OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System |LATEST UPDATE

T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 1 of 18 Chapter 19: Diseases of the Immune System * = Correct answer Multiple Choice 1. An allergy is an example of which of the following? A. a type I hypersensitivity* B. a type II hypersensitivity C. a type III hypersensitivity D. a type IV hypersensitivity Difficulty: Easy ASM Standard: N/A 2. If someone were accidentally given blood of the wrong type, which of the following is likely to occur? A. an autoimmune disorder B. anaphylaxis C. a hemolytic transfusion reaction* D. a type I hypersensitivity Difficulty: Easy ASM Standard: N/A 3. Granules in mast cells are released to the extracellular environment through which of the following processes? A. an Arthus reaction B. anaphylaxis C. degranulation* D. the hemolytic response Difficulty: Easy ASM Standard: N/A 4. The term immune tolerance means which of the following? A. becoming sensitized with repeated exposures B. developing autoimmune disease after repeated exposures C. having an unusually weak immune response to common antigens D. the ability to recognize self and prevent immune attack on one’s own cell* Difficulty: Easy ASM Standard: N/A 5. Desensitization treatment is also known by which of the following terms? A. allografting TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 2 of 18 B. autoimmunity C. hyposensitization therapy* D. serum treatment Difficulty: Easy ASM Standard: N/A 6. A granuloma is which of the following infections? A. acute systemic infection B. chronic local infection* C. chronic systemic infection D. disseminated infection Difficulty: Easy ASM Standard: N/A 7. Rh factors are which of the following? A. a type of T cell B. important examples of immune cells C. important RBC antigens* D. unimportant in blood transfusions Difficulty: Easy ASM Standard: N/A 8. Serum sickness is which of the following? A. systemic type I hypersensitivity B. systemic type II hypersensitivity C. systemic type III hypersensitivity* D. systemic type IV hypersensitivity Difficulty: Easy ASM Standard: N/A 9. Which of the following types of transplants has the lowest risk of rejection? A. allograft B. autograft* C. isograft D. xenograft Difficulty: Moderate ASM Standard: N/A 10. Which of the following types of infection is most common in an individual with X-linked agammaglobulinemia? A. infections associated with autoimmune inflammations TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 3 of 18 B. infections caused by extracellular, pyogenic pathogens* C. infections caused by intracellular pathogens D. viral infections Difficulty: Moderate ASM Standard: N/A 11. In some cases, transplanted tissue (such as bone marrow) can produce cytotoxic T cells that attack the host cells of the recipient. Which of the following describes such an attack? A. a hemolytic transfusion reaction B. an autograft reaction C. graft versus host disease* D. transplant rejection Difficulty: Moderate ASM Standard: N/A 12. Which of the following is an advantage of using vaccines instead of antibacterial sera, such as the diphtheria antitoxin? A. Antitoxins are less likely to cause type I hypersensitivity. B. Antitoxins are more likely to cause the disease they are intended to treat. C. Vaccines are less likely to cause systemic type III hypersensitivity.* D. Vaccines are less likely to cause type II hypersensitivity. Difficulty: Moderate ASM Standard: N/A 13. Which of the following is an example of a CD4 Th1-mediated reaction? A. anaphylactic reaction B. chronic asthma C. delayed type hypersensitivity* D. transplant rejection Difficulty: Moderate ASM Standard: N/A 14. Contact dermatitis is an example of which of the following? A. CD4 TH1-mediated reaction* B. CD4 TH2-mediated reaction C. type of serum sickness D. underdeveloped immune response Difficulty: Moderate ASM Standard: N/A TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 4 of 18 15. When serum sickness occurs, the immune complexes are removed by which of the following? A. antigenic cells B. phagocytic cells* C. the major histocompatibility complex D. transplanted tissues Difficulty: Moderate ASM Standard: N/A 16. Which of the following describes what happens when someone has a reaction to poison ivy? A. The antigen circulates in the blood, causing a systemic response, such as serum sickness. B. The antigen remains on the surface of cells, where it is picked up by macrophages. C. The individual’s cells absorb the antigen and are then targeted by CTLs, which induce apoptosis.* D. The individual’s cells resist the antigen, which is cleared from the cell surfaces by antibodies. Difficulty: Moderate ASM Standard: N/A 17. Tissue damage caused by delayed type hypersensitivities is largely the result of which of the following? A. activated macrophages* B. antibodies C. direct attack by sensitized memory TH1 cells D. reactions involving CD4 TH2 cells Difficulty: Moderate ASM Standard: N/A 18. An individual’s first exposure to an antigen capable of eliciting a type I hypersensitivity initially causes which of the following responses? A. a response by TH1 cells B. a response by TH2 cells* C. cross-linking of IgE D. the release of leukotrienes Difficulty: Moderate ASM Standard: N/A 19. The regions of IgE antibodies capable of binding to specific mast cell receptors are called which of the following? A. activated regions B. fragment crystallizable regions* C. histamine regions TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 5 of 18 D. tumor necrosis factor binding sites Difficulty: Moderate ASM Standard: N/A 20. During degranulation, which of the following occurs? A. Antigen-binding sites attach to granules in cells. B. Antigens are released into the plasma. C. Cytotoxic T cells are released. D. Mast cells release granules containing histamine and other preformed components.* Difficulty: Moderate ASM Standard: N/A 21. Degranulation results in the release of which of the following? A. bradykinin only B. bradykinin, histamine, and serotonin only C. bradykinin, histamine, serotonin, leukotrienes, prostaglandins, and cytokines* D. prostaglandins, leukotrienes, cytokines, and IgE Difficulty: Moderate ASM Standard: N/A 22. When people take antihistamines, they are most likely trying to treat which of the following symptoms? A. itching, headache, and reduced tear production B. pruritus, sneezing, watery eyes, and runny nose* C. redness and swelling associated with an infection D. vomiting and nausea Difficulty: Moderate ASM Standard: N/A 23. Histamine and serotonin can stimulate which of the following? A. constipation B. decreased vascular permeability C. vasoconstriction D. vomiting* Difficulty: Moderate ASM Standard: N/A 24. Which of the following are the symptoms of a localized type I hypersensitivity reaction? A. asthma only B. asthma, hay fever rhinitis, and hives* C. constriction of respiratory passages TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 6 of 18 D. vasodilation and hypotension Difficulty: Moderate ASM Standard: N/A 25. Which of the following symptoms distinguish anaphylaxis from milder type I hypersensitivity reactions? A. hypertension, blockage of airways, and risk of death B. hypotension, blockage of airways, shock, and risk of death* C. massive tissue damage from cytotoxic reactions with risk of death D. pruritus and rhinitis Difficulty: Moderate ASM Standard: N/A 26. The A and B antigens on the surface of blood cells are which of the following? A. carbohydrates* B. glycoproteins C. lipids D. proteins Difficulty: Moderate ASM Standard: N/A 27. Severe bronchiole constriction during an allergic reaction can potentially cause which of the following? A. cyanosis* B. pruritus C. vasoconstriction D. vasodilation Difficulty: Difficult ASM Standard: N/A 28. Which of the following is one possible adaptive reason for type I hypersensitivities? A. They may be required for “test runs” of the immune response so that it is prepared to fight pathogens when needed. B. They may have evolved as a response to helminth infections.* C. They may have evolved to increase the risk of adaptive allergic reactions. D. They may have so much overlap with other hypersensitivities that adaptive benefits for those other hypersensitivities promote type I hypersensitivities. Difficulty: Difficult ASM Standard: N/A TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 7 of 18 29. According to current naming conventions, blood-group antigens are named using which of the following? A. a systematic approach involving the assignment of a number and classification within a particular group (i.e., a collection, group, or series)* B. a systematic approach involving the history of the discovery of the group C. the name of the person responsible for producing antibodies that target the blood-group antigens D. the name of the person who identified the blood-group antigens Difficulty: Difficult ASM Standard: N/A 30. During a hemolytic transfusion reaction, which of the following occurs? A. Antibodies from the transfused cells attack the recipient’s cells and cause them to lyse. B. Antigens on the transfused cells are recognized by IgA and IgE and are destroyed. C. Antigens on the transfused cells are recognized by IgG and IgM and are destroyed.* D. Antigens on the transfused cells spontaneously trigger lysis when exposed to the recipient’s blood. Difficulty: Difficult ASM Standard: N/A 31. Individuals who have type AB blood have a genotype with which of the following? A. one A allele and one B allele* B. one AB allele and one O allele C. the dominant AB allele D. two recessive AB alleles Difficulty: Moderate ASM Standard: N/A 32. Individuals with type O blood have which of the following? A. modified A or B glycoprotein antigens on the surface of their blood cells that are unable to trigger an immune response B. neither A nor B glycoprotein antigens on the surface of their blood cells* C. no glycoprotein antigens on the surface of their blood cells D. the O glycoprotein antigen only on the surface of their blood cells Difficulty: Moderate ASM Standard: N/A 33. The antibodies that respond to blood-group antigens are which of the following? A. antibodies produced from a combination of sources and called isohemagglutinins B. IgA antibodies called isohemagglutinins C. IgE antibodies called isohemagglutinins D. IgM antibodies called isohemagglutinins* TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 8 of 18 Difficulty: Difficult ASM Standard: N/A 34. Which of the following happens last during the series of inflammatory events triggered by the accumulation of immune complexes in a type III hypersensitivity reaction? A. C3a and C5a are produced. B. Complement activation occurs. C. IgG binds to antibody receptors. D. Neutrophil and macrophage recruitment occurs.* Difficulty: Difficult ASM Standard: N/A 35. Hypersensitivity pneumonitis can be either a type III or a type IV hypersensitivity depending upon which of the following? A. whether an environmental cause is present over the short or long term B. whether an environmental or occupational cause is present C. whether immune complexes develop and mediate the response* D. whether there is a different response with subsequent exposures Difficulty: Difficult ASM Standard: N/A 36. Which of the following hypothetical statements would not be predicted by the hygiene hypothesis? A. Children in smaller families are more likely to have autoimmune diseases. B. Children who attend daycare have a lower risk of allergies than those who stay home until they reach school age. C. Exposure to cleaning chemicals results in greater allergy risk.* D. Living on a farm is associated with reduced risk of hay fever. Difficulty: Difficult ASM Standard: 23 37. Which of the following describes why it is possible that type I hypersensitivities result from an adaptation against helminth infection? A. Helminths are unusual parasites because they are targeted by IgE and most parasites are not.* B. Helminths can trigger a type I hypersensitivity, so individuals who have these hypersensitivities are also less susceptible to helminth infections. C. Repeated exposure to helminths reduces the effectiveness of IgE in responding to other infections. D. Repeated type I hypersensitivity reactions reduce the risk of helminth infection. Difficulty: Difficult TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 9 of 18 ASM Standard: N/A True/False 38. Mechanisms are in place so that hemolytic transfusion reactions no longer occur. Answer: False Difficulty: Easy ASM Standard: N/A 39. Serum sickness is another term for systemic type III hypersensitivity. Answer: True Difficulty: Easy ASM Standard: N/A 40. Hypersensitivity pneumonitis can be a type III or type IV hypersensitivity, depending on whether immune complexes accumulate. Answer: True Difficulty: Moderate ASM Standard: N/A 41. IgE only responds to cell-bound antigens. Answer: False Difficulty: Moderate ASM Standard: N/A 42. Clonal proliferation in a type I hypersensitivity reaction results from the release of cytokines from TH2 cells. Answer: True Difficulty: Moderate ASM Standard: N/A 43. Systemic anaphylaxis is a type I hypersensitivity caused by the release of cytokines by TH1 cells. Answer: False Difficulty: Moderate ASM Standard: N/A 44. IgE molecules have three Fab sites to which allergens can bind. Answer: False TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 10 of 18 Difficulty: N/A ASM Standard: Difficult 45. Opsonization of red blood cells occurs after phagocytosis. Answer: False Difficulty: NA ASM Standard: Difficult 46. The production of IgE-secreting plasma cells can be triggered by interleukin-4. Answer: True Difficulty: Difficult ASM Standard: N/A 47. Angioedema is caused by vasoconstriction following release of chemical mediators during a type I hypersensitivity reaction. Answer: False Difficulty: Difficult ASM Standard: N/A Matching 48. Match each chemical mediator with the best description of its effects. A. heparin i. causes increased mucus and tear formation, increased vascular permeability, and smooth-muscle contraction B. histamine ii. stimulates bradykinin production C. serotonin iii. causes inflammation and cytokine production D. TNF-α iv. causes vasodilation, smooth-muscle contraction, and increased vascular permeability Answers: A. ii, B. i, C. iv, D. iii Difficulty: Moderate ASM Standard: N/A 49. Match each type of transplant with its best definition. A. allograft i. transplanting tissue from an animal to a human B. autograft ii. transplanting tissue from one individual (not an identical twin) to another of the same species C. isograft iii. transplanting tissue from an individual back to that individual D. xenograft iv. transplanting tissue from one identical twin to another Answers: A. ii B. iii, C. iv, D. i Difficulty: Easy ASM Standard: N/A TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 11 of 18 50. Match each type of hypersensitivity with its best definition. A. type I hypersensitivity i. involves IgG, IgM, and IgA B. type II hypersensitivity ii. involves the reaction of IgE with soluble antigen; mastcell degranulation occurs C. type III hypersensitivity iii. involves the reaction of IgG and IgM antibodies with cellular antigens, resulting in cell damage D. type IV hypersensitivity iv. mediated by T cells Answers: A. ii, B. iii, C. i, D. iv Difficulty: Moderate ASM Standard: N/A 51. Match each autoimmune disease with its best description. A. Addison disease i. causes damage to the adrenal gland; possible symptoms include weakness, hypotension, fatigue, and kidney failure B. multiple sclerosis ii. causes damage to the pancreas; possible symptoms include hyperglycemia, weight loss, excessive urination, and fatigue C. psoriasis iii. causes damage to the myelin sheaths of nerve cells; possible symptoms include muscle weakness, numbness, and problems with memory D. systemic lupus erythematosus iv. epidermal cell turnover is excessive; itchy and sore skin patches develop E. type I diabetes mellitus v. associated with the production of autoantibodies against cytoplasmic and nuclear molecules, and with tissue damage and inflammation Answers: A. i, B. iii, C. iv, D. v, E. ii Difficulty: Moderate ASM Standard: N/A 52. Match the primary immunodeficiency with the best description. A. chronic granulomatous disease i. because bacteria within phagolysosomes are not effectively killed, infections and granulomas develop B. selective IgA deficiency ii. results in lack of IgA, causing increased risk of infections in the lungs and gastrointestinal tract C. severe combined immunodeficiency disease iii. caused by deficient immune responses (both cell mediated and humoral), resulting in susceptibility to severe infections D. X-linked agammaglobulinemia iv. because B cells do not fully mature and differentiate, recurrent, generally pyogenic, infections occur Answers: A. i, B. ii, C. iii, D. iv TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 12 of 18 Difficulty: Moderate ASM Standard: N/A 53. Match the type IV hypersensitivity with its effector type. A. chronic asthma i. Cytotoxic T-lymphocyte–mediated reactions occur. B. contact dermatitis ii. Eosinophils release cytokines and chemicals that promote inflammation. C. tissue transplant reaction iii. An inflammatory response is caused by macrophages, which also damage tissue. D. tuberculin reaction iv. can be caused by either an inflammatory response caused by macrophages or by cytotoxic T-lymphocyte– mediated reactions Answers: A. ii, B. iv, C. i, D. iii Difficulty: Difficult ASM Standard: N/A Fill in the Blank 54. In ________, a systemic allergic reaction causes symptoms such as hypotension, shock, nausea, vomiting, hives, and swelling of the throat. Answer: anaphylaxis Difficulty: Easy ASM Standard: N/A 55. When a self-antigen causes a type II hypersensitivity reaction, the reaction can be described as a(n) ________ disorder. Answer: autoimmune Difficulty: Easy ASM Standard: N/A 56. When a prick puncture skin test or intradermal test is performed to test for allergies, a positive response is indicated by a(n) ________ reaction. Answer: wheal-flare Difficulty: Moderate ASM Standard: N/A 57. Although they may be measured during diagnosis, measurement of serum ________ levels is not sufficient to confirm allergic disease. Answer: IgE Difficulty: Moderate ASM Standard: N/A TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 13 of 18 58. A common treatment for insect venom allergies is ________therapy. Answer: desensitization Difficulty: Moderate ASM Standard: N/A 59. When individuals are treated using allergy shots (i.e., injections of allergen), IgG antibodies are produced that can act as ________. Answer: blocking antibodies Difficulty: Moderate ASM Standard: N/A 60. The first treatment for life-threatening anaphylaxis is an injection of ________. Answer: epinephrine Difficulty: Moderate ASM Standard: N/A 61. Rh− mothers who carry Rh+ fetuses and who then become pregnant with another Rh+ fetus are given injections of ________ during the 28th week of pregnancy and after delivery. Answer: RhoGAM [or human Rho(D) immune globulin] Difficulty: Moderate ASM Standard: N/A 62. TSH-receptor antibody (thyroid-stimulating immunoglobulin) is produced by individuals with ________. Answer: Graves disease Difficulty: Difficult ASM Standard: N/A 63. The production of antibodies that target acetylcholine receptors causes ________, resulting in muscle weakness that can be severe and life threatening. Answer: myasthenia gravis Difficulty: Difficult ASM Standard: N/A Short Answer 64. Which type of hypersensitivity is systemic lupus erythematosus? Sample Answer: SLE is a type III hypersensitivity. Difficulty: Easy TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 14 of 18 ASM Standard: N/A 65. Why would someone use a Mantoux test? Sample Answer: The Mantoux test is a screening test for tuberculosis. Difficulty: Easy ASM Standard: N/A 66. What triggers allergy-induced asthma? Sample Answer: Allergy-induced asthma occurs when someone is exposed to inhaled allergens. Difficulty: Easy ASM Standard: N/A 67. Which hypothesis suggests that normal exposure to antigens is important in developing a healthy immune response and reducing the risk of allergies? Sample Answer: The hygiene hypothesis suggests that normal antigen exposure reduces the risk of developing immune disease. Difficulty: Easy ASM Standard: N/A 68. What do immunohematologists study? Sample Answer: Immunohematologists study the relationship between the immune response, the blood, and blood-forming tissues. Difficulty: Moderate ASM Standard: N/A 69. How does the ABO blood group system show codominance? Sample Answer: Individuals who have one A allele and one B allele fully express both alleles, which is an example of codominance. Difficulty: Moderate ASM Standard: N/A 70. What types of symptoms occur if someone is accidentally given a transfusion with the wrong blood type? Sample Answer: A transfusion with an incompatible blood type causes hypotension, pruritus, fever, chills, urticaria, dyspnea, and hemoglobinuria. If the reaction is sufficiently severe, blood pressure can lower drastically, shock can occur, and the patient may die. Difficulty: Moderate ASM Standard: N/A TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 15 of 18 71. Hospitals have systems in place to prevent incompatible blood transfusions. What are these systems called? Sample Answer: Systems to prevent incompatible blood transfusions are called hemovigilance systems. Difficulty: Moderate ASM Standard: N/A 72. Which type of reaction occurs when someone is exposed to poison ivy? Sample Answer: Poison ivy causes contact dermatitis. This is a type IV hypersensitivity reaction. Difficulty: Moderate ASM Standard: N/A 73. What type(s) of hypersensitivity cause cheese handler’s disease? Sample Answer: Cheese handler’s disease is a type of hypersensitivity pneumonitis. It can be caused by type III or type IV hypersensitivities. Difficulty: Moderate ASM Standard: N/A 74. Which type of cells are involved in type IV hypersensitivities? Sample Answer: T cells are involved in type IV hypersensitivities. Difficulty: Moderate ASM Standard: N/A 75. Which types of treatments are common for mild type I hypersensitivities? Sample Answer: A variety of medications are available to treat type I hypersensitivities, including over-the-counter treatments. These include antihistamines, antileukotrienes, antiprostaglandins, and anti-inflammatory medications. Difficulty: Moderate ASM Standard: N/A 76. The detection of which antibodies can help in the diagnosis of celiac disease? Sample Answer: Diagnosis of celiac disease can involve the detection of IgA antibodies to gluten. Testing also involves the detection of autoantibodies to endomysium, among other components. Difficulty: Difficult ASM Standard: N/A 77. Why does SLE affect so many different organ systems? TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 16 of 18 Sample Answer: Autoantibodies are produced, especially antinuclear antibodies. They can target many types of tissues, which can lead to a wide range of possible symptoms. Difficulty: Difficult ASM Standard: N/A 78. Why is a positive ANA test insufficient to make a lupus diagnosis? Sample Answer: Although elevated ANA is found in greater than 95% of patients with SLE, elevated ANA does not necessarily mean that an individual has SLE. Instead, at least four of 11 symptoms must be identified, in addition to the detection of autoantibodies, to make the diagnosis. Difficulty: Difficult ASM Standard: N/A Brief Essay Essay Question Rubric RATING Failing Below Average Competent Advanced Criteria for evaluation Answer does not provide an argument. Answer contains inaccuracies. Writing is poor and contains numerous grammatical mistakes and misspellings. Answer fails to provide examples to support an argument. Writing is poor and grammatical errors are common. Answer is somewhat incoherent. Answer provides an argument with one or two examples that support it. Writing is acceptable for the college level but may contain one or two grammatical mistakes or misspellings. Answer clearly provides an argument with two or more excellent examples that support it; student makes the argument clearly and eloquently. Answer is well organized and free of grammatical errors and misspellings. POINT VALUE 0 1 2 3 Assume rating/grading scale for the question ranges from 0 to 3 points. 79. Explain how an individual’s first and subsequent exposures to an allergen differ by describing how the immune system responds to exposure. Answer: Student answers will vary but should include components of the following. There is a strong Th2-cell response after the first exposure to an allergen. These cells produce IL-4 and IL-13, activating B cells. Clonal proliferation occurs, followed by differentiation of the clones that differentiate into plasma cells. There is a switch from IgM to IgE antibody production. The IgE antibodies bind to mast-cell receptors throughout the body. At this point, the individual is sensitized and capable of an allergic reaction to the allergen. On subsequent exposure to an allergen, the IgE antibodies already present bind to the allergen and this results in the formation of cross-links between IgE molecules on mast cells. This causes degranulation, releasing histamine and other chemicals that cause the allergic response. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 17 of 18 Difficulty: Moderate ASM Standard: N/A 80. How is an antinuclear antibody test helpful in the diagnosis of systemic lupus erythematosus? Why is this test insufficient for the diagnosis? Answer: Student answers will vary but should include components of the following. Individuals with lupus have type III hypersensitivity reactions that involve the production of autoantibodies that target the nucleus and cytoplasmic proteins. In most cases, the individual’s antibodies attack the nucleus, and 95% of patients with SLE have antinuclear antibodies (ANAs). Although a positive ANA test is helpful in diagnosis, patients must have at least four of 11 specified symptoms, as well as a positive autoantibody test. Difficulty: Moderate ASM Standard: N/A 81. Why does IgA deficiency result in increased risk of lung and gastrointestinal infections? In your answer, include a discussion of the normal role of IgA. Answer: Student answers will vary but should include components of the following. IgA is important in the gastrointestinal and respiratory tracts because it is found in secretions (such as mucus). It helps stop pathogens from penetrating epithelial tissues, helping those tissues form effective barriers. Without sufficient IgA in the secretions, pathogens can more easily attach to the linings of the gastrointestinal and respiratory tracts. This increases the risk that they can cause infections. Difficulty: Difficult ASM Standard: N/A 82. Explain how normal exposures to microbes relate to the “hygiene hypothesis.” Provide examples of evidence. Make sure to explain how people are exposed to microbes in everyday life and through the normal human microbiota. Answer: Student answers will vary but should include components of the following. The hygiene hypothesis suggests that normal exposure to microbes throughout life reduces the risk of immune disorders. The textbook describes the comparison of immune disorders in less developed countries and industrialized countries, and suggests that the reduced exposure to microbes and antigens in the latter is associated with greater incidence of immune disorders. Additionally, families with more children have lower rates of hay fever than those with fewer children. This relationship may reflect rates of infection or differences in antigen exposure that may correlate with average family size. The role of the normal microbiota in this process is not explicitly discussed in this chapter, so students need to use their prior knowledge to speculate about its effects and may have answers such as the following. Humans have a normal microbiota that interacts with potential pathogens. For example, the normal microbiota may outcompete other microbes and can produce chemicals (such as bacteriocins) that inhibit their growth. Exposure to the normal microbiota, and its effects on exposure to other microbes, also could affect immune system function. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER T E S T B A N K S E L L E R . C O M OpenStax Microbiology Test Bank Chapter 19: Diseases of the Immune System Page 18 of 18 Difficulty: Difficult ASM Standard: 7 This file is copyright 2017, Rice University. All rights reserved. TESTBANKSELLER.COM TESTBANKSELLER.COM #1 TEST BANKS WHOLESALER