JACI PRIMER STUDY QUESTIONSNEWEST 2024 WITH
COMPLETE QUESTIONS AND CORRECT VERIFIED
ANSWERS (DETAILED ANSWERS) ALREADY GRADED
A+ 100% GUARANTEED TO PASS CONCEPTS!!!
1. Answer: A
Explanation: All TNF inhibitors have been shown to improve the signs and symptoms of
RA. Although anti-TNF mAbs have been effective in the treatment of Crohn disease, the
fusion protein etanercept has not been effective. Despite increased levels of TNF in
patients with congestive heart failure and multiple sclerosis, TNF inhibitors have not
improved and have sometimes worsened clinical outcomes. - ✔✔ANSW✔✔..Question
1. TNF inhibitors have been shown to be effective in the treatment of several
autoimmune diseases. Which of following statements is true regarding the efficacy of
TNF inhibitors?
A. All approved TNF inhibitors are effective in the treatment of rheumatoid arthritis (RA).
B. Etanercept is effective in the treatment of inflammatory bowel disease (eg, Crohn
disease).
C. TNF inhibitors are effective in the treatment of congestive heart failure.
D. TNF inhibitors are effective in the treatment of demyelinating diseases (eg, multiple
sclerosis).
1. Answer: A
Explanation: IL-6 signals through a ligand-binding IL-6 receptor a chain (CD126) and
the signal-transducing component glycoprotein 130 (CD130). CD130 is the common
signal transducer for several cytokines in the IL-6 family and is ubiquitously expressed. -
✔✔ANSW✔✔..Question 1. IL-6 and the IL-6 family of cytokines trigger signal transducer
and activator of transcription 3 phosphorylation through which of the following
receptors?
A. glycoprotein 130
B. shared g chain
C. shared b chain (CD131)
D. nuclear factor IL-6
,E. oncostatin M receptor a chain
1. Answer: A
Explanation: SCID includes a heterogeneous group of disorders characterized by
severe defects in T-cell development. Some (but not all) forms of SCID also have
defects in B-cell development, natural killer cell development, or both, whereas impaired
myeloid differentiation is restricted to a few rare forms of SCID. Regardless of the
presence or absence of B cells, patients with SCID have a severe defect in antibody
production, reflecting a lack of T lymphocytes. - ✔✔ANSW✔✔..Question 1. Which of the
following statements concerning severe combined immunodeficiency (SCID) is true?
A. SCID is characterized by severe deficiency of T cells.
B. SCID is characterized by severe deficiency of T and B cells.
C. SCID is characterized by severe deficiency of T, B, and natural killer cells.
D. SCID is characterized by severe deficiency of both lymphocytes and neutrophils.
1. Answer: A
Explanation: The mannose-binding lectin pathway is initiated by binding of mannose-
binding lectin to a variety of sugars on the surface of microbes. -
✔✔ANSW✔✔..Question 1. The complement pathway initiated by the binding of a
plasma protein to sugars on the surface of a microbe is —
A. the lectin pathway.
B. the alternative pathway.
C. the classical pathway.
D. the kinin pathway.
1. Answer: A
Explanation: This is important not only because control of indoor humidity is important in
reducing mite exposure but also because the presence of house dust mites is less in
arid climates or at higher altitudes. - ✔✔ANSW✔✔..Question 1. Concentrations of which
of the following allergens are most closely related to indoor humidity?
A. Dermatophagoides farinae
B. Blatella germanica
C. Alternaria alternata
D. Felis domesticus
1. Answer: B
Explanation: Anti-CCP antibodies can be present years before the onset of clinical
disease. Patients with RA who have anti-CCP antibodies tend to have more aggressive
erosive disease. Anti-CCP antibodies are more specific but less sensitive than
rheumatoid factor for diagnosing RA. - ✔✔ANSW✔✔..Question 1. Which of the
following statements is true regarding anti-CCP antibodies in patients with RA?
A. The appearance of anti-CCP antibodies in the bloodstream coincides with the onset
of clinical RA.
B. Anti-CCP antibodies are highly specific for RA.
C. Patients with RA who have anti-CCP antibodies tend to
have milder disease than those who do not have the
,antibodies.
D. Rheumatoid factor and anti-CCP antibodies are about
equally specific for RA.
1. Answer: B
Explanation: DR3/4 is the highest-risk genotype for type 1 diabetes. Insulin
autoantibodies are remarkably inversely related to age of onset of type 1 diabetes, with
levels being highest in the youngest children presenting with diabetes.
Transglutaminase autoantibodies occur in approximately 10% of patients with type 1
diabetes, and half of these patients have high levels associated with a positive intestinal
biopsy result for celiac disease. - ✔✔ANSW✔✔..Question 1. Which of the following
statements concerning type 1 diabetes is true?
A. The highest-risk genotype for type 1 diabetes is DR4/4.
B. Islet autoantibodies typically appear years before the
development of diabetes.
C. Insulin autoantibodies are most common in adults rather
than children with diabetes.
D. Celiac disease and anti-transglutaminase autoantibodies
are not increased in patients with type 1 diabetes.
1. Answer: B
Explanation: From the 4 options, option B is the most likely answer. HIV infection can be
considered as a cause of immunodeficiency at any age. Options A, C, and D are
primary immunodeficiencies that present clinically in infancy or early childhood. -
✔✔ANSW✔✔..Question 1. An 18-year-old woman presents with a history of recurrent
respiratory tract infections in the past 3 months. She has been previously healthy.
Which of the following is the most likely cause of immunodeficiency in this patient?
A. severe combined immunodeficiency
B. HIV infection
C. X-linked agammaglobulinemia
D. hyper-IgM syndrome
1. Answer: B
Explanation: In pulmonary TB lesions, there are reduced numbers of cytolytic T cells
expressing low levels of perforin and granulysin. In addition, there are increased
numbers of CD41CD251 Tregs, suggesting that an imbalance in the proportion of
effector T cells to Treg cells may contribute to establishment of granulomas in TB
infection. - ✔✔ANSW✔✔..Question 1. In patients with pulmonary tuberculosis, the
number of CD41CD251 regulatory T cells is —
A. decreased.
B. increased.
C. very low or absent.
D. very high.
1. Answer: B
, Explanation: In virus-infected cells, some viral proteins are degraded in the cellular
proteasome, the major cellular protein degrading organelle. TAP-1 and TAP-2 are
proteins that participate in the transport of peptide fragments from the proteasome into
the endoplasmic reticulum where they are loaded into newly synthesized class I MHC
molecules. Without TAP-1 or TAP-2, viral peptides are not loaded into class I
molecules, and recognition by CD8+ T cells does not occur. HLA-DM is required for
peptide loading into class II MHC molecules, permitting recognition by CD4+ T cells. B-
lymphocytes must traffic through the germinal center in order to undergo somatic
mutation and differentiation to high affinity antibody producing cells. Trafficking through
the germinal center is not required for CD81 T cells devel- opment or differentiation.
Some viruses down-regulate (extinguish) expression of the class I prote -
✔✔ANSW✔✔..Question 1. For CD8+ T lymphocytes to recognize virally infected cells,
the infected cells must —
A. express functional HLA-DM molecules.
B. express functional transporter associated with antigen
presentation (TAP) 1 and 2 proteins.
C. have trafficked through a germinal center.
D. extinguish expression of its class I HLA molecules.
1. Answer: B
Explanation: Parents are haploidentical with their children. One fourth of siblings can be
HLA genoidentical to the patient. A matched unrelated donor would be HLA
phenoidentical. The risk of graft-versus-host disease increases with differences in minor
antigens, leading to increased morbidity/mortality in nonrelated recipients. -
✔✔ANSW✔✔..Question 1. Allogeneic hematopoietic stem cell transplantation is often
used for the treatment of acute leukemia. The most de- sirable source of donor cells is
from —
A. a parent.
B. an HLA-matched sibling.
C. HLA-matched umbilical cord blood.
D. an HLA-matched unrelated donor.
1. Answer: B
Explanation: Patients with aspirin-exacerbated respiratory disease can be tolerized by
repeated administration of aspirin, but this is not SIT. The other indications are
appropriate. - ✔✔ANSW✔✔..Question 1. Which of these conditions is not an indication
for specific immunotherapy (SIT)?
A. bee venom-induced anaphylaxis
B. aspirin-induced asthma
C. allergic rhinitis
D. cat dander-induced asthma
1. Answer: B
Explanation: Studies of a referral population in the United States indicated that only
11% resolved egg and 19% resolved milk allergy by age 4 years; however, about 80%
resolved these allergies by age 16 years. Allergy to fish/shellfish is reported more often
COMPLETE QUESTIONS AND CORRECT VERIFIED
ANSWERS (DETAILED ANSWERS) ALREADY GRADED
A+ 100% GUARANTEED TO PASS CONCEPTS!!!
1. Answer: A
Explanation: All TNF inhibitors have been shown to improve the signs and symptoms of
RA. Although anti-TNF mAbs have been effective in the treatment of Crohn disease, the
fusion protein etanercept has not been effective. Despite increased levels of TNF in
patients with congestive heart failure and multiple sclerosis, TNF inhibitors have not
improved and have sometimes worsened clinical outcomes. - ✔✔ANSW✔✔..Question
1. TNF inhibitors have been shown to be effective in the treatment of several
autoimmune diseases. Which of following statements is true regarding the efficacy of
TNF inhibitors?
A. All approved TNF inhibitors are effective in the treatment of rheumatoid arthritis (RA).
B. Etanercept is effective in the treatment of inflammatory bowel disease (eg, Crohn
disease).
C. TNF inhibitors are effective in the treatment of congestive heart failure.
D. TNF inhibitors are effective in the treatment of demyelinating diseases (eg, multiple
sclerosis).
1. Answer: A
Explanation: IL-6 signals through a ligand-binding IL-6 receptor a chain (CD126) and
the signal-transducing component glycoprotein 130 (CD130). CD130 is the common
signal transducer for several cytokines in the IL-6 family and is ubiquitously expressed. -
✔✔ANSW✔✔..Question 1. IL-6 and the IL-6 family of cytokines trigger signal transducer
and activator of transcription 3 phosphorylation through which of the following
receptors?
A. glycoprotein 130
B. shared g chain
C. shared b chain (CD131)
D. nuclear factor IL-6
,E. oncostatin M receptor a chain
1. Answer: A
Explanation: SCID includes a heterogeneous group of disorders characterized by
severe defects in T-cell development. Some (but not all) forms of SCID also have
defects in B-cell development, natural killer cell development, or both, whereas impaired
myeloid differentiation is restricted to a few rare forms of SCID. Regardless of the
presence or absence of B cells, patients with SCID have a severe defect in antibody
production, reflecting a lack of T lymphocytes. - ✔✔ANSW✔✔..Question 1. Which of the
following statements concerning severe combined immunodeficiency (SCID) is true?
A. SCID is characterized by severe deficiency of T cells.
B. SCID is characterized by severe deficiency of T and B cells.
C. SCID is characterized by severe deficiency of T, B, and natural killer cells.
D. SCID is characterized by severe deficiency of both lymphocytes and neutrophils.
1. Answer: A
Explanation: The mannose-binding lectin pathway is initiated by binding of mannose-
binding lectin to a variety of sugars on the surface of microbes. -
✔✔ANSW✔✔..Question 1. The complement pathway initiated by the binding of a
plasma protein to sugars on the surface of a microbe is —
A. the lectin pathway.
B. the alternative pathway.
C. the classical pathway.
D. the kinin pathway.
1. Answer: A
Explanation: This is important not only because control of indoor humidity is important in
reducing mite exposure but also because the presence of house dust mites is less in
arid climates or at higher altitudes. - ✔✔ANSW✔✔..Question 1. Concentrations of which
of the following allergens are most closely related to indoor humidity?
A. Dermatophagoides farinae
B. Blatella germanica
C. Alternaria alternata
D. Felis domesticus
1. Answer: B
Explanation: Anti-CCP antibodies can be present years before the onset of clinical
disease. Patients with RA who have anti-CCP antibodies tend to have more aggressive
erosive disease. Anti-CCP antibodies are more specific but less sensitive than
rheumatoid factor for diagnosing RA. - ✔✔ANSW✔✔..Question 1. Which of the
following statements is true regarding anti-CCP antibodies in patients with RA?
A. The appearance of anti-CCP antibodies in the bloodstream coincides with the onset
of clinical RA.
B. Anti-CCP antibodies are highly specific for RA.
C. Patients with RA who have anti-CCP antibodies tend to
have milder disease than those who do not have the
,antibodies.
D. Rheumatoid factor and anti-CCP antibodies are about
equally specific for RA.
1. Answer: B
Explanation: DR3/4 is the highest-risk genotype for type 1 diabetes. Insulin
autoantibodies are remarkably inversely related to age of onset of type 1 diabetes, with
levels being highest in the youngest children presenting with diabetes.
Transglutaminase autoantibodies occur in approximately 10% of patients with type 1
diabetes, and half of these patients have high levels associated with a positive intestinal
biopsy result for celiac disease. - ✔✔ANSW✔✔..Question 1. Which of the following
statements concerning type 1 diabetes is true?
A. The highest-risk genotype for type 1 diabetes is DR4/4.
B. Islet autoantibodies typically appear years before the
development of diabetes.
C. Insulin autoantibodies are most common in adults rather
than children with diabetes.
D. Celiac disease and anti-transglutaminase autoantibodies
are not increased in patients with type 1 diabetes.
1. Answer: B
Explanation: From the 4 options, option B is the most likely answer. HIV infection can be
considered as a cause of immunodeficiency at any age. Options A, C, and D are
primary immunodeficiencies that present clinically in infancy or early childhood. -
✔✔ANSW✔✔..Question 1. An 18-year-old woman presents with a history of recurrent
respiratory tract infections in the past 3 months. She has been previously healthy.
Which of the following is the most likely cause of immunodeficiency in this patient?
A. severe combined immunodeficiency
B. HIV infection
C. X-linked agammaglobulinemia
D. hyper-IgM syndrome
1. Answer: B
Explanation: In pulmonary TB lesions, there are reduced numbers of cytolytic T cells
expressing low levels of perforin and granulysin. In addition, there are increased
numbers of CD41CD251 Tregs, suggesting that an imbalance in the proportion of
effector T cells to Treg cells may contribute to establishment of granulomas in TB
infection. - ✔✔ANSW✔✔..Question 1. In patients with pulmonary tuberculosis, the
number of CD41CD251 regulatory T cells is —
A. decreased.
B. increased.
C. very low or absent.
D. very high.
1. Answer: B
, Explanation: In virus-infected cells, some viral proteins are degraded in the cellular
proteasome, the major cellular protein degrading organelle. TAP-1 and TAP-2 are
proteins that participate in the transport of peptide fragments from the proteasome into
the endoplasmic reticulum where they are loaded into newly synthesized class I MHC
molecules. Without TAP-1 or TAP-2, viral peptides are not loaded into class I
molecules, and recognition by CD8+ T cells does not occur. HLA-DM is required for
peptide loading into class II MHC molecules, permitting recognition by CD4+ T cells. B-
lymphocytes must traffic through the germinal center in order to undergo somatic
mutation and differentiation to high affinity antibody producing cells. Trafficking through
the germinal center is not required for CD81 T cells devel- opment or differentiation.
Some viruses down-regulate (extinguish) expression of the class I prote -
✔✔ANSW✔✔..Question 1. For CD8+ T lymphocytes to recognize virally infected cells,
the infected cells must —
A. express functional HLA-DM molecules.
B. express functional transporter associated with antigen
presentation (TAP) 1 and 2 proteins.
C. have trafficked through a germinal center.
D. extinguish expression of its class I HLA molecules.
1. Answer: B
Explanation: Parents are haploidentical with their children. One fourth of siblings can be
HLA genoidentical to the patient. A matched unrelated donor would be HLA
phenoidentical. The risk of graft-versus-host disease increases with differences in minor
antigens, leading to increased morbidity/mortality in nonrelated recipients. -
✔✔ANSW✔✔..Question 1. Allogeneic hematopoietic stem cell transplantation is often
used for the treatment of acute leukemia. The most de- sirable source of donor cells is
from —
A. a parent.
B. an HLA-matched sibling.
C. HLA-matched umbilical cord blood.
D. an HLA-matched unrelated donor.
1. Answer: B
Explanation: Patients with aspirin-exacerbated respiratory disease can be tolerized by
repeated administration of aspirin, but this is not SIT. The other indications are
appropriate. - ✔✔ANSW✔✔..Question 1. Which of these conditions is not an indication
for specific immunotherapy (SIT)?
A. bee venom-induced anaphylaxis
B. aspirin-induced asthma
C. allergic rhinitis
D. cat dander-induced asthma
1. Answer: B
Explanation: Studies of a referral population in the United States indicated that only
11% resolved egg and 19% resolved milk allergy by age 4 years; however, about 80%
resolved these allergies by age 16 years. Allergy to fish/shellfish is reported more often
