Immunobiology Exam 3 Practice test

15. Delayed skin reactions to an intradermal injection of antigen may be markedly decreased by? A) exposure to a high dose of X-irradiation. B) treatment with antihistamines. C) treatment with an antineutrophil serum. D) removal of the spleen. E) decreasing levels of complement.

A

26. Diseases in which TH cells and cytotoxic CD8+ T cells probably play major roles in their pathology include all of the following except ? A) myasthenia gravis. B) Hashimoto's thyroiditis. C) rheumatoid arthritis. D) multiple sclerosis. E) insulin-dependent diabetes mellitus.

A

4. All of the following procedures would be likely to induce tolerance to a protein antigen except? A) intramuscular injection of the antigen in adjuvant. B) intravenous injection of deaggregated protein. C) injection of cyclosporine with the antigen. D) injection of antigen at a stage in development before mature lymphocytes appear. E) intravenous injection of small amounts of antigen.

A

13. A positive delayed-type hypersensitivity skin reaction involves the interaction of? A) antigen, complement, and cytokines. B) antigen, antigen-sensitive lymphocytes, and macrophages. C) antigen —antibody complexes, complement, and neutrophils. D) IgE antibody, antigen, and mast cells. E) antigen, macrophages, and complement.

B

14. Cell-mediated immune responses are? A) enhanced by depletion of complement. B) suppressed by cortisone. C) enhanced by depletion of T cells. D) suppressed by antihistamine. E) enhanced by depletion of macrophages.

B

17. Positive skin tests for delayed-type hypersensitivity to intradermally injected antigens indicate that? A) a humoral immune response has occurred. B) a cell-mediated immune response has occurred. C) both T cell and B cell systems are functional. D) the individual has previously made IgE responses to the antigen. E) immune complexes have been formed at the injection site.

B

22. Rheumatoid factor, found in synovial fluid of patients with rheumatoid arthritis, is most frequently found to be? A) IgM reacting with L chains of IgG. B) IgM reacting with H-chain determinants of IgG. C) IgE reacting with bacterial antigens. D) antibody to collagen. E) antibody to DNA.

B

24. Autoimmune hemolytic anemia? A) is usually due to warm agglutinins belonging to the IgM class directed against Rh antigens on red blood cells B) may be due to the production of either cold agglutinins after viral infection or autoantibodies following drug treatment. C) is the result of cytotoxic T cells lysing red blood cells D) does not generally involve complement components in red blood cell lysis E) can be characterized by a negative Coombs test

B

27. Hashimoto's thyroiditis? A) is due primarily to antibodies formed to thyroid-stimulating hormone receptors. B) mimics an animal model in which the disease is induced by immunization with thyroglobulin. C) can be transplacentally transmitted causing a neonatal form of the disease. D) is an autoimmune disease which affects males and females equally. E) is characterized by immune complex deposition in the thyroid.

B

32. The MHC contains all of the following except? A) genes that encode transplantation antigens. B) genes that encode immunoglobulins. C) genes that regulate immune responsiveness. D) genes that encode some components of complement. E) genes that encode class I and class II antigens.

B

36. Tumor antigens have been shown to cross-react immunologically in cases of? A) tumors induced by chemical carcinogens. B) tumors induced by RNA viruses. C) all tumors. D) tumors induced by irradiation with ultraviolet light. E) tumors induced by the same chemical carcinogen on two separate sites on the same individual

B

45. Active, durable immunization against poliomyelitis can be accomplished by oral administration of attenuated vaccine (Sabin) or by parenteral injection of inactivated (Salk) vaccine. These vaccines are equally effective in preventing disease because? A) both induce adequate IgA at the intestinal mucosa, the site of entry of the virus. B) antibody in the serum protects against the viremia that leads to disease. C) viral antigen attaches to the anterior horn cells in the spinal cord, preventing attachment of virulent virus. D) both vaccines induce formation of interferon. E) both vaccines establish a mild infection that can lead to formation of antibody.

B

46. The administration of vaccines is not without hazard. Of the following, which is least likely to affect adversely an immunocompromised host? A) measles vaccine B) pneumococcal vaccine C) bacille Calmette-Gu;aaerin D) mumps vaccine E) Sabin poliomyelitis vaccine

B

47. The administration of foreign (e.g., equine) antitoxin for passive protection in humans can lead to serum sickness, which is characterized by all of the following except? A) production by host of antibody to foreign antibody. B) onset in 24—48 hours. C) use of homologous antitoxin. D) deposition of antigen—antibody complexes at various sites in the host. E) although delayed, the reaction is not a cell-mediated, delayed, type IV immune response.

B

5. When a tolerogenic injection of a protein antigen is given experimentally, it can be shown that? A) B-cell tolerance is more rapidly induced than T-cell tolerance. B) B-cell tolerance is lost as new B cells come from the bone marrow. C) B-cell tolerance can be induced only when low doses are used. D) T-cell tolerance can be induced only when high doses are used. E) T-cell tolerance is shorter lasting than B-cell tolerance.

B

50. In order to prevent Rhesus hemolytic disease of the newborn developing in babies that are at risk because of the parents' blood group types, to whom and at what time should Rhogam (anti-Rhesus) be administered? A) The baby should be transfused once with Rhogam in utero as soon as the procedure is feasible B) The mother should receive it within 3 days of birth C) The mother should receive it before pregnancy and again as soon as she knows she is pregnant D) The mother should receive it immediately after the baby is born and then again within about 2-3 weeks E) The newborn baby should receive it within 24 hours of delivery Page

B

8. An IgA antibody to a red blood cell antigen is unlikely to cause autoimmune hemolytic anemia because? A) it would be made only in the gastrointestinal tract. B) its Fc region would not bind receptors for Fc on phagocytic cells. C) it can fix complement only as far as C1, C4, C D) it has a too-low affinity. E) it requires secretory component to work.

B

12. Which of the following does not involve cell-mediated immunity? A) contact sensitivity to lipstick B) rejection of a liver graft C) serum sickness D) tuberculin reaction E) immunity to chicken pox

C

19. Most autoimmune diseases are caused by a? A) single genetic defect. B) known infectious organism. C) constellation of genetic and environmental events. D) hormonal dysregulation. E) B-cell defect.

C

25. Systemic lupus erythematosus? A) is due to a mutation in double-stranded DNA. B) is a classic example of a T-cell-mediated autoimmune disease. C) has multiple symptoms and affects many organs. D) results from antibodies specific to thyroid. E) affects only skin epithelial cells.

C

43. Antigenic variation is a mechanism of immune evasion that results in? A) interference with attachment to host receptors. B) induction of immune suppression. C) alterations in important surface antigens such that escape variants arise as a result of immune selection. D) mutations in surface antigens. E) destruction of antigens by proteolytic enzymes.

C

48. The pneumococcal polysaccharide vaccine should be administered to all except? A) individuals with chronic cardiorespiratory disease. B) elderly (over 60 years of age) persons. C) children (under 2 years of age). D) persons with chronic renal failure. E) individuals with sickle-cell disease

C

6. Blocking any of the following processes can result in peripheral tolerance in mature T cells except? A) the interaction of costimulatory molecules on T cells with their ligands on APC. B) intracellular signal transduction mechanisms. C) negative selection of thymocytes. D) activation of the IL-2 gene. E) the binding of antigen with MHC molecules.

C

9. The lesions in immune complex-induced glomerulonephritis? A) are dependent on erythrocytes and complement. B) result in increased production of urine. C) require both complement and neutrophils. D) are dependent on the presence of macrophages. E) require all nine components of complement

C

1. An individual does not make an immune response to a self-protein because? A) self-proteins cannot be processed into peptides. B) peptides from self-proteins cannot bind to MHC class I. C) peptides from self-proteins cannot bind to MHC class II. D) lymphocytes that express a receptor reactive to a self-protein are inactivated by deletion or anergy. E) developing lymphocytes cannot rearrange V genes required to produce a receptor for selfproteins.

D

10. The final damage to vessels in immune complex-mediated arthritis is due to? A) cytokines produced by T cells. B) histamine and SRS-A. C) the C5, C6, C7, C8, C9 membrane attack complex. D) lysosomal enzymes of polymorphonuclear leukocytes. E) cytotoxic T cells.

D

2. Which of the following is incorrect concerning immune tolerance? A) Tolerance induction is antigen-specific. B) Tolerance results from inactivation and/or elimination of B and/or T cells. C) Tolerance can be induced in both young and old individuals. D) Immature neutrophils are more susceptible to tolerance than mature neutrophils. E) The breakdown of tolerance can result in autoimmunity.

D

20. Identifying an autoimmune disease in humans is often accomplished by? A) finding an antibody against self-components. B) passively transferring specific T cells from a patient to a healthy individual. C) showing that T cells or antibodies are the cause of the tissue damage. D) circumstantial evidence, such as MHC association and clinical improvement, with immunosuppressive drugs. E) finding the definitive agent or agents responsible for the disease.

D

29. A 9-month-old baby was vaccinated against smallpox with attenuated smallpox virus. He developed a progressive necrotic lesion of the skin, muscles, and subcutaneous tissue at the site of inoculation. The vaccination reaction probably resulted from? A) B-lymphocyte deficiency. B) reaction to the adjuvant. C) complement deficiency. D) T-cell deficiency. E) B- and T-lymphocyte deficiency.

D

3. Which of the following statements is incorrect concerning the immune response to antigens? A) Reactivity is influenced by extremes of age. B) Greater immune responses are produced when antigen is given with adjuvant. C) Impaired nutrition depresses immunity. D) The presence of preexisting antibody does not affect the subsequent response to antigen. E) Different protein antigens stimulate different levels of antibody production.

D

33. Which of the following statements regarding GVH disease is incorrect? A) GVH can result from MHC differences between donor and recipient. B) GVH requires immunocompetent donor cells. C) GVH may result from infusion of blood products that contain viable lymphocytes into an immunologically incompetent recipient. D) GVH requires natural killer cells. E) GVH may occur in an immunosuppressed individual

D

37. Which of the following is not considered a mechanism by which cytokines mediate antitumor effects? A) They enhance the expression of MHC class I molecules. B) They activate LAK and TIL cells. C) They have direct antitumor activity. D) They induce complement-mediated cytolysis. E) They increase activity of cytotoxic T cells, macrophages, and NK cells.

D

39. Immunotoxins are? A) toxic substances released by macrophages. B) cytokines. C) toxins completed with the corresponding antitoxins. D) toxins coupled to antigen-specific immunoglobulins. E) toxins released by cytotoxic T cells

D

40. It has been shown that a B-cell lymphoma could be eliminated with anti-idiotypic serum. The use of this approach to treat a plasma cell tumor would not be warranted because? A) plasma cell tumors have no tumor-specific antigens. B) plasma cell tumors are not expected to be susceptible to ADCC. C) plasma cell tumors can be killed in vivo only by cytotoxic T lymphocytes that bear the same A, B, and C transplantation antigens. D) the plasma cells do not have surface Ig. E) the idiotype on the plasma-cell surface is different from that on the B-cell surface

D

41. The usual sequence of events in the development of an effective immune response to a viral infection is? A) interferon secretion, antibody synthesis, cellular immune response, NK cell ADCC. B) antibody synthesis, interferon secretion, NK cell ADCC, cellular immune response. C) NK cell ADCC, interferon secretion, antibody synthesis, cellular immune response D) interferon secretion, cellular immune response, antibody synthesis, NK cell ADCC. E) cellular immune response, interferon secretion, antibody synthesis, NK cell ADCC.

D

44. The best way to provide immunologic protection against tetanus neonatorum (of the newborn) is to? A) inject the infant with human tetanus antitoxin. B) inject the newborn with tetanus toxoid. C) inject the mother with toxoid within 72 hours of the birth of her child. D) immunize the mother with tetanus toxoid before or early in pregnancy. E) give the child antitoxin and toxoid for both passive and active immunization

D

7. An individual with a defect in CTLA-4 (CD152) will be most likely to have which of the following? A) Type I hypersensitivity B) immunodeficiency C) recurrent Neisseria infections D) lymphoproliferative disease

D

11. Type II hypersensitivity? A) is antibody-independent. B) is complement-independent. C) is mediated by CD8+ T cells. D) requires immune complex formation. E) involves antibody-mediated destruction of cells.

E

16. Patients with DiGeorge syndrome who survive beyond infancy would be capable of? A) rejecting a bone marrow transplant. B) mounting a delayed-type hypersensitivity response to dinitrochlorobenzene. C) resisting intracellular parasites. D) forming antibody to T-dependent antigens. E) None of the above.

E

18. T cell-mediated immune responses can result in? A) formation of granulomas. B) induration at the reaction site. C) rejection of a heart transplant. D) eczema of the skin in the area of prolonged contact with a rubberized undergarment. E) All of the above.

E

21. The following is/are possible mechanism(s) for the recognition of self-components by the immune system in autoimmune diseases? A) alteration of a self-antigen so it is recognized as foreign B) leakage of sequestered self-antigen C) loss of suppressor cells D) infection with a microorganism that carries a cross-reactive antigen E) Any of the above.

E

23. The pathology in autoimmune diseases due to antibody may be a result of? A) the formation of antigen —antibody complexes. B) antibody blocking a cell receptor. C) antibody-induced phagocytosis. D) antibody-induced complement mediated lysis. E) Any of the above.

E

28. Immunodeficiency disease can result from? A) a developmental defect of T lymphocytes. B) a developmental defect of bone marrow stem cells. C) a defect in phagocyte function. D) a defect in complement function. E) All of the above.

E

30. An 8-month-old baby has a history of repeated gram-positive bacterial infections. The most probable cause for this condition is that? A) the mother did not confer sufficient immunity on the baby in utero. B) the baby suffers from erythroblastosis fetalis (hemolytic disease of the newborn). C) the baby has a defect in the alternative complement pathway. D) the baby is allergic to the mother's milk. E) None of the above.

E

31. A 50-year-old worker at an atomic plant who previously had a sample of his own bone marrow cryopreserved was accidentally exposed to a minimal lethal dose of radiation. He was subsequently transplanted with his own bone marrow. This individual can expect? A) to have recurrent bacterial infections. B) to have serious fungal infections due to deficiency in cell-mediated immunity. C) to make antibody responses to thymus-independent antigens only. D) All of the above. E) None of the above.

E

34. Transplant rejection may involve? A) cell-mediated immunity. B) type III (immune complex) hypersensitivity. C) complement-dependent cytotoxicity. D) the release of IFN-g. E) All of the statements are correct.

E

35. The appearance of many primary lymphoreticular tumors in humans has been correlated with? A) hypergammaglobulinemia. B) acquired hemolytic anemia. C) BCG treatment. D) resistance to antibiotics. E) impairment of cell-mediated immunity.

E

38. Rejection of a tumor may involve which of the following? A) T-cell-mediated cytotoxicity B) ADCC C) complement-dependent cytotoxicity D) destruction of tumor cells by phagocytic cells E) All are correct.

E

42. Differences between gram-positive and gram-negative bacteria include? A) staining with crystal violet. B) ability of complement to lyse cells. C) thickness of the peptidoglycan layer. D) endotoxin in the cell walls of gram-negative bacteria. E) All of the above.

E

49. The following statements about human immune serum globulin (ISG) are true except? A) The source is human placenta. B) The globulins are obtained by precipitation with cold ethanol. C) The concentration of IgG is more than 10-fold greater than in plasma. D) IgA and IgM are present in concentrations slightly lower than in plasma. E) The ethanol precipitation does not render preparation of globulin free of hepatitis virus

E