Download Exam 3 2006

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Exam #3
November 30, 2006
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I. Multiple Choice. Please select the best answer. (50 questions, 2 points each, total 100 points)
1. Which category of hypersensitivity BEST describes hemolytic disease of the newborn caused by Rh
incompatibility?
A. atopic or anaphylactic
B. cytotoxic
C. immune complex
D. delayed
2. The principal difference between cytotoxic (type II) and immune complex (type III) hypersensitivity
is
A. the class (isotype) of antibody.
B. type II involves platelets and type III involve eosinophils
C. the participation of complement.
D. the participation of T cells.
3. A child stung by a bee experiences respiratory distress within minutes and lapses into
unconsciousness. This reaction is probably mediated by
A. IgE antibody.
B. IgG antibody.
C. sensitized T cells.
D. complement.
E. IgM antibody.
4. Spontaneous autoimmunity in NZB mice serves as a model for studying
A. systemic lupus erythematosus
B. diabetes
C. multiple sclerosis
D. rheumatoid arthritis
5. A positive tuberculin skin test (a delayed hypersensitivity reaction) indicates that
A. a humoral immune response has occurred.
B. a cell-mediated immune response has occurred.
C. both the T and B cell systems are functional.
D. only the B cell system is functional.
6. Cross placenta hypersensitivity reactions are rare but can occur in the developing fetus. The antibody
involved is:
A. IgE
B. IgA
C. IgG4
D. IgG1
E. IgM
-27. When immune complexes from the serum are deposited on glomerular basement membrane, damage
to the membrane is caused mainly by
A. gamma interferon.
B. phagocytosis.
C. cytotoxic T cells.
D. enzymes released by mononuclear and polymorphonuclear cells.
8. Individuals of blood group type AB
A. are Rh negative.
B. are "universal recipients" of red blood cell transfusions.
C. have circulating anti-A and anti-B antibodies.
D. are universal recipients of plasma transfusions
E. B, C, and D are correct
9. Hemolytic disease of the newborn caused by Rh blood group incompatibility requires maternal
antibody to enter the fetal bloodstream. Therefore, the mediator of this disease is
A. IgE antibody.
B. IgG antibody.
C. IgM antibody.
D. IgA antibody.
10. Reduction of human tumor burden by treatment of individuals with VEGF-gelonin fusion protein
works by
A. enhancing cytotoxic T cells
B. enhancing T helper 1 cells
C. reduction of intratumoral blood vessels
D. causing inflammatory reactions
11. You have a patient who makes autoantibodies against his own red blood cells, leading to
hemolysis. Which one of the following mechanisms is MOST likely to explain the hemolysis?
A. Perforins from cytotoxic T cells lyse the red cells.
B. Neutrophils release proteases that lyse the red cells.
C. Interleukin-2 binds to its receptor on the red cells, which results in lysis of the red cells.
D. Complement is activated, and membrane immune attack complexes lyse the red cells.
12. All of the following are true with respect to IgE molecules, EXCEPT which one?
A.
B.
C.
D.
E.
They are the principal immunoglobulin class involved in allergic reactions.
They are involved in mediating anti-parasitic immune responses.
They will cross the placenta and fix complement.
They can effect the release of histamine and other chemical mediators.
They are the least abundant immunoglobulin in the serum.
13. Inherited cancers account for approximately _______% of all cancers
A. 5-10%
D. 50%
B. 15%
E. 90%
C. 15-20%
14 The biggest risk factor for getting cancer is
A. Smoking
B. Diet
C. UV radiation
D. Aging
-315. Cancers:
A. are clonal in origin
B. are multiclonal in origin
C. have undergone mutational events
D. A and C are correct
E. B and C are correct
16. Breast cancer rates are different based on where one lives. For example, the incidence of breast
cancer in U.S. is high and low in Japan. The breast cancer incidence of third generation Japanese women
(Japanese marriages) living in the U.S.
A. is low, suggesting a role for genetics in the origin of breast cancer
B. is high, suggesting a role for environmental factors in the origin of breast cancer
C. is much higher than U.S. population, suggesting a role for genetics & environment
D. none of the above
17. Tumors of the immune system can be classified as:
A. carcinoma
D. lymphoma
B. sarcoma
E. C and D are correct
C. leukemia
18. Chemical induced cancer can be described as occurring in the following order
A. progression, promotion, initiation
B. initiation, progression, promotion
C. promotion, initiation, progression
D. initiation, promotion, progression
E. promotion, progression, initiation
19. Benzo(a)pyrene from tobacco is the most potent carcinogen known and is responsible for inducing
specific mutations (hot spots) in _____ tumor suppressor gene(s).
A. Rb
D. A and C are correct
B. p16
E. A, B and C are correct
C. p53
20. The concept (theory) that the immune response system plays a major role in destruction of aberrant
(cancer) cells is called
A. immune inhibition
B. immune enhancement
C. immune destruction
D. immune surveillance
E. immune protection
21. A high percentage of NK cells express _______marker on their cell surface membrane, a receptor
for the Fc region of IgG
A. CD 2
D. CD 16
B. CD28
E. None of the above
C. T Cell Receptor
22. Although the cause of scleroderma, deposition of calcium in tissues and organs, is unknown, there
is an association of this disorder with
A. elevated T helper 1 cells
B. elevated T hel[per 2 cells
C. elevated cytotoxic T cells
D. elevated macrohages
E. large number of fetal cells in blood
-423. What term has been given to describe immune involvement in the stages of "elimination",
"equilibrium" and "escape" in the development of cancer?
A. immune tolerance
B. immune editing
C. Ig editing
D. T cell editing
24. Which cell type accounts for >90% of all cancers in humans?
A. endothelial
B. epithelial
C. hematopoietic/lymphoid
D. stromal (adipose, fibroblast, connective)
E. epidermis
25. A couple have 4 children, one with no retinoblastoma, 2 with retinoblastoma in one eye only, and
one with retinoblastoma in both eyes. What is the most likely "Rb" genotype of the parents?
A. the two Rb alleles are wildtype for both parents
B. the two Rb alleles are mutant for both parents
C. one Rb allele is mutant and the other Rb allele is wildtype for both parents
D. one Rb allele is mutant and the other Rb allele is wildtype in one parent and both Rb alleles of the
other parent are mutant.
E. none of the above
26. An early event in the immortalization of human mammary epithelial cells (HMECs) in culture is
A. activation of Her-2/neu
B. inactivation of p53
C. activation of Ras
D. inactivation of Rb
E. inactivation of p16
27. T regulatory (TRegs) can be distinguished from other T cells by
A. expression of CD 8 receptor
B. presence of activated transcription factor FOXP3
C. expression of CD25 receptor
D. B and C are correct
E. A, B, and C are correct
28. TRegs
A. suppress reaction to self antigens
B. suppress T cell functions
C. suppress APC functions
D. A and B are correct
E. A, B, and C are correct
29. Sporadic retinoblastoma requires _____ mutation(s) for cancer to develop.
A. one
D. four
B. two
E. fivc
C. three
30. The experimental animal model used for studying multiple sclerosis is
A. the Arthus reaction in rabbits
B. experimental autoimmune encephalomyelitis mice
C. lrp mice
D. NOD mice
-531. Some autoimmune diseases may result from cross-reactions between immune responses to
microorganisms reacting with host tissues, a phenomenon called
A. molecular mimicry
B. antigenic variation
C. tissue sensitization
D. autosensitization
E. tissue destruction phenomenon
32. Autoimmune diseases
A. occur more often in females than males
B. are a heterogenous group of clinical and pathological diseases
C. can be described as organ specific or systemic
D. A and B are correct
E. A, B, and C are correct
33. Experimental autoimmune Myasthenia Gravis can be induced by injecting mice with
A. myelin basic proteins
B. thyroid hormones
C. acetylcholine receptors
D. antigens derived from nerve cells
E. antigens derived from T cells
34. Autoimmune diseases are characterized by
A. a defect in the cell-mediated immune system
B. a defect in thymus development
C. an immune response against self-antigens
D. a defect in the antibody-mediated immune system
E. T cell deficiency
35. NOD mice serve as a model for which autoimmune disease?
A. Hayshimoto's thyroiditis
B. Insulin-dependent diabetes mellitus
C. multiple sclerosis
D. systemic lupus erythmatosus
E. myasthenia gravis
36. What was the proto-oncogene that gave rise to the oncogene ERB-B/ Her2/Neu?
A. Rb
B. P53
C. EGFR
D. E2F
E. GAG
37. Bishop and Varnus saw a non-transforming virus become a transforming virus by obtaining an
oncogene:
A. From viral gene by mutation
D. from other viruses
B. From host (chicken) cellular gene by mutations
E. none of the above
C. Only from mammalian tumor cells
38. An individual of blood type O could receive whole blood from the following individuals:
A. blood type A
D. blood type O
B. blood type B
E. A, B, C, and D are correct
C. blood type AB
-639. It is thought that the possible causes of Type I Diabetes are
A. Inappropriate expression of MHC class I on pancreatic beta cells
B. Inappropriate expression of MHC class II on pancreatic beta cells
C. Failure of T reg cells to maintain tolerance in the pancreas
D. A and C
E. B and C
40. The cell type shown to the pathology of inflammatory bowel disease (ulcerative colitis) is
A. T helper 1 cells
B. T helper 2 cells
C. cytotoxic T cells
D. T 17 cells
E. macrophages
41. "PTEN" is
A. an oncogene
B. a tyrosine kinase
C. a phosphatase that is a tumor suppressor gene
D. a transcription factor
E. a DNA repair gene
42. Which of the following molecules, when present in its normal, functional form, does not help
"brake" or slow down the cell cycle?
A. p53
B. p21
C. AKT
D. cyclin B1
43. What role do adiposites, (high body fat content) play in occurrence of breast cancer cancer?
A. Cause a B cell response to self to be made
B. Cause increase in pro-inflammatory molecules (macrophages,neutrophils) and subsequent DNA
damage
C. Cause release of carcinogens into the body
D. None of the above
44. What percentage of caloric restriction can reduce tumor occurrence/growth without severe ill
effects?
A. 10%
B. 20%
C. 40%
D. 60%
E. You cannot reduce tumor occurrence/growth via caloric restriction
45. How does Herceptin act to prevent Her2/neu activated cell proliferation?
A. Kills the cell via lysis
B. Binds to Her2 leading to internalization and prevention of growth signaling by heterodimers
C. A and B are correct
D. None of the above are correct
46. What form of Estrogen receptor is most associated with breast cancer?
A. ER alpha
D. A and B are correct
B. ER beta
E. A, B and C are correct
C. ER gamma
-747. Knockout of CTLA-4 (CTLA-4 -/-) in mice
A. prevents T cell proliferation
B. leads to rampant lympho-proliferative disorder
C. affects only CD8 cells
D. inhibits NK cells
48. "Knock-out" of p53 in colon cancer is a late event. Loss of p53 is associated with rapid colon
cancer growth. With this in mind, what role do you think p53 is probably playing at this late stage of
cancer?
A. DNA repair gene
B. Inducer of apoptosis
C. Inhibitor of cell proliferation
D. A and B are correct
E. A, B and C are correct
49. What is a possible side effect of inactivating T reg cells while attempting to induce immune
response for destruction of cancerous cells?
A. Increased proliferation of cancer cells
B. Induction of an autoimmune situation
C. Inability to induce apoptosis
D. Induction of a new cancer
50. Blocking monoclonal antibody to CTLA-4 in mice transplanted with colon cancer cells
A. acts as a B cell mitogen by causing proliferation of B cells
B. acts as a specific T helper cell mitogen by causing proliferation of T helper cells
C. temporarily breaks tolerance permitting immune response to tumor differentiation antigens
D. B and C are correct