Deck 18: Immune Disorders

Question 1

An agricultural worker experiences difficulty breathing which becomes progressively worse. Tests show inflammation and damage of the lung tissue, but IgE antibodies and granulocytes are in the normal ranges. With which disorder of the immune system are these signs and symptoms consistent?

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

Answer 1

B

Question 2

A young woman comes into the clinic complaining of itchy, red skin and swelling on her arms and legs. She had not been in any parks or wooded areas recently, but she had been shopping. A blood sample reveals elevated levels of granulocytes. What treatment is the physician likely to prescribe at this point?

A) interferon
B) corticosteroids
C) methotrexate
D) cyclophosphamide
E) antihistamines

Answer 2

E

Question 3

Grafting skin from one area of the body to another in order to cover a burn is considered a(n)

A) autograft.
B) isograft.
C) dermograft.
D) xenograft.
E) allograft.

Answer 3

A

Question 4

Which of the following is NOT considered a hypersensitivity reaction?

A) a rash caused by poison ivy
B) itchy eyes and a runny nose in a dusty environment
C) breaking into hives after eating strawberries
D) dermatitis at the site of a metal watchband
E) immune system attack on the thyroid gland

Question 5

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

A) 85% of the population is Rh negative.
B) Rh antibodies are less abundant than the ABO antibodies.
C) It is present on the surface of the red blood cells of 85% of humans.
D) Preexisting antibodies do not occur.
E) It is an antibody found in humans and rhesus monkeys.

Question 6

Opportunistic infections typical of AIDS but rare otherwise include

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

Question 7

Primary immunodeficiency diseases

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

Question 8

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

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

Question 9

The syndrome known as AIDS is characterized by

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

Question 10

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

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

Question 11

The glycoprotein and glycolipid molecules on the surface of red blood cells

A) act to transport glucose and ions across the cytoplasmic membrane.
B) stimulate the production of antibodies that contribute to a transfusion reaction.
C) act as receptors for foreign antigens and trigger an early immune response.
D) cause degranulation of the cell when it is exposed to allergens.
E) function as a binding site for IgD.

Question 12

Severe malnutrition may lead to immunodeficiency by

A) promoting the development of food allergies.
B) triggering the proliferation of T cells.
C) preventing to proliferation of B cells.
D) decreasing the ability of the body to produce phagocytes.
E) triggering an inflammatory response.

Question 13

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

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

Question 14

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

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

Question 15

Which of the following would test positive for the tuberculin response?

A) someone who has previously had tuberculosis
B) someone who has previously been injected subcutaneously with tuberculin
C) someone who has been immunized with the tuberculosis vaccine
D) someone who has been immunized with the tuberculosis vaccine or has previously had tuberculosis
E) someone who has been immunized with the tuberculosis vaccine or previously been injected subcutaneously with tuberculin

Question 16

Which of the following bind the constant region of IgE?

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

Question 17

What is the underlying problem in most acquired immunodeficiencies?

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

Question 18

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

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

Question 19

A small amount of antigen is injected under the skin of a patient. After 30 minutes there is no apparent change at the injection site, but 36 hours later the patient reports that the area is red and swollen. This type of response is due to

A) type II hypersensitivity.
B) immunodeficiency.
C) type I hypersensitivity.
D) type IV hypersensitivity.
E) type III hypersensitivity.

Question 20

Hypotheses explaining the development of autoimmune disease include

A) hormonal stimulation of cytotoxic T cells.
B) molecular mimicry, genetic factors, and hormonal stimulation of cytotoxic T cells.
C) anaphylactic shock triggered by molecular mimicry.
D) molecular mimicry.
E) genetic factors.

Question 21

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

A) contraction of smooth muscle in the lungs and gastrointestinal tract
B) increased vascular permeability
C) increased production of tears and saliva
D) stimulation of nerve endings, causing itching and pain
E) destruction of nearby cells and activation of the complement system

Question 22

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

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

Question 23

Treatment with which of the following may result in acquired immunodeficiency?

A) azathioprine
B) interferon
C) corticosteroids
D) RhoGAM
E) antihistamine

Question 24

A child has a history of repeated severe infections and frequently has recurring infections with the same bacterial pathogen. A blood sample shows some lymphopenia, and serological tests are negative. Based on this information, which of the following is the likeliest diagnosis for this child?

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

Question 25

The tuberculin response is mediated by

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

Question 26

Multiple sclerosis is

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

Question 27

Which of the following is a tissue cell which produces leukotrienes and prostaglandins in response to allergen binding?

A) lymphocyte
B) mast cell
C) eosinophil
D) neutrophil
E) basophil

Question 28

Which of the following statements concerning allografts is TRUE?

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

Question 29

Which condition occurs when antibodies bind to and stimulate receptors that elicit production of thyroid hormone and growth of the thyroid gland?

A) DiGeorge syndrome
B) farmer's lung
C) Graves' disease
D) type I diabetes
E) multiple sclerosis

Question 30

Which of the following blood types can be safely transfused into someone with O blood type?

A) B
B) O
C) A
D) A and O
E) A, B, and O

Question 31

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

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

Question 32

The facial rash commonly occurring in patients with SLE is the result of

A) CTL attack on skin cells altered by sun damage.
B) CTL attack on connective tissue fibroblasts.
C) the release of histamines and kinins in response to sunburn.
D) antibody- antigen complexes accumulating in the skin.
E) autoantibodies causing mast cell degranulation.

Question 33

The disorder known as DiGeorge syndrome is a form of

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

Question 34

Which of the following statements regarding cyclosporine is FALSE?

A) It is active on resting and activated T cells.
B) It is sometimes used in combination with steroids.
C) It is produced by fungi.
D) It is less toxic than cyclophosphamide.
E) It is useful in preventing allograft rejection.

Question 35

Graft rejection can be reduced by

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

Question 36

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

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

Question 37

An accident victim receives a blood transfusion. Shortly thereafter, he begins to have difficulty breathing, develops a fever, and experiences nausea and vomiting. Which of the following is the most likely interpretation of these events?

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

Question 38

How is hemolytic disease of the newborn prevented?

A) treating with glucocorticoids throughout pregnancy
B) immunizing a woman against Rh factor prior to pregnancy
C) administering anti- IgG antibodies during pregnancy
D) administering anti- Rh IgG late in pregnancy and after pregnancy ends
E) treating with cytokines to prevent B cell activation late in pregnancy

Question 39

Type I diabetes is a(n)

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

Question 40

Failure to produce functional phagocytes results in disease known as

A) chronic granulomatus disease.
B) systemic lupus erythematosus.
C) pneumonitis.
D) DiGeorge syndrome.
E) agammaglobulinemia.

Question 41

One feature of hemolytic disease of the newborn is excessive (erythrocytes/bilirubin/hemoglobin), which leads to jaundice in the newborn.

Question 42

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

Question 43

Failure of the (marrow/spleen/thymus) to develop results in DiGeorge syndrome.

Question 44

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

Question 45

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

Question 46

A person comes to the clinic complaining of aching joints and muscles, swelling, and a decrease in urine output. The clinician also notes a rash on the skin of the face. A probable diagnosis is

A) Graves' disease.
B) immunodeficiency.
C) systemic lupus erythematosus.
D) pneumonitis.
E) dermatitis.

Question 47

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

Question 48

The (histamines/leukotrienes/prostaglandins/proteases) released in an immediate hypersensitivity reaction leads to the destruction of nearby cells and the activation of the complement system.

Question 49

If circulating immune complexes are deposited in the glomeruli, the ensuing type III hypersensitivity reaction can result in

A) allergic contact dermatitis.
B) multiple sclerosis.
C) pneumonitis.
D) kidney damage.
E) rheumatoid arthritis.

Question 50

Antigen- antibody complexes trapped in tissues and triggering complement activation or mast cell degranulation are characteristic of

A) type II hypersensitivity.
B) autoimmunity.
C) type I hypersensitivity.
D) graft rejection.
E) type III hypersensitivity.

Question 51

A graft that is from one identical twin to another is an (allograft/autograft/isograft).

Question 52

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

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

Question 53

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

Question 54

The damage caused by mismatched blood transfusions results from the activation of (antibody/complement/histamine) proteins.

Question 55

Immunological attack on the islets of Langerhans resulting in the inability to produce insulin leads to type (I/II) diabetes Mellitus. (Use roman numerals in your answer.)

Question 56

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

Question 57

Which of the following reactions is the result of type IV (delayed) hypersensitivity?

A) dermatitis in response to latex gloves
B) runny nose triggered by pollen
C) breathing difficulties after exposure to mold spores
D) skin irritation after wearing wool
E) sensitivity to pet dander

Question 58

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

Question 59

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

Question 60

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

Question 61

One of the important inherited defects in the second line of immune defense is a condition called chronic granulomatous disease. What is this disease, and how is it caused?

Question 62

Xenografts are tissue transplants from one individual to another within the same species.

Question 63

All autoimmune diseases have a genetic cause.

Question 64

A patient arrives at a hospital suffering from serious difficulty breathing and shortness of breath. Initial tests indicate none of the standard respiratory infectious agents are present. The physician suspects an immune disorder. What clinical indicators would distinguish between asthma, pneumonitis and Pneumocystic pneumonia?

Question 65

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

Question 66

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

Question 67

The tuberculin response is an example of allergic contact dermatitis.

Question 68

In most cases, production of antibodies against foreign ABO antigens is stimulated by exposure to foreign blood cells.

Question 69

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

Question 70

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

Question 71

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

Question 72

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

Question 73

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

Question 74

Hashimoto's thyroiditis and Graves' disease are autoimmune diseases involving the thyroid, but Hashimoto's results in hypothyroidism (low thyroid function), whereas Graves' results in hyperthyroidism (overactive thyroid). Both diseases are characterized by antithyroid antibodies. Discuss ways in which the autoimmune responses may produce the different outcomes.

Question 75

What type of hypersensitivity reaction is the tuberculin response?