IMMULOLOGY FINAL EXAM

Which of the following is true concerning the human immune system?

Secondary lymphoid centers are like "police stations" which contain B cells and T cells which are capable of quickly reacting to pathogens

Which of the following pathogens is considered the most common cause of community-acquired pneumonia?

Streptococcus Pneumoniae

Inhibition of which of the following would result in increased macrophage activity?

TH1 Helper T Cells

Which of the following is correct concerning passive immunity?

Transplacental IgG transfer from a pregnant mother to a fetus is an example of passive immunity.

A 29 year old male is currently on a blind date with a nice young lady. She has offered to pay for dinner since he "forgot" his wallet at home; while he is looking at the menu of the Red Lobster that they are attending, she orders crab legs. To his dismay, he begins to develop severe tachypnea, cyanosis, and urticaria (hives) all over the visible surfaces of his arms and neck. Which of the following is most likely occuring in this situation?

Type I Hypersensitivity Reaction

Which of the following is true concerning the adaptive immune system?

Upon re-exposure to a particular pathogen, the adaptive immune system is capable of reacting more rapidly and efficiently.

Which of the following biochemical processes is most responsible for the formation of immunoglobulins with different binding affinities for different pathogens?

VDJ Recombination

Which of the following, in increased, would result in decreased complement cascade activity?

C1 Esterase Inhibitor

A 55 year old male with a history of alcohol abuse until age 50 has just undergone a successful hepatic transplant. 12 hours after the liver was transplanted, however, he began to experience significant fevers, chills, and severe pain at the incision site in the abdomen. One of the nurses in the surgical ICU noted that his IV methylprednisolone had been inadvertently stopped. Which of the following is the most likely diagnosis?

Acute Organ Transplant Rejection

A 26 year old female firefighter is undergoing a transplant procedure after being exposed to a large fire. The procedure involved the transfer of epidermal keratinocytes from the patient's own thigh to her arms. Which of the following best characterizes this type of organ transplantation procedure?

Autograft

A 19 year old hiker was attempting to find wood for a campfire in a forest; while searching, he accidentally stepped in some poison ivy. He was unsure as to whether it was actually poison ivy until 2 days later, after which he experienced severe itching and redness at the site of exposure. Which of the following mediates the response to poison ivy?

CD8 T Cells and Macrophages

An immunohistochemist is currently studying a line of cancer cells which are implicated in a rare subtype of malignant melanoma. She wishes to determine which immune cells are most highly geared to destroy these cancer cells. To test this, she exposed the cancer cells to the following cell lines:

D) CD8 T Cells

A 7 year old Colombian male presents to a local clinic in Guyana after his mother found him unconscious at the playground. Per the mother, the child was bleeding profusely from his nose and appeared to be extremely pale; in addition to this, she noticed that a lymph node under his jaw appeared to be significantly larger than it did 3 months ago. The child appeared extremely cachectic on physical exam, and his labs were revealing of severe pancytopenia; further diagnostic testing was revealing of Burkitt Lymphoma. Which of the following factors effectively increases the risk of cancer formation?

Exposure to carcinogenic substances Lack of Cell Cycle Inhibition Inability of cells to undergo apoptosis All of these are correct. Increased expression of oncogenes

A 29 year old Caucasian male with no previously known medical history is presenting to the Case Western Emergency Department with severe hypotension and altered mental status. He had just returned from a recent military tour in Bishkek, Kyrgyzstan, where he denied any exposure to sick contacts. Of note, his girlfriend states that he has been coughing up large amounts of bright red blood and urinating large amounts of dark blood for the last 12 hours. Serological testing revealed the presence of anti-glomerular basement membrane antibodies. Which of the following is the most likely diagnosis?

Goodpasture Syndrome

A 33 year old male presents to a nurse practitioner with a 6 month history of worsening myalgias (muscle pains), fevers, and chills. He feels that his symptoms have been progressively worsening despite taking a plethora of antibacterial antibiotics. He has noticed significant lymphadenopathy (lymph node swelling which is painful to the touch) within the past 3 months which appears to be worsening, and he has lost approximately 50 pounds despite not actually attempting to do so. When asked about his sexual history, he notes that he has been in a homosexual relationship with his boyfriend for 8 months now and that his boyfriend is asymptomatic. HIV ELISA testing for this patient was positive. Which of the following is most correct pertaining to this patient at this time?

HIV is a diagnosis which is highly associated with secondary cancers and severe opportunistic infections.

Which of the following cytokines is responsible for the induction of fever in the human inflammatory response?

IL-1 (Interleukin-1)

A 25 year old female presents to her family doctor with complaints of a sore throat, cough productive of thick sputum, and a subjective feeling of chills. She states that her symptoms began approximately 3 nights ago after a night of heavy drinking with her friends. She states that her sputum is thick and whitish and that, despite drinking orange juice and chamomile tea, her symptoms have not yet improved. Given her presentation at this time, which of the following is most correct?

IL-1 is most likely decreased in this patient, resulting in fever and chills. Given the time frame of 3 days, her adaptive immune system is most likely beginning to become more active. Her quantitative levels of CD28 are likely decreased. She should be checked for signs and symptoms of delirium tremens given the history of heavy alcohol abuse and given intravenous thiamine immediately. Her innate immune system is likely releasing cytokines such as CD28 which allow the innate immune system to demonstrate memory.

Which of the following antibody isotypes is highly associated with mucosal secretions and the colostrum of breast milk?

IgA

Which of the following autoimmune diseases is NOT one of the classic HLA-B27 associated disorders?

IgA Nephropathy

Which of the following signal transduction pathways is utilized almost exclusively by interferons?

JAK-STAT Pathway

Dendritic cells are highly active antigen presenting cells which attract helper T cells and effectively strengthen the adaptive immune response to pathogens. Which of the following is most highly involved in the attraction of helper T cells to the dendritic cells?

MHC II

Which of the following does not derive from a common myeloid progenitor?

NK Cells

Crimean Congo Hemorrhagic Fever (CCHV) is an exotic intracellular virus which has been known to cause rapid death among African people due to the inhibition of platelet aggregation and, therefore, hemorrhage. Given that this virus is intracellular, which of the following pattern recognition receptors (PRR's) will most likely be responsible for targeting this pathogen?

NOD Proteins

Which of the following infectious pathogens is the most likely cause of pneumonia in an HIV infected patient with a CD4 count of less than 200?

Pneumocystis Jirovecii (Carinii)

A 19 year old female with a history of IV methamphetamine abuse presents to the emergency department with chest pain, shortness of breath, and acute onset of fever and diaphoresis. Upon arrival, her blood pressure was found to be 70/50 with a heart rate of 190, and her temperature was found to be 105.3 degrees Fahrenheit. Her blood cultures were positive for staphlyococcus aureus. Which of the following is the most appropriate treatment for this patient at this time?

Vancomycin