Deck 11: Immune Responses Against Tumors and Transplants

Question 1

Patients with which of the following disorders would be LEAST likely to develop Epstein-Barr virus-associated Burkitt's lymphoma?

A)AIDS
B)Bruton's disease
C)DiGeorge syndrome (congenital absence of the thymus)
D)Malarial infection
E)Immunosuppressive therapy for renal allograft

Answer 1

Bruton's disease

Question 2

A 47-year-old woman had a mastectomy because she had breast carcinoma that was previously diagnosed by biopsy.Pathologic examination revealed that several axillary lymph nodes contained metastatic tumors.A test was performed on tumor cells extracted from the mastectomy specimen,which indicated that the tumor cells overexpressed a certain cellular proto-oncogene.On the basis of this test result,the patient was treated with an FDA-approved monoclonal antibody specific for the protein encoded by that gene.Which of the following was most likely the protein target of this antibody therapy?

A)p53
B)H-Ras
C)HPV E7
D)Rb
E)Her2

Answer 2

Her2

Question 3

The first experiments that demonstrated protective adaptive immune responses to tumors involved transplantation of chemical carcinogen-induced tumors between rodents.Which of the following facts was learned from these experiments?

A)There are only a limited number of antigens that can evoke a protective anti-tumor response.
B)Transplanted sarcomas can evoke protective cytolytic T lymphocyte responses.
C)Carcinomas express tumor antigens that are recognized by T lymphocytes.
D)Protective immune responses against tumors are largely mediated by antibodies.
E)Spontaneously arising tumors are often eradicated by cytolytic T lymphocytes.

Answer 3

Transplanted sarcomas can evoke protective cytolytic T lymphocyte responses.

Question 4

Which of the following molecules is involved in the principal mechanism by which the immune system kills tumor cells?

A)Perforin
B)Complement C3
C)IgG
D)TGF- $\gamma$
E)Interleukin-2

Question 5

Class I MHC-restricted T cell responses to tumors can be demonstrated in patients with various types of tumors,yet most of these tumors do not express costimulatory molecules.Which mechanism most likely explains how naive CD8⁺ T cells specific for antigens expressed by these tumors are stimulated to differentiate into cytolytic T lymphocytes?

A)Malignant transformation of CD8⁺ T cells
B)Tumor secretion of T cell-activating cytokines
C)Cross reaction of microbe-specific CD8⁺ T cells with tumor antigens
D)Cross priming
E)Antigenic modulation

Question 6

A 17-year-old girl from southern China has had a sore throat and fever for 1 week.On physical examination,generalized lymphadenopathy is noted.A rapid strep test for streptococcal infection is negative and a CBC shows 20% atypical lymphocytes.A Monospot test for the presence of heterophile antibodies is positive.This illness is associated with eventual development of which of the following malignancies?

A)Kaposi's sarcoma
B)Cervical carcinoma
C)Follicular lymphoma
D)Human T cell lymphoma
E)Nasopharyngeal carcinoma

Question 7

All of the following statements about immune responses to tumors are true EXCEPT:

A)T cells specific for tumor antigens can be found in many human tumor patients.
B)Antibodies specific for tumor antigens can be found in many human tumor patients.
C)The presence of lymphocytic infiltrates in certain tumors is associated with a better prognosis than lymphocyte-poor tumors of the same histologic type.
D)Immunodeficient individuals are more likely to develop the most common forms of cancer than are immunocompetent individuals.
E)The host immune response is usually incapable of eradicating tumors once they are established.

Question 8

A 56-year-old woman sees her primary care physician complaining of flank pain and hematuria and is found to have a hematocrit of 56%.She is subsequently diagnosed with advanced renal cell carcinoma.Part of the patient's management involves systemic cytokine therapy;however,the patient develops severe pulmonary edema as a result of the treatment.Which of the following cytokines was most likely used in this patient's therapy?

A)Interleukin (IL)-2
B)IL-6
C)IL-12
D)GM-CSF (granulocyte-macrophage colony-stimulating factor)
E)TNF (tumor necrosis factor)

Question 9

Injections of the mycobacterium Bacillus Calmette-Guérin (BCG)at the sites of tumor growth helps to activate which of the following effector immune cells?

A)B cells
B)Cytolytic T lymphocytes
C)Natural killer cells
D)Macrophages
E)Neutrophils

Question 10

Which of the following is NOT a mechanism by which tumors evade immune responses?

A)Decreased synthesis of TAP
B)Increased expression of glycocalyx
C)Lack of costimulatory molecule expression
D)Increased expression of TGF-
E)Increased expression of Fas