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Blood Bank - Clinical Rotation > Immunology - Hypersensitivity > Flashcards

Immunology - Hypersensitivity Flashcards

1
Q

An example of a condition that involved type III hypersensitivity is:

A

Rheumatoid arthritis

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2
Q

Which of the following diseases is an example of type II hypersensitivity

A

Myasthenia gravis

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3
Q

1.) A 5-year-old girl was rushed to the emergency department because she was having trouble breathing. She had been playing at the park when she fell down and her face and neck started to swell up. One of her friends thought that the girl might have been stung by a bee because a bee was flying around them, and shortly before the girl fell to the ground, she had screamed. The girl had a large red bump on her cheek. This girl likely has:

a. Bruton’s hypogammaglobulinemia.
b. type I diabetes.
c. type IV hypersensitivity.
d. type I hypersensitivity.

A

d. type I hypersensitivity.

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4
Q

2.) A 30-year-old clinical laboratory science student complains of being tired but is not able to sleep. The woman also states that she has without reason have increase nervousness/anxiety. She has also lost 20 pounds over the past 2 months without trying. The woman’s pulse and blood pressure are elevated, and her eyes seem to be bulging. Her complete blood count (CBC) is normal. Her thyroid-stimulating hormone is decreased; however, her thyroid hormones are elevated. This woman most likely has:

a. myasthenia gravis
b. Graves disease
c. diabetes mellitus
d. Reiter’s syndrome

A

b. Graves disease

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5
Q

3.) A 35-year-old female experiences difficulty in walking, and her hands and feet are numb from time to time. Suspecting a disease involving the central nervous system, her physician orders magnetic resonance imaging (MRI). The MRI reveals lesions on the myelin sheath. What is the most likely disease?

a. Multiple sclerosis
b. Myasthenia gravis
c. Rheumatoid arthritis
d. Graves disease

A

a. Multiple sclerosis

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6
Q

4.) A 56-year-old woman presents to her physician complaining of weight gain and joint problems. She is increasingly having difficulty walking up stairs and manipulating her fingers. Fingers in both hands as well as knees on both legs are equally painful and stiff. The symptoms have been getting progressively worse over the past 6 months. Rheumatoid factor is elevated, and antinuclear antibodies are not detected. Complement levels in her joints are decreased. This woman most likely has:

a. rheumatoid arthritis
b. systemic lupus erythematosus
c. myasthenia gravis
d. Grave’s disease
e. insulin-dependent diabetes mellitus

A

a. rheumatoid arthritis

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7
Q

5.) A pregnant Rh-negative woman is concerned of possible hemolytic disease in her newborn and in future children. The best approach to avoid this problem is

a. administer RhoGam to the first newborn.
b. administer RhoGam to the mother for all pregnancies.
c. not to administer RhoGam.
d. administer RhoGam to each newborn.

A

b. administer RhoGam to the mother for all pregnancies.

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8
Q

6.) Active systemic lupus erythematosus is characterized by:

a. increase in cells lining the synovial membrane.
b. presence of dsDNA antibodies.
c. HLA-DR antigens expressed on thyroid epithelial cells.
d. absence of immune complexes.

A

b. presence of dsDNA antibodies.

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9
Q

7.) All of the hypersensitivity responses have which of the following in common?

a. Activation of macrophage against a pathogen.
b. Involvement of antibody
c. Asymptomatic sensitization phase
d. Release of histamine

A

c. Asymptomatic sensitization phase

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10
Q

8.) An autoimmune disease characterized by pain and progressive destruction of the joints, weight loss, morning stiffness, and presence of an antibody directed against IgG best describes:

a. diabetes mellitus
b. lupus
c. hemolytic anemia.
d. Graves disease
e. rheumatoid arthritis

A

e. rheumatoid arthritis

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11
Q

9.) Anaphylactic reactions are mediated by:

a. lymphocytes
b. mast cells.
c. natural killer cells
d. macrophages

A

b. mast cells.

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12
Q

10.) An exaggerated reaction directed against an antigen that is harmless is called:

a. immune complex disease
b. assive cutaneous anaphylaxis
c. hypersensitivity
d. atopy

A

c. hypersensitivity

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13
Q

11.) Antibodies to cyclic citrullinated proteins (anti-CCP) are specific diagnostic indicators for:

a. diabetes mellitus
b. multiple sclerosis
c. rheumatoid arthritis
d. Graves disease

A

c. rheumatoid arthritis

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14
Q

12.) Autoimmune hemolytic anemia targets which cells or tissues?

a. Connective tissues
b. White blood cells
c. Platelets
d. Liver
e. Red blood cells

A

e. Red blood cells

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15
Q

13.) Central tolerance, in which lymphocytes learn to distinguish between self-antigens and foreign antigens, takes place in the thymus and:

a. liver
b. spleen
c. lymph nodes
d. bone marrow

A

d. bone marrow

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16
Q

14.) Complement is responsible for tissue damage in which of the following reactions? (Choose all correct answers)

a. Anaphylaxis
b. Type II hypersensitivity
c. Delayed-type hypersensitivity
d. Type III hypersensitivity
e. Immediate hypersensitivity

A

d. Type III hypersensitivity

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17
Q

15.) Hypersensitivities to poison ivy and nickel are:

a. mediated by IgG and IgM antibodies.
b. mediated by eosinophils
c. macrophage and T-cell responses to a hapten.
d. IgE responses to a hapten.

A

c. macrophage and T-cell responses to a hapten.

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18
Q

16.) Immune injury resulting from the localization of immune complexes in blood vessels and tissues describes which hypersensitivity reaction?
a. II
b. IV
c. III
d. I

A

III

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19
Q

17.) In the rheumatoid factor test, what is being detected?
a. antithyroglobulin antibody
b. antinuclear antibody
c. IgM directed against IgG
d. IgG directed against IgM

A

IgM directed against IgG

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20
Q

18.) In which of the following autoimmune diseases are antibodies to acetylcholine receptors produced, thereby blocking the signal to muscles?

a. Multiple sclerosis
b. Autoimmune hemolytic anemia
c. Myasthenia gravis
d. Systemic lupus erythematosus
e. Sjögren’s syndrome

A

c. Myasthenia gravis

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21
Q

19.) Reaction to poison ivy is which type of hypersensitivity?
a. II
b. III
c. IV
d. I

A

c. IV

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22
Q

20.) The fluorescent antinuclear antibody test for lupus is an example of which of the following?

a. Direct fluorescence testing
b. Indirect fluorescence testing
c. Competitive immunoassay
d. Flow cytometry

A

b. Indirect fluorescence testing

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23
Q

21.) The normal activity of a type I hypersensitivity response is protection primarily against which of the following?

a. Viruses
b. Fungi
c. Bacteria
d. Parasites

A

d. Parasites

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24
Q

22.) The principal difference between type II and type III hypersensitivity reactions is:

a. involvement of helper T cells and macrophages.
b. whether the antigen is cellular or soluble.
c. the isotype of the antibody involved.
d. complement-mediated lysis of host cells

A

b. whether the antigen is cellular or soluble.

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25
Q

23.) The purified protein derivative reaction to determine exposure to tuberculosis is based on which of the following?

a. Formation of antigen–antibody complexes
b. A sensitized T-cell response
c. An immediate hypersensitivity reaction
d. A type II hypersensitivity reaction

A

b. A sensitized T-cell response

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26
Q

24.) Type I hypersensitivity involves:

a. a kidney membrane antigen and specific antibody.
b. IgE binding to mast cells and basophils.
c. natural killer cell activation
d. phagocytic cell degranulation and proteolytic enzyme activity

A

b. IgE binding to mast cells and basophils.

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27
Q

25.) What is the target of the autoimmune response that leads to multiple sclerosis?

a. Nucleic acid
b. Myelin
c. Beta-islet cells
d. Thyroid-stimulating hormone receptor

A

Myelin

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28
Q

26.) Which isotype of immunoglobulin is involved in a type I hypersensitivity?

a. IgM
b. IgA
c. IgG
d. IgE
e. IgD

A

d. IgE

29
Q

27.) Which of the following is an immune privileged site?
a. Lung
b. Appendix
c. Thyroid
d. Adrenal gland
e. Testes

A

e. Testes

30
Q

28.) Which of the following is considered a systemic autoimmune disease?
a. Systemic lupus erythematosus
b. Myasthenia gravis
c. Multiple sclerosis
d. Graves disease

A

a. Systemic lupus erythematosus

31
Q

29.) Which of the following occurs in hemolytic disease of the newborn?
a. gE builds up on the mother’s cells.
b. The baby must be Rh–.
c. The Rh– mother is exposed to Rh+ baby cells.
d. The Rh+ mother is exposed to Rh– baby cells.

A

c. The Rh– mother is exposed to Rh+ baby cells.

32
Q

30.) Which mechanism is involved in peripheral tolerance to self-antigens?
a. Negative selection
b. No answer text provided.
c. Positive selection
d. Lack of co-stimulatory signals from antigen-presenting cells

A

d. Lack of co-stimulatory signals from antigen-presenting cells

33
Q

Immune injury resulting from the localization of immune complexes in blood vessels and
tissues described which hypersensitivity reaction?
a. IV
b. I
c. III
d. II

A

III

34
Q

Type I hypersensitivity involves:
a. A kidney membrane antigen and specific antibody
b. IgE binding to mast cells and basophils
c. Phagocytic cell degranulation and proteolytic enzyme activity
d. Natural killer cell activation

A

b. IgE binding to mast cells and basophils

35
Q

A 45 year old male presents toh is physician complaining of ach joints, chronic runny nose, and coughing up blood. Chest x-ray shows pulmonary infiltrates. Cortisol is increased; ESR is slightly elevated. Tests for autoantibodies are positive for anti-neutrophil cytoplasmic abnormalities. On the basis of these findings, a likely diagnosis ofr this patient is:

A

Wegener’s granulomatosis

36
Q

Which of the following diseases is an example of type II hypersensitivity?

A

Myasthenia gravis

37
Q

A spackled nuclear pattern in an ANA indicates:

A

Antibody to an extractable nuclear antigen

38
Q

A 10-year-old girl visits her physician’s office because she has been complaining about being thirsty and having to go to the bathroom all the time. She has lost 15 pounds over the past 6 months and has been more irritable than usual, especially after meals. The girls fasting blood glucose is 575 mg/dL (Ref. Range <100 mg/dL), her C-peptide is 0.5 ng/mL (Ref. Range, 0.8-3.1 ng/mL), and she has autoantibodies against glutamic acid decarboxylase and insulin. On the basis of these findings, a likely diagnosis for this girl is:

A

Type 1 diabetes

39
Q

By gradually increasing doses of an allergen over time, allergen immunotherapy is thought to:

A

Induce Treg cell development

40
Q

To determine whether a patient can accept a solid organ transplant from a nonrelated donor, which of the following tests would be used to verify compatibility after an HLA match is determined?
ABO blood typing
CDC assay
HLA antibody screen
RAST test

A

HLA antibody screen

41
Q

Cold autoimmune hemolytic anemia is an example of which type of hypersensitivity?

A

II

42
Q

A 54-year-old woman presents to her optometrist complaining that she has been having difficulty focusing on objects near and far. Her vision problems are getting progressively worse. She also thinks that her eyelids are drooping, and she is thinking of getting plastic surgery to “put them back up.” The optometrist cannot find a good reason for her vision problems but is able to fit her with glasses and recommends that she see a rheumatologist, as this would be consistent with myasthenia gravis. What autoantibody would you recommend be tested for in this patient?

A

Antibody to the acetylcholine receptor

43
Q

A 7-month-old boy is seen by a specialist because of hypocalcemia, viral pneumonia, a history significant for recurrent diarrhea, and oral candidiasis. An x-ray reveals the lack of a thymic shadow. A likely diagnosis for this boy is:

A

DiGeorge anomaly

44
Q

A 9-month old boy is suspected of having an immune deficiency because he had many recurrent infections with Streptococcus pneumoniae. Laboratory tests reveal a normal percentage of T cells and T cell subsets but a lack of mature B cells and immunoglobulins. This boy most likely has

A

X-linked agammaglobulinemia

45
Q

4.) A child suspected of having an inherited humoral immunodeficiency disease is given a diphtheria/tetanus vaccine. Two weeks after the immunization, his level of antibody to the specific antigens is measured. Which result is expected for this patient if he does have this deficiency?

a. An increase in IgG-specific antibody but not IgM-specific antibody
b. No change in the level of specific antibody
c. Increased levels of nonspecific antibody
d. Increased levels of specific antibody

A

b. No change in the level of specific antibody

46
Q

1.) A 6-month-old baby has suffered from recurrent bacterial infections. Flow cytometry results indicate a lack of B cells but the presence of normally functioning T cells. Which is the most likely diagnosis?

a. DiGeorge syndrome
b. Bruton’s tyrosine kinase deficiency
c. Selective IgA immunodeficiency
d. Severe combined immunodeficiency

A

b. Bruton’s tyrosine kinase deficiency

47
Q

5.) A nitroblue tetrazolium test shows little color in cells observed under a microscope. What disease does this finding correlate with?

a. Bruton’s tyrosine kinase deficiency
b. Transient hypogammaglobulinemia
c. Wiskott-Aldrich syndrome
d. Chronic granulomatous disease
e. Ataxia telangiectasia

A

d. Chronic granulomatous disease

48
Q

6.) A patient has a monoclonal serum band. Which of the following additional criteria would support a diagnosis of multiple myeloma?

a. Increased abnormal plasma cells in bone marrow or monoclonality of plasma cells
b. Nose bleeds or bruising
c. Presence of Reed-Sternberg cells
d. Recurrent infections

A

a. Increased abnormal plasma cells in bone marrow or monoclonality of plasma cells

49
Q

7.) A patient’s immunofixation electrophoresis shows excessive amounts of free monoclonal light chains. These light chains are referred to as:

a. Bence Jones proteins.
b. precipitated immunoglobulin A.
c. alpha-1 antitrypsin.
d. albumin.

A

a. Bence Jones proteins.

50
Q

8.) A transplant patient on a follow-up visit to his physician is noted to have progressive fibrosis and scarring with narrowing of the vessels leading to the transplanted organ. What type of rejection is occurring?

a. Acute
b. Accelerated
c. Chronic
d. Hyperacute

A

Chronic

51
Q

9.) A transplantation patient suffers an organ rejection within hours after the procedure. What type of rejection occurred?

a. Hyperacute
b. Chronic
c. Acute
d. Graft-versus-host disease

A

a. Hyperacute

52
Q

10.) Decreased CD3-positive lymphocytes and a lack of responsiveness to phytohemagglutinin in the circulation are typically associated with:

a. DiGeorge anomaly.
b. transient hypogammaglobulinemia.
c. chronic granulomatous disease.
d. inflammation.

A

a. DiGeorge anomaly.

53
Q

11.) If a patient suffers with an increased susceptibility to septicemias by Neisseria sp., but not other bacteria. Which of the following complement activities is most likely deficient in this patient?

a. Mast cell degranulation
b. Enhancing phagocytosis
c. Recruitment of neutrophils
d. Formation of membrane attack complex

A

d. Formation of membrane attack complex

54
Q

12.) In a patient who is exhibiting signs of graft-versus-host disease, which cell type is most likely responsible for the reaction?

a. T cells
b. B cells
c. Eosinophils
d. Macrophages

A

a. T cells

55
Q

13.) In indirect allorecognition, the host’s T helper cells recognize foreign protein and uptake, process, and present it to recipient antigen-presenting cells (APCs).

a. True
b. False

A

b. False

56
Q

14.) In direct allorecognition, the recipient T cells bind and respond directly to foreign HLA proteins.

a. True
b. False

A

a. True

57
Q

15.) Patients with recombinase activating gene 1 (RAG-1) or RAG-2 deficiencies have decreased numbers of:

a. monocytes.
b. lymphocytes.
c. Granulocytes
d. all of the other answers are true

A

b. lymphocytes.

58
Q

16.) Serum samples from day 1 and day 4 were collected from a patient showing signs of disease. The serum samples were assayed for IgG titer against a potential pathogen consistent with the patient’s clinical signs. The titers for the first sample was 16 while the second sample was 32.

a. Need a sample taken later as the two samples assayed may have been collected too close together
b. The patient is immune to the pathogen as the antibody levels are high enough to resist infection
c. No answer text provided.

A

a. Need a sample taken later as the two samples assayed may have been collected too close together

59
Q

18.) The accumulation of immune complexes in renal glomeruli or joints (lupus-like syndromes) can be caused by a deficiency in the complement component:

a. Factor B
b. C5.
c. C2.
d. properdin.

A

c. C2.

60
Q

19.) The basic difference between a leukemia and lymphoma is the

a. typical age of patients.
b. migration pattern of cells.
c. stage of cell differentiation of proliferating cell.

A

b. migration pattern of cells.

61
Q

20.) The most serious impairment of opsonization and antimicrobial defense is caused by a deficiency in complement component:

a. C1q
b. C5
c. factor B
d. C3

A

d. C3

62
Q

21.) Which is true of selective IgA deficiency?

a. Patients may develop an anti-IgA antibody.
b. It is very rare.
c. It is invariably fatal.
d. It mainly occurs in older adults.

A

a. Patients may develop an anti-IgA antibody.

63
Q

22.) Which of the following diseases is characterized by skin involvement?

a. Multiple myeloma
b. Hairy cell leukemia
c. Hodgkin’s disease
d. Sézary syndrome

A

d. Sézary syndrome

64
Q

23.) Which of the following findings is a diagnostic criterion for monoclonal gammopathy of undetermined significance?

a. Presence of CRAB features
b. Serum monoclonal protein greater than 3 g/dL
c. Increased calcium in the blood
d. Plasma cell count lower than 10% of total cells in bone marrow

A

d. Plasma cell count lower than 10% of total cells in bone marrow

65
Q

24.) Which of the following is characteristic of an acute graft-versus-host disease episode?

a. The reaction involves the skin, gastrointestinal (GI) tract, and liver.
b. The reaction involves the recipient’s bone marrow.
c. The reaction occurs within 100 days of the transplant.
d. The reaction produces a fibrous condition of the mouth and eyes.

A

a. The reaction involves the skin, gastrointestinal (GI) tract, and liver.

66
Q

25.) Which of the following statements about severe combined immunodeficiency is true?

a. It occurs only in males.
b. It is accompanied by hypergammaglobulinemia.
c. Patients can be vaccinated with live virus.
d. It may be associated with a signal transduction defect.

A

d. It may be associated with a signal transduction defect.

67
Q

26.) Which type of gene is required for cell growth and division but can cause malignant transformation when altered?

a. Anti-tumor gene
b. Tumor suppressor gene
c. Proto-oncogene
d. Immunoglobulin gene

A

c. Proto-oncogene

68
Q

27.) Your otherwise healthy Caucasian patient has recurrent sinopulmonary infections and diarrhea. You find there is an isolated antibody deficiency. This rather common immunodeficiency disorder is most likely to be:

a. IgA
b. IgM
c. IgG
d. IgE

A

a. IgA

Blood Bank - Clinical Rotation (17 decks)

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