Immunity Science Quiz
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In biological terms, immunity is the capability of organisms to defeat harmful microorganisms. In a simpler language, your body's power to defeat an incoming infection is called immunity. The study of the topic is called Immunology.
Think you know the science of immunity? Take this quiz and find out
- 1.
Which one of the following immunoglobulins can form pentameric structure
- A.
IgE
- B.
IgM
- C.
IgA
- D.
IgD
- E.
IgG
Correct Answer
A. IgEExplanation
IgM is the correct answer because it is the only immunoglobulin that can form a pentameric structure. IgM is the first antibody produced during an immune response and its pentameric structure allows for increased binding capacity and efficient neutralization of pathogens. IgE, IgA, IgD, and IgG all have different structures and functions.Rate this question:
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- 2.
Which of the following are closed methods of abscess treatment?
- A.
Absecessotomy, drainage by sewing the wound with the primary suture
- B.
Ultrasound- guided puncture and drainage
- C.
Warming compresses + puncture
- D.
CT guided drainage
- E.
Antibiotics + regular punctures
- F.
Antibiotics + drainage
Correct Answer(s)
B. Ultrasound- guided puncture and drainage
D. CT guided drainageExplanation
The correct answer is Ultrasound-guided puncture and drainage and CT guided drainage. These methods involve using imaging techniques such as ultrasound or CT scans to guide the puncture and drainage of an abscess. This ensures accurate placement of the needle and helps to avoid damaging surrounding tissues. By using these closed methods, the abscess can be effectively drained without the need for open surgery, reducing the risk of complications and promoting faster healing.Rate this question:
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- 3.
Which of the following is characteristic of anaphylaxis
- A.
Bleeding from nose is common
- B.
It typically involves multiple body systems
- C.
Spleen and lymphnodes are enlarged in almost all cases
- D.
It is rapid in onset (minutes to few hours)
- E.
Arthralgia or joint swelling is present
Correct Answer(s)
B. It typically involves multiple body systems
D. It is rapid in onset (minutes to few hours)Explanation
Anaphylaxis is a severe allergic reaction that typically involves multiple body systems. It can affect the skin, respiratory system, cardiovascular system, gastrointestinal system, and nervous system. It is characterized by a rapid onset, usually occurring within minutes to a few hours after exposure to an allergen. Symptoms may include hives, swelling, difficulty breathing, low blood pressure, vomiting, and dizziness. Bleeding from the nose is not a characteristic of anaphylaxis, and enlargement of the spleen and lymph nodes is not present in all cases. Arthralgia or joint swelling may or may not be present in anaphylaxis.Rate this question:
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- 4.
Which of the following statements about CD8 CTL is (are) incorrect?
- A.
They cannot kill infected CD4 T cells
- B.
They cause target cell apoptosis
- C.
They don't need be activated before exerting their cytotoxic function
- D.
They lyse targets by synthesizing perforin and granzymes
- E.
They interact with their target through paired cell surface molecules
- F.
Option 6
Correct Answer(s)
A. They cannot kill infected CD4 T cells
C. They don't need be activated before exerting their cytotoxic functionExplanation
CD8 CTLs are capable of killing infected CD4 T cells, so the statement "They cannot kill infected CD4 T cells" is incorrect. Additionally, CD8 CTLs do need to be activated before they can exert their cytotoxic function, so the statement "They don't need to be activated before exerting their cytotoxic function" is also incorrect.Rate this question:
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- 5.
- The following properties render a substance immunogenic, except:
- A.
Foreign to the immunized individual
- B.
Chemical complexity
- C.
Being a native molecule
- D.
Sufficient stability and persistence after infection
- E.
High molecular weight
Correct Answer(s)
A. Foreign to the immunized individual
C. Being a native moleculeExplanation
The correct answer is "Foreign to the immunized individual" and "Being a native molecule". These properties do not render a substance immunogenic. Immunogenic substances are typically foreign to the immunized individual, meaning they are not naturally found in the body. Additionally, being a native molecule, or a molecule that is already present in the body, does not typically elicit an immune response.Rate this question:
- 6.
Which statement concerning H1 antihistamines is correct?
- A.
The motor coordination involved in driving an automobile is not affected by the use of first generation H1 antihistamines
- B.
Second- generation H1 antihistamines are relatively free of adverse effects
- C.
H1 antihistamines can be used in the treatment of acute anaphylaxis
- D.
All answers are correct
- E.
Because of the established long term safety of first- generation H1 antihistamines, they are first choise for allergic rhinitis
Correct Answer
B. Second- generation H1 antihistamines are relatively free of adverse effectsExplanation
Second-generation H1 antihistamines are relatively free of adverse effects. This means that compared to first-generation H1 antihistamines, second-generation antihistamines have fewer side effects. This is an important characteristic when considering the use of antihistamines, as adverse effects can impact a person's overall well-being and quality of life.Rate this question:
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- 7.
Which organs have their impressions on visceral surface of spleen?
- A.
Left kidney
- B.
Liver
- C.
Stomach
- D.
Colon
- E.
Duodenum
- F.
Right kidney
Correct Answer(s)
A. Left kidney
C. Stomach
D. ColonExplanation
The visceral surface of the spleen has impressions from the left kidney, stomach, and colon. This means that these organs are in close proximity to the spleen and may leave indentations or markings on its surface. The liver, duodenum, and right kidney do not have their impressions on the visceral surface of the spleen.Rate this question:
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- 8.
16. What are the main cofactors of anaphylaxis?
- A.
Exercise
- B.
Emotional stress
- C.
Air pollution
- D.
Hyperlipidemia
- E.
Smoking
- F.
Option 6
Correct Answer(s)
A. Exercise
B. Emotional stressExplanation
The main cofactors of anaphylaxis are exercise and emotional stress. These factors can trigger anaphylactic reactions in individuals who are already sensitized to certain allergens. Exercise-induced anaphylaxis is a condition where physical activity leads to an allergic reaction, while emotional stress can also contribute to the severity of anaphylactic symptoms. Other factors such as air pollution, hyperlipidemia, and smoking may have an impact on overall health but are not directly linked to anaphylaxis.Rate this question:
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- 9.
18. Converting a toxin to a toxoid
- A.
Induces only humoral immunity
- B.
Increases phagocytosis
- C.
Enhances binding with antitoxin
- D.
Makes the toxin more immunogenic
- E.
Reduces the toxic activity of the toxin
Correct Answer
E. Reduces the toxic activity of the toxinExplanation
Converting a toxin to a toxoid reduces the toxic activity of the toxin. This is because a toxoid is a modified form of the toxin that has been treated to eliminate or reduce its toxicity while still retaining its ability to stimulate an immune response. By reducing the toxic activity of the toxin, the toxoid can be used as a vaccine to induce an immune response without causing harm to the individual.Rate this question:
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- 10.
The second pregnancy for a 23-year-old woman appears uncomplicated until ultrasound performed at 19 weeks shows hydrops fetalis. The fetal organ development is consistent for 19 weeks, and no congenital anomalies are noted. Her first pregnancy was uncomplicated and resulted in the birth of a normal girl at term. The current pregnancy ends with birth of a baby boy at 32 weeks gestation. On examination the baby has marked icterus. Laboratory studies show a hemoglobin of 75 g/L, and neonatal exchange transfusion is performed. Which of the following immunological mechanisms best explains this infant’s findings?
- A.
-Loss of self tolerance
- B.
- Anti-receptor antibody produced by fetus
- C.
-Immune complex formation
- D.
-Complement mediated cell destruction
- E.
- Delayed type hypersensitivity
Correct Answer
B. - Anti-receptor antibody produced by fetusExplanation
The presence of marked icterus and a low hemoglobin level suggests that the baby is experiencing hemolytic anemia. The fact that the baby required an exchange transfusion further supports this. The most likely immunological mechanism causing this is the production of anti-receptor antibodies by the fetus. These antibodies can bind to receptors on the baby's red blood cells, leading to their destruction and subsequent anemia. This condition is known as immune-mediated hemolytic disease of the newborn.Rate this question:
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- 11.
Why facial-area furuncles sometimes are called “malignant
- A.
Due to frequent relapse
- B.
May be malignant
- C.
May cause blindness due to retinal vascular thrombosis
- D.
May cause meningitis, sinus cavernous thrombosis
- E.
Scars disfigure the face
Correct Answer
D. May cause meningitis, sinus cavernous thrombosisExplanation
Facial-area furuncles are sometimes called "malignant" because they can lead to serious complications such as meningitis and sinus cavernous thrombosis. These conditions can be life-threatening and require immediate medical attention. The presence of furuncles in the facial area increases the risk of infection spreading to the brain and other vital structures, leading to potentially severe consequences. Therefore, it is important to treat facial-area furuncles promptly to prevent these complications.Rate this question:
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- 12.
. The 32-year-old woman complains that after starting treatment with cyproheptadine, she is very bothered by dry mouth, constipation, and difficulty urinating. In addition, appetite was greatly increased. Which receptor CNS blockade is associated with such side effects of this drugs in this patient?
- A.
Dopaminergic and alpha-1 adrenergic
- B.
M cholinergic and serotonergic
- C.
H2 histaminergic and alpha-1 adrenergic
- D.
Serotonergic and alpha-1 adrenergic
- E.
H2 histaminergic and M cholinergic
Correct Answer
B. M cholinergic and serotonergicExplanation
The side effects of dry mouth, constipation, difficulty urinating, and increased appetite are consistent with the blockade of M cholinergic receptors and serotonergic receptors. M cholinergic receptors are involved in the regulation of salivation, gastrointestinal motility, and urinary function, so their blockade can lead to dry mouth, constipation, and difficulty urinating. Serotonergic receptors are involved in the regulation of appetite, so their blockade can lead to increased appetite. Therefore, the side effects described in the patient are likely due to the blockade of M cholinergic and serotonergic receptors.Rate this question:
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- 13.
30. Which cytokine promotes the differentiation of CD4 T cells into the effector Th1?
- A.
IL12
- B.
IL-10
- C.
IL-5
- D.
TNF
- E.
IL-4
Correct Answer
A. IL12Explanation
IL-12 is the correct answer because it promotes the differentiation of CD4 T cells into the effector Th1 cells. Th1 cells are known for their role in cell-mediated immunity and the production of pro-inflammatory cytokines. IL-12 stimulates the production of IFN-gamma, which is a key cytokine produced by Th1 cells. This cytokine helps in the activation of macrophages and enhances the immune response against intracellular pathogens.Rate this question:
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- 14.
What of the following statements concerning the haptens are correct
- A.
They can stimulate secondary antibody responses without carriers
- B.
They are substances, usually of low molecular weight
- C.
They are antigenic and immunogenic
- D.
Interact with specific antibody only conjugated with high-molecular weight carrier
- E.
They require carrier molecules to be immunogenic
Correct Answer(s)
B. They are substances, usually of low molecular weight
D. Interact with specific antibody only conjugated with high-molecular weight carrier
E. They require carrier molecules to be immunogenicExplanation
Haptens are substances, usually of low molecular weight, that require carrier molecules to be immunogenic. They can stimulate secondary antibody responses without carriers. They interact with specific antibody only when conjugated with a high-molecular weight carrier.Rate this question:
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- 15.
What of the following statements concerning infection agent of tetanus are correct?
- A.
Gram-positive rods that colonize animal and human intestines
- B.
Penetrating trauma provides environment for bacterial growth and releasing of neurotoxin
- C.
Tetanus toxin prevent release of acetylcholine at peripheral cholinergic synapse
- D.
Spore-forming obligate aerobic bacteria
- E.
Induce intoxication like botulism, not infection disease
Correct Answer(s)
A. Gram-positive rods that colonize animal and human intestines
C. Tetanus toxin prevent release of acetylcholine at peripheral cholinergic synapseExplanation
The correct answer is "Gram-positive rods that colonize animal and human intestines" and "Tetanus toxin prevent release of acetylcholine at peripheral cholinergic synapse". These statements accurately describe the infection agent of tetanus. Tetanus is caused by a bacterium called Clostridium tetani, which is a gram-positive rod-shaped bacterium that can colonize the intestines of animals and humans. The bacterium produces a neurotoxin called tetanus toxin, which prevents the release of acetylcholine at peripheral cholinergic synapses. This leads to muscle stiffness and spasms, characteristic symptoms of tetanus.Rate this question:
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- 16.
36. MHC class I molecules are important for what of the following?
- A.
Binding to CD8 molecules on T cells
- B.
Presenting viral peptides to antigen-presenting cells (APC)
- C.
Presenting endogenous antigen to cytotoxic T cells
- D.
Binding to CD4 molecules on T cells
- E.
Binding to immunoglobulins on B cells
Correct Answer(s)
A. Binding to CD8 molecules on T cells
C. Presenting endogenous antigen to cytotoxic T cellsExplanation
MHC class I molecules are important for binding to CD8 molecules on T cells and presenting endogenous antigens to cytotoxic T cells. These interactions are crucial for the activation of cytotoxic T cells, which play a key role in immune responses against infected or cancerous cells. By binding to CD8 molecules, MHC class I molecules facilitate the recognition of infected or abnormal cells by cytotoxic T cells. Additionally, by presenting endogenous antigens, MHC class I molecules help cytotoxic T cells identify and eliminate these abnormal cells.Rate this question:
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- 17.
37. Active fragments of C5a can lead to the following, except:
- A.
Opsonization of cells
- B.
Contraction of smooth muscle
- C.
Attachment of lymphocytes to macrophages
- D.
Vasodialatio
- E.
Attraction of leukocytes
Correct Answer(s)
A. Opsonization of cells
C. Attachment of lymphocytes to macrophagesExplanation
Active fragments of C5a can lead to contraction of smooth muscle, vasodilation, and attraction of leukocytes. However, opsonization of cells and attachment of lymphocytes to macrophages are not processes that are directly mediated by C5a.Rate this question:
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- 18.
An antibody made against the antigen tetanus toxoid (TT) reacts with it even when the TT is denatured by disrupting all disulfide bonds. Another antibody against TT fails to react when TT is similarly denatured. The most likely explanation can be stated as follows:
- A.
The first antibody is specific for the primary amino acid sequence of TT, whereas the second is specific for conformational determinants
- B.
The first antibody is specific for several epitopes expressed by TT
- C.
The second antibody is specific for disulfide bonds
- D.
The first antibody has a higher affinity for TT
- E.
The second antibody has a lower affinity for TT
Correct Answer
A. The first antibody is specific for the primary amino acid sequence of TT, whereas the second is specific for conformational determinantsExplanation
The first antibody is able to react with the denatured TT because it recognizes the primary amino acid sequence of TT, which remains intact even when the disulfide bonds are disrupted. On the other hand, the second antibody is specific for conformational determinants, which are disrupted when the disulfide bonds are disrupted. Therefore, the second antibody fails to react with the denatured TT.Rate this question:
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- 19.
The 15-year-old healthy girl with no major medical problems notes diarrhea within a 20-30 minutes every time she eats seafood. These problems abate within 3 hours, and then physical examination reveals no abnormal findings. Which of the following immunologic abnormalities is she most likely to have?
- A.
Complement activation
- B.
Cell-mediated hypersensitivity
- C.
Hypergammaglobulinemia
- D.
Localized anaphylaxis
- E.
Immune complex deposition
Correct Answer
D. Localized anaphylaxisExplanation
The girl's symptoms of diarrhea after eating seafood and the resolution of symptoms within 3 hours suggest an immediate hypersensitivity reaction, which is characteristic of localized anaphylaxis. This type of reaction occurs when an allergen, in this case seafood, triggers the release of histamine and other inflammatory mediators, leading to symptoms such as diarrhea. The absence of abnormal findings on physical examination suggests that the reaction is localized rather than systemic.Rate this question:
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- 20.
Twenty hours after going on a hike through dense foliage, 40-year-old man notices a slightly raised and tender irregular reddish rash on one forearm that was not covered by clothing. This rash gradually increases in intensity for 2 days and then fades away after two weeks. Which of the following forms of immunologic hypersensitivity is most likely demonstrated in this patient.
- A.
Type III hypersensitivity
- B.
Type II hypersensitivity
- C.
Type I hypersensitivity
- D.
Type IV hypersensitivity
Correct Answer
D. Type IV hypersensitivityExplanation
The patient's symptoms, including the delayed onset of the rash, its gradual increase in intensity, and its eventual fading away after two weeks, are consistent with a Type IV hypersensitivity reaction. Type IV hypersensitivity is a cell-mediated immune response that involves the activation of T cells. In this case, it is likely that the patient was exposed to an allergen during the hike, which triggered a delayed hypersensitivity reaction. The reaction is characterized by the recruitment of inflammatory cells, causing the rash.Rate this question:
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- 21.
Every springtime, a young healthy man is bothered by episodes of nasal congestion accompanied by sneezing and watery eyes. He has no cough. On physical examination he is afebrile. There is welling of his nasal passageways, but no other findings. His conditions improves with use of loratadine. His problems are most likely produced by release of chemical mediators from which of the following cell types?
- A.
CD4+
- B.
Neutrophil
- C.
Macrophage
- D.
NK cell
- E.
Mast cell
Correct Answer
E. Mast cellExplanation
The young man's symptoms of nasal congestion, sneezing, and watery eyes suggest an allergic reaction, commonly known as hay fever. These symptoms are caused by the release of chemical mediators, such as histamine, from mast cells. Mast cells are abundant in the nasal passageways and are known to be involved in allergic reactions. The fact that the symptoms improve with the use of loratadine, an antihistamine, further supports the involvement of mast cells in this case. Therefore, mast cells are the most likely cell type responsible for the young man's symptoms.Rate this question:
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- 22.
46. What is the most common cause of Liudwig’s angina?
- A.
Odontogenic infection
- B.
Tongue piering
- C.
Parapharyngeal infection
- D.
Tongue trauma
- E.
Tongue tumors
Correct Answer
A. Odontogenic infectionExplanation
Ludwig's angina is a serious infection of the floor of the mouth, usually caused by a dental infection. Odontogenic infection refers to infections originating from the teeth or oral cavity, and it is the most common cause of Ludwig's angina. Tongue piercing, parapharyngeal infection, tongue trauma, and tongue tumors are not typically associated with Ludwig's angina.Rate this question:
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- 23.
Macrophages are located in the stroma of reticular cells and reticular fibers and filter the blood in which of the following locations?
- A.
Cortex of the red bone marrow
- B.
Primary lymphoid nodules of the lymph node
- C.
Medulla of the lymph node
- D.
Cortex of thymus
- E.
Splenic red pulp
- F.
Splenic white pulp
Correct Answer
D. Cortex of thymusExplanation
Macrophages are located in the stroma of reticular cells and reticular fibers and filter the blood in the cortex of the thymus.Rate this question:
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- 24.
Which of the enzymes creates DNA using RNA
- A.
Intergrase
- B.
Protease
- C.
Reverse transcriptase
Correct Answer
C. Reverse transcriptaseExplanation
Reverse transcriptase is the correct answer because it is an enzyme that can synthesize DNA from an RNA template. This process is known as reverse transcription and is commonly found in retroviruses, which use reverse transcriptase to convert their RNA genome into DNA. Reverse transcriptase is also used in laboratory techniques such as reverse transcription polymerase chain reaction (RT-PCR) to convert RNA into complementary DNA (cDNA) for further analysis.Rate this question:
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- 25.
52. What is the characteristic for HIV-1?
- A.
Chronic course of the disease
- B.
Global pandemic
- C.
Higher prevalence in west africa
Correct Answer
B. Global pandemicExplanation
HIV-1 is characterized by being a global pandemic. This means that it has spread widely across the world, affecting various regions and populations. The term "pandemic" refers to a disease that has reached epidemic proportions on a global scale, indicating that HIV-1 has become a significant public health concern affecting numerous countries and populations worldwide.Rate this question:
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- 26.
A patients has come to the clinic complaining of itching in his eyes, sneezing, and running nose during each spring for the last three year. To identify the offending allergens, the patient is scheduled for diagnostic skin tests. Which skin test may be helpful in this case (and is used in routine clinical practice)?
- A.
Skin prick test
- B.
Allergen application on the skin
- C.
Patch test
- D.
Intradermal skin test
Correct Answer
A. Skin prick testExplanation
The skin prick test is the most commonly used and helpful test in routine clinical practice for identifying allergens. It involves pricking the skin with a small amount of allergen extract and observing for any allergic reaction, such as redness or swelling. This test is effective in diagnosing allergies to airborne substances, such as pollen, which could be the cause of the patient's symptoms during spring. The other options, such as allergen application on the skin, patch test, and intradermal skin test, are not as commonly used for identifying airborne allergens.Rate this question:
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- 27.
55. Which statements of the following best describes maturation of T lymphocytes:
- A.
Maturation of T lymphocytes is dependent upon epithelial reticular cells in the thymus
- B.
Maturation of T lymphocytes is complete before the cells leave the bone marrow
- C.
Maturation of T lymphocytes starts in the white pulp of spleen
- D.
Maturation of T lymphocytes occurs in the cortex of lymph nodes
Correct Answer
A. Maturation of T lymphocytes is dependent upon epithelial reticular cells in the thymus -
- 28.
56. Why clostridium difficile causes diarrhea after antibiotic therapy?
- A.
-C. difficile spores are resistant to most common antibiotics
- B.
-Antibiotics disrupt the normal gut flora and permit the overgrowth of C. difficile
- C.
-Antibiotics activate tox-genes of bacteria
- D.
-Antibiotics injury epithelium of intestines and increase and increase sensitivity to bacterial toxin
- E.
Antibiotics can be contaminated with spores of C. difficile
Correct Answer(s)
A. -C. difficile spores are resistant to most common antibiotics
B. -Antibiotics disrupt the normal gut flora and permit the overgrowth of C. difficile
D. -Antibiotics injury epithelium of intestines and increase and increase sensitivity to bacterial toxinExplanation
Clostridium difficile causes diarrhea after antibiotic therapy because its spores are resistant to most common antibiotics. Additionally, antibiotics disrupt the normal gut flora, which allows for the overgrowth of C. difficile. Moreover, antibiotics can injure the epithelium of the intestines and increase sensitivity to bacterial toxins.Rate this question:
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- 29.
57. What is characteristic for serum sickness?
- A.
Pollens are the main triggers of the hypersensitivity
- B.
Sudden drop of blood pressure
- C.
A low- grade fever and general malaise
- D.
A fleeting (migratory) nature of wheals (which subside in 5 hours)
- E.
Enlargement of lymph nodes
Correct Answer(s)
C. A low- grade fever and general malaise
E. Enlargement of lymph nodesExplanation
Serum sickness is a type III hypersensitivity reaction that occurs in response to the administration of certain medications or the injection of foreign proteins, such as antiserum. It is characterized by symptoms such as fever, malaise, and the enlargement of lymph nodes. These symptoms are indicative of an immune response and inflammation in the body. The other options mentioned in the question are not specific to serum sickness and do not align with its characteristic symptoms.Rate this question:
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- 30.
. Which NSTI (necrotizing soft tissue infection) treatment components have the greatest imact on outcomes?
- A.
Early intravenous antibiotic therapy
- B.
HBO- hyperbaric oxygen therapy
- C.
Supportive therapy
- D.
Urgent necrosectomy
- E.
Intravenous infusion therapy, correction of water, electrolytes and acid-base balance
Correct Answer(s)
B. HBO- hyperbaric oxygen therapy
D. Urgent necrosectomyExplanation
Hyperbaric oxygen therapy (HBO) and urgent necrosectomy are the treatment components that have the greatest impact on outcomes in necrotizing soft tissue infections (NSTIs). HBO therapy involves delivering 100% oxygen at high pressure, which helps improve tissue oxygenation and promote wound healing. Urgent necrosectomy refers to the surgical removal of necrotic (dead) tissue, which is crucial in preventing the spread of infection and promoting healing. These interventions are considered essential in the management of NSTIs and have been shown to significantly improve patient outcomes.Rate this question:
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- 31.
63. Which class of immunoglobulins is most abundant in bodily secretions?
- A.
IgE
- B.
IgM
- C.
IgA
- D.
IgG
- E.
IgD
Correct Answer
C. IgAExplanation
IgA is the most abundant class of immunoglobulins in bodily secretions. It is found in high concentrations in mucosal areas such as the respiratory tract, gastrointestinal tract, and genitourinary tract. IgA plays a crucial role in preventing the attachment and invasion of pathogens at these mucosal surfaces, providing a first line of defense against infections. It is also involved in neutralizing toxins and allergens. IgA is produced by plasma cells in the mucosal tissues and is transported across epithelial cells to be released into bodily secretions.Rate this question:
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- 32.
64. At the onset of regular childbirth activities, the first-time mother was brought to the obstetrics department. It turned out that there are 27 weeks of pregnancy, the estimated weight of the fetus - 850g, the opening of the cervix - 6 cm. The mother was given a medicine to mature of the fetal lungs. Which drug was most likely infected?
- A.
Betamethasone
- B.
Acetylsalicylic acid
- C.
Indomethacin
- D.
Ketorolac
- E.
Celecoxib
Correct Answer
A. BetamethasoneExplanation
Betamethasone is the most likely drug that was given to the first-time mother to mature the fetal lungs. This is because betamethasone is a corticosteroid that is commonly used in obstetrics to promote fetal lung maturation in cases of preterm labor. It helps to accelerate the production of surfactant in the lungs, which is essential for the proper functioning of the lungs after birth. The other options, such as acetylsalicylic acid, indomethacin, ketorolac, and celecoxib, are not typically used for this purpose in obstetrics.Rate this question:
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- 33.
67. Injection of endotoxin into an animal stimulates the following responses, except:
- A.
Activation of the Hageman factor leading to intravascular coagulation and haemorrhage
- B.
An inflammatory response resulting in fever
- C.
Opsonized bacteria and activate phagocytosis of macrophages
- D.
Activation of complement leading to inflammation
- E.
An immunological response resulting in long duration antibodies production
Correct Answer
E. An immunological response resulting in long duration antibodies productionExplanation
Injection of endotoxin into an animal stimulates various responses, including activation of the Hageman factor leading to intravascular coagulation and hemorrhage, an inflammatory response resulting in fever, opsonized bacteria and activation of phagocytosis of macrophages, and activation of complement leading to inflammation. However, endotoxin injection does not directly result in the production of long duration antibodies. Antibody production is typically a result of an adaptive immune response, which takes time to develop and is not an immediate response to endotoxin injection.Rate this question:
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- 34.
69. The classical complement pathway is initiated by:
- A.
Formation of antibody-antigen complexes
- B.
Teichoic acid from gram-positive cell walls
- C.
Lipopolysaccharides from gram-negative cell walls
- D.
Mannose- containing residues of glycoproteins on certain microbes
- E.
Toll-like receptor binding to pathogen- associated molecular patterns
Correct Answer
A. Formation of antibody-antigen complexesExplanation
The classical complement pathway is initiated by the formation of antibody-antigen complexes. When antibodies bind to antigens, they can activate the complement system. This triggers a cascade of enzymatic reactions that leads to the formation of the membrane attack complex, which can destroy the target cell. This pathway is an important part of the immune response against pathogens.Rate this question:
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- 35.
71. Cisterna chyli collects lymph from:
- A.
Left lung
- B.
Small intestine
- C.
Liver
- D.
Right lung
- E.
Right lower limb
- F.
Left upper limb
Correct Answer(s)
B. Small intestine
C. Liver
E. Right lower limbExplanation
The cisterna chyli is a lymphatic structure that collects lymph from various parts of the body. In this case, it collects lymph from the small intestine, liver, and right lower limb. The small intestine is a major site of nutrient absorption and lymphatic vessels in this area help transport absorbed fats and fat-soluble vitamins. The liver is involved in various metabolic processes and produces lymph that contains waste products. The right lower limb has lymphatic vessels that drain lymph from the leg and foot.Rate this question:
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- 36.
What statements about radiologic features of the lymphadenopathy in primary tuberculosis are correct?
- A.
Never occurs in children
- B.
X-ray and ct are non-informative
- C.
Resolution is never seen after treatment
- D.
Enlarged hilar and paratracheal lymph nodes
- E.
Typically unilateral and right sided
Correct Answer(s)
D. Enlarged hilar and paratracheal lymph nodes
E. Typically unilateral and right sidedExplanation
The radiologic features of lymphadenopathy in primary tuberculosis include enlarged hilar and paratracheal lymph nodes, which are typically unilateral and right-sided. This means that the lymph nodes in the chest area near the trachea and around the lung hilum become enlarged in tuberculosis. X-ray and CT scans are not informative in diagnosing primary tuberculosis, and resolution of lymphadenopathy can be seen after treatment. The statement "never occurs in children" is incorrect, as primary tuberculosis can occur in individuals of any age.Rate this question:
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- 37.
A 5-year-old boy with influenza had a high fever for 4 days and was treated with antipyretic analgesics. On the fifth day the boy plunged into a coma and did not survive. Autopsy revealed diffuse micro-vascular fatty infiltration of the liver, heart, kidney and cerebral edema. Which of the following medications could cause death?
- A.
Acetylsalicylic acid
- B.
Diclofenac
- C.
Ibuprofen
- D.
Indomethacin
- E.
Paracetamol
Correct Answer
A. Acetylsalicylic acidExplanation
Acetylsalicylic acid, also known as aspirin, can cause a rare but serious condition called Reye's syndrome in children with viral infections, such as influenza. Reye's syndrome is characterized by liver and brain damage, which can lead to coma and death. The symptoms of Reye's syndrome include high fever, fatty infiltration of the liver, and cerebral edema, which are consistent with the autopsy findings in the case of the 5-year-old boy. Therefore, acetylsalicylic acid is the medication that could cause death in this scenario.Rate this question:
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- 38.
Immunohistochemical test found amyloidosis, what are the possible causes?
- A.
Non-hodgkin lymphoma (follicular lymphoma)
- B.
Chronic myeloid leucosis
- C.
Multiple myeloma
- D.
Hemodialysis- associated amyloidosis
- E.
Acute lymphoid leucosis
- F.
Acquired bronchiectasis
- G.
Fibrocavernous pulmonary tuberculosis
- H.
Hodgkin lymphoma
Correct Answer(s)
F. Acquired bronchiectasis
G. Fibrocavernous pulmonary tuberculosis
H. Hodgkin lymphomaExplanation
Immunohistochemical tests can be used to detect the presence of amyloidosis, which is an abnormal protein buildup in tissues. The possible causes of amyloidosis include acquired bronchiectasis, fibrocavernous pulmonary tuberculosis, and Hodgkin lymphoma. These conditions can lead to the deposition of amyloid proteins in various tissues, causing organ dysfunction and damage. Non-Hodgkin lymphoma (follicular lymphoma), chronic myeloid leukemia, multiple myeloma, acute lymphoid leukemia, and hemodialysis-associated amyloidosis are not typically associated with amyloidosis.Rate this question:
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- 39.
For which pathological conditions does ESR increase?
- A.
Iron deficiency anemia
- B.
Hypoalbuminemia
- C.
Stable angina pectoris
- D.
Myocardial infarction
- E.
Polycytemia
- F.
Sickle cell anemia
- G.
Hyperalbuminemia
Correct Answer(s)
A. Iron deficiency anemia
B. Hypoalbuminemia
D. Myocardial infarction -
- 40.
A pathology (clinical) autopsy (postmortem examination) of 65 years old deceased with a clinical history of progressing renal failure was performed. Macroscopic morphologic changes detected in his kidneys are presented below: Microscopic examination of injured renal tissue revealed multiple necrotic vascular walls replaced by smudgy, pink ‘fibrinoid’ material. Considering localization of injuries and pattern of macroscopic and microscopic morphologic changes, most likely, pathogenesis mechanism of morphologic changes in patients kidneys is predominantly related to:
- A.
Immune complex-mediated inflammation and tissue injury
- B.
Formation of immune complexes
- C.
Degranulation of mast cells
- D.
T-cell mediated cytolysis
- E.
Anti-body mediated cellular dysfunction
- F.
Opsonization and phagocytosis
Correct Answer(s)
A. Immune complex-mediated inflammation and tissue injury
B. Formation of immune complexesExplanation
The presence of multiple necrotic vascular walls replaced by smudgy, pink "fibrinoid" material in the kidneys suggests that there is inflammation and tissue injury occurring. This type of morphologic change is commonly associated with immune complex-mediated inflammation and tissue injury. Immune complexes are formed when antibodies bind to antigens, leading to the activation of inflammatory pathways and subsequent tissue damage. Therefore, the most likely pathogenesis mechanism for the morphologic changes in the patient's kidneys is immune complex-mediated inflammation and tissue injury, which is supported by the formation of immune complexes.Rate this question:
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- 41.
A 45 - year - old man, working in a fish processing plant, arrived to the hospital emergency department with complains of fever, redness, swelling and intense pain in the finge. He fell ill five days ago. He can’t sleep at night due to pain. T-37.8C. The second finger of the right hand is swollen,red, very painful,, with fluctuation. What is your diagnosis?
- A.
Panaritium subunguale
- B.
Panaritium subcutaneum
- C.
Panaritium cutaneum
- D.
Felon
- E.
Pandactilitis
- F.
Panaritium paraunguale
Correct Answer
E. PandactilitisExplanation
The correct diagnosis is Pandactilitis. The patient presents with symptoms of fever, redness, swelling, and intense pain in the finger, which are consistent with an infection. The fact that the finger is swollen, red, very painful, and has fluctuation suggests an abscess formation. Pandactilitis refers to an infection involving multiple structures of the finger, including the skin, subcutaneous tissue, and deep structures such as the tendon sheaths. This diagnosis is more appropriate than the other options, which refer to infections limited to specific structures such as the nail (Panaritium subunguale) or the skin (Panaritium subcutaneum and Panaritium cutaneum).Rate this question:
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- 42.
A pathology (clinical) autopsy (postmortem examination) was performed for 67 years old deceased with a clinical history of chronic osteomyelitis of right femoral bone. Macroscopic images below represent findings detected during this autopsy (marked as image A, B, and C) 1. Considering clinical context of the deceased, morphologic features and anatomical sites of observed lesions, most likely direct complication of chronic osteomyelitis is/are visible in ________ 2. and most likely method to confirm this/these image (-s) as complication(-s)
- A.
1. A and B
- B.
1. B and C
- C.
1. A and C
- D.
2. Immunohistochemical reaction
- E.
2. congo red testing
Correct Answer(s)
A. 1. A and B
D. 2. Immunohistochemical reactionExplanation
The correct answer is 1. A and B, 2. Immunohistochemical reaction. Based on the clinical history of chronic osteomyelitis of the right femoral bone, the morphologic features and anatomical sites of the observed lesions in images A and B are most likely direct complications of the osteomyelitis. The immunohistochemical reaction is the most likely method to confirm these images as complications, as it can help identify specific markers or antigens associated with the inflammatory process in the affected tissues. The congo red testing is not relevant to confirming the complications of chronic osteomyelitis.Rate this question:
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- 43.
34 years old patient suffered from small puncture wound at his left thumb’s tip. Electron microscopy images presented below represent morphologic changes in early stages of inflammation in indicated anatomical area (images A and B represent same cell, abbreviations: Gr- granules, B- nucleus, M- mitochondria
- A.
Histamine
- B.
Kinins
- C.
Neutrophilic granulocytes chemotactic factor
- D.
Nitric oxide
- E.
Interleukin-1
- F.
Complement proteins
- G.
Interleukin-6
Correct Answer(s)
A. Histamine
C. Neutrophilic granulocytes chemotactic factorExplanation
The correct answer is histamine and neutrophilic granulocytes chemotactic factor. Histamine is released by mast cells during inflammation and causes vasodilation and increased vascular permeability. Neutrophilic granulocytes chemotactic factor attracts neutrophils to the site of inflammation. Both of these factors play a role in the early stages of inflammation and can be observed in the electron microscopy images presented.Rate this question:
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- 44.
A biopsy (tissue fragment for diagnostics purposes) of one of the enlarged cervical lymph nodes was taken. Microscopic morphology features of this lymph node visible by light microscopy presented below: Considering microscopic morphologic features in presented image, most likely structures marked by green arrows represent:
- A.
A- hodgkin cell; B-Reed-Sternberg cell
- B.
A and B- Reed-Sternberg giant cells
- C.
A- Reed- Sternberg giant cell, B-Hodgkin cell
- D.
A and B- Hodgkin cells
- E.
A-Langhans type giant cell, B-Reed-sternberg giant cell
Correct Answer
C. A- Reed- Sternberg giant cell, B-Hodgkin cellExplanation
The correct answer is A- Reed-Sternberg giant cell, B-Hodgkin cell. The structures marked by the green arrows in the microscopic image are most likely Reed-Sternberg giant cells and Hodgkin cells.Rate this question:
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- 45.
45 years old patient complained about progressing weakness, dyspnea,relapsing minor respiratory infections, and these clinical symptoms are lasting for several months. Microscopic, morphologic examination of his bone marrow biopsy ( tissue fragment for diagnostics purposes revealed morphologic feature presented in the images below (left- lower power magnification, right- higher power magnification). Considering clinical context and microscopic morphologic features visible in presented images, most likely cause(-s) of patient’s pathology:
- A.
Fish tapeworm (parasitic) infestition
- B.
Deficiency of vitamin B12
- C.
Intoxication by alkylating chemical agents
- D.
-Deficiency of folate acid
- E.
Whole-body irradiation
- F.
Atrophic gastritis
Correct Answer(s)
C. Intoxication by alkylating chemical agents
E. Whole-body irradiationExplanation
The morphologic features visible in the bone marrow biopsy, along with the patient's clinical symptoms, suggest that the most likely cause of the patient's pathology is intoxication by alkylating chemical agents and whole-body irradiation. This is because both of these factors can cause bone marrow suppression, leading to symptoms such as weakness, dyspnea, and susceptibility to respiratory infections. The morphologic features seen in the biopsy may also be consistent with the effects of these agents on the bone marrow.Rate this question:
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- 46.
A 68-year-old man was recently diagnosed with osteoarthritis.he was bleeding from a stomach ulcer 6 month ago. The patient fully recovered after triple therapy for peptic ulcer. Which of the following NSAIDs could be prescribed to a patient for pain relief?
- A.
Ibuprofen
- B.
Acetylsalicyclic acid
- C.
Indomethacin
- D.
Celecoxib
- E.
Ketorolac
Correct Answer
A. IbuprofenExplanation
The correct answer is Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can be prescribed for pain relief in patients with osteoarthritis. It is a commonly used NSAID and is generally well-tolerated. The patient's history of bleeding from a stomach ulcer 6 months ago is important to consider, as some NSAIDs can increase the risk of gastrointestinal bleeding. However, Ibuprofen is considered to have a lower risk of causing stomach ulcers compared to other NSAIDs, making it a suitable choice for this patient.Rate this question:
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- 47.
What type of paraproctitis is the deepest?
- A.
Pelvirectal
- B.
Submucosal
- C.
Ischiorectal
- D.
Perianal
- E.
Intersphincteric
Correct Answer
A. Pelvirectal -
- 48.
Individuals with undeveloped thymus would be expected to have a disturbed immune response and diminished number of cells in the following region(s):
- A.
Periarterial lymphoid sheath in the spleen
- B.
Paracortex of the lymph node
- C.
Fenestrated capillaries of bone marrow
- D.
Germinal centers of primary lymphoid nodules
- E.
Splenic trabeculae
- F.
Medulla of the lymph node
Correct Answer(s)
A. Periarterial lymphoid sheath in the spleen
B. Paracortex of the lymph nodeExplanation
Individuals with an undeveloped thymus would be expected to have a disturbed immune response and diminished number of cells in the periarterial lymphoid sheath in the spleen and the paracortex of the lymph node. The thymus plays a crucial role in the development and maturation of T cells, which are important for immune response. Without a properly developed thymus, the production and function of T cells would be compromised, leading to a decreased number of cells in these regions. The other options listed, such as fenestrated capillaries of bone marrow, germinal centers of primary lymphoid nodules, splenic trabeculae, and medulla of the lymph node, are not directly affected by thymus development.Rate this question:
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- 49.
94. Which statements about post-primary pulmonary tuberculosis are true?
- A.
Cavitation is the hallmark of the post-primary lung tuberculosis
- B.
Patchy consolidation in the upper lobes is seen
- C.
Large self-limited bilateral pleural effusions are always seen
- D.
Bilateral involvement of the upper lung lobes is never seen
- E.
Most common outcome in post-primary tuberculosis resolving without sequelae
Correct Answer(s)
A. Cavitation is the hallmark of the post-primary lung tuberculosis
B. Patchy consolidation in the upper lobes is seenExplanation
Post-primary pulmonary tuberculosis is characterized by cavitation, which is the formation of cavities or hollow spaces in the lung tissue. This is the hallmark feature of this stage of tuberculosis. Additionally, patchy consolidation in the upper lobes of the lungs is commonly seen in post-primary tuberculosis. However, large self-limited bilateral pleural effusions are not always present in this stage, and bilateral involvement of the upper lung lobes can occur. The most common outcome of post-primary tuberculosis is resolution without any long-term complications or sequelae.Rate this question:
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