Deck 18: Immune Disorders

Question 1

Transfusion reactions are the result of antibody reaction to

A) glycolipids and glycoproteins on the surface of red blood cells.
B) MHC molecules on red blood cells.
C) MHC molecules on white blood cells.
D) plasma proteins.
E) foreign antibodies.

Answer 1

A

Question 2

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.

Answer 2

D

Question 3

The release of ________ during a type I hypersensitivity reaction contributes to swelling.

A) histamine
B) prostaglandins
C) leukotrienes
D) both histamines and leukotrienes
E) both proteases and prostaglandins

Answer 3

D

Question 4

A person identified as a universal recipient has ________ blood type.

A) A
B) B
C) AB
D) O
E) Rh-negative

Question 5

Which of the following bind the constant region of IgE?

A) eosinophils
B) mast cells
C) monocytes
D) both mast cells and monocytes
E) both eosinophils and mast cells

Question 6

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

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

Question 7

What is the function of the kinins released when mast cells degranulate?

A) activation of the complement system
B) increased vascular permeability
C) smooth muscle contraction
D) increased production of tears and saliva
E) chemotactic factors

Question 8

Which of the following is a type of blood cell that undergoes degranulation in type I hypersensitivity reactions?

A) B cell
B) basophil
C) T cell
D) macrophage
E) plasma cell

Question 9

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

A) watery eyes after exposure to animals
B) destruction of red blood cells after an incompatible blood transfusion
C) farmer's lung
D) immune complexes accumulation in the kidneys
E) the tuberculin response

Question 10

Which of the following statements concerning the Rh factor is CORRECT?

A) The Rh antigen is on white blood cells.
B) Eighty-five percent of humans are Rh positive.
C) Preexisting antibodies occur in 85% of the population.
D) Rh antibodies are more abundant than the ABO antibodies.
E) Eighty-five percent of the human population is Rh negative.

Question 11

What is the cause of hemolytic disease of the newborn?

A) The mother has eosinophilia during pregnancy.
B) An O blood type mother produces anti-A antibodies which cross the placenta and react with the baby's A antigens.
C) Antibodies of an A or B blood type mother cross the placenta and react with baby's O antigens.
D) The mother produces anti-Rh antibodies which cross the placenta and react with baby's Rh antigens.
E) The mother's mast cells degranulate in the placenta, damaging it.

Question 12

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

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

Question 13

A reaction to an allergen is a ________ hypersensitivity.

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

Question 14

The non-leukocyte tissue cells known as ________ produce leukotrienes and prostaglandins in response to allergen binding.

A) neutrophils
B) basophils
C) monocytes
D) lymphocytes
E) mast cells

Question 15

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

Question 16

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

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

Question 17

Which of the following is both a hypersensitivity disorder and an autoimmune disorder?

A) anaphylaxis
B) glomerulonephritis
C) graft rejection
D) hemolytic disease of the newborn
E) rheumatoid arthritis

Question 18

When immune complexes in the blood become trapped in the kidneys the resulting disease is known as

A) autoimmunity.
B) hemolytic disease.
C) glomerulonephritis.
D) urticaria.
E) anaphylaxis.

Question 19

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

Question 20

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

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

Question 21

The condition known as graft-versus-host disease may result after

A) a bone marrow allograft.
B) a mismatched blood transfusion.
C) a bone allograft.
D) a plasmapheresis procedure.
E) any type of allograft procedure.

Question 22

Primary immunodeficiency diseases

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

Question 23

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) autoimmunity.
E) graft rejection.

Question 24

The tuberculin response is mediated by

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

Question 25

Failure of thymus development may result in

A) type I diabetes.
B) Grave's disease.
C) Bruton-type agammaglobulinemia.
D) DiGeorge syndrome.
E) chronic granulomatous disease.

Question 26

Which hypersensitivity disorder is the result of cell-mediated response?

A) type I
B) type II
C) type III
D) type IV
E) both type I and II

Question 27

A child has a history of recurring serious bacterial infections. A blood sample shows lymphocyte levels are a little below normal, and no antibodies to the pathogens are detected in serologic tests. Based on this information, which of the following is the likeliest diagnosis for this child?

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

Question 28

The HIV virion attaches to ________ on the surface of lymphocytes.

A) IgG
B) MHC II
C) IL-2R
D) CD4
E) CD3

Question 29

Which of the following is the mechanism of action of cyclosporine?

A) It blocks the complement cascade.
B) It blocks the activity of activated Th1 T cells.
C) It directly blocks CTL activity.
D) It interferes with activation of Th2 T cells.
E) It is an anti-inflammatory interfering with leukotriene function.

Question 30

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

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

Question 31

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

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

Question 32

What is the underlying problem in most acquired immunodeficiencies?

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

Question 33

Which of the following statements concerning allografts is TRUE?

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

Question 34

Treatment with glucocorticoids to suppress type IV hypersensitivity may result in

A) acquired immunodeficiency.
B) anaphylaxis.
C) autoimmune disease.
D) DiGeorge syndrome.
E) primary immunodeficiency.

Question 35

Hypotheses explaining the development of autoimmune disease include

A) molecular mimicry.
B) genetic factors.
C) overuse of vaccines.
D) molecular mimicry and vaccines.
E) molecular mimicry and genetic factors.

Question 36

Type I diabetes is a(n)

A) autoimmune disease.
B) immunodeficiency disease.
C) immune complex-mediated hypersensitivity disorder.
D) delayed hypersensitivity disorder.
E) immediate hypersensitivity disorder.

Question 37

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) corticosteroids
B) cyclophosphamide
C) azathioprine
D) methylprednisolone
E) antihistamines

Question 38

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

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

Question 39

Antibody binding to receptors on the thyroid may result in

A) multiple sclerosis.
B) Graves' disease.
C) DiGeorge syndrome.
D) type I diabetes.
E) autoimmune hemolytic anemia.

Question 40

Multiple sclerosis is

A) a type IV hypersensitivity disease in which cytotoxic T cells attack the myelin sheath of neurons.
B) a genetic birth defect of the nervous system.
C) a type II hypersensitivity to the myelin of neurons.
D) the formation of antibodies against transplanted tissue.
E) a neurological disease due to the accumulation of immune complexes in nerves.

Question 41

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

Question 42

Which of the following types of cells is NOT infected by HIV?

A) T cells
B) B cells
C) macrophages
D) monocytes
E) microglia

Question 43

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

Question 44

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

Question 45

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

Question 46

Depletion of the helper T cell population by HIV results in the development of AIDS.

Question 47

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

Question 48

Graft rejection can be reduced by

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

Question 49

The syndrome known as AIDS is characterized

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

Question 50

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

Question 51

Opportunistic infections typical of AIDS but rare otherwise include

A) tuberculosis.
B) Pneumocystis pneumonia.
C) Kaposi's sarcoma.
D) tuberculosis and shingles.
E) Pneumocystis pneumonia and Kaposi's sarcoma.

Question 52

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

Question 53

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

Question 54

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

Question 55

All autoimmune diseases have a genetic cause.

Question 56

Contact dermatitis is a type (I/II/III/IV) hypersensitivity disorder.

Question 57

Individuals with AB blood type are called "universal donors" because they do not have antibodies against blood group antigens.

Question 58

Systemic lupus erythematosus (SLE or lupus) is distinct from other autoimmune disorders because

A) it is also a hypersensitivity disorder.
B) it involves an antibody response.
C) multiple organs and tissues are affected.
D) it may be triggered by an infection.
E) there is a genetic predisposition.

Question 59

Rheumatoid arthritis is a type (I/II/III/IV) hypersensitivity reaction that results when B cells produce autoantibodies that damage the joints.

Question 60

The tuberculin response is an example of allergic contact dermatitis.

Question 61

Chronic granulomatous disease is a disorder of the (first/second/third) line of immune defense.

Question 62

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

Question 63

The effectiveness of ART is determined by (ELISA/IFA/PCR) testing.

Question 64

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 65

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

Question 66

When the release of chemicals in an allergic reaction exceeds the body's ability to adjust, a life-threatening condition called (anaphylaxis/autoimmunity/inflammation) may occur.

Question 67

The most common type of transplant involves an (allograft/autograft/isograft).

Question 68

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

Question 69

Immunological attack on the islets of Langerhans resulting in the inability to produce insulin leads to type (I/II/IV) diabetes Mellitus.

Question 70

The mechanism of action of RhoGAM is to (activate/neutralize/prevent) an anti-Rh immune response.

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

In the wake of the recent Ebola outbreak in West Africa, researchers have observed infectious Ebola virus is present in the eyes and semen of infected individuals months after apparent recovery from the acute stage of the disease. Based on information in this chapter, propose an explanation for this observation.

Question 73

Graves' disease is an autoimmune disease that affects the (lymph/thyroid/adrenal) gland.

Question 74

Describe the tuberculin response and identify the type of response involved.

Question 75

Many of the signs and symptoms of inflammation, including redness and itching, are due to the release of (histamines/leukotrienes/proteases) by degranulation of mast cells.