Final Exam White Version

White Version Answer Key: 1. D 2. D 3. B 4. E 5. D 6. B 7. B 8. C 9. D 10. B 11. E 12. E 13. C 14. A 15. B 16. A 17. E 18. C 19. A 20. C 21. E 22. A 23. E 24. B 25. D 26. A 27. B 28. C 29. A 30. D 31. B 32. B 33. A 34. A 35. B 36. A 37. A 38. B 39. B 40. B 41. A 42. A 43. A 44. A 45. B 46. B 47. A 48. B 49. A 50. A 51. B 52. B 53. B 54. A 55. B 56. B 57. B  Final Exam Spring 2009 Questions 1-30: Select one answer for each question. (1 point/question) 1. What would happen if a patient was able to produce a normal version of C5a but they produced a mutated version of C5b that was not functional? a. none of their complement proteins would be able to induce changes in endothelial cells b. none of their complement proteins would be able to activate neutrophils c. a and b d. none of their complement proteins would be able to punch holes in bacteria e. their complement proteins would not opsonize bacteria 2. What occurs when a receptor on NK cells binds to MHC I and self peptide? a. ITAMs are phosphorylated and kinases are activated b. ITAMs are phosphorylated and phosphatases are activated c. ITIMs are phosphorylated and kinases are activated d. ITIMs are phosphorylated and phosphatases are activated 3. During serum sickness, when do patients feel the worst? a. when their levels of autoreactive antibodies are highest b. when their levels of C3 are lower c. when their levels of a blood-borne virus are highest d. when their levels of IgE are highest e. when their levels of IL-10 are highest 4. When someone has a positive allergy test, what causes the immediate redness on the skin? a. IL-4 is a chemokine for red blood cells and increases the amount of red blood cells in the area b. a large number of eosinophils (which are red) are recruited into the area c. enzymes break apart the blood vessels and allow red blood cells to leave the blood vessels d. IL-4 is secreted and makes the eosinophils under the skin proliferate, increasing the number of eosinophils e. histamines cause blood vessels to dilate, causing more red blood cells to accumulate in the area 5. Knowing what causes graft-versus-host-disease, how could it be prevented? a. by inhibiting alloreactive B cells from the recipient b. by inhibiting alloreactive B cells from the donor c. by inhibiting alloreactive CTLs from the recipient d. by inhibiting alloreactive CTLs from the donor e. by inhibiting alloreactive macrophages from the donor 6. If someone is treated with the C4 binding protein, what occurs? a. the classical complement pathways is activated b. the lectin complement pathway is inhibited c. a and b d. the alternative complement pathway is inhibited e. the alternative complement pathway is activated 7. When a patient experiences acute rejection of a transplant, what will happen to the transplant? a. the blood vessels will be destroyed by alloreactive antibodies but the surrounding tissue will remain healthy b. the blood vessels and surrounding tissue will be destroyed by Th1 mediated inflammation c. the blood vessels will remain undamaged but the surrounding tissue will be destroyed by cytotoxic T cells d. a large amount of scar tissue will develop in the transplant e. large open lesions or soars will develop in the area surrounding the transplant 8. How would you diagnose autoimmune hyperthyroidism in a patient? a. test for autoreactive CTLs in the thyroid b. test for autoreactive Th2 cells in the thyroid c. test for antibodies that bind a thyroid receptor and activate it d. test for antibodies that bind a thyroid receptor and inhibit it e. look for an increased number of macrophages in the thyroid 9. How do regulatory T cells (Tregs) affect tumors in colon cancer patients? a. the Tregs stimulate dendritic cells to endocytose the cancer cells b. the Tregs stimulate cytotoxic T cells to attack and kill the tumor cells while protecting the normal cells c. the Tregs suppress tumor cells from dividing by secreting IFN- d. the Tregs suppress cytotoxic T cells from attacking the tumor e. b and c 10. Which of the following treatments is being used to stop rejection of transplanted organs? (think about what needs to be done to the recipient’s T cells and which dendritic cell is more likely to perform that function) a. stimulating a recipient’s T cells with immature dendritic cells b. inhibiting a recipient’s T cells with immature dendritic cells c. stimulating a recipient’s T cells with mature dendritic cells d. inhibiting a recipient’s T cells with mature dendritic cells 11. How are antibodies transferred from a mother to a developing fetus? a. the mother’s IgA binds to poly Ig receptors on fetal blood vessels, is transported through the endothelial cells and is then released into the fetal blood circulation b. the mother’s IgA specific plasma cells migrate through the walls of the fetal blood vessels into the fetal blood circulation c. the mother’s IgG binds to poly Ig receptors on fetal blood vessels, is transported through the endothelial cells, and is then released into the fetal blood circulation d. the mother’s IgG specific plasma cells migrate through the walls of the fetal blood vessels into the fetal blood circulation e. the mother’s IgG binds to FcN receptors on fetal blood vessels, is transported through the endothelial cells, and is then released into the fetal blood circulation 12. For patients with asthma, what causes the extended shortness of breath and difficulty breathing? a. major basic protein destroys epithelial cells in the lungs b. histamines binding to bronchial muscles for long periods of time and cause contraction c. IL-4 binding to epithelial cells and stimulating mucus production d. platelet activating factor binding to bronchial muscles and causing relaxation for long periods of time e. leukotrienes binding to bronchial muscles and cause contraction for long periods of time 13. If someone develops Rheumatic Fever, why are they more likely to have heart disease as they age? a. Autoreactive cytotoxic T cells in the heart are activated by a Streptococcus infection in the heart b. Streptococcus infect heart cells and eventually cause the heart cells to lyse open c. Antibodies against a mutated form of Streptococcus cross-react with antigens on the heart cells d. a large amount of antibody/Streptococcus complexes build up in the body’s capillaries and block blood flow to the heart e. Streptococcus stops compliment inhibitors and allows compliment to destroy heart cells 14. Which of the following tumor vaccines would directly activate tumor specific CTLs (without requiring other APCs)? a. giving a patient tumor cells with CD80/CD86 b. giving a patient tumor cells that secrete IL-10 c. giving a patient tumor cells that secrete GM-CSF d. a and c e. all of the above would immediately activate tumor specific CTLs 15. How are alloreactive T cells activated during indirect allorecognition in host (recipient) versus graft (donor) disease? a. the recipient’s T cells are activated by the donor’s APCs and donor 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 recipient’s peptides d. the donor’s T cells are activated by the donor’s APCs and recipient’s peptides e. the donor’s T cells are activated by the recipient’s APCs and recipient’s peptides 16. If someone has an allergic response to certain foods, what causes the intestinal hypermotility? a. histamines bind to the intestinal smooth muscles and cause them to contract b. cytokines bind to the intestinal smooth muscles and cause them to contract c. histamines bind to the intestinal smooth muscles and cause them to relax d. cytokines bind to the intestinal smooth muscles and cause them to relax e. leukotrienes bind to the intestinal sooth muscles and cause them to relax 17. What happens when cells are killed by antibody dependent cell-mediated cytotoxicity? a. NK cells kill cells that have large amounts of complement proteins bound to the cell b. mast cells kill cells that have IgE bound to antigens on the cell c. cytotoxic T cells kill cells that have IgG bound to antigens on the cell d. eosinophils kill cells that have IgA bound to antigens on the cell e. NK cells kill cells that have IgG bound to antigens on the cell 18. How can Systemic Lupus Erythematosis be diagnosed in a patient? a. look for autoreactive antibodies that bind to healthy red blood cells b. look for autoreactive T cells that bind to healthy red blood cells c. look for autoreactive antibodies that bind to DNA d. look for autoreactive T cells that bind to DNA e. look for inflammation in the liver 19. What type of antibody would be the most useful for tumor therapy? a. IgG with radioactivity attached to it b. IgE with radioactivity attached to it c. the Fab portion of IgA d. the Fab portion of IgD e. all of the above would be useful 20. Why do blood vessels become leaky during allergic reactions? a. histamines bind to smooth muscle cells around the blood vessel and directly stimulate the smooth muscles to contract b. leukotrienes stimulate smooth muscle cells around the blood vessels to contract and pull the endothelial cells apart c. histamines stimulate endothelial cells to shrink and pull away from each other d. digestive enzymes break apart the proteins holding the endothelial cells together e. platelet activating factor stimulates endothelial cells to shrink and pull away from each other 21. What occurs during the germinal center reaction? a. immature B cells die if they bind to self antigen b. immature T cells die if they bind to self antigen c. mature T cells rearrange their alpha chain genes d. mature B cells rearrange their light chain genes e. mature B cells hypermutate their immunoglobulin genes 22. What occurs during positive selection of T cells? a. T cells with a low affinity for self peptide and self MHC survive b. T cells with a low affinity for self peptide and self MHC die c. T cells with a high affinity for self peptide and self MHC survive d. T cells with no affinity for self peptide and self MHC survive 23. How is a lymph node organized? a. the B cells are in the paracortex and the T cells are in the cortex b. the B cells are in the medulla and the T cells are in the paracortex c. the B cells are in the follicles and the T cells are in the periarteriolar lymphoid sheath d. the B cells are in the periarteriolar lymphoid sheath and the T cells are in the cortex e. the B cells are in the cortex and the T cells are in the paracortex 24. What is the function of CD28? a. CD28 helps to activate T cells when it binds to CD40 b. CD28 helps to activate T cells when it binds to CD80 c. CD28 stops T cell activation when it binds to CTLA-4 d. CD28 helps to activate T cells by binding to CD4 e. CD28 helps to activate T cells by binding to CD8 25. How are macrophages different from neutrophils? a. neutrophils are long lived and macrophages are short lived b. macrophages circulate in the blood and neutrophils reside in tissues c. macrophages phagocytose antigens and neutrophils only secrete enzymes to destroy antigens d. macrophages manage tissue repair after an infection has been cleared e. dead macrophages make up the majority of cells in a scab 26. What is the difference between a Th1 cell and a Th2 cell? a. the Th1 cell activates macrophages b. the Th2 cell activates macrophages c. the Th1 cell produces TGF- d. the Th2 cell stimulates production of opsonizing antibodies e. the Th1 cell stimulates production of IgE 27. When memory cells respond to an antigen, how is their response different from naïve cells? a. memory B cells predominantly produce IgM and naïve B cells predominantly produce IgG b. memory B cells produce more high affinity antibodies than naïve B cells c. memory B cells respond to an antigen in 10-14 days following exposure to the antigen d. memory B cells express fewer co-stimulatory molecules than naïve B cells e. memory B cells are unable to activate helper T cells 28. How do antigens and lymphocytes circulate through the spleen? a. antigens and lymphocytes enter through the afferent lymphatics and leave through the efferent lymphatics b. antigens and lymphocytes enter through the high endothelial venules (HEVs) and leave through the efferent lymphatics c. antigens and lymphocytes enter through arteries and leave through veins d. antigens and lymphocytes enter through afferent lymphatics and leave through HEVs e. antigens enter through afferent lymphatics, lymphocytes enter through HEVs, and both leave through efferent lymphatics 29. How is a CD8+ T cell activated? a. the T cell is presented with antigen peptide and MHC class I b. the T cell is presented with antigen peptide and MHC class II c. the T cell is presented with whole antigen and MHC class I d. the T cell is presented with whole antigen and MHC class II 30. What is the function of RAG? a. to activate transcription of the IL-2 gene b. to switch isotypes in B cells c. to stimulate apoptosis of target cells d. to rearrange Ig and TCR gene segments e. to digest phagocyted material 31-55: True/False. Choose one answer for each question. (1 point/question) 31. The difference between an unsensitized mast cell and a sensitized mast cell is the number of granules in the cell’s cytoplasm. a. True b. False 32. Without C1r and C1s, mannose binding lectin can not activate the complement pathway. a. True b. False 33. One way to diagnose multiple sclerosis is to look for autoreactive T cells in the patient’s spinal fluid. a. True b. False 34. C3b is an opsin and is also a component of the C5 convertase. a. True b. False 35. The drug Bexxar (developed at University of Michigan) is a radioactive antibody that kills T cells in a patient with T cell non-Hodgkin’s Lymphoma. a. True b. False 36. If fatty acids can not be removed from a mast cell membrane and converted, the mast cell will be able to produce histamines, but it will be unable to produce leukotrienes. a. True b. False 37. CD59 inhibits the classical pathway, the lectin pathway, and the alternative complement pathway. a. True b. False 38. Inhibiting the production of IL-10 would decrease the chances of chronic rejection developing in a transplant patient. a. True b. False 39. The secretory component stabilizes the same isotype of antibody that activates NK cells. a. True b. False 40. Some fast acting inhalers contain cromolyn which treats an asthma attack by stopping the synthesis of lipid mediators. a. True b. False 41. Regulatory T cells can be produced by culturing naïve T cells with immature dendritic cells and TGF- . a. True b. False 42. Insulin resistant diabetes and mysanthenia gravis are both caused by autoreactive antibodies that bind to receptors and inhibit the receptors. a. True b. False 43. Epinephrine treats symptoms caused by lipid mediators released from mast cells and corticosteroids treat symptoms associated with the cytokines produced by mast cells. a. True b. False 44. A mixed lymphocyte reaction is used to determine if acute rejection will occur in a transplant patient due to direct allorecognition of alloreactive T cells. a. True b. False 45. NK cells and cytotoxic T cells both use granzymes and fas ligand to kill infected cells. a. True b. False 46. Cyclosporine inhibits the transcription of TNF- and IL-1 genes and therefore prevents acute transplant rejection. a. True b. False 47. Fusion proteins and fetal proteins on tumor cells can be used to stimulate the immune system to attack the tumor cells. a. True b. False 48. Factor B is required for the C3 convertase to form in the classical, lectin, and alternative complement pathways. a. True b. False 49. To determine if a patient has alloreactive antibodies, doctors can mix serum from the patient with cells from the donor, add complement proteins, and then see if the donor cells are destroyed. a. True b. False 50. Decidual NK cells are needed to recruit embryonic cells to the wall of the uterus and to stimulate blood vessel development. a. True b. False 51. Hyperacute rejection occurs when the antibodies in a recipient with type AB blood bind to the antigens on red blood cells from a type O donor. a. True b. False 52. Opsonizing antibodies bind to receptors on macrophages and activate transcytosis in the macrophage. a. True b. False 53. Removing Th1 cells from a NOD mouse can decrease their hypersensitivity symptoms while removing Th2 cells from a mouse with EAE can decrease their hypersensitivity symptoms. a. True b. False 54. Eosinophils and mast cells are both activated by IgE and allergen, but only one of the cells (either eosinophils or mast cells) releases histamines when it is activated. a. True b. False 55. CTLA-4 Ig is used to treat cancer patients by inhibiting the interaction between regulatory T cells and tumor specific effector T cells. a. True b. False Extra Credit: 56. What is the purpose of Rhogam and how does it work? a. to activate regulatory T cells in patients with diabetes b. to inhibit the production of specific memory B cells in pregnant women c. to specifically inhibit the production of mucus associated with allergic rhinitis d. to inhibit NK cells from attack fetal blood vessels in the placenta e. to remove CD25+ cells from a tumor 57. What is absent on the surface of decidual NK cells but is present on the surface of peripheral blood NK cellls? a. MHC I b. Fcreceptor c. CD25 d. natural cytotoxicity receptors (ex: NKp44) e. all of the above