DAMB 721 Microbiology Exam 1A 100 points

Your name (Please, print Clearly):

______

I. Multiple Choice: Choose the ONE BEST answer. Mark the correct answer on the answer sheet. Use a #2 pencil.

1. An inflammatory response to self antigens which results in tissue damage in the host is a/an:

1 A. B. transfusion reaction C. response D. immune deficiency disease

2. The effector cell in an immediate hypersensitivity reaction is a/an:

A. B. Langerhans cell C. IgE opsonized mast cell D. lymphocyte E. IgE opsonized erythrocyte

3. In the activation phase of an immediate hypersensitivity response:

A. the complement cascade is activated by binding of the C1 complement fragment to the Fc region of IgE that is attached to mast cells

B. allergens cause mast cell degranulation by crosslinking two IgE that are bound to the mast cell Fc

C. an antigen specific activates a macrophage that attacks the IgE covered mast cell

D. IgE antibodies are produced in response to allergen and bind to mast cells

4. A skin reaction that is seen in a response:

A. tuberculin reaction B. C. “wheal and flare” D. E. Farmer’s lung

5. The immunopathology observed in a Type III hyspersensitivity response could be due to:

A. activation of the complement cascade by antigen complexes B. phagocytic attack on opsonized cells C. Antibody dependent cell cytotoxicity D. All of the above.

2 6. Which of the following: is a preformed chemical mediator released from mast cells; causes the smooth muscle contraction and vascular dilation associated with the symptoms of a Type I hypersensitivity; is active in the early phase of an allergic or anaphylactic response?

A. PAF B. Histamine C. PGD2 D. Interleukin B4,C4,D4,E4

7. Which of the following is a skin test that: takes 24 to 72 hours to develop; is characterized by a lesion that is red, swollen and indurated; is mediated by activated ?

A. tuberculin B. wheal and flare C. Arthus D. It is impossible to determine from this description.

8. Cells that participate in the sensitization (induction) phase of contact sensitivity (a Type IV hypersensitivity) are:

A. activated macrophages B. Langerhans cells C. mast cells D. eosinophils E. IgE opsonized erythrocytes

9. Eosinophiles and neutrophils are mediators of:

A. cytotoxic hypersensitivity (Type II) B. delayed type hypersensitivity (Type IV) C. immediate systemic hypersensitivity (Type I) D. the late phase response following or (Type I)

10. An IgM antibody that binds human IgG to cause the deposition of immune complexes in the joints is:

A. rheumatoid factor B. the cause of a Type III hypersensitivity response. C. associated with an autoimmune disease D. all of the above E. all except B

3 11. Which of the following is not characteristic of atopic individuals:

A. may display symptoms of hay fever or B. suffer from immediate (Type I) hypersensitivity C. may experience anaphylactic reactions D. in response to specific allergens will have higher than normal levels of (IgE) in their serum E. will have antigen specific populations of T helper cells that activate macrophages in response to the antigen

12. The administration of small doses of an allergen over time will desensitize an individual with a Type I hypersensitivity response to the allergen. No one knows exactly why this occurs; which of the following theory(ies) attempt to explain this observation?

A. the Th1/Th2 balance is shifted to increase the ratio of Th1 cells B. the Th1/Th2 balance is shifted to increase the ratio of Th2 cells C. serum IgG produced in sensitized individuals intercepts the allergen before it can bind to IgE on mast cells D. A and C E. B and C

13. Cell lysis associated with erythroblastois fetalis, transfuson incompatability, and thrombocytopenia purpura is characteristic of:

A. a Type II hypersensitivity in which blood cells become coated with IgE B. a Type II hypersensitivity in which blood cells become coated with IgG or IgM C. a Type III hypersensitivity in which blood cells become coated with immune complexes D. Both A and C

14. An infection associated autoimmune disease in which antibodies produced in response to the bacterium which causes strep throat (Streptococcus pyogenes) cross react with human heart muscle.

A. B. Graves disease C. Addison’s Disease D. Systemic Erythematosus E. Hashimoto’s Thyroiditis

15. An immunodeficiency disease in which stem cells fail to develop into

4 mature lymphocytes leaving the patient with severe lymphopenia and susceptibility to the same opportunistic diseases that occur in AIDS patients.

A. Chediak-Higashi syndrome B. DiGeorge syndrome C. Severe Combined Immunodeficiency Disease (SCID) D. Complement deficiency

16. An immunodeficiency disease in which the patient has a specific defect and cannot mount an immune response to a nonpathogenic fungus.

A. Chediak-Higashi syndrome B. DiGeorge syndrome C. Severe Combined Immunodeficiency Disease (SCID) D. Complement deficiency E. Mucocutaneous Candidiasis

17. An autoimmune disease in which a patient develops anti-nuclear antibodies in response to their own double stranded DNA.

A. dependent diabetes mellitis B. C. Graves disease D. Systemic Lupus Erythematomus E. Goodpasture’s syndrome

18. An autoimmune disease in which antibodies develop against the receptor for thyroid stimulating hormone to cause hyperthyroidism:

A. Rheumatic fever B. Graves disease C. Multiple Sclerosis D. Systemic Lupus Erythematosus E. Hashimoto’s Thyroiditis

19. An indication that an asthmatic patient has entered the late phase of a Type I hypersensitivity reaction would be:

A. decreased levels of blood IgE B. milder symptoms

5 C. failure to respond to epinephrine (bronchodialtors) or antihistamines D. neutropenia

20. Statement 1: All hypersensitivity reactions are mediated by humoral immunity. Statement 2: Type IV hypersensitivity is a cell mediated immune response.

A. Statement 1 is true. B. Statement 2 is true. C. Both statement 1 and 2 are true.

21. Which of the following is true of Type II and Type III ?

A. the immunopathology of each is significantly different. B. the time courses of the two are significantly different. C. in Type II cells are coated with autoantibody while in Type III autoimmune complexes are deposited in the tissues. D. in Type III cells are coated with autoantibody while in Type II autoimmune complexes are deposited in the tissues.

22. An autoimmune disease in which the pathological consequences are due to a Type IV hypersensitivity.

A. Insulin dependent diabetes mellitis B. Multiple sclerosis C. Goodpasture’s syndrome D. Both A and B E. Both B and C

23. A baby born with transient hypogammaglobulinemia:

A. will be abnormally susceptible to virus infections and intracellular parasites B. should not be immunized with live vaccines C. may suffer from celiac disease D. will overcome the immunodeficiency at 1 to 2 years of age E. Both B and D.

24. Upon her annual visit to the dentist, a 50 year old woman is observed to have developed an unusual number of caries, and she is complaining that her mouth feels dry all of the time. The woman has possibly developed:

A. B. Graves disease C. Sjogrens syndrome

6 D. Goodpasture’s syndrome E. Hashimoto’s thyroiditis

25. An autoimmune disease in which a patient produces antibodies that attach to the intercellular adhesion molecules (ICAM) on the mucosal epithelium.

A. Pemphigus vulgaris B. Graves disease C. Sjogrens syndrome D. Goodpasture’s syndrome E. Chronic granulomatous disease

26. Patients suffering from DiGeorge syndrome:

A. will not have a thymus B. will be unusually susceptible to viruses and intracellular parasites C. will have recurrent bacterial infections D. All of the above. E. A and B are true.

27. Patients that tend to develop in their skin, lymph nodes and connective tissues have immunodeficiency diseases associated with:

A. B lymphocytes B. T lymphocytes C. neutrophil function D. complement deficiency

28. Histamine binding to an H1 receptor on smooth muscle will cause

A. relaxation of smooth muscle B. constriction of smooth muscle C. vasodilation D. acid secretion in the stomach

29. In an Arthus response, complement is activated, then, specific complement fragments that are released into the tissues may activate mast cells. What fragment (s)?

A. C5b B. muramyl dipeptide C. C3a, C4a D. PAF

30. Which of the following complement factors will opsonize antigen?

7 A. C3a, C4a and C5a B. C5a C. C3b, C4b D. C5b through 9

31. The erythrocytes from an individual with an A blood group:

A. will have a glycoprotein receptor with galactose at the end of the chain

B. will have a glycoprotein receptor with N-acetylgalactosamine at the end of the chain

C. will have a glycoprotein receptor with N-acetylglucosamine at the end of the chain

D. will have a glycoprotein receptor with fucose at the end of the chain

32. A common prophylactic measure for Hemolytic Disease of the Newborn is:

A. administration of the father’s blood cells to the mother immediately after the baby is born B. antibody to the D antigen on the baby’s Rh+ cells is injected into the mother’s bloodstream soon after she gives birth C. Transfusion of the baby with an ABO blood group that is different from that of the Rh- mother D. administraton of antibody to the C antigen on the baby’s Rh+ cells

33. A patient who is to receive a blood transfusion has her ABO blood group determined by mixing her erythrocytes with anti-A and anti-B antisera. Upon testing, an agglutination reaction occurs with anti-A antisera. To verify her blood type, her serum is mixed with A and B erythrocytes. Which of the following erythrocyte types should be agglutinated by her serum.

A. A B. B C. neither D. A and B

8 34. In a direct test to determine if a baby’s red blood cells are coated with IgG, the baby’s blood cells are mixed with anti-IgG antibodies. Assume good news meaning the baby does not have antibodies on it’s red cells. What should the test show?

A. no agglutination B. agglutination C. There is not enough information to determine the outcome.

35. Haptens binding to blood cells may induce Type II hypersensitivities that sometimes lead to autoimmune disease. Which of the following is an example of this hapten action?

A. rheumatoid factor binds IgG; the resulting immune complexes deposit in the synovium B. penicillin binds readily to proteins on the surface of blood cells to induce an immune response C. penicillin causes a form of “molecular mimicry” in which antibodies to penicillin attack the blood cells D. complement is activated by penicillin and attacks the blood cells

Bonus Question: Write the answer on the back of the answer sheet. For question 2, do not write more than two sentences. I will not grade longer answers.

1. (1 point) What type of drugs could be used to treat the late phase of a Type I hypersensitivity response.

2. (2 points) Referring to question 1, why will this drug or class of drugs work when other drugs usually used to treat an immediate hypersensitivity will not?

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