Quiz 103: Alterations in Immunity and Inflammation McCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th Edition

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Quiz 103: Alterations in Immunity and Inflammation
McCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th Edition

Questions 41
Instructor Verified Answers Included
WarofGrades Guaranteed A+ Graded Tutorial

MULTIPLE CHOICE

1. How is hypersensitivity best defined?
a. A disturbance in the immunologic tolerance of self-antigens
b. An immunologic reaction of one person to the tissue of another person
c. An altered immunologic response to an antigen that results in disease
d. An undetectable immune response in the presence of antigens

2. What is a hypersensitivity reaction that produces an allergic response called?
a. Hemolytic shock
b. Anaphylaxis
c. Necrotizing vasculitis
d. Systemic erythematosus

3. The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins?
a. IgE
b. IgG
c. IgM
d. T cells

4. What are blood transfusion reactions an example of?
a. Autoimmunity
b. Alloimmunity
c. Homoimmunity
d. Hypersensitivity

5. During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
a. Neutrophils
b. Monocytes
c. Eosinophils
d. T lymphocytes

6. During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?
a. Bronchial edema caused by the chemotactic factor of anaphylaxis
b. Bronchial edema caused by binding of the cytotropic antibody
c. Smooth muscle contraction caused by histamine bound to H1 receptors
d. Smooth muscle contraction caused by histamine bound to H2 receptors

7. A patient is having an IgE-mediated hypersensitivity reaction. What action by the healthcare professional is best?
a. Give the patient an antihistamine.
b. Prepare to give the patient a blood transfusion.
c. Ask the patient is he/she is having pain at the site.
d. Apply warm, moist heat to the affected area.

8. What characteristic do atopic individuals have that make them genetically predisposed to develop allergies?
a. Greater quantities of histamine
b. More histamine receptors
c. Greater quantities of IgE
d. A deficiency in epinephrine

9. A student asks about the mechanism that results in type II hypersensitivity reactions. What description by the professor is best?
a. Antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators.
b. Antibodies bind to soluble antigens that were released into body fluids, and the immune complexes are then deposited in the tissues.
c. Cytotoxic T lymphocytes or lymphokine-producing helper T 1 cells directly attack and destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface.

10. When mismatched blood is administered causing an ABO incompatibility, how are the erythrocytes destroyed?
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Natural killer cells

11. When antibodies are formed against red blood cell antigens of the Rh system, how are the blood cells destroyed?
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products

12. When soluble antigens from infectious agents enter circulation, what is tissue damage a result of?
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products

13. How are target cells destroyed in a type II hypersensitivity reaction?
a. Tissue damage from mast cell degranulation
b. Antigen-antibody complexes deposited in vessel walls
c. Cytotoxic T lymphocytes attack the cell directly.
d. Natural killer cells

14. Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction?
a. Modulation
b. Antibody-dependent cell-mediated cytotoxicity
c. Neutrophil-mediated damage
d. Complement-mediated lysis

15. Type III hypersensitivity reactions are a result of which of these?
a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
c. Tc cells or lymphokine-producing Th1 cells directly attacking and destroying cellular targets
d. Antibodies binding to the antigen on the cell surface

16. A type IV hypersensitivity reaction causes which result?
a. Antibodies coating mast cells by binding to receptors that signal its degranulation, followed by the discharge of preformed mediators
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
c. Lymphokine-producing Th1 cells directly attacking and destroying cellular targets
d. Antibodies binding to the antigen on the cell surface

17. In a type III hypersensitivity reaction, the harmful effects after the immune complexes that are deposited in tissues are a result of what?
a. Cytotoxic T cells
b. Natural killer cells
c. Complement activation
d. Degranulation of mast cells

18. A healthcare professional is teaching a patient about Raynaud phenomenon and instructs the patient to avoid cold. What is the best explanation of how cold impacts the manifestations of this disease?
a. Immune complexes that are deposited in capillary beds, blocking circulation
b. Mast cells that are bound to specific endothelial receptors, causing them to degranulate and creating a localized inflammatory reaction that occludes capillary circulation
c. Cytotoxic T cells that attack and destroy the capillaries so that they are unable to perfuse local tissues
d. Antibodies that detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species

19. Deficiencies in which element can produce depression of both B- and T-cell function?
a. Iron
b. Zinc
c. Iodine
d. Magnesium

20. An Rh-negative woman gave birth to an Rh-positive baby. When discussing Rho[D] immunoglobulin with her, what information should the healthcare professional provide?
a. It provides protection against infection from poor immunity in the baby.
b. It prevents alloimmunity and hemolytic anemia of the newborn.
c. It provides necessary antibodies in case the mother doesn’t breastfeed.
d. It causes the intestinal tract of the newborn to produce antibodies.

21. Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease?
a. Hemolytic anemia
b. Pernicious anemia
c. Systemic lupus erythematosus
d. Myasthenia gravis

22. A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ transplantation. What response by the professional is best?
a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.
b. Circulating immune complexes are deposited in the endothelial cells of transplanted tissue, where the complement cascade lyses tissue.
c. Receptors on natural killer cells recognize antigens on the cell surface of transplanted tissue, which releases lysosomal enzymes that destroy tissue.
d. Antibodies coat the surface of transplanted tissue to which mast cells bind and liberate preformed chemical mediators that destroy tissue.

23. Which blood cell carries the carbohydrate antigens for blood type?
a. Platelets
b. Neutrophils
c. Lymphocytes
d. Erythrocytes

24. A person with type O blood needs a blood transfusion. What blood type does the healthcare professional prepare to administer to the patient?
a. A
b. B
c. AB
d. O

25. Which class of immunoglobulins forms isohemagglutinins?
a. IgA
b. IgE
c. IgG
d. IgM

26. Which component of the immune system is deficient in individuals with infections caused by viruses, fungi, or yeast?
a. Natural killer cells
b. Macrophages
c. B cells
d. T cells

27. A child in the clinic has an absence of a parathyroid gland, structural heart defects, and a shortened structure of the upper lip. What immune dysfunction does the healthcare professional suspect?
a. Partial-to-complete absence of T-cell immunity
b. X-linked recessive microcephaly
c. An autoimmune disease like systemic lupus erythematosus
d. Adenosine deaminase deficiency

28. How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?
a. 1 to 2
b. 4 to 5
c. 6 to 8
d. 10 to 12

29. Considering the effects of nutritional deficiencies on the immune system, severe deficits in calories and protein lead to deficiencies in the formation of which immune cells?
a. B cells
b. T cells
c. Natural killer cells
d. Neutrophils

30. Urticaria is a manifestation of a which type of hypersensitivity reaction?
a. IV
b. III
c. II
d. I

31. What is Graves disease a result of?
a. Increased levels of circulating immunoglobulins
b. The infiltration of the thyroid with T lymphocytes
c. Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites
d. Exposure to acetylates in substances such as rubber

32. Raynaud phenomenon is an example of which type of hypersensitivity?
a. IV
b. III
c. II
d. I

33. Which statement is true concerning an atopic individual?
a. They tend to produce less IgE.
b. They tend to produce more Fc receptors.
c. They tend to attract very few mast cells.
d. They tend to produce very high levels of IgM.

34. Which statement is true regarding immunodeficiency?
a. Immunodeficiency is generally not present in other family members.
b. Immunodeficiency is never acquired; rather, it is congenital.
c. Immunodeficiency is almost immediately symptomatic.
d. Immunodeficiency is a result of a postnatal mutation.

35. A person with type O blood is considered to be the universal blood donor because type O blood contains which of these?
a. No antigens
b. No antibodies
c. Both A and B antigens
d. Both A and B antibodies

36. Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?
a. I
b. II
c. III
d. IV

37. A pregnant woman has Graves disease. What test/s does the healthcare professional advise the woman about?
a. Frequent tests of the newborn’s muscular strength and movement.
b. Blood test for hyperthyroidism
c. Monthly OB checkups for fetal anomalies or pregnancy loss
d. Serum complete blood count including platelet count

MULTIPLE RESPONSE

1. When a tuberculin skin test is positive, the hard center and erythema surrounding the induration are a result of which of these? (Select all that apply.)
a. Histamine
b. T lymphocytes
c. Immune complexes
d. Products of complement
e. Macrophages

2. Exposure to which of these could result in a type IV hypersensitivity reaction? (Select all that apply.)
a. Poison ivy
b. Neomycin
c. Dairy products
d. Nickel
e. Detergents

3. Which disorders are considered autoimmune? (Select all that apply.)
a. Crohn disease
b. Addison disease
c. Rheumatoid arthritis
d. Systemic lupus erythematosus
e. Type 2 diabetes

4. Which statements best define acute rejection? (Select all that apply.)
a. Acute rejection is a cell-mediated immune response.
b. Acute rejection is usually a type III rejection.
c. Immunosuppressive drugs delay or lessen the intensity of an acute rejection.
d. Acute rejection is associated with the body’s response to an organ transplant.
e. Acute rejection is a response against unmatched human leukocyte antigens (HLAs).

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