Immunology Class Exams

Fall 2009 BLUE VERSION Exam IV MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) Many people with severe allergies carry "epi pens". The epinephrine in the "pens" can immediately stop an allergic response by: A) binding to smooth muscle and causing them to relax B) inhibiting production of lipid mediators C) inhibiting production of inflammatory cytokines D) binding directly to Fc receptors and inhibiting their cross-linking 2) Under what condition do patients develop a large number of immune complexes A) during the first pregnancy B) during an asthma attack C) during insulin dependent diabetes D) during an infection with a chronic virus 3) What observation suggests that transplant rejection is mediated by the adaptive immune system? A) when skin is transplanted onto a syngeneic mouse, the transplant is rejected in 3 days B) when skin is transplanted onto an allogeneic mouse, the transplant is rejected in 3 days C) when a mouse receives two skin transplants from an allogeneic donor, the second transplant is rejected in 10 days D) when a mouse receives two skin transplants from an allogeneic donor, the second transplant is rejected in 3 days 4) What do mysanthenia gravis and insulin independent diabetes have in common? A) they are both caused by an autoreactive antagonistic antibody B) they are both caused by an autoreactive agonistic antibody C) they are both type I hypersensitivity reactions D) A and C E) B and C 5) What occurs during serum sickness? A) serum proteins mutate and become toxic to endothelial cells B) autoreactive antibodies in the serum bind to antigens on blood vessels and cause inflammation C) immune complexes build up in small capillaries and activate neutrophils D) autoreactive helper T cells are activated by serum proteins and cause inflammation in blood vessels 6) Why do transplant patients take cyclosporine? A) the drug binds to the IL-2 receptor on T cells and inhibits binding of IL-2 B) the drug binds to CD3 on T cells and induces apoptosis C) the drug inhibits the signaling in T cells that is responsible for IL-2 production D) the drug inhibits macrophages from secreting cytokines 7) Which of the following is NOT an example of a tumor antigen? A) Ras B) mutated p53 C) HPV E6 protein D) fetal antigens 1 8) Which of the mutations would increase a person's chance of developing autoimmunity? A) a mutation in the IL-4 gene that increases production of IL-4 B) a mutation in the IL-10 gene that increases production of IL-10 C) a mutation in the CTLA-4 gene that increases levels of CTLA-4 D) a mutation in the FoxP3 gene that increases levels of FoxP3 E) a mutation in the AIRE gene that makes the protein non-functional 9) In graft versus host disease, how would alloreactive T cells be activated through direct allorecognition? A) the donor's T cells are activated by the recipient's APCs and recipient's peptides B) the recipient's T cells are activated by the recipient's APCs and donor peptides C) the recipient's T cells are activated by the donor's APCs and donor peptides D) the donor's T cells are activated by the donor's APCs and recipient's peptides 10) How are the blood vessels affected during an allergic response? A) histamines bind to the endothelial cells and make the endothelial cells squeeze together B) prostaglandins stimulate the endotheial cells to begin secreting mucus C) leukotrienes help stimulate the smooth muscles around the blood vessels to relax D) major basic protein is released and breaks apart the tight juctions between endothelial cells 11) Which of the following is most likely to develop a hypersensitivity disorder? A) a 30 year old female, non-smoker B) a 30 year old male, non-smoker C) a 30 year old male, smoker D) a 30 year old female, smoker 12) What is the difference between a sensitized mast cell and an activated mast cell? A) only one (either sensitized or activated) has granules containing IL-4 in the cytoplasm B) only one (either sensitized or activated) circulates continuously in the blood C) only one (either sensitized or activated) has IgE bound to its surface D) only one (either sensitized or activated) has allergen associated with its surface proteins 13) What treatment would most likely help patients with insulin dependent diabetes? A) removing cells with specific MHC I alleles B) removing CD25+ cells C) removing all the antibodies from the blood D) remvoing CD4+ cells 14) What do erythroblastosis fetalis and hyperthyroidism have in common? A) both involve autoreactive antibodies B) both involve destruction by IgG and IgM C) both involve an abnormally high level of immune complexes D) none of the above 15) Which of the following would most likely decrease or stop chronic rejection? A) blocking IFN-g production in the recipient before the transplant B) removing antibodies from the donor's blood before the transplant C) blocking IL-4 production in the recipient before the transplant D) all of the above equally inhibit the main cause of chronic rejection 2 16) Cromolyn, an ingredient in many inhalers used during asthma attacks, works by: A) binding to and inhibiting leukotriene receptors B) binding to and inhibiting histamine receptors C) inhibiting exocytosis in mast cells D) inhibiting synthesis of leukotrienes 17) Which of the following treatments is being used to treat colon cancer patients? A) injecting anti-CD20 into the tumor B) transfecting tumor cells with a plasmid containing the IL-4 gene C) transfecting tumor cells with a plasmid containing the Fca receptor gene D) injecting anti-CD25 into the tumor 18) Which of the following is a type IV hypersensitivity disorders? A) allergic reaction to penicillin B) Lupus C) serum sickness D) multiple sclerosis 19) How would a tumor escape recognition by both NK cells and cytotoxic T cells? A) by increasing expression of Fas B) by inhibiting expression of MHC I C) by secreting IFN-g D) by stopping production of a tumor antigen 20) What is the difference between histamines and leukotrienes? A) histamines are short-lived, leukotrienes are long-lived B) histamine synthesis is inhibited by steroids, leukotriene synthesis is not affected by steroids C) histamines are only secreted by mast cells, leukotrienes are only secreted by basophils and eosinophils D) histamines affect smooth muscles, leukotrienes do not affect smooth muscle 21) If tumor cells are transfected with a plasmid containing the GM-CSF gene, how will the treatment help the patient? A) more NK cells will be recruited into the tumor B) the tumor cells will be able to prime and activate naive T cells C) the tumor cells will be able to perform cross-presentation D) more professional APCs will be recruited into the tumor 22) What is being used to treat certain breast cancer patients? A) a radioactive antibody that binds to CD20 B) an antibody that binds to and blocks ligand b inding to the fibroblast growth factor receptor C) a radioactive antibody that binds to the CEA antigen on the surface of mammary cells D) an antibody that binds to and blocks dimerization of the epidermal growth factor receptor 23) If a person who is type AB blood received blood from a type B donor, what will happen? A) the anti-B antibodies in the donor's blood will bind to and cause destruction of the cells in the recipient B) the anti-A antibodies in the recipient's blood will bind to and cause destruction of the cells from the donor C) the anti-B antibodies in the recipient's blood will bind to and cause destruction of the cells from the donor D) two of the above are correct E) none of the above are correct 3 24) How may molecular mimicry lead to development of an autoimmune disease? A) body cells infected with viruses produce CTLA-4 which directly affect T cell activation B) macrophages infected with viruses present viral peptides that are similar to self peptides C) extracellular bacteria produce proteins similar to B7-1/B7-1 (CD80/CD86) to activate T cells D) extracellular bacteria produce proteins similar to CD28 to activate T cells 25) How can doctors screen patients for alloreactive antibodies? A) mixing serum from the donor with serum from the recipient, then add complement proteins B) mixing serum from the donor with recipient cells, then add complement proteins C) using the mixed lymphocyte reaction D) mixing serum from the recipient with donor cells, then add complement proteins 26) What cytokine(s) is/are secreted by regulatory T cells? A) TNF-b B) IL-10 C) IL-1 D) A and B 27) What occurs during cross-presentation? A) dendritic cells phagocytose cells, the antigens are processed and presented on MHC I B) intracellular peptides are processed and presented on MHC II on neutrophils C) peptides from intracellular antigens move between MHC I and MHC II on dendritic cells D) macrophages phagocytose cells, the antigens are processed andpresented on MHC II 28) How do cytotoxic T cells kill target cells? A) they use granzymes to induce necrosis of a target cells B) they use proteins to punch holes in the plasma membrare C) they use Fas ligand to induce apoptosis of a target cells D) they use 29) The main function of bone marrow stromal cells is to: A) replace damaged bone B) present antigens to mature T cells C) provide growth factors for developing cells D) phagocytose apoptotic cells 30) How do B cells switch isotypes? A) they change their heavy chain constant region B) they change their light chain constant region C) they change their heavy chain variable region D) A and B are correct 31) How is a CD4+ T cell activated? A) the T cell is presented with MHC I and antigen peptide B) the T cell is presented with MHC II and whole antigen C) the T cell is presented with MHC II and antigen peptide D) the T cell is presented with MHC I and whole antigen 4 32) What is the difference between active immunity and passive immunity? A) only one (either passive or active) involves antibodies B) only one (either passive or active) can activate macrophages C) only one (either passive or active) is used to treat cancer patients D) only one (either passive or active) leads to development of memory cells 33) What occurs during negative selection? A) T cells with low affinity for peptide/MHC die B) T cells with high affinity for peptide/MHC live C) T cells with high affinity for peptide/MHC die D) T cells live if they do not bind to peptide/MHC 34) What happens in mice that lack 2 microglobulin? A) they have fewer helper T cells B) they have fewer B cells C) they have fewer red blood cells D) they have fewer cytotoxic T cells 35) How do adjuvants work? A) they activate macrophages which then increase the number of activate T cells B) they bind to MHC/peptide complexes and incease the overall affinity of the interaction C) they bind to antigens and increase the affinity between an antigen and an antibody D) they bind to and increase expression of CD40 on helper T cells 36) How are gd T cells different from ab T cells? A) the TCR on gd T cells only binds to MHC II, not MHC I B) gd T cells are only activated by intracellular antigens C) gd T cells do not develop in the thymus D) gd T cells are less diverse than ab T cells 37) How do antigens and lymphocytes circulate through the lymph nodes? A) antigens and lymphocytes enter through the arteries and leave through the veins B) antigens enter through the afferent lymphatics, lymphocytes enter through the blood, and both antigens and lymphocytes leave through the efferent lymphatics C) antigens and lymphocytes enter through the blood and leave through the efferent lymphatics D) antigens and lymphocytes enter through the afferent lymphatics and both leave through the efferent lymphatics 38) TLR is a major antigen receptor because it binds to: A) a component of the nuclear membrane in all gram positive bacteria like Streptococcus B) the flagella on Salmonella C) a component of the cell wall in all gram negative bacteria like E. coli D) single stranded DNA 39) What molecules are located in the cSMAC of B cells? A) MHC II B) the ligand for CD3 C) CD28 D) all of the above 5 40) What cytokines are secreted by Th2 cells? A) cytokines that activate neutrophils B) cytokines that activate the complement cascade C) cytokines that stimulate production of IgE D) cytokines that stimulate production of IgM 41) The lesions or ulcers found in patients experiencing graft versus host disease often contain NK cells from the donor. A) True B) False 42) During an allergic response, the smooth muscles around the blood vessels relax while the smooth muscles in the digestive tract contract. A) True B) False 43) The majority of symptoms in patients experiencing serum sickness occur when the levels of C3b are high. A) True B) False 44) Photopheresis stimulates the differentiation of monocytes into immature dendritic cells which can then anergize alloreactive T cells. A) True B) False 45) Patients with rheumatic fever develop immune complexes that specifically deposit in the coronary arteries of the heart. A) True B) False 46) Tests looking for autoreactive antibodies that bind to histones are used to diagnose a specific Type II hypersensitivity disorder. A) True B) False 47) Major basic protein and membrane attack complex have similar shapes and both are activated when they bind directly to an antibody. A) True B) False 48) Peptide pulsing dendritic cells with tumor peptides has a shorter effect in patients than transfecting dendritic cells with a plasmid containing tumor antigen genes. A) True B) False 49) A kidney transplant can come from an allogeneic or syngeneic donor, but not an autologous donor. A) True B) False 50) If a pathologist is looking at a transplanted organ that was rejected, the pathologist can determine whether hyperacute or acute rejection occured simply by looking for the presence of alloreactive antibodies because they are only associated with one type of rejection. A) True B) False 51) All hypersensitivity reactions cause autoimmunity. A) True B) False 6 52) A major difference between basophils and eosinophils is that basophils have major basic protein and eosinophils have histamines instead. A) True B) False 53) The number of alloreactive T cells in a person if far greater than the number of E. coli specific T cells. A) True B) False 54) If the HLA type of a donor and recipient match, the chance of allreactive T cells being activated by indirect allorecognition is much less, but the chance of alloreactive T cells being activated by direct allorecognition is just as high as patients who have differenet HLA types. A) True B) False 55) Many people with severe allergies have a mutation that leads to increased levels of IFN-g. A) True B) False 56) A common response during an allergic reaction to food allergens is increased contraction of smooth muscles in the digestive tract. A) True B) False 57) If transcription was inhibited in mast cells, the wheal-and-flare reaction would not occur. A) True B) False 58) People in third world countries have higher levels of eosinophils than people in developed countries. A) True B) False 59) Drugs such as rapamycin are often used to treat both transplant patients and patients with melanoma. A) True B) False 60) The NOD mouse and EAE mouse both spontaneously develop type IV hypersensitivity disorders. A) True B) False 61) EXTRA CREDIT: How does Advair work? A) it inhibits exocytosis in mast cells and basophils B) it blocks both histame and leukotriene receptors on target cells C) it blocks TNF production and causes smooth muscles to relax D) it is an antagonist for the Fce receptor 62) EXTRA CREDIT: How does Rhogam work? A) it is a drug that blocks fetal red blood cells from entering the maternal circulation B) it is an antibody that binds to and blocks the anti-Rh antibody C) it is an antibody that binds to and blocks the Rh antigen D) it is a drug that blocks the transport of maternal IgG into the fetal circulation 7