Chapter 19 Disorders Associated with the Immune System My Nursing Test Banks

Microbiology: An Introduction, 12e, (Tortora)

Chapter 19   Disorders Associated with the Immune System

19.1   Multiple-Choice Questions

1) All of the following are true of hypersensitivity EXCEPT

A) it occurs in the presence of an antigen.

B) it is synonymous with allergy.

C) it occurs when an individual is exposed to an allergen for the first time.

D) it is due to an altered immune response.

E) it requires previous exposure to an antigen.

Answer:  C

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.3

2) The chemical mediators of anaphylaxis are

A) found in basophils and mast cells.

B) antibodies.

C) antigens.

D) antigen-antibody complexes.

E) the proteins of the complement system.

Answer:  A

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.3

3) Which of the following may result from systemic anaphylaxis?

A) hay fever

B) asthma

C) shock

D) hives

E) immunodeficiency

Answer:  C

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.3

4) Which antibodies will be in the serum of a person with blood type B, Rh+?

A) anti-A, anti-B, anti-Rh

B) anti-A, anti-Rh

C) anti-A

D) anti-B, anti-Rh

E) anti-B

Answer:  C

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.8

5) Which of the following types of transplant is least compatible?

A) autograft

B) allograft

C) isograft

D) xenotransplant

E) All of these types of transplant are equally compatible.

Answer:  D

Section:  19.3

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.17

6) When testing donated blood for compatibility you would find a person with O type blood

A) has O type antigens on their red blood cells.

B) will lack plasma antibodies to A and B type antigens.

C) will lack A and B red blood cell antigens.

D) lacks HLA and MHC antigens.

E) will have anti-O antibodies in their plasma.

Answer:  C

Section:  19.1

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  8.5

Learning Outcome:  19.7

7) Graft-versus-host disease will most likely be a complication of a(n)

A) skin graft.

B) bone marrow transplant.

C) blood transfusion.

D) Rh incompatibility between mother and fetus.

E) corneal transplant.

Answer:  B

Section:  19.3

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.18

8) A positive tuberculin skin test is an example of

A) delayed cell-mediated immunity.

B) autoimmunity.

C) acute contact dermatitis.

D) psoriasis.

E) innate immunity.

Answer:  A

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.10

9) A healthy immune system destroys cancer cells with

A) tumor-specific antigens.

B) CTLs.

C) CTLs and activated macrophages.

D) activated macrophages.

E) CD+ T cells.

Answer:  C

Section:  19.4

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.20

10) The symptoms of an immune complex reaction are due to

A) destruction of the antigen.

B) complement activation.

C) phagocytosis.

D) antibodies against self.

E) cytokines.

Answer:  B

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.9

11) Rheumatoid arthritis is due to deposition of

A) IgG and IgA complexes in joints.

B) IgA antibodies in joints.

C) IgD and IgE complexes in joints.

D) complement in joints.

E) complexes of IgM and IgG and also complement in joints.

Answer:  E

Section:  19.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.12

12) Allergic contact dermatitis is due to

A) sensitized T cells.

B) IgG antibodies.

C) IgE antibodies.

D) IgM antibodies.

E) activated macrophages.

Answer:  A

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.10

13) Attachment of HIV to the target cell depends on

A) gp120 combining with the CD4+ receptor.

B) gp120 combining with the chemokine receptor CCR5.

C) gp41 binding to the CD4+ receptor.

D) gp120 binding to the CD4+ plasma membrane.

E) CXCR4 binding to the CD4+ receptor.

Answer:  A

Section:  19.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  19.24

14) All of the following pertain to serological tests EXCEPT

A) they can detect antibodies but not antigens.

B) they can be used to diagnose various diseases.

C) reactions can be detected by uptake of trypan blue by damaged cells.

D) they are used to test for specific HLAs on lymphocytes.

E) they are used to detect compatible tissues for transplantation.

Answer:  A

Section:  19.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  8.3

Learning Outcome:  19.28

Global Outcome:  5

15) The process of desensitization to prevent allergies involves the injection of increasing amounts of

A) IgE.

B) IgG.

C) antihistamine.

D) antigen.

E) RhoGAM.

Answer:  D

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.5

Global Outcome:  5

16) Which of the following statements about type I reactions is FALSE?

A) They involve helper T cells.

B) They involve IgE antibodies.

C) The symptoms are due to histamine.

D) Antibodies bind to mast cells and basophils.

E) The symptoms occur soon after exposure to an antigen.

Answer:  A

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.2

17) Which of the following statements about type IV reactions is FALSE?

A) Reactions are primarily due to T cell proliferation.

B) Reactions are not apparent for a day or more.

C) Cytokines initiate tissue damage.

D) Allergic contact dermatitis is an example.

E) Hemolytic disease of the newborn is an example.

Answer:  E

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.10

18) Table 19.1

Donor

Recipient

1.  AB, Rh

AB, Rh+

2.  A, Rh+

A, Rh

3.  A, Rh

O, Rh+

4.  B, Rh 

B, Rh+

5.  B, Rh

A, Rh+

Which blood transfusions in Table 19.1 are incompatible?

A) 2 and 5

B) 1, 2, and 3

C) 2, 3, and 5

D) 3 and 4

E) 1 and 2

Answer:  C

Section:  19.1

Blooms Taxonomy:  Analysis

Learning Outcome:  19.8

Global Outcome:  2

19) Hemolytic disease of the newborn can result from an

A) Rh+ mother with an Rh fetus.

B) Rh mother with an Rh+ fetus.

C) AB mother with a B fetus.

D) AB mother with an O fetus.

E) Rh mother and an A fetus.

Answer:  B

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.8

20) Which is true regarding Herceptin therapy?

A) It neutralizes the growth factor EGF.

B) It acts as an immunotoxin to target and kill cancer cells.

C) It is used to treat some breast cancer patients.

D) It is a vaccine to prevent the development of cancer.

E) It is an endotoxin that stimulates TNF by macrophages.

Answer:  C

Section:  19.4

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.21

Global Outcome:  5

21) Which of the following utilizes a combination of monoclonal antitumor antibody and immunotoxin?

A) immunologic enhancement

B) immunologic surveillance

C) immunotherapy

D) immunosuppression

E) immune complex

Answer:  C

Section:  19.4

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.21

Global Outcome:  5

22) All of the following are reasons why an HIV vaccine has not been developed EXCEPT

A) there is no known animal model of natural immunity for HIV infection.

B) use of a weakened virus would potentially transmit the infection.

C) small, inexpensive animals which could be used for HIV vaccine research are not available.

D) vaccines are not effective against viral infections.

E) HIV has a high mutation rate so one vaccination would not be effective to treat the world-wide pandemic.

Answer:  D

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  19.21

23) Treatment with certain drugs to reduce transplant rejection can cause

A) immunologic enhancement.

B) immunologic surveillance.

C) immunotherapy.

D) immunosuppression.

E) autoimmunity.

Answer:  D

Section:  19.3

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.14

24) Which of the following statements about human embryonic stem cells is TRUE?

A) They are obtained in great numbers from umbilical cords of newborns.

B) They express no MHC II antigens.

C) They are pluripotent.

D) They are typically obtained from the zygote stage of embryonic development.

E) They are pluripotent and typically obtained from the blastocyst stage of embryonic development.

Answer:  E

Section:  19.3

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.16

Global Outcome:  5

Figure 19.1

25) In immune complex reaction shown in Figure 19.1, what is the small, circular/spherical structure labeled a?

A) antibody

B) antigen

C) complement

D) neutrophil

E) mast cell

Answer:  B

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.9

26) In immune complex reaction shown in Figure 19.1, what is the end result of the reaction?

A) IgG is directed against cell membrane antigens.

B) Complement is activated.

C) Neutrophils are attracted and release enzymes.

D) Endothelial cells are damaged.

E) Antibodies destroy neutrophils.

Answer:  D

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.9

27) Worldwide, the primary method of transmission of HIV is

A) heterosexual intercourse.

B) homosexual intercourse.

C) intravenous drug use.

D) blood transfusions.

E) nosocomial.

Answer:  A

Section:  19.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  19.29

28) HIV spikes attach to CD4+ receptors found on

A) T helper cells.

B) macrophages.

C) dendritic cells.

D) T helper cells and macrophages.

E) T helper cells, macrophages, and dendritic cells.

Answer:  E

Section:  19.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  19.24

29) Which of the following is the least likely vaccine against HIV?

A) attenuated virus

B) glycoprotein

C) protein core

D) subunit

E) All of these vaccines are equally likely.

Answer:  A

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  6.3

Learning Outcome:  19.31

Global Outcome:  5

30) Which of the following is a possible outcome of an HIV infection?

A) Virions may remain latent.

B) There may be persistent yeast infections.

C) Infection may initially be asymptomatic.

D) The disease does not progress to AIDS.

E) All of the answers are correct.

Answer:  E

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  19.26

31) Which of the following regions has the greatest distribution of HIV infection and AIDS in the world?

A) North America

B) Eastern Europe and Central Asia

C) South and Southeast Asia

D) sub-Saharan Africa

E) Latin America

Answer:  D

Section:  19.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  5.4

Learning Outcome:  19.30

32) Chemotherapy to inhibit the progression of HIV infection utilizes all of the following mechanisms EXCEPT

A) termination of viral DNA.

B) inhibition of viral proteases.

C) blockage of viral attachment.

D) prohibition of viral integration into host cell DNA.

E) destruction of viral ribosomes.

Answer:  E

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  3.4

Learning Outcome:  19.31

Global Outcome:  5

33) During the asymptomatic phase I of HIV disease, HIV infection is diagnosed by

A) detecting viral RNA.

B) detecting antibodies against HIV.

C) counting CD4+ T cells.

D) counting CD8+ T cells.

E) the Western blot test.

Answer:  A

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  8.3

Learning Outcome:  19.28

Global Outcome:  5

34) Anaphylaxis is the term for reactions caused when certain antigens combine with

A) IgE antibodies.

B) macrophages.

C) IgG antibodies.

D) complement.

E) histamine.

Answer:  A

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.2

35) All of the following regarding immune privileged sites are true EXCEPT

A) they include corneal and brain tissue.

B) they do not have lymphatic vessels.

C) they are rarely rejected.

D) they include any tissue transplanted from a pig.

E) they explain how animals tolerate pregnancies without rejecting the fetus.

Answer:  D

Section:  19.3

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.15

36) All of the following are considered examples of type I hypersensitivity EXCEPT

A) asthma.

B) dust allergies.

C) penicillin allergic reactions.

D) pollen allergies.

E) transplant rejections.

Answer:  E

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.10

37) All of the following lead to drug-induced thrombocytopenic purpura. Which occurs first?

A) Antibodies and complement react with platelets.

B) Antibodies against haptens are formed.

C) Drug binds to platelets.

D) Platelets are destroyed.

E) Purpura occurs on the skin.

Answer:  C

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.6

38) Immunodeficiencies are a result of all of the following EXCEPT

A) HIV infection.

B) cyclosporine.

C) DiGeorge syndrome.

D) Hodgkins disease.

E) autoimmune diseases.

Answer:  E

Section:  19.5

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.22

39) Which of the following describes a cytotoxic autoimmune reaction?

A) Antibodies react to cell-surface antigens.

B) Antibodies are not made.

C) Cells are killed.

D) Immune complexes form.

E) Mediate by T cells.

Answer:  A

Section:  19.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.12

40) Symptoms of delayed cell-mediated reactions are due to

A) IgE antibodies.

B) neutrophils.

C) cytokines.

D) IgG antibodies.

E) antigens.

Answer:  C

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.10

41) Desensitization involves injection of

A) antigens.

B) IgG antibodies.

C) IgE antibodies.

D) antihistamine.

E) histamine.

Answer:  A

Section:  19.1

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  8.5

Learning Outcome:  19.5

Global Outcome:  5

42) In the serological method for tissue typing, if human cells expressing HLA-I are mixed with anti-HLA-I, complement, and trypan blue, what would indicate the cells are HLA-I?

A) Enzyme is released from neutrophils.

B) Cells are damaged by complement.

C) Trypan blue enters the cells.

D) Anti-HLA antibodies bind to HLAs on lymphocytes.

E) None of the answers are correct; the T cells are missing.

Answer:  C

Section:  19.3

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  8.5

Learning Outcome:  19.13

Global Outcome:  5

43) In rheumatoid arthritis, IgM, IgG, and complement deposit in joints. This is an example of

A) cytotoxic autoimmunity.

B) immune complex autoimmunity.

C) cell-mediated autoimmunity.

D) immunosuppression.

E) acquired immunodeficiency.

Answer:  B

Section:  19.2

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.12

44) The number of T cells drops to below 200 cells/microliter in which phase of HIV infection?

A) phase 1

B) phase 2

C) phase 3

D) initial phase

E) asymptomatic phase

Answer:  C

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  19.26

45) HIV can evade host antibodies by

A) remaining an inactive provirus.

B) causing cell-to-cell fusion.

C) remaining an inactive provirus, causing cell to cell fusion, and virions remaining latent in vacuoles.

D) lowering the CD4+ cell count.

E) virions remaining latent in vacuoles.

Answer:  C

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  19.25

19.2   True/False Questions

1) Individuals who do not express CCR5 are highly resistant to infection by HIV.

Answer:  TRUE

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  19.24

2) Vaccines against HIV have proven to be very effective in halting the spread of disease.

Answer:  FALSE

Section:  19.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  6.3

Learning Outcome:  19.31

Global Outcome:  5

3) All hypersensitivities involve antibody-antigen reactions.

Answer:  FALSE

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.10

4) Skin tests are reliable indicators for the diagnosis of food-related allergies.

Answer:  FALSE

Section:  19.1

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.4

5) HIV attack of CD4+ T cells causes suppression of both cell-mediated and humoral immune responses.

Answer:  TRUE

Section:  19.6

Blooms Taxonomy:  Comprehension

ASMcue Outcome:  5.4

Learning Outcome:  19.27

6) Autoimmune diseases occur when the immune system is unable to discriminate self from nonself.

Answer:  TRUE

Section:  19.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.11

7) Xenotransplantation is an effective alternative to using isografts.

Answer:  FALSE

Section:  19.2

Blooms Taxonomy:  Comprehension

Learning Outcome:  19.12

Global Outcome:  5

8) All stem cells are derived from embryonic stem cells.

Answer:  FALSE

Section:  19.3

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.16

Global Outcome:  5

9) Cancer is similar to an infectious disease in that it is due to a failure of the bodys defenses.

Answer:  TRUE

Section:  19.4

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.20

10) HIV is believed to have arisen by mutation of a virus endemic to wild animals in Africa.

Answer:  TRUE

Section:  19.6

Blooms Taxonomy:  Knowledge

ASMcue Outcome:  1.3

Learning Outcome:  19.23

11) A hypersensitivity reaction refers to immune responses to antigens beyond what would be normal.

Answer:  TRUE

Section:  19.1

Blooms Taxonomy:  Knowledge

Learning Outcome:  19.1

19.3   Essay Questions

1) Differentiate type II from type III hypersensitivity reactions.

Section:  19.1

Blooms Taxonomy:  Analysis

Learning Outcome:  19.8

Global Outcome:  8

2) Even though AIDS is an infectious disease caused by a virus, why is it also considered an immunodeficiency disease?

Section:  19.6

Blooms Taxonomy:  Evaluation

ASMcue Outcome:  5.4

Learning Outcome:  19.27

Global Outcome:  8

3) What is desensitization? Explain how this treatment can induce systemic anaphylaxis. How is systemic anaphylaxis treated?

Section:  19.1

Blooms Taxonomy:  Analysis

Learning Outcome:  19.5

Global Outcome:  8

4) A health care worker had a needlestick injury while drawing blood from an AIDS patient. Lab tests on the workers serum were negative. Explain why the worker can still be infected even though her lab tests were negative. How should her health care be monitored?

Section:  19.6

Blooms Taxonomy:  Analysis

ASMcue Outcome:  8.3

Learning Outcome:  19.28

Global Outcome:  8

5) Explain why a transplant tissue would be rejected if that tissue had different HLAs compared to the HLAs of the recipient. How can this rejection be decreased?

Section:  19.3

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.3a

Learning Outcome:  19.14

Global Outcome:  8

6) Explain the relationship between thymic selection of maturing T cells and self tolerance.

Section:  19.2

Blooms Taxonomy:  Analysis

ASMcue Outcome:  7.3a

Learning Outcome:  19.11

Global Outcome:  8

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