Host Defense Practice Exam 2

What type of hypersensitivity disease is Goodpasture's Syndrome?

• Type I

• Type II

• Type III

• Type IV

Which complement component and biological activity are incorrectly paired?

• C9; membrane pore formation

• C3b; pathogen opsonization

• C3a; anaphylatoxin

• C4a; binding to erythrocyte for IC removal

• C5a; chemoattractant for leukocyte recruitment

Under the hyper-hygiene hypothesis, which of the following factors contributes to allergic hypersensitivity?

• Increase in the number of childhood illnesses

• Later exposure to acute childhood infections

• Large families and/or early day care

• Too much early exposure to environmental and infectious antigens

• Over-production of T-regulator cells

All of the following are examples of Host-versus-graft disease except

• Hyperacute rejection

• Bone marrow transplant

• Acute rejection

• Chronic rejection

• Xenotransplant rejection

Which of the following statements is true:

• Serum sickness is an example of a systemic, rather than local, immune response

• Persons with chronic infections usually have monoclonal hypergammaglobulinemia

• Glomerular nephritis, thyroiditis, and juvenile rheumatoid arthritis result from Type I hypersensitivity responses

• Platelets, but not fibrin, are found where an IC binds to FcgR on vascular endothelium

• None of the above

Which of the following would directly regulate formation of the membrane attack complex?

• Factor H

• Factor I & CD 46

• CD 55

• CD 59

• C1 INH

Which of the following statements is true:

• UVA light is especially influential in stimulating antigen presentation by dendritic cells of the skin

• Postmenopausal women have a higher likelihood of developing autoimmune disorders due to their decreased estrogen levels

• Patients with systemic immune complex disorders like SLE (systemic lupus erythomatus) often present with skin rashes, glomerular nephritis and joint pain

• SLE is an example of Type II hypersensitivity

• None of the above

Tregs regulate in all of the following ways except...

• Competition

• Inhibition via DCs

• Secreting TGF-B

• T-cell inhibition

• Secreting INF-g

Which of the following is an antigen-transporting cell?

• Follicular Dendritic Cell

• Langerhans Cell

• Kupffer Cell

• M Cell

• B Cell

A deficiency of complement component C1 would cause increased susceptibility to:

• Immune complex disease

• Bacterial infections, particularly in childhood

• Infection by pyogenic bacteria and Neisseria spp.

• Infection by Neisseria spp. only

• Infection by pyogenic bacteria only

In order to combat diptheria toxin (extracellular toxin), you would do all of the following except...

• Stimulate a Th2 response

• Stimulate a Th1 response

• Use the appropriate cytokines

• Use IV anti-toxin IgG

• Use an antigen that mimics the toxin

Which of the following properties is NOT shared by basophils and mast cells?

• Both constitutively express high affinity Fce receptors

• Both have cytoplasmic stores of vasoactive mediators

• Both develop from hematopoietic precursors

• Both reside in tissue sites

• Both have cytoplasmic granules

Choose the answer that best describes the role of an adjuvant in providing immunization.

• An adjuvant is a peptide that is given to induce immunity to another peptide.

• An adjuvant is a peptide that is hooked onto a polysaccharide antigen to help induce a T-dependent response to gain memory cells.

• An adjuvant is a peptide that is hooked onto a polysaccharide antigen to help induce a NK-cell response to get rid of the antigen.

• An adjuvant is a polysaccharide that is hooked onto a peptide antigen to help induce a T-dependent response to gain memory cells.

• An adjuvant is a polysaccharide that is hooked onto a peptide antigen to help induce a NK-cell response to get rid of the antigen.

What are the effects of corticosteroids in an individual experiencing an allergic response and at what point do they act in the immune response?

• Prevent anaphylaxis, early phase

• Inhibit degranulation of IgE-armed mast cells and basophils, early reaction

• Inhibit production of IL-4 and IL-13, late reaction

• Suppress the production of IgE and enhance production of IgG, late reaction

• Inhibit production of pro-inflammatory cytokines, late reaction

C3 and C5 convertases are involved in which pathway(s)?

• Classical pathway only

• MB-Lectin pathway only

• Alternative pathway only

• Both classical and MB-Lectin pathways

• Classical, MB-Lectin and alternative pathways

Onset of symptoms associated with X-linked Agammaglobulinemia develop later in infancy than problems associated with SCID.  For X-linked Agammaglobulinemia, this is in part due to the mother's maternal Ab conferring immunity for 6-9 months post-partum.  Why doesn't the maternal antibody help the SCID patients as much and why is the IgG pooled antibody administration not the preferred treatment choice for SCID patients?

• Maternal antibody is inactivated in children with SCID; antibody administration is too risky

• SCID involves a defect with both B & T cells; administering pooled antibodies does not solve the T-cell defect

• SCID involves a defect with only T cells; administering pooled antibodies does not solve T-cell related defects

• SCID patients have B-cells that are functional but they do not develop; administering pooled antibodies does not stimulate these faulty B-cells

• Maternal antibody does help the SCID patients and IgG pooled antibody is the preferred treatment choice

Which is Type III hypersensitivity?

• Systemic Lupus

• Allergic Rhinitis

• Goodpasture's Syndrome

• A positive TB skin test

• Grave's Disease

What is the major way the body clears excess immune complexes?

• They travel unbound in the blood to the liver.

• They are bound to CR1 receptors on vascular endothelium and cause vascular inflammation

• They travel bound to erythrocytes in the blood to the spleen

• They travel in the circulation to the liver bound to CR1 receptors on blood cells

• They are degraded at the site of inflammation

Commensal bacteria...

• Promote the colonization of pathogenic bacteria in the guyt

• Thrive with antibiotic treatment

• Inhibit regulatory T cells

• Are not involved in mucosal tolerance

• Prevent the differentiation of immature dendritic cells to mature dendritic cells

Some SCID patients cannot be treated with a bone marrow transplant because they have no sibs that match and there is no donor in the registry who is an MHC match, so they are sometimes treated with gene transfer.  What is the reason for a rare gamma-delta T-cell lymphoma found in SCID gene transfer patients?

• The point of insertion of the viral vector leads to the lymphoma

• The pathology of SCID leads to the lymphoma

• A failed bone marrow transplant leads to the lymphoma

• An uncontrolled TMMI response leads to the lymphoma

• HLA antigen incompatibility leads to the lymphoma

A patient is stung by a bee for the second time and develops urticaria, what isotype antibodies are being produce against the bee venom antigen and is this an appropriate immune response to bee venom?

• Both IgE and IgG are produced, this is an appropriate immune responses to bee venom

• Only IgE is produced, this is an appropriate response to bee venom

• Both IgE and IgG are produced, this is an inappropriate immune responses to bee venom

• Only IgG is produced, this is an inappropriate response to bee venom

• Both IgE and IgA are produced, this is an appropriate response to bee venom

When an antigen is consumed orally, the key feature that distinguishes the induction of a response and the induction of tolerance is...

• Desensitization

• Commensal bacterial development

• Dendritic cell inactivation

• Inflammation

• Mucosal epithelium leakiness

Which of the following is not a symptom of selective IgA deficiency?

• A family history of IgA deficiency of aggamaglobulinemia

• A high incidence of oral infections

• Frequency of respiratory infections

• Chronic diarrhea

• Subcutaneous mycoses in adulthood

The genetic defect allowing infants to have BCG (intracellular pathogen) is most likely the result of:

• IL-12

• IL-10

• IL-17

• TGF-B

• IL-4

Which of the following is an absolute requirement for an allergic reaction to occur?

• IgG isotype switch

• Armed basophils

• IL-5 and eosinophils

• Sensitization event

• Low exposure to infectious agents as a child

Which of the following is not characteristic of a Superantigen?

• A superantigen does not bind to the conventional antigen binding site on MHC class II molecules

• Superantigens are found in an unprocessed form between an MHC Class II and TCR

• Superantigens can be responsible for septic shock and toxic shock syndrome via release of INF-gamma and massive release of TNF-alpha

• A bacterial superantigen binds to the Beta chain on MHC class II molecule and the Alpha chain on the TCR

• Superantigens can activate up to 20% of available CD4 cells

Which of the following distinguishes an Arthus reaction from a normal inflammatory response?

• Erythrocytes are needed to take excess IC to the liver for disposal

• Activated neutrophils release IL-8

• Preexisting antibodies complex with antigen

• Antigen-antibody complexes interact with both FcR and CR1 on neutrophils

• Painful inflammation results

In regards to the immune system failing during response to a tumor antigen, choose the correct event that takes place during this malfunction of the immune system.

• NK cells not only kill tumor cells, but normally dividing cells as well.

• B-cells lack the ability to differentiate to plasma cells and subsequently cannot make antibodies due to blockage of cytokine receptor by tumor cells.

• Chemokines secreted by the tumor induce a Th0 cell to become a Treg cell, which provides protection for the tumor.

• MHC-I or MHC-II is not able to present tumor peptide as foreign and therefore does not induce an immune response.

• TLRs of the DCs do not recognize the tumor cells.

Leprosy can induce a Th1 or Th2 response depending on (??).  All of the following would be considered in a vaccine against leprosy except:

• IL-12 genes

• IL-12R genes

• IL-10 genes

• INF-g genes

• Th1 TLR activation genes

Which of the following correctly describes IgA?

• Serum IgA is primarily dimeric

• Secreted mucosal IgA is mostly monomeric

• The production of sIgA requires only the epithelial cells of the mucosa, not the plasma cell epithelium

• SIgA contains a component of pIgR that is bound covalently

• Dimeric IgA has no J chain

Which one of these cells is probably not bone-marrow derived?

• Th2 cell

• Plasma Cell

• Follicular Dendritic Cell

• Macrophage

• Eosinophil

• TH1 cells producing IFN-gamma

• TH17 cells producing IL-17

• DC cells producing IL-12

• GATA3 transcription factor

• T-Bet transcription factor

Mast cells do NOT contain:

• Histamine

• Heparin

• Thrombopoietin

• GM-CSF

• TNF-a

Which of the following would not be a good example of a strategy used by a virus to evade the immune response?

• Down-regulation of a TLR

• Interference with MHC Class I and II antigen loading

• Downregulate TGF-B in the vicinity of the pathogen

• Increase IL-10 production in vicinity of the pathogen

• Produce soluble cytokine receptors

Which of the following is NOT a characteristic of Common Variable Immunodeficiency (CVI)?

• Patient has increased number of lymphocytes and produces abnormal IgG

• Early B-cell development is normal but there is a marked reduction in terminal B-cells, plasma cells and reduced numbers of germinal centers

• On an FACS analysis, you not normal or normal high levels of B-cells

• CVI could involve inappropriate inhibition of B-cells by CD4, 25 FoxP3 cells

• Defects may reside in defective cytokine signaling or cross-talk between B and Th2 cells

Which of the following is not a reason why there is a wide disparity of symptoms experienced by a large population of humans after being infected with a virus?

• Some individuals may have too few or mutated TLRs causing them to have no response to pathogen

• Inherent polymorphism found at each level, including MHC, TLR, cytokines and DCs

• Having the "wrong" TLR causing an ineffective or pathologic response

• Having too many TLR creating a hyper-response and causing collateral damage

• None of the above

Which of the following statements is true:

• The development of swelling, redness and throbbing pain in the patient's arm 8 hours after receiving a tetanus shot for the second time in a month is an example of acute hypersensitivity

• If a patient develops Immune Complex disease, this is a definite sign that the patient has a bacterial infection

• Peroxidase or immunoflorescent labelled anti-IgG, but not anti-C3b, are reagents used to identify ICs in a tissue biopsy

• Binding of the IC to endothelial CR1 receptors results first in production of cytokines and next in attraction of neutrophils to the site of binding

• None of the above

The immediate reaction stage of an allergic reaction is characterized by

• Infiltration by eosinophils, neutrophils and mast cells

• Direct complement activation by trypase cleavage

• Release of IL-3 and 5, and GM-CSF

• Increase of FceR display

• Eosinophil production of major basic protein and leukotrienes

Which of the following disease or afflictions has NOT been thought to be controlled by the use of monoclonal antibodies?

• Rheumatoid Arthritis

• Hashimoto's disease

• Allergies

• Transplantation rejection

• B-cell antibody mediated diseases (B lymphoma)

Which of the following is incorrectly matched?

• Synapse I; location deep cortex, involves DC interacting with Th cell

• Synapse II; Ag-activated Th cell interacting with Ag-activated B cell

• Synapse III; B cell post-germinal center interacting with Th cell

• CCL 19 and CCL 21 attract B cells to Dendritic Cells

• All of the above are correct

Which of the following would be unhelpful in determining the antigen/antibody systems and antibody isotypes present in a patient's serum?

• Ouchterlony test

• Agar Gel Immunopreciptin assay

• RAST

• Skin test and serum tryptase

• None of the above

Which of the following statements is true:

• In secondary immune responses the level of IgG in a patient's serum is always greater than the level of albumin

• In SLE, the patient makes antibodies against proteins encoded in their DNA

• Spleenomegaly develops as a result of the spleen's attempt to phagocytize the increased number of antibody-antigen complexes formed during IC disease

• Serum from a patient with a chronic infection would have significantly increased levels of polyclonal IgE antibodies

• None of the above

Choose the correct choice in each set of answers in the parentheses.  How was the Rh problem solved?Maternal (APCs/B-cells) are inactivated by Rh specific (IgM/IgG) binding to (FcgRII/FcgRIII).  The associated (ITAM/ITIM) signals the cell to stop (producing antibody/presenting antigen).  This will protect the second Rh+ pregnancy.