Immunology Exam 2 & 3 (Chapters 6, 7, 14, 15, 25)
Which of the following explains the difference between type II and type III hypersensitivity reactions?
Type II involves cellular antigens
What was one of the major contributions of Louis Pasteur to vaccine development?
Use of attenuated microorganisms in vaccines
Recombinant protein vaccine
a vaccine produces by cloning the gene coding for the vaccine antigen into the genome of bacteria, yeast, or cultured cells.
Immunoprophylaxis
the use of immunization to prevent disease
immunotherapy
treatment that uses the ability of the immune system to destroy tumor cells
Suppose a vaccine was available in two forms- attenuated and inactivated. What is an advantage of the attenuated form?
It induces both humoral and cell-mediated immunity.
What is a major characteristic of adoptive immunotherapy?
It involves the transfer of cells to deliver immunity
Cross-reactivity
A phenomenon that occurs when an antibody reacts with an antigen that is structurally similar to the original antigen that induced antibody production
Immunization
A process by which resistance to an infectious disease is acquired
Passive immunity
A type of immunity acquired by the transfer of antibody from immunized host to nonimmune individual
Which autoantibodies are strongly associated with granulomatosis with polyangiitis (Wegner's granulomatosis)?
ANCA
Which of the following is associated with an increase in IgE production?
Activation of Th2 cells
Which best describes the role of CR2 on cell membranes?
Acts as co-receptor on B cells for antigen
Which of the following are diseases associated with complement deficiencies or improper control? Age-related macular degeneration (AMD) Paroxysmal nocturnal hemoglobinuria (PNH) Atypical hemolytic uremic syndrome (aHUS) C3 glomerulopathy All of the above
All of the above
Which of the following is a general characteristic of hypersensitivity reactions?
An exaggerated immune response to an antigen occurs
A speckled pattern of staining of the nucleus on IIF may be caused by which of the following antibodies?
Anti-SS-A/Ro antibody
Which of the following would support a diagnosis of drug-induced lupus?
Anti-histone antibodies
A 20-year-old woman made an appointment to see her physician because she was experiencing intermittent diarrhea. Laboratory testing revealed that she also had an iron-deficiency anemia. To determine of the patient has celiac disease, her doctor should order which of the following lab tests?
Anti-tTG
Which of the following would be considered a significant finding in Grave's disease?
Anti-thyroglobulin antibody
Which of the following is associated with anaphylaxis?
Buildup of IgE on mast cells
Mannose-binding protein in the lectin pathway is most similar to which classical pathway component?
C1q
All of the following are true of the recognition unit EXCEPT: it consists of C1q, C1r, C1s the subunits require calcium for binding together binding occurs at the Fc region of antibody molecules C1q becomes an active esterase
C1q becomes an active esterase
Which of the following is NOT a cofactor for Factor I? a) Factor H b) C4-binding protein c) Membrane cofactor protein (MCP, CD46) d) C3bBbC3b
C3bBbC3b
Which best describes and characterizes the MAC?
C9 polymerizes to form the transmembrane channel
Selective destruction of Th cells by the HIV virus contributes to immune suppression by which means?
Decrease in IL-2
A decreased CH50 level and a normal AH50 level indicate which deficiency?
Decrease in components of the classical pathway only
Which of the following would result from a lack of TNF?
Decreased ability to fight gram-negative bacterial infections
What is the immune phenomenon associated with the Arthus reaction?
Deposition of immune complexes in blood vessels
What is the immune mechanism involved in type III hypersensitivity reactions?
Deposition of immune complexes occurs in antibody excess
Which would the the best assay to measure a specific cytokine?
ELISA testing
Factor H acts by competing with which of the following for the same binding site?
Factor B
Which of the following would be considered an organ-specific autoimmune disease?
Hashimoto's thyroiditis
A lack of C1-INH has been associated with which of the following conditions?
Hereditary angioedema
IFN-alpha and IFN-beta differ in which was from IFN-gamma?
IFN-alpha and IFN-beta inhibit viral replication, whereas IFN-gamma stimulates antigen presentation by class II MHC molecules
A patient in septic shock caused by a gram-positive bacterial infection exhibits the following symptoms: high fever, very low blood pressure, and disseminated intravascular coagulation. Which cytokine is the most likely contributor to these symptoms?
IFN-gamma
IL-10 acts as an antagonist to what cytokine?
IFN-gamma
Which cytokine acts to promote differentiation of T cells to the Th1 subclass?
IL-12
Which of the following cytokines is also known as the 'T-cell growth factor'?
IL-2
Why might a CSF be given to a cancer patient?
Increase the production of certain types of leukocytes
Which of the following represents an autocrine effect of IL-2?
Increased IL-2 receptor expression by the Th cell producing it
Which of the following is NOT true of the amplification loop in complement activation? Improper control can lead to disease It can amplify activation that is initiated by the classical pathway C3b is the product that is increased Increasing amounts of C1qrs are produced
Increasing amounts of C1qrs are produced
In vitro methods to detect a cell-mediated response to M tuberculosis measure production of which of the following immunologic components?
Interferon gamma
Which of the following best characterizes HUS?
It is a common cause of renal failure in children
Which of the following is a mechanism used to achieve peripheral tolerance?
Lack of costimulatory signal to autoreactive T cells in the lymph nodes
Tumor-infiltrating lymphocytes (TILs)
Lymphocytes within a tumor mass that are able to react with antigens on tumor cells to help destroy them
Which of the following effects can be attributed to IL-1?
Mediation of the innate immune system
Destruction of the myelin sheath of axons caused by the presence of antibody is characteristic of which disease?
Multiple sclerosis
Which of the following precursors is a target cell for IL-3?
Myeloid precursors Lymphoid precursors Erythroid precursors
Which of the following is characteristic of complement components?
Normally present in serum
Which of the following describes the properties of a toxoid?
Not pathogenic but immunogenic
Which of the following illustrates passive immunity?
Passage of IgG antibodies through the placenta of a pregnant woman to her fetus
passive immunotherapy
Passive immunization of an individual with commercial preparations of antibodies formed by other hosts to prevent or treat a disease
The CH50 test measures which of the following?
Patient serum required to lyse 50% of sensitized sheep RBCs
Blood was drawn from a 25-year-old woman with suspected SLE. A FANA screen was performed and a speckled pattern resulted. Which of the following actions should be taken next? a. Report out as diagnostic for SLE b. Report out as drug-induced lupus c. Perform an assay for specific ANAs d. Repeat the test
Perform an assay for specific ANAs
SLE can be distinguished from RA on the basis of which of the following?
Presences of anti-dsDNA antibodies
Anti-mitochondrial antibodies are strongly associated with which disease?
Primary biliary cholangitis
Which condition would result in hemolytic disease of the fetus and newborn?
Prior exposure to foreign RBC antigen
Anti-CCP (cyclic citrullinated proteins) is specifically associated with which autoimmune disease? A. RA B. MG C. Autoimmune hepatitis D. Goodpasture's syndrome
RA (rheumatoid arthritis)
Chimeric antigen receptors in CAR-T cells are composed of which of the following components?
Single-chain variable fragment of a monoclonal antibody complexed with CD3 and a costimulatory molecule
Which of the following describes the role of properdin in the alternative pathway?
Stabilization of C3 convertase
Which preparation would you recommend for treatment of a patient with an antibody deficiency?
Standard human immune serum globulin
What is the major function of Treg cells?
Suppression of the immune response by inducing IL-10
Th17 cells affect the innate immune response by inducing production of which cytokines?
TNF-alpha and IL-6
Toxoids
a chemically inactivated bacterial toxin used in some vaccines
Serotype
a group of related bacteria or viruses that share specific antigens that can be identified by serological testing
attenuation
a process of producing nonpathogenic bacteria or viruses for use in vaccines. these organisms have been weakened with treatment by chemical, exposure to elevated or cold temperatures, or repeated passage in a cell culture
Human Immune Serum Globulin (HISG)
a sterile preparation of concentrated antibodies made from pooled serum thousands of donors, used as prophylactic treatment in patients with antibody deficiencies
adjuvant
a substance administered with an immunogen that enhances and potentiates the immune response
Which of the following are associated with type I hypersensitivity EXCEPT: release of preformed mediators from mast cells activation of complement cell-bound antibody bridged by antigen an inherited tendency to respond to allergens
activation of complement
Suppose an individual develops antibodies in response to a streptococcal pharyngitis infection. This is an example of:
active immunity
Adoptive immunotherapy
administration of immune cells to treat patients with conditions such as immunodeficiency diseases or cancer
Infusion of TILs into a cancer patient is an example of:
adoptive community
A technologist performs an IIF test of ANCAs and observes that there is an intense fluorescent staining of the nuclear lobes of the neutrophils. How can this type of staining be differentiated from an ANA? a. Perform the test on formalin-fixed leukocytes b. Perform IIF with HEp-2 cells c. Perform an ELISA for ANCAs d. all of the above
all of the above
Reactions to latex are caused by a. type I hypersensitivity. b. type IV hypersensitivity. c. skin irritation. d. all of the above.
all of the above
A young woman developed red, itchy papules on her wrist two days after wearing a new bracelet. This reaction was caused by:
an inflammatory response induced by cytokines released from Th1 cells
antitoxin
antibody used in passive. immunization for the purpose of neutralizing a bacterial toxin
The classical complement pathway is activated primarily by
antigen-antibody complexes
Which of the following conclusions can be drawn about a patient whose total IgE level was determined to be 150 IU/mL
antigenic-specific testing should be done
Two days after administration of the tuberculin skin test, a female health-care worker developed an area of redness and induration 12 mm in size at the injection site. This result means that she has:
been exposed to M. tuberculosis
Immunoglobulins consisting of a mouse-derived variable region combined with a human-derived constant region are known as:
chimeric antibodies
All of the following may contribute to autoimmunity EXCEPT: clonal deletion of self-reactive T cells molecular mimicry increased expression of class II MHC antigens polyclonal activation of B cells
clonal deletion of self-reactive T cells
herd immunity
community immunity
Community immunity
concept of extending protection to unvaccinated individuals by reducing spread of an infection when a significant proportion of individuals in the population have been immunized (also known as herd immunity)
Which of the following is referred to as C3 convertase? a) C1qrs b) C4bC2a c) C3bBb d) all of the above e) Only b and c
only b and c
Which of the following is NOT a characteristic of passive immunity? a. Transfer of antibodies b. Occurs naturally or because of therapy c. Provision of immediate protection d. Development of long term memory.
d. Development of long term memory.
What factor(s) influence the effectiveness of a person's immune response to a vaccine? a. Age of recipient b. The individual's immune response c. The nature of the vaccine d. all of the above
d. all of the above
All of the following represent functions of the complement system EXCEPT: decreased clearance of antigen-antibody complexes lysis of foreign cells increase in vascular permeability migration of neutrophils to the tissues
decreased clearance of antigen-antibody complexes
A lack of IL-4 may result in which of the following effects?
decreased eosinophil count
Epitope spreading refers to
expansion of the immune response to unrelated antigens
CAR-T cells
genetically modified T cells possessing a chimeric antigen receptor that binds to an antigen that can serve as a target for adoptive immunotherapy
When one individual becomes immunized by receiving a series of vaccine injections according to schedule, the resulting protection extends to that individual's nearby contacts. This concept is known as:
herd immunity
HAMAs are:
human antibodies that are produced against mouse proteins
active immunity
immunity resulting from natural exposure to an infectious agent or administration of a vaccine
adoptive immunity
immunity resulting from the transfer of cells of the immune system (usually lymphocytes) from an immunized host to a nonimmune individual
Which best describes the role of an anaphylatoxin?
increases permeability of blood vessels
Which of the following would be expected to be true for the testing of a patient who is on a complement C5 inhibitor? a) Low CH50 b) Low AH50 c) High sC5b-9 d) All of the above e) Only a and b
only a and b
To determine a cold agglutinin titer
patient serum should be separated from whole blood at 37 deg C and tested at 4 deg C
The ability of a single cytokine to alter the expression of several genes is called:
pleiotropy
The antigenic component of the hepatitis B vaccine differs from those of many of the conventional vaccines in that it consists of a:
recombinant antigen
To determine if a patient is allergic to ryegrass, the best test to perform is the:
skin prick test
