Immunology

Question 1

A Type II hypersensitivity reaction is mediated by which 2 immunoglobulins?

Answer 1

IgM and IgG

Question 2

Which T cell is the only T cell capable of directly attacking and killing other cells, and whose main target is virally infected cells?

Answer 2

Cytotoxic T cell (can release cytokines after attacking virus infected cell)

Question 3

Two types of complement pathways

Answer 3

classic and alternative

Question 4

One of the two main immunity strategies found in vertebrates that uses cytokines for inflammation, complement to identify bacteria, activate phagocytes, promote clearance of dead cells, identification and removal of foreign substances through WBCs, and acts as a physical and chemical barrier to infectious agents (ie: skin, sweat)?

Answer 4

Innate immunity

Question 5

Which immunoglobulin is present on the surface of B cells and is the FIRST TO RESPOND during and antigenic challenge?

Answer 5

IgM

Question 6

Myasthenia Gravis, an autoimmune disorder, is when self reactive antibodies bind to receptor sites for the neurotransmitter ___________, which causes _________ ___________.

Answer 6

Acetylcholine Ach, muscle fatigue

Question 7

T-cells pertain to which type of immunity?

Answer 7

Cell mediated immunity

Question 8

Are T cells able to recognize Ag’s?

Answer 8

No, they respond only to processed fragments of Ag’s found on APC’s

Question 9

antibody

Answer 9

reacts with a specific antigen

Question 10

Which immunoglobulin blocks transport of microbes across MUCOSA?

Answer 10

IgA

Question 11

Leukopoor blood, where the leukocytes are removed leaving packed RBCs, is used for what purpose?

Answer 11

To minimize immune reactions to blood

Question 12

Which immunoglobulin is the MOST ABUNDANT circulating Ab, is present after immunizations and infections, and is also the only one able to cross the placenta?

Answer 12

IgG

Question 13

T/F: When talking about blood type and compatibility of blood products, blood that is Rh negative can be given to a patient with Rh positive blood.

Answer 13

True

Question 14

Antigen

Answer 14

substances that target an immune response

Question 15

A type IV hypersensitivity reaction is when T helper cells are activated to release cytokines upon binding to antigen, resulting in macrophage and cytotoxic T cell accumulation. Name 2 examples.

Answer 15

Contact dermatitis, transplant rejection

Question 16

What cells are phagocytes, engulfing the invading cell and presenting “flags” on their surface for CD4+ T helper cell recognition?

Answer 16

Macrophages, Neutrophils, Dendritic cells, B cells, any kind of antigen presenting cell (APC)

Question 17

Both Multiple Myeloma and MGUS create an M spike in the gamma wave on SPE, but how is multiple myeloma differentiated?

Answer 17

In Multiple myeloma, plasma B cells over-proliferate and infiltrate the bone marrow causing lytic lesions of bone, which is picked up during imaging.

Question 18

When would you find IgE

Answer 18

In an allergic reaction and in cases of parasitic infection

Question 19

Multiple Myeloma and MGUS are both diseases of Ig overproduction by what type of cells? (What cells make antibodies?)

Answer 19

Plasma B Cells

Question 20

T Helper CD4 turn immune response ____ (on or off)

Answer 20

on

Question 21

True or false: B-cells are involved with humoral immunity

Answer 21

true

Question 22

T-helper CD4+ cell receptors bind to APC where?

Answer 22

MHC II

Question 23

What 3 antibiotics or antibiotic genres should be avoided if a patient has Myasthenia Gravis due to risk of exacerbation?

Answer 23

Fluoroquinolones, gentamycin, azithromycin

Question 24

What cells leave a tag on invading microbes for macrophages to destroy

Answer 24

t-cells

Question 25

``` The mono test-Heterophile AB, or “monospot,” looks for what immunoglobulin? A. IgD B. IgM C. IgE D. IgA E. All of the above F. None of the above ```

Answer 25

IgM for acute phase of disease

Question 26

Name the substance released by virus infected cells that notifies other cells of the infection so they can protect themselves.

Answer 26

Interferon

Question 27

What kind of infections may there be IgA present

Answer 27

Upper respiratory and Gastrointestinal. Any tract with musosal lining

Question 28

Why are a majority of T cells destroyed before they are released?

Answer 28

Because they illicit a strong self-antigenic response

Question 29

What substance mobilizes and attracts macrophages and NK cells?

Answer 29

Interferon

Question 30

Name the antibody independent complement pathway where complement attaches to the outer membrane of a microbe, encapsulating it.

Answer 30

Alternative complement pathway

Question 31

T/F: The T-helper CD4+ cell needs to be primed by an APC.

Answer 31

True

Question 32

The ________ cell is the “off switch” for the immune system.

Answer 32

T-suppressor CD8

Question 33

Immune senescence also includes a loss of memory B cells and cell mediated immunity. What simple task can slow age related decline in immune function?

Answer 33

Exercise

Question 34

T/F: When talking about blood types and blood compatibility, Rh positive blood can be given to a patient with Rh negative blood.

Answer 34

True, but the 2nd time may be fatal. The immune system recognizes the foreign Ab as an antigen after the first encounter, but the second time it could mount an immune response.

Question 35

After maturity, what 3 locations do T cells reside?

Answer 35

Spleen Lymph nodes Other lymph areas such as tonsils

Question 36

Both complement pathways converge on protein ___, which promotes phagocytosis, cell lysis, and increases inflammation.

Answer 36

C3

Question 37

What cells are descended from blood stem cells, don’t have receptors like other lymphocytic cells, are short lived (1 week), DESTROY TUMOR CELLS, viruses, parasites, fungi, and produce cytokines?

Answer 37

Natural Killer or NK cells

Question 38

MHC II is found on the outside of APC’s to present the Ag particle to T-helper cells so they can activate the immune response, but they also allow for recognition between what other cells?

Answer 38

Immune system cells, so they don’t attack each other

Question 39

____ cells attract Neutrophils to site via release of lymphokines.

Answer 39

T-helper CD4+

Question 40

Which MHC activates cytotoxic T cells?

Answer 40

MHC I

Question 41

T cell populations

Answer 41

CD4, CD8, Cytotoxic

Question 42

``` MGUS is differentiated from multiple myeloma through a bone marrow aspirate test. The test will show a: A. Proliferation of B cells B. Normal level of B cells C. Proliferation of T cells D. Proliferation of platelets ```

Answer 42

B. Normal B cell levels; Proliferation of B cells is only present with multiple myeloma

Question 43

True or false: everyone with an M-spike will have multiple myeloma

Answer 43

false: but they are at a higher risk of developing it

Question 44

Which immunoglobulin would present on a lab test that would indicate acute infection of a certain microbe?

Answer 44

IgM

Question 45

IgG

Answer 45

Most abundant in the body. It is present with long term and past infection. Also present if someone has been vaccinated

Question 46

MHC II is present on the surface of what types of cells?

Answer 46

B, T, and APC’s (antigen present cells)

Question 47

What cells are important in preventing autoimmune reactions by suppressing B and T cell immunity?

Answer 47

T-suppressor CD8

Question 48

Where is MHC I (major histocompatibility complex) found?

Answer 48

On all body cells except blood cells

Question 49

65-85% of circulating lymphocytes are T or B cells?

Answer 49

T cells predominate

Question 50

Would you expect to find an increase/decrease in a) CD4 b)CD8 as it relates to immune senescence? Answer for both

Answer 50

Decrease in CD4 Helper, increase in CD8 suppressor

Question 51

A Type III hypersensitivity reaction is immune complex mediated where immune complexes (ex: IgG bound to IgM) are deposited in tissues leading to local or systemic inflammatory reactions. Name 2 examples of a Type III reaction.

Answer 51

RA, SLE

Question 52

``` The HIV virus infects which cells? A. plasma B cells B. CD8 Suppressor C. Memory B cells D. CD4 helper ```

Answer 52

D. CD4 helper

Question 53

Name the two types of lymphocyte cells

Answer 53

T and B

Question 54

What is the universal donor and why?

Answer 54

Type O, it has no A/B/Rh antigens on RBC surface, so it can be given to anyone without them having an immune response.

Question 55

``` One of the immunoelectrophoresis tests, a Serum protein electrophoresis (SPE), shows M spikes on the: A. Alpha 1 wave B. Alpha 2 wave C. Beta wave D. Gamma wave ```

Answer 55

D. M spikes will show up on the gamma wave

Question 56

Immunoelectrophoresis is necessary to identify MONOCLONAL ANTIBODIES, which show a class ______, which is found in both Multiple Myeloma and Monoclonal Gammopathy of Unknown Significance (MGUS).

Answer 56

M spike

Question 57

Which two immunoglobulins are present on the surface of B cells?

Answer 57

IgD IgM

Question 58

Which type of hypersensitivity reaction is the only true immune response, Type I, II, III, or IV?

Answer 58

Type I

Question 59

Rheumatoid arthritis, an autoimmune disorder of chronic inflammation of the joints, occurs when ______ _______ _____ produced by macrophages infiltrates the joints.

Answer 59

Tumor necrosis factor

Question 60

Name the part of the immune system that is composed of both humoral and cell-mediated immunity, that has “memory” from previous infections which leads to enhanced responses during subsequent encounters with the same pathogen (also is the basis for immunization)?

Answer 60

Acquired or Adaptive Immunity

Question 61

3 Type I hypersensitivity reaction examples are?

Answer 61

Allergic rhinitis, allergic asthma, anaphylaxis

Question 62

Which immunoglobulin is increased in allergic and parasitic infections?

Answer 62

IgE

Question 63

Which Ab is 1st to respond during an acute infection? Which is 2nd?

Answer 63

IgM | IgG

Question 64

ELISA, or Enzyme linked immunosorbent assays, uses a known antibody (one from patient, one indicator) to test for what 3 things?

Answer 64

HIV, D-dimer, hepatitis

Question 65

An antigenic challenge activates B cells, which divide and become either ____ or ____.

Answer 65

``` Clone memory B cells (just hang out in case of secondary infection) Plasma cells (create and secrete Ab to further attack Ag) ```

Question 66

Patients who experience multiple myeloma are prone to infections from what 2 common bacteria that are native to humans?

Answer 66

S. Pneumo and H. Influenzae

Question 67

True or false: cytotoxic t-cells are the only t-cells that can directly attack and kill other cells

Answer 67

True

Question 68

What T cell turns on (on switch) the immune response?

Answer 68

T-helper CD4+

Question 69

Name the antibody (Ab) dependent pathway of complement.

Answer 69

Classic

Question 70

What is the name of the proteins present in the urine of someone with Multiple Myeloma?

Answer 70

Bence-Jones proteins (this is a board question)

Question 71

What are histocompatibility antigens on the surface of all cells except RBC’s that are important in ORGAN MATCHING?

Answer 71

MHC

Question 72

Immunophenotyping/Cytogenetics uses _____ _______ to quantitate cell populations taken from bone marrow and blood to help choose the appropriate chemotherapy.

Answer 72

Flow cytometry

Question 73

T cells recognize MHC I as ____ .

Answer 73

Self

Question 74

A negative ANA test a) includes b) excludes SLE?

Answer 74

B. Excludes

Question 75

Systemic Lupus Erythematous (SLE) is an autoimmune disorder of unknown cause. Circulating immune complexes of bound ____ and ____ lead to glomerulonephritis and skin manifestations.

Answer 75

IgG and IgM

Question 76

Humoral immunity involves B or T cells?

Answer 76

B cells

Question 77

The ability of the immune system to respond more efficiently with a 2nd infection/antigenic challenge is called?

Answer 77

Anamnestic response (think not amnesia, it doesn’t forget) or memory

Question 78

interferons

Answer 78

released by virus infected cells to help protect other cells. Attracts macropahges and natural killer cells

Question 79

What complement protein causes macrophages to be beckoned to a cell tagged for phagocytosis and opsonization?

Answer 79

C3 protein (yup, it’s pretty important)

Question 80

Name 2 examples of a Type II hypersensitivity reaction disease.

Answer 80

Myasthenia Gravis, Graves’ disease

Question 81

A major function of ___ cells is to stimulate proliferation of other T and B cells that are directly bound to the Ag.

Answer 81

T-helper CD4+

Question 82

IgA

Answer 82

Blocks transport of microbes across mucosa

Question 83

What is a group of at least 20 plasma proteins that are in circulation, which are activated by Ag-Ab binding to RBC or bacteria, is part of the INNATE immune system, stimulates phagocytes to clear foreign and damaged material, stimulates inflammation to attract additional phagocytes, and activation of the MAC (membrane attack complex)?

Answer 83

Complement proteins

Question 84

What is the only cell type that MHC I is not on

Answer 84

blood cells

Question 85

What protein of complement binds to the target cell and inserts the membrane attack complex (MAC), causing cell lysis?

Answer 85

C3 protein

Question 86

What immunoglobulin would be present on B-cells

Answer 86

IgD, IgM

Question 87

What blood type is the universal acceptor and why?

Answer 87

AB, there is no anti A/B antibodies on the RBC surface

Question 88

True or false: alternative complement pathway is dependent on antibodies?

Answer 88

False

Question 89

Lymph areas (where mature lymphocytes may live)

Answer 89

spleen, lymph nodes, tonsils

Question 90

HLA B27 is linked with what degenerative disease process?

Answer 90

Ankylosis spondylitis

Question 91

A classic example of a Type IV delayed reaction is seen during what test given under the skin?

Answer 91

PPD for tuberculin

Question 92

Another term for age related decline in immune function is _______ ________.

Answer 92

Immune senescence

Question 93

B cells are part of the humoral immunity. What immunoglobulins are present on the exterior of their membrane?

Answer 93

IgD and IgM

Question 94

A patient with selective IgA deficiency would most likely develop recurrent infections in their _____ and _____ systems.

Answer 94

GI and Respiratory

Question 95

What are the 3 types of immunity?

Answer 95

Humoral (B cells, memory) Complement (chemoattractants) Cell-mediated (Cytotoxic T cells, T helper CD4+ cells, T suppressor CD8 cells, macrophages, neutrophils, Natural killer cells)