Immunology Exam 3
This flashcard set tests knowledge of the primary immune response to viral infections, particularly influenza. It emphasizes the specific viral surface proteins—hemagglutinin and neuraminidase—that antibodies target during an initial immune defense.
A primary immune response against influenza virus produces antibodies that bind to _____.
a. protein toxins
b. variable surface glycoproteins
c. EBNA-1
d. hemagglutinin and neuraminidase
e. gp41 and gp120
d. hemagglutinin and neuraminidase
Key Terms
A primary immune response against influenza virus produces antibodies that bind to _____.
a. protein toxins
b. variable surface glycoproteins
c. EBNA-1
d. hemagglutinin and neuraminidase
e. gp41 and gp120
d. hemagglutinin and neuraminidase
The serotypes of Streptococcus pneumoniae differ in their _____.
a. capsular polysaccharides
b. variable surface glycoproteins
c. superantigen products
d. ability to fix complement
e. rates of gene conversion
a. capsular polysaccharides
Shingles is associated with infection by _____.
a. Epstein–Barr virus
b. Staphylococcus aureus
c. Candida albicans
d. Listeria monocytogenes
e. herpes zoster
e. herpes zoster
All of the following are associated with superantigens except _____.
a. activate α:β T cells
b. effective at minuscule concentrations
c. processing to peptides is not required for T-cell activation
d. massive production of IL-2, IFN-γ, and TNF-α
e. nonspecific activation of 2–20% of body’s CD8 T cells
e. nonspecific activation of 2–20% of body’s CD8 T cells
Which of these characteristics is not true of IFN-γ?
a. When it acts on target cells, it enhances the engulfment and killing of bacteria.
b. It is the major activating cytokine of macrophages.
c. It activates the JAK–STAT signal transduction pathway after binding to its cognate receptor.
d. It is secreted by CD8 cytotoxic T cells, CD4 TH1 cells, and NK cells.
e. It is secreted and functions as a monomer but facilitates the dimerization of its receptor.
f. It is able to render target cells responsive even if they express only one functional allele of IFNγR1.
e. It is secreted and functions as a monomer but facilitates the dimerization of its receptor.
Paroxysmal nocturnal hemoglobinuria is caused by _____.
a. a profound deficiency of neutrophils
b. complement-mediated lysis of erythrocytes
c. leukocytosis
d. immune-complex deposition in tissues
e. defects in recruitment of phagocytes to infected tissues
b. complement-mediated lysis of erythrocytes
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| Term | Definition |
|---|---|
A primary immune response against influenza virus produces antibodies that bind to _____. a. protein toxins | d. hemagglutinin and neuraminidase |
The serotypes of Streptococcus pneumoniae differ in their _____. a. capsular polysaccharides | a. capsular polysaccharides |
Shingles is associated with infection by _____. a. Epstein–Barr virus | e. herpes zoster |
All of the following are associated with superantigens except _____. a. activate α:β T cells | e. nonspecific activation of 2–20% of body’s CD8 T cells |
Which of these characteristics is not true of IFN-γ? a. When it acts on target cells, it enhances the engulfment and killing of bacteria. | e. It is secreted and functions as a monomer but facilitates the dimerization of its receptor. |
Paroxysmal nocturnal hemoglobinuria is caused by _____. a. a profound deficiency of neutrophils | b. complement-mediated lysis of erythrocytes |
Severe combined immune deficiency (SCID) describes a condition in which neither _____ nor _____ are functional. a. innate; acquired immune responses | c. T-cell-dependent antibody responses; cell-mediated immune responses |
Which of the following explains why Streptococcus pneumoniae can infect an individual recurrently? a. S. pneumoniae is never completely eradicated during an infection and can reactivate if the host is immunocompromised. | e. Immune responses against S. pneumoniae are serotype-specific and protect only against strains that possess the same capsular polysaccharide antigens. |
All of the following contribute to new epidemics and the long-term survival of the influenza virus in the human population, except: a. The virus loses the capacity to express hemagglutinin, thereby rendering neutralizing antibodies useless. | a. The virus loses the capacity to express hemagglutinin, thereby rendering neutralizing antibodies useless. |
An epidemic affects _____, whereas a pandemic affects _____. a. susceptible individuals; immune individuals | b. local populations; global populations. |
Trypanosomes escape from adaptive immunity by altering the type of _____ expressed on the parasite surface. a. variable surface glycoprotein (VSG) | a. variable surface glycoprotein (VSG) |
Which of the following is not a characteristic of staphylococcal enterotoxins? a. They cause T cells to divide and differentiate into effector T cells. | d. They bind to MHC class I molecules and T-cell receptors. |
Which of the following statements regarding inherited immunodeficiency diseases is correct? a. Affected individuals are less susceptible to infection. | b. Mortality rates are reduced by the administration of antibiotics to affected individuals. |
Which statement regarding retrovirus proviruses is false? a. Proviruses are flanked by repetitive sequences called long terminal repeats (LTRs). | e. Proviruses form immediately after the RNA genome assembles with viral proteins and infectious virions are produced. |
Reverse transcriptase is a _____ encoded by _____. a. DNA-dependent DNA polymerase; influenza virus | d. RNA-dependent DNA polymerase; HIV |
Which of the following is not mediated by antibodies? a. type III hypersensitivity | c. type IV hypersensitivity |
_____ hypersensitivity reactions interact with soluble epitopes and not cell-surface associated epitopes. a. type I and II | e. type I and III |
During a primary immune response IgM sometimes switches to IgE. Which of the following best describes the consequence of this early switch? a. The IgE produced would have low affinity for antigen. | a. The IgE produced would have low affinity for antigen. |
Which of the following regarding FcεRI is false? a. It is expressed on the surface of mast cells and basophils. | b. It is a low-affinity receptor involved in type I hypersensitivity reactions. |
Identify the mismatched pair. a. TNF-α: immediate release from mast cells | d. mucosal mast cell production: T-cell immunodeficiencies |
Which of the following directly inhibits the cyclooxygenase pathway by inhibiting the activity of prostaglandin synthase? a. aspirin (acetyl salicylate) | a. aspirin (acetyl salicylate) |
Aspirin (acetyl salicylate) inhibits prostaglandin synthesis by binding irreversibly to prostaglandin synthase, the first enzyme in the _____ pathway. a. carboxypeptidase | d. cyclooxygenase |
During the course of a successful desensitization process, the patient’s antibodies will change from an _____isotype to an _____ isotype. a. IgG1:IgG4 | c. IgE:IgG4 |
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. This medical emergency would most probably result in immediate _____ before any subsequent treatment. a. intravenous injection of corticosteroids | d. subcutaneous injection of epinephrine |
The underlying molecular basis for distinguishing blood-group antigens A, B and O is _ at the erythrocyte surface. a. structural polymorphisms in the Rhesus D antigen | e. differences in the oligosaccharide attached to the lipid ceramide |
Which of the following is a permissible match between a blood donor and a recipient (donor: recipient)? a. O +: AB – | d. O –: AB + |
The direct pathway of allorecognition involves interaction of , whereas the indirect pathway of alloreaction involves interaction of . a. recipient T cells with allogeneic HLA molecules on donor dendritic cells; recipient T cells with peptides of allogeneic HLA molecules on recipient dendritic cells | a. recipient T cells with allogeneic HLA molecules on donor dendritic cells; recipient T cells with peptides of allogeneic HLA molecules on recipient dendritic cells |
The risk of _ is the primary complication in bone marrow transplants. a. acute host-versus-graft disease | b. acute graft-versus-host disease |
_ from a bone marrow transplant facilitate alloreactive responses, causing the condition defined as acute graft-versus-host disease. a. Natural killer cells | e. Mature T cells |
Males engrafted with HLA-identical bone marrow from their sisters develop graft-versus- host disease because _. a. NK-cell alloreactions occur | d. mature T cells in the graft have specificity for male-specific minor histocompatibility antigens |
George Cunningham was diagnosed with Crohn’s disease when 23 years old. He was experiencing acute abdominal pain, diarrhea, rectal bleeding, anemia and weight loss. He did not respond to conventional immunosuppressive therapies and was given a course of infliximab, an anti-TNF-α monoclonal antibody that suppresses inflammation by blocking TNF-α activity. On day 12 after receiving his first infusion, he developed a mild fever, generalized vasculitis, swollen lymph glands, swollen joints and joint pain. Traces of blood and protein were detected in his urine. Which of the following is the most likely cause of these recent symptoms? a. Type III hypersensitivity caused by immune complex deposition in blood vessels. | a. Type III hypersensitivity caused by immune complex deposition in blood vessels. |
The term _ is used to describe polymorphic antigens that vary between individuals of the same species. a. xenoantigens | e. alloantigens |
Which of the following best explains why a bone marrow donor needs to be HLA-matched to the recipient? a. Reconstituted T cells are restricted by donor, not recipient, HLA allotypes. | d. The recipient’s MHC molecules mediate positive selection of thymocytes in the thymus that interact with donor-derived MHC molecules in the periphery. |
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 _. a. because Don is HLA-haploidentical and male, there is no risk of alloreactivity toward major or minor histocompatibility antigens | c. T-cell depletion will remove alloreactive T cells from the donor and prevent the potential for graft-versus-host disease (GVHD) |
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? a. A: 0301/0201; B: 4402/0801; DRB1: 0301/0403 | b. A: 0101/0101; B: 5701/0801; DRB1: 0701/0701 |
What type of hypersensitivity reaction would result from a mismatched blood transfusion? a. Type IV | d. Type II |
If _ occurs in an organ to be transplanted, endothelial activation, leukocyte infiltration, inflammatory cytokine production, and complement activation may occur. a. ischemia | a. ischemia |
Acute rejection of a kidney graft involves the activation of recipient T cells by of origin. a. B cells; recipient | e. dendritic cells; donor |
When donor MHC:donor self-peptide complexes activate recipient T cells, _. a. suppression occurs and transplanted organs are tolerated | d. acute rejection of transplanted organs occurs |
The extent to which an individual’s T cells respond to allogeneic HLA expressed on irradiated donor cells can be measured in vitro using _. a. the mixed lymphocyte reaction | a. the mixed lymphocyte reaction |
In chronic rejection, effector T cells respond to complexes on -derived dendritic cells. a. donor MHC class I:donor self peptide; donor | b. recipient MHC class II:donor MHC peptide; recipient |
Alloantibody production after organ transplantation involves _. a. the transfusion effect | d. the indirect pathway of allorecognition by CD4 T cells |
Patients who have previously received a blood transfusion that has HLA-DR allotypes in common with their kidney transplant are _. a. more likely to reject the graft owing to the presence of HLA alloantibodies | c. less likely to reject the graft owing to the presence of regulatory CD4 T cells |
_ is a nitrogen mustard compound converted to a DNA-alkylating agent in the body that is used to inhibit cell proliferation after transplantation. a. Methotrexate | b. Cyclophosphamide |
Corticosteroids interfere with chemotaxis of leukocytes by _. a. inhibiting the expression of adhesion molecules on endothelial vessels | a. inhibiting the expression of adhesion molecules on endothelial vessels |
Which type of autoimmune disease is correctly matched with its cause? a. type III: immune complex deposition in tissues | a. type III: immune complex deposition in tissues |
Which of the following is an example of a type IV autoimmune response? a. pemphigus vulgaris | d. type 1 diabetes |
_ is a highly variable type III autoimmune disease in which immune complexes form and may cause glomerulonephritis of the kidney, arthritis of the joints, and vasculitis of the face. a. Rheumatoid arthritis | d. Systemic lupus erythematosus |
Which of the following describes myasthenia gravis? a. Ectopic lymphoid tissue forms and impairs endocrine function. | b. The neuromuscular junction is compromised. |
The reason why babies born to mothers with Graves’ disease suffer passively from the disease for only a short while after birth is that _. a. the newborn’s regulatory T cells suppress autoantibody production | e. only antibodies, and not the B cells making the autoantibodies, cross the placenta |
A(n) _ binds to the antigen-binding site of another antibody. a. cryptic epitope | d. anti-idiotypic antibody |
Thyroid-stimulating hormone is made in the and induces the release of thyroid hormones after proteolytic processing of . a. hypothalamus; thyroxine | c. pituitary gland; thyroglobulin |
Graves’ disease causes , whereas Hashimoto’s disease causes . a. hypoglycemia; hyperglycemia | d. hyperthyroidism; hypothyroidism |
Which of the following are correctly matched? a. beta cells of pancreas: insulin production | a. beta cells of pancreas: insulin production |
_ is the term used to describe how pathogen antigens resemble host antigens and can sometimes trigger autoimmune disease. a. intramolecular epitope spreading | b. molecular mimicry |
A(n) _ is an epitope that is typically not accessible to the immune system but is revealed under inflammatory or infectious states. a. cryptic epitope | a. cryptic epitope |
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? a. immune complexes fixing complement in kidney, joints, and blood vessels; systemic lupus erythematosus | a. immune complexes fixing complement in kidney, joints, and blood vessels; systemic lupus erythematosus |
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? a. Regulatory T cells fail to activate autoreactive T cells in secondary lymphoid organs. | e. An inability to produce immunological tolerance toward CNS-derived constituents results in the generation of self-reactive lymphocytes. |
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? a. urticarial rash | e. anti-gliadin IgA antibodies |
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? a. elevated anti-acetylcholine receptor antibodies | a. elevated anti-acetylcholine receptor antibodies |