База тестів крок-1 з патофізіології (пмк-1)



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ИММУНИТЕТ
Test 56

The delayed type hypersensitivity does not occur in hairless mice. Choose most possible cause explaining this fact:



  1. Abnormality in phagocytosis

  2. Disorder in hematopoiesis

  3. Absence of the thymus?

  4. Abnormality in сomplement system

  5. Absence of immunoglobulins in the blood


Test 57

Skin transplantation is performed to a patient with widespread burns. The graft becomes swollen and changed in color on the 8th day and is rejected in two weeks after the transplantation. Which of the following cells mediate this reaction?



  1. Neutrophils

  2. Macrophages

  3. Eosinophils

  4. B-lymphocytes

  5. T-lymphocytes


Test 58

All immunoglobulin levels are decreased in a 2-year old boy. Maturation of which of the following immune cells is most likely to be affected?



  1. B cells

  2. T-killers

  3. NK-cells

  4. T-helpers

  5. T-suppressors


Test 59

It is known that plasma cells produce specific antibodies against a given antigen. Number of plasma cells increases after introduction of the antigen. Which of the following cells are precursors of plasma cells?



  1. Neutrophils

  2. B-lymphocytes

  3. Basophils

  4. T-lymphocytes

  5. Eosinophils


Test 60

A neonate develops convulsions. On his examination the absence of parathyroid gland and thymus and decrease in blood content of T-lymphocytes are reviled. What is the correct diagnosis?



  1. Chronic granulomatous disease

  2. Bruton’s disease

  3. Di George syndrome

  4. Primary complement deficiency

  5. Secondary T- cell deficiency


Test 61

A 2-year-old boy has a history of recurrent infections which began when he was 4 month. B-lymphocytes and plasma cells are absent in his blood and lymph nodes; his tuberculin test is positive. What is the correct diagnosis?



  1. Chronic granulomatous disease

  2. X-linked agammaglobulinaemia

  3. Di George syndrome

  4. Primary complement deficiency

  5. Secondary immunodeficiency


Test 62

A 25-year-old man develops lymphadenopathy, diarrhea, night sweats, oral candidiasis and weight loss. He is injection drug addict. HIV-test is positive in the patient. Which of the following cell types is affected at this disorder?



  1. B lymphocytes

  2. APCs

  3. NK cells

  4. CD4+ T-cells

  5. CD8+ T-cells


Test 63

A 5-year-old boy suffers from hereditary sex-linked disorder. His blood test shows an absence of IgG, IgA and IgM antibodies. T-lymphocyte response is normal. What is the correct diagnosis?



  1. Bruton’s disease

  2. Luis-Barr syndrome

  3. Acquired immunodeficiency

  4. Swiss type of immunodeficiency

  5. Di George syndrome


Test 64

A 7-month-old child is hospitalized for a yeast infection that does not respond to therapy. The patient has a history of multiple, acute Pyogenic infections. Physical examination reveals that the spleen and lymph nodes are not palpable. A differential WBC count shows 95% neutrophils, 1% lymphocytes, and 4% monocytes. A bone marrow biopsy contains no plasma cells or lymphocytes. A chest x-ray reveals the absence of a thymic shadow. Tonsils are absent. These findings are most consistent with?



  1. Bruton's disease

  2. Chediak – Higashi syndrome

  3. Di-George syndrome

  4. Severe combined immunodeficiency

  5. Wiskott-Aldrich syndrome


Test 65

A 4-month-old male presents with twitching of the facial muscles. He has previously been seen for several severe episodes of Candida infections. On examination, the child has low-set ears, decreased T lymphocytes in the blood. What additional findings would be likely in this individual?



  1. Absent thymic shadow on chest x-ray

  2. Decreased IgM levels

  3. Decreased IgA levels

  4. Neutropenia E. Elevated IgE levels

АЛЛЕРГИЯ
Test 66

A woman who is allergic to cats visits a neighbor who has several cats. During the visit, she inhales cat dander, and within minutes, she develops nasal congestion with abundant nasal secretions. Which of the following substances is most likely to produce these findings?



  1. Bradykinin

  2. Complement C5a

  3. Histamine

  4. Interleukin-1

  5. Phospholipase C


Test 67

A 40-year-old man has been infected with HIV for the past 10 years. During this time, he has had several bouts of oral candidiasis, but no major illnesses. He is now diagnosed with Kaposi sarcoma involving the skin. He has had a 7-kg weight loss in the past 6 months. Which of the following types of cells is most depleted in his lymph nodes?



  1. CD4+ lymphocyte

  2. CD8+ lymphocyte

  3. Eosinophil

  4. Follicular dendritic cell

  5. Macrophage


Test 68

A 22-year-old man has had a urethral discharge for the past week. A culture of the exudate from the urethra grows Neisseria gonorrhea. He is treated with penicillin G, but within minutes after injection, he develops itching and erythema of the skin. This is quickly followed by severe respiratory difficulty with wheezing and stridor. Which of the following immunoglobulins has most likely become attached to the penicillin G and mast cells to produce these symptoms?



  1. IgA

  2. IgG

  3. IgM

  4. IgD

  5. IgE


Test 69

A 40-year-old laboratory technician accidentally injects a chemical into his skin. The next day, he notes that an area of erythematous, indurated skin is forming around the site of injection. Two days later, the induration measures 10 mm in diameter. A microscopic section from this area, with immunostaining using antibody to CD4, shows many positive lymphocytes. Which of the following immunological reactions is most consistent with this appearance?



  1. Systemic anaphylaxis

  2. Arthus reaction

  3. Graft-versus-host disease

  4. Delayed-type hypersensitivity

  5. Serum sickness



Test 70

Ten minutes after being stung by a wasp, a 30-year-old male develops multiple patches of red, irregular skin lesions over his entire body. These lesions (urticaria) are pruritic, and new crops of lesions occur every day. This response is primarily the result of liberation of specific vasoactive substances by the action of



  1. Activated T lymphocytes on smooth muscle cells

  2. IgA on basophils and mast cells

  3. IgA on lymphocytes and eosinophils

  4. IgE on basophils and mast cells

  5. IgE on lymphocytes and eosinophils


Test 71

After receiving incompatible blood, a patient develops a transfusion reaction in the form of back pain, fever, shortness of breath, and hematuria. This type of immunologic reaction is classified as



  1. Systemic anaphylactic reaction

  2. Systemic immune complex reaction

  3. Delayed type hypersensitivity reaction

  4. Complement-mediated cytotoxicity reaction

  5. T cell–mediated cytotoxicity reaction


Test 72

A 29-year-old Mexican American woman receives an intradermal tuberculin injection and later develops an indurated, erythematous papule 12 mm in diameter. This reaction is an example of which of the following?



  1. Antibody-dependent cell-mediated cytotoxicity

  2. Local anaphylaxis

  3. T-cell mediated cytotoxicity

  4. Type III hypersensitivity

  5. Type IV hypersensitivity



Test 73

A neonate born from a rhesus-positive father and a rhesus-negative mother develops severe hemolytic anemia. What disorder underlines hemolysis in this newborn?



  1. Decreased osmotic resistance of RBCs

  2. Antenatal intoxication

  3. Antenatal infection

  4. Genetic abnormality of erythrocytes

  5. Antibody-mediated cytotoxicity



Test 74

Novocaine blockade was carried out to a 35-year old man suffering from radiculitis (back pain). Just after the injection his blood pressure dropped to 70/40 mm Hg and he lost consciousness. Which of the following types of reactivity does he develop?



  1. Hypoergic

  2. Normoergic

  3. Nonspecific

  4. Hyperergic

  5. Physiological


Test 75

A 72-year old man consults a dentist about redness and edema which develop in his mouth in a month after dental prosthesis. Contact stomatitis is diagnosed in the patient. Which of the following types of hypersensitivity reactions underlies this disorder?



  1. Allergy

  2. Cell-mediated hypersensitivity

  3. Immune complex reaction

  4. Anaphylactic reaction

  5. Immediate hypersensitivity


Test 76

Anaphylactic shock develops in a 13-year old boy after wasp sting. Which of the following mechanisms is involved in anaphylaxis?



  1. Interaction of antigen with T-killers

  2. Interaction of antigen with IgM

  3. Interaction of antigen with IgG

  4. Interaction of antigen with IgE

  5. Interaction of antigen with B cells


Test 77

A skin tuberculin test is carried out to a 17-year-old man. In two days skin swelling of 40 mm in diameter and hyperemia develop in the site of injection. Which of the following mediators are responsible for this reaction?



  1. Lymphokines

  2. Histamine

  3. Prostaglandins

  4. Leukotriens

  5. Kinins


Test 78

A 42-year old woman develops severe purulent endometritis and is administered a broad spectrum antibiotic. In 10 minutes after the antibiotic is injected the woman develops sudden hypotension, severe bronchoconstriction and collapse. Which of the following reactions underlines this disorder?



  1. Serum sickness

  2. Anaphylaxis

  3. Atopic reaction

  4. Arthus phenomenon

  5. Sensitization


Test 79

Nausea, fatigue, stomach ache, palpitation, difficult respiration and skin blisters develop in a patient in 25 minutes after he is injected with antibiotic. What stage of allergic reaction is described?



  1. Pathochemical

  2. Biochemical

  3. Pathophysiological

  4. Immunological

  5. Sensitization


Test 80

A skin tuberculin test is carried out to a patient with unexplained fever. Local hyperemia and edema develop in the site of intracutaneous introduction of tuberculin within 48 hours. Which of the following cells are primary effectors in pathogenesis of this reaction?



  1. Neutrophils

  2. T-lymphocytes

  3. B-lymphocytes

  4. Endotheliocytes

  5. Eosinophyles


Test 81

To produce experimental Arthus reaction horse serum is repeatedly injected into rabbit’s skin. Hyperemia, swelling and then tissue necrosis occur in the place of injections. Which of the following mediators are responsible for this reaction?



  1. IgE antibodies

  2. Mast cell mediators

  3. IgG and IgM antibodies

  4. NK cells

  5. Lymphokines


Test 82

Skin rash, itching, swelling and pain in joints, an increase in body temperature, and proteinuria occur in a patient in 7 days after he is introduced antiserum. Serum sickness is diagnosed. Which of the following is the primary pathogenesis of this syndrome?



  1. Accumulation of immune complexes in the blood

  2. Degranulation of mast cells

  3. Activation of T-killers

  4. Activation of endotheliocytes

  5. Systemic cytolysis of blood cells


Test 83

Skin tests are used to confirm a diagnosis of many infectious diseases (tuberculosis, brucelosis, tularemia etc).The diagnosis is confirmed if a papule and redness appear in a place of the antigen injection. Which of the following factors mediate the reactions to the antigen?



  1. IgE and histamine

  2. IgG and macrophages

  3. T-lymphocytes and lymphokines

  4. IgE and mast cells

  5. IgM and complement


Test 84

Every year in spring and early summer, when trees and flowers are in blossom, a 19-year old girl develops conjunctivitis and rhinitis. Production of specific antibodies to pollen underlies this syndrome. Which of the following cells participate in the antibodies production?



  1. Neutrophils

  2. Macrophages

  3. Lymphocytes

  4. Plasma cells

  5. Mast cells


Test 85

Thyrotoxicosis is diagnosed in a 45-year old woman. Antithyroid IgG antibodies are revealed in her blood. Which of the following types of hypersensitivity reactions underlies the development of the disorder?



  1. Immune complex reactions

  2. Cytotoxic reactions

  3. Anaphylactic reactions

  4. Immediate hypersensitivity

  5. Cell-mediated reactions


Test 86

Arthralgia, skin itching and swelling of lymphatic nodes develop in a patient in 9 days after he is introduced antiserum. Which of the following reactions underlines this disorder?



  1. Sensitization

  2. Serum sickness

  3. Anaphylactic shock

  4. Arthus phenomenon

  5. Angioedema


Test 87

A tooth is extracted in a teenager under Novocaine anesthesia. Ten minutes later skin paleness, dyspnea and hypotension occur in the patient. Which of the following types of hypersensitivity reactions underlines this disorder?



  1. Type 1

  2. Type 2

  3. Arthus phenomenon

  4. Type 4

  5. Type 3


Test 88

A tooth is extracted in a 20 year old girl under Novocaine anesthesia. Ten minutes later skin itching; dyspnea and hypotension occur in the patient .Which of the following substances reacts with an allergen on the surface of mast cells?



  1. IgE

  2. Complement

  3. IgA

  4. Histamine

  5. IgM


Test 89

A guinea-pig is injected with 0,1 ml of horse serum to cause sensitization. The sensitization can be identified by which of the following:



  1. Skin itching

  2. Bronchoconstriction

  3. Increased IgE levels

  4. Eosinophylia

  5. Increased IgG levels


Test 90

A 15-year-old girl suffers from bronchial asthma. During the spring blossoming period she develops severe asthmatic attacks. Which of the following mediators is responsible for prolonged bronchoconstriction?



  1. Leukotrien

  2. Prostaglandin

  3. C3b

  4. IgE

  5. Histamine


Test 91

A 30-year old woman consults a doctor about headache, sneezing, itchy eyes which develop every spring in a blossoming period. Which of the following types of hypersensitivity reactions by Gell and Coombs underlies this disease?



  1. Immediate hypersensitivity

  2. Arthus phenomenon

  3. Antibody-dependent cytotoxicity

  4. Immune complex reactions

  5. Delayed hypersensitivity


Test 92

Contact dermatitis occurs in a nurse working in the manipulation room .Which of the following disorders underlies this disease?



  1. Acquired immunodeficiency

  2. Immediate hypersensitivity

  3. Delayed hypersensitivity

  4. Primary B-cell immunodeficiency

  5. Primary T-cell immunodeficiency


Test 93

A 15-year old boy with pneumonia is injected with penicillin. Anaphylactic shock develops in the patient in 10 minutes after the injection. Which of the following biologically active substances mediates this disorder?



  1. IL-1

  2. Prostaglandin

  3. Histamine

  4. Complement

  5. Lymphokine


Test 94

A 32-year old man suffers from hay fever for several years. His blood test shows increased IgE levels. Desensitization therapy can be performed by means of which of the following:



  1. CaCl2 injections

  2. Antihistamine drugs use

  3. Repeated injections of increasingly greater amounts of allergen

  4. Immunotherapy

  5. Glucocorticoids use


Test 95

Serum disease develops in a child in a week after he is injected with tetanus antitoxin. Which of the following types of immune reactions underlines this disorder?



  1. Autoallergy

  2. Anaphylactic

  3. Cytotoxic

  4. Immune complex

  5. Cell-mediated



Test 96

A 45-year-old woman suffers from allergic rhinitis. Every time when native-grasses are in blossom she develops headache, sneezing, and itchy eyes. Which of the following types of leukocytosis is a characteristic of this disease?



  1. Basophylia

  2. Neutrophylia

  3. Lymphocytosis

  4. Eosinophylia

  5. Monocytosis




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