Bah Immunology Test Bank

Front 1

An antibody capable of neutralizing a virus and preventing infection is capable of doing so by?

Back 1

Binding to cell receptor recognition sites on the virus and preventing attachment to a susceptible cell

Front 2

What is an example of artificial passive acquired specific immunity?

Back 2

Injection of pooled human gamma globulin

Front 3

What type of immunoglobulin would you expect to find in mucosal secretions?

Back 3

IgA

Front 4

When would you expect to see a Fall in the C3 component of the complement serum without a corresponding Fall in the C4 component in the serum?

Back 4

Activation of the alternate pathway

Front 5

Immunity to fungal infectious disease agents is primarily provided through?

Back 5

The cell mediated immune response

Front 6

What region of the immunoglobulin monomer binds antigen?

Back 6

Fab

Front 7

Which term is synonymous with incomplete antigen?

Back 7

Hapten

Front 8

What body tissues provide the primary mechanism for exclusion of entrance of foreign materials into the human body?

Back 8

Skin and Mucous Membranes

Front 9

In the normal individual what type of acquired immunity would you expect to provide protection for the longest period?

Back 9

Recovery from a childhood disease infection

Front 10

What is responsible for attracting circulating PMN leukocytes to the inflammatory site?

Back 10

Chemotactic substances like IL-8

Front 11

If you separated the peptide chains of an immunoglobulin monomer by reducing all the disulfide bonds, what would happen?

Back 11

The normally Y-shaped molecule would take on a T shape

Front 12

What would you expect to find in the blood of a person exhibiting a fever that is not in the blood of a nonfebrile person?

Back 12

Endogenous Pyrogens

Front 13

What type of Ig would you expect to attach to mast cells?

Back 13

IgE

Front 14

What would cause a fall in both C3 and C4 components of the complement system?

Back 14

Activation of the classical pathway

Front 15

Immunity to a viral infectious disease agent that enters the body through the mucous membrane is primarily provided through?

Back 15

IgA

Front 16

What is produced during the inflammatory response reaction and is significantly responsible for the pain sensation at the site of a local inflammation?

Back 16

Bradykinin

Front 17

What region of the immunoglobulin monomer binds complement for activating the complement cascade?

Back 17

Fc

Front 18

An attenuated strain of virus would be used to produce what type of vaccine and would be unsafe to use in what group?

Back 18

Live vaccine, immunocomprimised patients

Front 19

What is an antigen that accentuates the immunologic response to a weak antigen introduced at the same time?

Back 19

Adjuvant

Front 20

If you separated the peptide chains of an immunoglobulin monomer by splitting the monomer in the hinge region, what would happen?

Back 20

Two Fab fragments and one Fc fragment would form

Front 21

In which of the following situations would antipyretic therapy be warranted?

a) 4 yr old with strep throat fever of 103
b) 9 day old child with severe gram negative septicemia but no fever
c) 62 yr old woman with congestive heart failure and a fever of 101.5 and a urinary tract infection
d) a, b, and c
e) none of the above

Back 21

c?

Front 22

Eight hours following open heart surgery a patient has a WBC count of 11,800 which of the following conclusions is valid?

a) the patient has developed an infection and requires aggressive IV antibiotic therapy
b) the patient is leucopenic
c) the patient is in need of a transfusion to recover blood loss
d) this would not be an unusual finding and just reflects a systemic inflammatory leucocytosis due to surgical trauma
e) this reflects an impending infection and requires prophylactic antibiotic therapy

Back 22

d?

Front 23

What is the order of the local inflammatory response?

Back 23

1. Hageman factor activated
2. Vascular dilation and increased vascular permeability
3. Neutrophil exudation
4. Phagocytic cell accumulation
5. Fibroblasts migrate into site

Front 24

Vascular changes associated with the initiation of the inflammatory response reaction at the site of tissue injury are triggered by what substances?

Back 24

Release of histamines from mast cells and basophils
Kinins such as bradykinin activated by active Hageman Factor

Front 25

What are opsonins and what process are they involved in?

Back 25

IImmunoglobulins in the serum that improve immune adherence by white blood cells

Front 26

What materials would you expect to be the most immunogenic?

Back 26

Long-chain complex proteins

Front 27

Antibody activity is primarily associated with what serum protein fraction?

Back 27

Gamma globulin

Front 28

What category would a WBC count of 2000/mm3 fall into?

Back 28

Leucopenic

Front 29

Which is greater, a maximum titer of IgG after primary or secondary contact with antigen?

Back 29

Secondary contact with antigen

Front 30

Which is greater, the period of expected protective immunity by passive or active immunization?

Back 30

Active immunization

Front 31

Which is greater, the size of IgA in mucous secretions or IgG in serum?

Back 31

IgA (monomeric in serum, dimeric in mucosal surfaces, breast milk, and tears)

Front 32

Which is greater, the likelihood of activation of C3 complement component by classical or alternate pathway?

Back 32

They are equal?

Front 33

Which is greater, the chance that and immunogen will produce an active immunity when injected into an animal or that the immunoglobulin will produce an active immunity when injected into an animal?

Back 33

Immunogen will produce an active immunity when injected into an animal

Front 34

Which is greater, the size of a hapten of an immunogen?

Back 34

Immunogen

Front 35

Which is greater, the degree of immunogenicity of protein or lipid?

Back 35

Protein? (LPS??)

Front 36

Which is greater, the possibility that Fab fragment of IgG will bind to antigen or Fc fragment of IgG will bind to antigen?

Back 36

Fab

Front 37

Which is greater, Degree of protection against bacterial toxins provided by cell mediated immune response or humorally mediated immune response

Back 37

Humorally mediated immune response

Front 38

Which is greater, the chance of IgA or IgM class being involved in activation of complement?

Back 38

IgM

Front 39

Which is greater, the likelihood of a virus with a complex envelope will be inactivated by ether or a naked virus inactivated by ether?

Back 39

enveloped

Front 40

Which is greater, the number of antigen binding sites on IgM or IgE?

Back 40

IgM

Front 41

Which is greater, the protection against tissue transplants provided by humorally mediated system (circulating antibodies) or cell mediated system (activated T cells)?

Back 41

Cell mediated system

Front 42

Which is greater, IgM or IgG ability to cross the placenta?

Back 42

IgG

Front 43

Which Ig class is found in the highest amount in gamma globulin fraction of serum?

Back 43

IgG

Front 44

What is a type of WBC primarily involved in the initial stages of local inflammatory response reaction?

Back 44

Neutrophil

Front 45

What group is most likely NOT to demonstrate a febrile response during systemic bacterial infection?

a) Neonates
b) Pregnant women
c) HIV infected individuals
d) 2-6 year old child
e) Adolescent

Back 45

Neonates?

Front 46

What component of the complement cascade is activated by C1?

Back 46

C4

Front 47

What portion of the Ig monomer that binds and activates complement?

a) Fc of IgM monomer
b) Fc of IgE monomer

Back 47

Fc of IgM monomer

Front 48

What does an increased neutrophil count and shift to the left indicate?

Back 48

An ongoing inflammatory response reaction in the body

Front 49

What group is at greatest risk of febrile convulsive response?

Back 49

Young Children

Front 50

What is the serum protein fraction that would most likely have IgM immunoglobulins at a higher level than IgG immunoglobulins?

Back 50

Beta fraction

(IgA & IgG = gamma; IgM = beta)

Front 51

What is a material that when added to weakly immunogenic material and injected into the body will increase immunogenicity of immunogen?

Back 51

Adjuvant

Front 52

When would you expect to see a fall in both C3 and C4 components of the complement system?

Back 52

Activation of the Classical Pathway

Front 53

What type of acquired immunity would you expect to provide protection for the longest period?

Back 53

Recovery from a childhood disease

Front 54

What is an example of Artificial Passive Acquired Specific Immunity?

Back 54

Injection of pooled human gamma globulin

Front 55

What is an example of Natural Passive Acquired Specific Immunity?

Back 55

Transplacental transfer of maternal Ig to fetus

Front 56

What would cause a fall in the C3 component of the complement system without a corresponding fall in the C4 component in the serum?

Back 56

Activation of the alternate pathway

Front 57

What complement component is directly activated by C42?

Back 57

C3

Front 58

What group is at greatest risk of febrile convulsive response?

Back 58

Young children

Front 59

What type of immunity is produced by injection of serum from immune individuals into a nonimmune individual?

Back 59

Artificial passive immunity

Front 60

What are the initiators of the inflammatory response reaction?

Back 60

Chemical cell injury
Immunologic cell injury
Physical cell injury
Infectious disease agent cell injury

Front 61

What is the lowest body temperature at which you expect loss of control of body temperature?

a) 95
b) 102
c) 106
d) 112
e) 117

Back 61

112

Front 62

Physiologic response that is associated with dissipiation of heat from the body?

Back 62

Sweating

Front 63

The release of neutrophil chemotactic factor by activated WBCs at the site of a serious tissue injury would be responsible for what inflammatory response reaction?

Back 63

Leucocytosis

Front 64

What is responsible for the chills that are experienced at the initiation of the fever response?

Back 64

Constriction of the surface blood vessels and redirection of blood from skin to deeper blood vessels

Front 65

If a patient has surgery and 24-72 hrs later develops a WBC count of 11,800, what should be done?

Back 65

The patient has developed an infection and requires aggressive IV antibiotic therapy

Front 66

Which of the following represents the only component of specific immune response mechanisms that functions as an external specific defense mechanism

a) alveolar macrophage phagocytosis
b) Interferon
c) Microbial antagonism
d) Cell mediated immune response T cell lymphocytes
e) IgA immunoglobulins

Back 66

IgA

a) alveolar macrophage phagocytosis
b) Interferon (non-specific)
c) Microbial antagonism (non-specific)
d) Cell mediated immune response T cell lymphocytes (internal)
e) IgA immunoglobulins

Front 67

In the condition known as autoimmune hemolytic anemia, the human body forms immunoglobulins that bind to antigens on the surface of the RBC membrane. When the immunoglobulins isolated from a patient's serum suspected of having this condition are mixed with freshly harvested and washed RBCs from the patient, no hemolysis occurs. The technician running the test reports that the test is negative since the cells did not lysel and therefore, the patient does not suffer from auotimmune hemolytic anemia. What is your assessment of his conclusion?

Back 67

He is wrong because he can't tell if the antibodies were present or not in the serum until complement is added to see if the RBCs lyse

Front 68

Which of the following is not correctly matched with its approximate time fram?

a) first use of cowpox to immunize against small pox 1800-1810
b) Identification of most of the bacterial causative agents of infectious disease 1800-1910
c) Elucidation of the structure of the immunoglobulins and their role in providing immunity 1900-1910
d) Discovery of antibiotics and their introduction into use in clinical medicine 1940-1950
e) Development of recombinant DNA and genetic engineering principles 1980-1995

Back 68

C Ig structure was 1960s

Front 69

What body tissues provide the primary mechanism for exclusion of entrance of foreign materials into the human body?

Back 69

Skin and mucous membranes

Front 70

The lowest body temperature at which you expect loss of control of body temperature is?

Back 70

112 deg F

Front 71

The LPS molecule known as bacterial endotoxin is associated with what?

Back 71

Outer layer of gram negative cell wall

Front 72

Delayed type hypersensitivity reactions are mediated by?

a) IgE
b) Immune complex reactions
c) IgM and complement activation
d) Cell mediated immunologic attack of antigen labelled tissue
e) any type of slowly developing immunopathologic tissue damage

Back 72

d

Front 73

Immunoglobulin molecules are characterized by

a) antibody activity
b) Presence of light chains and heavy chains
c) Presence of interchain disulfide bonds
d) Absence of carbohydrates

Back 73

abc

Front 74

The anatomic locations of B-cells (humoral immunity) in a lymph node is/are the

a) paracortical area
b) periarteriolar sheath
c) subcapsular space
d) follicular germinal center

Back 74

d

Front 75

The Fc region of the IgG is important for the following biological activities

a) complement fixation (C1q binding)
b) Combination with antigen
c) Transport across the placenta
d) immunosuppresion

Back 75

a&c?

Front 76

Activation of the classical complement pathway occurs following antigen antibody reactions involving

a) IgA
b) IgG
c) IgE
d) IgM

Back 76

b&d

Front 77

Which of the following are associated with T lymphocytes?

a) Lymphokine production
b) Surface Ig
c) Cytotoxicity
d) Phagocytosis

Back 77

a&c

Front 78

Which of the following would be present in a normal healthy newborn?

a) Maternal IgG
b) High level IgG
c) Low, but detectable level of IgM
d) High titer of antibody to maternal HLA not present in the newborn

Back 78

a&c

Front 79

Which of the following immune phenomena primarily involve T cells?

a) anaphylactic reactions
b) immediate hypersensitivity reaction
c) activation of the complement system
d) delayed hypersensitivity reaction

Back 79

d

Front 80

Will antihistamines inhibit delayed type hypersensitivity reactions?

Back 80

No

Front 81

Immediate hypersensitivity reactions involve

a) basophils (mast cells)
b) IgE
c) SRS-A (leukotriene)
d) Histamine

Back 81

all of the above

Front 82

Which of the following are characteristic features of immediate hypersensitivity reactions

a) Clinical manifestations occur within 24-38 hrs after exposure to the antigen involved
b) Complement system is involved
c) T-helper, T-suppresor ratio is increased
d) These reactions are usually blocked by antihistamines

Back 82

d only

Front 83

Which of the following are characteristic properties of IL-2?

a) It is produced by Th cells
b) It is produced by Ts cells
c) It is a glycoprotein with molecular weight of 16-18,000 daltons
d) It is produced by sensitized B cells

Back 83

a&c

Front 84

Which of the following cells produce IL-1

a) Th cells
b) Ts cells
c) NK cells
d) Monocytes and macrophages

Back 84

d

Front 85

Which of the following is associated with an inflammatory reaction occurring in the body?

a) Leucopenia
b) Lymphocytosis
c) Elevated erythrocyte sedimentation rate
d) Lack of C-reactive protein in serum
e) elevated number of RBC in circulation

Back 85

c

Front 86

Which of the following stages would occur earliest in the course of an acute infection

a) Crisis
b) Acute phase
c) Convalescent phase
d) Latent Phase
e) Prodromal phase

Back 86

Prodromal phase

Front 87

You would always expect to be able to find which of the following in the blood of a person suffering from fever?

a) Bacteria or viruses
b) Endogenous pyrogens
c) Exotoxins
d) Superoxides
e) Histamines

Back 87

Endogenous pyrogens

Front 88

Which of the following would be most likely to be associated with septic shock

a) Rapidly spreading viral infection
b) Gram negative sepsis
c) Viremia
d) Localized but severe staphylococcal infection
e) Hemolysins

Back 88

b

Front 89

Finding bacteria in which of the following specimens would be of greatest clinical significance?

a) Swab of the nares
b) Urine
c) Pleural fluid
d) Sputum
e) Tears

Back 89

b?

Front 90

Which of the following WBCs is found to increase in peripheral circulation in response to an acute primary bacterial infection accompanied by the accumulation of pus at the site of infection?

a) Lymphocytes
b) eosinophils
c) basophils
d) megakaryocytes
e) neutrophils

Back 90

e

Front 91

A strain of pathogen which has lost its ability to cause an infection in normal hosts is referred to as?

Back 91

An avirulent strain of pathogen

Front 92

Which of the following is associated with an inflammatory reaction occurring in the body?

a) Leucopenia
b) Lymphocytosis
c) Elevated erythrocyte sedimentation rate
d) Lack of C-reactive protein in serum
e) Elevated number of RBCs in circulation

Back 92

c

Front 93

Obligate anaerobes that are killed by even small amounts of oxygen would lack which of the following enzymes?

a) Catalase
b) Catalase, superoxide dismutase, and peroxidase
c) Enzymes of the Embden-Myerhoff pathway
d) Peroxidase
e) TCA cycle enzymes

Back 93

b

Front 94

Where is peptidoglycan found in bacteria?

a) Pili
b) Cell wall
c) Ribosomes
d) Capsule
e) Cytoplasmic inclusions

Back 94

Cell wall

Front 95

The swelling at the site of a local inflammatory site produced by infectious injury is the result of which of the following?

a) Fluid and cellular exudation
b) Presence of bradykinin and other activators
c) Vascular dilation and fibrin clot formation
d) Activation of the complement system
e) Activation of the fibroblasts forming scar tissue

Back 95

a