypotension, renal impairment, and chest pain.
C) Administration of infliximab is associated with an infusion reaction that can include fever, chills, hives, hypotension, and chest pain.
D) None of these are correct.

Question 11

Using immunomodulation and immunosuppression as the basis,select the correct information to give to a patient who does not understand their difference.

A) Immunosuppressing drugs are used after organ transplantation and in the treatment of severe inflammatory and allergic conditions when the immune system is hyperactive and causing harmful effects. Immunomodulating drugs are indicated for the
B) treatment of various cancers, hepatitis, myelosuppression, and other conditions where increasing the activity of the immune system is beneficial.
C) Immunosuppression refers to drugs and biological factors that decrease immune activity. Immunmodulation refers to actions or drugs that stimulate the activity of the immune system.
D) Immunosuppressing drugs are administered orally or by injection, and immuno-modulating drugs are administered by injection.
E) All of these are correct.

Question 12

Identify the main function of the macrophages.

A) Macrophages regulate the activity of the immune system.
B) Macrophages are cells that release chemicals that help us fight infection from infectious organisms and foreign substances.
C) Macrophages are scavenger cells that engulf and digest infectious organisms and foreign substances.
D) All of these are correct.

Question 13

An example of an immune-based disease that benefits from the drugs that suppress the immune response is:

A) Multiple sclerosis
B) Myasthenia gravis
C) Systemic lupus erythematosus
D) All of these are correct.

Question 14

Describe the common adverse effects of the use of the interferons.

A) Common adverse effects of the use of the interferons are nausea, vomiting, diarrhea, and muscle aches and pains.
B) Common adverse effects of the use of the interferons are flu-like symptoms: chills, fever, and muscle aches and pains.
C) Common adverse effects of the use of the interferons are nausea, vomiting, hair loss, and bone marrow depression.
D) None of these are correct.

Question 15

Using mechanism of action,explain to a patient with lupus erythematosus how azathioprine (Imuran) works.

A) Azathioprine prevents the production of adenine and guanine, which are required for the production of deoxyribonucleic acid (DNA) and for cell growth and reproduction. Inhibition of DNA synthesis leads to the death of many existing lymphocytes and suppresses the formation of new B-cells and T-cells.
B) Azathioprine causes B-cell production of antibodies and killer T-cell activity.
C) Azathioprine stimulates the bone marrow to increase the production of macrophages and granulocytes.
D) None of these are correct

Question 16

Using the terms mutagenic,carcinogenic,and teratogenic,select the false statement related to the adverse effects of azathioprine.

A) Azathioprine and the other cytotoxic drugs are capable of causing mutations in cells and tissues of the body.
B) Azathioprine and the other cytotoxic drugs are capable of causing cancer in cells and tissues of the body.
C) Azathioprine and the other cytotoxic drugs are capable of causing abnormal developments in cells and tissues of the body.
D) None of these are false.

Question 17

Select the true statement related to infliximab (Remicade) used in the treatment of Crohn's disease

A) Infliximab is a cytotoxic drug that inhibits the activity of the T-cells and B-cells.
B) Infliximab is a monoclonal antibody that binds to and inhibits the activity of tumor necrosis factor (TNF-alpha). TNF-alpha is a mediator of inflammation and immune activation.
C) Administration of infliximab is not associated with any adverse reactions.
D) None of these are correct.

Question 18

Using the adverse-effects profile,explain to a patient using filgrastim (Neupogen) which adverse reactions to report to the physician.

A) The patient should immediately report to the physician any fever, chills, GI disturbances, and muscle and bone pain.
B) The patient should immediately report to the physician any nausea, vomiting, hair loss, and bone pain.
C) The patient should immediately report to the physician any fever, flu-like symptoms, and fluid retention.
D) The patient should immediately report to the physician the presence of swollen glands, sore throat, and feelings of tiredness.

Question 19

Select the true statement that outlines the actions of a natural killer cell.

A) The natural killer cell releases perforins, which polymerize and form a hole in the enemy cell membrane.
B) Granzymes from the natural killer cell enter the perforin hole and degrade the enemy cell enzymes.
C) The enemy cell dies by apoptosis. The macrophage engulfs and digests the dying cell.
D) All of these are correct.

Question 20

Select the false statement related to the adverse effects of cyclophosphamide (Cytoxan).

A) Cyclophosphamide causes nausea, vomiting, alopecia (hair loss), and bone marrow depression.
B) During the metabolism of cyclophosphamide, a toxic metabolite is formed.
C) Increased fluid intake can minimize the incidence of the adverse effects of cyclophosphomide.
D) None of these are false.