Immuno Exam 3 + after

In routine blood transfusions, which of the following must be matched correctly? (Select all that apply) - A and B antigens - O antigens - Rhesus D antigen - MHC class I molecules - MHC class II molecules

- A and B antigens - Rhesus D antigen

Herpesviruses include all of the following except _____. - varicella-zoster - Epstein-Barr virus - herpes simplex virus - cytomegalovirus - All of the above are herpesviruses.

- All of the above are herpesviruses.

For a viral subunit vaccine to be effective, _____. (Select FOUR that apply.) - B cells must be activated - cytotoxic T cells must be activated - neutralizing antibodies must be induced - CD4 TFH cells must be activated - NK cells must be activated - it must be derived from viral surface components.

- B cells must be activated - neutralizing antibodies must be induced - CD4 TFH cells must be activated - it must be derived from viral surface components.

Adaptive immune responses targeted at infections by helminth worms and other parasitic multicellular animals employ all of the following except _____. (Select all that apply): - CD8 T cells - IgE - eosinophils - mast cells - CD4 TH2 cells - basophils - neutrophils - IL-4

- CD8 T cells - neutrophils

Which of the following is an example of a type II autoimmune response? (Select all that apply) - Graves disease - multiple sclerosis - systemic lupus erythematosus - myasthenia gravis

- Graves disease - myasthenia gravis

Which of the following statements about human immunodeficiency virus (HIV) are correct? (Select all that apply) - HIV has a DNA genome. - HIV must synthesize reverse transcriptase - immediately after infecting a cell. - HIV infects cells expressing CD4. - HIV requires the CXCR4 co-receptor for internalization by T cells. - NFkB is a transcription factor that facilitates the transcription of proviral RNA.

- HIV infects cells expressing CD4. - HIV requires the CXCR4 co-receptor for internalization by T cells. - NFkB is a transcription factor that facilitates the transcription of proviral RNA.

Which of the following genetic polymorphisms is associated with a predisposition to asthma? (Select all that apply) - promoter variants of IL-5 - structural variant of IgG receptor - HLA class II allotypes - β2-adrenergic receptor variant - ACOX5 (5-lipoxygenase)

- HLA class II allotypes - β2-adrenergic receptor variant - ACOX5 (5-lipoxygenase)

With reference to the RotaTaq vaccine, identify the FALSE statement. (Select TWO that apply.) - It is an attenuated vaccine derived from a human rotavirus. - It has been genetically engineered to express a variety of human VP4 and VP7 glycoproteins. - It is a mixture of five bovine rotaviruses. - It is pathogenic if a genetic reversion occurs. - Standard tissue culture methods are used for its production. - It took decades of research to develop this vaccine to an adequate standard.

- It is an attenuated vaccine derived from a human rotavirus. - It is an attenuated vaccine derived from a human rotavirus.

Indicate which of the following statements is TRUE. - The Bacille Calmette-Guérin (BCG) vaccine is commonly used in the United States to provide protection against tuberculosis. - BCG is a heat-killed strain of bovine Mycobacterium tuberculosis. - Lipopolysaccharide-deficient Salmonella typhi is used to vaccinate against typhoid fever. - Live attenuated bacterial vaccines are more common than live attenuated viral vaccines.

- Lipopolysaccharide-deficient Salmonella typhi is used to vaccinate against typhoid fever.

Which of the autoimmune diseases is CORRECTLY matched with the autoantigen? (Select all that apply). - Mysathenia gravis - acetylcholine receptor - Graves disease - rheumotoid factor - Multiple sclerosis - myelin basic protein - Autoimmune hemolytic anemia - Rh antigen - Autoimmune hemolytic anemia - glycophorin

- Mysathenia gravis - acetylcholine receptor - Multiple sclerosis - myelin basic protein - Autoimmune hemolytic anemia- Rh antigen - Autoimmune hemolytic anemia - glycophorin

Which of the following contribute to new epidemics and the long-term survival of the influenza virus in the human population? (Select all that apply) - New viral strains possess epitopes not recognized by antibodies made in the previous epidemic. - The first influenza strain provoking a primary immune response constrains the types of antibodies made during a subsequent encounter with a different strain. - The virus loses the capacity to express hemagglutinin, thereby rendering neutralizing antibodies useless. - The virus uses gene rearrangement to achieve antigenic variation, which creates new epitopes. - The RNA genome of the influenza virus is subject to point mutations during viral replication.

- New viral strains possess epitopes not recognized by antibodies made in the previous epidemic. - The first influenza strain provoking a primary immune response constrains the types of antibodies made during a subsequent encounter with a different strain. - The RNA genome of the influenza virus is subject to point mutations during viral replication.

Which of the following explain why the safety standards for vaccines are set higher than those for drugs? (Select all that apply.) - Some vaccines can induce a disease state. - Vaccines provoke side-effects in otherwise healthy children. - Vaccines are much more costly to develop and test than most drugs. - Vaccination programs are targeted at large populations. - Subunit vaccines can potentially integrate into the host genome and activate host oncogenes, leading to the development of cancer.

- Some vaccines can induce a disease state. - Vaccines provoke side-effects in otherwise healthy children. - Vaccination programs are targeted at large populations

In which ways do memory B cells active in a secondary immune response differ from the naive B-cell population activated in a primary immune response? (Select all that apply.) - The antibody produced is of higher affinity in a secondary immune response. - The frequency of antigen-specific B cells is lower in a secondary immune response. - The level of somatic hypermutation is higher in a secondary immune response. - Higher levels of IgM are produced in secondary immune responses - .B cells do not require T-cell help in secondary immune responses. - Memory B cells express higher levels of MHC class II molecules.Naive B cells express higher levels of co-stimulatory molecules.

- The antibody produced is of higher affinity in a secondary immune response. - The level of somatic hypermutation is higher in a secondary immune response. - Memory B cells express higher levels of MHC class II molecules.

Which of the following is FALSE regarding the history of vaccination? - Edward Jenner is credited with the development of the technique called vaccination - Fluid from a cowpox blister can be used to protect against smallpox - An ancient chinese practice used dried smallpox pustules and introduced material from the pustule into healthy individuals to protect against smallpox - The cowpox virus cannot infect humans

- The cowpox virus cannot infect humans

Which of the following characterizes immunological memory? (Select all that apply.)

- The host retains the capacity to mount a secondary immune response. - The host retains the ability to respond to pathogen many years after primary exposure. - Memory B cells produce higher-affinity antibody than naive B cells.

Identify which of the following is NOT a characteristic of γ:δ T cells. - Most do not express either CD4 or CD8. - Most circulating cells do not enter secondary lymphoid tissue - They undergo gene rearrangement. - They originate from the same precursor cells as do α:β T cells. - Their response is solely dependent on the T-cell receptor.

- Their response is solely dependent on the T-cell receptor.

Which of the following statements regarding NK cells is false? - They express either inhibitory receptors or activating receptors, but not both. - Their inhibitory receptors are necessary to prevent killing of healthy cells. - They all express CD56. - Because NK cells express diverse combinations of receptors, no single NK cell expresses them all. - Some of their activating and inhibitory receptors use MHC class I ligands.

- They express either inhibitory receptors or activating receptors, but not both.

Memory B cells differ from memory T cells in the following ways. (Select all that apply) - They suppress naive antigen-specific lymphocytes during secondary immune responses. - They recirculate only through secondary lymphoid organs. - They secrete their antigen receptors throughout their life-span. - They generate long-lived clones of memory cells during the primary immune response.

- They suppress naive antigen-specific lymphocytes during secondary immune responses. - They recirculate only through secondary lymphoid organs.

Which of the following are potential means by which type I allergic reactions can be managed or treated? (Select all that apply) - Use antihistamines to block histamine binding to H1 histamine receptors. - Use corticosteroids to suppress inflammation. - Desensitize the patient by feeding them allergen and skewing the immune response from an IgE to an IgA response. - Anergize allergen-specific T cells through vaccination with allergen-derived peptides. - Administer Il-4, IL-5, or IL-1β to promote TH1 responses. - Block high-affinity IgE receptors to prevent mast-cell degranulation.

- Use antihistamines to block histamine binding to H1 histamine receptors. - Use corticosteroids to suppress inflammation. - Anergize allergen-specific T cells through vaccination with allergen-derived peptides. - Block high-affinity IgE receptors to prevent mast-cell degranulation.

An example of a physical agent that increases an individual's predisposition to developing cancer is_____. (Select all that apply.) - cigarette smoke - X-rays - ultraviolet radiation - asbestos - exposure to radioactive sources.

- X-rays - ultraviolet radiation - exposure to radioactive sources.

express FcεRI and contain granules containing inflammatory mediators. (Select all that apply) - macrophages - activated eosinophils - mast cells - natural killer cells - basophils

- activated eosinophils - mast cells - basophils

Blood transfusions mismatched for ABO and/or rhesus antigens are associated with _____. (Select all that apply) - type III hypersensitivity reactions - alloreactive immune responses - lysis of recipient red blood cells - laboratory errors in the cross-matching procedure - activation of host complement and destruction of donor cells

- alloreactive immune responses - laboratory errors in the cross-matching procedure - activation of host complement and destruction of donor cells

The haplotype A1-B8-DR3-DQ2 is associated with several common autoimmune diseases including all of the following except _____. - ankylosing spondylitis - systemic lupus erythematosus - autoimmune hepatitis - myasthenia gravis - type 1 diabetes - primary biliary cirrhosis

- ankylosing spondylitis

For infectious HIV virions to be made, the infected cell must _____. (Select all that apply) - be CD4-positive - express low levels of CCR5 - express functional NFκB - be latent - be polyreactive

- be CD4-positive - express functional NFκB

Identify which of the following is not a characteristic of CD94:NKG2A. - prevents killing of self cells - is an inhibitory NK-cell receptor - binds to carbohydrate ligands - is a disulfide-linked heterodimer - contains an immunoreceptor tyrosine-based inhibitory motif (ITIM)

- binds to carbohydrate ligands

Which of the following immunosuppressive drugs functions by inhibiting DNA synthesis? (Select all that apply) - cyclophosphamide - prednisone - azathioprine - methotrexate - mycophenolate mofetil - cyclosporin A - tacrolimus

- cyclophosphamide - azathioprine - methotrexate - mycophenolate mofetil

All of the following are associated with the ability of influenza virus to escape from immunity except _____. - age - error-prone replication of its DNA genome - co-infection with avian and human influenza viruses - recombinant strains - the phenomenon of 'original antigenic sin.'

- error-prone replication of its DNA genome

If autoantibodies of the IgG or IgM isotype were produced with specificity for components found on the surface of erythrocytes, which of the following would occur? (Select all that apply.) - formation of membrane-attack complex - immune-complex deposition in renal glomeruli - anemia - hypothyroidism - receptor-mediated phagoytosis via Fc receptors on phagocytes.

- formation of membrane-attack complex - anemia - receptor-mediated phagoytosis via Fc receptors on phagocytes.

Residual leukemia cells persisting in a patient after they have received chemotherapy, irradiation, and a bone-marrow transplant are sometimes eliminated by a _____ effect which involves the action of _____. (Select all that apply) - graft-versus-leukemia; alloreactive T cells - haploidentical; regulatory T cells - acute minor histocompatibility; recipient NK cells - myeloablation; mature T cells - graft-versus-leukemia; alloreactive NK cells

- graft-versus-leukemia; alloreactive T cells - graft-versus-leukemia; alloreactive NK cells

Which of the following is the cause of red blood cell deficiency in autoimmune hemolytic anemia? (Select all that apply.) - inability of red blood cells to develop normally in the bone marrow - loss of red blood cells due to widespread pinpoint hemorrhages - hemolysis by assembly of membrane-attack complexes - phagocyte-mediated clearance in the spleen - rapid turnover of red blood cells due to CD8 T-cell killing

- hemolysis by assembly of membrane-attack complexes - phagocyte-mediated clearance in the spleen

Deficiency in the production of AIRE results in _____. (select all that apply) - normal expression of tissue-specific proteins in the bone marrow and thymus - incomplete negative selection of developing T cells - the development of autoimmune B-cell and T-cell responses against endocrine glands and other tissues - death in infancy - the development of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED)

- incomplete negative selection of developing T cells - the development of autoimmune B-cell and T-cell responses against endocrine glands and other tissues - the development of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED)

RhoGAM is administered to pregnant RhD- women so as to _____. (Select all that apply.) - stimulate only anti-RhD IgM antibody - cause selective removal of anti-RhD memory B cells from the maternal circulation - inhibit a primary immune response to RhD antigen - block transcytosis of IgG to fetal circulation by interfering with FcRn function - prevent hemolytic anemia of the newborn

- inhibit a primary immune response to RhD antigen - prevent hemolytic anemia of the newborn

Inactivation of viruses for vaccine use can be achieved by _____.

- irradiation - heat treatment - formalin treatment

Prednisone is a steroid used in transplantation that _____. (Select all that apply) - binds to a cell-surface receptor and inhibits the function of NFkB - is combined with cytotoxic drugs to improve its efficacy - decreases the synthesis of IkBa - causes a decrease in production of inflammatory cytokines - can lead to bone demineralization as an unwanted side-effect

- is combined with cytotoxic drugs to improve its efficacy - causes a decrease in production of inflammatory cytokines - can lead to bone demineralization as an unwanted side-effec

A malignant tumor is characterized by which of the following features? (Select all that apply.) - encapsulation - localized - restricted in size - metastasizes to distant sites - results from multiple mutations affecting cell division or survival

- metastasizes to distant sites - results from multiple mutations affecting cell division or survival

Myeloablative therapy is carried out in bone marrow transplantation in order to _____. (Select all that apply) - prevent graft-versus-host disease - prevent host-versus-graft disease - suppress autoreactive T cells in the graft - disable the patient's hematopoietic stem cells but not their circulating leukocytes - provide space for colonization of transplanted stem cells in bone marrow stroma - destroy tumors of immune-system cells

- prevent host-versus-graft disease - provide space for colonization of transplanted stem cells in bone marrow stroma - destroy tumors of immune-system cells

For the patient's new immune system to function effectively in bone marrow recipients, some HLA allotypes must be shared because _____. (Select all that apply) - professional antigen-presenting cells are host-derived - professional antigen-presenting cells are donor-derived - otherwise an autoimmune disease would develop - newly generated T cells are positively selected on the recipient's thymic epithelium - if all HLA molecules were mismatched, acute rejection of the grafted cells would occur

- professional antigen-presenting cells are donor-derived - newly generated T cells are positively selected on the recipient's thymic epithelium

Which viral targets for HIV therapy is involved in processing of long viral polypeptides into shorter peptides (select ONE that applies): - reverse transcriptase - matrix protein - gp120 - CD4 - protease

- protease

Tacrolimus causes which of the following effects? (Select all that apply) - reduced T-cell proliferation - decreased production of nitric oxide - decreased production of IL-3, IL-4, GM-CSF, and TNF-a - decreased activity of cyclo-oxygenase type 2 - serum sickness

- reduced T-cell proliferation - decreased production of IL-3, IL-4, GM-CSF, and TNF-a

Which of the following describes processes by which self-reactive lymphocytes are rendered incapable of mounting an autoimmune response? (Select SEVEN that apply.) - sequestration of autoantigens in immunologically privileged sites - induction of anergy in peripheral compartments - positive selection of autoimmune T lymphocytes in secondary lymphoid tissues - negative selection of T lymphocytes in the thymus - suppression by regulatory T cells - negative selection of B lymphocytes in the bone marrow - expression of AIRE in the bone marrow - induction of alloreactive responses it the thymus - somatic hypermutation to an alternative antigen specificity - apoptosis in primary lymphoid tissue - deprivation of T-cell help

- sequestration of autoantigens in immunologically privileged sites - induction of anergy in peripheral compartments - negative selection of T lymphocytes in the thymus - suppression by regulatory T cells - negative selection of B lymphocytes in the bone marrow - apoptosis in primary lymphoid tissue - deprivation of T-cell help

Which of the following are consequences of anaphylactic shock? (Select all that apply) - smooth muscle contraction - immune complex deposition on blood vessels - loss of blood pressure - constriction of airways - complement activation

- smooth muscle contraction - loss of blood pressure - constriction of airways

A characteristic of the human eye that enables the cornea to be transplanted with a 90% success rate is that _____. (Select all that apply) - antigen-presenting cells in the eye do not express the co-stimulatory molecule B7 - the cornea is not vascularized - anterior-chamber-associated immune deviation (ACAID) establishes a state of tolerance in the eye - only regulatory T cells express the adhesion molecules necessary to enter the cornea - the aqueous humor of the anterior chamber contains TGF-b, which downregulates CD40 and inhibits IL-12 secretion

- the cornea is not vascularized - anterior-chamber-associated immune deviation (ACAID) establishes a state of tolerance in the eye - the aqueous humor of the anterior chamber contains TGF-b, which downregulates CD40 and inhibits IL-12 secretion

Monoclonal antibodies are used in cancer treatment for the following reasons EXCEPT - to target tumor cells for immune responses such as ADCC or opsonization - deliver radioactive molecule to track or kill tumor cells - to be conjugated to cytotoxic drugs to kill tumor cells - to enhance the expression of tumor-specific antigens

- to enhance the expression of tumor-specific antigens

Which of the following are associated with soluble antigen? (Select all that apply) - type I hypersensitivity - type II hypersensitivity - type III hypersensitivity - type IV hypersensitivity - mast-cell activation

- type 1 hypersensitivity - type III hypersensitivity - type IV hypersensitivity - mast-cell activation

Which of the following are matched correctly? (Select all that apply) - type I hypersensitivity: IgE - type II hypersensitivity: IgG - type III hypersensitivity: immune complexes - type IV hypersensitivity: IgG - type IV hypersensitivity: delayed-type hypersensitivity

- type I hypersensitivity: IgE - type II hypersensitivity: IgG - type III hypersensitivity: immune complexes - type IV hypersensitivity: delayed-type hypersensitivity

Forty-four-year old Danielle Bouvier is on the waiting list for a kidney transplant and is receiving weekly dialysis. Her HLA type is: HLA-A: 0101/0301; HLA-B: 0702/0801; HLA-DRB1: 0301/0701. Today, Danielle's physician informed her that several potential kidney donors are available. Which of the following would be the most suitable?

0101/0101; B: 5701/0801; DRB1: 0701/0701

What is the probability that a sibling will be able to provide a HLA-haploidentical kidney for transplantation?

50%

Which of the following will happen If tumor cells are taken from a mouse that has both RAG genes knocked out and the tumor cells are injected into a normal syngeneic mouse (wild-type RAG genes)?

A high proportion of normal mice will develop tumors

Which genetic event can convert a HIV macrophage tropic virus to a lymphocyte tropic virus?

A point mutation in the gp120 protein

__ is a monoclonal antibody administered to transplant patients before and after transplantation in order to induce lymphopenia.

Alemtuzumab

At 42 years old, Stephanie Goldstein developed occasional blurred and double vision, numbness and 'pins and needles' in her arms and legs (paresthesia), and bladder incontinence. After a month of these symptoms she went to her doctor, who sent her to the neurology specialist. An MRI scan revealed areas of demyelination in the central nervous system (CNS), and Stephanie was diagnosed with the autoimmune disease multiple sclerosis (MS). Which of the following best explains why some people are susceptible to the development of MS?

An inability to produce immunological tolerance toward CNS-derived constituents results in the generation of self-reactive lymphocytes.

Which of the following is an Elite neutralizer of HIV?

An individual making broadly neutralizing antibodies after exposure to several HIV strains

Anita Garcia, 17 years old, and her roommate Rosa Rosario were celebrating a friend's birthday at a dessert buffet at a local restaurant when Anita developed acute dyspnea, and angioedema. She complained of an itchy rash, and then had difficulty swallowing. Rosa drove Anita to the emergency room two blocks away rather than wait for an ambulance. As they approached the hospital, Anita lost consciousness. Anita was suffering from _______ likely caused by _____ present in the cake.

Anaphylaxis; nuts

_____ cause(s) mild and limited disease, whereas _____ cause(s) more severe disease and higher mortality.

Antigenic drift; antigenic shift

Epstein-Barr virus infects and establishes latency in _____, gaining entry by binding to _____.

B cells; CR2

Rituximab, used in the treatment of rheumatoid arthritis, depletes _____ through a process involving the cross-linking of _____ on the surface of NK cells and the induction of antibody-dependent cell-mediated cytotoxicity.

B cells; FcγRIII

Which of the following statements about the CCR5-D32 mutant is NOT correct? - A mutated allele of the CCR5 gene with a 32-nuclelotide deletion in the coding region. - Both CCR5-D32 heterozygotes and homozygotes resist HIV infection. - The mutation alters the reading frame and results in a nonfunctional CCR5 protein. - This renders such individuals resistant to primary infection by macrophage-tropic variants ofHIVbut stillsusceptibleto lymphocyte-tropicstrainsthat usetheCXCR4co-receptor

Both CCR5-D32 heterozygotes and homozygotes resist HIV infection

When deficient, which of the following proteins does not render the individual more susceptible to encapsulated bacteria? - C1INH - C3 - Bruton's tyrosine kinase - factor D - factor I - CD40 ligand

C1INH

The only single receptor that can activate NK cells without the need for a second activating receptor is _____.

CD16

A tumor-associated antigen normally expressed only in the testis is called a _____ antigen.

CT

_____ is/are commonly associated with the fusion between the BCR gene and the ABL proto-oncogene.

Chronic myelogenous leukemia

A mutation in only one copy of a tumor suppressor gene can cause malignant transformation.

F

ABO or Rhesus antigen mismatches stimulate cytotoxic T-cell responses.

F

Antithymocyte globulin (ATG) is a monoclonal antibody specific for T-cell surface antigens.

F

Autoimmune responses are the result of innate immune responses directed toward self antigens.

F

During pregnancy the fetus is exposed to maternal leukocytes.

F

During pregnancy, IgG antibodies and activated lymphocytes can cross the placenta and enter the circulatory system of the fetus.

F

Immunosuppressive xenogeneic antibodies can be used repeatedly for multiple episodes of transplant rejection without complication.

F

Lymphocytes and erythrocytes express HLA class I and II molecules.

F

_____ results from alloreactions mediated by donor T cells in the graft subsequent to hematopoietic stem-cell transplantation.

Graft-versus-host disease (GVHD)

Individuals with an immunodeficiency affecting B-cell function are more susceptible to infections caused by which of the following pathogens?

Haemophilus influenzae

During the course of a successful desensitization process, the patient's antibodies will change from an isotype to an isotype.

IgE:IgG4

During the course of a successful desensitization process, the patient's antibodies will change from an _____isotype to an _____ isotype.

IgE:IgG4

Which of the following explain why infections with influenza virus erode immunological memory over time?

Influenza is a highly mutable virus that changes its epitope composition

Which of the following regarding FcεRI is FALSE? - It is expressed on the surface of mast cells and basophils - It is a high-affinity receptor involved in type I hypersensitivity reactions - It binds to IgG in the absence of antigen - It is a membrane-bound protein - It contains signaling components.

It binds to IgG in the absence of antigen

Which of the following is FALSE regarding an inactivated or killed virus vaccine? - It elicits a strong B cell response - It elicits a strong T cell response - Usually is injected intramuscularly - Usually elicits a humoral response

It elicits a strong T cell response

Which of these characteristics is FALSE regarding IFN-γ? - When it acts on target cells, it enhances the engulfment and killing of bacteria. - It is the major activating cytokine of macrophages. - It activates the JAK-STAT signal transduction pathway after binding to its cognate receptor. - It is secreted by CD8 cytotoxic T cells, CD4 TH1 cells, and NK cells. - It is secreted and functions as a monomer but facilitates the dimerization of its receptor. - It is able to render target cells responsive even if they express only one functional allele of IFNγR1.

It is secreted and functions as a monomer but facilitates the dimerization of its receptor.

A deficiency in _____ would cause a condition that closely resembles X-linked severe combined immunodeficiency and is characterized by inefficient cytokine signaling.

Janus 3 kinase (Jak3)

Herpes simplex virus favors neurons for latency because of the low level of , which reduces thelikelihood of killing by CD8 T cells.

MHC class 1

Herpes simplex virus favors neurons for latency because of the low level of _____, which reduces the likelihood of killing by CD8 T cells.

MHC class I

A stressed cell will express

MIC glycoproteins

A stressed cell will express....

MIC glycoproteins

_____ describes the condition in which a cell becomes able to cause cancer.

Malignant transformation

Which of the following statements is INCORRECT regarding memory B cells? - In secondary responses, the number of pathogen-specific B cells is about 10-100-fold more than thatseen in primary responses - The sensitivity of memory B cells is improved compared with naive B cells because affinitymaturation has occurred - Memory B cells express IgM isotype antibody - Memory B cells differentiate into plasma cells more rapidly than do naive B cells.

Memory B cells express IgM isotype antibody

Which of the following statements is incorrect regarding memory B cells? - Memory B cells are maintained for life. - In secondary responses, the number of pathogen-specific B cells is about 10-100-fold that seen in primary responses. - The sensitivity of memory B cells is improved compared with naive B bells because affinity maturation has occurred. - Memory B cells express lower levels of MHC class II and B7 than do naive B cells. - Memory B cells differentiate into plasma cells more rapidly than do naive B cells.

Memory B cells express lower levels of MHC class II and B7 than do naive B cells.

Which of the following statements regarding inherited immunodeficiency diseases is correct? - Affected individuals are less susceptible to infection. - Mortality rates are reduced by the administration of antibiotics to affected individuals. - Most deficiency syndromes are caused by dominant gene defects. - Women are more likely than men to inherit X-linked immunodeficiencies. - Extracellular bacterial infections are common in deficiency syndromes with T-cell defects.

Mortality rates are reduced by the administration of antibiotics to affected individuals.

Individuals with an antibody deficiency are more susceptible to infections by all of the following except _____. - Streptococcus pneumoniae - Haemophilus influenzae - Streptococcus pyogenes - Mycobacterium tuberculosis - Staphylococcus aureus.

Mycobacterium tuberculosis

Chronic granulomatous disease (CGD), a condition resulting in chronic bacterial and fungal infections, is caused by one or more defects in _____, compromising the ability of macrophages to _____.

NADPH oxidase; produce superoxide radical (O2-)

Which of the following statements about human immunodeficiency virus (HIV) is NOT correct? - Reverse transcriptase uses the single-stranded RNA genome of HIV as a template to make a double-stranded DNA. - HIV infects cells expressing CD4. - HIV requires the CXCR4 co-receptor for internalization by T cells. - NFkB is a transcription factor that facilitates the reverse transcription of DNA.

NFkB is a transcription factor that facilitates the reverse transcription of DNA.

Which of the following does NOT characterize immunological memory? - The host retains the capacity to mount a secondary immune response - The host retains the ability to respond to pathogen many years after primary exposure - Naive T cells are activated more quickly when exposed to pathogen - Memory B cells produce higher-affinity antibody than naive B cells.

Naive T cells are activated more quickly when exposed to pathogen

During a secondary immune response, high-affinity IgG antibodies are produced. Which of the following best explains why low-affinity IgM antibodies are not made?

Naive pathogen-specific B cells are suppressed by negative signaling through FcγRIIB1.

describes the situation when the immune response generated against an influenza strain limits future antibody responses to variant epitopes of a different, but similar, strain.

Original antigenic sin

Reverse transcriptase is a _____ encoded by _____.

RNA-dependent DNA polymerase; HIV

Reverse transcriptase is a encoded by

RNA-dependent DNA polymerase; HIV

Which of the following is incorrectly matched? - Neisseria gonorrhoeae: sexually transmitted disease - Salmonella typhimurium: food poisoning - Neisseria gonorrhoeae: Variant pilin protein expression - Salmonella typhimurium: Coating its surface with human proteins

Salmonella typhimurium: Coating its surface with human proteins

A neoplasm is characterized by abnormal cell division, which can cause disruption to organ function.

T

A possible side-effect of using antilymphocyte globulin (ALG) is serum sickness.

T

All autoimmune diseases involve a breach of T-cell tolerance.

T

Autoimmune diseases are rarely resolved.

T

Autoimmune diseases can be induced after an infection.

T

Blood plasma exchange (plasmapheresis) can be used to remove maternal IgG from the newborn.

T

Most cancers develop in tissues that are actively undergoing division.

T

There are polymorphic antigens other than ABO and Rhesus antigens that can cause type II hypersensitivity reactions

T

Richard French, 53 years old, was diagnosed with chronic myelogenous leukemia. His elder brother Don is HLA-haploidentical and will donate bone marrow. Richard's oncologist has recommended him to a medical center that favors using bone marrow depleted of mature T cells prior to infusion. The most likely rationale for employing the practice of T-cell depletion is that _____.

T-cell depletion will remove alloreactive T cells from the donor and prevent the potential for graft-versus-host disease (GVHD)

Severe combined immune deficiency (SCID) describes a condition in which neither _____ nor _____ are functional.

T-cell-dependent antibody responses; cell-mediated immune responses

Severe combined immune deficiency (SCID) describes a condition in which neither nor are functional

T-cell-dependent antibody responses; cell-mediated immune responses

Which of the following is FALSE regarding NKT cells? - they are another subpopulation of T cells bearing both T cell and NK cell markers - they are well known for secreting lots of IFNγ and IL-4 - they recognize glycolipid antigens presented by CD1d - TCRs are composed of γ and δ chains as opposed to α and β subunits.

TCRs are composed of γ and δ chains as opposed to α and β subunits.

Which property of HIV renders the virus difficult to eradicate by the body's immune defenses and also limits the efficacy of drug therapies?

The HIV reverse transcriptase is an error-prone DNA polymerase resulting in increased protein mutations.

During a primary immune response IgM sometimes switches to IgE. Which of the following best describes the consequence of this early switch?

The IgE produced would have low affinity for antigen.

Which of the following explains why the first baby born to a RhD- mother and a RhD+ father does notdevelop hemolytic disease of the newborn?

The antibodies made by the RhD- mother during the first pregnancy are predominantly IgM and have low affinity for the Rhesus antigen

Which of the following is TRUE regarding the evolution of the immune system? - Innate immune system developed after the appearance of the adaptive immune system - The innate immune system is found only in invertebrates - The adaptive immune system is absent in sharks - The appearance of the RAG genes is associated with the appearance of the adaptive immune system

The appearance of the RAG genes is associated with the appearance of the adaptive immune system

Which of the following is TRUE regarding the evolution of the immune system? - innate immune system developed after the appearance of the adaptive immune system - The innate immune system is found only in invertebrates - The adaptive immune system is absent in sharks - The appearance of the RAG genes is associated with the appearance of the adaptive immune system.

The appearance of the RAG genes is associated with the appearance of the adaptive immunesystem.

Which of the following describes myasthenia gravis?

The neuromuscular junction is compromised.

Some people are resistant to HIV infection because a primary infection cannot be established in macrophages or memory T cells. What is the likely reason for this?

They are homozygous for a mutant form of CCR5 that cannot be used by HIV as a co-receptor

What medical condition does a Staphylococci infection result in?

Toxic shock syndrome from the action of superantigens

Match the type of hypersensitivity with its description.

Type I- IgE-mediated Type II- antibodies directed against extracellular matrix on the cell surface Type III- deposition of soluble immune complexes in tissues Type IV- T cell-mediated

George Cunningham was diagnosed with Crohn's disease when 23 years old. He was experiencing acute abdominal pain, diarrhea, rectal bleeding, anemia and weight loss. He did not respond to conventional immunosuppressive therapies and was given a course of infliximab, an anti-TNF-α monoclonal antibody that suppresses inflammation by blocking TNF-α activity. On day 12 after receiving his first infusion, he developed a mild fever, generalized vasculitis, swollen lymph glands, swollen joints and joint pain. Traces of blood and protein were detected in his urine. Which of the following is the most likely cause of these recent symptoms?

Type III hypersensitivity caused by immune complex deposition in blood vessels.

"Original antigenic sin" is best described as a phenomenon in which _____.

a highly mutable virus gradually escapes from immunological memory and interferes with compensatory immune responses.

What would be the outcome if a naive B cell were to bind to pathogen coated with specific antibody made by an effector B cell in a primary immune response using FcγRIIB1, and simultaneously bind to the same pathogen using its B-cell receptor?

a negative signal leading to inhibition of the production of low-affinity IgM antibodies

What would be the outcome if a naive B cell were to bind to pathogen coated with specific antibody made byan effector B cell in a primary immune response using FcγRIIB1, and simultaneously bind to the samepathogen using its B-cell receptor?

a negative signal leading to inhibition of the production of low-affinity IgM antibodies

A benign tumor of glandular tissue is known as a(n) _____.

adenoma

A genetic defect in _____ results in the accumulation of toxic levels of nucleotide metabolites and loss of T-cell function.

adenosine deaminase (ADA)

_____ autoantibodies enhance receptor function

agonist

Reasons complicating the development of vaccines to combat chronic diseases include _____. (Select all that apply.) - evasion of the host's immune system by the pathogen - the polymorphic diversity of MHC class I and class II molecules - the generation of inappropriate immune responses that do not eradicate the pathogen - survival of the infectious agent for long periods inside the host - high mutation rates in the pathogen

all of the above

All of the following are biological effects mediated by the products of mast cells except _____. - chemotaxis of neutrophils, eosinophils, and effector T cells - growth factor secretion - smooth muscle contraction - connective tissue remodeling - All of the above are mediated by mast cells

all of the above are mediated by mast cells

The antigens that provoke hypersensitivity reactions are referred to as

allergens

_____ accounts for the production of different isoforms of the CD45 protein observed in naive, effector, and memory T cells.

alternative splicing

The wheal-and-flare inflammatory reaction is an example of

an immediate type I allergic response

If, during development, none of the KIRs expressed by a NK cell are able to interact with self-MHC class I molecules,then the NK cell is likely to be

anergic

Cancers develop their own blood supply and become vascularized through _____.

angiogenesis

During infection with HIV, a person is said to undergo seroconversion when _____.

anti-HIV antibodies are detectable in their blood serum

Anders Anderson, was seen by his pediatrician at 24 months old after a recent bout of diarrhea and vomiting. He had lost his appetite and complained that his stomach hurt. Anders was in the 5% centile for weight, had slender limbs, wasted buttocks, and a protuberant abdomen. Jejunal biopsy revealed abnormal surface epithelium, and villous atrophy with hyperplasia of the crypts. Which of the following would be a likely clinical finding in this patient?

anti-gliadin IgA antibodies

The mode of evolution responsible for the production of recombinant influenza viruses composed of a genome derived from two different influenza variants is called

antigenic shift

The mode of evolution responsible for the production of recombinant influenza viruses composed of a genome derived from two different influenza variants is called _____.

antigenic shift

Women who are heterozygous for a defective Bruton's tyrosine kinase (Btk) gene _____.

are healthy and all their B cells have functional Btk

Which of the following regarding HLA compatibility is TRUE? a. B cell receptors have evolved to recognize polymorphic MHC molecules bearing non-self peptides b. The major antigenic determinants for graft rejection are the MHC class I and class II molecules c. ABO matching is a more difficult problem than HLA compatibility due to the polymorphic nature of MHC genes d. A fairly low percentage of mature T cells respond to any non-self-MHC-peptide complex e. CD8 T cells respond to the HLA class II differences, CD4 T cells respond to the class Idifferences.

b. The major antigenic determinants for graft rejection are the MHC class I and class II molecules

Which of the following regarding hyperacute rejection is FALSE? a. It is so fast the tissue never becomes vascularized b. It caused by an ABO mismatch since endothelial cells express ABO antigens c. It is a type III hypersensitivity reaction d. Antibodies against door blood group antigens bind vascular endothelium resulting ininflammatory reaction Graft become engorged and purple-colored because of hemorrhage

c. It is a type III hypersensitivity reaction

Chemical and physical agents that increase mutation rates by damaging DNA and increase the likelihood of developing cancer are known as _____.

carcinogens

Alloantibodies to blood-vessel endothelium on solid organ grafts

cause hyperacute rejection

Alloantibodies to blood-vessel endothelium on solid organ grafts _____.

cause hyperacute rejection

Which is not considered an immunotherapy treatment for cancer?

chemotherapy

Hematopoietic stem cell transplantation is appropriate for all of the following conditions except _____. - thalassemia major - Wiskott-Aldrich syndrome - Fanconi's anemia - cirrhosis of the liver - sickle-cell anemia - non-Hodgkin's lymphoma

cirrhosis of the liver

By which process are fetal erythrocytes destroyed in hemolytic anemia of the newborn?

clearance of antibody-coated erythrocytes by macrophages in the fetal spleen

A mechanism by which cancer cells can evade an immune response involves an alteration in the amount of MIC on the cell surface by

cleavage of MIC at the cell surface by a protease

An adjuvant enhances the effectiveness of vaccines by inducing the expression of _____ on ________.

co-stimulatory molecules; macrophages and dendritic cells

Which of the following are transplanted with a relatively high success rate despite major differences in HLA class I and II between donor and recipient?

cornea

Aspirin (acetyl salicylate) inhibits prostaglandin synthesis by binding irreversibly to prostaglandin synthase, the first enzyme in the _____ pathway.

cyclooxygenase

Aspirin (acetyl salicylate) inhibits prostaglandin synthesis by binding irreversibly to prostaglandinsynthase, the first enzyme in the pathway.

cyclooxygenase

Which of the following immunosuppressive drugs functions by inhibiting DNA synthesis?

cyclophosphamide

In routine blood transfusions, which of the following must be matched correctly? a. A and B antigens b. RhD (Rhesus D) antigen c. MHC class I molecules d. a and b e. a, b and c

d. a and b

Which of the following are potential means by which type I allergic reactions can be managed or treated? a. Use antihistamines to block histamine binding to H1 histamine receptors. b. Use corticosteroids to suppress inflammation. c. Block high-affinity IgE receptors to prevent mast-cell degranulation. d. a and c e. a, b and c

d. a and c

Acute rejection of a kidney graft involves the activation of recipient T cells by _____ of _____ origin.

dendritic cells; donor

Acute rejection of a kidney graft involves the activation of recipient T cells by of origin.

dendritic cells; donor

As time progresses following an organ transplant, the alloreactive T-cell response shifts from a(n) _____ pathway to a(n) _____ pathway of allorecognition.

direct; indirect

Following a hematopoietic stem cell transplant, T-cell responses will be activated by dendritic cells of _____ origin.

donor

Which of the following are consequences of anaphylactic shock? a. smooth muscle contraction b. high blood pressure c. constriction of airways d. a and c e. a, b and c

e. a, b and c

Seventeen-year-old Lisa Montague practiced piano for 3-4 hours each day while preparing for music college auditions. Some of her pieces required sustained arm-muscle activity and she began to find them hard to play, even though she had previously played them easily. When she also started to have difficulty swallowing and chewing, she told her mother, who took her to the emergency room, where the physician noticed drooping eyelids and limitation of ocular motility. An electromyogram detected impaired nerve-to-muscle transmission. Administration of pyridostigmine rapidly improved Lisa's symptoms. Which of the following blood-test results would be most consistent with her condition?

elevated anti-acetylcholine receptor antibodies

Individuals who have two defective alleles of the AIRE gene _____.

exhibit symptoms of autoimmunity at a young age

The production of CD45RO results from the removal of _____ during _____ processing.

exons A, B, and C; post-transcriptional

_____ is an example in which physical trauma provides access of lymphocytes to an otherwise immunologically privileged site. (Select only ONE).

eye trauma

The CD45RA isoform is associated with stronger signals in response to antigen.

false

Which of the following is NOT an inactivated virus vaccine? - Flumist - Salk Polio vaccine - Hepatitis A - Influenza

flumist

Which of the following is required for fusion of the human immunodeficiency viral envelope with the hostcell membrane and subsequent internalization?

gp41

Family members who donate their bone marrow to a transplant patient and who share one out of the two HLA haplotypes are providing a(n) _____ transplant.

haploidentical

A primary immune response against influenza virus produces antibodies that bind to _____.

hemagglutinin and neuraminidase

When a subpopulation of unvaccinated individuals are protected against a pathogen because the vast majority ofindividuals in the overall population are vaccinated, this is called

herd immunity

Shingles is associated with infection by _____.

herpes zoster

Former president Jimmy Carter was treated for metastatic brain cancer with a new drug called Keytruda. Which of the following characteristics on tumor cells would increase the chance of a cancer patient responding to treatment with pembrolizumab (Keytruda)?

high levels of PD-L1

Amanda Chenoweth, 21 years of age, returned from a summer job as a pianist on a cruise ship where she was exposed daily to excessive sun; she developed a rash on her cheeks. She complained that her finger joints were stiff and painful, which made it difficult to play the piano, and that her hips became painful after sitting at the piano for long periods. Her blood sample tested positive for anti-nuclear antibodies and had decreased serum C3 levels. A urine albumin test showed elevated protein levels. A course of prednisone (an anti-inflammatory steroid) in combination with naprosyn (a nonsteroidal anti-inflammatory agent) was begun and her condition improved rapidly. What is the most likely cause and clinical name of her condition?

immune complexes fixing complement in kidney, joints, and blood vessels; systemic lupus erythematosus

Roche applied for U.S. Food and Drug Administration (FDA) approval of Enfuvirtide, a 36 amino acid peptide that binds to gp41 and is designed for the treatment of HIV infections. This drug would be expected to

inhibit HIV from binding, entering and infecting cells

Prednisone is a steroid used in transplantation that

inhibits activation of NF-kB

Antagonistic autoantibodies made against the insulin receptor cause _____. (Select only ONE.)

insulin-resistant diabetes

The process by which the human thymus gradually decays is known as _____.

involution

Adoptive transfer of sipuleucel-T-primed dendritic cells is a form of immunotherapy currently used for the treatment of _____.

late-stage metastatic prostate cancer

The pol gene of HIV produces all of the following except _____. - integrase - protease - matrix protein - reverse transcriptase

matrix protein

Males engrafted with HLA-identical bone marrow from their sisters develop graft-versus-host disease because _____.

mature T cells in the graft have specificity for male-specific minor histocompatibility antigens

Graft-versus-host disease (GVHD) is a consequence of _____.

mature T lymphocytes from the donor mounting an immune response against tissue of the recipient

_____ is the term used to describe how pathogen antigens resemble host antigens and can sometimes trigger autoimmune disease.

molecular mimicry

Approximately one-quarter of individuals infected with hepatitis C _____.

mount an effective immune response and eradicate the virus

Which of the following is associated with type III hypersensitivity? - nickel - recombinant human insulin - plant oil - mouse-derived monoclonal antibody - helminth infection

mouse-derived monoclonal antibody

_____ do NOT express FcεRI and contain granules containing inflammatory mediators.

natural killer cells

The efficiency and specificity of adaptive immune defenses and immunological memory improve each time a particular pathogen is encountered because _____.

of affinity maturation.

All of the following are characteristics of blood donations and transfusions that enable their extensive use for transplantation purposes except _____. - individuals can donate on a regular basis without any deleterious effects - erythrocytes do not express MHC class I or class II molecules - the blood components only need to function for a few weeks - only the ABO antigens need to be compatible between donor and recipient - blood transfusion is a straight forward and inexpensive process.

only the ABO antigens need to be compatible between donor and recipient

A protein expressed in response to damage to DNA that results in death to the cell is _____.

p53

In CAR (chimeric antigen receptor) therapy

patient T cells are isolated, engineered to express a high-affinity highly active TCR and returned to the patient

A conjugate vaccine is one that couples _____ to _____ so as to stimulate T-dependent antibody responses.

polysaccharide; a protein carrier

A conjugate vaccine is one that couples to so as to stimulate T-dependent antibodyresponses.

polysaccharide; a protein carrier

In a mixed lymphocyte reaction the donor cells are irradiated to ensure that they do not _____.

proliferate

Which of the following is NOT matched correctly? - pol: reverse transcriptase, protease, and integrase - gag: core and matrix protein - env: gp120 and gp41 - nef: assists viral replication, and decreases expression of MHC class I and class II molecules and CD4 - tat: transcript export from nucleus

tat: transcript export from nucleus

When a naive B cell binds to an IgG:antigen complex on its cell surface using FcγRIIB1, while simultaneously binding to the same antigen using membrane-bound IgM, _____.

the B cell becomes anergia

The Human Papilloma Virus (HPV) vaccine is controversial because of which association?

the implicit association with adolescent sexual activity

Alloantibody production after organ transplantation involves _____.

the indirect pathway of allorecognition by CD4 T cells

All of the following are characteristic of NK cells except . - they do not rearrange immunoglobulin genes - they are tolerant of healthy cells - they circulate in a partly activated state - they all express the same selection of activating and inhibitory NK-cell receptors - they can be activated by FcγRIIIA (CD16a).

they all express the same selection of activating and inhibitory NK-cell receptors

Dominant mutant forms of IFNγR1 exhibit all of the following in heterozygotes except _____. - they are hyperactive receptors resulting in increased signaling - the cytoplasmic tail is truncated - they are able to form stable dimers with the normal form - they cause less severe immunodeficiency than do the homozygous recessive forms - they are unable to transduce signals when bound to the normal form

they are hyperactive receptors resulting in increased signaling

Autoimmune diseases, which are classified on the basis of the effector mechanism that causes the symptoms, include all of the following types of hypersensitivity reaction except

type I

What type of hypersensitivity reaction would result from a mismatched blood transfusion?

type II

Identify the mismatched pair. - type I hypersensitivity: IgE - type II hypersensitivity: T cell mediated - type III hypersensitivity: immune complexes - type IV hypersensitivity: delayed-type hypersensitivity - type IV hypersensitivity: modified intracellular human proteins

type II hypersensitivity: T cell mediated

Which of the following is not mediated by antibodies? - type I hypersensitivity - type II hypersensitivity - type III hypersensitivity - type IV hypersensitivity

type IV hypersensitivity

The serotypes of Streptococcus pneumoniae differ in their

variable surface glycoproteins

Genes encoding _____ rearrange in trypanosomes permitting replication and survival of the pathogen until the host produces an antibody response against the altered gene product.

variable surface glycoproteins (VSGs)