Chapter 16 - Disorders in Immunity

Chapter 16
Disorders in Immunity

Multiple Choice Questions

1. The major categories of hypersensitivities that typically involve a B-cell immunoglobulin

response is/are
A. Type 1 only.
B. Type 1 and Type 4.
C. Type 4 only.
D. Type 1, Type 2, Type 3.
E. Type 1, Type 2, Type 3, and Type 4.

2. Atopy and anaphylaxis are hypersensitivities in the category

A. Type 1 only.
B. Type 1 and Type 4.
C. Type 4 only.
D. Type 1, Type 2, Type 3.
E. Type 1, Type 2, Type 3, and Type 4.

3. All of the following are involved in Type 2 hypersensitivity except

A. IgM.
B. IgG.
C. IgE.
D. complement.
E. foreign cells.

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4. Human blood types involve all the following except

A. MHC genes.
B. ABO antigen markers.
C. inheritance of two of three possible alleles.
D. genetically determined glycoprotein markers.
E. genes that code for an enzyme that adds a terminal carbohydrate to RBC receptors.

5. The serum of a person with blood type A, Rh- will have which of the following?
A. anti A, anti Rh
B. anti B, anti Rh
C. anti A
D. anti B
E. anti A, anti B, anti Rh

6. A person with O type blood

A. lacks antibodies to A and B blood types.
B. lacks A and B antigens.
C. could not have the Rh factor.
D. is called a universal recipient.
E. All of the choices are correct.

7. A person who has anti-A and anti-B serum antibodies will have blood type
A. A.
B. B.
C. AB.
D. O.
E. Rh.

8. Transfusion of the wrong blood type can cause

A. recipient antibody activating the complement cascade to attack the RBCs.

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B. fever and anemia.

C. systemic shock and kidney failure.
D. massive hemolysis of the donor RBCs.
E. All of the choices are correct.

9. A female who is Rh+

A. inherited two recessive genes.
B. is in the majority of the population with regard to Rh status.
C. is at risk for a pregnancy resulting in hemolytic disease of the newborn.
D. can only have an Rh positive baby.
E. All of the choices are correct.

10. The potential for hemolytic disease of the newborn occurs when
A. maternal Rh+ cells enter an Rh- fetus.
B. fetal Rh+ cells enter an Rh- mother.
C. maternal Rh- cells enter an Rh+ fetus.
D. fetal Rh- cells enter an Rh+ mother.
E. fetal Rh+ cells enter an Rh+ mother.

11. Erythroblastosis fetalis can be prevented by

A. injecting the mother with antibodies against the Rh factor late in the pregnancy and after
giving birth.
B. treating the fetus with immune globulin.
C. birth by cesarean section.
D. treating the mother with RhoGAM early in the pregnancy.
E. None of the choices are correct.

12. Bee sting venom is considered to be which type of allergen?

A. Ingestant
B. Inhalant

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C. Injectant
D. Contactant
E. None of the choices are correct.

13. Mold spores and animal dander are considered to be which type of allergen?
A. Ingestant
B. Inhalant
C. Injectant
D. Contactant
E. None of the choices are correct.

14. The initial encounter with an allergen is called the

A. sensitizing dose.
B. provocative dose.
C. allergic dose.
D. hypersensitivity dose.
E. desensitizing dose.

15. What will be the immediate action of allergen when it enters the body for a second time?
A. degranulation
B. bonding of allergen to adjacent IgE binding sites on mast cells and basophils
C. binding of IgE by the Fc region to mast cells and basophils
D. histamine acts on smooth muscle
E. prostaglandins cause vasodilation and increased vascular permeability

16. Which event is the process of releasing chemical mediators?

A. Degranulation
B. Binding of allergen to adjacent IgE binding sites on mast cells and basophils
C. Binding of IgE by the Fc region to mast cells and basophils
D. Histamine acts on smooth muscle

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E. Prostaglandins cause vasodilation and increased vascular permeability

17. Which of the following is incorrect about the role of mast cells and basophils in
allergies?
A. They degranulate when triggered by a specific allergen through the IgE bound to them.
B. They carry high numbers of cell receptors that bind to IgE antibodies.
C. Their cytoplasmic secretory vesicles contain physiologically active cytokines.
D. They are found mainly in the lymph nodes.
E. None of the above is incorrect.

18. Which of the following is not a possible symptom of Type I hypersensitivity?

A. rhinitis
B. rashes
C. sneezing
D. diarrhea
E. contact dermatitis

19. Which is mismatched?

A. Fod allergy - Type I hypersensitivity
B. Poison ivy dermatitis - Type 4 hypersensitivity
C. Serum sickness - Type 3 hypersensitivity
D. Transfusion reaction - Type 2 hypersensitivity
E. Hay fever - Type 4 hypersensitivity

20. Any heightened or inappropriate immune response resulting in tissue damage is called
a/an
A. autoimmune disease.
B. immunodeficiency.
C. hypersensitivity.
D. transfusion reaction.

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E. desensitization.

21. Histamine causes all the following except

A. increased sensitivity to light.
B. constriction of smooth muscle of bronchi and the intestine.
C. relaxes vascular smooth muscle.
D. wheal and flare reaction in skin.
E. pruritis and headache.

22. The chemical mediator that causes prolonged bronchospasm, vascular permeability, and
mucus secretion of asthmatic patients is
A. prostaglandin.
B. histamine.
C. leukotriene.
D. serotonin.
E. platelet-activating factor.

23. All of the following are associated with IgE- and mast cell-mediated allergy except
A. drug allergy.
B. eczema.
C. anaphylaxis.
D. allergic asthma.
E. systemic lupus erythematosus.

24. Epinephrine
A. is an antihistamine.
B. reverses constriction of airways.
C. causes desensitization.
D. inhibits the activity of lymphocytes.
E. All of the choices are correct.

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25. Treatment for agammaglobulinemia is

A. frequent transfusions of Rh+ blood.
B. passive immunotherapy and continuous antibiotic therapy.
C. bone marrow transplant.
D. allografts of skin.
E. continuous immunosuppressive therapy.

26. Allergic patients receiving small, controlled injections of specific allergens are
undergoing
A. desensitization.
B. sensitization.
C. tissue matching.
D. degranulation.
E. None of the choices are correct.

27. Large quantities of antibodies that react to the second entry of antigen and lead to
formation of antigen-antibody complexes that deposit in basement membranes occur in
A. serum sickness.
B. delayed hypersensitivity.
C. anaphylaxis.
D. hemolytic disease of the newborn.
E. All of the choices are correct.

28. Autoantibodies cause tissue injury in all the following diseases except
A. rheumatoid arthritis.
B. myasthenia gravis.
C. Graves' disease.
D. tuberculin reaction.
E. multiple sclerosis.

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29. Contact dermatitis involves

A. a sensitizing and provocative dose.
B. allergen entering the skin.
C. T lymphocytes secrete inflammatory cytokines.
D. itchy papules and blisters.
E. All of the choices are correct.

30. When grafted tissue such as bone marrow contains passenger lymphocytes what could
result?
A. Host rejection of graft
B. Graft versus host disease
C. Formation of autoantibodies
D. Hypogammaglobulinemia
E. None of the choices are correct.

31. This can be a consequence of a genetic deficiency in B cell survival and maturity
A. host rejection of graft
B. graft versus host disease
C. formation of autoantibodies
D. hypogammaglobulinemia
E. None of the choices are correct.

32. The DiGeorge syndrome is the result of

A. autoantibodies.
B. delayed hypersensitivity.
C. congenital absence or immaturity of the thymus gland.
D. failure of B cell development and maturity.
E. a genetic defect in the development of both T cells and B cells.

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33. Severe combined immunodeficiencies (SCIDs) are due to

A. autoantibodies.
B. delayed hypersensitivity.
C. congenital absence or immaturity of the thymus gland.
D. failure of B cell development and maturity.
E. a genetic defect in the development of both T cells and B cells.

34. A secondary acquired immunodeficiency is

A. AIDS.
B. adenosine deaminase (ADA) deficiency.
C. DiGeorge syndrome.
D. agammaglobulinemia.
E. Type I diabetes.

35. All of the following operate in surveillance and destruction of tumor cells except
A. macrophages.
B. B cells.
C. natural killer cells.
D. cytotoxic T cells.

36. Which of the following can causes secondary acquired immunodeficiencies in T cells and
B cells?
A. Radiation
B. Chemotherapy
C. Organic disease
D. Infection
E. All of the choices are correct.

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37. Which is incorrect about DiGeorge syndrome?

A. It is severe deficiency of T cells.
B. Sometimes it is associated with a deletion in chromosome 22.
C. Common childhood diseases can be fatal in affected children.
D. The major therapy is a bone marrow transplant.
E. Symptoms include reduced growth and unusual facial characteristics.

38. Jose needs a kidney due to his diabetes. His sister is a close match and is willing to give
him one of hers. What type of transplant is this?
A. Allograft
B. Xenograft
C. Autograft
D. Heterograft
E. None of the choices are correct.

39. A xenograft is a tissue exchange

A. between identical twins.
B. between siblings.
C. from one site on the body to another site.
D. between individuals of different species.

40. What is the Arthus reaction?

A. An autoimmune disorder.
B. An acute response to a second injection of vaccines at the same site.
C. A positive tuberculosis skin test.
D. The lysis of RBC due to complement during an incorrect blood transfusion.
E. The name given to skin wheals that occur during an allergy skin test.

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41. Which of the following is mismatched?

A. Ingestant - nuts
B. Inhalant - bee
C. Injectant - vaccine
D. Contactant - rubber
E. Ingestant - food additive

42. Which cells play the greatest role in allergic symptoms?

A. T cells
B. monocytes
C. plasma cells
D. mast cells
E. eosinophils

43. Which of these chemicals is a powerful inflammatory agent that also stimulates uterine
contractions?
A. Bradykinin
B. Platelet-activating factor
C. Prostaglandins
D. Leukotriene
E. Histamine

44. All of the following are correct about Type O blood except
A. persons with this type of blood are considered universal donors.
B. persons with this type of blood carry an O antigen on their RBC.
C. persons with this type of blood have anti-A and anti-B antibodies in their plasma.
D. this is the most common blood type among all racial groups in the U.S.

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45. All of the following are examples of autoimmune diseases except

A. multiple sclerosis.
B. Graves disease.
C. Hashimoto thyroiditis.
D. myasthenia gravis.
E. Wiskott-Aldrich syndrome.

46. The heart of a baboon transplanted to a human would be a

A. xenograft.
B. autograft.
C. allograft.
D. heterograft.
E. homograft.

47. All of the following cells participate in immune surveillance except

A. macrophages.
B. natural killer cells.
C. cytotoxic T cells.
D. plasma cells.
E. All of the choices participate.

True / False Questions

48. The tuberculin reaction develops within 30 minutes of the skin test in people with prior
sensitization due to tuberculosis infection.
FALSE

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49. During graft rejection, cytotoxic T cells of the recipient recognize and respond to foreign
class I MHC receptors on the grafted cells.
TRUE

50. The allergen in poison ivy plants is oil called urushiol.

TRUE

51. The most common immunoglobulin deficiency is an IgG deficiency.

FALSE

52. After a bone marrow transplant, the recipient's blood type may change to the blood type of
the donor.
TRUE

53. The practice of delaying the introduction of solid foods has no validity in preventing
allergies in children.
FALSE

54. In an isograft, tissue from an identical twin is used.

TRUE

55. Systemic anaphylaxis can quickly result in airway blockage, shock, and death.
TRUE

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56. Eczema is an autoimmune disorder.

FALSE

57. Food allergies include gastrointestinal symptoms and often hives.

TRUE

58. A person who is Rh negative will have anti-Rh antibodies in their serum from early
infancy.
FALSE

Fill in the Blank Questions

59. The antigens to which allergic individuals are sensitive are termed _____.
allergens

60. Allergic reactions to penicillins are considered a _____ hypersensitivity.

Type I

61. Allergic _________ is a seasonal reaction to inhaled pollen or molds.

rhinitis

62. Tissue transplanted from one body site on a patient to a different body site on that patient
is called an _____.

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autograft

63. _____ involves determination of donor HLA antigens compared to those of the recipient's
tissue.
Tissue Typing

64. The ___________ theory explains that during embryonic growth, some tissues are
immunologically privileged.
sequestered antigen

65. An _____ is any chronic local allergy.

atopy

66. The _____ dose of an allergen results in signs and symptoms of the allergy.
provocative

67. _____ hypersensitivities involve soluble antigen with IgM or IgG forming complexes that
can deposit in tissues.
Type III

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Short Answer Questions

68. Compare and contrast local atopies and systemic anaphylaxis with regard to: a) events of
the hypersensitivity, b) chemical mediators and their effects, c) patient tissues involved, and

d) two specific examples of each.

Answers will vary.

69. Discuss the proposed theories that attempt to explain the origin of autoimmunity.

Answers will vary.

70. Compare and contrast local atopies and contact dermatitis with regard to: a) components
and events of the immune response, b) tissue damaging mediators, and, c) two examples of
each.

Answers will vary.

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