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General Pathology Exam 2 Quiz Questions IgG are the first antibodies secreted in an infection (T/F) ✔✔False Helper T cells like Th1 Th2 Th17 express a CD8 type receptor (T/F) ✔✔True Microbiome represent the micromolecules that insure the tightness of the basement membrane (T/F) ✔✔False What are causes of secondary immunodeficiency? (MACA) deficiency in generating ROS due to NADPH gene mutation Malnutrition Cancer chemotherapy HIV infection Anti-rejection therapy Extensive open chest cardiac surgery ✔✔Malnutrition Cancer chemotherapy HIV infection Anti-rejection therapy Extensive open chest cardiac surgery What tests are comonly used to investigate a patient with AIDS due to HIV? HIV antibody and CD4+ cell count HIV antigen and CD8+ cell count HIV antibody and B cell count ✔✔HIV antibody and CD4+ cell count A 3 month old boy has had recurrent infections of the respiratory, intestinal and urinary tracts since birth. Infectious agents have included Candida albicans, Pneumocystis carinii, and Cytomegalovirus. Despite antibiotics and antifungals, he dies at 5 months of age. An autopsy would show: Small lymph nodes with no T cells in the paracortex and some germinal centers Small lymph nodes with no germinal centers but a present paracortex Enlarged lymph nodes with relative normal germinal center an an enlarged reactive cortex enlarged lymph nodes due to the constant infections ✔✔Small lymph nodes with no T cells in the paracortex and some germinal centers A patient presents with recurrent respiratory tract infections after 6 months of age and has a low number of B cells in the blood and lymphoid organs as well as an absence of plasma cells. What condition is this most likely to be? Severe combined immunodeficiency Selective IgA deficiency Di George syndrome
X-linked aggamaglobulinemia ✔✔X-linked aggamaglobulinemia Irradiation and chemotherapy treatments for cancer cause secondary immunodeficiencies through which mechanism? Decreased phagocytosis of microbes Metabolic derangements inhibit lymphocyte maturation and function Depletion of CD 4+ helper T cells Decreased bone marrow precursors for all lymphocytes ✔✔Decreased bone marrow precursors for all lymphocytes Select appropriate characteristics of the natural or specific immunity A: Innate B: Adaptive Immunity 1: Mediated by lysozyme 2: Non-specific 3: immediate response 4: Includes the presence of microbiome 5: Develops in time after an initial exposure 6: Depends on the presence of T lymphocytes 7: Includes the participations of plasma cells 8: Includes immunoglobulins ✔✔1: A 2: A 3: A 4: A 5: B 6: B 7: B 8: B Select multiple correct answers (MACA) about Toll - Like Receptors (TLR) They are integral membrane proteins that bind PAMPs (pathogen-associated molecular patterns) Activate immune cells in combination with mechanoreceptors like Piezo Participate in both innate and aquired immunity May be involved in apoptosis are blocked by NSAIDs (nonsteroidal anti-inflammatory drugs) ✔✔They are integral membrane proteins that bind PAMPs (pathogen-associated molecular patterns) Activate immune cells in combination with mechanoreceptors like Piezo Participate in both innate and aquired immunity May be involved in apoptosis are blocked by NSAIDs (nonsteroidal anti-inflammatory drugs) Immunodeficiency is suspected in case of infections that are: (MACA)
Macrophages Neutrophils Dendritic cells ✔✔CD+ T cell Blood transfusion reactions are what type of hypersensitivity? Type IV Type III Type I Type II ✔✔Type II Muscle weakness seen in patients suffering from myasthenia gravis occurs due to ______________. Immune complexes depositing on the neuromuscular junction Lymphocytes attacking muscle cells Anitbodies binding to acetylcholine receptor in the neuromuscular junction Antibodies binding acetylcholine in the neuromuscular junction ✔✔Anitbodies binding to acetylcholine receptor in the neuromuscular junction The tissue damage caused by type III hypersensitivity is mediated by Activated T lymphocytes IgE interaction with mast cells Antigen-antibody complexes Mainly IgG and IgM antibodies ✔✔Antigen-antibody complexes An allograft is between a human and an animal two individuals who are not identical twins Identical twins an individual who donates to him/her self ✔✔two individuals who are not identical twins Minutes after a donor kidney is connected to the recipient's blood vessels, the transplanted kidney turns blue, becomes flaccid, excretes a few drops of bloody urine and has to be removed. Histological examination showed immunoglobulin and complement proteins deposited in blood vessel walls. This type of rejection is due primarily to Donor cytotoxic T lymphocytes that are directed against host anitgens Host cytotoxic T lymphocytes that are director against donor antigens Preformed host antibodies that are directed against the donor antigens Preformed donor antibodies that are directed against host antigens ✔✔Preformed host antibodies that are directed against the donor antigens Chronic rejection occurs what time after the transplant?
Hours weeks Minutes Months or years ✔✔Months or years Contact dermatitis like poison ivy occurs _______________ after exposure. Immediately I hour later 6 - 8 hours later 24 - 48 hours ✔✔ 24 - 48 hours There is evidence that autoimmune diseases have higher incidence if there was a lack of infections in childhood. (T/F) ✔✔True Select all correct description about rejection of transplant: (MACA) graft blood vessels are the most protected from damage due to ABO matching before transplant donor antigens from the graft are processed and presented by recipient antigen presenting cells (APC) activated recipient Thelper cells induce both cytotoxic and antibody response recognition of non-self antigens is performed by recipient B cells ✔✔ An imature pre Tcell that is exposed and binds strongly to self antigens may be changed into regulatory T cell going through receptor editing and tested again changed into a cytotoxic T cell through positive selection changed into a phagocyte cell ✔✔changed into regulatory T cell Rheumatoid arthritis develops pannus in the joints that leads to radial deviation of the fingers. (T/F) ✔✔False What molecules are found on the outside of all nucleated cells and platelets? MHC I HLA III ABO system MHC II ✔✔MHC I Peripheral tolerance may be induce by the following mechanisms (MACA) Functional inactivation (Anergy) Necrosis through ROS production
Recipient antigens are foreign to donor tissue Immunocompromised recipient Transplanted tissue destroys the recipients body Which of the following is not a clinical feature of CREST syndrome Decreased motility of the esophagus Dilation of capillaries in the skin Erosion of cartilage at joints Thickening of the skin on the fingers and hand ✔✔Erosion of cartilage at joints For the development of an autoimmune disease to occur there is loss of tolerance produced by genetic susceptibility and an environmental trigger. (T/F) ✔✔True An imature pre Bcell that is exposed and strongly recognize a self antigens may be changed into regulatory B cell changed into memory B cell through positive selection going through receptor editing and tested again changed into a phagocyte cell ✔✔going through receptor editing and tested again What molecules are found on the outside of macrophages and dendritic cells MHC II HLA III ABO system MHC I ✔✔MHC II External antigens are attached and presented to Thelper (CD4+) cells using which type of molecules? ABO system MHC I HLA III MHC II ✔✔MHC II Although rheumatoid arthritis involves joints predominantly it is also a systemic disease. (T/F) ✔✔True The pressure in the interstitial tissue is regulated mostly by Extracellular matrix expansion Amount of globulins Content of salt Presure of disolved gases ✔✔Extracellular matrix expansion
29 - year-old women has a history of frequent nose bleeds and increased menstrual flow. On physical examination, petechiae and purpura are present on the skin. Laboratory studies show a decrease in von Willebrand factor activity. The patient most likely has a derrangement of which step in hemostasis? Vasoconstriction Platelet adhesion Prothrombin generation Platelet aggregation ✔✔Platelet adhesion What produces the nutmeg liver due to passive congestion? Chronic LVF Chronic RVF Acute RVF Acute LVF ✔✔Chronic RVF The intrinsic and extrinsic pathways of coagulation come together with the activation of what coagulation factor? VII X V VIII ✔✔X What is the first stage in hemostasis? Platelet aggregation Vasoconstriction Coagulation Thrombolysis ✔✔Vasoconstriction While shaving one morning, a 23 year-old nicks his lip with a razor. Seconds after the injury, the bleeding stops. which of the following mechanisms is most likely to reduce blood loss from a small dermal arteriole? Protein C activation Vasoconstriction Platelet aggregation Fibrin polymerization ✔✔Vasoconstriction Glymphatic system helps draining the lymphatic fluid from glomerulus helps draining lymphatic fluid from the brain during sleep drains the lymphatic fluid from gonads
Cardiac embolus Fat embolus Thromboembolus Gas embolus ✔✔Gas embolus Cytoskeleton alteration and formation of membrane blebs are a sign of: Early cellular injury Chromosomal damage Na/K pump activation Early fibrosis ✔✔NOT: Chromosomal damage I THINK: Early cellular injury A pulmonary embolus always produces a pulmonary infarction. (T/F) ✔✔False Arterial occlusion of a leg artery will result in a warm, swollen leg. (T/F) ✔✔False A white infarction usually occurs due to venous obstruction. (T/F) ✔✔False Match the following descriptions to the correct terms. A. Hemorrhage B. Active hyperemia C. Congestion
- Purpura
- Petechiae
- Inflamed skin
- Nutmeg liver
- Exercising
- Congestive heart failure ✔✔A - Purpura A - Petechiae B - Inflamed skin C - Nutmeg liver B - Exercising C - Congestive heart failure During initial phase of ischemia There is a influx of glycogen there are membrane fragments that deposits extracellularly There is a depletion of ATP and failure of Na/K ATP pump fibroblasts are recruited and activated ✔✔There is a depletion of ATP and failure of Na/K ATP pump
A 72 year-old man who was hospitalized 3 weeks ago for a cerebral infarct (stroke) is attempting to walk for the first time. Within minutes, he has sudden onset of dyspnea and dies. An autopsy is performed and a big saddle thrombus was discovered on the bifurcation of pulmonary artery. Which factor contributed most to this finding? Factor V mutation Bronchopneumonia Venous stasis atherosclerosis ✔✔Venous stasis Venous occlusion of a leg deep vein will result in a warm, swollen leg, with pitting edema. (T/F) ✔✔True A white infarction usually occurs when there is a block of an end artery. (T/F) ✔✔True When an individual experiences chest pain, they should rest and not go out and exercise in order to? test the integrity of the collateral circulation Decrease tissue metabolic rate Increase tissue susceptibility to ischemia Increase the rate of development of the occlusion ✔✔Decrease tissue metabolic rate Neurons are very susceptible to the effect of decreased blood flow because they do not have the ability to adapt. (T/F) ✔✔True During initial phase of ischemia There are membrane lipid fragments that are calcified DNA is transcribed in an emergency mode There is an eflux of Ca ions There is a decrease protein synthesis ✔✔There is a decrease protein synthesis Where would an arterial obstruction produce a red infarction? Brain Liver Fingers Prostate ✔✔Liver Venous occlusion of a leg deep vein will result in a warm, swollen leg, with pitting edema. (T/F) ✔✔True A white infarction usually occurs due to venous obstruction. (T/F) ✔✔False The mechanism of cardiogenic shock is to directly reduce cardiac output. (T/F) ✔✔True
Amniotic fluid and snake venom may induce Disseminated Intravascular Coagulation (DIC) by activating Complement cascade. (T/F) ✔✔False The questions I-VIII refer to the following information: After extended space travel, a new phenomenon appeared: more and more men and few women were able to perceive ultraviolet (UV) radiation as a new color. No adverse effects were noted. Extended investigation discovered a mutation on X chromosome in an uncoded area that produced a new RECESIVE gene (named UV223). A young female discovered that even though she doesn't see UV radiation as a color, she is a carrier of the UV223. To maximize the chances of her children to see the new color, she looked for men who also have the gene. And she found one who had it. Based on classical (mendelian) transmission of the gene, answer the following questions about the possible children of this family. (1/4 = 25%, 1/2 = 2/4 = 50%, 3/4 = 75%, 2/2=4/4 = 100%) The probability of a girl to inherit the gene is: ✔✔100% (all) The probability of a girl to see UV as a color is ✔✔50% The probability of a boy to inherit the gene (and see the new color) is: ✔✔50% Questions IV-VIII are a continuation of the above setup, with the following ADDITIONAL information: During a detailed consult it was revealed that due to a severe gastric ulcer the young man is following a strong antacid treatment for more than an year which altered his methylation processes and lead to imprinting of the area of UV223. Think about this new context, recalculate the above probabilities in case they have changed, and answer the following questions based on all the information presented. Does imprinting affect the expression of the UV223 genes? ✔✔Yes..? The probability of a girl to see UV as a color is ✔✔0% (none) The probability of a girl to inherit the UV223 gene is ✔✔50% The probability of a boy to inherit the gene (and see the new color) is: ✔✔50% Assuming the imprinting is reversible, and the antacid treatment is stopped, what time would you counsel the couple to wait for the effects (if any) to be seen in all the sperm-cells? ✔✔More than 4 months You have an 18 year-old come to your clinic complaining of back pain. You see that the patient is tall with long arms and fingers, has cataracts as well as a heart murmur. Where is the defect that leads to these signs and symptoms. ✔✔Fibrillin molecule Which of the following are x-linked disorder that arise as a result of trinucleotide repeats? ✔✔Fragile X
Macrophages activation path (M1 to M2) can be changed by mechanical tissue properties (tension, stretch, etc) through epigenetic pathway. ✔✔True Select multiple correct answers about importance of epigenetic factors for human development ✔✔Literally all of them... What is the most surviveable of the autosomal chromosomal defects? ✔✔Down's Syndrome The allele of a gene that is present is always expressed is a ___________________ gene. ✔✔Dominant A patient has Neurofibrosis 1. What is the type of problem that caused this? ✔✔Disease of growth control proteins Which of the following is an example of a disease caused by an alteration to enzyme structure and function.? ✔✔Phenylketonuria Proper correction of tissue tone after an injury will improve healing through epigenetic mechanisms ✔✔True Which of the following statements are true of Cytogenetic disorders? ✔✔Monosomes of autosomal chromosomes are usually incompatible with life Having an extra chromosome or being short one chromosome (monosomies and trisomies) are called ____________________. ✔✔Aneuploidy
