front 1 A pregnant patient’s placenta produces a cytokine that shifts maternal helper T cells away from a Th1 profile to improve fetal survival. Which cytokine is responsible? | back 1 IL-4 |
front 2 Because of placental immune biasing during pregnancy, most humans are born with helper T cells skewed toward which cytokine profile? Th___ cytokines | back 2 Th2 cytokines |
front 3 A child raised with limited microbial exposure later develops multiple environmental allergies. Which concept best explains this association? A. Molecular mimicry B. Hygiene hypothesis C. Epitope spreading D. Anergy escape | back 3 B. Hygiene hypothesis |
front 4 According to the hygiene hypothesis, early childhood microbial infections tend to bias immune responses toward which helper T-cell subset? A. Th17 cells B. Tfh cells C. Th2 cells D. Th1 cells | back 4 D. Th1 cells |
front 5 In populations with improved hygiene and fewer childhood infections, which disease pattern is expected to increase? A. Allergic disease B. Severe neutropenia C. Complement deficiency D. Chronic granulomas | back 5 A. Allergic disease |
front 6 Early exposure to certain allergens is thought to reduce later allergy risk by promoting which immune bias? A. Th2 polarization B. Th1 polarization C. IgE fixation D. Mast-cell priming | back 6 B. Th1 polarization |
front 7 Which T-cell population helps prevent IgE production against common environmental allergens? ____ ____ cells | back 7 Regulatory T cells |
front 8 A tissue helper T cell is induced to suppress allergic antibody production. What cell type has it most likely become? ____ cell | back 8 iTreg cell |
front 9 An iTreg suppresses allergic sensitization by producing cytokines that redirect antibody class switching. Which cytokine pair is involved? A. IL-4 and IL-5 B. IL-2 and IL-12 C. IFN-gamma and TNF D. IL-10 and TGF-beta | back 9 D. IL-10 and TGF-beta |
front 10 In non-atopic individuals, most CD4+ T cells specific for common allergens belong to which population? A. Th17 cells B. Regulatory T cells C. Cytotoxic T cells D. Follicular T cells | back 10 B. Regulatory T cells |
front 11 A patient has mutant IgE receptors that signal excessively after crosslinking. Which mast-cell cytokine is abnormally increased? | back 11 IL-4 |
front 12 Excessive IL-4 secretion from mast cells in an atopic patient would most directly increase production of which antibody class? | back 12 IgE |
front 13 Omalizumab prevents allergic activation by binding which region of IgE? ___ region | back 13 Fc region |
front 14 Omalizumab blocks IgE from binding most directly to which allergy-effector cell? A. Eosinophils B. Mast cells C. Th1 cells D. Tregs | back 14 B. Mast cells |
front 15 What defines autoimmune disease? A. Loss of self-tolerance B. Excessive IgA switching C. Persistent eosinophilia D. Failed antigen uptake | back 15 A. Loss of self-tolerance |
front 16 Chronically stimulated self-reactive T cells are normally eliminated after ligation of which surface molecule? ____ | back 16 Fas |
front 17 Which tolerance mechanism eliminates chronically stimulated T cells through Fas-mediated signaling? A. Somatic hypermutation B. Molecular mimicry C. Class switching D. Activation-induced cell death | back 17 D. Activation-induced cell death |
front 18 Molecular mimicry is when a microbe expresses an _____ that resembles a _____ _____ , activating self-reactive _____ . | back 18 antigen host antigen lymphocytes |
front 19 Molecular mimicry can activate lymphocytes that had previously failed to respond to which antigen type? ____-____ | back 19 Self-antigens |
front 20 A patient develops seasonal allergic rhinitis after exposure to outdoor aeroallergens. Which source most likely triggered hay fever? A. Mold spores or pollens B. Animal venoms C. Indoor endotoxins D. Bacterial capsules | back 20 A. Mold spores or pollens |
front 21 Compared with hay fever allergens, asthma-triggering allergens are most commonly found in which location? | back 21 Indoors |
front 22 A non-allergic person and an atopic person encounter the same environmental antigen. Which antibody pattern is most likely? A. IgE versus IgG B. IgG versus IgE C. IgA versus IgM D. IgM versus IgA | back 22 B. IgG versus IgE |
front 23 During initial allergen sensitization, mast cells bind which region of newly produced IgE? A. Fab region B. Variable region C. Hinge region D. Fc region | back 23 D. Fc region |
front 24 An atopic patient is re-exposed to an allergen after prior sensitization. What event directly initiates mast-cell degranulation? A. IgE crosslinking B. IgG opsonization C. Fas ligation D. Treg induction | back 24 A. IgE crosslinking |
front 25 Free IgE in blood has approximately what half-life? A. Two months B. Two weeks C. Two days D. Two hours | back 25 C. Two days |
front 26 When IgE is attached to mast cells, it can persist for approximately how long? A. Hours B. Days C. Weeks D. Months | back 26 D. Months |
front 27 Which cells mediate the immediate phase of allergic reactions? _____ cells and _____ | back 27 Mast cells and basophils |
front 28 Which allergic effector cell is primarily stationed in tissues? | back 28 Mast cell |
front 29 Which allergic effector cell is primarily found circulating in blood? | back 29 Basophil |
front 30 Which cell type mainly mediates the delayed phase of allergic reactions? _____ | back 30 Eosinophils |
front 31 In chronic allergic reactions, T-cell production of which cytokine recruits eosinophils from bone marrow? | back 31 IL-5 |
front 32 A germinal center dominated by Th1 cells is most likely to generate B cells producing which antibody class? | back 32 IgG |
front 33 Th1-dominated germinal centers promote IgG class switching through secretion of which cytokine? | back 33 IFN-gamma |
front 34 A germinal center dominated by Th2 cells is most likely to generate B cells producing which antibody class? | back 34 IgE |
front 35 Th2-dominated germinal centers promote allergic antibody production through which cytokines? A. IL-2 and IL-12 B. IL-10 and TGF-beta C. IL-4 and IL-5 D. IFN-gamma and TNF | back 35 C. IL-4 and IL-5 |
front 36 An atopic patient has recurrent allergic rhinitis and asthma after common environmental exposures. Which helper T-cell subset would be increased? A. Th1 cells B. Th2 cells C. Th17 cells D. Tfh cells | back 36 B. Th2 cells |
front 37 A Th1 cell secretes TNF during a cellular immune response. Which innate immune cell is most directly activated? ___ ___ cell | back 37 NK cell |
front 38 A Th1 response produces IL-2 during intracellular infection. Which cell populations proliferate in response? ____ cells and ____ | back 38 NK cells and CTLs |
front 39 At the maternal-fetal interface, placental cytokines shift helper T cells away from Th1 immunity. Which helper T-cell fate is promoted? A. Th17 cell B. Tfh cell C. Th1 cell D. Th2 cell | back 39 D. Th2 cell |
front 40 An infant’s early microbial infection biases later immune responses toward which helper T-cell subset? A. Th1 cells B. Th2 cells C. Tfh cells D. Treg cells | back 40 A. Th1 cells |
front 41 The composition of the intestinal microbiota is mainly established during which period? A. First few years B. Early adolescence C. Late adulthood D. Fetal development | back 41 A. First few years |
front 42 A patient has inherited allergy susceptibility involving antigen presentation to CD4 cells. Which gene group is implicated? A. Class I MHC B. Class II MHC C. TCR alpha D. CD8 coreceptor | back 42 B. Class II MHC |
front 43 An atopic patient has inherited IgE receptor variants that amplify mast-cell signaling. Which cytokine becomes elevated? A. IL-10 B. IFN-gamma C. IL-4 D. IL-12 | back 43 C. IL-4 |
front 44 A patient receives glucocorticoids for severe allergic disease. Which immune effect explains symptom improvement? Block ____ ____ | back 44 Block helper cytokines |
front 45 Glucocorticoids reduce allergic responses partly by lowering helper T-cell cytokines. What downstream B-cell effect follows? Fewer activated ____ cells | back 45 Fewer activated B cells |
front 46 A patient on chronic glucocorticoids has improved allergies but develops recurrent infections. What adverse immune effect explains this? A. Weakened immune system B. Enhanced Th1 immunity C. Increased complement lysis D. Excessive IgA secretion | back 46 A. Weakened immune system |
front 47 Which allergy treatment is described as the only approach capable of curing allergies? A. Omalizumab therapy B. Glucocorticoid therapy C. Specific immunotherapy D. Antihistamine therapy | back 47 C. Specific immunotherapy |
front 48 Specific immunotherapy treats allergy by repeatedly giving which type of exposure? A. Decreasing allergen doses B. Increasing allergen doses C. Single allergen bolus D. Continuous steroid pulses | back 48 B. Increasing allergen doses |
front 49 Current theory suggests allergen immunotherapy induces regulatory T cells to produce which cytokines? A. IL-4 and IL-5 B. IFN-gamma and TNF C. IL-2 and IL-12 D. IL-10 and TGF-beta | back 49 D. IL-10 and TGF-beta |
front 50 An allergy patient develops increased IL-10 after therapy. What outcome would this cytokine most likely promote? A. Prevent allergic reaction B. Increase IgE secretion C. Activate mast cells D. Recruit eosinophils | back 50 A. Prevent allergic reaction |
front 51 A child has autoimmune lymphoproliferative syndrome with enlarged lymph nodes. What mechanism best explains the disorder? ____ signaling defect | back 51 Fas signaling defect |
front 52 In autoimmune lymphoproliferative syndrome, defective Fas signaling causes which cellular abnormality? A. B cells die early B. T cells survive too long C. NK cells lose cytotoxicity D. Eosinophils leave marrow | back 52 B. T cells survive too long |
front 53 A patient with Canale-Smith syndrome develops lymphadenopathy and autoantibodies. Which cell type accumulates abnormally? A. T cells B. Mast cells C. Neutrophils D. Basophils | back 53 A. T cells |
front 54 Which finding is characteristic of autoimmune lymphoproliferative syndrome? A. Self-reactive antibodies B. Absent class II MHC C. Low lymphocyte counts D. Failed IgE binding | back 54 A. Self-reactive antibodies |
front 55 For autoimmune disease to occur, MHC molecules must be able to present which antigen type? ____ antigen | back 55 Self antigen |
front 56 Which lymphocyte feature is required for autoimmune disease development? Self-____ ____ | back 56 Self-reactive receptors |
front 57 Besides genetic susceptibility and self-reactive lymphocytes, which factor often contributes to autoimmunity? ____ trigger | back 57 Environmental trigger |
front 58 A patient develops autoimmune disease after infection because lymphocyte receptors cross-react with host tissue. Which hypothesis explains this? | back 58 Molecular mimicry |
front 59 Rheumatic heart disease after streptococcal infection is classically an example of which mechanism? | back 59 Molecular mimicry |
front 60 A self-reactive T cell encounters a microbial mimic of self antigen. What additional condition is needed for activation? A. Simultaneous local inflammation B. Absent antigen presentation C. Complete cytokine silence D. Immediate eosinophil depletion | back 60 A. Simultaneous local inflammation |
front 61 For molecular mimicry to activate self-reactive T cells, inflammation must occur in tissue that also expresses what? A. IgE receptor B. Self antigen C. Fc fragment D. Complement receptor | back 61 B. Self antigen |
front 62 In insulin-dependent diabetes mellitus, which pancreatic cell type is initially targeted by autoimmune injury? A. Alpha cells B. Beta cells C. Delta cells D. Acinar cells | back 62 B. Beta cells |
front 63 In insulin-dependent diabetes mellitus, beta cells are located in which organ? A. Pancreas B. Thyroid C. Adrenal gland D. Pituitary | back 63 A. Pancreas |
front 64 Which immune cell initially attacks beta cells in insulin-dependent diabetes mellitus? ____ ____ cells | back 64 Killer T cells |
front 65 Reduced CTLA-4 RNA increases diabetes susceptibility by impairing control of which cells? _____-____ T cells | back 65 Self-reactive T cells |
front 66 Which molecule normally helps restrain self-reactive T cells in diabetes susceptibility? A. CTLA-4 B. CD40L C. IL-17 D. IgM | back 66 A. CTLA-4 |
front 67 Plaque psoriasis most characteristically produces which skin finding? ____ and ____ | back 67 Thickening and scaling |
front 68 Plaque psoriasis is driven mainly by which immune cell type? A. Th2 cells B. B cells C. CD8 cells D. Neutrophils | back 68 C. CD8 cells |
front 69 In plaque psoriasis, CD8 cells produce which cytokine that promotes keratinocyte proliferation? | back 69 IL-17 |
front 70 In plaque psoriasis, IL-17 causes proliferation of which cell type? A. Keratinocytes B. Fibroblasts C. Chondrocytes D. Oligodendrocytes | back 70 A. Keratinocytes |
front 71 The proposed self-reaction in psoriasis involves class I MHC recognition of streptococcal antigens and what self-cell target? A. Cartilage B. Keratinocytes C. Myelin D. Beta cells | back 71 B. Keratinocytes |
front 72 The proposed infectious trigger in plaque psoriasis involves which organism group? A. Mycobacteria B. Epstein-Barr virus C. Streptococcal bacteria D. Candida species | back 72 C. Streptococcal bacteria |
front 73 Rheumatoid arthritis is primarily characterized by autoimmune inflammation of which structure? A. Pancreatic islets B. Central myelin C. Hair follicles D. Joints | back 73 D. Joints |
front 74 In rheumatoid arthritis, autoimmune cells react against cartilage and a protein from which infection? A. Tuberculosis B. Epstein-Barr virus C. Streptococci D. Influenza | back 74 A. Tuberculosis |
front 75 Which tissue antigen is targeted in rheumatoid arthritis? A. Myelin B. Cartilage C. Keratin D. Insulin | back 75 B. Cartilage |
front 76 In rheumatoid arthritis, abundant IgM antibodies bind which region of IgG? A. Fab region B. Hinge region C. Fc region D. Variable region | back 76 C. Fc region |
front 77 The IgM antibody that binds IgG Fc in rheumatoid arthritis forms which pathogenic structure? A. Cytotoxic synapse B. IgE tetramer C. MHC complex D. Immune complex | back 77 D. Immune complex |
front 78 In rheumatoid arthritis, IgM-IgG immune complexes activate which inflammatory cell? A. Macrophage B. Mast cell C. Basophil D. Keratinocyte | back 78 A. Macrophage |
front 79 Activated macrophages in rheumatoid arthritis produce which cytokine causing inflammation? | back 79 TNF |
front 80 Multiple sclerosis involves immune-mediated destruction of which structure? A. Cartilage B. Keratin C. Myelin D. Beta cells | back 80 C. Myelin |
front 81 Myelin is required primarily for which nervous-system function? A. Cytokine production B. Antibody secretion C. Cartilage repair D. Electrical signaling | back 81 D. Electrical signaling |
front 82 Multiple sclerosis occurs almost exclusively in people previously infected with which virus? | back 82 Epstein-Barr virus |
front 83 Epstein-Barr virus establishes chronic infection in which cell type? ____ cells | back 83 B cells |
front 84 The classic facial rash of lupus involves which areas? ____ and ____ | back 84 Forehead and cheeks |
front 85 The “red wolf” appearance in lupus refers most directly to which manifestation? A. Kidney damage B. Hair loss C. Arthritis D. Facial red rash | back 85 D. Facial red rash |
front 86 Systemic lupus erythematosus results from breakdown of tolerance in which lymphocyte groups? A. B and T cells B. NK and mast cells C. CD8 and basophils D. Neutrophils and monocytes | back 86 A. B and T cells |
front 87 In lupus, loss of B- and T-cell tolerance results in production of which self-reactive antibody class? | back 87 IgG |
front 88 One proposed lupus mechanism involves defective interaction between Fas and which partner molecule? | back 88 Fas ligand |
front 89 Another proposed lupus mechanism involves mutation in which innate immune receptor family? A. IgE receptors B. TNF receptors C. IL-2 receptors D. Toll-like receptors | back 89 D. Toll-like receptors |