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M1 immunology term 2 quiz 2 > levinson questions > Flashcards

levinson questions Flashcards

1
Q 
387: which category of hypersensitivity best describes hemolytic disease of the newborn caused by Rh incompatibility?
A: atopic or anaphylactic
B: cytotoxic
C: immune complex
D: delayed
A

B

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2
Q

388: the principal difference between cytotoxic (type II) and immune complex (type III) hypersensitivity is:
A: the class (isotype) of antibody
B: whether the antibody reacts with the antigen on the cell or reacts with antigen before it interacts with the cell
C: the participation of complement
D: the participation of T cells

A

B

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3
Q 
389: a child stung by a bee experiences respiratory distress within minutes and lapses into unconsciousness. this reaction is probably mediated by:
A: IgE antibody
B: IgG antibody
C: sensitized T cells
D: complement
E: IgM antibody
A

A

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4
Q

390: a patient with rheumatic fever develops a sore throat from which beta-hemolytic streptococci are cultured. the patient is started on treatment with penicillin, and the sore throat resolves within several days. however, 7 days after initiation of penicillin therapy, the patient develops a fever of 103 F, a generalized rash, and proteinuria. this most probably resulted from:
A: recurrence of the rheumatic fever
B: a different infectious disease
C: an IgE response to penicillin
D: an IgG-IgM response to penicillin
E: a delayed hypersensitivity reaction to penicillin

A

D

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5
Q

391: a kidney biopsy specimen taken from a patient with acute glomerulonephritis and sustained with fluorescein-conjugated anti-human IgG antibody would probably show:
A: no fluorescence
B: uniform fluorescence of the glomerular basement membrane
C: patchy, irregular fluorescence of the glomerular basement membrane
D: fluorescent B cells
E: fluorescent macrophages

A

C

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6
Q

392: a patient with severe asthma gets no relief from antihistamines. they symptoms are most likely to be caused by:
A: interleukin-2
B: slow-reacting substance A (leukotrienes)
C: serotonin
D: bradykinin

A

B

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7
Q 
393: hypersensitivity to penicillin and hypersensitivity to poison oak are both:
A: mediated by IgE antibody
B: mediated by IgG and IgM antibody
C: initiated by haptens
D: initiated by Th-2 cells
A

C

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8
Q

412: a positive tuberculin skin test (a delayed hypersensitivity reaction) indicates that:
A: a humoral immune response has occured
B: a cell-mediated immune response has occcured
C: both the T- and B-cell systems are functional
D: only the B-cell system is functional

A

B

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9
Q 
413: reaction to poison ivy or poison oak is:
A: an IgG-mediated response
B: an IgE-mediated response
C: a cell-mediated response
D: an arthus reaction
A

C

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10
Q 
414: a child disturbs a wasp nest, is stung repeatedly, and goes into shock within minutes, manifesting respiratory failure and vascular collapse. this is most likely to be due to:
A: systemic anaphylaxis
B: serum sickness
C: an arthus reaction
D: cytotoxic hypersensitivity
A

A

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11
Q 
426: a patient with a central nervous system disorder is maintained on teh drug methyldopa. hemolytic anemia develops, which resolves shortly after the drug is withdrawn. this is most probably an example of:
A: atopic hypersensitivity
B: cytotoxic hypersensitivity
C: immune-complex hypersensitivity
D: cell-mediated hypersensitivity
A

B

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12
Q

428: a delayed hypersensitivity reaction is characterized by:
A: edema without a cellular infiltrate
B: an infiltrate composed of neutrophils
C: an infiltrate composed of helper T cells and macrophages
D: an infiltrate composed of eosinophils

A

C

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13
Q

436: when immune complexes from the serum are deposited on glomerular basement membrane, damage to the membrane is caused mainly by:
A: gamma interferon
B: phagocytosis
C: cytotoxic T cells
D: enzymes released by polymorphonuclear cells

A

D

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14
Q 
452: a patient skin-tested with purified protein derivative (PPD) to determine previous exposure to mycobacterium tuberculosis develops induration at the skin test site 48 hours later. histologically, the reaction site would most probably show
A: eosinophils
B: neutrophils
C: helper T cells and macrophages
D: b cells
A

C

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15
Q 
453: hemolytic disease of the newborn caused by Rh blood group incompatibility requires maternal antibody to enter the fetal bloodstream. therefore, the mediator of this disease is:
A: IgE antibody
B: IgG antibody
C: IgM antibody
D: IgA antibody
A

B

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16
Q 
454: an Rh-negative woman married to a heterozygous Rh-positive man has three children. the probability that all three of their children are Rh-positive is:
A: 1:2
B: 1:4
C: 1:8
D: zero
A

C

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17
Q

455: which one of the following statements best explains the relationship between inflammation of the heart (carditis) and infection with group A beta-hemolytic streptococci?
A: streptococcal antigens induce antibodies cross-reactive with heart tissue
B: streptococci are polyclonal activators of B cells
C: streptococcal antigens bind to IgE on the surface of heart tissue and histamine is released
D: streptococci are ingested by neutrophils that release proteases that damage heart tissue

A

A

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18
Q

458: you have a patient who makes autoantibodies against his own red blood cells, leading to hemolysis. which one of the following mechanisms is most likely to explain the hemolysis?
A: perforins from cytotoxic T cells lyse the red cells
B: neutrophils release proteases that lyse the red cells
C: interleukin-2 binds to its receptor on the red cells, which results in lysis of the red cells
D: complement is activated, and membrane attack complexes lyse the red cells

A

D

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19
Q

474: each of the following statements concerning haptens is correct except:
A: a hapten can combine with (bind to) an antibody
B: a hapten cannot induce an antibody by itself; rather, it must be bound to a carrier protein to be able to induce antibody
C: in both penicillin-induced anaphylaxis and poison ivy, the allergens are haptens
D: haptens must be processed by CD8+ cells to become immunogenic

A

D

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20
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: immediate hypersensitivity
B: cytotoxic hypersensitivity
C: immune-complex hypersensitivity
D: delayed hypersensitivity

499: irregular deposition of IgG along glomerular basement membrane

A

C

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21
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: immediate hypersensitivity
B: cytotoxic hypersensitivity
C: immune-complex hypersensitivity
D: delayed hypersensitivity

500: involves mast cells and basophils

A

A

22
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: immediate hypersensitivity
B: cytotoxic hypersensitivity
C: immune-complex hypersensitivity
D: delayed hypersensitivity

501: involves macrophages and helper T cells

A

D

23
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: systemic lupis erythematosus
B: rheumatoid arthritis
C: rhematic fever
D: graves disease
E: myasthenia gravis

531: associated with antibody to the thyroid stimulating hormone (TSH) receptor

A

D

24
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: systemic lupis erythematosus
B: rheumatoid arthritis
C: rhematic fever
D: graves disease
E: myasthenia gravis

532: associated with antibody to IgG

A

B

25
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: systemic lupis erythematosus
B: rheumatoid arthritis
C: rhematic fever
D: graves disease
E: myasthenia gravis

533: associated with antibody to the acetylcholine receptor

A

E

26
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: systemic lupis erythematosus
B: rheumatoid arthritis
C: rhematic fever
D: graves disease
E: myasthenia gravis

534: associated with antibody to DNA

A

A

27
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: systemic lupis erythematosus
B: rheumatoid arthritis
C: rhematic fever
D: graves disease
E: myasthenia gravis

535: associated with antibody to streptococci

A

C

28
Q

394: a recipient of a 2-haplotype MHC-matched kidney from a relative still needs immunosuppression to prevent graft rejection because:
A: graft-versus-host disease is a problem
B: class II MHC antigens will not be matched
C: minor histocompatibility antigens will not be matched
D: complement components will not be matched

A

C

29
Q

395: bone marrow transplantation in immunocompromised patients presents which major problem?
A: potentially lethal graft-versus-host disease
B: high risk of T-cell leukemia
C: inability to use a live donor
D: delayed hypersensitivity

A

A

30
Q

396: what is the role of class II MHC proteins on donor cells in graft rejection?
A: they are the receptors for interleukin-2, which is produced by macrophages when they attack the donor cells
B: they are recognized by helper T cells, which then activate cytotoxic t cells to kill the donor cells
C: they induce the production of blocking antibodies that protect the graft
D: they induce IgE which mediates graft rejection

A

B

31
Q

397: grafts between genetically identical individuals (ie identical twins):
A: are rejected slowly as a result of minor histocompatibility antigens
B: are subject to hyperacute rejection
C: are not rejected, even without immunosuppresion
D: are not rejected if a kidney is grafted, but skin grafts are rejected

A

C

32
Q

400: chemically induced tumors have tumor-associated transplantation antigens that
A: are always the same for a given carcinogen
B: are different for two tumors of different histologic type even if induced by the same carcinogen
C: are very strong antigens
D: do not induce an immune response

A

B

33
Q

401: polyomavirus (a DNA virus) causes tumors in “nude mice” (nude mice do not have a thymus because of a genetic defect) but not in normal mice. The best interpretation is that:
A: macrophages are required to reject polyomavirus-induced tumors
B: natural killer cells can reject polyomavirus-induced tumors without help from T lymphocytes
C: T lymphocytes play an important role in the rejection of polyomavirus-induced tumors
D: B lymphocytes play no role in rejection of polyomavirus-induced tumors

A

C

34
Q 
425: a woman had a high fever, hypotension, and a diffuse macular rash. when all cultures showed no bacterial growth, a diagnosis of toxic shock syndrome was made. regarding the mechanism by which the toxin causes this disease, which one of the following is least accurate?
A: the toxin is not processed within the macrophage
B: the toxin binds to both the class II MHC protein and the T-cell receptor
C: the toxin activates many CD4-positive T cells and large amounts of interleukins are released
D: the toxin has an A-B subunit structure - the B subunit binds to a receptor, and the A subunit enters the cells and activates them
A

D

35
Q

429: two dissimilar inbred strains of mice, A and B, are crossed to yield an F1 hybrid strain, AB. If a large dose of spleen cells from an adult A mouse is injected into an adult AB mouse, which one of the following is most likely to occur?
A: the spleen cells will be destroyed
B: the spleen cells will survive and will have no effect in the recipient
C: the spleen cells will induce a graft-versus-host reaction in the recipient
D: the spleen cells will survive and induce tolerance of strain A grafts in the recipient

A

C

36
Q

430: this question is based on the same strains of mice described in the previous question. if adult AB spleen cells are injected into a newborn B mouse, which one of the following in most likely to occur?
A: the spleen cells will be destroyed
B: the spleen cells will survive without any effect on the recipient
C: the spleen cells will induce a graft-versus-host reaction in the recipient
D: the spleen cells will survive and induce tolerance of strain A grafts in the recipient

A

D

37
Q

431: the minor histocompatibility antigens on cells:
A: are detected by reaction with antibodies and complement
B: are controlled by several genes in the major histocompatibility complex
C: are unimportant in human transplantation
D: induce reactions that can cumulatively lead to a strong rejection response

A

D

38
Q 
433: an antigen found in relatively high concentration in the plasma of normal fetuses and a high proportion of patients with progressive carcinoma of the colon is:
A: viral antigen
B: carcinoembryonic antigen
C: alpha-fetoprotein
D: heterophil antigen
A

B

39
Q

440: individuals of blood group type AB:
A: are Rh(D)-negative
B: are “universal recipients” of transfusions
C: have circulating anti-A and anti-B antibodies
D: have the same haplotype

A

B

40
Q

450: in which one of the following situations would a graft-versus-host reaction be most likely to occur (mouse strains A and B are highly inbred; AB is an F1 hybrid between strain A and B)
A: newborn strain A spleen cells injected into a strain B adult
B: X-irradiated adult strain A spleen cells injected into a strain B adult
C: adult strain A spleen cells injected into an x-irradiated strain AB adult
D: adult strain AB spleen cells injected into a strain A newborn

A

C

41
Q

451: in a mixed-lymphocyte culture, lymphocytes from person X, who is homozygous for the HLA-Dw7 allele, are irradiated and then cultured with lymphocytes from person Z. it is found that DNA synthesis is not stimulated. the proper conclusion to be drawn is that:
A: person z is homozygous for HLA-Dw7
B: person Z is homozygous or heterozygous for HLA-Dw7
C: person Z is heterozygous for HLA-Dw7
D: person Z does not carry the HLA-Dw7 allele

A

B

42
Q

459: your patient is a child who has no detectable T or B cells. this immunodeficiency is most probably the result of a defect in:
A: the thymus
B: the membrane attack complex of complement
C: t cell-b cell interaction
D: stem cells originating in the bone marrow

A

D

43
Q

467: which one of the following is the best method of reducing the effect of graft-versus-host disease in a bone marrow recipient?
A: matching the complement components of donor and recipient
B: administering alpha interferon
C: removing mature T cells from the graft
D: removing the pre-B cells from the graft

A

C

44
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: severe combined immunodeficiency disease (SCID)
B: x-linked hypogammaglobulinemia
C: thymic aplasia
D: chronic granulomatous disease
E: hereditary angioedema

526: caused by a defect in the ability of neutrophils to kill microorganisms

A

D

45
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: severe combined immunodeficiency disease (SCID)
B: x-linked hypogammaglobulinemia
C: thymic aplasia
D: chronic granulomatous disease
E: hereditary angioedema

527: caused by a development defect that results in a profound loss of T cells

A

C

46
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: severe combined immunodeficiency disease (SCID)
B: x-linked hypogammaglobulinemia
C: thymic aplasia
D: chronic granulomatous disease
E: hereditary angioedema

528: caused by a deficiency in an inhibitor of the C1 component of complement

A

E

47
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: severe combined immunodeficiency disease (SCID)
B: x-linked hypogammaglobulinemia
C: thymic aplasia
D: chronic granulomatous disease
E: hereditary angioedema

529: caused by a marked deficiency of B cells

A

B

48
Q

For each numbered item, select the one lettered option that is most closely associated with it.

A: severe combined immunodeficiency disease (SCID)
B: x-linked hypogammaglobulinemia
C: thymic aplasia
D: chronic granulomatous disease
E: hereditary angioedema

530: caused by a virtual absence of both B and T cells

A

A

49
Q

3: a 25-year-old man has a history of four episodes of bois in the last year. boils are abscesses caused by staphylococcus aureus. which one of the following is most likely to be the underlying immunologic factor that predisposes him to multiple episodes of boils?
A: a deficient amount of the C8 component of complement in his plasma
B: an inability of his macrophages to present antigen in association with class I MHC proteins
C: a failure to release granzymes from his cytotoxic T cells
D: an insufficient amount of IgG in his plasma

A

D

50
Q 
13: your patient has been treated for endocarditis with penicillin G for the past 2 weeks. she now has a fever and maculopapular erythematous rash over her chest and abdomen. a urinalysis shows significant protein in the urine. if the fever, rash, and proteinuria are immunologic in origin, which one of the following is most likely to be involved?
A: IgG and complement
B: IgE and histamine
C: IL-2 and cytotoxic T cells
D: Gamma interferon and macrophages
A

A

51
Q

33: allergic rhinitis is characterized by sneezing, rhinorrhea, nasal congestion, and itching of the eyes and nose. persons with allergic rhinitis have “X” that bind to high-affinity receptors on “Y.” On reexposure to antigen, the “Y” of patients with allergic rhinitis degranulate, releasing “Z” and other mediators. Which one of the following sets best describes X, Y, and Z?
A: X is IgE, Y is macrophages, and Z is tumor necrosis factor
B: X is IgE, Y is basophils, and Z is histamine
C: X is IgG, Y is eosinophils, and Z is histamine
D: X is IgG, Y is neutrophils, and Z is tumor necrosis factor
E: X is IgA, Y is eosinophils, and Z is interleukin-5

A

B

52
Q

37: a 22-year-old woman has an erythematous rash on the malar eminences of her face that gets worse when she is out in the sun. she has lost about 10 lb and feels tired much of the time. she took her temperature a few times and it was 99 F. physical examination was normal except for the rash. laboratory tests revealed a hemoglobin of 11 and a white blood cell count of 5500. urinalysis showed albumin in the urine but no red cells, white cells, or bacteria. which one of the following is the most likely laboratory finding in this disease?
A: decreased number of helper (CD4-positive) T cells
B: high level of antibodies to double-stranded DNA
C: increased number of cytotoxic (CD8-positive) T cells
D: low level of C1 inhibitor
E: low microbicidal activity of neutrophils

A

B

M1 immunology term 2 quiz 2 (2 decks)

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