Deck 18: Aids and Other Immune Disorders

Question 1

The events illustrated in the figure are part of a(n) disorder.

A) type I hypersensitivity
B) type II hypersensitivity
C) type III hypersensitivity
D) immunodeficiency
E) autoimmune

Answer 1

A

Question 2

If circulating immune complexes are deposited in the glomeruli, the ensuing type III hypersensitivity reaction can result in

A) kidney damage.
B) allergic contact dermatitis.
C) rheumatoid arthritis.
D) pneumonitis.
E) multiple sclerosis.

Answer 2

A

Question 3

Which of the following blood types can be safely transfused into someone with O blood type?

A) O
B) A
C) B
D) A and O
E) A, B, and O

Answer 3

A

Question 4

Which of the following reactions is the result of type IV (delayed) hypersensitivity?

A) breathing difficulties after exposure to mold spores
B) dermatitis in response to latex gloves
C) skin irritation after wearing wool
D) sensitivity to pet dander
E) runny nose triggered by pollen

Question 5

The destruction of tissue cells resulting from severe allergic reaction is due to the release of

A) proteases.
B) leukotrienes.
C) histamines.
D) kinins.
E) prostaglandins.

Question 6

Which of the following could result in hemolytic disease of the newborn?

A) Rh-positive mother and Rh-positive father
B) Rh-negative mother and Rh-positive father
C) Rh-negative mother and Rh-negative father
D) Rh-positive mother and Rh-negative father
E) either Rh-positive mother and Rh-negative father or Rh-negative mother and Rh-positive father

Question 7

Immediate hypersensitivity reactions result when a first exposure to antigen results in

A) activation of IgG-producing B cells.
B) activation of IgE-producing B cells.
C) the activation of CTL.
D) an elevation of eosinophils.
E) activation of IgA-producing B cells.

Question 8

The redness, swelling and itching of urticaria is due to release.

A) kinin
B) protease
C) kinin and protease
D) leukotriene
E) histamine

Question 9

Which of the following is an example of a type I hypersensitivity reaction?

A) destruction of red blood cells after an incompatible blood transfusion
B) farmerʹs lung
C) the tuberculin response
D) watery eyes after exposure to animal dander
E) deposition of immune complexes in the glomeruli of the kidneys

Question 10

When mast cells degranulate and release histamine, which of the following events may occur?

A) constriction of small blood vessels
B) increased mucus production
C) bronchial spasms
D) both constriction of small blood vessels and bronchial spasms
E) both bronchial spasms and increased mucus production

Question 11

The constriction of the airways and mucus production of asthma is the result of a(n) response.

A) type II hypersensitivity
B) delayed hypersensitivity
C) autoimmune
D) type III hypersensitivity
E) type I hypersensitivity

Question 12

How is hemolytic disease of the newborn prevented?

A) treating with glucocorticoids throughout pregnancy
B) administering anti-IgG antibodies during pregnancy
C) immunizing a woman against Rh factor prior to pregnancy
D) administering anti-Rh IgG late in pregnancy and after pregnancy ends
E) treating with cytokines to prevent B cell activation late in pregnancy

Question 13

A small amount of antigen is injected under the skin of a patient. After 30 minutes there is no apparent change at the injection site, but 36 hours later the patient reports that the area is red and swollen. This type of response is due to

A) type I hypersensitivity.
B) type II hypersensitivity.
C) type III hypersensitivity.
D) type IV hypersensitivity.
E) immunodeficiency.

Question 14

A person with no siblings or children receives a kidney transplant. The kidney is an example of a(n)

A) xenograft.
B) autograft.
C) dermograft.
D) allograft.
E) isograft.

Question 15

Which of the following is NOT considered a hypersensitivity reaction?

A) dermatitis at the site of a metal watchband
B) a rash caused by poison ivy
C) breaking into hives after eating strawberries
D) itchy eyes and a runny nose in a dusty environment
E) immune system attack on the thyroid gland

Question 16

Jess has A- blood type, has never received a blood transfusion, and has never been pregnant. Antibodies against what blood antigens will be present in Jessʹ blood?

A) O and Rh antigens
B) B and Rh antigens
C) B antigens
D) O antigens
E) A antigens

Question 17

An agricultural worker experiences difficulty breathing, which becomes progressively worse. Tests show inflammation and damage of the lung tissue, but IgE antibodies and granulocytes are in the normal ranges. With which disorder of the immune system are these signs and symptoms consistent?

A) type III (immune complex-mediated) hypersensitivity
B) acquired immunodeficiency
C) autoimmunity
D) type IV (delayed) hypersensitivity
E) allergic reaction

Question 18

The glycoprotein and glycolipid molecules on the surface of red blood cells

A) stimulate the production of antibodies that contribute to a transfusion reaction.
B) cause degranulation of the cell when it is exposed to allergens.
C) act to transport glucose and ions across the cytoplasmic membrane.
D) function as a binding site for IgD.
E) act as receptors for foreign antigens and trigger an early immune response.

Question 19

An accident victim receives a blood transfusion. Shortly thereafter, he begins to have difficulty breathing, develops a fever, and experiences nausea and vomiting. Which of the following is the most likely interpretation of these events?

A) The blood transfusion was mismatched and contained pyrogens.
B) The blood transfusion was mismatched.
C) The recipient had previously been exposed to foreign blood group antigens.
D) The blood transfusion contained pyrogens.
E) The blood transfusion was mismatched and the recipient had previously been exposed to the foreign blood group antigens.

Question 20

Which of the following immunoglobulins is produced by plasma cells in response to an allergen?

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

Question 21

Hypotheses explaining the development of autoimmune disease include

A) hormonal stimulation of cytotoxic T cells.
B) anaphylactic shock triggered by molecular mimicry.
C) molecular mimicry.
D) genetic factors.
E) molecular mimicry, genetic factors, and hormonal stimulation of cytotoxic T cells.

Question 22

The disease known as is a disorder in which phagocytes are inefficient at killing bacteria.

A) chronic granulomatous disease
B) immune thrombocytopenic purpura
C) autoimmune hemolytic anemia
D) severe combined immunodeficiency disease
E) hemolytic disease of the newborn

Question 23

Which of the following statements concerning rheumatoid arthritis (RA) is TRUE?

A) The onset of disease is clearly correlated with having been infected with a specific microbe.
B) Accumulations of antibody complexes lead to inflammation in and destruction of the joints.
C) The symptoms are due to damage caused by cytotoxic T cells.
D) There is no genetic influence on the likelihood of developing RA.
E) It occurs in humans and animals.

Question 24

Which of the following statements concerning allografts is TRUE?

A) They induce strong type IV hypersensitivity reactions and must be treated with immunosuppressive drugs.
B) They are the best type of transplants because they are not associated with rejection.
C) They are impossible to perform because the antigens between donor and recipient are so different.
D) They are the rarest type of transplants.
E) They always require complete destruction of the recipientʹs bone marrow cells.

Question 25

Monoclonal antibodies that bind the IL-2 receptor have been successfully used to reverse graft rejection. Why is this approach effective?

A) B cells are suppressed by exposure to IL-2.
B) IL-2 suppresses Th 2 cells.
C) IL-2 stimulates the activity of CTL.
D) IL-2 is an immunosuppressive cytokine.
E) IL-2 contributes to type VI hypersensitivity responses.

Question 26

Primary immunodeficiency diseases

A) develop later in life.
B) are never associated with genetic defects.
C) may be caused by malnutrition.
D) are sometimes caused by severe stress.
E) are detectable close to birth.

Question 27

A young woman comes into the clinic complaining of itchy, red skin and swelling on her arms and legs. She had not been in any parks or wooded areas recently, but she had been shopping. A blood sample reveals elevated levels of granulocytes. What treatment is the physician likely to prescribe at this point?

A) antihistamines
B) interferon
C) corticosteroids
D) cyclophosphamide
E) methotrexate

Question 28

Which of the following would test positive for the tuberculin response?

A) someone who has previously been injected subcutaneously with tuberculin
B) someone who has previously had tuberculosis
C) someone who has been immunized with the tuberculosis vaccine
D) someone who has been immunized with the tuberculosis vaccine or has previously had tuberculosis
E) someone who has been immunized with the tuberculosis vaccine or previously been injected subcutaneously with tuberculin

Question 29

Which condition occurs when antibodies bind to and stimulate receptors that elicit production of thyroid hormone and growth of the thyroid gland?

A) DiGeorge syndrome
B) multiple sclerosis
C) farmerʹs lung
D) type I diabetes
E) Gravesʹ disease

Question 30

What is the underlying problem in most acquired immunodeficiencies?

A) production of autoantibodies
B) anemia
C) declining humoral immunity
D) declining cell-mediated immunity
E) eosinophilia

Question 31

The responses observed in type IV hypersensitivities result from the action of

A) IgE antibodies and mast cells.
B) IgG and complement.
C) inflammatory chemicals.
D) T cells and phagocytes.
E) autoantibodies.

Question 32

An acquired immunodeficiency may result from treatment with

A) antihistamine.
B) RhoGAM.
C) azathioprine.
D) corticosteroids.
E) interferon.

Question 33

The production of cytotoxic T cells specific for the myelin sheath of neurons leads to the disorder known as

A) type 1 diabetes mellitus.
B) Graveʹs disease.
C) systemic lupus erythematosus.
D) multiple sclerosis.
E) autoimmune neuralgia.

Question 34

The name systemic lupus erythematosus refers in part to the distinctive rash resulting from

A) the release of histamines and kinins in response to sunburn.
B) CTL attack on connective tissue fibroblasts.
C) CTL attack on skin cells altered by sun damage.
D) antibody-antigen complexes accumulating in the skin.
E) autoantibodies causing mast cell degranulation.

Question 35

The tuberculin response is mediated by

A) memory T cells.
B) B lymphocytes.
C) mast cells.
D) plasma cells.
E) eosinophils.

Question 36

A person comes to the clinic complaining of aching joints and muscles, swelling, and a decrease in urine output. The clinician also notes a rash on the skin of the face. A probable diagnosis is

A) pneumonitis.
B) Gravesʹ disease.
C) systemic lupus erythematosus.
D) immunodeficiency.
E) dermatitis.

Question 37

If a T cell is exposed to a ʺhiddenʺ antigen, what kind of immune reaction will result?

A) an autoimmune disease
B) an allergy
C) a cytotoxic hypersensitivity reaction
D) a delayed hypersensitivity reaction
E) allergic contact dermatitis

Question 38

A child has a history of repeated severe infections and frequently has recurring infections with the same bacterial pathogen. A blood sample shows some lymphopenia and serological tests are negative. Based on this information, which of the following is the likeliest diagnosis for this child?

A) systemic lupus erythematosus (SLE)
B) Bruton-type agammaglobulinemia
C) severe combined immune deficiency (SCID)
D) hemolytic disease of the newborn
E) DiGeorge syndrome

Question 39

A combination of genetic predisposition and viral infection is suspected in the development of

A) Bruton-type agammaglobulinemia.
B) type 1 diabetes mellitus.
C) autoimmune hemolytic anemia.
D) rheumatoid arthritis.
E) glomerulonephritis.

Question 40

Antigen-antibody complexes trapped in tissues and triggering complement activation or mast cell degranulation are characteristic of

A) type I hypersensitivity.
B) type II hypersensitivity.
C) type III hypersensitivity.
D) graft rejection.
E) autoimmunity.

Question 41

All autoimmune diseases have a genetic cause.

Question 42

Rheumatoid arthritis is a type (I/II/III/IV) hypersensitivity reaction that results when B cells produce autoantibodies that damage the cartilage in the joints. (Be sure to use Roman numerals in your answer.)

Question 43

Anaphylactic shock is a type III hypersensitivity disorder.

Question 44

Contact dermatitis is a type (I/II/III/IV) hypersensitivity disorder. (Be sure to use Roman numerals in your answer.)

Question 45

Xenografts are tissue transplants from one individual to another within the same species.

Question 46

If an Rh-positive woman marries an Rh-negative man, their children are at risk for hemolytic disease of the newborn.

Question 47

Severe malnutrition may lead to immunodeficiency by

A) preventing to proliferation of B cells.
B) promoting the development of food allergies.
C) decreasing the ability of the body to produce phagocytes.
D) triggering an inflammatory response.
E) triggering the proliferation of T cells.

Question 48

Type I hypersensitivity reactions are also commonly known as (allergies/autoimmunities/inflammation).

Question 49

The figure represents the HIV infection cycle. What virus-specified proteins are required for the
Events indicated by 1 and 2? (Be sure they are in the correct sequence.)

A) reverse transcriptase, protease
B) RNA polymerase, gp120
C) integrase, protease
D) gp41, protease
E) integrase, gp120

Question 50

Infection with certain viruses may lead to the development of type I diabetes.

Question 51

The syndrome known as AIDS is characterized by

A) the presence of HIV.
B) an opportunistic disease resulting from herpesvirus reactivation.
C) one or more opportunistic diseases and the presence of HIV.
D) CTL attack on CD4 T cells.
E) the presence of anti-HIV antibodies.

Question 52

Systemic lupus erythematosus (SLE) is a disease resulting from accumulation of immune complexes in various organs and tissues.

Question 53

Normally, complement-activating immune complexes are eliminated from the body by phagocytosis.

Question 54

MHC genes are significant genetic factors in predisposition to develop autoimmune disease.)

Question 55

Although autoantibodies to nucleic acids are characteristic of (HIV/GVH/SLE), many other autoantibodies are produced.

Question 56

Graft rejection can be reduced by

A) preventing T cell proliferation.
B) preventing B cell activation.
C) antiphagocytic factors.
D) epinephrine.
E) antihistamines.

Question 57

Opportunistic infections typical of AIDS but rare otherwise include

A) tuberculosis.
B) Pneumocystis pneumonia.
C) tuberculosis and shingles.
D) Pneumocystis pneumonia and Kaposiʹs sarcoma.
E) Kaposiʹs sarcoma.

Question 58

Children with Bruton-type agammaglobulinemia are highly susceptible to recurrent bacterial infections.

Question 59

In most cases, production of antibodies against foreign ABO antigens is stimulated by exposure to foreign blood cells.

Question 60

Critically low levels of CD4 lymphocytes are a key diagnostic indicator of (AIDS/SCID/SLE).

Question 61

Failure of the (spleen/thymus/thyroid) to develop results in DiGeorge syndrome.

Question 62

Hashimotoʹs thyroiditis and Gravesʹ disease are autoimmune diseases involving the thyroid, but Hashimotoʹs results in hypothyroidism (low thyroid function), whereas Gravesʹ results in hyperthyroidism (overactive thyroid). Both diseases are characterized by antithyroid antibodies. Discuss ways in which the autoimmune responses may produce the different outcomes.

Question 63

The (histamines/leukotrienes/prostaglandins/proteases) released in an immediate hypersensitivity reaction leads to the destruction of nearby cells and the activation of the complement system.

Question 64

A positive response on a tuberculin test is an example of a type (I/II/III/IV) hypersensitivity response. (Be sure to use Roman numerals in your answer.)

Question 65

A graft that is from one identical twin to another is an (allograft/autograft/isograft).

Question 66

A recent news story claimed a man was cured of AIDS by a bone marrow transplant he had received three years previously for treatment of leukemia. The donor bone marrow cells lacked the fusin (CCR) protein. Discuss basis for this claim and whether or not it is reasonable.

Question 67

A person with (A/B/AB/O) blood type can safely receive any blood type for transfusion.

Question 68

One feature of hemolytic disease of the newborn is excessive (erythrocytes/bilirubin/hemoglobin), which leads to jaundice in the newborn.

Question 69

A patient arrives at a hospital suffering from serious difficulty breathing and shortness of breath. Initial tests indicate none of the standard respiratory infectious agents are present. The physician suspects an immune disorder. What clinical indicators would distinguish between asthma, pneumonitis and Pneumocystic pneumonia?

Question 70

Compare and contrast type I hypersensitivity with type IV hypersensitivity with respect to reaction time, mediators, and cells involved.

Question 71

One of the important inherited defects in the second line of immune defense is a condition called chronic granulomatous disease. What is this disease, and how is it caused?

Question 72

Stress may result in the production of (corticosteroids/leukotrienes/interleukins), which may lead to acquired immunodeficiency disease.

Question 73

Type 1 diabetes mellitus is the result of CTL attack on the (kidney/pancreas/thyroid).

Question 74

Binding of IgE to the surface of sensitized cells leads to (activation/degranulation/lysis) of the cell, releasing many inflammatory chemicals.

Question 75

The damage caused by mismatched blood transfusions results from the activation of (antibody/complement/histamine) proteins.