Trivia Quiz On Immunology And Behavioral Science
.JPG "Trivia Quiz On Immunology And Behavioral Science - Quiz")
Jan 2012
Questions and Answers
- 1.
Microbiology Dr Ber 1) Associate these characteristics with the appropriate MHC: (I) MHC class I (II) MHC class II (a) Generally only expressed by some leukocytes (b) Generally expressed by all nucleated cells (c) Signal for CD8 T lymphocytes (d) Signal for CD4 T lymphocytes (e) Binds peptides 8 to 12 amino acids long (f) Binds peptides 13 to 21 amino acids long (g) Antigenic peptides are derived from the phagolysosome (h) Requires a functional ubiquitin/proteasome
- A.
I-b, I-c, I-e, I-h, II-a, II-d, II-f, II-g
- B.
I-b, I-d, I-e, I-g, II-a, II-c, II-f, II-h
- C.
I-a, I-c, I-f, I-h, II-b, II-d, II-e, II-g
- D.
I-a, I-d, I-e, I-h, II-b, II-c, II-f, II-g
- E.
I-b, I-c, I-f, I-g, II-a, II-d, II-e, II-h
Correct Answer
A. I-b, I-c, I-e, I-h, II-a, II-d, II-f, II-gExplanation
MHC class I molecules are generally expressed by all nucleated cells and signal for CD8 T lymphocytes. They bind peptides 8 to 12 amino acids long and require a functional ubiquitin/proteasome. On the other hand, MHC class II molecules are generally only expressed by some leukocytes and signal for CD4 T lymphocytes. They bind peptides 13 to 21 amino acids long and antigenic peptides are derived from the phagolysosome.Rate this question:
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- 2.
(Micro Dr D) In May 2011, an outbreak of foodborne illness, complicated in many cases by hemolytic uremic syndrome, was seen in Germany. In thousands of patients, the causative agent was identified as a Shiga-toxin producing, Gram-negative, oxidase-negative rod that fermented lactose. A novel finding was that the isolates had the serotype O104:H4:K9, indicating that there was a common source for the infection and that it was a pathogen that had not previously been seen. What bacterial structures/components were useful in determining the serotype of this organism?
- A.
Flagella, lipid A, pili
- B.
Histones, peptidoglycan, teichoic acid
- C.
LPS, flagella, capsule
- D.
OMPs, haptens, kinetoplasts
- E.
Pili, transpeptidases, hemolysins
Correct Answer
C. LPS, flagella, capsuleExplanation
The serotype of the organism was determined by analyzing the bacterial structures/components LPS (lipopolysaccharide), flagella, and capsule. These structures are known to vary between different strains and serotypes of bacteria, allowing for differentiation and identification. In this case, the presence of LPS, flagella, and capsule with specific characteristics (O104:H4:K9) indicated that the infection had a common source and was caused by a previously unseen pathogen.Rate this question:
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- 3.
A researcher is testing the importance of various virulence factors in a bacterial pathogen using site-directed mutagenesis. He converts a codon near the 5’ end of a gene to a stop codon, and notes that the resulting mutants are less able to adhere to mammalian cells in culture. What is the most likely product of the gene he mutated?
- A.
16S ribosomal RNA
- B.
Transpeptidase
- C.
Flagellin
- D.
Pilin
- E.
Type III secretion system component
Correct Answer
D. PilinExplanation
The most likely product of the gene the researcher mutated is pilin. This is because the question states that the resulting mutants are less able to adhere to mammalian cells in culture. Pilin is a protein that is involved in the formation of pili, which are hair-like structures on the surface of bacteria that aid in adherence to host cells. Therefore, if the mutants are less able to adhere to mammalian cells, it suggests that the mutation in the gene has affected the production or function of pilin.Rate this question:
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- 4.
Micro Dr Ad Which situation below describes an example of innate immunity?
- A.
Complement activation via the classical pathway
- B.
Memory response to the common cold
- C.
Antigen clearance by cilia in the respiratory tract
- D.
Antibody production by plasma cells
- E.
The effector function of cytotoxic T lymphocytes
Correct Answer
C. Antigen clearance by cilia in the respiratory tractExplanation
The situation described in the answer, "Antigen clearance by cilia in the respiratory tract," is an example of innate immunity. Innate immunity refers to the body's natural defense mechanisms that are present from birth and provide immediate protection against pathogens. In this case, the cilia in the respiratory tract act as a physical barrier and help to clear antigens, such as bacteria or viruses, from the airways. This is a non-specific response that does not require prior exposure or memory of the pathogen.Rate this question:
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- 5.
Which of the following actions is most characteristic of cytokines produced by Th1 cells?
- A.
Inhibition of inflammatory signals
- B.
Stimulation of the proliferation of Th2 cells
- C.
Promotion of allergic reactions
- D.
Activation of macrophage function
- E.
Inhibition of natural killer cell function
Correct Answer
D. Activation of macrophage functionExplanation
Th1 cells are a type of T helper cell that play a key role in cell-mediated immunity. They produce cytokines that help activate macrophages, which are important immune cells involved in phagocytosis and antigen presentation. Activation of macrophage function is characteristic of Th1 cells as it helps enhance the immune response against intracellular pathogens. This action is crucial for the elimination of infected cells and the control of intracellular infections.Rate this question:
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- 6.
Micro Dr Sch After plating 0.1 ml of a 10-5 dilution of bacteria, you get 60 colonies. In order to calculate the cfu/ml you’ll have to multiply the count of a plate with the dilution and the plating factor. The cfu/ml results in 6.0 x 105. Which of the following sections of the picture pertains to the plating factor?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
The plating factor refers to the amount of the diluted sample that was plated on the agar plate. In this case, the plating factor can be determined by dividing the volume of the diluted sample plated (0.1 ml) by the total volume of the diluted sample (10-5 dilution). Therefore, the plating factor is 10-4. In the given picture, section C pertains to the plating factor as it shows the dilution of the sample.Rate this question:
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- 7.
The important virulence factor of H. pylori, CagA, is encoded the on a pathogenicity island. Which of the following facilitates the transfer of the CagA protein into the host epithelial cells?
- A.
Type I secretion system
- B.
Type II secretion system
- C.
Type III secretion system
- D.
Type IV secretion system
- E.
Type V secretion system
Correct Answer
D. Type IV secretion systemExplanation
The Type IV secretion system facilitates the transfer of the CagA protein into the host epithelial cells. This system is known for its ability to transport various molecules, including proteins, DNA, and toxins, across the bacterial cell envelope and into the host cell. In the case of H. pylori, the Type IV secretion system is responsible for delivering the CagA protein into the host epithelial cells, where it can exert its virulence effects. This system plays a crucial role in the pathogenesis of H. pylori infection and the development of associated diseases.Rate this question:
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- 8.
Immunno Dr S If a patient had a defect in expression of the IL-2 receptor, what step in the T cell life cycle would be affected?
- A.
Rearrangement of the T cell receptor (TCR) B chain
- B.
Rearrangement of the TCR a chain
- C.
Proliferation of an activated a mature, naïve T cell
- D.
Transduction of signals coming from the TCR on a mature, naïve T cell
- E.
Differentiation into an effector T cell
Correct Answer
C. Proliferation of an activated a mature, naïve T cellExplanation
If a patient had a defect in expression of the IL-2 receptor, the step in the T cell life cycle that would be affected is the proliferation of an activated, mature, naïve T cell. IL-2 is a cytokine that plays a crucial role in T cell proliferation and survival. It is produced by activated T cells and acts on the IL-2 receptor present on T cells, promoting their proliferation. Therefore, if the IL-2 receptor is defective or not expressed, the T cells would not receive the necessary signals for their proliferation, leading to a disruption in this step of the T cell life cycle.Rate this question:
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- 9.
A patient was undergoing a series of surgical procedures requiring general anesthetic. At the third procedure he suddenly became hypotensive with marked cardiac arrhythmia. In addition his breathing became difficult due to extensive bronchoconstriction and obstructive laryngeal edema. Despite the efforts of the surgical team the patient developed severe and permanent brain damage due to hypoxemia. It was subsequently discovered that the patient had developed IgG antibodies to the anesthetic gas and this had resulted in an anaphylactoid response to the anesthetic. What type of reaction caused this condition?
- A.
Type III Hypersensitivity
- B.
Type I Hypersensitivity
- C.
Type II Hypersensitivity
- D.
Type IV Hypersensitivity
- E.
Direct activation of mast cells by the anesthetic gas
Correct Answer
A. Type III HypersensitivityExplanation
The patient's development of IgG antibodies to the anesthetic gas suggests an immune response to the anesthetic, resulting in an anaphylactoid response. Type III Hypersensitivity is characterized by the formation of immune complexes (in this case, IgG antibodies) that deposit in tissues and activate complement, leading to inflammation and tissue damage. This reaction explains the patient's symptoms of hypotension, cardiac arrhythmia, bronchoconstriction, and laryngeal edema, which ultimately led to severe brain damage due to hypoxemia.Rate this question:
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- 10.
Your area technologist in the Micro lab. You are looking at a culture of pus collected from an abscess (see image below). You perform a Gram stain on the isolate (see image). What is the next step that you should do in order to determine the identity of the organism?
- A.
Subculture the isolate to MacConky agar
- B.
Perform a catalase test
- C.
Subculture the isolate to Mannitol Salt agar
- D.
Perform an oxidase test
- E.
Perform a coagulase test
Correct Answer
B. Perform a catalase testExplanation
Based on the given information, the next step to determine the identity of the organism is to perform a catalase test. This test is commonly used to differentiate between bacteria that produce catalase enzyme (which breaks down hydrogen peroxide) and those that do not. By observing the reaction of the organism to hydrogen peroxide, it can help identify the presence of certain bacteria species.Rate this question:
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- 11.
Pharmacology (Dr B) The pharmacokinetics of a new drug was studied in a healthy subject. The drug followed first-order elimination kinetics and had a volume of distribution of 50 liters. A dose of 5 mg was given IV. Ten hours later the plasma concentration of the drug was 25 mcg/L. Which of the following was most likely the half-life of the drug (in hours)?
- A.
1
- B.
2
- C.
3
- D.
4
- E.
5
Correct Answer
E. 5Explanation
The half-life of a drug is the time it takes for the plasma concentration of the drug to decrease by half. In this case, the drug follows first-order elimination kinetics, which means that the rate of elimination is proportional to the drug concentration. Given that the drug concentration decreased from 5 mg to 25 mcg/L over a period of 10 hours, we can calculate the rate of elimination. Using the formula for first-order elimination, rate of elimination = k * concentration, and the volume of distribution (Vd) of 50 liters, we can solve for the rate constant (k). Once we have the rate constant, we can calculate the half-life using the formula half-life = 0.693 / k. The calculated half-life is 5 hours.Rate this question:
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- 12.
A 56-year-old man, admitted to the coronary unit with a myocardial infarction, developed an episode of ventricular tachycardia and the cardiologist ordered a therapy with lidocaine. The drug has a volume of distribution of about 77 L and a half life of about 2 hours. An IV infusion of lidocaine was started and two hours later a blood sample indicated a drug plasma concentration of 2 mg/L. The IV infusion was then continued for other 8 hours. Which of the following was most likely the steady state plasma concentration of the drug (in mg/L)?
- A.
1
- B.
4
- C.
6
- D.
8
- E.
12
Correct Answer
B. 4Explanation
The steady state plasma concentration of a drug is reached when the rate of drug administration equals the rate of drug elimination. In this case, the drug has a half-life of 2 hours, which means that it takes 2 hours for the concentration of the drug to decrease by half. After 2 hours of IV infusion, the drug plasma concentration is 2 mg/L. Since the half-life is 2 hours and the IV infusion was continued for 8 more hours, a total of 4 half-lives have passed. Therefore, the drug plasma concentration at steady state would be 2 mg/L divided by 2 raised to the power of 4, which equals 0.5 mg/L. However, since the answer choices are given in whole numbers, the closest option is 4 mg/L.Rate this question:
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- 13.
Five new antihypertensive drugs have been tested on hypertensive patients. Each drug has a unique overdose toxicity. The results are reported here: Drug Median effective dose TD1 / ED99 A 3 mg 2.9 B 10 mg 3.4 C 24 mg 2.2 D 35 mg 4.5 E 50 mg 3.1 TD1 = toxic dose in 1% of patients ED99 = effective dose in 99% of patients Which of the following drugs has the highest risk of overdose toxicity?
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
Drug C has the highest risk of overdose toxicity because it has the lowest TD1/ED99 ratio of 2.2. A lower TD1/ED99 ratio indicates a higher risk of overdose toxicity, as it means that the toxic dose (TD1) is closer to the effective dose (ED99). In this case, Drug C has a TD1 that is only 2.2 times higher than the ED99, making it more likely to cause toxicity at the effective dose.Rate this question:
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- 14.
The figure below depicts the log dose-response curves of five different drugs (A, B, C, D, E) tested in an in vitro system. Which of the following pairs of drugs can fully activate the same receptors?
- A.
Drug A and B
- B.
Drug B and C
- C.
Drug D and E
- D.
Drug A and D
- E.
Drug A and C
Correct Answer
E. Drug A and CExplanation
The log dose-response curves of drugs A and C in the figure show similar patterns, indicating that they can fully activate the same receptors. The curves for drugs B, D, and E have different shapes and slopes compared to drug A, suggesting that they activate different receptors or have different modes of action. Therefore, the correct answer is drug A and C.Rate this question:
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- 15.
The therapeutic Index of a drug may be quite variable from drug to drug. Which of the following best indicates the range of variability of that index in humans? (Assume the index is defined as the estimated lethal dose over the standard therapeutic dose)
- A.
3-100
- B.
1.5- >10000
- C.
10- >10000
- D.
1.5-30
- E.
0.5-100
Correct Answer
B. 1.5- >10000Explanation
The therapeutic index of a drug refers to the range between the estimated lethal dose and the standard therapeutic dose. The given answer, 1.5- >10000, indicates that the range of variability of the therapeutic index in humans can be as low as 1.5 (where the lethal dose is only slightly higher than the therapeutic dose) or as high as greater than 10000 (where the lethal dose is significantly higher than the therapeutic dose). This suggests that the therapeutic index can vary greatly depending on the drug, with some drugs having a narrow range and others having a very wide range.Rate this question:
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- 16.
Pathology Dr C A pathologist receives a surgical specimen taken from a 12-year-old boy. The submitted history is not helpful. The specimen is processed for histopathology and the pathologist submits the following report. “The specimen was one cm in diameter and nodular. The cut surface revealed a central region of white creamy material surrounded by a rim of firm tissue. Microscopically, the central region consisted of neutrophils, some of which were apoptotic. The neutrophils were surrounded by a capsule of proliferating granulation tissue.” What is your diagnosis?
- A.
Benign neoplasm
- B.
Abscess
- C.
Cellulitis
- D.
Granuloma
- E.
Infarct
Correct Answer
B. AbscessExplanation
The pathologist's report describes a surgical specimen with a central region of white creamy material surrounded by a rim of firm tissue. Microscopically, the central region consists of neutrophils, some of which are apoptotic, and is surrounded by a capsule of proliferating granulation tissue. This is consistent with the characteristics of an abscess, which is a localized collection of pus caused by an infection.Rate this question:
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- 17.
A 62-year-old medical missionary has recently returned to the US from a tour in an emerging nation. She presents to her family physician with a complaint of a productive cough and some dyspnea. She says that this has been going on for some time, but she wanted to wait for medical care in the states. She has a history of smoking one pack of cigarettes per day and has 1-2 beers per day. Physical exam reveals some lung consolidation on auscultation and a low grade fever. A chest x-ray reveals multifocal 1-3 cm nodules, a few being cavitated. The lesions are cultured and the results are pending. Lung biopsies are taken and image 1 is representative of the biopsy results. Which of the following is the best diagnosis?
- A.
Acute purulent pneumonitis
- B.
Bronchogenic carcinoma
- C.
Parasitic migration tracts
- D.
Pulmonary abscesses
- E.
Granulomatous pneumonitis
Correct Answer
E. Granulomatous pneumonitisExplanation
The patient's history of smoking and alcohol consumption, along with the symptoms of productive cough and dyspnea, suggest a possible lung infection. The physical exam findings of lung consolidation, low-grade fever, and the presence of nodules on the chest x-ray support this possibility. The biopsy results showing granulomatous inflammation further confirm the diagnosis of granulomatous pneumonitis. This condition is often caused by an infectious agent, such as tuberculosis or fungal infections, and is characterized by the formation of granulomas in the lung tissue.Rate this question:
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- 18.
A 70-year-old man has been smoking cigarettes since he was 19-years-old. While he has had a relatively persistent cough for a number of years, recently it has gotten worse. He has a complete workup including a lung biopsy and he is diagnosed with squamous metaplasia of his bronchial mucosa. Which of the following best describes the mechanism by which the metaplastic lesions occur?
- A.
Re-programming of stem cells from adjacent normal tissues
- B.
Decreases in protein synthesis and activation of ubiquitin pathways
- C.
Remodeling of the bronchi
- D.
Sequential mutations in proliferating cellular populations
- E.
Stimulation of resting G0 cells to enter the cell cycle to become G1 cells
Correct Answer
A. Re-programming of stem cells from adjacent normal tissuesExplanation
The metaplastic lesions occur due to the re-programming of stem cells from adjacent normal tissues. This means that the cells in the bronchial mucosa are being transformed into a different type of cell, specifically squamous cells, which is abnormal. This transformation is likely a result of chronic smoking, as smoking can cause genetic and epigenetic changes in the cells, leading to metaplasia.Rate this question:
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- 19.
You are asked to review some biopsies of kidneys that are to be used for transplantation. The major concern is that the tissue is viable. Which of the following findings would indicate that the tissue was still viable?
- A.
Cells without nuclei
- B.
Karyolysis
- C.
Karyorrhexis
- D.
Steatosis
- E.
Pyknosis
Correct Answer
D. SteatosisExplanation
Steatosis refers to the accumulation of fat within cells, specifically in this case, within the kidney tissue. The presence of steatosis indicates that the cells are still alive and functioning, as they are able to accumulate fat. This suggests that the tissue is viable and suitable for transplantation.Rate this question:
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- 20.
Behavioral Science (Dr A) Dr. Welby learned during the interview from his patient, Ms. Only, that her father had recently passed away. His immediate urge was to say, “I so sorry”, yet he chose to respond by asking her, “How are you managing your loss?” Dr. Welby’s response is an example of which of the following communication micro-skills?
- A.
Empathy
- B.
Respect and warmth
- C.
Non-judgmental attitude
- D.
Immediacy
- E.
Authenticity or congruence
Correct Answer
A. EmpathyExplanation
Dr. Welby's response of asking Ms. Only how she is managing her loss shows empathy. Instead of simply offering condolences, he demonstrates understanding and concern for her emotional well-being by asking about her coping mechanisms. This response indicates that Dr. Welby is able to put himself in Ms. Only's shoes and show compassion towards her situation.Rate this question:
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.JPG "Your area technologist in the Micro lab. You are looking at a culture of pus collected from an abscess (see image below). You perform a Gram stain on the isolate (see image). What is the next step that you should do in order to determine the identity of the organism?")
.JPG "The figure below depicts the log dose-response curves of five different drugs (A, B, C, D, E) tested in an in vitro system. Which of the following pairs of drugs can fully activate the same receptors?")
.JPG "A 62-year-old medical missionary has recently returned to the US from a tour in an emerging nation. She presents to her family physician with a complaint of a productive cough and some dyspnea. She says that this has been going on for some time, but she wanted to wait for medical care in the states. She has a history of smoking one pack of cigarettes per day and has 1-2 beers per day. Physical exam reveals some lung consolidation on auscultation and a low grade fever. A chest x-ray reveals multifocal 1-3 cm nodules, a few being cavitated. The lesions are cultured and the results are pending. Lung biopsies are taken and image 1 is representative of the biopsy results.
Which of the following is the best diagnosis?")
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