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Exam 3 Block 1 Immuno lecture 26-30

Total questions: 25

Worksheet time: 24mins

Name
Class
Date
1.

  1. Which of the following is not true about aging?

a)

  1. Increased IL-7 production

b)

  2. Increased IgG serum levels

c)

  2. Increased CD8 cells

d)

  1. Increased IL-6

2.

  1. Select the cell least likely to be affected by chemotherapy

a)

Tumor cells

b)

Neurons

c)

GI epithelium

d)

Hematopoietic Cells

3.

  1. A patient comes into the clinic. They present with a headache, fever, sore throat, and generalized lymphadenopathy. Social history shows that their last sexual encounter was 6 weeks ago. If this patient has been infected with HIV, what phase would they currently be in?

a)

Phase I

b)

Phase II

c)

Phase III

d)

Latency

4.

  1. Lab work from the patient in the last question did indicate an HIV infection. When the patient comes back 6 weeks later, they are no longer experiencing any flu-like symptoms. What is not true about this phase of HIV?

a)

It may last for years

b)

  1. CD4 + T cell count is declining

c)

  2. The virus is continuing to replicate in the thymus

d)

  1. The viral load has dropped to the viral set-point

5.

  1. What is an example of an allograft?

a)

  1. Woman donates a kidney to her identical twin sister

b)

  1. Liver transplant from an organ donor in child with biliary atresia

c)

  1. Patellar tendon of patient used for patient’s anterior cruciate ligament (ACL) reconstruction

d)

  1. Using coral as bone grafting material for replacing harvested iliac bone

6.

  1. What statement is true regarding mixed lymphocyte reaction tests?

a)

  1. The test is done in less than a day

b)

  1. It is less sensitive in detecting HLA differences than serology

c)

  1. If reactive, recipient cells proliferate and make cytokines

d)

  1. Recipient lymphocytes are irradiated and mixed with live donor lymphocytes

7.

  1. A patient with end-stage heart failure undergoes heart transplant surgery. Shortly after ensuring proper vascular connections and blood flow to the new heart while the patient is still under anesthesia, there is sudden deterioration in the patient’s condition. There is a rapid drop in blood pressure, signs of shock, and the heart shows poor contractility and circulation. What is the primary mediator of this graft rejection?

a)

  1. NK cells

b)

  1. IgG

c)

  1. T cells

d)

  1. Macrophages

8.

  1. After receiving a bone marrow transplant, a patient experiences rash, widespread erythema, nausea/vomiting, diarrhea, and increasing serum bilirubin. What is happening to this patient?

a)

  1. Recipient APC is presenting ingested graft cells

b)

  1. Recipient antibodies are initiating hyperacute graft rejection

c)

  1. Recipient T cells recognize MHC on donor dendritic cells

d)

  1. Recipient MHC is recognized as foreign by donor T cells

9.

What is this blood type?

a)

A+

b)

B+

c)

A-

d)

B-

10.

What is this blood type?

a)

D-

b)

O-

c)

O+

d)

Inconclusive

11.

  1. Sophie wants to know who her dad is for her upcoming wedding, but her mother Donna cannot tell her. Sophie invites all 3 possible men to her wedding, and secretly takes a blood sample from them. Mamma Mia! If Sophie is type O+ and her mother is O- who is her father?

a)

  1. Harry who is type O+

b)

  1. Sam who is type A+

c)

  2. Bill who is type B+

d)

  1. It could be any of them

12.

  1. What is not included in a transfusion?

a)

  1. Leukocytes

b)

  1. Erythrocytes

c)

  1. Plasma

d)

  1. Platelets

13.

  1. Within 4 hours of initiating a transfusion in a child, the patient presents with fever (less than 2 degrees celsius), chills, and mild dyspnea. What happened?

a)

  1. Urticarial transfusion reaction

b)

  1. Primary hypotensive reaction

c)

  1. Febrile nonhemolytic transfusion reaction

d)

  1. Acute hemolytic transfusion reaction

14.

  1. When testing to see if a patient is experiencing acute HTR you check to see if they are experiencing hemoglobinuria. If they are experiencing this, what do you expect to see and why?

a)

After centrifuging the urine expect to see red pellet because of antibodies to donor blood antigen causing agglutination

b)

After centrifuging the urine expect no pellet to form and liquid to stay red because RBCs have been lysed due to complement-mediated pathways

c)

  1. After centrifuging the urine expect to see red pellet because RBCs have been lysed due to complement-mediated pathways

d)

  1. After centrifuging the urine expect no pellet to form and liquid to stay red because of antibodies to donor blood antigen causing agglutination

15.

  1. What do you do if a transfusion reaction occurs?

a)

  1. Maintain IV line with saline and discard blood bag

b)

  1. See if bilirubin is elevated within 3-6 hours

c)

  1. Give furosemide to decrease renal blood flow

d)

  1. Do not bother the patient by checking vital signs since they already feel anxiety and dread

16.

  1. Which of the following activates an immune response?

a)

  1. Abatacept an CTLA4-Ig

b)

  2. Ibrutinib which blocks BCR-mediated signaling

c)

Tofacitnib a JAK inhibitor

d)

  2. Sargrastim a GM-CSF

17.

  1. Which of the following prevents activation and reduces the number of self-reactive T cells by preventing binding of T cells to APC?

a)

  1. Alefacept an anti-CD2 medicine

b)

  1. Nivolumab an anti-PD1 medicine

c)

  1. Ipilimumab an anti CTLA4 medicine

d)

Natalizumab an anti-alpha4 integrin

18.

  1. Chimeric antigen receptor (CAR) T cells…

a)

  1. Work best in solid tumors

b)

  1. Cytoplasmic tail contains ITAM and costimulatory domains

c)

  1. Reinforces MHC restriction in T cells

d)

  1. Is an antibody based therapy

19.

  1. Which of the following situations would not be of concern?

a)

  1. Prescribing anti-TNF therapies to a patient that once has tuberculosis

b)

  1. Prescribing anti-CD52 to an MS patient who has JC virus

c)

  1. Prescribing CAR T cell therapy along with a checkpoint inhibitor such as atezolizumab for lung cancer

d)

  2. Prescribing natalizumab, an anti-alpha4 integrin, for Crohn’s disease in combination with interferon beta

20.

  1. Which of the following would most likely be an antitumor mAB prescribed for B cell lymphomas?

a)

  1. Rituximab, specific for CD20

b)

  1. Ipilimumab, specific for CTLA-4

c)

  1. Pembrolizumab, specific for PD-1/PD-L1

d)

Trastuzumab, specific for HER2

21.

  1. What is not true about tumor-associated antigens (TAAs)?

a)

  1. Self-antigens

b)

  1. VEGF is an example

c)

  1. Can be from oncogenic virus proteins

d)

  1. They have low tumoral specificity

22.

  1. Which is an example of immune suppression?

a)

  1. Rapid accumulation of Ag causing T and B cell exhaustion

b)

  1. Shedding immunogenic Ags

c)

  1. Reducing expression of MHC I

d)

  1. Expression of CTLA4

23.

  1. A patient with acute lymphoblastic leukemia is being treated with Blinatumomab which links T cells to CD19. This is an example of a BiTE meaning…

a)

  1. T cell/target cell interaction is independent of MHC

b)

  1. It is a T cell with an inserted cytokine gene

c)

  1. It has an intramembrane and cytoplasmic portion of CD3

d)

  1. Intra-tumor T cells were isolated and expanded ex vivo

24.

  1. Provenge (sipuleucel-T) is a dendritic cell vaccine for prostate cancer. What is false regarding this vaccine?

a)

  1. It is custom to each patient due to cell collection

b)

  1. Drives DC to optimal phenotype

c)

  1. Can be loaded with TSAs or autologous tumor RNA

d)

  1. Do not work well because DC’s are not the APC for naive T cells

25.

  1. Which of the following is not a cancer immunotherapy?

a)

  1. Inhibitor of IL-10

b)

  1. Anti-IL-7

c)

  1. Anti-PDL1

d)

  1. Anti-VEGF

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