Combined Immunology HMX Exam with 100% Correct Answers 2024/2025.

Combined Immunology HMX Exam with 100% Correct Answers 2024/2025. Individuals who are not identical twins differ in many genes that they do not inherit. This means individuals will have different proteins based on these different genes. These differences are called ______________________ - Correct Answer-polymorphisms In transplantation, if one person is a donor and another is a recipient, then there might be a difference in proteins between each person. So, when an organ is transplanted, the recipient's immune system can detect the transplanted cells as non-self and lead an attack against them. This attack involves ________________ and ____ cells and is called an ___________________ ________________ _______________ - Correct Answer-antibodies T cells allogeneic immune response The recipient's T cells and antibodies that enter the implanted organ after transplantation cause inflammation in the organ as if the organ is a foreign invader, like a microbe. This leads to injury/death of the implanted organ. This is called _________________ _______________ - Correct Answer-transplant rejection The most polymorphic genes in our entire genome are the _____________________ ___________________ _________________ genes. - Correct Answer-major histocompatibility complex (aka HLA genes) MHC class II has the variants: __________, __________, and _________ proteins - Correct Answer-DP DQ DR MHC class I has the variants: ____________, ______________ and _________ - Correct Answer-A B C If we take all the different alleles in the human population that encode normal functioning versions of the MHC class I and II variants, there are over ______________ alleles - Correct Answer-5,000 HLA-B has over _______________ alleles - Correct Answer-2,500 _______ is the major immunological barrier to transplantation - Correct Answer-MHC ______________ have carbohydrates on their surface, but they differ from one person to another - Correct Answer-RBCs The antigens on red blood cells include: _______, _________, _________ or _________ - Correct Answer-A B AB O If someone is type A, this means they have the A antigen and they have antibodies that recognize the antigens that they do not express. So, type A has natural ______ antibodies that recognize the ______ antigen. Type B has antibodies that recognize the ______ antigen. Type O has antibodies that recognize the ________ and _______ antigen. Type AB has _________ antibodies - Correct Answer-IgM B A A B neither If you want to transfuse blood across individuals, then the antibodies can cause trouble. For example, if type A is transfused into someone with type B, then the recipient with type B (who has antibodies against type A) will cause the destruction of type A blood either by ___________________ activation or _________________. This is called a ____________________ ________________ - Correct Answer-complement phagocytosis transfusion reaction Given what you have learned about the genetic loci that are most important for transplant compatibility, it is likely that ____________ are the primary mediators of transplant rejection. 1. B lymphocytes 2. T lymphocytes 3. macrophages 4. neutrophils - Correct Answer-2. T lymphocytes A burn victim receives a skin transplant. Theoretically, his medical team could choose from several different donors, but the choice of donor is obvious in this case. Who is the donor? 1. the patient's twin brother 2. the patient's spouse 3. the patient's son 4. the patient - Correct Answer-4. the patient Which immune mechanisms or processes are most commonly associated with transfusion reactions? (select two answers) 1. antibody-dependent cellular cytotoxicity 2. complement activation 3. CTL degranulation 4. neutralization 5. opsonization - Correct Answer-2. complement activation 5. opsonization The antigens of the ABO blood groups are: 1. carbohydrates. 2. nucleic acids. 3. proteins. 4. lipids. - Correct Answer-1. carbohydrates. To predict the chances of transplant rejection, three HLA proteins are the most important: __________, ___________ and __________ - Correct Answer-HLA-A HLA-B DR ___________ ____________ is used to reduce chances of rejection. We can match proteins of the donor and recipient to see if the recipient has similar proteins as the donor. Identical proteins are usually found amongst _______________. If there is not a sibling donor with a perfect match, then we can try to find someone who at least shares some MHC genes. - Correct Answer-HLA matching siblings If some genes are different, there will be an immune response against those HLA proteins which can lead to rejection. To treat the potential of rejection, we can treat the patient with ______________________ drugs. - Correct Answer-immunosuppressive The most common immunosuppressive drugs that block the T cell response after T cells bind to the antigen are called ____________________ _____________________. The most common of these drugs is ________________________ - Correct Answercalcineurin inhibitors Cyclosporin Normally, after T cell activation, the T cell releases cytokines which bind to the T cell's interleukin 2 receptor. The most common immunosuppressive drug that blocks activation from the ______________________ ____ receptor is _____________________ - Correct Answer-interleukin 2 Rapamycin There are drugs that are antibodies that are given to transplant recipients that bind to molecules on the surface of activated T cells and lead to their death. These are ____________________ _____________________ _____________________ - Correct Answer-lymphocyte depleting antibodies Type ________ has neither A nor B antigens and therefore can give blood to any blood type because the recipient will have antibodies that cannot kill red blood cells with no antigens. This is the __________________ ________________ - Correct Answer-O universal donor ______________ ________________ starts with taking blood of a potential recipient and asking what antibodies are present in the patient's serum that might bind to the blood of a donor. Then, we can look at the blood of potential donors with different antigens on their surface. In a lab, we can see if the mixture of a recipient's serum and donor's blood cells __________________. If this happens, we know it is not a good match. If a donor does not have antigens that would be killed by the recipients antibodies then we have a ________________ _______________ _______________ - Correct Answer-Cross matching agglutinate positive cross match Cross matching can be done on _________________ (which have HLA molecules on their surface, unlike RBCs) as well - Correct Answer-leukocytes Some individuals who undergo chemotherapy for cancer require a hematopoietic stem cell (HSC) transplant after therapy, because the therapy can eliminate the HSCs in the bone marrow. Consider the following scenarios: Self: an individual receives a transplant of her own HSCs that were harvested before she initiated chemotherapy. Identical Twin: an individual receives an HSC transplant from her identical twin. Parent: an individual receives an HSC transplant from one of her parents. Cousin: an individual receives an HSC transplant from a first cousin (a parent's sibling's child). Recall that HSC transplantation is colloquially known as a "bone marrow transplant". Assume that HLA matching is not performed in any of these scenarios. Given this information alone, predict the order of the likelihood of transplant rejection for these scenarios. Note that in all cases below, answers are ordered from lowest risk of transplant rejection (left) to greatest risk of rejection (right). 1. Parent Cousin = Identical Twin Self 2. Self Identical Twin Parent Cousin 3. Self = Identical Twin Parent Cousin 4. Self = Identical Twin Cousin = Parent 5. Cousin Parent Self Identical Twin 6. Self Identical Twin = Parent Cousin - Correct Answer-3. Self = Identical Twin Parent Cousin You have learned about many different kinds of immune diseases in this course. The therapies given to patients to prevent transplant rejection are most similar to therapies used to treat: 1. autoimmune diseases. 2. bacterial infections. 3. viral infections. 4. allergies. - Correct Answer-1. autoimmune diseases. A man with blood type A is in a car accident and has a large amount of internal bleeding. He needs an emergency red blood cell (RBC) transfusion. RBCs of which blood types, below, can be safely transfused? Note that for the purposes of this exercise, we are not considering the Rh factor, which is commonly denoted with a positive or negative after the blood type. (select all that apply) 1. A 2. B 3. AB 4. O - Correct Answer-1. A 4. O _____________________ ___________________ is the process of transferring useful antibodies to a second host to provide protection and cause them to recover. This is an expensive approach with a low throughput - Correct Answer-Passive Immunotherapy ________________________ _______________________ is the cloning of the genes of a working antibody and transferring them to another individual. These antibodies are injected into muscle cells. This injection allows the synthesis of the new antibody in the new host. This is an inexpensive approach - Correct Answer-Vectored Immunoprophylaxis ________________________ ___________________ _______________ ______ cells are created by introducing a DNA sequence that contains a recognition portion of an antibody and a signaling component of the T cell receptor into a T cell. When the genes of the recognition portion of an antibody and signaling component of the T cell receptor are joined together, they can be introduced into a T cell. This allows the T cell to make a _______________ receptor. This new type of T cell can recognize the antigen on a tumor cell, be activated and kill the tumor. The T cell can also proliferate and undergo clonal expansion. These expanded T cells can be reactivated, see the tumor antigen and kill the tumor. This process can also form ______________ cells which may reside in the host for their entire life and kill tumor cells that pop up - Correct Answer-Chimeric antigen receptor (CAR) T cells chimeric memory In 2015, there was a major outbreak of disease caused by Ebola virus that caused a public health emergency in West Africa. The outbreak was eventually controlled with public health measures (isolation and treatment of infected individuals and careful follow-up with other individuals with whom infected individuals had been in contact). Some individuals with severe disease were treated with blood or serum transfusions from Ebola survivors. What form of therapy was this, and how does it work? 1. Vectored immunoprophylaxis; protection is mediated by antibodies transferred from the survivors. 2. Vectored immunoprophylaxis; protection is mediated by T cells transferred from the survivors. 3. Passive immunotherapy; protection is mediated by antibodies transferred from the survivors. 4. Passive immunotherapy; protection is mediated by T cells transferred from the survivors. - Correct Answer-3. Passive immunotherapy; protection is mediated by antibodies transferred from the survivors. Which of the methods of immune therapy that have been covered so far in this course involve the transfer of new genetic material into an individual's cells? (select two answers) 1. vectored immunoprophylaxis 2. passive immunotherapy 3. organ transplantation 4. blood transfusion 5. CAR T cells - Correct Answer-1. vectored immunoprophylaxis 5. CAR T cells To date, the most common clinical use of CAR T cell therapy has been for the treatment of patients with B cell leukemias. To review what you have learned about B cell malignancies in this course, select this link. Which antigen is the most likely target of these CAR T cells? 1. CD40 (a cell surface antigen on antigen presenting cells) 2. OCT2 (a transcription factor expressed in B cells) 3. CD19 (a cell surface antigen on most B cells) 4. CD3 (a cell surface antigen on most T cells) - Correct Answer-3. CD19 (a cell surface antigen on most B cells) ___________________ ______________ involves finding mutant peptides and discovering whether those mutant peptides can bind to an MHC molecule that the host has inherited. Once you know what the mutant gene is, you can synthesize large amounts of mutant peptides which can be used as an immunogen. These peptides can be introduced to the host. The host dendritic cells will capture the peptide and display them on an MHC molecule. This allows T cells to bind to them and be activated which allows T cells to proliferate and undergo clonal expansion. These T cells can then recognize the tumor cells peptides that are presented on MHC molecules and kill them. This is a form of _________________ ________________ - Correct AnswerNeoantigen discovery tumor vaccination __________________ ________________ is the reactivation of existing T cells that are nonfunctional due to inhibitory signaling (cancer cells have an inhibitory ligand that bind to a T cell's co-inhibitory receptor, leading to T cell exhaustion). This is accomplished by blocking inhibitory receptors with an antibody, which rejuvenates exhausted T cells - Correct Answer-Checkpoint blockade Which of the therapies listed below involves administration of antibodies to activate T cells? 1. tumor vaccination with neoantigens 2. vectored immunoprophylaxis 3. checkpoint blockade 4. CAR T cell therapy - Correct Answer-3. checkpoint blockade Like many medical specialties, oncology is increasingly moving towards personalization of therapy. Which of the therapies that we have discussed in this course so far require the most personalization of therapy based on a cancer patient's genotype? 1. vaccination with cancer neoantigens 2. anti-CD20 therapy for lymphoma 3. CAR T cells that target CD19 4. checkpoint blockade - Correct Answer-1. vaccination with cancer neoantigens __________________ ______________ is a melanoma composed of cancerous melanocytes that do not make melanin. They have a light color - Correct AnswerAmelanotic melanoma _____________ is a cytokine with diverse effects on lymphocytes. It promotes T cell and B cell proliferation, but it is also required for regulatory T cell survival and function - Correct Answer-IL-2