Microbiology, Ch 17, Nester's 9th

Allografts: A) are normally rejected within hours. B) are grafts between non-identical members of the same species. C) involve tissues from non-human animals. D) are grafts between identical members of the same species. E) are grafts between identical twins.

B C is xenografts D and E are autografts

Killing of graft cells occurs through a complex series of mechanisms including: A) sensitized T cytotoxic cells AND NK cells. B) sensitized T cytotoxic cells AND erythrocytes. C) NK cells AND erythrocytes. D) erythrocytes AND basophils. E) sensitized T cytotoxic cells AND basophilic cells.

A) sensitized T cytotoxic cells AND NK cells.

What type of hypersensitivity reaction causes rejection of transplanted organs? A) Immediate IgE-mediated B) Cytotoxic C) Immune-complex mediated D) Delayed-type cell-mediated E) Cytotoxic OR delayed-type cell-mediated

D) Delayed-type cell-mediated

If the thymus is removed from a 2-year-old child, which of the following is likely to occur? A) Decreased success of an organ transplant and increased incidence of cancer. B) Decreased incidence of cancer and decreased incidence of viral infection. C) Decreased success of an organ transplant and increased incidence of viral infection. D) Increased success of an organ transplant and increased incidence of bacterial infection. E) Increased success of an organ transplant and decreased incidence of bacterial infection.

D) Increased success of an organ transplant and increased incidence of bacterial infection.

The tissue antigens most involved in graft rejection involve: A) Rhesus antigen. B) ABO antigens. C) MHC molecules. D) MLB proteins. E) immune complexes.

MHC molecules. - I think this is a Focus Your Perspective in Ch 15.

T/F - MHC plays a pivotal role in transplant rejection.

True

If the body recognizes parts of itself as being foreign, this is termed: A) immunodeficiency disease. B) agammaglobulinemia. C) autoimmune disease. D) AIDS. E) hypersensitivity.

- autoimmune disease

In which of the following is/are B cells involved? A) Asthma, hemolytic disease of the newborn, AND allergic contact dermatitis B) Hives, transplanted organ rejection, AND transfusion reactions C) Systemic anaphylaxis, hives, AND graft-versus-host reactions D) Anaphylactic shock, hemolytic disease of the newborn, AND glomerulonephritis E) Hives, transfusion reactions, disseminated intravascular coagulation, AND allergic contact dermatitis

D) Anaphylactic shock, hemolytic disease of the newborn, AND glomerulonephritis - Type I, II and III Hypersensitivities. -contact dermatitis and transplant rejection is Type IV - T cells

Patch tests are used to detect: A) hives. B) serum sickness. C) immune complexes. D) contact hypersensitivity. E) Arthus reaction.

D) contact hypersensitivity. Against skin under bandaids, rxn peaks in a couple days - Type IV.

If the thymus fails to develop, A) functional T cells are absent. B) functional B cells are absent. C) Di George's syndrome exists. D) complement deficiencies exist. E) functional T cells are absent AND Di George's syndrome exists.

E

Stem cells: A) have an almost unlimited capacity to divide. B) can differentiate into different tissues. C) may be used to test the effects of drugs on human cells. D) come from fetal material. E) All of the answer choices are correct.

E

The natural antibodies in serum that react with A or B polysaccharide antigens are mostly of the class: A) IgG. B) IgE. C) IgM. D) IgD. E) IgA.

IgM

If the immune system responds inadequately to antigenic stimulation, this is termed: A) hypersensitivity. B) immunodeficiency. C) autoimmunity. D) cell-mediated immunity. E) allergy.

Immunodeficiency

The initial work on anaphylaxis was done by: A) Watson and Crick. B) Pasteur. C) Richet and Portier. D) Fleming. E) van Leeuwenhoek.

Richet and Portier. - jelly fish, sea anemone, toxins that dogs survived once then died at second exposure.

Defects in bone marrow stem cells result in a condition known as: A) SCID. B) AIDS. C) Di George's syndrome. D) Chediak-Higashi disease. E) Chronic granulomatous disease.

SCiD - Severe combined immunodeficiency (SCID) - primary immune deficiency - defining characteristic is usually a severe defect in both the T- & B-lymphocyte systems. Infants with SCID appear healthy at birth but are highly susceptible to severe infections.

Generalized anaphylaxis is generally characterized by: A) wheal and flare. B) inflammation. C) shock. D) rash. E) sepsis.

Shock pg 442 - anaphylactic shock - anaphylaxis is life threatening - epi pen - Type I Hypersensitivity: Immediate IgE-mediated.

Delayed-type cell-mediated hypersensitivity primarily involves: A) erythrocytes. B) B cells. C) T cells. D) mast cells. E) T cells and platelets.

- T cells It's the only 1 of the 4 types whose effector isn't a B cell.

Your father has just been diagnosed with rheumatoid arthritis. He has pain and the sensation of "pins and needles" in some if his finger joints and also in his wrists. He knows you covered autoimmune diseases in your microbiology class, so asks you to help him understand his condition. You explain to your Dad that the causes of RA are not clear, but may involve all of the following EXCEPT A) insufficient production of B cells, helper T cells, and cytotoxic T cells, so that the adaptive immune response is unable to differentiate "self" from "foreign." B) infections—an immune response against a pathogen engaged in molecular mimicry may inappropriately attack healthy tissues as well. C) regulatory T cell problems—sometimes these cells are deficient or do not function properly; these cells play a role in regulating inappropriately activated lymphocytes. D) genetics—RA is often seen in related people who share genes for major histocompatibility molecules. E) These are all factors involved in developing RA.

A) insufficient production of B cells, helper T cells, and cytotoxic T cells, so that the adaptive immune response is unable to differentiate "self" from "foreign."

Hemolytic disease of the newborn: A) may not manifest itself fully until after birth. B) is due to the action of IgM. C) is due to the action of IgE. D) is a type I hypersensitivity reaction. E) may not manifest itself fully until after birth AND is due to the action of IgE.

A) may not manifest itself fully until after birth. - mom's enzymes protect fetus but degrade after birth w/o being renewed and baby's RBCs get lysed. - at first exposure Mom's antibodies are IgM (don't cross the placenta) but the second time an Rh- mom carries an Rh+ fetus, Mom's anti-Rh IgG antibodies an cross over. p.444 Type II Hypersensitivity: Cytotoxic

Which of the following is/are caused by immune-complex mediated hypersensitivities? A) Arthus reaction AND hemolytic disease of the newborn B) Arthus reaction, glomerulonephritis, AND disseminated intravascular coagulation C) Hemolytic disease of the newborn AND transplanted organ rejection D) Serum sickness, glomerulonephritis, AND allergic contact dermatitis E) Only disseminated intravascular coagulation

B) Arthus reaction, glomerulonephritis, AND disseminated intravascular coagulation

The cell type responsible for type II hypersensitivity is the: A) mast cell. B) B cell. C) macrophage. D) platelet. E) neutrophil.

B) B cell Chart on p.440 - effector: B cell - other immune cells involved: NK cells

Desensitization: A) stimulates an increase in IgG AND reduces the number of mast cells. B) reduces the number of mast cells AND increases the number of basophil cells. C) stimulates an increase in IgG AND is a treatment for hypersensitivity reactions. D) increases the number of basophil cells AND is a treatment for hypersensitivity reactions. E) increases the number of mast cells AND decreases the number of basophil cells.

C) stimulates an increase in IgG AND is a treatment for hypersensitivity reactions. - series of diluted shots of antigen Want the body to make IgG to bind to the allergen/antigen before IgE can. Type I Hypersensitivity: Immediate IgE-mediated - Increase in IgG and regulatory T cells, decrease in IgE.

Arthus reactions and serum sickness are examples of ________ hypersensitivity. A) type I B) type II C) type III D) type IV E) type V

C) type III

Allergic reactions occur only in people who are sensitized by prior exposure to a specific allergen. Please identify the correct sequence of events that occur in a type I response. 1. The activated B cells proliferate into IgE-producing plasma cells and memory cells. 2. The Fc portion of the IgE binds to Fc receptors on either mast cells or basophils, so that the Fab sites of the antibodies can interact with a specific allergen. 3. Sensitization begins when the first contact with the allergen induces an antibody response—helper T cells activate naive B cells. 4. Cross-linking triggers the mast cell or basophil to undergo degranulation, a process that releases its inflammatory mediators. 5. On second exposure to the antigen, when adjacent IgE molecules on a mast cell or basophil bind to that antigen, the IgE molecules are cross-linked. 6. These inflammatory mediators can have a variety of effects associated with a type I allergy response. A) 3, 4, 1, 2, 5, 6 B) 2, 3, 1, 4, 6, 5 C) 6, 4, 3, 2, 5, 1 D) 3, 1, 2, 5, 4, 6 E) 3, 1, 6, 5, 2, 4

D) 3, 1, 2, 5, 4, 6

Anti-A and anti-B antibodies: A) are considered natural antibodies. B) are present at birth. C) are typically IgM. D) easily cross the placenta. E) are considered natural antibodies AND are typically IgM.

E - We don't have them at birth (shocker!) and start making them in the first 6 months.

Which of the following is NOT true about HIV? A) It leads to development of AIDS. B) It is a retrovirus virus. C) It destroys T helper cells. D) It makes the patient vulnerable to infections. E) It is a dsDNA virus.

E - retrovirus - RNA virus

Which of the following have been an effective immunosuppressant for use in transplantation? A) Amphotericin B and cephalosporin B) Amphotericin B and cyclosporin A C) Amphotericin B and tacrolimus D) Cephalosporin and tacrolimus E) Cyclosporin A and tacrolimus

E) Cyclosporin A and tacrolimus Cyclosporin A is made by a fungus and tacromilus is from a species of Streptomyces

A transfusion reaction primarily involves: A) leukocytes. B) erythrocytes. C) phagocytes. D) platelets. E) IgE.

Erythocytes - RBC's - ABO groups - A and B antigens, Anti-A and Anti-B antibodies. - Type II Hypersensitivity

T/F - Anti-Rh antibodies may not cross the placenta.

False - anti-Rh IgG antibodies CAN cross the placenta the second time an Rh- mom carries an Rh+ fetus. The first time she carries same she makes IgM which doesn't cross the placenta.

T/F - First exposure to an allergen results in a violent hypersensitivity reaction.

False - first exposure is all about Sensitization.

T/F - Generalized anaphylaxis may be quickly controlled with the use of antihistamines.

False - get you an epinephrine pen!

T/F - Anti-A and anti-B antibodies are natural antibodies and are present at birth.

False - not present at birth

Antibodies that have arisen in the blood plasma without any obvious or deliberate stimulus are called: A) natural. B) acquired. C) injurious. D) active. E) inactive.

Natural

T/F - Anaphylaxis is the name given to allergic reactions caused by IgE-mediated release of mast cell granules.

True

A secondary immunodeficiency disease is not the result of: A) genetic defects. B) malignancies. C) advanced age. D) malnutrition. E) certain virus infections.

- genetic defects (that's primary (congenital) immunodeficiency) But the rest contribute to secondary immunodeficiency disease.

IgE molecules involved in hypersensitivity reactions have become attached to: A) neutrophils. B) mast cells. C) B cells. D) macrophages. E) mast cells AND B cells.

- mast cells It's my understanding that basophils are also an option. The granules these cells have contain histamine, leukotrienes, and prostaglandins - inflammatory mediators.

The hypersensitivity treatment that stimulates an increase of IgG and regulatory T cells, as well as causes a decrease in IgE, is known as: A) desensitization. B) immunity. C) sensitization. D) exposure. E) anaphylaxis.

desensitization

Which of the following is the correct explanation of desensitization? A) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce IgE against that allergen. The IgE antibodies protect the patient by binding to the antigen, coating it and facilitating its removal before it can attach to bound IgG on mast cells or basophils. B) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce multiple varied antibodies against that allergen. These antibodies protect the patient by binding to the antigen, coating it and destroying it before it can attach to bound IgE on mast cells or basophils. C) In desensitization, a newborn baby is exposed to multiple common allergens, stimulating the infant's immune system to produce antibodies against those allergens. The antibodies protect the child later in life by binding to any antigens they come into contact with, tagging them for destruction before they cause an allergic response. D) In desensitization, a pregnant woman is injected with dilute preparations of an allergen, causing their immune system to produce IgG against that allergen. The IgG antibodies cross the placenta, protecting the fetus by preventing it from being exposed to those allergens after birth. E) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce IgG against that allergen. The IgG antibodies protect the patient by binding to the antigen, coating it and facilitating its removal before it can attach to bound IgE on mast cells or basophils.

E) In desensitization, a person is injected with dilute preparations of an allergen, causing their immune system to produce IgG against that allergen. The IgG antibodies protect the patient by binding to the antigen, coating it and facilitating its removal before it can attach to bound IgE on mast cells or basophils.

T/F - Mismatch of either the Rh antigen or the AB antigen results in lysis of red blood cells by complement.

True

T/F - A lack of T cells makes one more vulnerable to intracellular parasites.

True - I think it's a subset of helper T cells.

T/F - Allergic rhinitis and hives may both respond to antihistamines.

True - Type I Hypersensitivity: Immediate IgE-mediated. Mast cell granules have histamines.

The type of hypersensitivity expressed with the lysing of red blood cells is: A) type I. B) type II. C) type III. D) type IV. E) type V.

Type II - Type I is Immediate IgE-mediated - Type III involves immune complexes - Type IV is delayed-type cell-mediated

During a Type I hypersensitivity reaction, the mast cells: - become phagocytic AND release IgG. - degranulate AND release IgE antibodies. - degranulate AND immediately release histamine. - take up histamine AND immediately degranulate. - become phagocytic AND immediately release histamine.

- degranulate AND immediately release histamine.

Regarding a mismatch of either the Rh antigen or the AB antigen, both: - result in destruction of red blood cells by the foreign antigen. - use complement to destroy red blood cells. - use antibody-dependent cellular cytotoxicity to destroy the red blood cells. - result in destruction of only leukocytes. - use either complement or ADCC to destroy red blood cells.

- use either complement or ADCC to destroy red blood cells. Type II Hypersensitivity - Cytotoxic

Type IV hypersensitivity reactions typically peak within: A) 2-3 days. B) 12 hours. C) weeks. D) minutes. E) seconds.

A peak in 48-72 hours = 2-3 days

What is NOT a reason that the kidneys are particularly prone to damage caused by immune complexes? A) Kidney blood vessel wall cells have receptors for antibodies on them, which makes them take up antibodies or immune complexes from the bloodstream. This blocks the kidneys up and causes them to malfunction and become damaged. B) Blood is pushed through the kidneys at a very high pressure. Any blockage of the vessels, such as what might be caused by immune complex deposits, can lead to ruptures/inflammation and damage of these organs. C) While blood vessel walls do NOT have receptors for antibodies, large immune complexes forced through small diameter vessels can become embedded within them. This can trigger complement system inflammation and cell destruction. D) Trapped immune complexes that initiate inflammation can attract neutrophils. The neutrophils degranulate in the area of the immune complexes, leading to cell/tissue destruction. E) These are all reasons that the kidneys are very susceptible to damage caused by immune complexes.

A) Kidney blood vessel wall cells have receptors for antibodies on them, which makes them take up antibodies or immune complexes from the bloodstream. This blocks the kidneys up and causes them to malfunction and become damaged.

Select the statement that best explains how RhoGAM works. A) RhoGAM contains anti-Rh antibodies; these bind to any Rh+ erythrocytes that may have entered the mother's circulation from an Rh+ baby, preventing these RBCs from stimulating a primary immune response in the mother. B) RhoGAM contains anti-Rh antibodies; these bind to any Rh- erythrocytes that may have entered the mother's circulation from an Rh- baby, preventing these RBCs from stimulating a primary immune response in the mother. C) RhoGAM contains anti-Rh antibodies; these bind to any Rh+ leukocytes that may have entered the mother's circulation from an Rh+ baby, preventing these WBCs from stimulating a primary immune response in the mother. D) RhoGAM contains anti-Rh antibodies; these bind to any Rh+ erythrocytes that may have entered the mother's circulation from an Rh+ baby, preventing these RBCs from stimulating a secondary immune response in the mother. E) RhoGAM contains anti-ABO antibodies; these bind to any ABO+ erythrocytes that may have entered the mother's circulation from a ABO+ baby, preventing these RBCs from stimulating a primary immune response in the mother.

A) RhoGAM contains anti-Rh antibodies; these bind to any Rh+ erythrocytes that may have entered the mother's circulation from an Rh+ baby, preventing these RBCs from stimulating a primary immune response in the mother.

Why do Rh-negative but not Rh-positive mothers sometimes have babies with hemolytic disease of the newborn? A) This disease results when an Rh-negative mother's immune system is primed to produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-positive, she won't produce any anti-Rh antibodies at all. B) Rh-positive mothers produce IgM antibody, not IgG. Even although they make anti-Rh antibody, IgM antibody can't cross the placenta, so it can't cause hemolytic disease of the newborn. C) Rh-positive mothers will receive a preventative shot from their physician prior to conception. This will provide the protection the fetus needs AFTER conception to avoid the disease. D) Rh-negativity is also associated with hyperproduction of antibodies. As such, Rh-negative mothers are more likely than Rh-positive mothers to produce the antibodies needed to produce this disease. E) This disease results when an Rh-positive mother's immune system is primed to produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-negative, she won't produce any anti-Rh antibodies at all.

A) This disease results when an Rh-negative mother's immune system is primed to produce anti-Rh IgG antibodies that can cross the placenta. If the mother is Rh-positive, she won't produce any anti-Rh antibodies at all.

Recombinant human monoclonal antibody (rhuMAb): A) appears promising as a treatment for asthma AND uses an engineered form of an IgG molecule. B) promotes crosslinking between IgE molecules on the mast cells AND appears promising as a treatment for asthma. C) appears promising as a treatment for asthma AND decreases the levels of IgG. D) uses an engineered form of an IgG molecule AND promotes crosslinking between IgE molecules on the mast cells. E) appears promising as a treatment for asthma AND uses an engineered form of an IgM molecule.

A) appears promising as a treatment for asthma AND uses an engineered form of an IgG molecule. p.443 -immunotherapy used in fighting severe ASTHMA that doesn't respond to inhaled corticosteroids or long-term bronchodilators uses recombinant humanized monoclonal antibodies - rhuMAbs are animal derived. ex)omalizumab (Xolair) used genetically engineered IgG that binds to the Fc part of IgE so that it can't bind to mast cells.

The redness and induration found after a tuberculin skin test involve the action of: A) sensitized T cells. B) IgE. C) complement proteins. D) basophil cells. E) activated dendritic cells.

A) sensitized T cells. induration. 1 : an increase in the fibrous elements in tissue commonly associated with inflammation and marked by loss of elasticity and pliability : sclerosis. 2 : a hardened mass or formation.

Your father has just been diagnosed with rheumatoid arthritis. He has pain and the sensation of "pins and needles" in some if his finger joints and also in his wrists. He knows you covered autoimmune diseases in your microbiology class, so asks you to help him understand his condition. Your father wonders how viruses or bacteria can potentially initiate an autoimmune disease. You tell him that A) viruses or bacteria could contain antigens that are similar to host tissue. Antibodies made in response to these agents may cross react with autoantigens. B) viruses and bacteria frequently over-stimulate cytotoxic T cells so that inappropriate antibodies are made against self antigens. C) autoimmunity usually develops when hematopoietic stem cells in the bone marrow fail to produce functional lymphocytes, as frequently happens during an infection. D) viruses or bacteria could contain antibodies that are similar to those of host tissue. Antigens made in response to these agents may cross react with self antibodies. E) autoimmunity often occurs when T cells do not differentiate and are absent in circulation; many pathogens suppress T cell maturation.

A) viruses or bacteria could contain antigens that are similar to host tissue. Antibodies made in response to these agents may cross react with autoantigens.

Urticaria are characterized by: A) diarrhea. B) wheal and flare. C) asthma. D) inflammation. E) weeping edema.

B - Hives - Type I Hypersensitivity: Immediate IgE-mediated - systemic reaction The wheal is the bump, the flare is the red around it. "Hives (urticaria) are red, itchy welts that result from a skin reaction."

Your father has just been diagnosed with rheumatoid arthritis. He has pain and the sensation of "pins and needles" in some if his finger joints and also in his wrists. He knows you covered autoimmune diseases in your microbiology class, so asks you to help him understand his condition. You explain to your father that usually, the immune system routinely eliminates or silences any lymphocytes that recognize autoantigens, which are the "self" antigens found in cells and on body tissues. This process is called self-tolerance. In autoimmune disease, self-tolerance is faulty. There are at least two mechanisms that lead to self-tolerance. Which are they? 1. Negative selection of developing lymphocytes that recognize autoantigens, resulting in apoptosis of those cells. 2. Introduction of antigen by the oral route, so that the immune system "learns" to tolerate it, just as it does the many antigens ingested in food. 3. Failure of naive lymphocytes that recognize antigen but do not receive the necessary second signals (MHC) to become responsive. A) 1 and 2 B) 1 and 3 C) 2 and 3 D) 1, 2, and 3 E) 1 only

B) 1 and 3

Please select the correct sequence of events that occur during an immune-complex hypersensitivity reaction. 1. When antigen is in slight excess, immune complexes form. 2. Immune-complexes activate complement, resulting in increased vascular permeability. 3. Neutrophils are attracted, and release enzymes that cause tissue damage. 4. Circulating immune complexes are trapped in the blood vessels, initiating inflammation. A) 1, 2, 3, 4 B) 1, 2, 4, 3 C) 4, 3, 1, 2 D) 1, 3, 2, 4 E) 4, 3, 2, 1

B) 1, 2, 4, 3

After a long cold winter, you are looking forward to spring semester, when you will complete your nursing degree. The only thing that concerns you is the allergies that hit you in April/May every year, exactly when you will be taking your final exams. Your roommate is currently taking microbiology, so you decide to review what you know about hypersensitivity with him. Your friend reminds you that hypersensitivity is an exaggerated immune response that injures tissue and can be categorized into one of four groups according to the mechanisms and timing of the response. He tells you that seasonal allergies are an example of type I hypersensitivity and describes the characteristics of this response. What statement made by your friend is INCORRECT? A) The effector cells involved in a type I response are B cells. B) A very common form of IgE-mediated allergy is systemic anaphylaxis. C) The mediators involved in the response include histidines, leukotrienes and prostaglandins. D) Examples of type I hypersensitivities include hives, asthma, and anaphylactic shock. E) Other cells involved in the response are basophils and mast cells.

B) A very common form of IgE-mediated allergy is systemic anaphylaxis. - not common, is more on the RARE side

Which of the following primary immunodeficiencies is/are the most common? A) Severe combined immunodeficiency B) Selective IgA deficiency C) Agammaglobulinemia D) Di George's syndrome E) Agammaglobulinemia AND Di George's syndrome

B) Selective IgA deficiency

In the tuberculin skin test, what would be the most likely reason why a positive test would NOT necessarily indicate an infection in progress in a patient who was born and grew up in the United States? A) False-positives occur all the time. This might simply be an example of that. B) The TB skin test is a measure of reactivation of memory T cells. The memory T cells would be formed during an active infection and would remain after the infection cleared. This would result in the test still showing positive, even though the patient is cleared of actual infection. C) Each person in the United States receives the BCG tuberculosis vaccine. This is an attenuated mycobacterium vaccine. The response to this vaccine makes us positive for the TB skin test, even though we may not have actually had a TB infection at any point in our lives. D) A positive TB skin test ALWAYS indicates a current, active infection.

B) The TB skin test is a measure of reactivation of memory T cells. The memory T cells would be formed during an active infection and would remain after the infection cleared. This would result in the test still showing positive, even though the patient is cleared of actual infection.

Insulin-dependent diabetes mellitus is an example of an autoimmune disease that involves: A) sensitized T cells. B) cytotoxic T cells. C) antibodies. D) IgD. E) phagocytosis.

B) cytotoxic T cells. - they destroy beta cells in the pancreas that make insulin.

The fetus is not rejected because: A) it is too small. B) it is in an immunologically privileged site. C) the father is immunosuppressed. D) it has no antigens. E) it has no normal microbiota.

B) it is in an immunologically privileged site. "The fetus as an allograft"

Your father has just been diagnosed with rheumatoid arthritis. He has pain and the sensation of "pins and needles" in some if his finger joints and also in his wrists. He knows you covered autoimmune diseases in your microbiology class, so asks you to help him understand his condition. You discuss treatment approaches that are taken for various autoimmune diseases. Which of the following is NOT a reasonable option for treating autoimmunity? A) Limiting the immune response with anti-inflammatory or immunosuppressant medications. B) Replacement therapy to restore damaged tissues or tissue products, for example giving insulin to diabetics. C) Gene therapy, using retroviruses to replace defective genes coding for enzymes involved in recognizing "self" antigens. D) Inducing tolerance by introducing the antigen by the oral route, so that the immune system "learns" to tolerate it. E) These are all reasonable approaches to treating autoimmunity.

C) Gene therapy, using retroviruses to replace defective genes coding for enzymes involved in recognizing "self" antigens.

Which autoimmune disease is CORRECTLY described? A) Systemic lupus erythematosus—antibodies bind to acetylcholine receptors at the neuromuscular junction, thereby blocking nerve impulses that normally cause muscle contraction. B) Diabetes mellitus—characterized by a variety of autoantibodies and immune complexes that lodge in tissues around the body, causing damage. C) Grave's disease—antibodies bind to the THS receptor of the thyroid and activate it inappropriately, leading to increased thyroid hormone production and enlargement of the gland. D) Myesthenia gravis—infiltration of connective tissues, most often within joints, by T cells that release cytokines and cause inflammation. E) Rheumatoid arthritis—formation of immune complexes in small blood vessels caused by autoantibodies to DNA and other nuclear components.

C) Grave's disease—antibodies bind to the THS receptor of the thyroid and activate it inappropriately, leading to increased thyroid hormone production and enlargement of the gland. - pic of the guy with a goiter

If a patient received a kidney transplant that was matched well across each of the major histocompatibility complex (MHC) molecules, but theystopped taking their anti-rejectiondrugs, what would happen and why? A) Nothing; the transplant is matched, so the patient doesn't need the drugs to prevent rejection. The new organ should be seen by the recipient's immune system as "self." B) The organ will be rejected very quickly, as allografts (tissue from the same species, but a different individual) are seen by the recipient's immune system as "foreign," and are quickly attacked. C) The organ will be rejected, but it will be a gradual process since it was matched well. There are a number of other proteins that cannot be matched between donors, so the graft will still be viewed as "foreign" by the recipient's immune system, and will still be attacked and rejected. D) Nothing; since the transplant was accepted for so long with the anti-rejection drugs, the person's immune system has had the time to become accustomed to it and now views the graft as "self." It will not be attacked. E) Nothing. The anti-rejection drugs are not really necessary once the patient's surgery wounds have healed. At the time their immune system returns to normal, so the new organ will not be rejected.

C) The organ will be rejected, but it will be a gradual process since it was matched well. There are a number of other proteins that cannot be matched between donors, so the graft will still be viewed as "foreign" by the recipient's immune system, and will still be attacked and rejected.

Why does a sensitized person not experience a skin reaction immediately after exposure to poison oak? A) The reaction is caused by activation of memory B cells formed as a result of the first exposure. Active B cells are not formed immediately. B) The reaction is caused by activation of plasma cells formed as a result of the first exposure. Active B cells are not formed immediately. C) The reaction is caused by activation of memory T cells formed as a result of the first exposure. Active T cells are not formed immediately. D) The reaction is caused by activation of macrophages formed as a result of the first exposure. Activated macrophages are not formed immediately. E) The reaction is caused by activation of dendritic cells formed as a result of the first exposure. Activated dendritic cells are not formed immediately.

C) The reaction is caused by activation of memory T cells formed as a result of the first exposure. Active T cells are not formed immediately. - think Type IV Hypersensitivity: delayed-type cell mediated - T cells, contact dermatitis.

If a patient lacks B cells, the resulting disease is: A) SCID. B) AIDS. C) agammaglobulinemia. D) Di George's syndrome. E) chronic granulomatous disease.

C) agammaglobulinemia. A - without, globulin - antibodies, -emia - blood Primary immune deficiency

Myasthenia gravis is an example of an autoimmune disease that involves; A) sensitized T cells. B) cytotoxic T cells. C) antibodies. D) IgD. E) muscle genes.

C) antibodies. - antibodies bind to acetylcholine receptors at neuromuscular junctions, blocking nerve impulses that would normally tell the muscle to contract. p450

Immunosuppressive drugs: A) are only needed during the first week after transplantation. B) are only needed for the first year after transplantation. C) are needed indefinitely after transplantation. D) are needed for transplants between identical twins. E) are needed indefinitely after transplantation AND are needed for transplants between identical twins.

C) are needed indefinitely after transplantation.

After a long cold winter, you are looking forward to spring semester, when you will complete your nursing degree. The only thing that concerns you is the allergies that hit you in April/May every year, exactly when you will be taking your final exams. Your roommate is currently taking microbiology, so you decide to review what you know about hypersensitivity with him. You tell your friend that ragweed pollen gives you hay fever, but now he needs some revision—he can't remember the signs and symptoms of this allergy. You remind him that they include A) spasms of smooth muscle tissue lining the bronchial tubes and increased mucus production, caused by inflammatory mediators in the lower respiratory tract. B) extensive blood vessel dilation and fluid loss from the blood, causing a severe drop in blood pressure that may lead to heart failure and insufficient blood flow to vital organs. C) teary eyes, a runny nose, and sneezing, caused by fluid leakage from dilated capillaries in the mucous membranes. D) an itchy swelling generally resembling a mosquito bite, surrounded by redness called a flare. E) fluid accumulation due to leaky dilated blood vessels, contraction of smooth muscles, itching and pain due to effects on nerve endings, and increased mucus production.

C) teary eyes, a runny nose, and sneezing, caused by fluid leakage from dilated capillaries in the mucous membranes.

Please select the INCORRECT definition regarding hypersensitivity. A) Hypersensitivity—an exaggerated immune response that damages tissues. B) Degranulation—release of mediators from a cell's granules, such as histamine released from mast cells. C) Systemic anaphylaxis—an immediate hypersensitivity reaction caused by IgE attached to circulating basophils. D) Anaphylactic shock—raised blood pressure and increased circulation caused by a severe allergic reaction. E) Delayed-type cell-mediated hypersensitivity—an exaggerated immune response of antigen-specific T cells.

D) Anaphylactic shock—raised blood pressure and increased circulation caused by a severe allergic reaction. - actually see low BP and decreased blood circulation to organs.

What might be an advantage to using an individual's own stem cells instead of pancreatic cell allografts to treat type I diabetes? A) Stem cells can disable the immune responses that led to the diabetes state in the first place. B) This process should be far cheaper than the surgical intervention needed for the allograft. C) You can't do this—stem cell research it is still theoretical, not approved by the FDA, and is currently illegal in the United States. As such, there is no advantage. D) If you were able to use a person's own cells, it would be considered an autograft rather than an allograft. As such, there should be no HLA/MHC matching required, and no long-term anti-rejection drugs would be needed. E) This process should be far cheaper than the surgical intervention needed for the allograft AND stem cells can disable the immune responses that led to the diabetes state in the first place.

D) If you were able to use a person's own cells, it would be considered an autograft rather than an allograft. As such, there should be no HLA/MHC matching required, and no long-term anti-rejection drugs would be needed.

After a long cold winter, you are looking forward to spring semester, when you will complete your nursing degree. The only thing that concerns you is the allergies that hit you in April/May every year, exactly when you will be taking your final exams. Your roommate is currently taking microbiology, so you decide to review what you know about hypersensitivity with him. You've forgotten what happens after sensitization, so your friend gives you a summary. Which is the CORRECT statement? A) Complement protein C3a binds to two IgE molecules bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators. B) On second exposure, complement protein C3a binds to two IgG molecules attached to the surface of the mast cell, causing it to degranulate and release interleukins. C) On second exposure, complement protein C5b cross-links two allergen molecules bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators. D) On second exposure, the allergen cross-links two IgE antibodies bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators. E) Second exposure to the allergen causes activation of B cells that are initially programmed to produce IgM molecules, but then undergo class switching to produce IgE.

D) On second exposure, the allergen cross-links two IgE antibodies bound to the surface of the basophil, causing it to degranulate and release histamine and other mediators.

Which of the following about immune complexes is FALSE? A) They consist of antigen-antibody bound together. B) They are usually cleared rapidly from the body. C) They bind to Fc receptors on cells. D) They are involved in type II hypersensitivity reactions. E) They are involved in type III hypersensitivity reactions

D) They are involved in type II hypersensitivity reactions.

After a long cold winter, you are looking forward to spring semester, when you will complete your nursing degree. The only thing that concerns you is the allergies that hit you in April/May every year, exactly when you will be taking your final exams. Your roommate is currently taking microbiology, so you decide to review what you know about hypersensitivity with him. Your allergies are so bad every year that you finally decide that you are going to go for desensitization treatments. These treatments A) involve getting concentrated shots of allergen that causes the immune system to produce IgM against it. When exposed to the allergen again, the IgM antibodies bind to it, coating it and preventing it from cross-linking bound IgE on T cells. B) involve you sitting in a room into which ragweed pollen will be introduced via the air system. This will force your immune system to recognize the allergen as "friendly" and stop reacting to it by causing basophils to degranulate. C) include receiving increasingly high doses of antihistamine so that a maximum level is reached on your blood stream. The antihistamines will neutralize the allergen by binding to it before it has the opportunity to bind to basophil-bound IgE. D) involve getting shots of very dilute allergen that causes the immune system to produce IgG against it. When exposed to the allergen again, the IgG antibodies bind to it, coating it and preventing it from cross-linking bound IgE on mast cells or basophils. E) involves recombinant humanized monoclonal antibodies (rhuMabs). These will bind to and neutralize the IgA made on on first exposure to ragweed pollen, and prevent your B cells from undergoing class switching.

D) involve getting shots of very dilute allergen that causes the immune system to produce IgG against it. When exposed to the allergen again, the IgG antibodies bind to it, coating it and preventing it from cross-linking bound IgE on mast cells or basophils

Your father has just been diagnosed with rheumatoid arthritis. He has pain and the sensation of "pins and needles" in some if his finger joints and also in his wrists. He knows you covered autoimmune diseases in your microbiology class, so asks you to help him understand his condition. You In an effort to help your father understand his symptoms, you tell him that RA A) is a localized disease, affecting only a single joint, usually the left knee. B) occurs when B cells infiltrate the joints and, when stimulated by specific antigens, release cytokines that cause inflammation. C) is one of the most rarest autoimmune diseases, and unlike arthritis that arises from wear and tear of joints, only occurs later in life. D) is characterized by joint damage that results when antibodies to tissue in the joints form immune complexes characteristic of type III hypersensitivity. E) is a condition in which cells called cytotoxic T cells release antibodies that target connective tissues, most often within joints.

D) is characterized by joint damage that results when antibodies to tissue in the joints form immune complexes characteristic of type III hypersensitivity.

To produce an allergic reaction in Type I hypersensitivity, the antigen: A) must bind to mast cells. B) must bind to free IgE molecules. C) must just bind to IgE on mast cells. D) must bind to two neighboring IgE molecules on mast cells, crosslinking them. E) must bind to two neighboring IgM molecules on mast cells, crosslinking them.

D) must bind to two neighboring IgE molecules on mast cells, crosslinking them. - it's the crosslinking that triggers degranulation.

Most cases of generalized anaphylaxis are a result of: A) fire ant stings and bites. B) aspirin and heparin. C) bananas and strawberries. D) peanuts, bee stings, or penicillin injections. E) All of these.

D) peanuts, bee stings, or penicillin injections. - penicillin is a hapten - pairs with a protein to create a hapten:protein complex that the immune system can see.

Delayed-type cell-mediated hypersensitivity is also known as ________ hypersensitivity. A) type I B) type II C) type III D) type IV E) type V

D) type IV There is no type 5.

Graft-versus-host disease is primarily a: A) type I reaction. B) type II reaction. C) type III reaction. D) type IV reaction. E) type V reaction.

D) type IV reaction. Transplant rejections involve T cells and NK cells.

65) Multiple myeloma is a plasma cell tumor in which a clone of malignant plasma cells produces large amounts of immunoglobulin. With all this excess immunoglobulin, how can a person with multiple myeloma be immunodeficient? A) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter. B) The multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses. C) The massive overproduction of immunoglobulin impairs the kidneys, preventing production of the correct hormones from the kidneys to balance immune system cell production from the bone marrow. D) Through a negative feedback loop, the large amount of immunoglobulin tricks the immune system into thinking it's making a strong response that is needed. As such, it shuts down production of other responses that might truly BE needed to fight off a pathogen. E) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter AND the multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.

E) All the immunoglobulin produced is most likely specific to one antigen. This limits the ability to respond to the diversity of antigens we encounter AND the multiplication of the malignant plasma cells may crowd out normal production of other immune cells required for protective responses.

After a long cold winter, you are looking forward to spring semester, when you will complete your nursing degree. The only thing that concerns you is the allergies that hit you in April/May every year, exactly when you will be taking your final exams. Your roommate is currently taking microbiology, so you decide to review what you know about hypersensitivity with him. You are very allergic to ragweed pollen, which gives you terrible hay fever. You remember from your own microbiology class that for you to have a reaction to this allergen every year, you must have become sensitized to it. Which step is not involved in or does not lead to sensitization? A) On first contact with the allergen, an antibody response is induced in the person. B) Helper T cells activate naive B cells, which proliferate and differentiate. C) Plasma cells produce IgE specific for the antigen that initiated the response. D) The Fc portion of the IgE binds to receptors on mast cells or basophils, positioned so that their Fab sites are free. E) These are all steps involved in sensitization.

E) These are all steps involved in sensitization.

Cyclosporin A: A) is a relatively general immunosuppressive agent AND activates macrophages. B) suppresses T-cell proliferation AND activates macrophages. C) activates macrophages AND stimulates antibody production. D) stimulates antibody production AND stimulates T-cell proliferation. E) is a relatively general immunosuppressant AND suppresses T-cell proliferation.

E) is a relatively general immunosuppressant AND suppresses T-cell proliferation.

Gene therapy technology: A) may be used to generate cells for transplantation. B) may overcome graft rejection. C) may treat cancer. D) may down-regulate the immune response. E) may overcome graft rejections AND may treat cancer.

E) may overcome graft rejections AND may treat cancer.

Which of the following is associated with contact dermatitis? A) poison ivy. B) latex. C) tuberculin skin test. D) hay fever. E) poison ivy, latex, AND tuberculin skin test.

E) poison ivy, latex, AND tuberculin skin test. Type IV Hypersensitivity: delayed-type cell-mediated Hay fever is Type I.

T/F - Type O blood is missing both anti-A and anti-B antibodies.

False - Type O plasma, containing both anti-A and anti-B antibodies, can only be given to O recipients. The antibodies will attack the antigens on any other blood type. Conversely, AB plasma can be given to patients of any ABO blood group, because it does not contain any anti-A or anti-B antibodies.

Which of the following disease states is not among those caused by immune complexes? A) Systemic lupus erythematosus B) Serum sickness C) Hay fever D) Glomerulonephritis E) Disseminated intravascular coagulation

Hay fever - that's Type I Hypersensitivity: Immediate IgE-mediated

Which allergic condition is characterized by the formation of a wheal and flare? A) Hives B) Transfusion reaction C) Arthus reaction D) Serum sickness E) All of these

Hives

The immunoglobulin associated with Type I hypersensitivity is: - IgM - IgA - IgE - IgD - IgG

IgE

Localized injury or death of tissue resulting from repeated injections of an antigen into a person with high levels of circulating specific antibody is known as: A) farmer's lung. B) German measles. C) serum sickness. D) an Arthus reaction. E) disseminated intravascular coagulation.

an Arthus reaction