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Microbiology with Diseases Body System 3rd Edition Bauman Test Bank

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Microbiology with Diseases Body System 3rd Edition Bauman Test Bank

ISBN-13: 978-0321712714

ISBN-10: 0321712714

 

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Microbiology with Diseases Body System 3rd Edition Bauman Test Bank

ISBN-13: 978-0321712714

ISBN-10: 0321712714

 

 

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Microbiology with Diseases Body System, 3e (Bauman)

Chapter 18   AIDS and Other Immune Disorders

 

18.1   Multiple-Choice Questions

 

1) Which of the following is NOT considered a hypersensitivity reaction?

  1. A) a rash caused poison ivy
  2. B) immune system attack on the thyroid gland
  3. C) itchy eyes and a runny nose in a dusty environment
  4. D) dermatitis at the site of a metal watchband
  5. E) breaking into hives after eating strawberries

Answer:  B

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

2) Which of the following immunoglobulins is produced plasma cells in response to an allergen?

  1. A) IgA
  2. B) IgD
  3. C) IgE
  4. D) IgG
  5. E) IgM

Answer:  C

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

3) Which of the following allergic reactions is the result of type IV (delayed) hypersensitivity?

  1. A) runny nose triggered pollen
  2. B) dermatitis in response to latex gloves
  3. C) sensitivity to pet dander
  4. D) skin irritation after wearing wool
  5. E) breathing difficulties after exposure to mold spores

Answer:  B

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

4) Which of the following is a connective tissue cell which produces leukotrienes and prostaglandins?

  1. A) neutrophil
  2. B) basophil
  3. C) eosinophil
  4. D) lymphocyte
  5. E) mast cell

Answer:  E

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

5) Which of the following is an example of a type I hypersensitivity reaction?

  1. A) watery eyes after exposure to animal dander
  2. B) destruction of red blood cells after an incompatible blood transfusion
  3. C) farmer’s lung
  4. D) deposition of immune complexes in the glomeruli of the kidneys
  5. E) the tuberculin response

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

6) When mast cells degranulate and release histamine, which of the following events may occur?

  1. A) constriction of small blood vessels
  2. B) bronchial spasms
  3. C) increased mucus production
  4. D) constriction of small blood vessels and bronchial spasms
  5. E) bronchial spasms and increased mucus production

Answer:  E

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

7) Which of the following substances released during a type I hypersensitivity reaction stimulates the release of eosinophils from the bone marrow?

  1. A) peptides
  2. B) prostaglandins
  3. C) leukotrienes
  4. D) histamine
  5. E) proteases

Answer:  A

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

8) Which of the following bind the constant region of IgE?

  1. A) eosinophils
  2. B) mast cells
  3. C) monocytes
  4. D) mast cells and monocytes
  5. E) eosinophils and mast cells

Answer:  E

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

 

9) What is the function of the proteases released when mast cells degranulate?

  1. A) destruction of nearcells and activation of the complement system
  2. B) increased vascular permeability
  3. C) contraction of smooth muscle in the lungs and gastrointestinal tract
  4. D) increased production of tears and saliva
  5. E) stimulation of nerve endings, causing itching and pain

Answer:  A

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

10) How can type I allergic reactions be diagnosed?

  1. A) encouraging the patient to visit rural areas during pollen season
  2. B) injecting very small quantities of dilute solutions of suspected allergens under the skin
  3. C) mixing antigens and antibodies with red blood cells
  4. D) injecting a protein solution from Mycobacterium tuberculosis under the skin
  5. E) taking a biopsy from the kidney to detect the deposition of immune complexes

Answer:  B

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

11) Which antibody can cross the placenta and cause hemolytic disease of the newborn?

  1. A) IgA
  2. B) IgD
  3. C) IgE
  4. D) IgG
  5. E) IgM

Answer:  D

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

12) The glycoprotein and glycolipid molecules on the surface of red blood cells

  1. A) stimulate the production of antibodies that contribute to the development of a transfusion reaction.
  2. B) act to transport glucose and ions across the cytoplasmic membrane.
  3. C) cause degranulation of the cell when it is exposed to allergens.
  4. D) function as a binding site for IgD.
  5. E) act as receptors for foreign antigens and trigger an early immune response.

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

 

13) An accident victim receives a blood transfusion. Shortly thereafter, he begins to have difficulty breathing, develops a fever, and experiences nausea and vomiting. Which of the following is the most likely interpretation of these events?

  1. A) the blood transfusion was mismatched.
  2. B) the blood transfusion contained pyrogens.
  3. C) the recipient had previously been exposed to the foreign blood group antigens.
  4. D) the blood transfusion was mismatched and contained pyrogens.
  5. E) the blood transfusion was mismatched, and the recipient had previously been exposed to the foreign blood group antigens.

Answer:  E

Bloom’s Rank:  Application

Section:  Hypersensitivities

14) Which of the following statements concerning the Rh factor is FALSE?

  1. A) It is an antibody found in humans and rhesus monkeys.
  2. B) It is present on the surface of the red blood cells of 85% of humans.
  3. C) Preexisting antibodies do not occur.
  4. D) Rh antibodies are less abundant than the ABO antibodies.
  5. E) 85% of the population is Rh negative.

Answer:  E

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

15) Which of the following could result in hemolytic disease of the newborn?

  1. A) Rh-negative mother and Rh-negative father
  2. B) Rh-positive mother and Rh-positive father
  3. C) Rh-positive mother and Rh-negative father
  4. D) Rh-negative mother and Rh-positive father
  5. E) Rh-positive mother and Rh-negative father or Rh-negative mother and Rh-positive father

Answer:  D

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

16) An agricultural worker experiences difficulty breathing which becomes progressively worse. Tests show inflammation and damage of the lung tissue, but IgE antibodies and granulocytes are in the normal ranges. With which disorder of the immune system are these signs and symptoms consistent?

  1. A) allergic reaction
  2. B) type III (immune complex-mediated) hypersensitivity
  3. C) type IV (delayed) hypersensitivity
  4. D) autoimmunity
  5. E) acquired immunodeficiency

Answer:  B

Bloom’s Rank:  Application

Section:  Hypersensitivities

 

 

17) If circulating immune complexes are deposited in the glomeruli, the ensuing type III hypersensitivity reaction can result in

  1. A) allergic contact dermatitis.
  2. B) pneumonitis.
  3. C) kidney damage.
  4. D) multiple sclerosis.
  5. E) rheumatoid arthritis.

Answer:  C

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

18) Grafting skin from one area of the body to another in order to cover a burn is considered

  1. A) a xenograft.
  2. B) an allograft.
  3. C) an isograft.
  4. D) a dermograft.
  5. E) an autograft.

Answer:  E

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

19) A small amount of antigen is injected under the skin of a patient. After 30 minutes there is no apparent change at the injection site, but 36 hours later the patient reports that the area is red and swollen. This type of response is due to

  1. A) type I hypersensitivity.
  2. B) type II hypersensitivity.
  3. C) type III hypersensitivity.
  4. D) type IV hypersensitivity.
  5. E) immunodeficiency.

Answer:  D

Bloom’s Rank:  Application

Section:  Hypersensitivities

 

20) Which of the following causes graft-versus-host disease?

  1. A) bone marrow transplant
  2. B) kidney transplant
  3. C) skin transplant from one location in the body to another or from one identical twin to another
  4. D) cornea transplant
  5. E) an Rh-positive fetus in the uterus of an Rh-positive mother

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

 

21) A young woman comes into the clinic complaining of itchy, red skin and swelling on her arms and legs. She had not been in any parks or wooded areas recently, but she had been shopping. A blood sample reveals elevated levels of granulocytes. What treatment is the physician likely to prescribe at this point?

  1. A) corticosteroids
  2. B) cyclophosphamide
  3. C) interferon
  4. D) methotrexate
  5. E) antihistamines

Answer:  E

Bloom’s Rank:  Application

Section:  Hypersensitivities

22) If a T cell is exposed to a “hidden” antigen, what kind of immune reaction will result?

  1. A) an autoimmune disease
  2. B) a delayed hypersensitivity reaction
  3. C) a cytotoxic hypersensitivity reaction
  4. D) allergic contact dermatitis
  5. E) an allergy

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Autoimmune Diseases

 

23) A person comes to the clinic complaining of aching joints and muscles, swelling, and a decrease in urine output. The clinician also notes a rash on the skin of the face. A probable diagnosis is

  1. A) pneumonitis.
  2. B) immunodeficiency.
  3. C) systemic lupus erythematosus.
  4. D) dermatitis.
  5. E) Graves’ disease.

Answer:  C

Bloom’s Rank:  Application

Section:  Hypersensitivities

 

24) Which of the following statements concerning rheumatoid arthritis is correct?

  1. A) It occurs in humans and animals.
  2. B) The symptoms are due to damage caused cytotoxic T cells.
  3. C) There is no genetic influence on the likelihood of developing RA.
  4. D) Accumulations of antibody complexes lead to inflammation and destruction of the joints.
  5. E) The onset of disease is clearly correlated with having been infected with a specific microbe.

Answer:  D

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

 

25) Primary immunodeficiency diseases

  1. A) develop later in life.
  2. B) are detectable close to birth.
  3. C) may be caused malnutrition.
  4. D) are never associated with genetic defects.
  5. E) are sometimes caused severe stress.

Answer:  B

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

26) Which of the following would test positive for the tuberculin response?

  1. A) someone who has previously had tuberculosis
  2. B) someone who has been immunized with the tuberculosis vaccine
  3. C) someone who has previously been injected subcutaneously with tuberculin
  4. D) someone who has been immunized with the tuberculosis vaccine or has previously had tuberculosis
  5. E) someone who has been immunized with the tuberculosis vaccine or previously been injected subcutaneously with tuberculin

Answer:  D

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

27) What is the underlying problem in most acquired immunodeficiencies?

  1. A) declining cell-mediated immunity
  2. B) declining humoral immunity
  3. C) production of autoantibodies
  4. D) eosinophilia
  5. E) anemia

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

28) Which of the following statements regarding cyclosporine is FALSE?

  1. A) It is useful in preventing allograft rejection.
  2. B) It is active on resting and activated T cells.
  3. C) It is produced fungi.
  4. D) It is less toxic than cyclophosphamide.
  5. E) It is sometimes used in combination with steroids.

Answer:  B

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

 

29) A child has a history of repeated severe infections and frequently has recurring infections with the same bacterial pathogen. A blood sample shows some lymphopenia, and serological tests are negative. Based on this information, which of the following is the best diagnosis for this child?

  1. A) Bruton-type agammaglobulinemia
  2. B) DiGeorge syndrome
  3. C) severe combined immune deficiency (SCID)
  4. D) systemic lupus erythematosus (SLE)
  5. E) hemolytic disease of the newborn

Answer:  A

Bloom’s Rank:  Application

Section:  Immunodeficiency Diseases

30) Immune thrombocytopenic purpura is

  1. A) a drug induced cytotoxic reaction.
  2. B) an autoimmune disease.
  3. C) a delayed hypersensitivity reaction.
  4. D) a cell-mediated immune reaction.
  5. E) a type of immunodeficiency.

Answer:  A

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

31) Hypotheses explaining the development of autoimmune disease include

  1. A) molecular mimicry.
  2. B) genetic factors.
  3. C) hormonal stimulation of cytotoxic T cells.
  4. D) anaphylactic shock triggered molecular mimicry.
  5. E) molecular mimicry, genetic factors, and hormonal stimulation of cytotoxic T cells.

Answer:  E

Bloom’s Rank:  Comprehension

Section:  Autoimmune Diseases

 

32) Multiple sclerosis is

  1. A) an autoimmune disease in which cytotoxic T cells attack the myelin sheath of neurons.
  2. B) a genetic birth defect of the nervous system.
  3. C) a type of allergy to myelin.
  4. D) the formation of antibodies against transplanted tissue.
  5. E) the development of neurological disease due to the deposition of immune complexes in nerves.

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Autoimmune Diseases

 

 

33) Which condition occurs when antibodies bind to and stimulate receptors that elicit production of thyroid hormone and growth of the thyroid gland?

  1. A) multiple sclerosis
  2. B) Graves’ disease
  3. C) DiGeorge syndrome
  4. D) type I diabetes
  5. E) farmer’s lung

Answer:  B

Bloom’s Rank:  Comprehension

Section:  Autoimmune Diseases

 

34) The tuberculin response is mediated by

  1. A) memory T cells.
  2. B) mast cells.
  3. C) B lymphocytes.
  4. D) plasma cells.
  5. E) eosinophils.

Answer:  A

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

35) Which of the following statements concerning allografts is correct?

  1. A) They are the best type of transplants because they are not associated with rejection.
  2. B) They induce strong type IV hypersensitivity reactions and must be treated with immunosuppressive drugs.
  3. C) They always require complete destruction of the recipient’s bone marrow cells.
  4. D) They are impossible to perform because the antigens between donor and recipient are so different.
  5. E) They are the rarest type of transplants.

Answer:  B

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

36) The disorder known as DiGeorge syndrome is a form of

  1. A) autoimmune disease.
  2. B) immune complex—mediated hypersensitivity.
  3. C) immediate hypersensitivity.
  4. D) immunodeficiency.
  5. E) delayed hypersensitivity.

Answer:  D

Bloom’s Rank:  Knowledge

Section:  Immunodeficiency Diseases

 

 

37) Type I diabetes is a(n)

  1. A) autoimmune disease.
  2. B) immunodeficiency disease.
  3. C) immune complex—mediated hypersensitivity disorder.
  4. D) delayed hypersensitivity disorder.
  5. E) immediate hypersensitivity disorder.

Answer:  A

Bloom’s Rank:  Knowledge

Section:  Autoimmune Diseases

 

38) Treatment with which of the following may result in acquired immunodeficiency?

  1. A) corticosteroids
  2. B) interferon
  3. C) azathioprine
  4. D) antihistamine
  5. E) RhoGAM

Answer:  A

Bloom’s Rank:  Knowledge

Section:  Immunodeficiency Diseases

 

39) HIV, the virus responsible for AIDS, is a member of what family?

  1. A) Picornaviridae
  2. B) Herpesviridae
  3. C) Poxviridae
  4. D) Retroviridae
  5. E) Rhinoviridae

Answer:  D

Bloom’s Rank:  Knowledge

Section:  Immunodeficiency Diseases

40) Which of the following cells is NOT a target for HIV infection?

  1. A) monocytes
  2. B) cytotoxic T lymphocytes
  3. C) helper T lymphocytes
  4. D) dendritic cells
  5. E) microglia

Answer:  B

Bloom’s Rank:  Knowledge

Section:  Immunodeficiency Diseases

 

 

41) The HIV genome encodes a variety of proteins required for successful infection. Which of the following enzymes contributes to the antigenic variation characteristic of this virus?

  1. A) integrase
  2. B) protease
  3. C) gp41
  4. D) reverse transcriptase
  5. E) RNA polymerase

Answer:  D

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

42) Opportunistic infections typical of AIDS but rare otherwise include

  1. A) tuberculosis.
  2. B) Pneumocystis
  3. C) Kaposi’s sarcoma.
  4. D) tuberculosis and shingles.
  5. E) Pneumocystis pneumonia and Kaposi’s sarcoma.

Answer:  E

Bloom’s Rank:  Knowledge

Section:  Immunodeficiency Diseases

 

43) Which of the following proteins is NOT a target of ART?

  1. A) reverse transcriptase
  2. B) integrase
  3. C) protease
  4. D) gp120
  5. E) both gp120 and integrase

Answer:  D

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

44) A young woman is experiencing persistent diarrhea that is at times bloody, and a nagging cough with shortness of breath. She has slight fever, but no rash. A blood test reveals normal leukocyte levels except for low levels of lymphocytes. Antibody titers are normal. The patient reports that she is currently monogamous, but previously “played around a bit,” and her mother has SLE. Which immune system disorder is this information consistent with?

  1. A) systemic lupus erythematosus (SLE)
  2. B) AIDS
  3. C) chronic granulomatous disease
  4. D) Bruton-type agammaglobulinemia
  5. E) hypersensitivity pneumonitis

Answer:  B

Bloom’s Rank:  Application

Section:  Immunodeficiency Diseases

 

 

45) Which of the following bodily fluids is primarily responsible for vertical transmission of HIV?

  1. A) saliva
  2. B) semen
  3. C) breast milk
  4. D) vaginal secretions
  5. E) blood

Answer:  C

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

18.2   True/False Questions

 

1) Normally, complement-activating immune complexes are eliminated from the body phagocytosis.

Answer:  TRUE

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

2) In most cases, production of antibodies against foreign ABO antigens is stimulated exposure to foreign blood cells.

Answer:  FALSE

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

3) MHC genes are significant genetic factors in predisposition to develop autoimmune disease.

Answer:  TRUE

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

4) The tuberculin response is an example of allergic contact dermatitis.

Answer:  FALSE

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

5) Children with Bruton-type agammaglobulinemia are highly susceptible to recurrent bacterial infections.

Answer:  TRUE

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

6) Systemic lupus erythematosus (SLE) is a disease resulting from accumulation of immune complexes in various organs and tissues.

Answer:  TRUE

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

 

7) If an Rh-positive woman marries an Rh-negative man, their children are at risk for hemolytic disease of the newborn.

Answer:  FALSE

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

8) Infection with certain viruses may lead to the development of type I diabetes.

Answer:  TRUE

Bloom’s Rank:  Comprehension

Section:  Autoimmune Diseases

 

9) Xenografts are tissue transplants from one individual to another within the same species.

Answer:  FALSE

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

10) Antiretroviral therapy (ART) is an effective cure for HIV infection.

Answer:  FALSE

Bloom’s Rank:  Knowledge

Section:  Immunodeficiency Diseases

 

18.3   Short Answer Questions

 

1) When bone marrow is transplanted, the donated bone marrow cells regard the patient’s cells as foreign, a condition referred to as __________ -versus-host disease.

Answer:  graft

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

2) Rheumatoid arthritis is a type __________ hypersensitivity reaction that results when B cells produce autoantibodies that damage the cartilage in the joints. (Use roman numerals in your answer.)

Answer:  III

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

3) Although autoantibodies to nucleic acids are characteristic of __________, many other autoantibodies are produced. (Be sure to use all capital letters in your answer.)

Answer:  SLE

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

4) Critically low levels of CD lymphocytes are a key diagnostic indicator of __________. (Be sure to use capital letters appropriately.)

Answer:  AIDS

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

5) Type I hypersensitivity reactions are also commonly known as __________.

Answer:  allergies

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

6) Binding of IgE to the surface of sensitized cells leads to __________ of the cell, releasing many inflammatory chemicals.

Answer:  degranulation

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

7) The __________ released in an immediate hypersensitivity reaction leads to the destruction of nearcells and the activation of the complement system.

Answer:  proteases

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

8) When the release of chemicals in an allergic reaction exceeds the body’s ability to adjust, a life-threatening condition called __________ may occur.

Answer:  anaphylaxis

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

9) Stress may result in the production of __________, which may lead to acquired immunodeficiency disease.

Answer:  corticosteroids

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

10) When the donor’s blood group antigens stimulate the production of antibodies in the recipient, __________ reactions occur.

Answer:  transfusion

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

11) One feature of hemolytic disease of the newborn is excessive __________, which leads to jaundice in the newborn.

Answer:  bilirubin

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

12) A graft that is from one identical twin to another is a(n) __________.

Answer:  isograft

Bloom’s Rank:  Knowledge

Section:  Hypersensitivities

 

 

13) Graves’ disease is an autoimmune disease that affects the __________ gland.

Answer:  thyroid

Bloom’s Rank:  Knowledge

Section:  Autoimmune Diseases

 

14) Immunological attack on the islets of Langerhans resulting in the inability to produce insulin leads to type __________ diabetes Mellitus. (Use roman numerals in your answer.)

Answer:  I

Bloom’s Rank:  Comprehension

Section:  Autoimmune Diseases

 

15) Failure of the __________ to develop results in DeGeorge syndrome.

Answer:  thymus

Bloom’s Rank:  Comprehension

Section:  Immunodeficiency Diseases

 

18.4   Essay Questions

 

1) Compare and contrast type I hypersensitivity with type IV hypersensitivity with respect to reaction time, mediators, and cells involved.

Answer:  Type I (immediate) hypersensitivity is very quick. The reaction time can be seconds to minutes after exposure to the allergen. This type of hypersensitivity starts with a prior sensitization to the allergen during which IgE specific for the allergen is produced. The IgE that is made binds to mast cells, basophils, and eosinophils. The response can be either local or systemic and is due to a subsequent exposure to the allergen. Upon subsequent exposure, the allergen binds to the IgE on mast cells, basophils, and eosinophils, causing them to degranulate and release a variety of inflammatory molecules, including histamines, kinins, proteases, leukotrienes, and prostaglandins.

Type IV (delayed or cell-mediated) hypersensitivity has a much slower reaction time. It takes 12-24 hours to start developing. Antigen does not bind to antibody; it binds to antigen-presenting cells and T cells. As with type I, a type IV response is due to a prior exposure, but in the case of the type IV hypersensitivity, memory T cells are produced. In both type I and type IV hypersensitivities, inflammation is a common result.

Bloom’s Rank:  Analysis

Section:  Hypersensitivities

2) Hashimoto’s thyroiditis and Graves’ disease are autoimmune diseases involving the thyroid, but Hashimoto’s results in hypothyroidism (low thyroid function), whereas Graves’ results in hyperthyroidism (overactive thyroid). Both diseases are characterized antithyroid antibodies. Discuss ways in which the autoimmune responses may produce the different outcomes.

Answer:  In Graves’ disease, the antithyroid antibodies react with receptors on the cells and stimulate their activity, leading to hyperthyroidism. In Hashimoto’s disease, the antibodies targeting the thyroid cells either damage the ability of the cells to function or trigger cytotoxic attack on the cells of the thyroid, which is eventually damaged to the point of loss of function.

Bloom’s Rank:  Analysis

Section:  Autoimmune Diseases

 

 

3) The virus responsible for AIDS was identified in 1983, and since that time scientists have been working to develop a vaccine to prevent HIV infection. Discuss the reasons why a safe and effective vaccine is not yet available.

Answer:  The primary obstacle to the development of a vaccine is the high mutation rate of the virus. The HIV reverse transcriptase is highly prone to making errors, and RNA polymerases (involved in the production of new RNA genomes) are also error-prone. The antigenic structures of HIV are constantly changing. Also, there are two related but somewhat different strains of the virus (HIV-1 and -2) circulating in the human population, which would require either a vaccine which provides protection from infection with both strains, or the development of two vaccines. While mucosal immunity mediated IgA antibodies is desirable to prevent infection, the production of IgG antibodies in response to a vaccine would contribute to the ability of B cells to deliver HIV to T cells. It is not possible with today’s technology to assure an IgA response without production of IgG. A cytotoxic T cell-mediated immune response is also desirable in order to kill infected cells before they begin to produce a new virus, but no vaccine strategy currently available assures cell-mediated immunity over antibody-mediated immunity. Testing candidate vaccines raises ethical issues. HIV only infects humans, so the vaccine would have to be tested on human volunteers, who could not be deliberately exposed. People who have been vaccinated with a candidate vaccine might have positive responses on HIV screening tests, which could result in social as well as medical problems.

Bloom’s Rank:  Analysis

Section:  Immunodeficiency Diseases

 

4) One of the important inherited defects in the second line of immune defense is a condition called chronic granulomatous disease. What is this disease, and how is it caused?

Answer:  Chronic granulomatous disease is a type of primary immunodeficiency. It is an inherited condition seen in children who have recurrent infections associated with the development of large masses of inflammatory cells in the lymph nodes, lungs, bones, and skin. It is due to the fact that neutrophils are unable to produce reactive forms of oxygen and therefore are unable to kill ingested bacteria.

Bloom’s Rank:  Application

Section:  Immunodeficiency Diseases

5) What type of hypersensitivity reaction is the tuberculin response?

Answer:  The tuberculin response is a type of delayed hypersensitivity reaction. It is used to diagnose contact with antigens from Mycobacterium tuberculosis. When tuberculin is injected into the skin of an individual who has never contracted tuberculosis and has never received the tuberculosis vaccine, no response occurs. If the patient has been exposed to tuberculin antigen infection or prior vaccination, a red swelling develops at the site of injection. This reaction is considered a positive tuberculin response.

Bloom’s Rank:  Comprehension

Section:  Hypersensitivities

 

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