Immunology Review Corner

Immunology Review Corner: Chapter 57 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al.

Prepared by Dr. Thao N. Tran, Puget Sound Allergy, Asthma and Immunology, Dr. Karla Lowe, Walter Reed Medical Center, and Dr. Michael R. Rupp, University of Mississippi Medical Center.

Chapter 57:  Cell-Mediated Immunity in Health and Disease

1. A 5 millimeters tuberculin skin test is considered positive in which of the following groups of patients?
a. Intravenous drug abusers
b. Patients who reside in a nursing home
c. Patients who have close contact with persons with tuberculosis (TB)
d. Patients with no identified risk factors for TB

2. Which of the following agents can be used to test for the ability to develop a new (primary) delayed type hypersensitivity reaction?
a. Trichophyton
b. Keyhole limpet hemocyanin
c. Candida antigen
d. Tetanus toxoid

3. Antigraft antibodies play a major pathogenic role in which of the following patterns of graft rejection?
a. Hyperacute rejection
b. Ischemic injury
c. Acute rejection
d. Chronic rejection

4. Which of the following factors enhances T cell responses to tumor cells?
a. Failure to express co-stimulatory molecule by T cell
b. Anti-tumor necrosis factor (anti-TNF)
c. Interleukin (IL)-10
d. Presentation of tumor antigen in an MHC-restricted manner by dendritic cells

5. Langerhans’ cells express receptors for the Fc portions of which of the following immunoglobulins?
a. IgG
b. IgA
c. IgD
d. IgM

6. Which of the following cytokines plays a major role in Langerhans’ cell activation and migration to the local lymph nodes?
a. IL-4
b. IL-12
c. IL-1beta
d. IL-2

7. Antibodies to ganglioside GM1 may be present in a patient with which of the following diseases?
a. Acute disseminated postinfectious encephalomyelitis (ADEM)
b. Guillain-Barre syndrome
c. Dermatomyositis
d. Graft-verses-host reaction

8. Which of the following antibodies is associated with polymyositis/ dermatomyositis?
a. Anti-myelin antibody
b. Myeloperoxidase antibody
c. Anti-Jo-1 (histidyl tRNA synthetase)
d. Anti-gliadin

9. Autoantibody against mitochondrial antigen is seen in which of the following autoimmune diseases?
a. Primary biliary cirrhosis
b. Ulcerative colitis
c. Crohn’s disease
d. Primary pernicious anemia

10. Type I diabetes (IDDM) is characterized by the production of which of the following autoantibodies?
a. Microsomal antibodies
b. Anti-transglutaminase
c. Anti-21-hydroxylase
d. Anti-glutamic acid decarboxylase

11. Transient depression of cell-mediated immunity can be seen in:
a. Puberty
b. Zinc deficiency
c. Hypereosinophilic syndrome
d. Lead poisoning

12. Prolonged depression of cell-mediated immunity is often observed in which of the following diseases?
a. Chronic lyme disease
b. Infectious mononucleosis
c. Sarcoidosis
d. Glomerulonephritis

13. Serum level of which of the following cells is increased within hours of corticosteroid administration?
a. CD4+ T cells
b. Monocytes
c. CD8+ T cells
d. Neutrophils

14. Which of the following immunosuppressive drugs is considered an alkylating agent?
a. Cyclophosphamide
b. Cyclosporine
c. 6-Mercaptopurine
d. Mycophenolate mofetil

Answers:
1. c, page 974 (Table 57-1)
2. b, page 975
3. a, page 977
4. d, page 978
5. a, page 978
6. c, page 979
7. b, page 981
8. c, page 982
9. a, page 983
10. d, page 984
11. b, page 985
12. c, page 987
13. d, page 989
14. a, page 999