Advanced Pathophysiology - Wilkes
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,1. When antibodies are formed against red blood cell antigens of the Rh system, the
blood cells are destroyed by:
- A) Complement-mediated cell lysis
- B) Phagocytosis by macrophages
- C) Phagocytosis in the spleen
- D) Neutrophil granules and toxic oxygen products
Answer: C) Phagocytosis in the spleen
Explanation: In cases of Rh incompatibility, antibodies target Rh-positive red blood
cells, and these cells are typically cleared from circulation through phagocytosis by
macrophages in the spleen.
2. When soluble antigens from infectious agents enter circulation, tissue damage is a
result of:
- A) Complement-mediated cell lysis
- B) Phagocytosis by macrophages
- C) Phagocytosis in the spleen
- D) Neutrophil granules and toxic oxygen products
Answer: D) Neutrophil granules and toxic oxygen products
Explanation: Soluble antigens can activate neutrophils, which release their granules
containing cytotoxic substances. This process can contribute to tissue injury and
inflammation.
3. How are target cells destroyed in a type II hypersensitivity reaction?
- A) Complement-mediated cell lysis
- B) Phagocytosis by macrophages
- C) Neutrophil granules and toxic oxygen products
- D) Natural killer cells
,Answer: A) Complement-mediated cell lysis
Explanation: Type II hypersensitivity involves antibodies binding to target cells,
which activates the complement system. This can lead to direct lysis of the cell through
membrane attack complexes.
4. Graves disease (hyperthyroidism) is an example of which type of hypersensitivity
reaction?
- A) Modulation
- B) Antibody-dependent cell-mediated cytotoxicity
- C) Neutrophil-mediated damage
- D) Complement-mediated lysis
Answer: A) Modulation
Explanation: Graves' disease is a type II hypersensitivity reaction where
autoantibodies stimulate the thyroid-stimulating hormone receptor, leading to excessive
thyroid hormone production and hyperthyroidism.
5. Type III hypersensitivity reactions are a result of which of the following?
- A) Antibodies coating mast cells by binding to receptors that signal its degranulation,
followed by the discharge of preformed mediators
- B) Antibodies binding to soluble antigens that were released into body fluids and the
immune complexes being deposited in the tissues
- C) Tc cells or lymphokine-producing Th1 cells directly attacking and destroying
cellular targets
- D) Antibodies binding to the antigen on the cell surface
Answer: B) Antibodies binding to soluble antigens that were released into body fluids
and the immune complexes being deposited in the tissues
, Explanation: Type III hypersensitivity occurs when immune complexes formed from
antibodies binding to soluble antigens deposit in tissues, leading to inflammation and
damage through complement activation.
6. Hypersensitivity is best defined as:
- A) Disturbance in the immunologic tolerance of self-antigens
- B) Immunologic reaction of one person to the tissue of another person
- C) Altered immunologic response to an antigen that results in disease
- D) Undetectable immune response in the presence of antigens
Answer: C) Altered immunologic response to an antigen that results in disease
Explanation: Hypersensitivity refers to an exaggerated or altered immune response
that leads to tissue damage, resulting in clinical disease. It encompasses various allergic
reactions where the immune system overreacts to perceived threats.
7. A hypersensitivity reaction that produces an allergic response is called:
- A) Hemolytic shock
- B) Anaphylaxis
- C) Necrotizing vasculitis
- D) Systemic erythematosus
Answer: B) Anaphylaxis
Explanation: Anaphylaxis is a severe and rapid hypersensitivity reaction characterized
by a systemic response, including symptoms such as difficulty breathing, swelling, and
in severe cases, shock. It is a critical medical emergency.
8. The common hay fever allergy is expressed through a reaction mediated by which
class of immunoglobulins?