Ch 16 book questions FINAL
Which of the following is the underlying immunological process in ankylosing spondylitis? A. Autoimmune disease associated with HLA gene B27 B. Development of autoantibodies against nucleic acids C. Immune-mediated destruction of neurons D. Immune deficiency associated with HLA gene DR4 E. Molecular mimicry of the acetylcholine receptor
The correct answer is A. Ankylosing spondylitis is an autoimmune disease in which over 90% of people with the disease carry the HLA827 gene. The autoimmune response does not target nucleic acids or acetylcholine receptors. It is not an immune deficiency disease
The failure to inactivate or eliminate self-reactive cells results in A. autoimmunity. B. positive selection. C. negative selection. D. suppression. E. tolerance.
The correct answer is A. Autoimmunity results from the failure to inactivate or eliminate self-reactive immune cells. Positive selection is the promotion of lymphocytes that can function within the body. Suppression, negative selection, and tolerance are various mechanisms by which the immune system produces tolerance.
A 55-year-old female presents with complaints of pain and stiffness in her hands and wrists that occurs mainly in the morning. Examination reveals tenderness and swelling in both wrists and hands. Testing reveals the presence of rheumatoid factor. The patient is diagnosed with rheumatoid arthritis. Resulting injury that will likely occur in this patient will result from A. both cell mediated and humoral immunity. B. both type II and type Ill hypersensitivity. C. lgE-mediated immune responses only. D. self-tolerance. E. type II hypersensitivity only
The correct answer is A. Rheumatoid arthritis involves damage inflicted by both antibody driven type Ill hypersensitivity responses and cellular type IV hypersensitivity responses. It does not involve type II hypersensitivity responses or lgE mediated (type I) responses. It results from the loss of self-tolerance
Graves disease is an example of which of the following immunologic processes? A. Autoimmune disease associated with HLA gene B27 B. Autoimmune disease associated with HLA gene DR3 C. Immune deficiency associated with HLA gene DR2 D. Immune deficiency associated with HLA gene DR4 E. Type Ill hypersensitivity associated with HLA gene Cw6
The correct answer is B. Graves disease is an autoimmune disease that is associated with the presence of the HLA-DR3 gene. It is not associated with HLA-827, -DR2, -DR4, or -Cw6. It does not result from immunodeficiency
A 47-year-old-male has a history of end-stage renal failure and required a kidney transplant. Approximately 4 weeks after receiving his transplanted kidney, he developed oliguria (decreased production of urine), fever, hypertension, and pain or tenderness over the allograft. On the basis of these findings, the most likely underlying immunological process is A. autoimmunity. B. acute rejection. C. chronic rejection. D. hyperacute rejection. E. peripheral tolerance.
The correct answer is B. The time span is appropriate for acute rejection of the transplanted organ but not for chronic or hyper acute rejection. There is no information suggesting autoimmunity. Peripheral tolerance is a mechanism for preventing responses to self-antigens
In Question 16.6, a defect or deficiency in which of the following is associated with the patient's condition? A. Adipose tissue B. Kidney tubules C. Pancreatic beta cells D. Thyroid gland E. Skeletal muscle
The correct answer is C. Destruction of pancreatic beta cells reduces insulin production. The other tissues listed are not targets of the autoimmune attack, although they may incur later secondary damage if the primary disease is not appropriately treated and controlled.
A 35-year-old male presents with symptoms of fatigue, paresthesia (numbness and tingling) of his arms and legs, and occasional blurred vision of 2 months' duration. Tests reveal several areas of demyelination within the central nervous system. Diagnosis of which of the following conditions is supported by these findings? A. Ankylosing spondylitis B. Hashimoto thyroiditis C. Multiple sclerosis D. Reactive arthritis E. Systemic lupus erythematosus
The correct answer is C. Multiple sclerosis is an autoimmune disease that results in demyelination within the central nervous system. Ankylosing spondylitis and reactive arthritis involve joints, Hashimoto thyroiditis involves the thyroid gland, and systemic lupus erythematosus is a systemic disease with primary effects on joints, muscles, skin, and kidneys.
A 20-year-old woman presents with right lower abdominal cramp-type pain associated with diarrhea and weight loss. Blood tests reveal a low hemoglobin level and high white blood cell counts. She is diagnosed with Crohn disease. The tissue that is most affected in this autoimmune disease is A. connective tissue. B. erythrocytes. C. pancreatic beta cells. D. the small intestine. E. the thyroid.
The correct answer is D. Crohn disease targets the small intestine. It is not directed at connective tissue, erythrocytes, pancreatic beta cells, or the thyroid gland
16.6 A previously healthy 12-year-old female lost 8 pounds over the past several weeks without dieting. Her parents are concerned about this weight loss and believe that she has an eating disorder. The patient's history reveals polydipsia (excessive thirst), polyuria (excessive urination), and nocturia (need to arise during the night for urination) over the last several weeks. A fasting blood glucose of 460 mg/dl is obtained (reference range: 70 to 100 mg/dl). The patient is diagnosed with an autoimmune disease. On the basis of these findings, which of the following conditions was most likely diagnosed in this patient? A. Anorexia nervosa B. Hyperthyroidism C. Nephrolithiasis (kidney stones) D. Type 1 diabetes mellitus E. Urinary tract infection
The correct answer is D. Type 1 diabetes mellitus is the autoimmune disease, among those listed, that impairs regulation of blood glucose levels. Some forms of hyperthyroidism can result from autoimmune diseases attacking thyroid receptors. Anorexia nervosa, nephrolithiasis, and urinary tract infections are not autoimmune diseases.
Lymphocytes expressing both the CD4 and CD25 markers on their surfaces function as A. antigen-presenting cells. B. autoantibody-secreting B cells. C. cytotoxic T cells. D. natural killer-like T cells. E. T regulatory cells
The correct answer is E. CD4+CD25+ T cells are a regulatory subset of T cells. They do not act as antigen-presenting cells, nor do they secrete antibodies. Cytotoxic T cells are COB+. They do not belong to the natural killer-like T-cell subset of T cells.
A previously healthy 65-year-old female presents with complaints of frequent bowel movements, weight loss, and nervousness. Her physical examination was remarkable for slight exophthalmos (protrusion of the eyeball) and atrial fibrillation (abnormal heart rhythm). Laboratory findings supported a diagnosis of Graves disease. Which of the following tissues/organs will be most affected by the ensuing immune reactions? A. Connective tissue B. Joints of lower extremities C. Heart valves D. Kidneys E. Thyroid gland
The correct answer is E. Graves disease results from autoimmune responses targeting the thyroid gland. The other tissues and organs listed are not targets of the autoimmune responses producing Graves disease
During an infection with Streptococcus pyogenes, an individual generated sufficiently high levels of lgM and lgG antibodies against a S. pyogenes antigen with structural similarity with molecules on the heart that cardiac damage was caused. In this example, the microbe contributed to autoimmunity via a process known as A. anergy. B. central tolerance. C. epitope spreading. D. loss of suppression. E. molecular mimicry
The correct answer is E. Molecular mimicry contributes to autoimmunity by triggering responses with microbial molecules that are cross-reactive with host molecules. Anergy and central tolerance are mechanisms for preventing autoimmunity. Epitope spreading involves the generation of responses to a series of different antigens, not to cross-reactive ones. The loss of suppression is a different mechanism by which tolerance can be broken.
A 30-year-old female presents with fatigue, weight loss, arthritis of her hands, and a malar ("butterfly") rash. Blood tests reveal decreased hemoglobin and the presence of antinuclear antibodies. These findings support which of the following diagnoses paired with its underlying immunologic process? A. Graves disease: autoantibodies to thyroid-stimulating hormone receptor B. Myasthenia gravis: autoimmunity associated with HLA gene DR3 C. Reiter syndrome: immune-mediated destruction associated with HLA gene B27 D. Rheumatoid arthritis: immune deficiency associated with HLA gene DR4 E. Systemic lupus erythematosus: autoantibodies to chromosomal proteins
The correct answer is E. Systemic lupus erythematosus results from the generation of autoimmune antibodies against chromosomal proteins (and nucleic acids). It is associated with the presence of HLA-DR3, but not -827 or -DR4. Myasthenia gravis results from autoantibodies against acetylcholine receptors on muscle cells. Reiter syndrome and rheumatoid arthritis target joints. The thyroid gland is not a target of the antinuclear antibodies
Failure of the immune system to respond against an epitope in an aggressive way is termed A. autoimmunity. B. positive selection. C. negative selection. D. suppression. E. tolerance.
The correct answer is E. Tolerance is the failure to generate a destructive response against an epitope that the immune system recognizes
Deliberate inactivation or destruction of lymphocytes bearing BCRs or TCRs capable of recognizing and binding specific self-epitopes results in A. hypersensitivity. B. autoimmunity. C. molecular mimicry. D. positive selection. E. self-tolerance.
The correct choice is E. The inactivation or destruction of lymphocytes bearing particular antigen receptors is one of the mechanisms producing tolerance. Hypersensitivity responses are heightened and destructive. Autoimmunity results from the absence of self-tolerance. Mimicry is a means of breaking tolerance. Positive selection is the promotion of lymphocytes that bear receptors capable of particular self-molecules
