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Immune System (LPU - NEST)

Description: Myasthenia gravis Hashimoto thyroiditis systemic autoimmune disease
Number of Questions: 20
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Tags: Myasthenia gravis Hashimoto thyroiditis systemic autoimmune disease Immune System
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The complement components of the human immune system are chemically

  1. glycolipids

  2. cytokines

  3. enzymes

  4. hormones

  5. antibodies


Correct Option: C
Explanation:

They act in a sequential proteolytic cascade which gives tremendous amplification of the response.

A young lady is suffering from Pernicious anaemia, which is an autoimmune disorder in which the body fails to make sufficient RBCs. Which of the following antibodies is/are of most use for the diagnosis of pernicious anaemia in such people?

  1. Anti-parietal cells

  2. Anti-thyroid peroxidase

  3. Anti-nuclear

  4. Anti-IgG Fc

  5. Anti-TSH receptor


Correct Option: A
Explanation:

Parietal cell antibodies detected by immunofluorescence in stomach sections are important markers of inflammatory atrophic gastritis and subsequent pernicious anaemia.

Which of the following initial complement components is bound by complement-fixing antibodies?

  1. C1s

  2. C3b

  3. C5a

  4. C9

  5. C1q


Correct Option: E
Explanation:

The constant region of IgM and of IgGI, IgG2 and IgG3 antibodies binds C1q after the antibody has complexed with antigen. 

Clonal selection is a crucial part of the primary immune response. It occurs in the body when an antigen is encountered by which of the following?

  1. Neutrophils

  2. Mast cells

  3. T-cells

  4. Basophils

  5. Eosinophils


Correct Option: C
Explanation:

Both T-cells and B-cells possess antigen specific receptors.

Serum is a clear liquid that can be separated from clotted blood. Specific antibodies are readily detectable in serum following primary contact with antigen after

  1. 10 min

  2. 1 h

  3. 5–7 days

  4. 3–5 weeks

  5. a second contact with antigen


Correct Option: C
Explanation:

5 days or more are required for B-cell proliferation, differentiation into plasma cells, and the secretion of a large enough amount of antibody for it to be readily detected systemically.

Adoptive transfer of acquired immune responsiveness involves the transfer of which of the following?

  1. Antibody

  2. Complement

  3. Phagocytes

  4. Lymphocytes

  5. Serum


Correct Option: D
Explanation:

Adoptive transfer experiments helped establish that immunological memory, one of the hallmarks of the adaptive immune response, is a property of small lymphocyte.

Which of the following is a non-organ-specific (systemic) autoimmune disease?

  1. Myasthenia gravis

  2. Systemic lupus erythematosus (SLE)

  3. Hashimoto's thyroiditis

  4. Pernicious anaemia

  5. Insulin-dependent diabetes mellitus


Correct Option: B
Explanation:

SLE is a disease involving antibodies to non-organ specific antigens.

Immunological unresponsiveness to self antigens is known as

  1. tolerance

  2. tolerogen

  3. memory

  4. acquired immunity

  5. ADCC


Correct Option: A
Explanation:

Tolerance is a specific immunological non-responsiveness. Whilst tolerance can be induced to any antigen, the mechanism is thought to have evolved as a means of preventing the maturation of pathogenic self-reactive lymphocytes.

Which of the following is an example of spontaneous organ-specific autoimmune diseases?

  1. (NZB x W)F1

  2. MRL-lpr/lpr

  3. Experimental autoallergic encephalomyelitis

  4. Thyroiditis induced by early thymectomy and irradiation

  5. Non-obese diabetic (NOD) mouse


Correct Option: E
Explanation:

These mice spontaneously develop an inflammatory attack on the islets of Langerhans.

HLA-DR2 is regarded as a risk factor for which of the following autoimmune diseases?

  1. Multiple sclerosis

  2. Insulin-dependent (type I) diabetes

  3. Ankylosing spondylitis

  4. Rheumatoid arthritis

  5. Myasthenia gravis


Correct Option: A
Explanation:

Individuals with HLA-DR2 are more at risk of developing multiple sclerosis than those with other HLA-DR specificities. 

Which of the following is incorrect regarding natural antibodies?

  1. Autoreactive

  2. Polyspecific

  3. Reactive with bacterial carbohydrates

  4. High affinity IgG

  5. Produced by CD5 + B-cells


Correct Option: D
Explanation:

Natural antibodies are low affinity IgM.

Which of following statements characterises the NZB model of autoimmune haemolytic anaemia in human beings?

  1. There are no T-cell regulatory abnormalities.

  2. Disease is unaffected by neonatal thymectomy.

  3. The red cell autoantibodies cause disease.

  4. CD5 + B-cells are not involved in pathogenesis.

  5. Thyroid autoantibodies are prevalent.


Correct Option: C
Explanation:

Transfection with rearranged genes encoding a red cell autoantibody causes early disease in normal animals.

A young child is suffering from pernicious anaemia. He is most susceptible to which of the following diseases?

  1. Addison's disease of adrenal

  2. Multiple sclerosis

  3. Autoimmune haemolytic anaemia

  4. Rheumatoid arthritis

  5. Graves' disease


Correct Option: E
Explanation:

Graves' disease is a fairly frequent organ-specific disease and is often found in association with pernicious anaemia.

Cryptic T-cell epitopes

  1. dominate the normal immune response

  2. negatively select T-cells

  3. are unable to bind in the MHC groove

  4. can be derived by antigen processing

  5. are presented by MHC class I, but not MHC class II molecules


Correct Option: D
Explanation:

In order to be T-cell epitopes, i.e. peptides, they must be derived by antigen processing. Qualitative and/or quantitative alterations in processing can lead to greatly increased production of cryptic peptides and thus, may trigger autoimmune disease.

Autoantigen selection of responding B-cells is indicated by which of the following?

  1. Germ line configuration of the antibody

  2. High affinity of antibody

  3. Expression of a public idiotype

  4. A monoclonal antibody response

  5. A response to many different autoantigens


Correct Option: B
Explanation:

The mutation of the antibody variable region genes in B-cells in the germinal centre produces a range of antibody affinities, and those B-cells bearing higher affinity antibody will be favourably selected for further stimulation by antigen.

Antiphospholipid syndrome is a disorder of the immune system that causes an increased risk of blood clots. Antiphospholipid syndrome is often found associated with

  1. infertility

  2. severe anaemia

  3. Wegener's granulomatosis

  4. raised platelet levels

  5. recurrent foetal loss


Correct Option: E
Explanation:

Recurrent foetal loss is a characteristic of antiphospholipid syndrome. In experimental situation, passive transfer of cardiolipin antibodies into mice also results in recurrent foetal loss.

Which of the following can be excluded from the main functions of macrophages?

  1. Pinocytosis

  2. Phagocytosis

  3. Antigen processing

  4. T-cell priming

  5. Antigen presentation to activated cells


Correct Option: D
Explanation:

Macrophages have an impressive range of functions but appear unable to prime naive lymphocytes. 

Celiac disease is an autoimmune disorder that can occur in genetically predisposed people. In celiac disease, there is T-cell sensitivity to which of the following?

  1. Vitamin B12

  2. Gluten

  3. B-adrenergic receptors

  4. Gastric H+ - K+ dependent ATPase

  5. Myelin basic protein


Correct Option: B
Explanation:

The normally acquired tolerance to the dietary protein wheat gluten breaks down in celiac disease. 

A doctor told a couple that their son is suffering from exophthalmos, in which either one or both eyeballs bulge out or protrude from the eye socket. This disease is found often associated with which of the following diseases?

  1. Hashimoto's disease

  2. Primary myxedema

  3. Graves' disease

  4. Idiopathic thrombocytopenic purpura

  5. Autoimmune haemolytic anaemia


Correct Option: C
Explanation:

In Graves' disease, there is hyperthyroidism due to stimulating autoantibodies to the TSH receptor, which continuously mimic the effect of TSH but which are not subject to the feedback mechanisms which lower the level of TSH, once sufficient thyroid hormone has been produced. 

Myasthenia gravis in the neonate is usually an autoimmune disorder is and is thought to be caused by

  1. an inherited genetic defect

  2. transplacental transfer of maternal IgG against the TSH receptor

  3. anti-idiotype to maternal IgG

  4. transplacental transfer of maternal IgG against the acetylcholine receptor

  5. maternal T-cells transferred across the placenta


Correct Option: D
Explanation:

Transient neonatal autoimmune diseases are seen due to the transplacental transfer of maternal IgG autoantibodies in those diseases in which IgG is the effector component of the autoimmune response. The disease will be of the same type as seen in the mother because the autoantibodies will determine the target organ specificity. The neonatal disease resolves after a few weeks as the maternal IgG is catabolised.

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