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Patho- Immune Disorders- Type I Hypersensitivity (Exam 4)

Total questions: 57

Worksheet time: 31mins

Name
Class
Date
1.

What type of sensitivity is an allergic or atopy reaction?

a)

I

b)

II

c)

III

d)

IV

2.

What is the mechanism of a type I hypersensitivity?

a)

Ag induces cross-linking of IgE bound to mast cells and basophils with release of vasoactive dilators

b)

Ab directed against cell surface antigens mediates cell destruction via complement activation or Ab-dependent cell-mediated cytotoxicity (ADCC). RBCs are common targets

c)

Ag-Ab complexes deposited in various tissues induce complement activation an dan ensuing inflammatory response mediated by massive infiltration of neutrophils

d)

sensitized T cells (TH1, TH2, and others) release cytokines that activate macrophages or TC cells, which mediate direct cellular damage

3.

What are the typical manifestations of a type I hypersensitivity?

a)

Induce systemic anaphylaxis and localized anaphylaxis such as hay fever, asthma, hives, food allergies, and eczema

b)

includes blood transfusion reactions, erythroblastosis, fettles, and autoimmune hemolytic anemia

c)

includes localized Arthus reaction and generalized reactions such as serum sickness, necrotizing vasculitis, glomerulonephritis, RA, and systemic lupus erythematosus

d)

includes contact dermatitis, tubular lesions, and graft rejection

4.

What are the signs and symptoms of allergic rhinitis?

a)

sneezing (and sneezing so hard/frequently that you get infraorbital cyanosis)

b)

nasal, ocular, palatal itching (which can cause the occurrence of transverse nasal crease)

c)

runny nose and/or congestion

d)

pale, bluish nasal mucosa

e)

cough

5.

What are the laboratory findings of allergic rhinitis?

a)

nasal eosinophils

b)

evidence of allergen-specific IgE by skin or radioallergosorbent testing (RAST)

c)

topical skin rash

d)

extranasal fluid

6.

Which immunoglobulin is responsible for type I hypersensitivity?

a)

IgE

b)

IgG

c)

IgA

d)

IgM

7.

In a person who is not experiencing a type I hypersensitivity or infection with worms, is the concentration of IgE high or low in concentration in the blood serum?

a)

high

b)

low

8.

What two things initiate an allergy?

a)

IgE antibody

b)

multivalent antigen

c)

T cells

d)

memory B cells

9.

_________ individuals produce IgE against common environmental antigens.

a)

atopic

b)

allergic

c)

weak

10.

When atopic individuals produce IgE against common environmental antigens, what are the antigens usually?

a)

proteins

b)

glycoproteins

c)

pet dander

d)

environmental factors (pollen etc)

11.

What type of response is induced after an antigen enters mucosal tissue at very low concentrations?

a)

IgE-stimulating TH2 responses

b)

IgE-stimulating TH1 responses

c)

IgE-stimulating TC cell release

12.

IgE antibodies act by cross-linking what kind of receptor on the surfaces of innate immune cells?

a)

Fcε receptors

b)

PAMPs

c)

G-protein-linked receptors

13.

Although antibodies are not harmful by themselves, the granule contents released include histamine, heparin, proteases, leukotrienes, prostaglandins, and chemokines, which can cause allergic reactions.

a)

true

b)

false

14.

Which receptor is responsible for most allergy symptoms and is expressed on mast cells and basophils?

a)

FcεRI

b)

Fcε

c)

FcεRII

15.

Which low affinity IgE receptor regulates production of IgE by B cells?

a)

FcεRI

b)

Fcε

c)

FcεRII

16.

The high-affinity IgE receptor FcεRI linking receptors trigger _____________ phosphorylation of ITAMs.

a)

oxidative

b)

Lyn-mediated

c)

glucose

d)

protein

17.

Lyn-mediated phosphorylation of ITAMs triggers which 2 pathways, leading to allergic effects?

a)

JAK-STAT

b)

PKC

c)

MAPK

18.

Mast cells express two types of receptors: FcεRI (activating) and FcγRIIB (inhibiting) Ig receptors. If a cell binds both IgE and IgG, which signal wins? (Hint: this is what makes allergy shots effective)

a)

IgE

b)

IgG

19.

________ can phosphorylate ITIMs on FcγRIIB, which will inhibit signaling.

a)

Lyn

b)

JAK-STAT

c)

MAPK

20.

Which type of immunity is responsible for type I hypersensitivity reactions?

a)

innate

b)

adaptive

21.

Which 2 molecules are produced by innate immune cells that are responsible for type I hypersensitivity symptoms?

a)

leukotrienes

b)

prostaglandins

c)

chemokines

d)

histidine

22.

Leukotrienes and prostaglandins are considered __________: formed when membrane phospholipids are enzymatically cleaved.

a)

primary mediators

b)

secondary mediators

c)

tertiary mediators

23.

Secondary mediators (leukotrienes and prostaglandins produced by innate immune cells) are 1000x more potent than histamine at inducing bronchoconstriction and more potent stimulators of:

a)

vascular permeability

b)

mucous secretion

c)

asthma

d)

vascular constriction

e)

neuropathy

24.

Mast cells and basophils release several signaling molecules, but the important ones are

a)

cytokines

b)

chemokines

c)

eosinophils

d)

immunoglobulins

25.

Interleukins are examples of ________.

a)

cytokines

b)

chemokines

26.

What do IL-4 and IL-13 stimulate?

a)

TH2 responses to increase IgE production by B cells

b)

TH1 responses to increase IgE production by B cells

c)

TH2 responses to increase IgE production by T cells

d)

TH1 responses to increase IgE production by T cells

27.

What stimulates the production and activation of myeloid cells such as granulocytes?

a)

GM-CSF

b)

TH2

28.

What type of response occurs within minutes of allergen exposure?

a)

early

b)

late

29.

How are early responses mediated?

a)

mast cell granule release of histamine, leukotrienes, and prostaglandins

b)

cytokines released from the mast cells increase expression of chemokines and CAMs on endothelium facilitating influx of neutrophils, eosinophils, and TH2 cells. Eosinophils play a large role in recruiting neutrophils and degranulation

30.

What type of response occurs hours later as a result of recruited cells?

a)

early

b)

late

31.

How are late responses mediated?

a)

mast cell granule release of histamine, leukotrienes, and prostaglandins

b)

cytokines released from mast cells increase expression of chemokines and CAMs on endothelium facilitating influx of neutrophils, eosinophils, and TH2 cells. Eosinophils play a large role in recruiting neutrophils and degranulation

32.

What is the third phase of a type I hypersensitivity described as involving?

a)

basophils

b)

eosinophils

c)

neutrophils

d)

fibroblasts

33.

Which type I hypersensitivity reaction is often initiated by an injected or gut-absorbed allergen such as bee sting venom, PCN, seafood, or nuts?

a)

systemic anaphylaxis

b)

localized reaction

c)

food allergy

34.

Which type I hypersensitivity is limited to a specific tissue or organ ie allergic rhinitis (hay fever), atopic dermatitis (eczema), or atopic urticaria (hives)?

a)

systemic anaphylaxis

b)

localized reaction

c)

food allergy

35.

Which type I hypersensitivity is a common type of atopy on the rise, often water-soluble glycoproteins stable to heat, acid, and proteases?

a)

systemic anaphylaxis

b)

localized reaction

c)

food allergies

36.

Which immunoglobulin mediates food allergies?

a)

IgG

b)

IgE

c)

IgA

d)

IgM

37.

What is used to explain why countries with improved hygiene are experiencing increases in asthma and allergy rates?

a)

the hygiene hypothesis, which says that exposure to some pathogens early in life allows for a better T-cell balance

b)

cleaner countries tend to have more air pollution

c)

because hygiene is better, pathogens have become stronger

38.

Can environmental factors and diet and genetics affect susceptibility to allergies?

a)

yes

b)

no

39.

Infants with eczema and children deficient in _________ support the hygiene hypothesis.

a)

filaggrin

b)

keratin

c)

melanin

d)

carotene

40.

Which type of epithelial cells produce innate cytokines that affect DCs and induce allergen-specific TH2 cells, which trigger B cell isotope switch to IgE?

a)

skin epithelial cells

b)

intestinal epithelial cells

41.

In which type of epithelial cells are ILC2, TH2, and TH9 cells activated by binding IgE to produce cytokines that recruit, support, and activate mast cells and basophils?

a)

skin epithelial cells

b)

intestinal epithelial cells

42.

When diagnosing type I hypersensitivities, skin testing may be used. What symptoms indicate allergic response?

a)

swelling

b)

redness

c)

anaphylaxis

d)

itching

43.

What binds and blocks H1 receptors on target cells for treatment of type I hypersensitivity?

a)

antihistamines

b)

leukotriene antagonists

c)

inhalation corticosteroids

44.

Which type I hypersensitivity inhibits innate immune cell activity in airways, treating asthma?

a)

inhalation corticosteroids

b)

antihistamines

c)

leukotriene antagonists

45.

How do leukotriene antagonists work?

a)

like antihistamines

b)

like inhalation corticosteroids

46.

Benadryl, or diphenhydramine is what kind of antihistamine?

a)

first generation

b)

second generation

47.

Acrivastine is what kind of antihistamine?

a)

first generation

b)

second generation

48.

Zyrtec, or cetirizine is which type of antihistamine? **still causes some drowsiness

a)

first generation

b)

second generation

49.

Allegra, or fexofenadine is what kind of antihistamine?

a)

first generation

b)

second generation

50.

Claritin, or loratadine is what kind of antihistamine?

a)

frist generation

b)

second generation

51.

Which antihistamine given can be used for the indication of dermatitis?

a)

Benadryl (diphenhydramine)

b)

Zyrtec (cetirizine)

c)

Allegra (fexofenadine)

d)

Claritin (loratadine)

52.

Which of the following cell-surface receptors is MOST closely linked to activating type I hypersensitivity reactions?

a)

FcεRII

b)

FcγRIIB

c)

FcεRI

d)

LFA-1

e)

none of the answers are correct

53.

Which of the following cell types are targets of the products of mast-cell degranulation, as well as the mediators produced by mast cells following degranulation?

a)

smooth muscle

b)

nervous tissue

c)

hematopoietic cells

d)

epithelial cells

e)

all of the answers are correct

54.

Which of the following effects is NOT a result of histamine binding to histamine receptor H1?

a)

intestinal smooth muscle contraction

b)

suppression of mast cell degranulation

c)

increased vascular permeability

d)

increased mucous secretion

e)

all of the answers result from histamine binding H1

55.

Which of the following cytokines is NOT generally associated with allergic reactions?

a)

TNF-α

b)

GM-CSF

c)

IL-4

d)

TGF-β

e)

all of the answers are associated with allergic reactions

56.

The immune response to a peanut allergy is MOST similar to a

a)

poison ivy rash

b)

positive PPD test

c)

bee sting

d)

transfusion reaction

e)

none of the answers are similar

57.

Which of the following is a potential cause of chronic inflammation?

a)

obesity

b)

infectious agents

c)

tissue damage

d)

intestinal commensal microbiota components

e)

all of the answers are correct