1.
The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?
Correct Answer
B. Prevalence
Explanation
Prevalence rate is the proportion of the population affected by a disease at a specific point in time. Prevalence is thus determined by both the incidence rate and the length of the survival period in affected individuals. (Incidence is the number of new cases)
2.
The _____ risk of developing a disease is expressed as the ratio of the disease rate among the exposed population to the disease rate in an unexposed population.
Correct Answer
D. Relative
Explanation
A common measure of the effect of a specific risk factor is the relative risk.
3.
Empirical risks for most multifactorial diseases are based on:
Correct Answer
B. Direct observation
Explanation
For most multifactorial diseases, empirical risks (i.e., risks based on direct observation of data) have been derived.
4.
What is the cause of familial hypercholesterolemia (FH)?
Correct Answer
C. A reduction in the number of LDL receptors on cell surfaces
Explanation
FH is caused by a reduction in the number of functional LDL receptors on cell surfaces. Lacking the normal number of LDL receptors, cellular cholesterol uptake is reduced and circulating cholesterol levels increase.
5.
Which risk factor for HTN is influenced by genetic factors and lifestyle?
Correct Answer
D. Obesity
Explanation
The most important environmental risk factors for hypertension are increased sodium intake, decreased physical activity, psychosocial stress, and obesity (but, as discussed later, the latter factor is itself influenced by genes and environment).
6.
An autosomal dominant form of breast cancer accounts for ___% of all cases.
Correct Answer
A. 5
Explanation
An autosomal dominant form of breast cancer accounts for approximately 5% of breast cancer cases in the United States.
7.
If a woman has one first-degree relative with breast CA, her risk of developing breast CA is ___ times what it would otherwise be.
Correct Answer
A. 2
Explanation
If a woman has one affected first-degree relative, her risk of developing breast cancer doubles.
8.
Cancers that cluster strongly in families include:
Correct Answer
A. Breast and colon
Explanation
Lung and colon cancers have proven to show a strong familial tendency.
9.
Which genes are responsible for an autosomal dominant form of breast CA?
Correct Answer
C. BRCA1 and BRCA2 genes
Explanation
Women who inherit a mutation in BRCA1 or BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer.
10.
The BRCA and BRCA2 mutations increase the risk of which cancer in women?
Correct Answer
A. Ovarian
Explanation
BRCA1 mutations increase the risk of ovarian cancer among women (20% to 50% lifetime risk), and BRCA2 mutations also confer an increased risk of ovarian cancer (10% to 20% lifetime prevalence).
11.
The primary characteristic that differentiates the immune response from other protective mechanisms is that the immune response is:
Correct Answer
B. Specific to the antigen that activates it
Explanation
Unlike inflammation, which is nonspecifically activated by cellular damage as well as pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms, that is, it has a “memory” function.
12.
B lymphocytes mature and undergo changes that commit them to becoming B cells in the:
Correct Answer
C. Bone marrow
Explanation
This process is called the generation of clonal diversity and occurs in specialized (primary) lymphoid organs; the thymus for T cells and the bone marrow for B cells.
13.
What is the term for the process in which lymphoid stem cells migrate from the bone marrow to the central lymphoid organs (thymus or bone marrow) where they undergo cellular changes into either immunocompetent T cells or immunocompetent B cells?
Correct Answer
A. Generation of clonal diversity
Explanation
This process is called the generation of clonal diversity and occurs in specialized (primary) lymphoid organs: the thymus for T cells and the bone marrow for B cells.
14.
Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?
Correct Answer
B. Active acquired
Explanation
Active acquired immunity (active immunity) is produced by an individual after natural exposure to an antigen or after immunization, whereas passive acquired immunity (passive immunity) does not involve the host’s immune response at all.
15.
Which type of immunity is produced when an immunoglobulin crosses the placenta?
Correct Answer
A. Passive acquired
Explanation
Passive acquired immunity (passive immunity) does not involve the host’s immune response at all. Rather, passive immunity occurs when preformed antibodies or T lymphocytes are transferred from a donor to the recipient. This can occur naturally, as in the passage of maternal antibodies across the placenta to the fetus, or artificially, as in a clinic using immunotherapy for a specific disease.
16.
The portion of the antigen that is configured for recognition and binding is called an antigenic determinant or a(n):
Correct Answer
C. Epitope
Explanation
The precise portion of the antigen that is configured for recognition and binding is called its antigenic determinant, or epitope.
17.
The most important determinant of immunogenicity is the antigen's:
Correct Answer
B. Foreignness
Explanation
Foremost among the criteria for immunogenicity is the antigen’s foreignness. A self-antigen that fulfills all these criteria except foreignness does not normally elicit an immune response. Thus most individuals are tolerant to their own antigens. The immune system has an exquisite ability to distinguish self (self-antigens) from non-self (foreign antigens).
18.
When antigens are administered to individuals to produce immunity, why are different routes of administration used (IV, SQ, nasal)?
Correct Answer
D. Each route stimulates a different lympHocyte-containing tissue resulting in different types of cellular and humoral immunity
Explanation
Each route preferentially stimulates a different set of lymphocyte-containing (lymphoid) tissues and therefore results in the induction of different types of cell-mediated or humoral immune responses.
19.
How are functions of the major histocompatibility molecules and CD1 molecules alike?
Correct Answer
A. They are both antigen-presenting (APC) molecules
Explanation
An essential set of recognition molecules are members of the MHC. Most antibody and cellular immune responses are dependent on antigen presentation by APCs. Another set of antigen-presenting molecules are members of the CD1 group.
20.
Antibodies are produced in:
Correct Answer
C. Plasma cells
Explanation
An antibody, or immunoglobulin, is a serum glycoprotein produced by plasma cells in response to a challenge by an immunogen.
21.
Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?
Correct Answer
A. IgA
Explanation
IgA can be divided into two subclasses, IgA1 and IgA2. IgA1 molecules are found predominantly in the blood, whereas IgA2 is the predominant class of antibody found in normal body secretions.
22.
Which antibody indicates a typical primary immune response?
Correct Answer
B. IgM
Explanation
This is the initial response, or primary immune response. Typically, IgM is produced first, followed by IgG against the same antigen.
23.
If a person had very low levels of Ig__, that individual is more susceptible to infections of the mucous membranes.
Correct Answer
C. A
Explanation
The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and “secretory piece.” This secretory piece is attached to the IgAs inside mucosal epithelial cells and may function to protect these immunoglobulins against degradation by enzymes also found in the secretions.
24.
B-cell receptor (BCR) complex function differs from the function of circulating antibodies because the BCR complex:
Correct Answer
D. Communicates information about the antigen to the cell nucleus
Explanation
Its role is to recognize antigen, but unlike circulating antibody, the receptor must communicate that information to the cell’s nucleus.
25.
During which phase of life does the generation of clonal diversity occur?
Correct Answer
A. Fetus
Explanation
Although generation of clonal diversity primarily occurs in the fetus, it probably continues to a low degree throughout most of adult life.
26.
What are characteristics of the generation of clonal diversity?
Correct Answer
C. The process takes place in the primary (central) lympHoid organs (i.e. thymus and bone marrow)
Explanation
Where does it occur? Central lymphoid organs: thymus for T cells, bone marrow for B cells.
27.
Which are characteristics of clonal selection?
Correct Answer
B. The process involves antigens selecting those lympHocytes with compatible receptors
Explanation
Clonal selection, during which antigen selects those lymphocytes with compatible receptors, expands their population, and causes differentiation into antibody-secreting plasma cells or mature T cells.
28.
What is an example of an endogenous antigen?
Correct Answer
B. Cancer cells
Explanation
Endogenous antigens are synthesized within a cell and also may include those uniquely produced by cancerous cells.
29.
Which cytokine is needed for the maturation of a functional helper T cell?
Correct Answer
B. IL-2
Explanation
Without IL-2 production, the Th cell cannot efficiently mature into a functional helper cell.
30.
Th2 cells produce IL-4 that suppresses:
Correct Answer
C. Th1
Explanation
Th2 cells produce IL-4, which suppresses Th1 and Th17 cells through their IL-4 receptors.
31.
What are the characteristics of Th1 cells?
Correct Answer
B. They are induced by antigens derived from cancer cells
Explanation
Antigens derived from viral or bacterial pathogens and those derived from cancer cells are hypothesized to induce a greater number of Th1 cells relative to Th2 cells.
32.
What are the characteristics of Th2 cells?
Correct Answer
A. They are induced by antigens derived from allergens
Explanation
For example, antigens derived from multicellular parasites and allergens are hypothesized as a result in production of more Th2 cells.
33.
When a person is exposed to most antigens, how long does it take before an antibody can be detected in the circulation?
Correct Answer
D. 6 days
Explanation
After approximately 5 to 7 days, IgM antibody specific for that antigen can be detected in the circulation.
34.
Vaccinations are able to provide protection against certain microorganisms because of the:
Correct Answer
B. Level of protection provided by IgG
Explanation
IgG production is increased considerably, making it the predominant antibody class of the secondary response. It is often present in concentrations several times larger than those of IgM, and levels of circulating IgG specific for that antigen may remain elevated for an extended period of time.
35.
Some viruses, such as measles and herpes, are inaccessible to antibodies after the initial infection because they:
Correct Answer
A. Do not circulate in the blood
Explanation
Many viruses (e.g., measles, herpes) are inaccessible to antibodies after initial infection because they do not circulate in the bloodstream but instead remain inside infected cells, spreading by direct cell-to-cell contact.
36.
Which is an example of a bacterial toxin that has been inactivated, but still retains its immunogenicity to protect the person?
Correct Answer
C. Tetanus
Explanation
The symptoms of tetanus or diphtheria are mediated by specific toxins. To prevent harming the recipient of immunization, bacterial toxins are chemically inactivated so that they have lost most of their harmful properties but still retain their immunogenicity. These are referred to as toxoids.
37.
Antibodies protect the host from bacterial toxins by:
Correct Answer
B. Binding to the toxins to neutralize their biologic effects
Explanation
To cause disease, most toxins must bind to surface molecules on the individual’s cells. Protective antibodies can bind to the toxins, prevent their interaction with cells, and neutralize their biologic effects.
38.
Which T cell controls or limits the immune response to protect the host's own tissues against an autoimmune response?
Correct Answer
D. Regulatory T (Treg) cells
Explanation
The role of Treg cells is to control or limit the immune response to protect the host’s own tissues against autoimmune reactions.
39.
At birth, samples of blood from the umbilical cord indicate which immunoglobulin levels, if any, are near adult levels?
Correct Answer
B. IgG
Explanation
At birth, total IgG levels in the umbilical cord are near adult levels.
40.
Increased age may cause which of these changes in lymphocyte function?
Correct Answer
A. Increased production of antibodies against self antigens
Explanation
B-cell function is altered with age as shown by decreases in specific antibody production in response to antigenic challenge, with concomitant increases in circulating immune complexes and in circulating autoantibodies (antibodies against self-antigens).