Chap 16

Chapter 16
Disorders in Immunity
Multiple Choice Questions

1. The major categories of hypersensitivities that typically involve a B-cell immunoglobulin
response include
A. type I only.
B. type I and type IV.
C. type IV only.
D. type I, type II, and type III.
E. type I, type II, type III, and type IV.
ASM Objective: 05.04 Microorganisms, cellular and viral, can interact with both human and nonhuman hosts in beneficial, neutral or
detrimental ways.
ASM Topic: Module 05 Systems
Blooms Level: 1. Remember
Learning Outcome: 16.01 Define immunopathology, and describe the two major categories of immune dysfunction.
Learning Outcome: 16.02 Identify the four major categories of hypersensitivity, or overreaction to antigens.
Section Number: 16.01
Topic: Hypersensitivities
2. Which is mismatched?
A. food allergy - type I hypersensitivity
B. poison ivy dermatitis - type IV hypersensitivity
C. serum sickness - type III hypersensitivity
D. transfusion reaction - type II hypersensitivity
E. hay fever - type IV hypersensitivity
detrimental ways.
Blooms Level: 2. Understand
3. Any heightened immune response resulting in tissue damage is called a/an

A. autoimmune disease.
B. immunodeficiency.
C. hypersensitivity.
D. transfusion reaction.
E. desensitization.
detrimental ways.
4. The study of diseases associated with excesses and deficiencies of the immune system is
A. humoralpathology.
B. hemopathology.
C. epidemiology.
D. immunopathology.
E. histopathology.
detrimental ways.
Learning Outcome: 16.01 Define immunopathology, and describe the two major categories of immune dysfunction.
Topic: Autoimmunity
Topic: Immunodeficiency
5. Atopy and anaphylaxis are hypersensitivities in the category

A. type I only.
B. type I and type IV.
C. type IV only.
D. type I, type II, and type III.
E. type I, type II, type III, and type IV.
detrimental ways.
6. Bee sting venom is considered to be which type of allergen?

A. ingestant
B. inhalant
C. injectant
D. contactant
detrimental ways.
Learning Outcome: 16.03 Summarize genetic and environmental factors that influence allergy development.
7. Fungal spores and animal dander are considered to be which type of allergen?
A. ingestant
B. inhalant
C. injectant
D. contactant
detrimental ways.
8. The initial encounter with an allergen is called the _____ dose.

A. sensitizing
B. provocative
C. allergic
D. hypersensitivity
E. desensitizing
detrimental ways.
Learning Outcome: 16.04 Outline the steps of a type I allergic response, and discuss the effects on target organs and tissue.
9. A second encounter with an allergen that causes a response is called the _____ dose.
A. sensitizing
B. provocative
C. allergic
D. hypersensitivity
E. desensitizing
detrimental ways.
10. What will be the immediate action of an allergen when it enters the body for a second
time?
A. degranulation
B. bonding of allergen to adjacent IgE binding sites on mast cells and basophils
C. binding of IgE by the Fc region to mast cells and basophils
D. histamine acts on smooth muscle
E. prostaglandins cause vasodilation and increased vascular permeability
detrimental ways.
11. Which event is the process of releasing chemical mediators?

A. degranulation
D. histamine acts on smooth muscle
E. prostaglandins cause vasodilation and increased vascular permeability
detrimental ways.
12. Which event occurs with the sensitizing dose of allergen?

A. degranulation
D. histamine acting on smooth muscle
E. prostaglandins causing vasodilation and increased vascular permeability
detrimental ways.
13. Which of the following is not a possible outcome of a type I hypersensitivity reaction?
A. rhinitis
B. rashes
C. sneezing
D. diarrhea
E. contact dermatitis
detrimental ways.
14. Histamine causes all of the following except

A. increased sensitivity to pain.
B. constriction of smooth muscle of bronchi and the intestine.
C. relaxation of vascular smooth muscle.
D. wheal and flare reaction in skin.
E. pruritis and headache.
detrimental ways.
15. The chemical mediator that causes prolonged bronchospasm, vascular permeability, and
mucus secretion of asthmatic patients is
A. prostaglandin.
B. histamine.
C. leukotriene.
D. serotonin.
E. platelet-activating factor.
detrimental ways.
16. Which type/s of hypersensitivities is IgG is involved with?

A. anaphylaxis
B. antibody-mediated
C. immune complex-mediated
D. Both anaphylaxis and antibody-mediated.
E. Both antibody-mediated and immune complex-mediated.
detrimental ways.
Learning Outcome: 16.12 Identify commonalities and differences between type II and type III hypersensitivities.
17. Allergic reactions to penicillins are considered a/n _____ hypersensitivity.

A. T-cell-mediated
B. antibody-mediated
C. immune complex-mediated
D. immediate
E. Both T-cell-mediated and antibody-mediated are correct.
detrimental ways.
Learning Outcome: 16.05 Identify three conditions caused by IgE-mediated allergic reactions.
18. Allergies run in families because

A. immunoglobulins pass from mother to fetus.
B. immunoglobulins pass through breast milk.
C. the variable region of antibodies is genetically determined.
D. the relative production of IgE is inherited.
detrimental ways.
19. A chronic, local allergy such as hay fever is considered

A. delayed.
B. T-cell-mediated.
C. atopic.
D. antibody-mediated.
E. systemic anaphylactic.
detrimental ways.
20. A systemic, sometimes fatal, reaction with airway obstruction and circulatory collapse is
A. delayed.
B. T-cell-mediated.
C. atopic.
D. antibody-mediated.
E. systemic anaphylaxis.

Learning Outcome: 16.06 Describe the symptoms of anaphylaxis and link these to physiological events.
21. A seasonal reaction to inhaled allergens is

A. atopic dermatitis.
B. eczema.
C. allergic rhinitis.
D. asthma.
E. anaphylaxis.
detrimental ways.
22. All of the following are associated with IgE and mast-cell-mediated allergy except
A. drug allergy.
B. eczema.
C. anaphylaxis.
D. allergic asthma.
E. systemic lupus erythematosus.
detrimental ways.
23. Epinephrine
A. is an antihistamine.
B. reverses constriction of airways.
C. causes desensitization.
D. inhibits the activity of lymphocytes.
detrimental ways.
24. Allergic patients receiving small, controlled injections of specific allergens are
undergoing
A. desensitization.
B. sensitization.
C. tissue matching.
D. degranulation.
detrimental ways.
Learning Outcome: 16.08 Explain the mode of action of two strategies for treating and preventing type I allergic reactions.
25. An antihistamine will

A. inhibit the activity of lymphocytes.
B. bind to histamine receptors on target organs.
C. block synthesis of leukotrienes.
D. relieve inflammatory symptoms.
E. reverse spasms of respiratory smooth muscles.
detrimental ways.
26. Corticosteroids will

A. inhibit the activity of lymphocytes.
B. bind to histamine receptors on target organs.
C. block synthesis of leukotrienes.
D. relieve inflammatory symptoms.
E. reverse spasms of respiratory smooth muscles.
detrimental ways.
27. All of the following are involved in type II hypersensitivity except

A. IgM.
B. IgG.
C. IgE.
D. complement.
E. foreign cells.
detrimental ways.
28. Human blood types involve all of the following except

A. MHC genes.
B. ABO antigen markers.
C. inheritance of two of three possible alleles.
D. genetically determined glycoprotein markers.
E. genes that code for an enzyme that adds a terminal carbohydrate to RBC receptors.
detrimental ways.
Learning Outcome: 16.09 List the three immune components causing cell lysis in type II hypersensitivity reactions.
Learning Outcome: 16.10 Explain the molecular basis for the ABO blood groups, and identify the blood type of a "universal donor" and the
blood type of a "universal recipient."
29. The serum of a person with blood type A and Rh- will have the ability to make which of
the following antibodies?
A. anti-A and anti-Rh
B. anti-B and anti-Rh
C. anti-A
D. anti-B
E. anti-A, anti-B, and anti-Rh
detrimental ways.
30. A person with O type blood

A. lacks all of the alleles for ABO blood type.
B. lacks A and B antigens.
C. could not have the Rh factor.
D. is called a universal recipient.
detrimental ways.
31. A person who produces anti-A and anti-B serum antibodies will have blood type
A. A.
B. B.
C. AB.
D. O.
E. Rh.
detrimental ways.
Blooms Level: 3. Apply
32. Transfusion of the wrong blood type can cause

A. recipient antibody activation of the complement cascade to attack the RBCs.
B. fever and anemia.
C. systemic shock and kidney failure.
D. massive hemolysis of the donor RBCs.
E. All of the choices are correct.
detrimental ways.
33. A female who is Rh

A. inherited two dominant genes.
B. is in the majority of the population with regard to Rh status.
C. is at risk for a pregnancy resulting in hemolytic disease of the newborn.
D. can never have an Rh+ baby.
detrimental ways.
Learning Outcome: 16.11 Explain the role of Rh factor in hemolytic disease development and how the disease is prevented in newborns.
34. The potential for hemolytic disease of the newborn occurs when
A. maternal Rh+ cells enter an Rh- fetus.
B. fetal Rh+ cells enter an Rh- mother.
C. maternal Rh- cells enter an Rh+ fetus.
D. fetal Rh- cells enter an Rh+ mother.
E. fetal Rh+ cells enter an Rh+ mother.
detrimental ways.
35. Once a mother has been sensitized to the Rh factor,

A. all other Rh+ fetuses are at risk.
B. she can be given RhoGAM in future pregnancies to prevent hemolytic disease of the
newborn.
C. she can never again have a low risk pregnancy.
D. only future Rh- fetuses are at risk.
E. None of the choices is correct.
detrimental ways.
36. Which of the following is not true of type III hypersensitivity?

A. Antigen-antibody complexes are deposited in the basement membrane of epithelial tissues.
B. It involves production of IgE antibodies.
C. It involves an immune complex reaction.
D. The Arthus reaction is a local response.
E. Serum sickness is a systemic response.
detrimental ways.
Learning Outcome: 16.13 Describe the ways in which the Arthus reaction differs from serum sickness.
37. Which of the following is not a target for immune complex deposition?
A. blood vessels and skin
B. heart and lungs
C. brain
D. joints
E. kidneys
detrimental ways.
38. Large quantities of antibodies that react to the second entry of antigen and lead to
formation of antigen-antibody complexes occurs in
A. serum sickness.
B. delayed hypersensitivity.
C. anaphylaxis.
D. hemolytic disease of the newborn.
detrimental ways.
39. Contact dermatitis involves

A. a sensitizing and provocative dose.
B. an allergen entering the skin.
C. T lymphocytes secreting inflammatory cytokines.
D. the production of itchy papules and blisters.
E. All of the choices are correct.
detrimental ways.
Learning Outcome: 16.14 Identify one type IV delayed hypersensitivity reaction, and describe the role of T cells in the pathogenesis of this
condition.
40. What could result when grafted tissue such as bone marrow contains passenger
lymphocytes?
A. host rejection of graft
B. graft versus host disease
C. formation of autoantibodies
D. hypogammaglobulinemia
detrimental ways.
Learning Outcome: 16.15 List four classes of grafts, and explain how host versus graft and graft versus host diseases develop.
41. Tissue transplanted from one body site on a patient to a different body site on that patient
is called a/an
A. isograft.
B. autograft.
C. allograft.
D. xenograft.
E. hypograft.
detrimental ways.
42. Autoimmunity is typically due to

A. transfusion reaction.
B. IgE and mast cells.
C. autoantibodies and T cells.
D. graft rejection.
E. a deficiency in T-cell development.
detrimental ways.
Learning Outcome: 16.16 Outline at least three different explanations for the origin of autoimmunity.
Topic: Autoimmunity
43. Autoantibodies cause tissue injury in all of the following diseases except
A. rheumatoid arthritis.
B. myasthenia gravis.
C. Graves' disease.
D. tuberculin reaction.
E. multiple sclerosis.
detrimental ways.
Learning Outcome: 16.17 List three autoimmune diseases, and immunologic features common to all.
Topic: Autoimmunity
44. All of the following are autoimmune diseases except

A. systemic lupus erythematosus.
B. Graves' disease.
C. type I diabetes.
D. metastatic cancer.
E. rheumatoid arthritis.
detrimental ways.
Topic: Autoimmunity
45. Myasthenia gravis disease arises from the production of autoantibodies against
A. myelin sheath cells of the nervous system.
B. acetylcholine receptors on smooth muscle.
C. acetylcholine receptors on skeletal muscle.
D. sodium pump proteins in the cell membrane.
E. cells in thyroid follicles.
detrimental ways.
Topic: Autoimmunity
46. In multiple sclerosis, autoantibodies attack

A. myelin sheath cells of the nervous system.
B. acetylcholine receptors on smooth muscle.
C. acetylcholine receptors on skeletal muscle.
D. sodium pump proteins in the cell membrane.
E. cells in thyroid follicles.
detrimental ways.
Topic: Autoimmunity
47. Which of the following is not a theory to explain the origin of autoimmune diseases?
A. sequestered antigen theory
B. forbidden clone theory
C. molecular mimicry theory
D. theory of bystander effect
E. All the choices are currently being investigated as possible explanations.
detrimental ways.
Topic: Autoimmunity
48. What can be a consequence of a genetic deficiency in B-cell survival and maturity?
A. host rejection of graft
B. graft versus host disease
C. formation of autoantibodies
D. hypogammaglobulinemia
detrimental ways.
Learning Outcome: 16.18 Distinguish between primary and secondary immunodeficiencies, explaining how each develops.
49. DiGeorge syndrome is the result of

A. autoantibodies.
C. congenital absence or immaturity of the thymus gland.
D. failure of B-cell development and maturity.
E. a genetic defect in the development of both T cells and B cells.
detrimental ways.
50. Severe combined immunodeficiencies (SCIDs) are due to

A. autoantibodies.
C. congenital absence or immaturity of the thymus gland.
D. failure of B-cell development and maturity.
E. a genetic defect in the development of both T cells and B cells.
detrimental ways.
Learning Outcome: 16.19 Define severe combined immunodeficiency, and discuss current therapeutic approaches to this type of disease.
51. An example of a secondary acquired immunodeficiency is

A. AIDS.
B. adenosine deaminase (ADA) deficiency.
C. DiGeorge syndrome.
D. agammaglobulinemia.
E. SCID.
detrimental ways.
Learning Outcome: 16.20 List three conditions that can lead to the development of secondary immunodeficiency diseases.
52. All of the following can result in acquired immune deficiency except
A. malnutrition.
B. stress.
C. pregnancy.
D. bacterial infection.
E. radiation treatment.
detrimental ways.
53. In the theory for allergic desensitization, which immunoglobulin blocks the allergen from
binding with IgE?
A. IgE
B. IgG
C. IgA
D. IgD
E. IgM
detrimental ways.
54. Degranulation of mast cells leads to

A. airway obstruction.
B. headache.
C. dilated blood vessels.
D. constricted bronchioles.
detrimental ways.
True / False Questions

55. Systemic anaphylaxis can quickly result in airway blockage, shock, and death.
TRUE
detrimental ways.
56. Food allergies include gastrointestinal symptoms and often hives.

TRUE
detrimental ways.
57. Allergic rhinitis is also known as asthma.

FALSE
detrimental ways.
58. A person who is Rh- will have anti-Rh antibodies in his/her serum from early infancy.
FALSE
detrimental ways.
59. The tuberculin reaction develops within 30 minutes of the skin test in people with prior
sensitization due to tuberculosis infection.
FALSE
detrimental ways.
condition.
60. During graft rejection, cytotoxic T cells of the recipient recognize and respond to foreign
class I MHC receptors on the grafted cells.
TRUE
detrimental ways.
61. The allergen in poison ivy plants is an oil called urushiol.

TRUE
detrimental ways.
62. A xenograft is graft tissue from a donor of one species transplanted to a recipient of
another species.
TRUE
detrimental ways.
63. Eczema is an autoimmune disorder.

FALSE
detrimental ways.
Topic: Autoimmunity
64. A viral infection can lead to the development of type I diabetes.

TRUE
detrimental ways.
Topic: Autoimmunity
65. The most common immunoglobulin deficiency is an IgG deficiency.

TRUE
detrimental ways.
66. AIDS is a secondary immunodeficiency disease that affects several types of immune
cells.
TRUE
detrimental ways.

67. Predict why insect stings and medication injections more often provoke anaphylactic
shock, as compared to other allergens found in food or in air.
A. The allergens go directly into the blood in large amounts, compared to allergens entering
the digestive tract or respiratory tract.
B. Chemicals from insects cause a combination of antibody types to be produced, resulting in
much larger amounts of total antibody.
C. Chemicals injected as medications cause problems in immune response, resulting in a
reduced immune coverage.
D. Histamine is overproduced as a result of injected chemicals.
detrimental ways.
68. John, a Peace Corps worker in the country of Mali in Africa, was in a car accident while
traveling through a rural area. He was treated at a tiny rural hospital, and due to his loss of
blood required a transfusion. John is B- blood type and has never received a transfusion
before. Which statement is correct regarding this scenario?
A. He can safely receive O- blood even though he makes anti-A antibodies.
B. He can be give types O or B, no matter whether Rh- or Rh+. At this point in time, he does
not have anti-Rh antibody. O has no antigens on the blood cells, so he is also safe to receive
that type in addition to his own B type.
C. He can be given A+ blood type, in addition to B+. Rh- means that he makes no antibody
to Rh.
D. The preferred blood type to give John, in addition to his own B type blood, would be AB.
Both types of blood have the B antigen on the cells, so they would correspond to his own
antigens. As for Rh, he can receive only Rh- blood since he would have a reaction against Rh
+.
detrimental ways.
Blooms Level: 4. Analyze
69. You have a dermatitis related to a particular material in your socks. Your feet are covered
with a really itchy rash, which has developed blisters over the last day or so. You had first
worn them 2 to 3 days ago, and you did not launder them after buying them at the store.
Finding some anti-histamine medication in your bathroom cabinet, you decide to take it to
relieve the itching rash believing:
A. The rash will go away because the anti-histamine neutralizes the histamine chemicals
coming from mast cells in your skin.
B. The anti-histamine will make the rash worse. The anti-histamine chemical in the
medication reacts with chemicals release by the lymphocytes in your skin, creating a much
worse reaction.
C. The anti-histamine will have no effect on the rash because histamine is not the chemical
mediator in this hypersensitivity.
D. The anti-histamine will have no effect because once a type I hypersensitivity kicks in, it
will last for a few days.
detrimental ways.
condition.
Ranking Questions
70. Place these events in the pathogenesis of contact dermatitis in order, with 1 being the first step.
1 chemical absorbed through skin
2 antigen identified by dendritic cell
4 cytokine chemicals attract macrophages, dendritic cells, and cytotoxic T lymphocytes to site of antigen
3 sensitized T lymphocytes recognize antigen and make cytokine chemicals
5 chemicals released from phagocytic cells and cytotoxic T cells, resulting in host tissue damage
detrimental ways.
condition.

71. You were out in the garage going through boxes when you were bitten by an a spider. You
tell the doctor that the spider was tiny and black, causing the doctor to think perhaps that it
was a black widow spider The doctor gives you an injection of antibody to the spider venom
to give you immediate protection. The antibody is produced in horses by injecting them with
small doses of the spider venom, causing the horse's immune system to make large amounts
of specific antibody to the antigen. The horse serum is then purified before being given to
humans.
A week later, you notice a red rash spreading away from the injection spot, where the doctor
gave you the anti-venom shot. A few days later, the rash has spread and swelling in also
present. You have joint pain as well as sore muscles all over your body. The lymph nodes in
the armpit are swollen and painful. Going back to the doctor, he diagnoses you with:
A. a Staphylococcus infection related to the spider bite.
B. anaphylactic shock.
C. a delayed type hypersensitivity mediated by cytotoxic T cells along with helper T cells.
D. serum sickness.
E. Arthus reaction.
detrimental ways.
72. In the situation of systemic lupus erythematosis (called lupus), complexes of antibody and
antigen form and these immune complexes insert themselves into small blood vessels, joints,
heart, and kidney, causing damage to the organ tissue. The course of the disease is
unpredictable, with periods of illness alternating with remissions. How is lupus, a type III
hypersensitivity, similar to infectious allergy, a type IV hypersensitivity reaction?
A. The mechanism of both lupus and infectious allergy involve large amounts of
inflammatory chemicals released into tissue.
B. Both lupus and infectious allergy involve large amounts of antibody production.
C. Both lupus and infectious allergy are immediate-type hypersensitivities, occurring within a
few hours.
D. Both lupus and infectious allergy have IgE in their mechanisms.
detrimental ways.
condition.
73. Many men make antibodies to sperm, resulting in destruction of sperm to the point of
sterility. What would be the likely origin of this autoimmune disease?
A. Since sperm are not made until after puberty, the immune system cannot scan the antigens
on the sperm for immune tolerance. After sperm are made and the immune system sees them,
they are recognized as foreign.
B. Antigens on sperm cells are similar to antigens on a variety of bacteria, like Streptococcus.
After a strep throat, caused by Streptococcus, the immune system produces antibodies to
streptococcal antigens, which then cross react with sperm antigens, destroying them.
C. T helper cells erroneously identify sperm cells as foreign invaders, triggering the T
cytotoxic cells to start killing sperm.
D. These antibodies are produced as a result of mutations in T lymphocytes, causing them to
make large amounts of antibody.
detrimental ways.
Topic: Autoimmunity

Chap 16

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Chap 16

Transféré par

Droits d'auteur :

Formats disponibles

Chapter 16

Multiple Choice Questions

3. Any heightened immune response resulting in tissue damage is called a/an

5. Atopy and anaphylaxis are hypersensitivities in the category

6. Bee sting venom is considered to be which type of allergen?

8. The initial encounter with an allergen is called the _____ dose.

11. Which event is the process of releasing chemical mediators?

12. Which event occurs with the sensitizing dose of allergen?

14. Histamine causes all of the following except

16. Which type/s of hypersensitivities is IgG is involved with?

17. Allergic reactions to penicillins are considered a/n _____ hypersensitivity.

18. Allergies run in families because

19. A chronic, local allergy such as hay fever is considered

ASM Topic: Module 05 Systems

21. A seasonal reaction to inhaled allergens is

25. An antihistamine will

26. Corticosteroids will

27. All of the following are involved in type II hypersensitivity except

28. Human blood types involve all of the following except

30. A person with O type blood

32. Transfusion of the wrong blood type can cause

33. A female who is Rh

35. Once a mother has been sensitized to the Rh factor,

36. Which of the following is not true of type III hypersensitivity?

39. Contact dermatitis involves

42. Autoimmunity is typically due to

44. All of the following are autoimmune diseases except

46. In multiple sclerosis, autoantibodies attack

49. DiGeorge syndrome is the result of

50. Severe combined immunodeficiencies (SCIDs) are due to

51. An example of a secondary acquired immunodeficiency is

54. Degranulation of mast cells leads to

True / False Questions

56. Food allergies include gastrointestinal symptoms and often hives.

57. Allergic rhinitis is also known as asthma.

61. The allergen in poison ivy plants is an oil called urushiol.

63. Eczema is an autoimmune disorder.

64. A viral infection can lead to the development of type I diabetes.

65. The most common immunoglobulin deficiency is an IgG deficiency.

Multiple Choice Questions

Multiple Choice Questions

Vous aimerez peut-être aussi