Deck 10: Hypersensitivity-And-Autoimmunity

Question 1

Which of the following is NOT associated with increased relative risk of developing systemic lupus erythematosus?

A)Female gender
B)Deficiency in complement protein C2
C)African-American ethnicity
D)Presence of HLA-DR3
E)Defect in B cell maturation

Answer 1

Defect in B cell maturation

Question 2

All of the following are effector mechanisms of antibody-mediated disease EXCEPT:

A)Opsonization and phagocytosis of cells
B)Fas-dependent apoptosis of cells
C)Complement- and Fc receptor-mediated inflammation and tissue injury
D)Antibody stimulation of cell surface receptors in the absence of the physiologic ligands
E)FceR crosslinking

Answer 2

Fas-dependent apoptosis of cells

Question 3

The most commonly identified alleles that are associated with risk for autoimmune diseases encode which type of the following proteins?

A)T cell costimulatory molecules
B)T cell inhibitory molecules
C)Class I MHC ( e.g HLA-B27)
D)Class II MHC
E)Complement proteins ( e.g.C3)

Answer 3

Class II MHC

Question 4

Which type of hypersensitivity disease is caused by deposition of antigen-antibody complexes in blood vessel walls?

A)Type I
B)Type II
C)Type III
D)Type IV
E)Type V

Question 5

For each of the clinical scenarios in questions ,choose the hypersensitivity type (A-D)that best matches the associated immunologic disease.(Answers may be used more than once. )
A 60-year-old man is evaluated for shortness of breath,lightheadedness,diarrhea,abdominal pain,and tingling in his fingers and toes.A blood smear from the patient is shown in the figure.Antibodies to intrinsic factor are detected in his serum.

A)Type I hypersensitivity
B)Type II hypersensitivity
C)Type III hypersensitivity
D)Type IV hypersensitivity

Question 6

In which of the following disorders is the underlying pathogenic mechanism NOT due to antibody-mediated damage to cells or tissues?

A)Pernicious anemia
B)Autoimmune hemolytic anemia
C)Pemphigus vulgaris
D)Acute rheumatic fever
E)Hyperacute allograft rejection

Question 7

For each of the clinical scenarios in questions ,choose the hypersensitivity type (A-D)that best matches the associated immunologic disease.(Answers may be used more than once. )
A 5-year-old girl is taken to the emergency department with lethargy ,confusion ,vomiting,abdominal pain ,and flushed skin that is warm to the touch.Respirations are fast and shallow and emanate a strong,fruity odor.The mother notes that the child has been excessively thirsty over the past week and that she began wetting her bed during naps.Urine dipstick testing reveals markedly elevated levels of glucose and ketones.

A)Type I hypersensitivity
B)Type II hypersensitivity
C)Type III hypersensitivity
D)Type IV hypersensitivity

Question 8

The figure shows routine histologic and immunofluorescence images of a kidney biopsy specimen taken from a 53-year-old man with acute-onset renal failure and hemoptysis (coughing up blood).The histologic section is notable for glomerular inflammation in a crescentic distribution.Staining,using fluorescently tagged anti-IgG antibody,shows linear deposits of IgG along the glomerular basement membrane.Urinalysis is positive for moderate proteinuria and red cell casts.A chest radiograph shows pulmonary infiltrates.Which of the following is the most likely diagnosis?

A)Systemic lupus erythematosus
B)Graves' disease
C)Chronic allograft rejection
D)Goodpasture's syndrome
E)Poststreptococcal glomerulonephritis

Question 9

Which of the following statements about immune complex-mediated diseases is NOT true?

A)Immune complexes may contain antibodies bound to either self or foreign antigens.
B)Immune complex-mediated diseases generally show systemic manifestations.
C)Pathologic features of immune complex diseases are determined by the cellular source of the antigen.
D)Small complexes are deposited in vessels more than large complexes,which are usually efficiently phagocytosed.
E)Complexes containing cationic antigens are more likely to produce severe,long-lasting injury by depositing in blood vessels and renal glomeruli.

Question 10

For each of the clinical scenarios in questions ,choose the hypersensitivity type (A-D)that best matches the associated immunologic disease.(Answers may be used more than once. )
A 23-year-old medical student is taken to the emergency department because of diffuse facial erythema (redness),tightness of the chest,and difficulty breathing.He reports that the symptoms began shortly after he ate a shellfish dinner at a nearby Thai restaurant.On physical examination,he appears to be in acute distress with elevated heart rate and respiratory rate and a dangerously low blood pressure.He is treated with epinephrine.

A)Type I hypersensitivity
B)Type II hypersensitivity
C)Type III hypersensitivity
D)Type IV hypersensitivity

Question 11

For each of the clinical scenarios in questions ,choose the hypersensitivity type (A-D)that best matches the associated immunologic disease.(Answers may be used more than once. )
A 29-year-old woman gives birth to an infant who is lethargic,jaundiced,and severely anemic and has an enlarged liver and spleen.The mother is RhD negative and the father is homozygous RhD positive.This is their second child.

A)Type I hypersensitivity
B)Type II hypersensitivity
C)Type III hypersensitivity
D)Type IV hypersensitivity