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Immunology SSN 2012 [PART 4 of 4] - Qiurio

Immunology SSN 2012 [PART 4 of 4]

Fourth and final part of the SSN 2012 immunology practice questions







Good job! Take a look at the report below for a more detailed analysis of your performance.

Score Card

Question Your Answer Correct Answer
This chart shows the number of test-takers who scored in various ranges. Your score of XX was as good or better than XX of all test-takers. . As more people take this test you'll get a more accurate idea of your relative performance.
Your Score X%
Set Average X%
Standard Deviation X
Percentile X

Score Frequency Distribution

Number of Test Takers
Score Range (%)

Performance Trend

Score (%)
Test Number
You've taken this test before. The chart on the left shows how your performance has changed with each sitting.

It's a good idea to repeat tests in which you performed poorly. Aim to improve your performance with each sitting by taking the time to review your mistakes.

Topic Breakdown

Topic Breakdown

Topic
Percent Correct (%)
This chart shows your performance by topic.

Be sure to identify topics on which you had difficulty and give these more attention.

It's equally important to know to what extent a topic will be represented in a test.

Difficult topics that appear rarely may not represent the highest yield material to review.

Difficulty Analysis

Question Difficulty

Rank Question Answered Incorrectly
This table ranks questions by difficulty.

The more a question is answered incorrectly the more difficult it likely is.

Alternatively, it may be a poorly constructed question.

Question 1
On your pediatrics rotation, you see a 2-year-old boy in the ER for an itchy rash. While taking the history, you learn that he has a congenital heart defect. Your very thorough physical examination reveals an odd-looking face, a cleft palate, and hyperreflexia (a sign of hypocalcemia). If this boy has what you think he has, which one of the following could NOT be the source of his rash?
A. Poison ivy
B. Chicken pox
C. Bedbugs
D. An allergic reaction to the peanut butter he ate for lunch

Explanation

Question 2
Your housemate comes back from vacation with some cute new metal bracelets she bought at a street fair. A few days later, she develops angry-looking red blisters on her wrists. What cells mediated the hypersensitivity reaction?
A. Mast cells
B. CD8 T cells
C. CD4 T cells
D. Eosinophils

Explanation

Question 3
You’re hanging out with the anesthesiologist, watching a gastric bypass surgery. Soon after the first incision, the patient becomes tachycardic and her blood pressure tanks. The whole OR panics as everyone realizes that they forgot the patient had a latex allergy. Crash carts are brought in. What type of heart failure is the patient experiencing, and why?
A. Low-output, because her heart has stopped pumping due to a Type II hypersensitivity reaction
B. Low-output, because of increased afterload due to smooth muscle constriction
C. High-output, because all her peripheral vasculature has dilated and become leaky and her heart is working overtime to try to deliver enough oxygen to her tissues
D. High-output, because she is overloaded with fluids

Explanation

Question 4
Luckily, the patient in the above question recovers thanks to the anesthesiologist’s quick administration of epinephrine. What other medication will be critical to this patient’s survival?
A. penicillin, to make a hapten
B. corticosteroids, to prevent the late-phase response of anaphylaxis
C. aspirin, to keep her platelets from aggregating all over the place
D. etanercept, to calm down her TNF-alpha

Explanation

Question 5
On your medicine rotation, you do a thorough cardiac exam on an elderly Dominican man and note an opening snap, followed by a mid-diastolic rumble heard best with the bell of your stethoscope held near the apex of his heart. In response to pimping by your attending, you say that you think this is mitral stenosis, likely the result of a childhood bout of rheumatic fever. This is a classic example of:
A. opsonization
B. molecular mimicry (Type II hypersensitivity)
C. immune-complex mediated damage (Type II hypersensitivity)
D. immune-complex mediated damage (Type III hypersensitivity)

Explanation

Question 6
How can a dendritic cell be activated, causing it to mature and cross-present antigen (including tumor antigen)?
A. Inflammatory cytokines like interferon-gamma and TNF
B. All of the above
C. T cell stimuli like CD40 ligand
D. Microbial stimuli like TLR ligands

Explanation

Question 7
How do natural killer cells kill tumor cells?
A. Antibody Dependent Cellular Cytotoxicity
B. Ancillary Disregulating Corpuscular Crepitus
C. Aberrant Dwarf Crime Circles
D. Activated Dendritic Cell Cytokines

Explanation

Question 8
How do tumor cells evade the immune response?
A. Upregulate survival pathways like akt and Bcl-2
B. Reduce the Fas receptor, making the tumor resistant to apoptosis
C. Lose the Class I MHC surface molecule, so they can hide from CTLs
D. Suppress T cell response with cytokines like TGF-beta and IL-10
E. All of the above, and more

Explanation

Question 9
A patient who has been suffering from gastroesophageal reflux for many years is diagnosed with esophageal adenocarcinoma. The association of chronic inflammation with malignancy is an example of what well-known hypothesis?
A. Point and shoot
B. Seed and soil
C. Wash and go
D. Swish and swallow

Explanation

Question 10
A 55 year old woman complains of dry mouth and eyes. She has trouble speaking for more than a few minutes at a time. On physical exam her buccal mucosa is dry and her salivary glands are enlarged. After the appropriate lab tests she is diagnosed with Sjogren's Syndrome. What is the likely nature of the lab tests performed?
A. T Cell serum count
B. Response to corticosteroids
C. Measurement of autoantibodies
D. Salivary gland biopsy

Explanation

Question 11
Cinderella lost a slipper. Her slipper oddly enough is in the shape of an HLA-DR4-0401 protein. Her foot, due to a tragic birth defect, is the shape of an unknown peptide. In a twist of fate, once reunited with her slipper, Cinderella develops a severe case of Rheumatoid Arthritis. What is the likely chemical nature of the inside of Cinderella's slipper?
A. Negatively charged insole
B. Positively charged insole
C. Neutral insole with aspartic acid at location 71
D. Neutral insole with glycine at location 71

Explanation

Question 12
Mary-kate was diagnosed with Systemic Lupus Erythematosus. Her twin, Ashley, has no symptoms. If we were to look at Ashley's serum what are we likely to find?
A. Nothing remarkable; healthy, bratty serum
B. dsDNA Autoantibodies
C. ANA Autoantibodies
D. Sm Autoantibodies

Explanation

Question 13
What’s the role of apoptosis in autoimmune disease?
A. Apoptosis is the result of cytotoxic action of self-recognizing T Cells, it’s a consequence not a cause of autoimmune damage
B. Apoptosis is the result of cytotoxic action of self-recognizing T Cells, it reveals intracellular antigens on blebs that become the ligands of autoantibodies that cause further damage
C. Apoptosis is rarely involved in autoimmune disease, inflammation is the only mechanism of injury
D. Apoptosis reduces the pool of antigens that can trigger an immune response causing a progressive decline in the severity of autoimmune disease

Explanation

Question 14
Certain rare autoimmune diseases have shed light on the possible mechanisms of autoimmune pathogenesis. Which of the following diseases revealed the role of peripheral maintenance of self-tolerance.
A. IPEX
B. PIPA
C. APECED
D. SOPA

Explanation

Notes

Discussion

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