Microbiology Ch. 14

After further investigation, it is learned that the father is Rh+, and so was the first child. However, Marian declines the RhoGAM injection because "there were no complications with my first pregnancy and delivery, how can you be sure there will be with this one?" Plus, she also explains how unpleasant the RhoGAM injection was with her first pregnancy, and she would like to avoid it, if at all possible. What is an appropriate response? "It is important you receive your RhoGAM injection, because this child will probably develop hemolytic disease of the newborn if you don't." "You were probably sensitized to Rh factor with your first pregnancy, so the chances are decreased that this child will develop hemolytic disease of the newborn. I'll ask the doctor if we can forego the injection." "It is important that we keep you from being sensitized to Rh factor, otherwise future pregnancies will be at risk for developing hemolytic disease of the newborn." "I didn't realize you received RhoGAM with your first pregnancy. There's a good chance you don't need it this time after all."

"It is important that we keep you from being sensitized to Rh factor, otherwise future pregnancies will be at risk for developing hemolytic disease of the newborn."

Jonathan is talking to you about his antirejection medications, and wants to know how they work. What is the best explanation? "They work on your liver to make it less hostile to its new environment, increasing the chances of organ acceptance." "They work by changing the MHC markers on your new liver to be more like your own." "They work by suppressing the body's immune response against a foreign organ." "They work by tricking your body into thinking its MHC markers are similar to your new liver's."

"They work by suppressing the body's immune response against a foreign organ."

Marian asks you to explain to her what an Rh reaction involves with her baby. What is the best explanation? "Your Rh antibodies will cross into your baby's fetal circulation, attacking and lysing his red blood cells." "Your baby's Rh+ antibodies cross into your system, attacking your red blood cells and making you unable to deliver a healthy baby." "Your baby has a type II hypersensitivity that will render its liver unable to clear bilirubin released from lysed cells." "As soon as your baby is born, if he doesn't receive RhoGAM, his body will reject not having Rh antibody anymore."

"Your Rh antibodies will cross into your baby's fetal circulation, attacking and lysing his red blood cells."

A secondary acquired immunodeficiency is SCID. AIDS. DiGeorge syndrome. adenosine deaminase (ADA) deficiency. agammaglobulinemia.

AIDS

Degranulation of mast cells leads to headache. airway obstruction. All of the choices are correct. dilated blood vessels.

All of the choices are correct

Transfusion of the wrong blood type can cause systemic shock and kidney failure. recipient antibody activating the complement cascade to attack the RBCs. fever and anemia. All of the choices are correct. massive hemolysis of the donor RBCs.

All of the choices are correct

Which of the following allergic mediators are being currently activated in Mark's system? All of the choices are correct. leukotrienes serotonin mast cells

All of the choices are correct

A person who are Rh- will have anti-Rh antibodies in their serum from early infancy. True False

False

The tuberculin reaction develops within 30 minutes of the skin test in people with prior sensitization due to tuberculosis infection. True False

False

All of the following are involved in type 2 hypersensitivity except foreign cells. IgE. IgG. complement. IgM.

IgE

What is the most likely development and progression of Mark's asthma? IgG-mediated response with lung tissue that is hypersensitive to products of mast cell degranulation IgE-mediated response with lung tissue that is hypersensitive to products of mast cell degranulation IgE response that causes the body to not recognize its own lung tissue, and fights against it by constricting bronchioles IgG response that causes the body to not recognize its own lung tissue, and fights against it by constricting bronchioles

IgE-mediated response with lung tissue that is hypersensitive to products of mast cell degranulation

Human blood types involve all the following except genetically determined glycoprotein markers. MHC genes. inheritance of two of three possible alleles. ABO antigen markers. genes that code for an enzyme that adds a terminal carbohydrate to RBC receptors.

MHC genes

If Jonathan experiences graft rejection, what type of cells will most likely be primarily responsible? T helper cells natural killer cells T memory cells T cytotoxic cells

T cytotoxic cells

A viral infection can cause type I diabetes mellitus. True False

True

During graft rejection, cytotoxic T cells of the recipient recognize and respond to foreign class I MHC receptors on the grafted cells. True False

True

Severe combined immunodeficiencies (SCIDs) are due to a genetic defect in the development of both T cells and B cells. delayed hypersensitivity. failure of B-cell development and maturity. congenital absence or immaturity of the thymus gland. autoantibodies.

a genetic defect in the development of both T cells and B cells

Myasthenia gravis disease arises from the production of autoantibodies against acetylcholine receptors on skeletal muscle. acetylcholine receptors on smooth muscle. cells in thyroid follicles. myelin sheath cells of the nervous system. sodium pump proteins in the cell membrane.

acetylcholine receptors on skeletal muscle

Once a mother has been sensitized to the Rh factor only future Rh- fetuses are at risk. she can never again have a low risk pregnancy. None of the choices is correct. all other Rh+ fetuses are at risk. she can be given RhoGAM in future pregnancies to prevent hemolytic disease of the newborn.

all other Rh+ fetuses are at risk

A seasonal reaction to inhaled allergens is atopic dermatitis. asthma. anaphylaxis. allergic rhinitis. eczema.

allergic rhinitis

What type of transplant did Jonathan receive? autograft xenograft allograft isograft

allograft

What is the most likely diagnosis for Mark? hay fever asthma seasonal allergy drug allergy

asthma

What is the most likely diagnosis for Mark? seasonal allergy hay fever asthma drug allergy

asthma

A chronic, local allergy such as hay fever is considered atopic. T-cell mediated. delayed. antibody mediated. systemic anaphylactic.

atopic

What classification of reaction is Mark currently experiencing? atopy cutaneous anaphylaxis acute allergic systemic anaphylaxis

atopy

Autoimmunity is typically due to graft rejection. a deficiency in T-cell development. autoantibodies and T cells. transfusion reaction. IgE and mast cells.

autoantibodies and T cells

Tissue transplanted from one body site on a patient to a different body site on that patient is called a(n) allograft. xenograft. hypograft. isograft. autograft.

autograft

Which event occurs with the sensitizing dose of allergen? histamine acts on smooth muscle prostaglandins cause vasodilation and increased vascular permeability binding of IgE by the Fc region to mast cells and basophils degranulation bonding of allergen to adjacent IgE binding sites on mast cells and basophils

binding of IgE by the Fc region to mast cells and basophils

What will be the immediate action of an allergen when it enters that body for a second time? bonding of allergen to adjacent IgE binding sites on mast cells and basophils degranulation histamine acts on smooth muscle binding of IgE by the Fc region to mast cells and basophils prostaglandins cause vasodilation and increased vascular permeability

bonding of allergen to adjacent IgE binding sites on mast cells and basophils

Which type(s) of hypersensitivity is IgG involved with? both antibody mediated and immune complex mediated anaphylaxis immune complex mediated antibody mediated both anaphylaxis and antibody mediated

both antibody mediated and immune complex mediated

What involves determination of donor HLA antigens compared to those of the recipient's tissue? both skin graft and organ transplantation All of the choices are correct. skin graft organ transplantation blood transfusion

both skin graft and organ transplantation

Which of the following is not a major organ that can be a target of immune complex deposition? heart and lungs blood vessels and skin brain kidneys joints

brain

The DiGeorge syndrome is the result of delayed hypersensitivity. autoantibodies. a genetic defect in the development of both T cells and B cells. congenital absence or immaturity of the thymus gland. failure of B-cell development and maturity.

congenital absence or immaturity of the thymus gland

Which of the following is not a possible symptom of type I hypersensitivity? sneezing contact dermatitis rhinitis rashes diarrhea

contact dermatitis

Allergic patients receiving small, controlled injections of specific allergens are undergoing None of the choices are correct. sensitization. tissue matching. desensitization. degranulation.

desensitization

Which of the following conditions would you expect Mark to have in his personal medical history? blood transfusion reaction eczema premature birth hay fever

eczema

Which of the following conditions would you expect Mark to have in his personal medical history? blood transfusion reaction premature birth eczema hay fever

eczema

Which factor would increase the risk of the unborn child being Rh+? history of preexisting type I hypersensitivity both maternal grandparents being Rh- previous child being Rh- father being Rh+

father being Rh+

The potential for hemolytic disease of the newborn occurs when maternal Rh+ cells enter an Rh- fetus. maternal Rh- cells enter an Rh+ fetus. fetal Rh- cells enter an Rh+ mother. fetal Rh+ cells enter an Rh+ mother. fetal Rh+ cells enter an Rh- mother.

fetal Rh+ cells enter an Rh- mother

What steps should you advocate to be taken by the doctor during this visit? plan for first dose of RhoGAM immediately after birth first dose of RhoGAM should be administered nothing, since it is not known if the first child was Rh+ yet nothing can be done about the Rh factor

first dose of RhoGAM should be administered

What could result when grafted tissue such as bone marrow contains passenger lymphocytes? None of the choices is correct. host rejection of graft formation of autoantibodies graft versus host disease hypogammaglobulinemia

graft versus host disease

Which is mismatched? hay fever - type IV hypersensitivity serum sickness - type III hypersensitivity poison ivy dermatitis - type IV hypersensitivity transfusion reaction - type II hypersensitivity food allergy - type I hypersensitivity

hay fever - type IV hypersensitivity

Any heightened or inappropriate immune response resulting in tissue damage is called a(n) immunodeficiency. transfusion reaction. hypersensitivity. autoimmune disease. desensitization.

hypersensitivity

Allergic reactions to penicillins are considered a(n) _____ hypersensitivity. antibody mediated both T-cell mediated and antibody mediated T-cell mediated immediate immune complex mediated

immediate

The study of diseases associated with excesses and deficiencies of the immune system is histopathology. epidemiology. immunopathology. humoralpathology. hemopathology.

immunopathology

Histamine causes all of the following except increased sensitivity to pain. constriction of smooth muscle of bronchi and the intestine. pruritis and headache. relaxes vascular smooth muscle. wheal and flare reaction in skin.

increased sensitivity to pain

Fungal spores and animal dander are considered to be which type of allergen? injectant contactant inhalant ingestant None of the choices is correct.

inhalant

Corticosteroids will inhibit the activity of lymphocytes. bind to histamine receptors on target organs. block synthesis of leukotrienes. reverse spasms of respiratory smooth muscles. relieve inflammatory symptoms.

inhibit the activity of lymphocytes

Bee sting venom is considered to be which type of allergen? injectant inhalant None of the choices is correct. ingestant contactant

injectant

A female who is Rh- is in the majority of the population with regard to Rh status. All of the choices are correct. is at risk for a pregnancy resulting in hemolytic disease of the newborn. inherited two dominant genes. can never have an Rh+ baby.

is at risk for a pregnancy resulting in hemolytic disease of the newborn

The chemical mediator that causes prolonged bronchospasm, vascular permeability, and mucus secretion of asthmatic patients is serotonin. leukotriene. prostaglandin. platelet-activating factor. histamine.

leukotriene

Each of the following is an autoimmune disease except type I diabetes. metastatic cancer. systemic lupus erythematosus. Graves' disease. rheumatic fever.

metastatic cancer

In multiple sclerosis, autoantibodies attack acetylcholine receptors on smooth muscle. cells in thyroid follicles. acetylcholine receptors on skeletal muscle. myelin sheath cells of the nervous system. sodium pump proteins in the cell membrane.

myelin sheath cells of the nervous system

A second encounter with an allergen that causes a response is called the provocative dose. hypersensitivity dose. sensitizing dose. desensitizing dose. allergic dose.

provocative dose

Allergies run in families because immunoglobulins pass from mother to fetus. relative production of IgE is inherited. the variable region of antibodies is genetically determined. All of the choices are correct. immunoglobulins pass through breast milk.

relative production of IgE is inherited

Epinephrine reverses constriction of airways. causes desensitization. inhibits the activity of lymphocytes. All of the choices are correct. is an antihistamine.

reverses constriction of airways

The initial encounter with an allergen is called the provocative dose. hypersensitivity dose. allergic dose. sensitizing dose. desensitizing dose.

sensitizing dose

A systemic, sometimes fatal reaction with airway obstruction and circulatory collapse is delayed. T-cell mediated. atopic. antibody mediated. systemic anaphylactic.

systemic anaphylactic

All of the following are associated with IgE and mast cell-mediated allergy except eczema. anaphylaxis. drug allergy. systemic lupus erythematosus. allergic asthma.

systemic lupus erythematosus

Autoantibodies cause tissue injury in all of the following diseases except multiple sclerosis. myasthenia gravis. tuberculin reaction. Graves' disease. rheumatoid arthritis.

tuberculin reaction

Atopy and anaphylaxis are hypersensitivities in the category type I only. type I, type II, type III, and type IV. type I and type IV. type IV only. type I, type II, and type III.

type I only

The major category(ies) of hypersensitivity that typically involve a B-cell immunoglobulin response is/are type I and type IV. type I, type II, and type III. type IV only. type I only. type I, type II, type III, and type IV.

type I, type II, and type III

What type of hypersensitivity reaction will Marian's babies be at risk for upon delivery? type II type IV type III type I

type II

What type of hypersensitivity reaction is Jonathan at risk for? type II type I type IV type III

type IV