Professional Documents
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Immunology
Questions
LYMPHOID STRUCTURES
1. Which lymph node structures communicate with efferent lymphatics and contain reticular cells and
macrophages? (p 96) ____________________________________________________________
2. Which lymph node area contains endothelial venules through which T and B cells enter the nodes
from the blood? (p 96) ___________________________________________________________
4. In which part of the lymph node are follicles located? (p 96) ______________________________
5. Which lymph node area becomes greatly enlarged during an extreme cellular immune response?
(p 96) ________________________________________________________________________
6. Match the area of the body with its primary lymph node drainage site. (Numbers may be used more
than once). (p 97)
7. Which side of the upper body does the thoracic duct drain, left or right? (p 97) ________________
8. What is the pathognomonic sign seen on peripheral blood smears of postsplenectomy patients?
(p 98) _________________________________________________________________________
______________________________________________________________________________
10. B cells mature in the _______________ (bone marrow/thymus), whereas T cells mature in the
_______________ (bone marrow/thymus). (p 98)
LYMPHOCYTES
11. In the following chart, check which components are part of the adaptive versus the innate immune
system. (p 99)
Antibody
B cells
Complement
Dendritic cells
Macrophages
Monocytes
Neutrophils
Secreted enzymes
T cells
12. What are the three MHC class I genetic loci? (p 100) ____________________________________
13. What are the three MHC class II genetic loci? (p 100) ____________________________________
14. What cell surface marker is specific to natural killer cells? (p 101) __________________________
15. Which cytokine is secreted by Th1 cells, enhancing the ability of monocytes and macrophages to
kill microbes they ingest? (p 102) ____________________________________________________
16. Name the enzymes used by CD8+ T cells to kill infected, neoplastic, and donor graft cells. (p 102)
______________________________________________________________________________
17. What two major anti-inflammatory cytokines are produced by regulatory T cells? (p 102)
______________________________________________________________________________
IMMUNE RESPONSES
18. By which three mechanisms is antibody diversity generated? (p 104) ________________________
______________________________________________________________________________
19. Match each immunoglobulin isotype with its characteristic. (Numbers may be used more than
once.) (p 105)
20. What activates the alternative, lectin, and classic pathways? (p 106) _______________________
______________________________________________________________________________
24. In the chart below, check which cell surface proteins and receptors are expressed by which type of
cell. (p 110)
28. Which type of hypersensitivity reaction occurs rapidly due to preformed antibody? (p 112) _______
29. Which type of hypersensitivity reaction is mediated by accumulation of immune complexes? (p 113)
______________________________________________________________________________
31. What immunodeficiency is most closely associated with each clinical scenario? (pp 116-117)
A. A 9-year-old boy presents with recurrent sinusitis, otitis media, and erythematous skin
infections. _________________________________________________________________
B. An infant is brought to his pediatrician for the sixth time in several months. Upper respiratory
infection had been diagnosed previously, and he underwent incision and drainage of several
buttock abscesses. Today he is fussy and febrile and has rhinorrhea and demarcated
erythema in the skin folds._____________________________________________________
C. An infant arrives for her 2-month well-child visit. Her abdomen is soft and nontender, but her
umbilical remnant is still present. A red, firm area is present on the back of her thigh, with no
evidence of fluctuance. _______________________________________________________
D. A 5-year-old presents because of recurrent skin infections. In the past, she has been treated
for an E coli urinary tract infection as well as numerous skin infections. Results of today’s
nitroblue tetrazolium test are negative. ___________________________________________
E. A 9-year-old boy presents with coarse facies and a rash. Physical examination reveals he
has two sets of teeth where his adult dentitia have erupted. ___________________________
32. Which autosomal-recessive immune deficiency presents with recurrent pyogenic staphylococcal
and streptococcal infections, partial albinism, and peripheral neuropathy? (p 117) _____________
______________________________________________________________________________
33. Which immunodeficiency presents with a triad of symptoms that include recurrent pyogenic
infections, thrombocytopenic purpura, and eczema? (p 117) _____________________________
34. Name two possible causes of severe combined immunodeficiency. (p 117) __________________
______________________________________________________________________________
35. What are the signs and symptoms of graft-versus-host disease? (p 119) _____________________
______________________________________________________________________________
IMMUNOSUPPRESSANTS
36. What is the mechanism of action of cyclosporine, and to which organ is it most toxic? (p 120) ____
______________________________________________________________________________
37. What is the mechanism of action of sirolimus, and what effect does this have on immunity? (p 120)
______________________________________________________________________________
38. Which antibodies are used to treat the following diseases? (p 122) _________________________
b) Osteoporosis__________________________________________________________________
Answers
LYMPHOID STRUCTURES
1. Medullary sinuses.
2. Paracortex.
3. Follicles.
4. Outer cortex.
5. Paracortex.
6. A-10, B-5, C-9, D-3, E-2, F-11, G-6, H-4, I-8, J-7, K-1.
7. Left.
LYMPHOCYTES
11.
Component Adaptive Immune System Innate Immune System
Antibody √
B cells √
Complement √
Dendritic cells √
Macrophages √
Monocytes √
Natural killer cells √
Neutrophils √
Physical epithelial barriers √
Secreted enzymes √
T cells √
IMMUNE RESPONSES
18. Random recombination of VJ or VDJ genes, random combination of heavy and light chains, and
addition of nucleotides to DNA during genetic recombination by terminal deoxynucleotidyl
transferase.
19. A-4, B-5, C-4, D-3, E-5, F-2, G-5, H-3, I-4, J-3, K-3, L-1.
20. The alternative and lectin pathways are activated by substances (eg, endotoxin) on microbial
surfaces, and the classic pathway is activated by antigen-antibody complexes.
23. A-11, B-8, C-1, D-6, E-9, F-4, G-10, H-7, I-5, J-2, K-3.
24.
Protein/Receptor B cells T cells Macrophages NK cells
B7 √ √
C3b receptor √
CD3 √
CD4 √
CD8 √
CD14 √
CD19 √
CD20 √
CD21 √
CD28 √
CD40 √ √
CD40L √
CD56 receptor √
Fc receptor √
IgG √
MHC I √ √ √ √
MHC II √ √
TCR √
28. Type I.
30. A-15, B-1, C-25, D-5, E-16, F-24, G-8, H-6, I-3, J-7, K-11, L-18, M-17, N-19, O-12, P-22, Q-2, R-23,
S-20, T-9, U-14, V-4, W-13, X-10, Y-21.
IMMUNOSUPPRESSANTS
36. Inhibits calcineurin and blocks T-cell activation by preventing IL-2 transcription. It is most toxic to
the kidney.
37. Inhibits mammalian target of rapamycin (mTOR) and blocks T-cell activation and differentiation by
preventing response to IL-2.
b) Denosumab.
c) Omalizumab