Deck 17: Pneumonia in the Immunocompromised Patient

Question 1

Which of these is/are congenital immune system deficiencies?

A)IgA deficiency
B)Chronic granulomatous disease
C)MCH class II deficiency
D)All the above

Answer 1

D

Question 2

Where do polymorphonuclear cells originate?

A)Spleen
B)Thymus
C)Lymph nodes
D)Bone marrow

Answer 2

D

Question 3

Which of these is the first antibody produced at the onset of infection?

A)IgM
B)IgD
C)IgE
D)IgA

Answer 3

A

Question 4

Your patient has recurrent bouts of an uncommon type of pneumonia refractory to treatment.This should lead you to suspect

A)Pneumococcal pneumonia
B)Staphyloccal pneumonia
C)Opportunistic pneumonia
D)None of the above

Question 5

Which antibody goes on to be the major one fighting an infection?

A)IgD
B)IgE
C)IgG
D)IgM

Question 6

The reaction of cell-mediated immunity to an antigen is termed what?

A)Anaphylaxis
B)Cytotoxicity
C)Immune complex reaction
D)Delayed hypersensitivity

Question 7

All of the following laboratory findings are indicative of immunosuppression except

A)Lymphocytopenia
B)Neutropenia
C)Reduced CD4+ cells
D)Increased WBCs

Question 8

Which of these is not a principle characteristic governing immunity?

A)Recognition of non-self
B)Memory
C)Specificity
D)Simplicity

Question 9

All of the following are known causes of acquired (secondary)immunodeficiencies except:

A)Radiation
B)Selective IgA deficiency
C)Chemotherapy
D)Malnutrition

Question 10

Which of these immune deficiencies leads to chronic,recurrent pulmonary infections?

A)Selective IgA deficiency
B)AIDS
C)Neither A nor B
D)Both A and B

Question 11

Which is by far the most common deficiency in cell-mediated immunity?

A)MCH class II deficiency
B)AIDS
C)Hereditary ataxia-telangiectasia
D)Wiskott-Aldrich syndrome

Question 12

Which of these best describes the typical chest radiograph findings in an immunocompromised patient with pneumonia?

A)Diffuse densities
B)Localized density
C)Lower lobe involvement
D)No associated lymphadenopathy

Question 13

Which of these is not a subgroup of T lymphocytes?

A)Helper T cells
B)Natural killer T cells
C)Polymorphonuclear T cells
D)Suppressor T cells

Question 14

IV drug use,sexual promiscuity,and opportunistic lung infection should lead you to suspect

A)AIDS
B)Klebsiella pneumonia
C)Primary atypical pneumonia
D)None of the above

Question 15

Which of these is a polymorphonuclear leukocyte?

A)Neutrophil
B)Lymphocyte
C)Monocyte
D)None of the above

Question 16

Which of these is not an autoimmune disease?

A)Rheumatoid arthritis
B)Leprosy
C)Scleroderma
D)Systemic lupus erythematosis

Question 17

Which of the following white blood cells is the most common granulocyte and also has the most phagocytic capabillities?

A)Basophil
B)Neutrophil
C)Eosinophil
D)Monocyte

Question 18

All of the following are true regarding antigens except:

A)They have molecular configurations that are foreign to the host
B)Immune "memory" enables the body to mount an amplified response on subsequent antigen invasions
C)Antigens are nonspecific as to their molecular configuration
D)Vaccinations are antigens resembling the organism the body needs to defend itself against

Question 19

Which is/are true regarding antibodies?

A)They come in 5 classes: G,A,M,D,E
B)They are also called immunoglobulins
C)They originate from plasma cells
D)All the above

Question 20

What cells are the major constituent of pus?

A)Dead and alive neutrophils
B)Dead and alive macrophages
C)Dead and alive eosinophils
D)Dead and alive lymphocytes

Question 21

Which of the following is NOT a common opportunistic pulmonary infection seen in a patient with a compromised immune system?

A)P.jaroveci
B)Mycobacterium avium complex
C)Candida albicans
D)Streptococcal pneumoniae

Question 22

Which of these statements does not describe empiric therapy for immunocompromised pneumonia patients?

A)Is initiated with a broad-spectrum antibiotic
B)Is directed toward organisms least likely to have caused infection
C)Initiated without waiting for culture results
D)Is not directed at any as yet identified organisms

Question 23

What treatment is initially given to the immunocompromised patient with fungal pneumonia?

A)Amphotericin B
B)High-dose steroids
C)Sulfa antibiotics
D)Amoxicillin

Question 24

What is the initial clue to a serious infection in the neutropenic patient?

A)Muscle weakness
B)Fever
C)Decreased sensorium
D)Hair loss

Question 25

What are the initial staining techniques for sputum cultures in the immunocompromised?

A)Acid-fast stain
B)Gram stain
C)Neither A nor B
D)Both A and B

Question 26

Which of these classes of organisms does NOT cause disease in the immunocompromised patient?

A)Algae
B)Viruses
C)Fungi
D)Bacteria