Unit 6: Hypersensitivity; Transplantation; Autoimmunity - Practice Quiz

1 Which antibody class primarily mediates type I hypersensitivity reactions?

2 Which cell releases histamine during a type I hypersensitivity reaction?

3 Which of the following is a classic example of a type I hypersensitivity reaction?

4 Type II hypersensitivity reactions are primarily mediated by antibodies directed against:

5 Which condition is a typical example of type II hypersensitivity?

6 Which antibody classes are mainly involved in type II hypersensitivity?

7 Type III hypersensitivity reactions are caused by the deposition of:

8 Which of the following is a classic example of type III hypersensitivity?

9 The localized inflammatory response caused by immune complex deposition at a site of antigen injection is called the:

10 Type IV hypersensitivity is also known as:

11 Which cells mediate type IV hypersensitivity reactions?

12 The tuberculin (Mantoux) skin test is an example of which type of hypersensitivity?

13 The main antigens responsible for graft rejection between individuals are the:

14 A graft transferred between genetically identical individuals is called a(n):

15 A graft between two different species is termed a:

16 Tissue typing before transplantation is primarily performed to match:

17 In which structure of the human genome are HLA genes located?

18 Which type of T cell is the main effector in cell-mediated graft rejection?

19 Which type of graft rejection typically occurs days to weeks after transplantation and is mainly cell-mediated?

20 Hyperacute graft rejection typically occurs:

21 A patient develops wheezing, urticaria, and hypotension within minutes of a bee sting. Which mediator released from mast cells is primarily responsible for the immediate vascular changes seen in this reaction?

22 The late-phase reaction of type I hypersensitivity, occurring several hours after allergen exposure, is characterized by tissue infiltration primarily of which cell type?

23 A newborn develops hemolytic disease due to maternal anti-Rh antibodies. This condition is best classified as which type of hypersensitivity?

24 In Graves' disease, autoantibodies bind the TSH receptor and stimulate thyroid hormone production. This is considered an atypical type II reaction because the antibodies:

25 A patient develops fever, arthralgia, and proteinuria about 10 days after receiving antivenom serum. The renal damage is most likely caused by:

26 Which feature distinguishes the Arthus reaction from anaphylaxis?

27 A positive tuberculin (Mantoux) skin test produces induration peaking at 48–72 hours. This delayed response is mediated primarily by:

28 Contact dermatitis from nickel jewelry is a type IV reaction. The nickel ions act as haptens by:

29 A graft transplanted between genetically identical twins is generally accepted without rejection. This type of graft is called a:

30 Which molecules are the principal targets recognized by the recipient's T cells during allograft rejection?

31 In direct allorecognition, recipient T cells recognize:

32 Before a kidney transplant, a crossmatch test is performed by mixing recipient serum with donor lymphocytes. A positive crossmatch indicates:

33 Which HLA loci are considered most important to match for improving solid organ graft survival?

34 Acute cellular rejection of a transplanted organ is primarily mediated by which effector cells?

35 Cyclosporine and tacrolimus prevent cell-mediated graft rejection mainly by:

36 A transplanted kidney turns cyanotic and mottled within minutes of vascular anastomosis. This hyperacute rejection is caused by:

37 Chronic graft rejection typically presents months to years after transplantation and is characterized histologically by:

38 Which mechanism best explains how molecular mimicry contributes to autoimmune disease?

39 In Hashimoto's thyroiditis, hypothyroidism results primarily from:

40 Systemic lupus erythematosus (SLE) is characterized by antibodies against nuclear components and tissue injury mediated largely by:

41 A patient develops anaphylaxis within minutes of a bee sting. During the late-phase reaction (6–12 hours later), tissue biopsy shows a predominant cellular infiltrate. Which cell type and mediator combination is MOST characteristic of this late phase rather than the immediate phase?

42 A researcher measures a patient's total serum IgE and finds it normal, yet the patient has a strongly positive skin prick test and clinical allergy to peanut. What is the BEST explanation for allergy despite normal total IgE?

43 In Goodpasture syndrome, autoantibodies target the non-collagenous (NC1) domain of the chain of type IV collagen. Why are the kidney and lung selectively affected in this disease?

44 A newborn of a group O mother develops mild hemolytic disease, while a different group A infant of an Rh-negative mother sensitized in a prior pregnancy develops severe disease. Which statement BEST explains the difference in severity between ABO and Rh hemolytic disease of the newborn?

45 In an Arthus reaction, a patient injected intradermally with antigen develops localized edema, hemorrhage, and necrosis over several hours. What is the KEY pathogenic event distinguishing this from a type I reaction at the same site?

46 The size and solubility of immune complexes influence their pathogenicity. Which type of immune complex is MOST likely to deposit in tissues and cause type III disease?

47 A tuberculin skin test is read at 48–72 hours as an area of induration. Which mechanism explains why the peak response is delayed rather than immediate?

48 In contact dermatitis to nickel, the metal itself is too small to be immunogenic. What immunological concept explains how nickel triggers a type IV response?

49 Hyperacute rejection of a transplanted kidney occurs within minutes of vascular anastomosis. Which pre-existing immunological factor is MOST responsible?

50 A recipient's T cells can recognize donor alloantigen via two pathways. Which statement correctly contrasts direct versus indirect allorecognition?

51 A patient awaiting a kidney transplant has a high panel reactive antibody (PRA) of 85%. What does this value indicate for transplant planning?

52 A complement-dependent cytotoxicity (CDC) crossmatch is positive between donor lymphocytes and recipient serum. What is the correct interpretation and consequence?

53 In acute cellular rejection of a solid organ graft, which effector mechanism causes direct parenchymal cell destruction?

54 Calcineurin inhibitors such as cyclosporine and tacrolimus are used to prevent cellular rejection. What is their primary molecular mechanism?

55 A kidney transplant recipient presents 8 months post-transplant with gradually rising creatinine, proteinuria, and biopsy showing interstitial fibrosis, tubular atrophy, and vascular intimal thickening. Which type of rejection is MOST consistent with these findings?

56 In graft-versus-host disease (GVHD) following allogeneic bone marrow transplant, which triad of organs is classically involved and why does this reaction occur?

57 Central and peripheral tolerance mechanisms normally prevent autoimmunity. A mutation in the AIRE gene causes APECED/APS-1. What is the underlying defect?

58 Molecular mimicry is proposed as a mechanism triggering autoimmunity after infection. Which example BEST illustrates this concept?

59 In Graves disease, hyperthyroidism results despite low circulating TSH. What is the immunologic mechanism producing this paradox?

60 A young woman with SLE develops glomerulonephritis. Serology shows high anti-dsDNA titers and low serum C3 and C4. What best explains the low complement levels?