Immunology Practice Test For Exam 2
Formative assessment with the intent of checking and reinforcing information for Immunology exam 2.
Facts not fully checked, learn at your own risk.
Also Questions 5 and 8 may or may not register correctly for all participants. There should be four answers for each, if it seems wrong check your notes. I'm not sure why it fails for certain people.
Questions and Answers
- 1.
Which of the following have live attenuated vaccines?
- A.
Hepatitis A
- B.
Hepatitis B
- C.
Hepatitis C
- D.
Varicella
- E.
Typhoid
- F.
Tetanus
- G.
Rotavirus
- H.
Influenza
- I.
Poliomyelitis
- J.
Rabies
- K.
Yellow Fever
- L.
Anthrax
- M.
Zoster
Correct Answer(s)
D. Varicella
E. Typhoid
G. Rotavirus
H. Influenza
K. Yellow Fever
M. ZosterExplanation
Live attenuated vaccines contain weakened forms of the virus or bacteria that cause the disease they are designed to protect against. These vaccines stimulate a strong immune response and provide long-lasting immunity. Varicella (chickenpox), Typhoid, Rotavirus, Influenza, Yellow Fever, and Zoster (shingles) are all examples of live attenuated vaccines. Hepatitis A, Hepatitis B, Hepatitis C, Tetanus, Poliomyelitis, Rabies, and Anthrax do not have live attenuated vaccines available.Rate this question:
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- 2.
Tetanus toxoid vaccines provide immunity to the organism for 10 years, after which a "booster" must be administered.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Toxoid vaccinations do not provide immunity to the organism, just to the toxins that organism uses to cause disease.Rate this question:
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- 3.
Little Suzie needs her MMR and Varicella vaccines. When can we administer them to her?
- A.
Both at the same time in different injection sites.
- B.
Both at the same time regardless of injection site.
- C.
One now and the other in 14 days, order doesn't matter.
- D.
One now and the other in 28 days, order doesn't mater.
- E.
A and C
- F.
A and D
- G.
B and C
- H.
B and D
Correct Answer
F. A and DExplanation
If you do not administer live vaccines at the same time, you must wait 28 days to allow the immune system's response to die down before administering another live vaccine.Rate this question:
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- 4.
A patient gets a vaccine now and is recommended to come back for a booster in several months. This is a quality of:
- A.
Live vaccines
- B.
Inactivated vaccines
- C.
Both Live and Inactivated vaccines
Correct Answer
B. Inactivated vaccinesExplanation
The first dose of a live vaccine is generally enough to provide protection while inactivated vaccines require multiple doses.Rate this question:
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- 5.
Large donor pools of IVIG provide:
- A.
Increased diversity
- B.
Decreased diversity
- C.
Increased batch variation
- D.
Rare Ig
- E.
Increased testing costs
- F.
Decreased testing costs
- G.
Increased infection risk
- H.
Decreased infection risk
Correct Answer(s)
A. Increased diversity
D. Rare Ig
E. Increased testing costs
G. Increased infection riskExplanation
Large donor pools of IVIG provide increased diversity, meaning that there is a wider range of antibodies present in the product. This can be beneficial as it increases the likelihood of finding the specific antibodies needed to treat various diseases or conditions. Additionally, large donor pools may also provide rare Ig (immunoglobulins), which are antibodies that are present in very low quantities in the general population. This can be particularly helpful for patients with rare or specific antibody deficiencies. However, having a larger donor pool can also result in increased testing costs and increased infection risk, as more donors need to be screened and tested for potential infections.Rate this question:
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- 6.
Renal disfunction from IVIG administration is related to:
- A.
The content of IgA present that attacks the kidney directly
- B.
The high sodium content that causes the kidneys to overwork from retention
- C.
Glucose content
- D.
Sucrose content
- E.
The large volume of the IV
- F.
All of these factors contribute to renal disfunction
Correct Answer
D. Sucrose contentExplanation
Sucrose content in IVIG administration can contribute to renal dysfunction. Sucrose is a type of sugar that can increase osmotic load on the kidneys, leading to increased fluid retention and potential damage to the renal system. This can result in impaired kidney function and renal dysfunction. Therefore, the sucrose content in IVIG can be a contributing factor to renal dysfunction.Rate this question:
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- 7.
It is ok to give a patient on IVIG a tetanus shot during the same trip to the clinic.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Tetanus is not a live vaccine and is thereby not affected by the administration of IVIG.Rate this question:
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- 8.
Small donor pools of IVIG provide:
- A.
Increased diversity
- B.
Decreased diversity
- C.
Increased batch variation
- D.
Rare Ig
- E.
Increased testing costs
- F.
Decreased testing costs
- G.
Increased infection risk
- H.
Decreased infection risk
Correct Answer(s)
B. Decreased diversity
C. Increased batch variation
F. Decreased testing costs
H. Decreased infection riskExplanation
Small donor pools of IVIG provide decreased diversity because there are fewer donors contributing to the pool, leading to a smaller range of antibodies present. This can result in decreased effectiveness in treating a wide range of conditions. Additionally, small donor pools can lead to increased batch variation due to the limited number of donors available for each batch. However, small donor pools can also have benefits such as decreased testing costs and decreased infection risk, as there are fewer samples to test and fewer potential sources of contamination.Rate this question:
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- 9.
The body excretes two different main corticosteroids from the adrenal medulla: cortisol (which has glucocorticoid action) and aldosterone (which has mineralocorticoid action).
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
These are in fact the two endogenous hormones AND are linked to the right action, but they are excreted from the cortex of the adrenal glands, not the medulla. Epinephrine and Norepinephrine are excreted from there.Rate this question:
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- 10.
Steroids work by three different mechanisms: Direct genomic effects, Indirect genomic effects, and non-genomic effects. Regardless of the method, the final product is always ____________.
- A.
Hormones
- B.
Proteins
- C.
Electrolytes
- D.
Nuclear receptors
- E.
B and D
Correct Answer
B. ProteinsExplanation
All three routes eventually cause transcription in the nucleus and eventually creates proteins. Corticosteroids are said to affect the transcription of thousands of genes in the cell of the body.Rate this question:
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- 11.
One of the areas of the body that contains many corticosteroid receptors is the brain. Activation of these receptors cause:
- A.
Leukocytosis
- B.
Headaches
- C.
Narcolepsy
- D.
Psychosis
- E.
Anatidaephobia
- F.
A and D
- G.
C and E
- H.
All of the above
Correct Answer
D. PsychosisExplanation
Corticosteroids do cause demargination of WBCs but only at vascular endothelial cells, not in the brain. Also Anatidaephobia is the fear that somewhere a duck is watching you.Rate this question:
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- 12.
Overstimulation of mineralocorticoid receptors could potentially lead to:
- A.
Hypernatremia
- B.
Hyponatremia
- C.
Hyperkalemia
- D.
Hypokalemia
- E.
Hypermagnesemia
- F.
Hypomagnesemia
Correct Answer(s)
A. Hypernatremia
D. HypokalemiaExplanation
Overstimulation of mineralocorticoid receptors can lead to an increase in sodium reabsorption in the kidneys, resulting in hypernatremia. This occurs because the excessive activation of mineralocorticoid receptors causes increased retention of sodium in the body, leading to higher levels of sodium in the blood. On the other hand, hypokalemia can occur due to the excessive excretion of potassium in the kidneys caused by mineralocorticoid receptor stimulation. This happens because increased sodium reabsorption in the kidneys leads to increased potassium excretion, resulting in lower levels of potassium in the blood.Rate this question:
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- 13.
Corticosteroids modify the immune system by all of these methods EXCEPT:
- A.
Blocking plasma cell antibody production
- B.
Directly killing circulating T cells
- C.
Blocking expression of inflammatory genes
- D.
Demargination of WBCs from storage compartments
Correct Answer
A. Blocking plasma cell antibody productionExplanation
Corticosteroids modify the immune system through various methods. They can block the expression of inflammatory genes, demarginate white blood cells from storage compartments, and directly kill circulating T cells. However, they do not block plasma cell antibody production.Rate this question:
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- 14.
Which of these is the anabolic mechanistic response from glucocorticoids?
- A.
Increase lipolysis
- B.
Inhibited protein synthesis
- C.
Increased gluconeogenesis
- D.
Inhibit uptake of glucose
Correct Answer
C. Increased gluconeogenesisExplanation
Glucocorticoids are known to increase gluconeogenesis, which is the process of synthesizing glucose from non-carbohydrate sources such as amino acids and fatty acids. This response is anabolic because it promotes the production of glucose, which is essential for energy metabolism and maintaining blood glucose levels. Gluconeogenesis is stimulated by glucocorticoids as a way to provide a constant supply of glucose to the body during times of stress or fasting.Rate this question:
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- 15.
Diabetics are at substantially increased risk of adverse side effects from taking glucocorticoids because of all of the following reasons EXCEPT:
- A.
Increased gluconeogenesis can cause hyperglycemia
- B.
Mood disorders are more pronounced, leading to higher rates of depression
- C.
The downregulation of the immune response adds to the already impaired immune response seen in these patients
- D.
Impaired wound healing can compound with their already impaired ability to heal wounds
Correct Answer
B. Mood disorders are more pronounced, leading to higher rates of depressionExplanation
Diabetics are at substantially increased risk of adverse side effects from taking glucocorticoids due to increased gluconeogenesis causing hyperglycemia, the downregulation of the immune response adding to the already impaired immune response seen in these patients, and impaired wound healing compounding with their already impaired ability to heal wounds. However, mood disorders being more pronounced and leading to higher rates of depression is not a reason why diabetics are at increased risk of adverse side effects from taking glucocorticoids.Rate this question:
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- 16.
Hi there! I love sodium but I hate potassium. I work real hard with my boys in the renin-angiotensin system but I don't occur naturally in the body. I could have a small effect elsewhere but I really just hang out at the kidneys. My name is:
- A.
Dexamethasone
- B.
Fludrocortisone
- C.
Hydrocortisone
- D.
Methylprednisolone
Correct Answer
B. FludrocortisoneExplanation
Fludrocortisone is the correct answer because it is a synthetic corticosteroid that primarily acts on the kidneys. It is used to treat conditions such as Addison's disease, where the body does not naturally produce enough of the hormone aldosterone. Fludrocortisone helps regulate sodium and potassium levels in the body by increasing sodium reabsorption and promoting potassium excretion in the kidneys. This medication does not occur naturally in the body and has a specific effect on the renin-angiotensin system.Rate this question:
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- 17.
I'm another unnatural corticosteriod, but I wouldn't do any of that wussy stuff the last guy did. I'm all about going in there and stopping those prostaglandins cold (the jerks). Sometimes I get a little out of control when I don't have hotheads to knock out and use the stomach as my punching bag. My name is:
- A.
Dexamethasone
- B.
Fludrocortisone
- C.
Hydrocortisone
- D.
Methylprednisolone
Correct Answer
A. DexamethasoneExplanation
Dexamethasone is the correct answer because it is a corticosteroid that is known for its potent anti-inflammatory effects. It works by inhibiting the production of prostaglandins, which are responsible for inflammation and pain. The statement in the question suggests that this corticosteroid is more aggressive and effective in stopping prostaglandins compared to other options.Rate this question:
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- 18.
Guess what? I'm another unnatural corticosteroid, but I'm not nearly as polarized as my two previous brothers. I tend to do all of the jobs equally and try to just blend in with the natural steroids. This jack of all trades is named:
- A.
Methylprednisolone
- B.
Prednisone
- C.
Hydrocortisone
- D.
Dexamethasone
Correct Answer
C. HydrocortisoneExplanation
Hydrocortisone is the correct answer because it is described as a corticosteroid that does all of the jobs equally and blends in with the natural steroids. This suggests that hydrocortisone has a balanced and versatile effect compared to the other options. Methylprednisolone, prednisone, and dexamethasone are not as suitable because they are either more polarized or have specific roles that do not align with the description given.Rate this question:
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- 19.
Sudden withdrawal of supratherapeutic corticosteroids can cause iatrogenic adrenal insufficiency. A symptom of this is:
- A.
Hypertension
- B.
Weight gain
- C.
Increased stress
- D.
Headaches
Correct Answer
C. Increased stressExplanation
Sudden withdrawal of supratherapeutic corticosteroids can cause iatrogenic adrenal insufficiency. This means that the adrenal glands are not able to produce enough cortisol, which is the hormone that helps the body respond to stress. As a result, increased stress can be a symptom of adrenal insufficiency.Rate this question:
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- 20.
Corticosteroids are used most frequently for their anti-inflammatory effect.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Corticosteroids are commonly used for their anti-inflammatory effect. These medications work by reducing inflammation in the body, which can help alleviate symptoms in a variety of conditions such as asthma, allergies, arthritis, and skin conditions. By suppressing the immune system and reducing inflammation, corticosteroids can provide relief and improve overall health. Therefore, it is true that corticosteroids are primarily used for their anti-inflammatory effect.Rate this question:
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- 21.
A type IV hypersensativity reaction could activate any of the following cells EXCEPT:
- A.
Macrophages
- B.
Dendritic cells
- C.
Eosinophils
- D.
Neutrophils
Correct Answer
B. Dendritic cellsExplanation
Type IV hypersensitivity reactions are mediated by T cells, specifically by CD4+ T cells. These T cells recognize antigens presented by antigen-presenting cells (APCs), such as macrophages and dendritic cells. Upon activation, T cells release cytokines that recruit and activate other immune cells, leading to inflammation and tissue damage. Eosinophils are not typically involved in type IV hypersensitivity reactions, as they are more commonly associated with type I hypersensitivity reactions. Neutrophils can also be activated in type IV hypersensitivity reactions, but dendritic cells are the primary APCs involved in presenting antigens to T cells. Therefore, dendritic cells are not activated in type IV hypersensitivity reactions.Rate this question:
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- 22.
Penicillin allergies are typically considered a type II or III hypersensativity reaction. Given a patient who presents with such a reaction but absolutely must take penacillin for a specific infection, you can administer a desensitization regimen to lessen the hypersensativity reaction.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Only type I reactions can respond from a desensitization regimen since it requires the crosslinkage of IgE antibodies.Rate this question:
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- 23.
The ultimate desired activity of calcineurin inhibitors is to block:
- A.
IL-1
- B.
IL-2
- C.
IL-3
- D.
IFN-gamma
Correct Answer
B. IL-2Explanation
Calcineurin inhibitors, such as cyclosporine and tacrolimus, are immunosuppressive drugs commonly used in organ transplantation. These inhibitors work by blocking the production of IL-2, a cytokine that plays a critical role in the activation and proliferation of T cells. By inhibiting IL-2, calcineurin inhibitors suppress the immune response, preventing the rejection of transplanted organs. Blocking IL-1, IL-3, or IFN-gamma is not the primary mechanism of action for calcineurin inhibitors.Rate this question:
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- 24.
Gengraf was created from sandimmune in order to:
- A.
Increase the bioavailability
- B.
Stabilize the bioavailability
- C.
Decrease the bioavailability
- D.
Increase dependance on bile
- E.
Stabilize dependance on bile
- F.
Decrease dependance on bile
- G.
A and D
- H.
A and E
- I.
A and F
- J.
B and D
- K.
B and E
- L.
B and F
- M.
C and D
- N.
C and E
- O.
C and F
Correct Answer
L. B and FExplanation
Gengraf was created from sandimmune to stabilize the bioavailability and decrease dependence on bile.Rate this question:
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- 25.
A common side effect of cyclosporine is nephrotoxicity that manifests in the form of electrolyte imbalances.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Cyclosporine is known to have nephrotoxic effects, meaning it can damage the kidneys. One of the ways this damage can manifest is through electrolyte imbalances. This means that taking cyclosporine can disrupt the normal levels of electrolytes in the body, such as sodium, potassium, and calcium. This can lead to various symptoms and complications related to kidney function. Therefore, the statement that a common side effect of cyclosporine is nephrotoxicity that manifests in the form of electrolyte imbalances is true.Rate this question:
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- 26.
Cyclosporine is a drug with a narrow therapeutic window and as such we always take frequent trough or peak concentrations.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Cyclosporine is a medication that has a narrow therapeutic window, meaning that the difference between a safe and effective dose and a toxic dose is very small. Therefore, it is important to closely monitor the concentration of the drug in the blood. Trough concentrations refer to the lowest concentration of the drug in the blood, usually taken just before the next dose is administered. Peak concentrations, on the other hand, refer to the highest concentration of the drug in the blood, usually taken shortly after the dose is given. By monitoring these concentrations, healthcare providers can ensure that the drug is being dosed correctly and adjust the dosage if necessary to maintain therapeutic levels.Rate this question:
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- 27.
A transplant patient is taking cyclosporine and admits that he just started taking St. John's Wort OTC. You would expect the cyclosporine levels to:
- A.
Increase
- B.
Decrease
- C.
Not change
Correct Answer
B. DecreaseExplanation
Cyclosporine is a medication used to suppress the immune system in transplant patients. St. John's Wort is an herbal supplement that can induce certain enzymes in the liver, leading to increased metabolism and decreased levels of other drugs. Since St. John's Wort can enhance the metabolism of cyclosporine, it is expected that the levels of cyclosporine would decrease in the presence of St. John's Wort.Rate this question:
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- 28.
A transplant patient is taking cyclosporine and has just been given fluconazole for a fungal infection. You would expect the cyclosporine levels to:
- A.
Increase
- B.
Decrease
- C.
Not change
Correct Answer
A. IncreaseExplanation
When a transplant patient is taking cyclosporine, it is important to note that cyclosporine is metabolized by the liver using a specific enzyme. Fluconazole, on the other hand, is known to inhibit this enzyme, thereby reducing its activity. As a result, the metabolism of cyclosporine is slowed down, leading to an increase in its levels in the body. Hence, when a transplant patient is given fluconazole for a fungal infection, the levels of cyclosporine are expected to increase.Rate this question:
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- 29.
Cyclosporine, being an older drug, has more nephrotoxitiy and more neurotoxicity than tacrolimus.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Cyclosporine and tacrolimus are both immunosuppressive drugs used in organ transplantation. While both drugs have potential side effects, it is not accurate to say that cyclosporine has more nephrotoxicity and neurotoxicity than tacrolimus. In fact, studies have shown that tacrolimus may have a higher risk of nephrotoxicity compared to cyclosporine. Therefore, the statement is false.Rate this question:
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