Microbiology Ch. 14
After further investigation, it is learned that the father is Rh+, and so was the first child. However, Marian declines the RhoGAM injection because "there were no complications with my first pregnancy and delivery, how can you be sure there will be with this one?" Plus, she also explains how unpleasant the RhoGAM injection was with her first pregnancy, and she would like to avoid it, if at all possible. What is an appropriate response? "It is important you receive your RhoGAM injection, because this child will probably develop hemolytic disease of the newborn if you don't." "You were probably sensitized to Rh factor with your first pregnancy, so the chances are decreased that this child will develop hemolytic disease of the newborn. I'll ask the doctor if we can forego the injection." "It is important that we keep you from being sensitized to Rh factor, otherwise future pregnancies will be at risk for developing hemolytic disease of the newborn." "I didn't realize you received RhoGAM with your first pregnancy. There's a good chance you don't need it this time after all."
"It is important that we keep you from being sensitized to Rh factor, otherwise future pregnancies will be at risk for developing hemolytic disease of the newborn."
Jonathan is talking to you about his antirejection medications, and wants to know how they work. What is the best explanation? "They work on your liver to make it less hostile to its new environment, increasing the chances of organ acceptance." "They work by changing the MHC markers on your new liver to be more like your own." "They work by suppressing the body's immune response against a foreign organ." "They work by tricking your body into thinking its MHC markers are similar to your new liver's."
"They work by suppressing the body's immune response against a foreign organ."
Marian asks you to explain to her what an Rh reaction involves with her baby. What is the best explanation? "Your Rh antibodies will cross into your baby's fetal circulation, attacking and lysing his red blood cells." "Your baby's Rh+ antibodies cross into your system, attacking your red blood cells and making you unable to deliver a healthy baby." "Your baby has a type II hypersensitivity that will render its liver unable to clear bilirubin released from lysed cells." "As soon as your baby is born, if he doesn't receive RhoGAM, his body will reject not having Rh antibody anymore."
"Your Rh antibodies will cross into your baby's fetal circulation, attacking and lysing his red blood cells."
A secondary acquired immunodeficiency is SCID. AIDS. DiGeorge syndrome. adenosine deaminase (ADA) deficiency. agammaglobulinemia.
AIDS
Degranulation of mast cells leads to headache. airway obstruction. All of the choices are correct. dilated blood vessels.
All of the choices are correct
Transfusion of the wrong blood type can cause systemic shock and kidney failure. recipient antibody activating the complement cascade to attack the RBCs. fever and anemia. All of the choices are correct. massive hemolysis of the donor RBCs.
All of the choices are correct
Which of the following allergic mediators are being currently activated in Mark's system? All of the choices are correct. leukotrienes serotonin mast cells
All of the choices are correct
A person who are Rh- will have anti-Rh antibodies in their serum from early infancy. True False
False
The tuberculin reaction develops within 30 minutes of the skin test in people with prior sensitization due to tuberculosis infection. True False
False
All of the following are involved in type 2 hypersensitivity except foreign cells. IgE. IgG. complement. IgM.
IgE
What is the most likely development and progression of Mark's asthma? IgG-mediated response with lung tissue that is hypersensitive to products of mast cell degranulation IgE-mediated response with lung tissue that is hypersensitive to products of mast cell degranulation IgE response that causes the body to not recognize its own lung tissue, and fights against it by constricting bronchioles IgG response that causes the body to not recognize its own lung tissue, and fights against it by constricting bronchioles
IgE-mediated response with lung tissue that is hypersensitive to products of mast cell degranulation
Human blood types involve all the following except genetically determined glycoprotein markers. MHC genes. inheritance of two of three possible alleles. ABO antigen markers. genes that code for an enzyme that adds a terminal carbohydrate to RBC receptors.
MHC genes
If Jonathan experiences graft rejection, what type of cells will most likely be primarily responsible? T helper cells natural killer cells T memory cells T cytotoxic cells
T cytotoxic cells
A viral infection can cause type I diabetes mellitus. True False
True
During graft rejection, cytotoxic T cells of the recipient recognize and respond to foreign class I MHC receptors on the grafted cells. True False
True
Severe combined immunodeficiencies (SCIDs) are due to a genetic defect in the development of both T cells and B cells. delayed hypersensitivity. failure of B-cell development and maturity. congenital absence or immaturity of the thymus gland. autoantibodies.
a genetic defect in the development of both T cells and B cells
Myasthenia gravis disease arises from the production of autoantibodies against acetylcholine receptors on skeletal muscle. acetylcholine receptors on smooth muscle. cells in thyroid follicles. myelin sheath cells of the nervous system. sodium pump proteins in the cell membrane.
acetylcholine receptors on skeletal muscle
Once a mother has been sensitized to the Rh factor only future Rh- fetuses are at risk. she can never again have a low risk pregnancy. None of the choices is correct. all other Rh+ fetuses are at risk. she can be given RhoGAM in future pregnancies to prevent hemolytic disease of the newborn.
all other Rh+ fetuses are at risk
A seasonal reaction to inhaled allergens is atopic dermatitis. asthma. anaphylaxis. allergic rhinitis. eczema.
allergic rhinitis
What type of transplant did Jonathan receive? autograft xenograft allograft isograft
allograft
What is the most likely diagnosis for Mark? hay fever asthma seasonal allergy drug allergy
asthma
What is the most likely diagnosis for Mark? seasonal allergy hay fever asthma drug allergy
asthma
A chronic, local allergy such as hay fever is considered atopic. T-cell mediated. delayed. antibody mediated. systemic anaphylactic.
atopic
What classification of reaction is Mark currently experiencing? atopy cutaneous anaphylaxis acute allergic systemic anaphylaxis
atopy
Autoimmunity is typically due to graft rejection. a deficiency in T-cell development. autoantibodies and T cells. transfusion reaction. IgE and mast cells.
autoantibodies and T cells
Tissue transplanted from one body site on a patient to a different body site on that patient is called a(n) allograft. xenograft. hypograft. isograft. autograft.
autograft
Which event occurs with the sensitizing dose of allergen? histamine acts on smooth muscle prostaglandins cause vasodilation and increased vascular permeability binding of IgE by the Fc region to mast cells and basophils degranulation bonding of allergen to adjacent IgE binding sites on mast cells and basophils
binding of IgE by the Fc region to mast cells and basophils
What will be the immediate action of an allergen when it enters that body for a second time? bonding of allergen to adjacent IgE binding sites on mast cells and basophils degranulation histamine acts on smooth muscle binding of IgE by the Fc region to mast cells and basophils prostaglandins cause vasodilation and increased vascular permeability
bonding of allergen to adjacent IgE binding sites on mast cells and basophils
Which type(s) of hypersensitivity is IgG involved with? both antibody mediated and immune complex mediated anaphylaxis immune complex mediated antibody mediated both anaphylaxis and antibody mediated
both antibody mediated and immune complex mediated
What involves determination of donor HLA antigens compared to those of the recipient's tissue? both skin graft and organ transplantation All of the choices are correct. skin graft organ transplantation blood transfusion
both skin graft and organ transplantation
Which of the following is not a major organ that can be a target of immune complex deposition? heart and lungs blood vessels and skin brain kidneys joints
brain
The DiGeorge syndrome is the result of delayed hypersensitivity. autoantibodies. a genetic defect in the development of both T cells and B cells. congenital absence or immaturity of the thymus gland. failure of B-cell development and maturity.
congenital absence or immaturity of the thymus gland
Which of the following is not a possible symptom of type I hypersensitivity? sneezing contact dermatitis rhinitis rashes diarrhea
contact dermatitis
Allergic patients receiving small, controlled injections of specific allergens are undergoing None of the choices are correct. sensitization. tissue matching. desensitization. degranulation.
desensitization
Which of the following conditions would you expect Mark to have in his personal medical history? blood transfusion reaction eczema premature birth hay fever
eczema
Which of the following conditions would you expect Mark to have in his personal medical history? blood transfusion reaction premature birth eczema hay fever
eczema
Which factor would increase the risk of the unborn child being Rh+? history of preexisting type I hypersensitivity both maternal grandparents being Rh- previous child being Rh- father being Rh+
father being Rh+
The potential for hemolytic disease of the newborn occurs when maternal Rh+ cells enter an Rh- fetus. maternal Rh- cells enter an Rh+ fetus. fetal Rh- cells enter an Rh+ mother. fetal Rh+ cells enter an Rh+ mother. fetal Rh+ cells enter an Rh- mother.
fetal Rh+ cells enter an Rh- mother
What steps should you advocate to be taken by the doctor during this visit? plan for first dose of RhoGAM immediately after birth first dose of RhoGAM should be administered nothing, since it is not known if the first child was Rh+ yet nothing can be done about the Rh factor
first dose of RhoGAM should be administered
What could result when grafted tissue such as bone marrow contains passenger lymphocytes? None of the choices is correct. host rejection of graft formation of autoantibodies graft versus host disease hypogammaglobulinemia
graft versus host disease
Which is mismatched? hay fever - type IV hypersensitivity serum sickness - type III hypersensitivity poison ivy dermatitis - type IV hypersensitivity transfusion reaction - type II hypersensitivity food allergy - type I hypersensitivity
hay fever - type IV hypersensitivity
Any heightened or inappropriate immune response resulting in tissue damage is called a(n) immunodeficiency. transfusion reaction. hypersensitivity. autoimmune disease. desensitization.
hypersensitivity
Allergic reactions to penicillins are considered a(n) _____ hypersensitivity. antibody mediated both T-cell mediated and antibody mediated T-cell mediated immediate immune complex mediated
immediate
The study of diseases associated with excesses and deficiencies of the immune system is histopathology. epidemiology. immunopathology. humoralpathology. hemopathology.
immunopathology
Histamine causes all of the following except increased sensitivity to pain. constriction of smooth muscle of bronchi and the intestine. pruritis and headache. relaxes vascular smooth muscle. wheal and flare reaction in skin.
increased sensitivity to pain
Fungal spores and animal dander are considered to be which type of allergen? injectant contactant inhalant ingestant None of the choices is correct.
inhalant
Corticosteroids will inhibit the activity of lymphocytes. bind to histamine receptors on target organs. block synthesis of leukotrienes. reverse spasms of respiratory smooth muscles. relieve inflammatory symptoms.
inhibit the activity of lymphocytes
Bee sting venom is considered to be which type of allergen? injectant inhalant None of the choices is correct. ingestant contactant
injectant
A female who is Rh- is in the majority of the population with regard to Rh status. All of the choices are correct. is at risk for a pregnancy resulting in hemolytic disease of the newborn. inherited two dominant genes. can never have an Rh+ baby.
is at risk for a pregnancy resulting in hemolytic disease of the newborn
The chemical mediator that causes prolonged bronchospasm, vascular permeability, and mucus secretion of asthmatic patients is serotonin. leukotriene. prostaglandin. platelet-activating factor. histamine.
leukotriene
Each of the following is an autoimmune disease except type I diabetes. metastatic cancer. systemic lupus erythematosus. Graves' disease. rheumatic fever.
metastatic cancer
In multiple sclerosis, autoantibodies attack acetylcholine receptors on smooth muscle. cells in thyroid follicles. acetylcholine receptors on skeletal muscle. myelin sheath cells of the nervous system. sodium pump proteins in the cell membrane.
myelin sheath cells of the nervous system
A second encounter with an allergen that causes a response is called the provocative dose. hypersensitivity dose. sensitizing dose. desensitizing dose. allergic dose.
provocative dose
Allergies run in families because immunoglobulins pass from mother to fetus. relative production of IgE is inherited. the variable region of antibodies is genetically determined. All of the choices are correct. immunoglobulins pass through breast milk.
relative production of IgE is inherited
Epinephrine reverses constriction of airways. causes desensitization. inhibits the activity of lymphocytes. All of the choices are correct. is an antihistamine.
reverses constriction of airways
The initial encounter with an allergen is called the provocative dose. hypersensitivity dose. allergic dose. sensitizing dose. desensitizing dose.
sensitizing dose
A systemic, sometimes fatal reaction with airway obstruction and circulatory collapse is delayed. T-cell mediated. atopic. antibody mediated. systemic anaphylactic.
systemic anaphylactic
All of the following are associated with IgE and mast cell-mediated allergy except eczema. anaphylaxis. drug allergy. systemic lupus erythematosus. allergic asthma.
systemic lupus erythematosus
Autoantibodies cause tissue injury in all of the following diseases except multiple sclerosis. myasthenia gravis. tuberculin reaction. Graves' disease. rheumatoid arthritis.
tuberculin reaction
Atopy and anaphylaxis are hypersensitivities in the category type I only. type I, type II, type III, and type IV. type I and type IV. type IV only. type I, type II, and type III.
type I only
The major category(ies) of hypersensitivity that typically involve a B-cell immunoglobulin response is/are type I and type IV. type I, type II, and type III. type IV only. type I only. type I, type II, type III, and type IV.
type I, type II, and type III
What type of hypersensitivity reaction will Marian's babies be at risk for upon delivery? type II type IV type III type I
type II
What type of hypersensitivity reaction is Jonathan at risk for? type II type I type IV type III
type IV