Chapter 11 quiz (13,16,17) Flashcards Preview

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Flashcards in Chapter 11 quiz (13,16,17) Deck (115):
1

_____ results when a gene affecting the immune system mutates, thereby compromising the immune defense against infection.

a. gene conversion

b. epidemics

c. primary immunodeficiency disease

d. secondary immunodeficiency disease

e. seroconversion

c. primary immunodeficiency disease

2

A primary immune response against influenza virus produces antibodies that bind to _____.

a. hemagglutinin and neuraminidase

b. variable surface glycoproteins

c. EBNA-1

d. protein toxins

e. gp41 and gp120

a. hemagglutinin and neuraminidase

3

The serotypes of Streptococcus pneumoniae differ in their _____.

a. superantigen products

b. ability to fix complement

c. rates of gene conversion

d. capsular polysaccharides

e. variable surface glycoproteins

d. capsular polysaccharides

4

All of the following are associated with the ability of influenza virus to escape from immunity except _____.

a. age

b. error-prone replication of its DNA genome

c. co-infection with avian and human influenza viruses

d. recombinant strains

e. the phenomenon of Ôoriginal antigenic sinÕ

b. error-prone replication of its DNA genome

5

All of the following use gene conversion to avoid immune detection except _____.

a. Salmonella typhimurium

b. Trypanosoma brucei

c. Treponema pallidum

d. Neisseria gonorrhoeae

e. None of the above

c. Treponema pallidum

6

Genes encoding _____ rearrange in trypanosomes permitting replication and survival of the pathogen until the host produces an antibody response against the altered gene product.

a. pilin

b. flagellin

c. variable surface glycoproteins (VSGs)

d. hemagglutinin

e. neuraminidase

c. variable surface glycoproteins (VSGs)

7

_____ is a strategy used by herpesviruses where replication and the generation of virus-derived peptides are avoided in order to hide from the immune response.

a. latency

b. antigenic shift

c. antigenic drift

d. seroconversion

e. gene conversion

a. latency

8

Which of the following statements regarding herpes simplex virus is false?

a. Because sensory neurons express low levels of MHC class I molecules, they provide appropriate sites for viral dormancy.

b. Reactivation of herpesviruses follows stressful incidents.

c. Cold sores develop as a consequence of CD8 T-cell killing.

d. In oneÕs lifetime, periodic episodes of reactivation are common.

e. Herpes simplex virus infects B lymphocytes.

e. Herpes simplex virus infects B lymphocytes.

9

Which of the following is not associated with the reactivation of herpesviruses?

a. hormonal fluctuations

b. antibody deficiency

c. bacterial infection

d. immunosuppression

e. ultraviolet radiation

b. antibody deficiency

10

Herpesviruses include all of the following except _____.

a. varicella-zoster

b. Epstein-Barr virus

c. herpes simplex virus

d. cytomegalovirus

e. All of the above are herpesviruses.

e. All of the above are herpesviruses.

11

Shingles is associated with infection by _____.

a. Epstein-Barr virus

b. Staphylococcus aureus

c. herpes zoster

d. Candida albicans

e. Listeria monocytogenes

c. herpes zoster

12

Superantigens bind to all of the following molecules except _____.

a. CD4

b. MHC class II alpha chain

c. CD28

d. T-cell receptor Vbeta chain

e. B-cell receptor

d. T-cell receptor Vbeta chain

13

All of the following are associated with superantigens except _____.

a. effective at minuscule concentrations

b. nonspecific activation of 2-20% of CD8 T cells

c. processing to peptides is not required for T-cell activation

d. massive production of IL-2, IFN-gamma, and TNF-alpha

e. activate alpha:beta T cells

b. nonspecific activation of 2-20% of CD8 T cells

14

Staphylococcal superantigen-like protein 7 (SSLP7) produced by Staphylococcus aureus, binds to _____ and thereby prevents the killing of the bacterium by the host immune system during infection.

a. NK-cell activating receptors

b. C5 complement protein and Fc region of IgA

c. B-cell receptor

d. CD8 co-receptor

e. T-cell receptor Vbeta chain

b. C5 complement protein and Fc region of IgA

15

Which of the following is not associated with bacterial infection due to a genetic defect in or pathogen-induced subversion of normal phagocytic processes?

a. leukocyte adhesion deficiency

b. chronic granulomatous disease

c. hereditary angioedema

d. Chediak-Higashi syndrome

e. Listeria monocytogenes

c. hereditary angioedema

16

Which of these characteristics is not true of IFN-gamma?

a. When it acts on target cells, it enhances the engulfment and killing of bacteria.

b. It is the major activating cytokine of macrophages.

c. It activates the JAK-STAT signal transduction pathway after binding to its cognate receptor.

d. It is secreted by CD8 cytotoxic T cells, CD4 Th1 cells, and NK cells.

e. It is secreted and functions as a monomer but facilitates the dimerization of its receptor.

e. It is secreted and functions as a monomer but facilitates the dimerization of its receptor.

17

Dominant mutant forms of IFNgammaR1 exhibit all of the following in heterozygotes except _____.

a. they are recycled by endocytosis more quickly than the normal receptor

b. the cytoplasmic tail is truncated

c. they are able to form stable dimers with the normal form

d. they cause less severe immunodeficiency than do the homozygous recessive forms

e. they are unable to transduce signals when bound to the normal form

a. they are recycled by endocytosis more quickly than the normal receptor

18

Individuals with an antibody deficiency are more susceptible to infections by all of the following except _____.

a. Streptococcus pneumoniae

b. Haemophilus influenzae

c. Streptococcus pyogenes

d. Mycobacterium tuberculosis

e. Staphylococcus aureus

d. Mycobacterium tuberculosis

19

All of the following are X-linked immunodeficiencies except _____.

a. WiskottÐAldrich syndrome caused by deficiency of WASP

b. hyper IgM syndrome caused by deficiency of CD40 ligand

c. lymphoproliferative syndrome caused by deficiency of SH2D1A

d. Chediak-Higashi syndrome caused by deficiency of CHS1

e. agammaglobulinemia caused by deficiency of Bruton tyrosine kinase

d. Chediak-Higashi syndrome caused by deficiency of CHS1

20

Paroxysmal nocturnal hemoglobinuria is caused by _____.

a. a profound deficiency of neutrophils

b. leukocytosis

c. immune-complex deposition in tissues

d. defects in recruitment of phagocytes to infected tissues

e. complement-mediated lysis of erythrocytes

e. complement-mediated lysis of erythrocytes

21

All of the following are associated with hereditary angioedema except _____.

a. possible death by suffocation

b. overproduction of vasoactive C2a fragment and peptide bradykinin

c. hyporesponsiveness of classical complement pathway

d. subepithelial edema

e. C1 inhibitor deficiency

c. hyporesponsiveness of classical complement pathway

22

Severe combined immune deficiency (SCID) describes a condition in which neither _____ nor _____ are functional.

a. classical; alternative pathways of complement

b. T-cell-dependent antibody responses; cell-mediated immune responses

c. innate; acquired immune responses

d. MHC class I; MHC class II molecules

b. T-cell-dependent antibody responses; cell-mediated immune responses

23

Mutations affecting all of the following except _____ interfere directly with the rearrangement of immunoglobulin and T-cell receptor genes.

a. Artemis

b. purine nucleoside phosphorylase (PNP)

c. DNA-dependent protein kinase (DNA-PK)

d. RAG-1

e. RAG-2

b. purine nucleoside phosphorylase (PNP)

24

A deficiency in _____ causes a condition that closely resembles X-linked severe combined immunodeficiency and is characterized by inefficient cytokine signalling.

a. adenosine deaminase (ADA)

b. class II transactivator (CIITA)

c. TAP1 or TAP2

d. RAG1 or RAG2

e. Janus 3 kinase (Jak3)

e. Janus 3 kinase (Jak3)

25

Patients who lack _____ are very susceptible to infections with intracellular bacteria, including the ubiquitous nontuberculous strains of mycobacteria.

a. CD40 ligand

b. IL-12 and IFN-gamma receptors

c. properdin (factor P)

d. CD18

e. IL-1 receptor

b. IL-12 and IFN-gamma receptors

26

Which of the following explains why Streptococcus pneumoniae can infect an individual recurrently?

a. Previous infection with S. pneumoniae wears down the immune system over time.

b. S.Êpneumoniae is never completely eradicated during an infection and can reactivate if the host is immunocompromised.

c. Immune responses against S. pneumoniae are serotype-specific and protect only against strains that possess the same capsular polysaccharide antigens.

d. Anti-capsular antibodies are cleared from the host quickly after an active infection.

e. The capsular polysaccharide antigens of S. pneumoniae do not induce immunological memory.

c. Immune responses against S. pneumoniae are serotype-specific and protect only against strains that possess the same capsular polysaccharide antigens.

27

Protective antibodies generated in response to influenza virus bind to _____ of the viral envelope.

a. hemagglutinin and neuraminidase

b. polysaccharides

c. variable surface glycoproteins

d. superantigens

e. gp41 and gp120

a. hemagglutinin and neuraminidase

28

All of the following contribute to new epidemics and the long-term survival of the influenza virus in the human population, except:

a. New viral strains possess epitopes not recognized by antibodies made in the previous epidemic.

b. The first influenza strain provoking a primary immune response constrains the types of antibodies made during a subsequent encounter with a different strain.

c. The virus loses the capacity to express hemagglutinin, thereby rendering neutralizing antibodies useless.

d. The RNA genome of the influenza virus is subject to point mutations during viral replication.

e. None of the above.

c. The virus loses the capacity to express hemagglutinin, thereby rendering neutralizing antibodies useless.

29

An epidemic affects _____, whereas a pandemic affects _____.

a. susceptible individuals; immune individuals

b. immune individuals; susceptible individuals

c. global populations; local populations

d. local populations; global populations

d. local populations; global populations

30

_____ cause(s) mild and limited disease, whereas _____ cause(s) more severe disease and higher mortality.

a. Antigenic drift; antigenic shift

b. Antigenic shift; antigenic drift

c. Epidemics; pandemics

d. Pandemics; epidemics

a. Antigenic drift; antigenic shift

31

Which of the following is not a virus that can cause a persistent infection in the host by establishing latency?

a. influenza virus

b. herpes simplex virus

c. varicella-zoster

d. Epstein-Barr virus

e. human immunodeficiency virus

a. influenza virus

32

Trypanosomes escape from adaptive immunity by altering the type of _____ expressed on the parasite surface.

a. neuraminidase

b. hemagglutinin

c. variable surface glycoprotein (VSG)

d. superantigen

e. capsular polysaccharide

c. variable surface glycoprotein (VSG)

33

EpsteinÐBarr virus infects and establishes latency in _____, gaining entry by binding to _____.

a. B cells; CR2

b. T cells; CD4

c. T cells; CD8

d. neurons; MHC class I

e. B cells; EBNA-1

a. B cells; CR2

34

Which of the following is not used by the herpes simplex virus to subvert host immune responses?

a. a virus-encoded Fc receptor

b. a virus-encoded complement receptor

c. inhibition of MHC class I expression

d. inhibition of peptide transport by transporter associated with antigen processing (TAP)

e. inhibition of ICAM-1 expression

e. inhibition of ICAM-1 expression

35

Listeria monocytogenes replicates in _____ of macrophages after _____.

a. the phagosome; inhibition of fusion of the phagosome with the lysosome

b. the cytosol; escaping from the phagosome

c. a specialized membrane-bound vesicle; infection of the cell

d. extracellular spaces; coating itself with human proteins

e. nucleus; fusion with the nuclear membrane

b. the cytosol; escaping from the phagosome

36

Which of the following is not a characteristic of staphylococcal enterotoxins?

a. They bind to MHC class I molecules and T-cell receptors.

b. They cause T cells to divide and differentiate into effector T cells.

c. They stimulate between 2% and 20% of the total T-cell population.

d. They cause excessive synthesis and release of cytokines.

e. They induce suppression of the immune response by causing T cells to undergo apoptosis.

a. They bind to MHC class I molecules and T-cell receptors.

37

Which of the following statements regarding inherited immunodeficiency diseases is correct?

a. Affected individuals are less susceptible to infection.

b. Mortality rates are reduced by the administration of antibiotics to affected individuals.

c. Most deficiency syndromes are caused by dominant gene defects.

d. Women are more likely than men to inherit X-linked immunodeficiencies.

e. Extracellular bacterial infections are common in deficiency syndromes with T-cell defects.

b. Mortality rates are reduced by the administration of antibiotics to affected individuals.

38

Individuals with an immunodeficiency affecting B-cell function are more susceptible to infections caused by which of the following pathogens?

a. Toxoplasma gondii

b. respiratory syncytial virus

c. Haemophilus influenzae

d. Listeria monocytogenes

e. Mycobacterium tuberculosis

c. Haemophilus influenzae

39

Which of the following deficiency syndromes affects T-cell but not B-cell function?

a. X-linked agammaglobulinemia

b. X-linked hyper IgM syndrome

c. X-linked lymphoproliferative syndrome

d. X-linked SCID

e. X-linked Wiskott-Aldrich syndrome

e. X-linked Wiskott-Aldrich syndrome

40

Chronic granulomatous disease (CGD), a condition resulting in chronic bacterial and fungal infections, is caused by one or more defects in _____, compromising the ability of macrophages to _____.

a. CD18; produce cell adhesion molecules

b. NADPH oxidase; produce superoxide radical

c. CD40 ligand; produce GM-CSF

d. C5-C9; defend against Neisseria

e. C3; opsonize capsulated bacteria

b. NADPH oxidase; produce superoxide radical

41

A genetic defect in _____ results in the accumulation of toxic levels of nucleotide metabolites and loss of T-cell function.

a. NADPH oxidase

b. glucose-6-phosphate dehydrogenase

c. myeloperoxidase

d. SH2D1A

e. adenosine deaminase (ADA)

e. adenosine deaminase (ADA)

42

Herpes simplex virus favours neurons for latency because of the low level of _____, which reduces the likelihood of killing by CD8 T cells.

a. LFA-3

b. Toll-like receptors (TLRs)

c. transporter associated with antigen processing (TAP)

d. MHC class I

e. MHC class II

d. MHC class I

43

Which statement regarding retrovirus proviruses is false?

a. Proviruses form immediately after the RNA genome assembles with viral proteins and infectious virions are produced.

b. Proviruses consist of double-stranded DNA.

c. Proviruses are flanked by repetitive sequences called long terminal repeats (LTRs).

d. The host cell must provide the transcriptional and translational machinery in order for RNA and protein products to be made from proviruses.

e. A cDNA intermediate is required in order to produce a provirus.

a. Proviruses form immediately after the RNA genome assembles with viral proteins and infectious virions are produced.

44

The pol gene of HIV produces all of the following except _____.

a. Integrase

b. protease

c. matrix protein

d. reverse transcriptase

c. matrix protein

45

For infectious HIV virions to be made, the infected cell must _____.

a. be CD4-positive and express functional NFkB

b. express low levels of CCR5

c. be latent

d. be polyreactive

e. be CD8-positive

a. be CD4-positive and express functional NFkB

46

Which of the following is required for fusion of the human immunodeficiency viral envelope with the host cell membrane and subsequent internalization?

a. reverse transcriptase

b. gp120

c. gp41

d. integrase

e. protease

c. gp41

47

During infection with HIV, a person is said to undergo seroconversion when _____.

a. HIV variants convert from macrophage-tropic to lymphocyte-tropic late in infection

b. anti-HIV antibodies are detectable in their blood serum

c. cellular transcription favors the production of HIV-encoded RNA

d. HIV is transferred from an infected person to an uninfected recipient

e. the initial phase of infection is followed by clinical latency

e. the initial phase of infection is followed by clinical latency

48

A patient is diagnosed with AIDS when CD4 T-cell counts _____.

a. rise markedly after T-cell activation

b. fall below the CD8 T-cell count

c. fall below 1000 cells/ul

d. fall below 500 cells/ul

e. fall below 200 cells/ul

e. fall below 200 cells/ul

49

Reverse transcriptase is a _____ encoded by _____.

a. DNA-dependent DNA polymerase; HIV

b. DNA-dependent DNA polymerase; influenza virus

c. RNA-dependent DNA polymerase; HIV

d. RNA-dependent DNA polymerase; influenza virus

e. RNA-dependent RNA polymerase; HIV

c. RNA-dependent DNA polymerase; HIV

50

Preferred viral targets for HIV therapy include:

a. reverse transcriptase and protease

b. matrix protein

c. gp120

d. CD4

e. polymerase

a. reverse transcriptase and protease

51

Autoimmune diseases, which are classified on the basis of the effector mechanism that causes the symptoms, include all of the following types of hypersensitivity reaction except _____.

a. type I

b. type II

c. type III

d. type IV

a. type I

52

Which type of autoimmune disease is correctly matched with its cause?

a. type I: IgE-mediated

b. type II: effector T cells

c. type III: immune complex deposition in tissues

d. type IV: extracellular matrix-associated autoantigens

e. type V: cell-surface components

c. type III: immune complex deposition in tissues

53

Which of the following is an example of a type II autoimmune response?

a. subacute bacterial endocarditis

b. GoodpastureÕs syndrome

c. multiple sclerosis

d. systemic lupus erythematosus

e. mixed essential cryoglobulinemia

b. GoodpastureÕs syndrome

54

Which of the following is an example of a type III autoimmune response?

a. subacute bacterial endocarditis

b. acute thrombocytopenia purpura

c. systemic lupus erythematosus

d. rheumatoid arthritis

e. insulin-resistant diabetes

c. systemic lupus erythematosus

55

Which of the following is an example of a type IV autoimmune response?

a. pemphigus vulgaris

b. autoimmune thrombocytopenia purpura

c. subacute bacterial endocarditis

d. type 1 diabetes

e. systemic lupus erythematosus

d. type 1 diabetes

56

All of the following are associated with GoodpastureÕs syndrome except _____.

a. alpha chain of type IV collagen

b. inflammation

c. extracellular matrix antigen

d. neutropenia and type III hypersensitivity reaction

e. renal tubules and glomeruli

d. neutropenia and type III hypersensitivity reaction

57

_____ is a highly variable type III autoimmune disease in which immune complexes form and may cause glomerulonephritis of the kidney, arthritis of the joints, and vasculitis of the face.

a. pemphigus vulgaris

b. systemic lupus erythematosus

c. rheumatoid arthritis

d. multiple sclerosis

e. GoodpastureÕs syndrome

b. systemic lupus erythematosus

58

Individuals who have two defective alleles of the AIRE gene _____.

a. exhibit symptoms of autoimmunity at a young age

b. are unable to activate regulatory T cells

c. exhibit decreased predisposition to autoimmune disease

d. are very effective at inducing anergy of circulating autoreactive B and T cells

e. are more likely to be women of African or Asian origin

a. exhibit symptoms of autoimmunity at a young age

59

All of the following autoimmune diseases are correctly matched with their HLA disease associations except _____.

a. HLA-B27: ankylosing spondylitis

b. HLA-DQ2: type 1 diabetes in Africans and Asians

c. HLA-B35: birdshot retinopathy

d. HLA-DR4: rheumatoid arthritis

e. HLA-DQ6: narcolepsy

c. HLA-B35: birdshot retinopathy

60

The haplotype A1-B8-DR3-DQ2 is associated with several common autoimmune diseases including all of the following except _____.

a. ankylosing spondylitis

b. systemic lupus erythematosus

c. autoimmune hepatitis

d. myasthenia gravis

e. type 1 diabetes

a. ankylosing spondylitis

61

With the exception of ______, these autoimmune diseases are more prevalent in women than in men.

a. rheumatoid arthritis

b. multiple sclerosis

c. ankylosing spondylitis

d. Sj grenÕs syndrome

e. GravesÕ disease

c. ankylosing spondylitis

62

Which of the following is not a characteristic of GravesÕ disease?

a. weight loss

b. enlarged thyroid gland

c. elevated thyroid-stimulating hormone

d. heat intolerance

e. overproduction of T3 and T4

c. elevated thyroid-stimulating hormone

63

All of the following are true regarding thyroglobulin except _____.

a. its tyrosine residues are iodinated and cross-linked

b. it is broken down to produce thyroid hormones

c. it is stored in follicles of the thyroid

d. it signals the pituitary gland to stop releasing thyroid-stimulating hormone

e. it is synthesized initially as a glycoprotein by thyroid epithelial cells

d. it signals the pituitary gland to stop releasing thyroid-stimulating hormone

64

Which of the following describes myasthenia gravis?

a. Ectopic lymphoid tissue forms and impairs endocrine function.

b. Disruption of adhesion molecules of cellular junctions.

c. Autoimmune response to proteins of anterior chamber of the eye.

d. Chronic inflammation of the gut mucosa.

e. The neuromuscular junction is compromised.

e. The neuromuscular junction is compromised.

65

The reason why babies born to mothers with GravesÕ disease suffer passively from the disease for only a short while after birth is that _____.

a. very little IgM is transported across the placenta

b. only antibodies, and not the B cells making the autoantibodies, cross the placenta

c. the newbornÕs regulatory T cells suppress autoantibody production

d. the newbornÕs thyroid gland develops resistance to the effects of maternal autoantibodies

e. thyroglobulin synthesis does not commence until months after birth

b. only antibodies, and not the B cells making the autoantibodies, cross the placenta

66

The formation of ectopic lymphoid tissues occurs in all of the following conditions except _____.

a. pemphigus foliaceus

b. chronic hepatitis C infection

c. HashimotoÕs disease

d. rheumatoid arthritis

e. multiple sclerosis

a. pemphigus foliaceus

67

A(n) _____ binds to the antigen-binding site of another antibody.

a. cryptic epitope

b. anti-idiotypic antibody

c. molecular mimic

d. receptor antagonist

e. autoantibody

b. anti-idiotypic antibody

68

All of the following are linked to the development of rheumatoid arthritis or are associated with its treatment except _____.

a. anti-immunoglobulin autoantibodies

b. Adalumumab

c. leukocyte infiltration in synovial tissue

d. joint inflammation

e. pulmonary hemorrhage and rheumatic fever

e. pulmonary hemorrhage and rheumatic fever

69

It is believed that the allotype DRB1*_____ may confer protection against rheumatoid arthritis because it contains _____ amino acid residues at positions 70 and 71 that bind to different subsets of peptides compared with the allotypes that confer susceptibility to this disease.

a. 04:01; acidic

b. 04:02; acidic

c. 04:04; basic

d. 04:05; basic

e. 04:08; acidic

b. 04:02; acidic

70

Celiac disease exhibits all of the following symptoms except _____.

a. villous atrophy

b. anemia

c. diarrhea

d. tissue ulceration

e. malabsorption

d. tissue ulceration

71

All of the following are characteristics of tissue transglutaminase except ____.

a. generation of negatively charged peptides that bind well to the positively charged pockets of the DQ2 and DQ8 allotypes

b. conversion of glutamine to glutamate by deamination

c. upregulation during tissue inflammation

d. stimulation of IgG or IgA autoantibodies in celiac disease

e. predisposition to celiac disease if individual possesses particular polymorphic variants

e. predisposition to celiac disease if individual possesses particular polymorphic variants

72

A recent therapy developed for the treatment of rheumatoid arthritis includes the use of _____ monoclonal antibodies that suppress the autoimmune response.

a. anti-TNF-alpha and anti-CD20

b. anti-C-reactive protein

c. anti-CD14

d. anti-rheumatoid factor

e. anti-CD3

a. anti-TNF-alpha and anti-CD20

73

Chronic diseases in which the immune response is targeted toward autologous entities of oneÕs body are known as _____.

a. hypersensitivity reactions

b. innate immune reactions

c. allergic reactions

d. autoimmune diseases

e. anergic reactions

d. autoimmune diseases

74

Which of the following would be consistent with a diagnosis of GoodpastureÕs syndrome?

a. pulmonary hemorrhage and glomerulonephritis

b. joint inflammation

c. hyperglycemia

d. anti-collagen IgG deposition in renal glomeruli

e. None of the above

a. pulmonary hemorrhage and glomerulonephritis

75

Thyroid-stimulating hormone is made in the _____ and induces the release of thyroid hormones after proteolytic processing of _____.

a. pituitary gland; thyroglobulin

b. hypothalamus; thyroxine

c. pancreas; thyroglobulin

d. pituitary gland; thyroid-stimulating hormone receptor

e. thyroid gland; thyroid peroxidase

a. pituitary gland; thyroglobulin

76

GravesÕ disease causes _____, whereas HashimotoÕs disease causes _____.

a. hypothyroidism; hyperthyroidism

b. hyperthyroidism; hypothyroidism

c. hypoglycemia; hyperglycemia

d. hyperglycemia; hypoglycemia

e. glomerulonephtitis; systemic vasculitis

b. hyperthyroidism; hypothyroidism

77

Which of the following are correctly matched?

a. exocrine tissue: islets of Langerhans

b. type 2 diabetes: insulin-dependent diabetes mellitus

c. beta cells of pancreas: insulin production incorrect

d. alpha cells of pancreas: insulin production

c. beta cells of pancreas: insulin production incorrect

78

Another name for anti-immunoglobulin autoantibodies is _____.

a. C-reactive protein

b. rheumatoid factor

c. Rituximab

d. thyroglobulin

e. ectopic antibodies

b. rheumatoid factor

79

Rituximab, used in the treatment of rheumatoid arthritis, depletes _____ through a process involving the cross-linking of _____ on the surface of NK cells and the induction of antibody-dependent cell-mediated cytotoxicity.

a. NK cells; NKG2D

b. T cells: NKG2D

c. inflammatory cytokines; TNF-alpha

d. C-reactive protein; FcgammaRIII

e. B cells; FcgammaRIII

e. B cells; FcgammaRIII

80

_____ autoantibodies enhance receptor function.

a. Neutralizing

b. Opsonizing

c. Agonist

d. Complement-fixing

e. Antagonist

c. Agonist

81

Ankylosing spondylitis has a strong association with polymorphisms found in _____.

a. HLA-B27

b. AIRE

c. CTLA-4

d. HLA-DQ6

e. HLA-Cw6

a. HLA-B27

82

Autoantibody specificities are affected by HLA class II polymorphisms. In the case of systemic lupus erythematosus, indicate which of the following associations between HLA-class II and autoantigens have been observed in these patients.

a. HLA-DR3; nuclear ribonucleoprotein complex

b. HLA-DR5; small cytoplasmic ribonucleoprotein complex

c. HLA-DR2; double-stranded DNA

d. HLA-DR4; single-stranded RNA

e. HLA-DQ8; double-stranded RNA

c. HLA-DR2; double-stranded DNA

83

_____ is the term used to describe how pathogen antigens resemble host antigens and can sometimes trigger autoimmune disease.

a. intramolecular epitope spreading

b. molecular mimicry

c. intermolecular epitope spreading

d. sympathetic senescence

e. linkage equilibrium

b. molecular mimicry

84

The upregulation of _____ by IFN-gamma can contribute to antigen-specific T-cell activation on thyroid epithelium.

a. CD4

b. CD8

c. HLA class I

d. HLA class II

e. CD28

d. HLA class II

85

A(n) _____ is an epitope that is typically not accessible to the immune system but is revealed under inflammatory or infectious states.

a. cryptic epitope

b. molecular mimic

c. regulatory peptide

d. carrier

e. adjuvant

a. cryptic epitope

86

The process by which the human thymus gradually decays is known as _____.

a. Apoptosis

b. Senescence

c. involution

d. the hygiene hypothesis

e. self-tolerance

c. involution

87

Amanda Chenoweth, 21 years old, returned from a summer job as a pianist on a cruise ship where she was exposed daily to excessive sun; she developed a rash on her cheeks. She complained that her finger joints were stiff and painful, which made it difficult to play the piano, and that her hips became painful after sitting at the piano for long periods. Her blood sample tested positive for anti-nuclear antibodies and had decreased serum C3 levels. A urine albumin test showed elevated protein levels. A course of prednisone (an anti-inflammatory steroid) in combination with naprosyn (a nonsteroidal anti-inflammatory agent) was begun and her condition improved rapidly. What is the most likely cause and clinical name of her condition?

a. deterioration of the central nervous system; multiple sclerosis

b. cartilage destruction by bone-cell enzymes; rheumatoid arthritis

c. immune complexes fixing complement in kidney, joints, and blood vessels; systemic lupus erythematosus

d. autoantibodies against acetylcholine receptor at the neuromuscular junction; myasthenia gravis

e. consumption of seafood to which she was allergic; acute systemic anaphylaxis

c. immune complexes fixing complement in kidney, joints, and blood vessels; systemic lupus erythematosus

88

At 42 years of age, Stephanie Goldstein developed occasional blurred and double vision, numbness and Ôpins and needlesÕ in her arms and legs (paresthesia), and bladder incontinence. After a month of these symptoms she went to her doctor, who sent her to the neurology specialist. An MRI scan revealed areas of demyelination in the central nervous system (CNS), and Stephanie was diagnosed with the autoimmune disease multiple sclerosis (MS). Which of the following best explains why some people are susceptible to the development of MS?

a. Negative selection of autoreactive T cells occurs during T-cell development.

b. Apoptosis of autoreactive B cells occurs in the bone marrow during B-cell development.

c. An inability to produce immunological tolerance toward CNS-derived constituents results in the generation of self-reactive lymphocytes.

d. An immunodeficiency inhibiting somatic recombination of immunoglobulins and T-cell receptors results in impaired lymphocyte development.

e. Regulatory T cells fail to activate autoreactive T cells in secondary lymphoid organs.

c. An inability to produce immunological tolerance toward CNS-derived constituents results in the generation of self-reactive lymphocytes.

89

Anders Anderson, was seen by his pediatrician at 24 months of age after a recent bout of diarrhea and vomiting. He had lost his appetite and complained that his stomach hurt. Anders was in 5th percentile for weight, had slender limbs, wasted buttocks, and a protuberant abdomen. Jejunal biopsy revealed abnormal surface epithelium, and villous atrophy with hyperplasia of the crypts. Which of the following would be a likely clinical finding in this patient?

a. Glomerulonephritis

b. urticarial rash

c. anti-gliadin IgA antibodies

d. chronic wheezing

e. low blood pressure

c. anti-gliadin IgA antibodies

90

Seventeen-year-old Lisa Montague practiced piano for 3Ð4 hours each day while preparing for music college auditions. Some of her pieces required sustained arm-muscle activity and she began to find them hard to play, even though she had previously played them easily. When she also started to have difficulty swallowing and chewing, she told her mother, who took her to the emergency room, where the physician noticed drooping eyelids and limitation of ocular motility. An electromyogram detected impaired nerve-to-muscle transmission. Administration of pyridostigmine rapidly improved LisaÕs symptoms. Which of the following blood-test results would be most consistent with her condition?

a. elevated rheumatoid factor

b. elevated anti-myelin basic protein antibodies

c. elevated anti-acetylcholine receptor antibodies

d. elevated anti-nuclear antibodies

e. elevated anti-Rh antibodies

c. elevated anti-acetylcholine receptor antibodies

91

Which of the following is mismatched?

a. oncology: diagnosis and treatment of tumors

b. carcinoma: characteristic cell types found in benign tumors

c. mutation: changes in DNA involving substitutions, deletions, insertions, recombinations, and translocations

d. leukemia: cancer of the immune system affecting circulating cells

e. malignant transformation: gain of ability to form a cancer

b. carcinoma: characteristic cell types found in benign tumors

92

Which of the following is mismatched?

a. tumor suppressor genes: mutated in over 50% of human cancer cases

b. HTLV-1: an RNA retrovirus associated with adult T-cell leukemia

c. Helicobacter pylori: bacterial infection associated with colon cancer

d. Sipuleucel-T cell vaccine: treatment for late-stage metastatic prostate cancer

e. cancer immunosurveillance: recognition and elimination of cancer cells by defense mechanisms

c. Helicobacter pylori: bacterial infection associated with colon cancer

93

Mutagens that increase one s predisposition to developing cancer are called _____.

a. carcinogens

b. tumor antigens

c. neoplastic mutagens

d. oncogenes

e. proto-oncogenes

a. carcinogens

94

Human papillomaviruses express proteins that bind to _____ and block its function.

a. MIC glycoproteins

b. p53 and Rb

c. CT antigens

d. TLR4

e. TLR2

b. p53 and Rb

95

In domestic dogs and Tasmanian devils, successful passage and growth of tumors through copulation and biting, respectively, are attributed to _____.

a. absence of quiescent cancer stem cells in the tumor

b. limited MHC diversity between animals

c. repression of tumor-specific antigen expression

d. repression of tumor-associated antigen expression

e. lack of regulatory T cells

b. limited MHC diversity between animals

96

_____ is/are commonly associated with the fusion between the BCR gene and the ABL proto-oncogene.

a. Non-small cell lung carcinoma

b. Bladder tumors

c. Melanoma

d. Head and neck squamous cell carcinoma

e. Chronic myelogenous leukemia

e. Chronic myelogenous leukemia

97

Which of the following cell types in a tumor biopsy would not be associated with a promising prognosis?

a. B cells

b. memory T cells

c. TFH cells

d. regulatory T cells

e. cytotoxic T cells

d. regulatory T cells

98

Adoptive transfer of Sipuleucel-T-primed dendritic cells is a form of immunotherapy currently used for the treatment of _____.

a. late-stage metastatic prostate cancer

b. multiple myeloma

c. chronic myelogenous leukemia

d. melanoma

e. cervical cancer

a. late-stage metastatic prostate cancer

99

When the immune system is involved in _____, an appraisal for cancer cells is occurring.

a. malignant transformation

b. apoptosis

c. antineoplasia

d. immunosurveillance

e. immunosuppression

d. immunosurveillance

100

A benign tumor of glandular tissue is known as a(n) _____.

a. sarcoma

b. myeloma

c. adenoma

d. adenocarcinoma

e. lymphoma

c. adenoma

101

A malignant tumor is characterized by which of the following features?

a. encapsulation

b. localized

c. restricted in size

d. metastasizes to distant sites

e. results from single mutation affecting cell division or survival

d. metastasizes to distant sites

102

_____ describes the condition in which a cell becomes able to cause cancer.

a. Malignant mutation

b. alignant recombination

c. Malignant neoplasm

d. Malignant transformation

e. Malignant suppression

d. Malignant transformation

103

A protein expressed in response to damage to DNA that results in death to the cell is _____.

a. Ras

b. p53

c. Rb

d. Abl

e. MAGEA1

b. p53

104

Human herpesvirus 8 (HHV8) is associated with the development of _____ in immunocompromised patients.

a. Burkitt lymphoma

b. chronic myeloid leukemia

c. melanoma

d. myeloma

e. Kaposi sarcoma

e. Kaposi sarcoma

105

Li-Fraumeni syndrome is linked to a greater risk of cancer as a result of the inheritance of a germline mutation in one copy of _____.

a. TLR-9

b. p53

c. CTLA4

d. heat-shock protein

e. Rb

b. p53

106

Chemical and physical agents that increase mutation rates by damaging DNA and increase the likelihood of developing cancer are known as _____.

a. oncogenes

b. malignant transformers

c. antitumor suppressor agents

d. carcinogens

e. tumor-associated agents

d. carcinogens

107

_____ agents usually cause single nucleotide substitutions in DNA, whereas _____ agents produce more significant damage to DNA.

a. mutagenic; carcinogenic

b. chemical; physical

c. benign; malignant

d. tumor-associated; tumor-specific

e. benign; oncogenic

b. chemical; physical

108

BurkittÕs lymphoma is a tumor associated with _____ infection, which causes _____ to divide uncontrollably.

a. Epstein-Barr virus; B cells

b. hepatitis B virus; epithelial human T-cell

c. leukemia; hepatocytes

d. human herpesvirus; T cells

e. papillomavirus; uterine cells

a. Epstein-Barr virus; B cells

109

Cancers develop their own blood supply and become vascularized through _____.

a. apoptosis

b. neoplasia

c. angiogenesis

d. metastasis

e. malignant transformation

c. angiogenesis

110

Systemic distribution of cancer cells to other sites of the body through the bloodstream or lymph is a process known as _____.

a. apoptosis

b. neoplasia

c. angiogenesis

d. metastasis

e. malignant transformation

d. metastasis

111

The efficacy of treating bladder cancer is increased by introducing the BCG vaccine. The vaccine component attributing this antitumor effect is _____, which induces a state of chronic inflammation.

a. mycolic acid

b. unmethylated CpG-containing DNA

c. lipopolysaccharide

d. teichoic acid

e. peptidoglycan

b. unmethylated CpG-containing DNA

112

Proteins not expressed on normal cells but found on tumor cells are called _____.

a. cancer stem cell antigens

b. oncogenic antigens

c. tumor-associated antigens

d. tumor-specific antigens

e. proto-oncogene products

d. tumor-specific antigens

113

A tumor-associated antigen normally expressed only in the testis is called a _____ antigen.

a. MIC

b. CT

c. male-specific

d. sex chromosome-encoded privileged

b. CT

114

A mechanism by which cancer cells can evade an immune response involves an alteration in the amount of MIC on the cell surface by _____________.

a. decreasing the level of MIC transcription

b. cleavage of MIC at the cell surface by a protease

c. switching from a transmembrane form of MIC to a secreted form

d. cytosolic degradation of MIC in proteasomes

e. alternative mRNA splicing resulting in a truncated form of MIC that is no longer able to bind to NKG2D

b. cleavage of MIC at the cell surface by a protease

115

One of the side effects of treating tumor patients with anti-CTLA4 monoclonal antibodies is _____.

a. the development of autoimmune disease

b. lymphoproliferative disorder

c. increased levels of mutation in tumor cells

d. upregulation of CT antigens

e. reactivation of embryonic genes

a. the development of autoimmune disease