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Огляд спроби 1
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Тест початий Monday 16 November 2020 10:02 AM

Завершено Monday 16 November 2020 10:02 AM
Пройшло часу 16 сек
Балів 0/20
Оцінка 0 з можливих 100 (0%)

1 A 35-year-old woman with a history of asthma and atopic dermatitis presents to

Балів: your office for followup. She was recently hospitalized for community-acquired
1 pneumonia complicated by an acute exacerbation of her asthma. Which of the
following statements most accurately describes the T cell response to allergenic
peptides in an atopic patient?

Виберіть a. In the THO response, T cells produce IL-12 and IL-18,

одну thereby causing differentiation from THO cells to TH1 cell
правильну
b. In the TH2 response, T cells form interleukin-4 (IL-4), IL-5,
відповідь
and IL-13, thereby directing the production of allergen-specific
antibodie
c. In the TH response, naive helper T cells differentiate into
mature T lymphocytes, producing IgG1 and IgG4 antibodie
d. In the TH1 response, T cells produce interferon gamma (IFN-
γ), thereby inducing T cell differentiation
e. In the TH17 response, T cells produce interferon gamma
(IFN-γ), thereby inducing T cell differentiation

2 Antibody is a key element of defense

Балів:
1 Виберіть a. against extracellular antigens
одну
 правильну b. against intracellular antigen
відповідь
c. against intracellular viruses
d. against intracellular microorganism
e. against tumor antigen

3 A 42-year-old white man presents to primary care clinic complaining of fatigue.

Physical examination is significant for splenomegaly. Laboratory data reveal a
Балів:
leukocytosis with 3% blasts and numerous immature cells of the granulocytic
1
lineage, and a low leukocyte alkaline phosphatase (LAP) level. Cytogenetic
analysis reveals the Philadelphia chromosome [t(9;22)], and a diagnosis of chronic
myelogenous leukemia (CML) is made. Subsequently, the patient seeks evaluation
for allogeneic stem cell transplantation. During your discussion with him, you
explain the importance of human leukocyte antigen (HLA) matching of donor and
recipient to reduce the incidence of graft-versus-host disease. Which cluster of
highly polymorphic genes encodes these cell surface markers?

Виберіть a. The cytokine histocompatibility complex

одну
правильну b. The chemokine histocompatibility cluster
відповідь c. The cytokine cluster loci
d. The interleukine histocompatibility complex
e. The major histocompatibility complex (MHC)

4 A 32-year-old African-American woman with systemic lupus erythematosus (SLE)

presents to your office for an examination. Her disease course has been
Балів:
1 complicated by hemolytic anemia, renal disease, synovitis, and rash. Her current
regimen consists of low-dose prednisone. During her visit, she says she has done
some research on the Internet and wants to know if her SLE is caused by a
problem with complement. Which of the following statements regarding
complement is false?

Виберіть a. Immune complexes can lodge in blood vessel walls and

одну activate complement to produce synovitis, vasculitis,
правильну dermatitis, and glomerulonephriti
відповідь b. A deficiency of complement regulatory proteins usually
causes excessive activation
c. Almost all inherited complement deficiencies are inherited
as autosomal dominant trait
d. C3 degradation occurs all the time, and C3 fragmentsbind to
host cells and foreign cells; however, regulatory proteins on
 host cells protect cells by inactivating such fragment
e. Deficiencies of early components (e.g., C1q, C1r/C1s, C4,
and C2) predispose to SLE, whereas deficiencies of C3, MBL,
or MAC components lead to recurrent bacterial infection

5 Macrophage performs all the following functions except:

Балів:
1 Виберіть a. Expresses molecules of MHC2
одну
b. Phagocytes antigen
правильну
відповідь c. Expresses molecules of MHC1
d. Synthesizes interleukin-2
e. Presents peptide fragments of antigen other cells of the
immune system

6 Which cells directly produce immunoglobulin A?

Балів:
1 Виберіть a. macrophege
одну
правильну b. CD-4 cell
відповідь c. Cytotoxic lymphocyte
d. T cell
e. Plasma cells of Peyer patche

7 Which cells do not belong to antigen-presenting cells?

Балів:
1 Виберіть a. monocytes
одну
правильну b. macrophage
відповідь c. eosinophil
d. neutrophil
e. dendritic cell

8
Балів:
A 43-year-old man comes for a routine follow-up. Several months ago, the patient
1
presented for evaluation of weight loss, rash, and iron-deficiency anemia. You
diagnosed him as having celiac disease. The patient states he is doing well on his
gluten-free diet. He has gained 10 lb since his last visit 2 months ago. Today his
anemia is also seen to have improved. You remember that celiac disease results
from immune dysregulation, and you are stimulated to learn more about adaptive
immunity. Which of the following statements regarding the antigens of the major
histocompatibility complex (MHC) is false?

Виберіть a. Class III antigens are encoded by the HLA-D region

одну
правильну b. Clonally determined antigen receptors on B cells recognize
відповідь and bind to specific peptide-MHC complexe
c. Class II antigens are encoded by the HLA-D region
d. MHC molecules act by binding peptide fragments of
antigens that have been processed in specialized antigen-
presenting cell
e. There are two structural types of MHC molecules, called
class I and class II

9 A 23-year-old primigravida who is known to be Rh-negative is told by her

obstetrician that she needs a medication to prevent complications (i.e.,
Балів:
erythroblastosis fetalis) of her next pregnancy. She wonders why she should be
1
using this medication. Which of the following immunologic responses is
prevented by the use of anti–Rh-positive antibodies (RhoGAM)?

Виберіть a. Class switch recombination

одну
правильну b. Immune tolerance response
відповідь c. Primary immune response to antigen
d. Secondary immune response (anamnestic or booster
response)
e. Somatic hypermutation

10 Which cells are reduced during aging of the organism?

Балів:
1 Виберіть a. B lymphocyte
одну
правильну b. T lymphocyte
відповідь c. eosinophil
d. basophils
 e. monocyte

11 A 24-year-old woman comes to your office complaining of bilateral hand pain, a

painful mouth, and a rash on her face that is particularly bothersome when she is
Балів:
exposed to the sun. She has had these symptoms for 6 weeks. Her examination is
1
remarkable for patchy alopecia and multiple mouth ulcers; the musculoskeletal
examination is normal. The patient tests positive for both ANA and anti–
doublestranded DNA. You make a diagnosis of systemic lupus erythematous, a
disease in which autoimmunity is known to play a central role. Which of the
following is NOT a possible mechanism of tolerance?

Виберіть a. Acquisition of anergy after ligation of the T cell receptor

одну complex in the absence of costimulation
правильну b. Sequestration of an antigen from the immune system as a
відповідь result of anatomic barrier
c. Failure of T cells bearing low-affinity receptors to recognize
antigens in the periphery
d. T cells in the thymus with high affinity for a self-antigen
undergo positive selection
e. Clonal deletion in the thymu

12 B- lymphocytes synthesize and express immunoglobulin:

Балів:
1 Виберіть a. in cytoplasmic phagosome
одну
правильну b. containing multiple epitope specificities
відповідь c. on their cell membrane surface
d. only after leaving the bone marrow
e. in membrane complexes also containing CD3

13 A 48-year-old woman with severe rheumatoid arthritis (RA) is advised by a

Балів: rheumatologist to consider a novel antibody, because her arthritis is not
1 responding to therapy with methotrexate. She asks you about this new
medication. Of the following, which is the therapeutic target of approved
engineered human monoclonal antibodies in the management of RA?
 Виберіть a. IL-2
одну
правильну b. IL-1
відповідь c. Interleukin-6 (IL-6)
d. IL-10
e. Tumor necrosis factor–α (TNF-α)

14 A 58-year-old white man presents with weight loss, night sweats, and dyspnea. On
Балів: examination, the patient appears chronically ill and is pale. Laboratory testing
1 reveals leukocytosis, anemia, and thrombocytopenia. A bone marrow biopsy with
aspirate is performed, and a diagnosis of acute myelogenous leukemia is
confirmed. In counseling the patient about chemotherapy, you inform him that he
is going to be at increased risk for infections and that a major source of infection
will be his own gastrointestinal tract. Which of the following statements regarding
the innate immune system and the epithelial barrier inthe GI tract is false?

Виберіть a. Lectins found in secretions bind sugars on pathogens and

одну activate the lectin pathway of complement activation
правильну b. Granulocytes marginate in small blood vessels throughout
відповідь much of the barrier tissues and are available for rapid
recruitment to a possible site of infection
c. Secretions on the epithelial barrier concentrate complement
in such a way that the concentration of complement in
secretions is higher than the concentration in plasma
d. Monocytes are present in secretions and in most tissues,
where they phagocytose unwanted microbe
e. Mucus itself is a protective barrier that traps organisms and
debri

15 A 22-year-old man presents to establish primary care. He has been healthy most
Балів: of his life, but he does have type 1 diabetes mellitus, which he reports has been
1 under very good control. He informs you that when last measured, his hemoglobin
A1C value was 5.2%. He has no history of retinopathy or neuropathy, and he states
that he saw his ophthalmologist 6 weeks ago. The patient has had protein in his
urine, and he takes an angiotensin-converting enzyme (ACE) inhibitor. He asks you,
“What causes type 1 diabetes?” You explain that the underlying problem is that his
body has mistaken its own pancreatic molecules for foreign molecules. Later that
day, you decide to read further on adaptive immunity. Which of the following
statements regarding antigen processing and presentation is false?
 Виберіть a. Class III molecules are expressed on a limited variety of
одну cells known as antigen-presenting cell
правильну b. Exogenous proteins are taken up by endosomes or
відповідь lysosomes, where they are catabolized; their peptides are then
bound to MHC class II molecule
c. MHC molecules first bind peptide fragments after the MHC
molecules reach the cell surface
d. Class I molecules are expressed on virtually all tissues and
are important in the recognition of virally infected cell
e. Class II molecules are expressed on a limited variety of cells
known as antigen-presenting cell

16 Which of the following is the predominant immunoglobulin isotype secreted in the

Балів: human MALT?
1
Виберіть a. Ig E
одну
правильну b. Ig G
відповідь c. Ig A
d. Ig M
e. Ig D

17 Main cells of cellular immunity are:

Балів:
1 Виберіть a. microphage
одну
правильну b. B cell
відповідь c. macrophage
d. T cell
e. complement system

18 A 26-year-old female patient has had recurrent infections with pyogenic

Балів: organisms. She has a follow-up appointment with you today to discuss her
1 options. You remember that complement is a major mechanism by which the
innate immune system can act and that certain complement deficiencies can
cause disease. Which of the following statements regarding the complement
cascade is false?
 Виберіть a. The membrane attack complex (MAC) allows perforation via
одну channel or pore formation into the foreign membrane
правильну b. The alternative pathway requires antibodies for initiation
відповідь
c. The three complement pathways are the classical pathway,
the alternative pathway, and the lectin pathway
d. C3 degradation occurs spontaneously all the time, and C3
fragmentsbind to host cells and foreign cells; however,
regulatory proteins on host cells protect cells by inactivating
such fragment
e. The classical pathway requires antibodies for initiation

19 Which answer is wrong? There are such subpopulations of lymphocytes:

Балів:
1 Виберіть a. B cell
одну
правильну b. T-helper cell
відповідь c. CD-15 T-ligand
d. CD-4 cell
e. CD-8 cell

20 The central human immune system include:

Балів:
1 Виберіть a. tonsils, thymus, bone marrow
одну
правильну b. bone marrow, spleen
відповідь c. Thymus, bone marrow
d. lymph nodes, thymu
e. Spleen, thymu

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