MEDICOLOGY: Apha FPGEE Practice MCQs No. 77

Wednesday, August 3, 2022

Apha FPGEE Practice MCQs No. 77

01. Contact dermatitis allergen contact with the epidermis resulting in inflammation and redness caused by infiltration of leukocytes and cytokine release Is following type?
A. Type I hypersensitivity 
B. Type II hypersensitivity 
C. Type III hypersensitivity 
D. Type IV hypersensitivity 

Answer: D. Type IV hypersensitivity also called delayed type hypersensitivity DTH Type of hypersensitivity mediated by a memory T-cell response that have been sensitised to an allergin by a previous contact recruit other leukocytes to the site of allergin upon a later encounter
Because of the recruitment a delay occurs in the allergic reaction.
Example: 
Tuberculin reaction (local reaction of inflammation and redness at the site of subcutaneous injection of prepared antigen 
From Mycobacterium tuberculosis.
Granulomatous reaction Stimulation from a foreign body or particulate such as talc or silica resulting in a granuloma, which is a mass of lymphocytes and macrophages surrounding an allergen too large to be phagocytized.

02. Granulomatous reaction Stimulation from a foreign body or particulate such as talc or silica resulting in a granuloma, which is a mass of lymphocytes and macrophages surrounding an allergen too large to be phagocytized Is following type?
A. Type I hypersensitivity 
B. Type II hypersensitivity 
C. Type III hypersensitivity 
D. Type IV hypersensitivity 

Answer: D. Type IV hypersensitivity also called delayed type hypersensitivity DTH Type of hypersensitivity mediated by a memory T-cell response that have been sensitised to an allergin by a previous contact recruit other leukocytes to the site of allergin upon a later encounter
Because of the recruitment a delay occurs in the allergic reaction.
Example: 
Tuberculin reaction (local reaction of inflammation and redness at the site of subcutaneous injection of prepared antigen 
From Mycobacterium tuberculosis.
Contact dermatitis allergen contact with the epidermis resulting in inflammation and redness caused by infiltration of leukocytes and cytokine release

03. When the donor and recipients are the same person as in the skin graft from one part of the body to different part of the body called?
A. Isograft
B. Allograft 
C. Xenograft
D. Autograft

Answer: D. Autograft
T-cells play a major role in graft rejection because Tc cells interact with MHC class I molecules which are present on all nucleated cells and TH cells interact with MHC class II molecules which are present on the surface of APCs. 

How rejection process Occurred?
During graft rejection, APCs from the graft(which express MHC class II) or from the host( which process and present graft antigen shed from the graft tissue). These both activate Th cells which in secrete IL-2 & IFN-gamma and other cytokines TNF-beta, IL-4, IL,5.
This section causes rapid immune activation in which B-cells activated to secrete graft specific antibodies and other phagocytes become activated.  Tc cells become activated, and expression of MHC molecules on APCs and the graft itself is up regulated.
All this activity results in antibody dependent cell mediated cytotoxicity through cooperation bw phagocytes, T-cell and B-cell; cell mediated cytotoxicity by the Tc cells and cell damage and lysis through complement activation and secretion of inflammatory mediators by macrophages.


04. A rare process because it involves a graft from a donor who is genetically identical to the recipient, which would be case for identical twins called?
A. Isograft
B. Allograft 
C. Xenograft
D. Autograft

Answer: A. Isograft
For Exact tissue matching of MHC haplotype is the most direct to successful transplant, it's impossible in allograft transplantation because more than 100 HLA are know yo be activated.
So allograft transplant recipient undergo immunosuppressive therapy yo to prevent transplant rejection. 
Common immunosuppressive drugs.
Steroids:
Anti inflammatory and suppress MHC expression and macrophages activation 
Cyclosporine, FK506, Rapamycin 
Fungal macrolides that interfere with production of IL-2 and IFN-gama leading to suppression of activation of macrophages and lymphocytes.
Azathioprine:
Neucleotide analog and anti proliferatative drug that incorporates quickly into newly synthesised DNA in rapidly deviding cells, therefore if leukocytes become activated and start proliferating they'll quickly die once azathioprine becomes incorporated into the genome.

05. A transplantation in which the donor is genetically related to the recipient but individual don't have familial relatives but more closely related have the better chance of success?
A. Isograft
B. Allograft 
C. Xenograft
D. Autograft

Answer: B. Allograft (most common type)

06. A transplantation occurs when the donor is different species than the recipient as in the case of monkey donor and human recipient is called?
A. Isograft
B. Allograft 
C. Xenograft
D. Autograft

Answer: C. Xenograft 
Graft rejection and success depend on the histocompatibility of the donor and recipient. Because MHC molecules are responsible for the strongest reaction of alloantigens matching the MHC hiplotype of the donor and recipient is crucial.

07. Which of the following B-cell deficiency is not hereditary defect infact acquired from previous Epstein-Barr virus infection?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. MHC class II deficiency 
E. Acquired immunodeficiency syndrome 

Answer: B. Common variable immunodeficiency (CVID)
Option A. Is a B-Cell immunodeficiency in which No B-cell maturation and little detectable serum antibody 
Option B. is Answer 
Option C. this is a T-cell deficiency disease in which a chromosomal defect in IL-7 receptor expression that lead to T cell maturation, or a separate defect of purine degradation enzyme leading to accommulation of neocleotides which is toxic to lymphocytes.
Option D. This deficiency leads to impaired TH cell development, resulting in poor B cells activation and differentiation and in poor antibodies response 
Option E. Caused by infection with human immunodeficiency virus which infects CD4+ T cells and leads to severe immunodeficiency caused by impaired T.h cell function 

08. Following is B-Cell immunodeficiency in which No B-cell maturation and little detectable serum antibody?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. MHC class II deficiency 
E. Acquired immunodeficiency syndrome 

Answer: A. X-Linked agammaglobulinemia
Also various deficiencies in different antibody isotypes (caused by defects in class switching)

09. Following is T-cell deficiency disease in which a chromosomal defect in IL-7 receptor expression that lead to T cell maturation?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. MHC class II deficiency 
E. Acquired immunodeficiency syndrome 

Answer: C. Severe combined immunodeficiency (SCID)
Or a separate defect of purine degradation enzyme leading to accommulation of neocleotides which is toxic to lymphocytes.

10. Following deficiency leads to impaired TH cell development, resulting in poor B cells activation and differentiation and in poor antibodies response?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. MHC class II deficiency 
E. Acquired immunodeficiency syndrome 


Answer: D. MHC  class II deficiency 

11. Following Caused by infection with human immunodeficiency virus which infects CD4+ T cells and leads to severe immunodeficiency caused by impaired TH cell function?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. MHC class II deficiency 
E. Acquired immunodeficiency syndrome 

Answer: E. Acquired immunodeficiency syndrome 

12. Following is a defect in DNA repair enzymes which leads to chromosomal breaks in the immunoglobulin or TCR loci, results in impaired antibody production and several cell mediated immune response?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. MHC class II deficiency 
E. Ataxia telangiectasia

Answer: E. Ataxia telangiectasia

13. A defect in an oxygen reduction enzyme resulting in faulty pathogen killing in the phagolysosome is called?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. Chronic granulomatous disease
E. Ataxia telangiectasia

Answer: D. Chronic granulomatous disease 

14. Complemen protein deficiency in which one or all of the complement protein are not expressed in an individual. Following is the example?
A. X-linked agammaglobulinemia 
B. Common variable immunodeficiency (CVID)
C. Severe combined immunodeficiency (SCID)
D. Chronic granulomatous disease
E. Ataxia telangiectasia

Answer: D. Chronic granulomatous disease  (Defect in phagocyte also occurs)
In addition, acquired immunodeficiency or secondary deficiency that is caused by number of factors:
Steroids use
Immunomodulatory drugs use
Cancer chemotherapy 
Nutrients deficiency 
Malnutrition  

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