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Which of the following has the greatest influence in promoting the manifestations of systemic lupus erythematosus? bacterial infection exposure to untraviolet light genetic predisposition trauma viral infections Each of the following is typically associated with scleroderma EXCEPT.... Libman-Sacks endocarditis Raynaud"s phenomenon pulmonary fibrosis esophageal fibrosis intimal hyperplasia of renal arterioles Each of the following is an important route of HIV transmission EXCEPT... aerosol droplet transmission blood transfusion heterosexual venereal contact intrauterine mother-to-fetus passage intravenous drug abuse Which statement relating to autoimmune disease is not appropriate? There is increased incidence among females, especially with a typical genetic make-up and in particular with regards to the HLA typing. Clonal elimination of "forbidden clones" is one of the methods of tolerance. Tolerance is the ability of the body to differentiate self from non-self antigens. Androgens are incriminated in the acceleration of autoimmune disease. Horrow autotoxicus implies the Type II hypersensitivity reaction especially related to increased T-cell function. Tissue injury in systemic lupus erythematosus is primarily mediated by: Activation of complement by immune complexes IgE Lymphokines Cell-mediated immunity Serum sickness is characterized by each of the following EXCEPT... circulating antigen-antibody comlexes erythematous rash, urticaria, arthralgia hypercomplementemia occurs a number of days after exposure to antigen Infants with immunodeficiency syndromes typically come to medical attention only after 5-6 months of age because... infants are not exposed to pathogenic microorganisms before that age antibody production by the newborn declines during the first 5-6 months of life maternally-derived Ig circulating in the infant declines after birth and becomes insufficient for defense against infection by 5-6 months during the first year of life, the infant"s immune system makes mostly IgM and this antibody class is ineffective in host defense in such syndromes antibody production by the infant is normal at birth nd only ceases at an age of 5-6 months istologic features of a three-day-old myocardial infarct include all of the following EXCEPT... necrotic muscle fibers interstitial polymorphonuclear leukocytes dilated capillaries with hemorrhage infiltration of numerous pigment-laden macrophages The disorder erythroblastosis fetalis or hemolytic disease of the newborn is related to the following EXCEPT... is attributable in large measure to transplacental transfer of maternal IgM with anti-erythrocyte specificity can usually be prevented by minimizing the chances of sensitization of a susceptible female may be followed by serious neurologic disease may be due to either ABO or Rh incompatibility The most common cause of ischemic heart disease is: Coronary artery atherosclerosis Coronary artery spasm Coronary arteritis Coronary artery dissection Embolus from aortic valve endocarditis It is postulated that initiating mechanisms of autoimmune disease may include all of the following, Except: Antibodies to foreign antigens that cross react with self antigens Emergence of sequestered antigens Emergence of forbidden clones Exposure of fetus to antigen in utero A 70 year old man is involved in a motor vehicle accident. A pelvic radiograph is taken to determine if a fracture is present. There is no fracture but there is increased brightness of the small muscular arteries in the region of the pelvis as a result of calcification. The MOST probably explanation for this finding is.... Hyaline arteriolosclerosis Hyperplastic arteriolosclerosis Medial calcific sclerosis Metastatic calcification Uncontrolled diabetes mellitus The principal cells involved in allergic dermatitis are: Eosinophils Mast cells PMN Plasma cells Soon after birth, a female neonate develops tetany from hypocalcemia. Within the next year, this infant has bouts of Pneumocystis carinii pneumonia, Aspergillus fumigatus pneumonia, and parainfluenza virus and herpes simplex virus upper respiratory infections. A cardiac murmur is present. Which of the following mechanisms is responsible for the clinical features seen in this case? Malformation of 3rd and 4th pharyngeal pouches Failure of maturation of B cells into plasma cells A deficiency of adenine deaminase Human immunodeficiency virus infection Failure of differentiation of pre-B cells inot B cells A myocardial infarct which is grossly detectable, yellow to gray in color and microscopically contains much debris, many macrophages, little hemosiderin, a few eosinophils and early granulation tissue is probably how old? 1 hour 12 hours 1 day 1 week 1 month Delayed hypersensitivity is responsible for most of the tissue injury in... tuberculosis abscesses both neither Atherosclerosis is characterized by : Lesions in the intima Disintegration of the internal elastic lamina in advanced lesions Higher frequency in large muscular arteries and lower frequency in smaller arteries Is considered by some scientists an autoimmune reaction of the artery A blood transfusion reaction caused by transfusion of type A blood into a type B individual is an example of a(n) atopic reaction antibody-mediated cytotoxic reaction immune complex reaction delayed hypersensitivity reaction Characteristics of infarcts in patients who die of acute myocardial infarction wtih cardiogenic shock include... involvement of more than 35 percent of the left ventricle transmural involvement both neither Myocardial rupture following myocardial infarction usually occurs : Immediately after myocardial infarction. Within the first 3 days after myocardial infarction. Is so rare that it can be ignored. 5-9 days after myocardial infarction. More than 2 weeks following myocardial infarction. Which one of the following is NOT an organ specific autoimmune disease? Addison"s disease Juvenile diabetes mellitus = IDDM Hashimoto"s thyroiditis Pernicious anemia Rheumatoid arthritis Each of the following fits in the same category of allergic disease EXCEPT..... allergic rhinitis asthma serum sickness systemic anaphylaxis urticaria An autoimmune reaction is best characterized as one that... protects against other diseases involves heterologous antibodies both neither Which of the following is/are characteristics of T-lymphocytes? Rarely play an important role in the resistance to pathogens such as TB, fungi and certain viruses Give rise to plasma cells when stimulated Are found in the paracortical areas of lymph nodes and the cuff areas surrounding germinal centers of lymphoid tissue Act primarily through immunoglobulin mediators Which of the following is most commonly affected by atherosclerosis? Ascending aorta Descending thoracic aorta Abdominal aorta Cerebral arteries Coronary arteries A patient dies suddenly two weeks after an acute myocardial infarction. Which of the following is the least likely cause of death? embolization from acute bacterial endocarditis extension of infarct to the conduction bundle resulting in cardiogenic shock rupture of the myocardium with acute tamponade rupture of a papillary muscle resulting in acute mitral insufficiency embolization from mural thrombus to cerebral vessels Which of the following statements is true: Atherosclerosis is a disease of wear and tear and is an inevitable accompaniment of aging in man. Atherosclerosis is a relatively recent phenomenon in Western industrialized countries and therefore must be due to some unidentified aspect of the industrial revolution. Of all known risk factors, a lifetime of moderate physical activity is the most likely to reduce the prevalence of atherosclerosis. If aortic fatty streaks are seen on autopsies of the young of a given population, a high incidence of clinical atherosclerosis later in life in that population is known to occur. It is possible to influence the likelihood of clinical atherosclerosis by modifying one or more aspects of our lifestyle. A 7-month old child was hospitalized for a yeast infection that would not respond to therapy. She had a history of repeated infections with pyogenic bacteria. Examination revealed lymphopenia, lack of a thymus shadow on xray, extrememly low levels of circulating Ig of all classes and absence of B cells demonstrated by fluorescent anatibody staining of a lymph node biopsy. These findings are most compatible with a diagnosis of... AIDS multiple myeloma chronic granulomatous disease Bruton"s syndrome severe combined immunodeficiency disease A 55-year-old man undergoes a right total hip replacement. During the surgery he receives 2 units of packed red blood cells, one of which came from a directed donation from his brother. Over the next week he develops worsening liver function, becomes septic, and dies. What is the most likely explanation for these findings? Donor lymphocytes attacked recipient tissues He did not receive cyclosporine therapy One of the units came from an unrelated donor Preformed antibodies to the transfused cells were present Red blood cells strongly express MHC I antigens A 49-year old man is treated appropriately in the hospital for an acute myocardial infarction. He does well until day five of hospitalization when you are called to see the patient, his condition having suddenly deteriorated. You find on physical exam distended neck veins, prominent hepatojugular reflux and distant heart sounds. The patient quickly lapses into shock and dies in spite of supportive treatment. At postmortem you would most likely find... an uncomplicated subendocardial infarct of the left ventricle an uncomplicated subendocardial infarct of the right ventricle rupture of the free wall of the left ventricle rupture of the papillary muscle of the mitral vavle rupture of the papillary muscle of the tricuspid valve Eosinophilia (an increase in the number of circulating eosinophils) is seen in... allergic diseases parasitic diseases both neither Death within the first 24 hours following an acute myocardial infarction is most often due to.... pericardial tamponade mitral insufficiency cerebrovascular accident cardiogenic shock congestive heart failure Which of the following risk factors is least important in the development of atherosclerosis? Advancing age Hypercholesterolemia Hypertension Type A personality Diabetes mellitus In a moderate sized myocardial infarct it would take approximately how long to replace the necrotic muscle with fibrous tissue? 2 days 2 weeks 2 months 2 years A 45-year-old man arrived in the emergency room complaining of chest pain of 2 hours" duration. The EKG was equivocal for acute myocardial infarction. CPK was twice normal, but the SGOT was normal... The patient probably does not have a myocardial infarct The SGOT value is probably in error The CPK value is probably in error The patient probably has an acute myocardial infarct A STAT LDH isoenzyme study should be ordered to resolve the question of acute myocardial infarction.