hypersensitivity and transplantation
d
Reactions to latex are caused by a. type I hypersensitivity. b. type IV hypersensitivity. c. skin irritation. d. all of the above
"hay fever'
Seasonal allergic rhinitis, triggered by tree and grass pollens in the air during the spring in temperate climates, is called ____
Anaphylaxis
Typical agents include venom from bees, wasps, and hornets; drugs such as penicillin; and foods such as shellfish, peanuts, and dairy products.;.
Cutaneous Testing
Uses a thousand fold higher concentration than intradermal tests, but a lesser amount of antigen is used.
Anaphylaxis
triggered by glycoproteins or large polypeptides.
Intradermal Tests
use a greater amount of antigen and are more sensitive than cutaneous testing.
Skin testing
used clinically to detect delayed hypersensitivity responses to a variety of antigens. T
indirect antiglobulin test (IAT)
used in the crossmatching of blood to prevent a transfusion reaction
hypersensitivity
which is defined as an exaggerated response to a typically harmless antigen that results in tissue injury, disease, or even death.
Arthus reaction
The classic example of a localized type III reaction is the ___
Allergic Asthma
"panting" or "breathlessness,
d
.A young woman developed red, itchy papules on her wrist 2 days after wearing a new bracelet. This reaction was caused by a. IgE-sensitized mast cells in the skin. b. antigen-antibody complexes in the skin. c. damage to the skin cells by antibodies and complement. d. an inflammatory response induced by cytokines released from Th1 cells
b
A renal transplant candidate was crossmatched with a donor who was mismatched for only the HLA-B35 antigen. The candidate was known to have an antibody specific for HLA-B35. Which of the following combinations of T- and B-cell flow cytometric crossmatch results would be expected? a. T-cell negative, B-cell negative b. T-cell positive, B-cell positive c. T-cell negative, B-cell positive d. T-cell positive, B-cell negative
b
All of the following are associated with type I hypersensitivity except a. release of preformed mediators from mast cells. b. activation of complement. c. cell-bound antibody bridged by antigen. d. an inherited tendency to respond to allergens
Accelerated rejection
Antibody-mediated rejection may take place over several days. Rejection involves intravascular thrombosis and necrosis of donor tissue.
c
Antigen receptors on T lymphocytes bind HLA class II + peptide complexes with the help of which accessory molecule? a. CD2 b. CD3 c. CD4 d. CD8
Goodpasture's syndrome
Antiglomerular basement membrane (anti-GBM) disease, formerly known as ____
antihistamines and bronchodilators
Asthma is often treated with a combination of therapeutic reagents, including ____and ____
Allergic Rhinitis
CAUSE: Pollen, mold spores, animal dander, and particulate matter from house dust mites
The cornea occupies a privileged site not usually seen by the immune system
Corneal tissue may be transplanted successfully from one patient to another because?
7 to 21 days
Generalized symptoms of serum sickness appear ____ after injection of the animal serum and include headache, fever, nausea, vomiting, joint pain, rashes, and lymphadenopathy.
antibodies
Hypersensitivity types I, II, and III are mediated by ____.
Graft versus host disease
In bone marrow transplantation, immunocompetent cells in the donor marrow may recognize antigens in the recipient and respond to those antigens. This phenomenon is an example of
d
In vitro methods to detect a cell-mediated response to M. tuberculosis measure production of which of the following immunologic components? a. IgE antibody b. Interleukin-1 c. Interleukin-2 d. Interferon gamma
b
Kidney allograft loss from intravascular thrombosis without cellular infiltration 5 days post-transplant may indicate which primary rejection mechanism? a. Hyperacute rejection b. Accelerated humoral rejection c. Acute humoral rejection d. Acute cellular rejection
antihistamines and decongestants
Localized allergic reactions, such as hay fever, hives, or rhinitis, can be treated with ____and ____
Anaphylactic Reaction
Most severe type of allergic response.
Hyperacute rejection
Occurs within minutes to hours after the vascular supply to the transplanted organ is established. This type of rejection is mediated by preformed antibody that reacts with donor vascular endothelium.
d
Patients who have received the following types of grafts are at risk for graft-versus-host disease (GVHD) except for recipients of a. bone marrow transplants. b. lung transplants. c. liver transplants. d. irradiated leukocytes.
a
Phenotyping for HLA class II antigens requires B lymphocytes because a. B lymphocytes express HLA class II antigens. b. B lymphocytes do not express HLA class I antigens. c. B lymphocytes are exquisitely sensitive to complement-mediated lysis. d. B lymphocytes represent the majority of lymphocytes in the peripheral blood.
1st statement is TRUE; 2nd statement is FALSE
Radio Immunosorbent Test (RIST) 1. Measures total IgE by capturing the antibody with solid phase anti-IgE. 2. Measures antigen-specific IgE by using solid-phase antigen to capture patient antibody.
b
Suppose a 30-year-old man was found to be a suitable donor for a kidney transplant to his younger sister. This transplant would be an example of a(an) a. autograft. b. allograft. c. isograft. d. xenograft.
Allergic Rhinitis
Symptoms include paroxysmal sneezing; rhinorrhea, or runny nose; nasal congestion; and itching of the nose and eyes.
allergens
The antigens that trigger type I hypersensitivity are called ____
a
The indirect allorecognition pathway involves which one of the following mechanisms? a. Processed peptides from polymorphic donor proteins restricted by recipient HLA class II molecules b. Processed peptides from polymorphic recipient proteins restricted by donor HLA class I molecules c. Intact polymorphic donor protein molecules recognized by recipient HLA class I molecules d. Intact polymorphic donor protein molecules recognized by recipient HLA class II molecules
Type II Hypersensitivity
The key components involved in these reactions are IgG and IgM antibodies, as well as complement.
Hemolysis
The major histocompatibility complex is located on chromosome 6 and is important in all the following immune functions except:
histamine
The most abundant preformed mediator is ____
type 2 helper T cells
The regulation of IgE production appears to be a function of the ______
Sensitization Phase
The response begins when a susceptible individual is exposed to an allergen and produces specific IgE antibody.
Skin Reactions
These reactions manifest as either acute urticaria or eczema.
passive cutaneous anaphylaxis
This type of reaction is known as ______. It occurs when serum is transferred from an allergic individual to a non-allergic individual
c
To determine a cold agglutinin titer, a. patient serum should be separated from whole blood at 4°C and tested at 4°C. b. patient serum should be separated from whole blood at 4°C and tested at 37°C. c. patient serum should be separated from whole blood at 37°C and tested at 4°C. d. patient serum should be separated from whole blood at 37°C and tested at 37°C.
b
To determine if a patient is allergic to ryegrass, the best test to perform is the a. total IgE test. b. skin prick test. c. DAT. d. complement fixation.
b
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 a. an active case of TB. b. been exposed to M. tuberculosis. c. developed protective immunity against TB. d. a result in the normal range for her risk group
sensitization and activation
Type I hypersensitivity has two major phases: ____and ____
b
What is the immune mechanism involved in type III hypersensitivity reactions? a. Cellular antigens are involved. b. Deposition of immune complexes occurs in antibody excess. c. Only heterologous antigens are involved. d. Tissue damage results from complement-mediated lysis
c
What is the immune phenomenon associated with the Arthus reaction? a. Tissue destruction by cytotoxic T cells b. Removal of antibody-coated RBCs c. Deposition of immune complexes in blood vessels d. Release of histamine from mast cells
d
Which condition would result in hemolytic disease of the fetus and newborn? a. Buildup of IgE on mother's cells b. Sensitization of cytotoxic T cells c. Exposure to antigen found on both mother and baby RBCs d. Prior exposure to foreign RBC antigen
d
Which immunosuppressive agent selectively inhibits IL-2 receptor-mediated activation of T cells? a. Mycophenolate mofetil b. Cyclosporine mofetil c. Corticosteroids d. Basiliximab
b
Which of the following HLA alleles differs from A*02:01:02 by a synonymous nucleotide substitution? a. A*01:01:01:01 b. A*02:01:03 c. A*02:02 d. A*02:03:01
c
Which of the following HLA antigens would be expected to elicit an HLA antibody response in a kidney transplant recipient with the following HLA type: HLA-A*01,03; B*07,14; C*01,04N; DRB1*16,07? a. HLA-A*01 b. HLA-B*14 c. HLA-C*04 d. HLA-DRB1*16
c
Which of the following conclusions can be drawn about a patient whose total IgE level was determined to be 150 IU/mL? a. The patient definitely has allergic tendencies. b. The patient may be subject to anaphylactic shock. c. Antigen-specific testing should be done. d. The patient will never have an allergic reaction.
a
Which of the following donors would be the most appropriate, based on ABO compatibility, for a renal transplant candidate with the ABO type = O? a. O b. A c. B d. AB
a
Which of the following explains the difference between type II and type III hypersensitivity reactions? a. Type II involves cellular antigens. b. Type III involves IgE. c. IgG is involved only in type III reactions. d. Type II reactions involve no antibody.
An exaggerated immune response to an antigen occurs
Which of the following is a general characteristic of hypersensitivity reactions?
c
Which of the following is a general characteristic of hypersensitivity reactions? a. The immune responsiveness is depressed. b. Antibodies are involved in all reactions. c. An exaggerated immune response to an antigen occurs. d. The antigen triggering the reaction is a harmful one.
b
Which of the following is associated with an increase in IgE production? a. Transfusion reaction b. Activation of Th2 cells c. Reaction to poison ivy d. Hemolytic disease of the fetus and newborn
a
Which of the following is associated with anaphylaxis? a. Buildup of IgE on mast cells b. Activation of complement c. Increase in cytotoxic T cells d. Large amount of circulating IgG
d
Which of the following properties is not exhibited by HLA molecules? a. They belong to the immunoglobulin superfamily. b. They are heterodimeric. c. They are integral cell membrane glycoproteins. d. They are monomorphic
b
Which of the following responses is the type of allograft rejection associated with vascular and parenchymal injury with lymphocyte infiltrates? a. Hyperacute rejection b. Acute cellular rejection c. Acute humoral rejection d. Chronic rejection
Anti-D from a pregnant woman crosses the placenta and attaches to the D antigen-positive red cells of the fetus, destroying the red cells.
Which of the following statement below explain the type II hypersensitivity?
d
Which of the following would cause a positive DAT test? a. Presence of IgG on RBCs b. Presence of C3b or C3d on RBCs c. A transfusion reaction caused by preformed antibody d. Any of the above
d
Which one of the following donors would be expected to elicit a positive mixed lymphocyte response in lymphocytes from a patient who has the HLA-DRB1*01:01, 01:03 alleles? a. DRB1*01:01, 01:03 b. DRB1*01:01, 01:01 c. DRB1*01:03, 01:03 d. DRB1*01:01, 01:05
b
Which reagents would be used in a donor-recipient crossmatch test? a. Donor serum and recipient lymphocytes + rabbit serum complement b. Recipient serum and donor lymphocytes + rabbit serum complement c. Donor stimulator cells + recipient responder cells + complete culture medium d. Recipient stimulator cells + donor responder cells + complete culture medium
Autoimmune hemolytic anemia
___ is an example of a type II hypersensitivity reaction directed against self-antigens because individuals with this disease form antibodies to their own RBCs
Hypersensitivity pneumonitis
___ is mediated predominantly by sensitized T lymphocytes that respond to inhaled allergens.
Transfusion reactions
____ are examples of cell destruction that results from antibodies combining with heteroantigens.
Mast cells
_____are the principal effector cells of immediate hypersensitivity.
Eosinophils
____play an important role in the late-phase reaction.
Serum sickness
___is a generalized type III hypersensitivity reaction that results from passive immunization of humans with animal serum
IgE
___is the least abundant antibody class in the serum,
Allergic Asthma
airflow obstruction due to bronchial smooth muscle contraction, mucosal edema, and heavy mucus secretion.
Type I hypersensitivity
also known as anaphylactic hypersensitivity
Type II hypersensitivity
also known as antibody-mediated cytotoxic hypersensitivity
Type IV hypersensitivity
also known as cell-mediated hypersensitivity
Type III hypersensitivity—
also known as complex-mediated hypersensitivity
intracellular pathogens or contact antigens
antigens that can trigger type IV hypersensitivity are generally one of two types: .
Hemolytic disease of the fetus and newborn (HDFN)
appears in infants whose mothers have been exposed to blood-group antigens
cold agglutinins
autoantibodies that react with antigens on the RBC membrane at cold temperatures.
food allergies
caused by cow's milk, eggs, nuts, soy, wheat, fish, and shellfish.
direct antiglobulin test (DAT)
detect transfusion reactions, HDFN, autoimmune hemolytic anemia, and drug-induced hemolytic anemia
delayed hypersensitivity.
do not appear until 24 to 48 hours after contact with antigen referred to as _____
allergy immunotherapy (AIT)
if environmental control and drug therapy are not successful in managing the symptoms in an individual with allergies, ____ may be considered
wheal-and-flare reaction
in the skin, local swelling and redness, sometimes referred to as ____
patch test
is considered the gold standard in testing for contact dermatitis.
ezcema
itchy red skin rash
Radio Allergosorbent Test (RAST)
measures antigenspecific IgE by using solid- phase antigen to capture patient antibody
Radio Immunosorbent Test (RIST)
measures total IgE by capturing the antibody with solidphase anti-IgE
Allergic Rhinitis
most common form of atopy, or allergy,
Anaphylaxis
most severe type of allergic response
Type II hypersensitivity
reactions are cytotoxic responses
angioedema
reactions occur deeper in the dermal tissues, they are known as ____
Allergic Asthma
recurrent airflow obstruction that leads to intermittent sneezing, breathlessness, and occasionally, a cough with sputum production.
sensitized T cells,
responsible for type IV hypersensitivity.
erythroblastosis fetalis
severe HDFN may be called ___
Type III hypersensitivity
similar to type II reactions in that IgG or IgM is involved and destruction is complement-mediated.
immediate hypersensitivity reactions
symptoms develop within a few minutes to a few hours after exposure to the inducing antigen, they are also known as ______
Th1 subclass of T helper (Th) cells.
the classic type IV response involves the ____
