immuno final - Flashcards | StudyHippo.com

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Which of the following is FALSE regarding the history of vaccination?

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The cowpox virus cannot infect humans

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All hematopoietic stem cells express

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CD34

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Immature B cells develop into B cells in the

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secondary lymphoid organs.

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Large pre-B cells are characterized by which of the following?

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? is assembled with VpreB?5.

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The latest stages of late pro-B-cell development are recognized by the association of a surrogate light chain with a ? chain. The surrogate light chain is composed of

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VpreB and ?5

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Which of the following cell-surface markers differentiates hematopoietic stem cells from other cell constituents in the bone marrow?

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CD34

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Which of the following is characteristic of a large pre-B cell?

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VDJ is successfully rearranged and ? heavy chain is made.

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Which of the following statements is correct? The ? light-chain genes rearrange before the heavy-chain genes. The ? light-chain genes rearrange before the ? light-chain genes. The ? light-chain genes rearrange before the heavy-chain genes. The ? light-chain genes rearrange before the ? light-chain genes. The ? heavy-chain genes rearrange first and then the ? light-chain genes rearrange.

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The ? light-chain genes rearrange before the ? light-chain genes.

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An important advantage of having two gene loci (? and ?) for the light chain is

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that the likelihood of a successful rearrangement of light-chain genes increases.

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Large pre-B cells undergo clonal expansion before the rearrangement of light-chain loci. Which of the following are beneficial consequences of clonal expansion? (Select all that apply.) Autoreactive B cells are eliminated before the expenditure of energy needed to rearrange a functional light-chain gene. The energy used to make a functional heavy chain is not wasted as a result of the inability to produce a functional light chain. RAG gene expression is decreased, which in turn signals light-chain rearrangement. A diverse population of immature B cells is generated that express the same ? chain but a distinct light chain. Approximately 85% of small pre-B cells will progress to the immature B-cell stage.

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The energy used to make a functional heavy chain is not wasted as a result of the inability to produce a functional light chain.

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There are two main types of B cells classified as B-1 and B-2. Which of the following statements it TRUE regarding B-1 cells? B-1 cells are continually renewed from the bone marrow B-1 cells are continually renewed from the thymus B-1 cells are first produced in the fetus B-1 cells require T cell help to produce antibodies

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B-1 cells are first produced in the fetus

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When expression of _______ is turned off in small pre-B cells, the result is the presence of P nucleotides but an absence of N nucleotides in around 50% of light-chain genes.

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TdT

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Which of the following is correctly matched? (Select all that apply.)

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- pre-B-cell receptor: VpreB?5/?u heavy chain - mature B cell: IgM plus IgD - immature B cell: ? heavy chain plus ? or ? light chain on surface

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Which of the following is not paired with its correct complement? N nucleotides: more abundant in rearranged heavy-chain genes than in rearranged light-chain genes second checkpoint in B-cell development: assembly of a functional B-cell receptor receptor editing: exchange of light chain for one that is not self-reactive first checkpoint in B-cell development: selection by the pre-B-cell receptor large pre-B-cell stage: constitutive expression of RAG-1 and RAG-2 proteins.

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large pre-B-cell stage: constitutive expression of RAG-1 and RAG-2 proteins.

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Which of the following would occur after the production of a functional ? chain as a pre-B-cell receptor? RAG proteins are degraded. The chromatin structure of the heavy-chain locus is reorganized to prevent gene rearrangement. Transcription of the RAG1 and RAG2 genes ceases. There is allelic exclusion of a second ? chain. All of the above would occur.

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All of the above would occur.

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Which two gene loci are involved in the chromosomal translocation that leads to Burkitt's lymphoma?

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Myc and a BCR gene

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Anergy is a state that exists in some B cells. What makes a B cell anergic and what is the most likely path that it will take in the body? The B cell will:

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Bind to a soluble self-antigen in the peripheral bloodstream and migrate to the lymph nodes where they are detained in the T cell area

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Negative selection of developing B cells ensures that

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B-cell receptors that bind to normal constituents of the body do not emerge

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Receptor editing occurs _____. (Select all that apply.)

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- to establish self-tolerance of the B-cell repertoire - in the bone marrow

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What is the fate of an immature B cell that encounters and has specificity for self antigen?

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Continued rearrangement of light-chain genes.

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Where would the majority of follicular dendritic cells be found in the lymph node?

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B cell area

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Which of the following pertains to the fate of immature B cells that have specificity for univalent self antigens? (Select all that apply.)

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- The cells acquire a state of unresponsiveness called anergy. - IgD on the cell surface fails to activate the B cell when bound to self antigen.

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All of the following cell-surface glycoproteins are expressed by double-negative thymocytes undergoing maturation in the thymus except _____. (Select all that apply.) CD2 CD5 CD127 (IL-7 receptor) CD34 CD1A CD4.

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CD34 CD4

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Apoptotic T cells are ingested by medullary epithelial cells.

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False

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If a double-negative thymocyte has just completed a productive ?-chain gene rearrangement, which of the following describes the immediate next step in the development of this thymocyte?

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A pre-T-cell receptor is assembled as a superdimer.

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In which of the following ways does the developmental pathway of ?:? T cells differ from that of B cells? (Select all that apply.) Their antigen receptors are derived from gene rearrangement processes. When the first chain of the antigen receptor is produced it combines with a surrogate chain. Cells bearing self-reactive antigen receptors undergo apoptosis. MHC molecules are required to facilitate progression through the developmental pathway. T cells do not rearrange their antigen-receptor genes in the bone marrow.

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- MHC molecules are required to facilitate progression through the developmental pathway. - T cells do not rearrange their antigen-receptor genes in the bone marrow.

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T-cell receptor rearrangements have many features in common with immunoglobulin rearrangement, including the use of the RAG-1 and RAG-2 genes.

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True

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The expression of the pre-T-cell receptor is required in order to halt ?-, ?-, and ?-chain rearrangements.

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True

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The human thymus begins to degenerate as early as one year after birth. This process is called ______ and is marked by the accumulation of ___ once occupied by thymocytes.

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involution; fat

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Which of the following is mismatched: double-negative CD3- thymocytes: cortico-medullary junction double-negative CD3- thymocytes: subcapsular zone double-positive CD3+ thymocytes: cortico-medullary junction cortical epithelial cells: subcapsular regions dendritic cells: cortico-medullary junction.

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double-negative CD3- thymocytes: cortico-medullary junction

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Which of the following is the first T-cell receptor complex containing the ? chain to reach the cell surface during the development of T lymphocytes?

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pT?:?:CD3.

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Which of the following processes is not dependent on an interaction involving MHC class I or class II molecules? (Select all that apply.)

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- intracellular signaling by pre-T-cell receptors - positive selection of ?:? T cells.

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All of the following types of protein are processed and presented by macrophages in the thymus except _____ proteins.

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tissue-specific

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Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is caused by a defect in

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a transcription factor that regulates tissue-specific gene expression in the thymus

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Double-negative thymocytes initiate rearrangement at the _____ locus (loci) before all other T-cell receptor genes.

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?, ?, and ?.

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Healthy individuals have approximately ____ of CD4 T cells compared with CD8 T cells.

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twice the number

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The function of negative selection of thymocytes in the thymus is to eliminate

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autoreactive thymocytes

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Thymocytes that are not positively selected

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make up about 98% of developing thymocytes and die by apoptosis in the thymic cortex

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Which of the following statements are true of a T cell that expresses two ? chains (and thus two different T-cell receptors) as a result of ineffective allelic exclusion of the ? chain during rearrangement? (Select all that apply.) Engaging either of the T-cell receptors on MHC molecules of the thymic epithelium will result in positive selection. One of the T-cell receptors will be functional while the other will most probably be non-functional. If either T-cell receptor binds strongly to self-peptides presented by self-MHC molecules, the thymocyte will be negatively selected. One of the T-cell receptors may be autoreactive but escape negative selection because its peptide antigen is present in tissues other than the thymus. Subsequent gene rearrangements may give rise to a ?:? T-cell receptor.

answer

- Engaging either of the T-cell receptors on MHC molecules of the thymic epithelium will result in positive selection. - One of the T-cell receptors will be functional while the other will most probably be non-functional. - If either T-cell receptor binds strongly to self-peptides presented by self-MHC molecules, the thymocyte will be negatively selected. - One of the T-cell receptors may be autoreactive but escape negative selection because its peptide antigen is present in tissues other than the thymus.

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Which of the following statements regarding positive selection is correct? All subsets of developing T cells undergo positive selection before export to the peripheral circulation. T-cell receptor editing is linked to the process of positive selection. Positive selection results in the production of T cells bearing T-cell receptors that have the capacity to interact with all allotypes of MHC class I and class II molecules, and not just those of the individual. Positive selection ensures that autoreactive T cells are rendered non-responsive. If there is a genetic defect in AIRE, then T-cell development is arrested as positive selection commences.

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T-cell receptor editing is linked to the process of positive selection.

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Dendritic cells take up, process or present antigen by all of the following routes except _____. receptor-mediated endocytosis of bacteria macropinocytosis of bacteria or viruses uptake of viruses using Toll-like receptor TLR9 cross-presentation from the MHC class II pathway to the MHC class I pathway cross-presentation from incoming infected dendritic cells to healthy resident dendritic cells in secondary lymphoid tissue delivery of viral peptides from cytosol to endoplasmic reticulum during viral infection.

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- receptor-mediated endocytosis of bacteria - macropinocytosis of bacteria or viruses - cross-presentation from the MHC class II pathway to the MHC class I pathway - cross-presentation from incoming infected dendritic cells to healthy resident dendritic cells in secondary lymphoid tissue

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Which of the following contributes to the activation of naive T cells?

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dendritic cells

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Which of the following describes an activated dendritic cell upon arriving in a lymph node?

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bears highly elaborated finger-like processes called dendrites

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Activated T cells express _____, which binds to B7 with 20 times higher affinity than CD28 and results in _____ of T-cell activity and proliferation.

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CTLA4; suppression.

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All of the following are included in the central supramolecular activation complex (c-SMAC) except _____. CD4 or CD8 ICAM-1 CD28 T-cell receptor PKC-?.

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ICAM-1

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Naive lymphocytes homing to lymphoid tissue use _____ to bind to CD34 and GlyCAM-1 on high endothelial venules.

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L-selectin

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The co-stimulatory molecule _____ on professional antigen-presenting cells binds _____ on the surface of naive T cells.

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B7; CD28

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Which of the following is a protein tyrosine kinase involved in T-cell activation culminating in T-cell proliferation and differentiation?

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ZAP-70

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All of the following statements regarding interleukin-2 (IL-2) or its receptor are true except _____. The low-affinity IL-2 receptor is a membrane-bound heterodimer composed of ? and ? chains. IL-2 production increases approximately 100-fold if a co-stimulatory signal is delivered. T-cell proliferation occurs upon binding of IL-2 to the high-affinity IL-2 receptor. The high-affinity IL-2 receptor is assembled after T-cell activation. Rapamycin is an immunosuppressive drug that inhibits signaling of IL-2 through the IL-2 receptor.

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The low-affinity IL-2 receptor is a membrane-bound heterodimer composed of ? and ? chains.

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Binding of _____ to _____ induces T-cell proliferation and differentiation of activated T cells.

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IL-2; the high-affinity IL-2 receptor

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If a non-professional antigen-presenting cell that lacks co-stimulatory molecules presents peptide:MHC complexes to a T cell specific for that peptide, then _____.

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T-cell tolerance occurs as a result of anergy.

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Tuberculoid leprosy is characterized by a _____-type response in which patients _____.

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TH1; usually survive

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Which of the following statements regarding leprosy is false? It is caused by the bacterium Mycobacterium leprae. Disease progression is influenced depending on whether the immune response is polarized toward either a TH1 or TH2 response. The tuberculoid form of leprosy is associated with localized inflammation and granuloma formation. In lepromatous leprosy, the patient makes a TH2 response that clears the mycobacteria from the body. The less severe form of leprosy presents with high levels of IL-2 and IFN-? produced by responding T cells.

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In lepromatous leprosy, the patient makes a TH2 response that clears the mycobacteria from the body.

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Many cytokine receptors are associated with cytoplasmic protein kinases called _____, which become activated when the cytokine receptors bind to their respective cytokines.

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JAKs

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Signal transducers and activators of transcription (STATs) are _____ that are phosphorylated by _____.

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transcription factors; JAKs

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The process by which cytotoxic T cells kill their targets involves _____. (Select all that apply.) inducing the target cell to undergo necrosis inducing apoptosis (programmed cell death) in the cytotoxic T cell DNA fragmentation in lengths of multiples of 200 base pairs in the target cell shedding of membrane-bound vesicles and shrinking of the target cell release of granzyme, perforin, and granulysin by the cytotoxic T cell.

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- DNA fragmentation in lengths of multiples of 200 base pairs in the target cell - shedding of membrane-bound vesicles and shrinking of the target cell

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Which of the following is a feature of regulatory T cells (Treg)? (Select all that apply.) Treg express CD8 and control effector cells by inducing apoptosis. Treg express high levels of CD25 (IL-2 receptor ? chain) and secrete pro-inflammatory cytokines such as IFN-?. Physical association between Treg and their target cells is mandatory for Treg function. By interacting with dendritic cells in secondary lymphoid tissue, Treg prevent the interaction and activation of naive T cells. Treg secrete TGF-? and suppress effector T-cell function.

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- Physical association between Treg and their target cells is mandatory for Treg function. - By interacting with dendritic cells in secondary lymphoid tissue, Treg prevent the interaction and activation of naive T cells. - Treg secrete TGF-? and suppress effector T-cell function.

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Which of the following is produced by CD8 T cells? IL-10 TGF-? IFN-? IL-4 IL-17

answer

IFN-?

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Which of the following statements is false regarding CD8 T cells? CD8 T cells have only one effector function, which is cytotoxicity. Compared with naive CD4 T cells, naive CD8 T cells have more stringent requirements for co-stimulatory activity. Effector CD8 cells require co-stimulation to kill their target cells. The most potent antigen-presenting cell for naive CD8 T cells is the dendritic cell.

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Effector CD8 cells require co-stimulation to kill their target cells.

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A B cell's sensitivity to antigen can be increased 1000-10,0000-fold by

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simultaneously ligating the B-cell receptor and co-receptor

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Naive B cells search for specific antigen displayed by follicular dendritic cells in primary follicles. Naive T cells, however, search for specific antigen presented by ______.

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dendritic cells

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The Ig?-associated tyrosine kinase _____ phosphorylates the cytoplasmic tail of CD19, which mediates signal transduction in activated B cells.

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Lyn

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The process that drives an increase in antibody affinity for antigen is known as _____.

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affinity maturation

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Which of the following is FALSE regarding follicular dendritic cells (FDCs)? They store antigens in the form of immune complexes on their dendrites They send survival signals to B cells that bind to them They are derived from hematopoietic stem cells They store antigens for years They are found in primary follicles of lymph nodes

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They are derived from hematopoietic stem cells

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Which of the following is not a function of antibodies?

answer

They exert toxic effects directly.

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Which of the following statements is TRUE regarding B cell activation mechanisms? Individuals with DiGeorge syndrome do not have a thymus so they do not produce any antibodies BCR crosslinking is necessary for activation of both thymus dependent and thymus independent processes The presence of dense and repeating epitopes on a pathogen can initiate activation of B cells without T cell involvement All of the above B and C

answer

B and C

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A primary focus of clonal expansion is best described as _____.

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the location in the medullary cords where conjugate pairs of B cells and T cells undergo cellular proliferation and IgM is secreted

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B cells migrating directly from a primary focus to the medullary cords in a lymph node after activation with a T-dependent antigen differentiate into plasma cells that secrete predominantly _____.

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IgM.

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HyperIgM syndrome is a rare disease. A number of different genetic defects can cause HyperIgM syndrome. All of these genetic defects have a common feature that causes HyperIgM syndrome. Which set of genetic defects would cause HyperIgM syndrome?

answer

Genetic defects that affect the interaction between T cells and B cells

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A primary focus forms after a circulating naive B cell forms a conjugate pair with _____ in the _____ of a lymph node.

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cytotoxic T cell; T-cell zone

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FcRn has which of the following characteristics? (Select all that apply.) It binds to monomeric IgA in acidified endocytic vesicles. It transports IgG out of the blood into tissue across the endothelium. It is similar in structure to an MHC class II molecule. It protects IgA from degradation by plasma proteases. Two molecules of FcRn are required to bind to each Fc region.

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- It transports IgG out of the blood into tissue across the endothelium. - Two molecules of FcRn are required to bind to each Fc region.

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The process involving receptor-mediated transport of macromolecules from one side of a cell to the other is called

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transcytosis

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The symptoms of allergy and asthma are induced after cross-linking of IgE antibody on Fc?RI receptors found on the surface of _____. (Select all that apply.) basophils eosinophils macrophages mast cells neutrophils.

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basophils eosinophils mast cells

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To mount the most effective antibody response that results in the synthesis of high-affinity antibodies, which of the following must occur? (Select all that apply.)

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- isotype switching - affinity maturation

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Which of the following antibodies is passively transferred from a mother to her infant via breast milk?

answer

dimeric IgA

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Which of the following is consistent with a recently antigen-activated mast cell?

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the absence of prepackaged granules

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Antibody-dependent cell-mediated cytotoxicity (ADCC) is carried out by _____ after cross-linking of IgG1 or IgG3 antibodies on _____ receptors.

answer

NK cells; Fc?RIII

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Complexes of IgG bound to soluble multivalent antigens can activate the classical pathway of complement, resulting in the deposition of _____ on the complex, targeting it for endocytic uptake by cells bearing _____.

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C3b; CR1 and Fc receptors

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IgM is particularly efficient at fixing complement because it _____.

answer

has five binding sites for C1q

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Immunoreceptor tyrosine-based activation motifs (ITAMs) are located on _____.

answer

the cytoplasmic tails of Ig? and Ig?

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Some types of B-cell tumor have been treated with rituximab, an anti-CD20 monoclonal antibody, which exerts its effect through a mechanism known as ______ involving the participation of NK cells.

answer

antibody-dependent cell-mediated cytoxicity

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The Fc?RI receptor binds to _____:antigen complexes and facilitates the phagocytosis of opsonized antigens.

answer

monomeric IgA.

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Which of the following are characteristics of systemic lupus erythematosus? (Select all that apply.) It is an autoimmune disease. It is associated with a deficiency of C4A. Increased levels of immune complexes are detected in the blood. CR1 receptor levels are decreased. Immune complexes are deposited on the kidney glomeruli, which can lead to kidney complications.

answer

- It is an autoimmune disease. - It is associated with a deficiency of C4A. - Increased levels of immune complexes are detected in the blood. - Immune complexes are deposited on the kidney glomeruli, which can lead to kidney complications

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Which of the following is FALSE regarding an inactivated or killed virus vaccine?

answer

It elicits a strong T cell response

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Indicate which of the following statements is TRUE.

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

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Which of the following is NOT an inactivated virus vaccine?

answer

Flumist

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With reference to the RotaTaq vaccine, identify the FALSE statement. (Select TWO that apply.)

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It is an attenuated vaccine derived from a human rotavirus. It is pathogenic if a genetic reversion occurs.

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

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irradiation heat treatment formalin treatment

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For a viral subunit vaccine to be effective, _____. (Select FOUR that apply.)

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

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

answer

the implicit association with adolescent sexual activity

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Which of the following explain why the safety standards for vaccines are set higher than those for drugs? (Select all that apply.)

answer

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

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Reasons complicating the development of vaccines to combat chronic diseases include _____. (Select all that apply.)

answer

- 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

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

answer

co-stimulatory molecules; macrophages and dendritic cells

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

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polysaccharide; a protein carrier

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

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mount an effective immune response and eradicate the virus

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

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CD16

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A stressed cell will express....

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MIC glycoproteins

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Which of the following statements regarding NK cells is false?

answer

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

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Identify which of the following is not a characteristic of CD94:NKG2A.

answer

binds to carbohydrate ligands

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Which of the following is TRUE regarding the evolution of the immune system?

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

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V?9:V?2 T cells differ from ?:? T cells in that they _____. (Select all that apply.)

answer

- respond to phosphorylated metabolic intermediates (phosphoantigens) of isoprenoid biosynthesis pathways - are not subject to positive and negative selection in the thymus - have limited diversity of V gene rearrangement.

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All NK cells express _____.

answer

NKG2D

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All of the following are correct regarding MAIT cells except _____. (Select all that apply.)

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- respond to viral infection - respond to antigen presented by BTN3A - positively selected by thymic epithelium expressing high levels of MR1.

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_____ is a molecule expressed on NK cells and V?:V?1 T cells.

answer

NKG2D

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All of the following are characteristic of NK cells except _____.

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

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Identify which of the following is not a characteristic of ?:? T cells. (Select all that apply.)

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- Their response is solely dependent on the T-cell receptor. - They make up the minority of resident T cells in tissues. - They are subject to MHC restriction.

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T cells are positively selected to recognize "self" while NK cells are often described as recognizing "missing self." Which process is NOT involved in how NK cells avoid killing other cells in the body?

answer

During development, NK cells capable of recognizing HLA class I molecules presenting self-peptides undergo apoptosis and are eliminated

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Which of the following is not a ligand for ?:? T cells?

answer

sulfatides

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In regard to killer-cell immunoglobulin-like receptors (KIRs) indicate which of the following statements is TRUE?

answer

KIRs bind to specific allotypes of HLA-A, -B, and -C molecules.

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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

answer

Anergic

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

answer

variable surface glycoproteins (VSGs)

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What medical condition does a Staphylococci infection result in?

answer

Toxic shock syndrome from the action of superantigens

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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)

answer

- 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.

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Shingles is associated with infection by _____.

answer

herpes zoster

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Herpesviruses include all of the following except _____.

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All of the above are herpesviruses.

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Listeria monocytogenes replicates in _____ of macrophages after _____.

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the phagosome; inhibition of fusion of the phagosome with the lysosome

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

answer

antigenic shift

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

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Antigenic drift; antigenic shift

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

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B cells; CR2

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All of the following are associated with the ability of influenza virus to escape from immunity except _____.

answer

error-prone replication of its DNA genome

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Individuals with an antibody deficiency are more susceptible to infections by all of the following except _____.

answer

Mycobacterium tuberculosis

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Which of the following is incorrectly matched?

answer

Salmonella typhimurium: Coating its surface with human proteins

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

answer

hemagglutinin and neuraminidase

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

answer

MHC class I

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All of the following are part of Waldeyer's ring except _____.

answer

appendix

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At which anatomical location are Peyer's patches?

answer

small intestine

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Because the mucosae _____, this tissue is predisposed to infection.

answer

constitute thin, permeable barriers

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Commensal microorganisms in the gastrointestinal tract facilitate all of the following except _____.

answer

secrete enzymes required for protein degradation

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Identify which of the following is not a property of secreted mucins.

answer

contain glycosylated cysteine residues

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In addition to M cells, _____ can capture pathogens directly from the lumen of the gut.

answer

dendritic cells

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Laboratory animals reared in gnotobiotic conditions _____.

answer

lack normal gut microbiota

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M cells, unlike dendritic cells, _____.

answer

do not process and present their antigen to naive T cells

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Mucosae of a healthy intestinal tract _____. (Select all that apply.)

answer

- have a large number of activated T and B cells - contain intraepithelial lymphocytes - are populated with both ?:? and ?:? effector T cells

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The large population of microbes that contribute to the gut microbiota and have an important role in food processing are called _____.

answer

commensal microorganisms

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Unlike secreted mucins, membrane mucins _____.

answer

are not cross-linked by disulfide bonds

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Which of the following describe M cells in the gut? (Select all that apply.)

answer

- They are located in the dome of a Peyer's patch. - They do not directly participate in antigen processing or presentation.

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Which of the following pairs is mismatched? (Select all that apply.)

answer

- mesenteric lymph nodes: urogenital tract - effector compartment: induction of adaptive immune responses - Peyer's patches: afferent lymphatics.

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_____ assists in the differentiation of blood-derived monocytes into intestinal macrophages.

answer

TGF-?

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All of the following soluble factors enhance isotype switching from IgM to IgA in B cells except _____.

answer

IL-9

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If a B cell has been activated by antigen in the mucosa of the respiratory tract, then _____. (Select all that apply.)

answer

- lactating mothers will provide antigen-specific natural IgA in breast milk - secretory IgA will be synthesized in the lamina propria of all mucosae - it will recirculate through all mucosal tissues, including respiratory and gastrointestinal mucosae

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Intracytoplasmic bacteria in enterocytes of the gastrointestinal tract are detected by _____.

answer

NOD proteins

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Secretory IgA and _____ can bind to the poly-Ig receptor and be transported into the lumen of the gut or across other mucosal surfaces.

answer

pentameric IgM.

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Secretory IgA binds to pathogens in all of the following locations except the _____.

answer

blood

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Secretory IgA is best described as _____.

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a non-inflammatory immunoglobulin that restricts the passage of antigens across mucosal surfaces

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The cytokine influencing eosinophil development and function during helminth infections is _____.

answer

IL-5.

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The dominant immunoglobulin synthesized at mucosal surfaces is _____.

answer

IgA

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Which of the following is not an activity associated with secretory IgA and secretory IgM in mucosal secretions?

answer

complement fixation

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Which of the following is not associated with the process by which B cells produce secretory IgA in breast milk?

answer

?E:?7

question

Which of the following types of immune response are most beneficial in clearing helminth infections in the intestinal tract? (Select all that apply.)

answer

- production of IgE antibodies - eosinophil activation - antibody-dependent cell-mediated cytotoxicity

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_____ compensates for the absence of secretory IgA in selective IgA deficiency because it can be secreted by mucosal tissues using the same receptor needed for transcytosis.

answer

IgM

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_____ is the vascular addressin found on endothelial cells of intestinal mucosa that binds to integrins of gut-homing effector lymphocytes.

answer

MAdCAM-1

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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?

answer

Naive pathogen-specific B cells are suppressed by negative signaling through Fc?RIIB1.

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

answer

false

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

answer

of affinity maturation

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

answer

exons A, B, and C; post-transcriptional

question

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 Fc?RIIB1, and simultaneously bind to the same pathogen using its B-cell receptor?

answer

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

question

When a naive B cell binds to an IgG:antigen complex on its cell surface using Fc?RIIB1, while simultaneously binding to the same antigen using membrane-bound IgM, _____.

answer

the B cell becomes anergic

question

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

answer

- 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.

question

Which of the following statements is incorrect regarding memory B cells?

answer

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

question

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

answer

Alternative splicing

question

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

answer

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

question

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

answer

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

question

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.)

answer

- 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.

question

Memory B cells differ from memory T cells in the following ways. (Select all that apply.)

answer

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

question

RhoGAM is administered to pregnant RhD- women so as to _____. (Select all that apply.)

answer

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

question

Which of these characteristics is FALSE regarding IFN-?? - 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 IFN?R1.

answer

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

question

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.

answer

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

question

Individuals with an immunodeficiency affecting B-cell function are more susceptible to infections caused by which of the following pathogens? - Toxoplasma gondii - respiratory syncytial virus - Haemophilus influenzae - Listeria monocytogenes - Mycobacterium tuberculosis

answer

Haemophilus influenzae

question

Listeria monocytogenes replicates in _____ of macrophages after _____.

answer

the phagosome; inhibition of fusion of the phagosome with the lysosome

question

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

answer

Janus 3 kinase (Jak3)

question

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

answer

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

question

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 _____.

answer

NADPH oxidase; produce superoxide radical (O2-)

question

Dominant mutant forms of IFN?R1 exhibit all of the following in heterozygotes except _____.

answer

they are hyperactive receptors resulting in increased signaling

question

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.

answer

Mycobacterium tuberculosis

question

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

answer

C1INH

question

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

answer

are healthy and all their B cells have functional Btk

question

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

answer

A point mutation in the gp120 protein

question

Which viral targets for HIV therapy is involved in processing of long viral polypeptides into shorter peptides (select ONE that applies):

answer

protease

question

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. - NF?B is a transcription factor that facilitates the transcription of proviral RNA

answer

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

question

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

answer

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

question

Which of the following is an Elite neutralizer of HIV?

answer

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

question

Reverse transcriptase is a _____ encoded by _____.

answer

RNA-dependent DNA polymerase; HIV

question

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

answer

anti-HIV antibodies are detectable in their blood serum

question

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?

answer

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

question

The pol gene of HIV produces all of the following except _____.

answer

matrix protein

question

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 NF?B - be latent - be polyreactive

answer

- be CD4-positive - express functional NF?B

question

_____ express Fc?RI and contain granules containing inflammatory mediators. (Select all that apply)

answer

- activated eosinophils - mast cells - basophils

question

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

answer

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

question

The antigens that provoke hypersensitivity reactions are referred to as

answer

allergens

question

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

answer

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

question

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

answer

IgE:IgG4

question

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

answer

The IgE produced would have low affinity for antigen.

question

Which of the following is not mediated by antibodies?

answer

type IV hypersensitivity

question

Which of the following is associated with type III hypersensitivity?

answer

mouse-derived monoclonal antibody

question

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

answer

an immediate type I allergic response

question

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-1? to promote TH1 responses. - Block high-affinity IgE receptors to prevent mast-cell degranulation.

answer

- 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.

question

All of the following are biological effects mediated by the products of mast cells except _____.

answer

All of the above are mediated by mast cells

question

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

answer

- CD8 T cells - neutrophils

question

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 - ?2-adrenergic receptor variant - ACOX5 (5-lipoxygenase)

answer

- HLA class II allotypes - ?2-adrenergic receptor variant - ACOX5 (5-lipoxygenase)

question

Which of the following are matched correctly? (Select all that apply)

answer

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

question

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

answer

cyclooxygenase

question

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.

answer

Anaphylaxis; nuts

question

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

answer

proliferate

question

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

answer

Type II

question

Indicate whether the following statement is true: There are polymorphic antigens other than ABO and Rhesus antigens that can cause type II hypersensitivity reactions

answer

True

question

Blood transfusions mismatched for ABO and/or rhesus antigens are associated with _____. (Select all that apply)

answer

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

question

Indicate whether the following statement is true: ABO or Rhesus antigen mismatches stimulate cytotoxic T-cell responses.

answer

False

question

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

answer

dendritic cells; donor

question

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.

answer

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

question

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

answer

donor

question

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

answer

direct; indirect

question

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

answer

cause hyperacute rejection

question

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

answer

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

question

Alloantibody production after organ transplantation involves _____.

answer

the indirect pathway of allorecognition by CD4 T cells

question

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)

answer

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

question

Indicate whether the following statement is true (T) or false (F): Antithymocyte globulin (ATG) is a monoclonal antibody specific for T-cell surface antigens.

answer

False

question

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

answer

cirrhosis of the liver

question

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

answer

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

question

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-?, which downregulates CD40 and inhibits IL-12 secretion

answer

- 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-?, which downregulates CD40 and inhibits IL-12 secretion

question

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?

answer

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

question

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

answer

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

question

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

answer

- 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-effect

question

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

answer

- cyclophosphamide - azathioprine - methotrexate - mycophenolate mofetil

question

Indicate whether the following statement is true: Lymphocytes and erythrocytes express HLA class I and II molecules.

answer

False

question

In routine blood transfusions, which of the following must be matched correctly? (Select all that apply)

answer

- A and B antigens - Rhesus D antigen

question

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

answer

Alemtuzumab

question

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.

answer

haploidentical

question

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-? decreased activity of cyclo-oxygenase type 2 serum sickness

answer

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

question

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)

answer

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

question

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

answer

50%

question

Indicate whether the following statement is true (T) or false (F): A possible side-effect of using antilymphocyte globulin (ALG) is serum sickness.

answer

True

question

Indicate whether the following statement is true (T) or false (F): Immunosuppressive xenogeneic antibodies can be used repeatedly for multiple episodes of transplant rejection without complication.

answer

False

question

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-? monoclonal antibody that suppresses inflammation by blocking TNF-? 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?

answer

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

question

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 _____.

answer

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

question

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

answer

Graft-versus-host disease (GVHD)

question

Indicate whether the following statement is true (T) or false (F): During pregnancy the fetus is exposed to maternal leukocytes.

answer

False

question

Which of the following describes myasthenia gravis?

answer

The neuromuscular junction is compromised.

question

Indicate whether the following statement is true (T) or false (F). Autoimmune diseases are rarely resolved.

answer

True

question

Which of the following is an example of a type II autoimmune response? (Select all that apply)

answer

- Myasthenia gravis. - Graves disease

question

Which of the following is the cause of red blood cell deficiency in autoimmune hemolytic anemia? (Select all that apply.)

answer

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

question

Indicate whether the following statement is true (T) or false (F): During pregnancy, IgG antibodies and activated lymphocytes can cross the placenta and enter the circulatory system of the fetus.

answer

False

question

Indicate whether the following statement is true (T) or false (F): Blood plasma exchange (plasmapheresis) can be used to remove maternal IgG from the newborn.

answer

True

question

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.)

answer

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

question

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?

answer

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

question

Indicate whether the following statement is true (T) or false (F). Autoimmune responses are the result of innate immune responses directed toward self antigens.

answer

False

question

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.

answer

B cells; Fc?RIII

question

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?

answer

elevated anti-acetylcholine receptor antibodies

question

_____ autoantibodies enhance receptor function.

answer

agonist

question

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?

answer

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

question

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

answer

exhibit symptoms of autoimmunity at a young age

question

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

answer

insulin-resistant diabetes

question

Indicate whether the following statement is true (T) or false (F): All autoimmune diseases involve a breach of T-cell tolerance.

answer

True

question

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

answer

ankylosing spondylitis

question

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

answer

involution

question

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

answer

type I

question

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?

answer

anti-gliadin IgA antibodies

question

Which of the following describes processes by which self-reactive lymphocytes are rendered incapable of mounting an autoimmune response? (Select SEVEN that apply.)

answer

- 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

question

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

answer

molecular mimicry

question

Deficiency in the production of AIRE results in _____. (Select all that apply.)

answer

- 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)

question

Indicate whether the following statement is true (T) or false (F): Autoimmune diseases can be induced after an infection.

answer

True

question

Match the type of hypersensitivity with its description.

answer

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

question

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

answer

adenoma

question

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)?

answer

A high proportion of normal mice will develop tumors

question

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

answer

p53

question

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

answer

carcinogens

question

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

answer

True

question

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

answer

cleavage of MIC at the cell surface by a protease

question

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

answer

False

question

Most cancers develop in tissues that are actively undergoing division.

answer

True

question

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

answer

CT

question

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

answer

angiogenesis

question

A malignant tumor is characterized by which of the following features? (Select all that apply.)

answer

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

question

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.

answer

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

question

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

answer

Malignant transformation

question

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

answer

late-stage metastatic prostate cancer

question

Monoclonal antibodies are used in cancer treatment for the following reasons EXCEPT

answer

to enhance the expression of tumor-specific antigens

question

Which is not considered an immunotherapy treatment for cancer?

answer

chemotherapy

question

In CAR (chimeric antigen receptor) therapy

answer

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

question

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)?

answer

High levels of PD-L1

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