A primary innunodeficiency of B cells is most likely to result in an increase in:

- bacterial infections

- fungal infections

- viral infections

- worm infections

Which of the following statements is/are associated with Type I latex allergy?

- allergens are latex proteins

- cross-reacting allergens are found in bananas

- both A and B are correct

- neither A nor B are correct

Autoimmune disease affects:

- females more often than males

- approximately 1 in 20 people

- relatives of those who have an autoimmune disease

- A, B, and C

- A and C only

Which of the following hypersensitivity reactions includes contact dermatitis?

 - Type I

- Type II

- Type III

- Type IV

Hypersensitivity reactions may be triggered by:

- certain infectious agents

- environmental substances

- self (host) antigens

- A, B, and C

- Both B and C only

Patients with SCIDS (severe combined immunodeficiency disease):

- can expect to live relatively normal lives

- are incapable of developing any type of acquired immune response

- Both A and B

- Neither A nor B

Patients with hereditary angioedema are at risk of:

- anaphylaxia

- asphyxia due to a blockage of the airway

- cardiac arrest

- stroke

Which of the following regarding viruses is CORRECT:

- All viruses that cause disease in man have envelopes derived from the host cell

- Larger viruses may replicate outside of host cells

- Viruses generate energy via fermentation pathways

- Viruses attach to specific receptors on host cells via VAPs (viral attachment proteins)

- Viruses have a cellular structure more proimitive than that of prokaryotes

The protein coat that surrounds the nucleic acid of a virion is termed the:

- capsid

- capsule

- envelope

- jacket

A deficiency in phagocytic cells is most likely to reslut in an increased incidence of _________ infections.

- bacterial

- fungal

- protozoal

- viral

- none of the above

The trigger for the development of an autoimmune disease is likely to be:

- a microbial infection

- hormonal changes (puberty, being prego, menopause)

- Either A or B

- Neither A nor B

Systemic lupus erythematosus (SLE) is characterized by circulating immune complexes which deposit in various tissues of the body. This classifies SLE as which type of hypersensitivity?

- Type I

- Type II

- Type III

- Type IV

In pemphigus and benign mucous membrane pemphigoid, antibodies develop to cell surface antigens. This type of hypersensitivity is:

- Type I

- Type II

- Type III

- Type IV

The terms urticaria, wheal, and flare, and hives are used to describe the clinical manifestation of which of the following reactions:

- Type IV hypersensitivity

- Type I hypersensitivity

- contact dermatitis

- delayed hypersensitive skin reaction

Which of the following hypersensitivity reactions involves sensitized T-lymphocytes?

- Type _____?

Prior sensitization of a host is required before:

- systemic anaphylaxis

- contact dermatitis

- wheal and flare reaction

- all of the above

Development of hives (urticaria) within minutes after donning latex gloves, is symptomatic of a __________ reactioncaused by water-soluable_______.

- Type I allergic/proteins

- Type IV allergic/chemical accelerators

- Type IV allergie/proteins

- Type I allergic/ chemical antioxidants

Which of the following is the primary pharmacologic mediator for Type I hypersensitivity?

- histamine

- epinephrine

- sensitized-CD4 cells

- Thiuram

The antigens most likely responsible for a Type IV allergic reaction to latex gloves and rubber dam are:

- corn starch powder

- talcum powder

- chemical accelerators

- proteins

A Type IV (delayed) hypersensitivity reaction manifested against penicillin is characterized by:

- edema without a cellular infiltrate

- an infiltrate primarily composed of neutrophils

- an infiltrate primarily composed of lymphocytes and macrophages

- an infiltrate primarily composed of esoinophils.

- an infiltrate primarily composed of lymphocytes and macrophages

Hemolytic desease of the newborn is what type of hypersensitivity reaction?

- Type___?

The sensitizing dose for Type I allergie reactions:

- stimulates the first clinical manifestations, such as hives

- results in synthesis of specific IgE antibodies

- both A and B

- neither A nor B

Tuberculin skin testing is based on which type of hypersensitivity reaction?

- Type ____?

Type IV

Arthus reaction and serum sickness are characteristic of which type of hypersensitivity reaction?

Type____

The majority of skin reactions seen in dentists and dental hygenists associated with latex glove use are the result of:

- Type I latex allergy

- allergic contact dermatitis

- irritant contact dermatitis

- none of the above

Patients with SCIDS are characterized by:

- having irtually no immune system

- being susceptible to all types of infections

- both A and B

- Neither A nor B

The glycoprotein spikes of enveloped viruses are known as:

- capsomeres

- peplomers

- protomers 

The proteins coat which surrounds the viral genome is known as the:

- capsid

- capsule

- envelope

- matrix

Type I hypersensitivity reactions manifest:

- on the skin usually confined to the contact area

- within minutes to an hour following contact

- Both A and B

- Neither A nor B

type of vaccine where an antigen is inserted via a plasmid into a cloning host (yeast) which then produces the antigen 

ex: include hepatitis B, petrussis vaccine

a route of transmission given just under the surface of the skin

ex: BCG and Vaccinia

route of administration for a vaccine that is given under the skin

ex: MMR, Varivax, Varicella

route of administration for a vaccine that is given into the muscle

ex: HBV, Flu, IPV

route of adminisration for a vaccine that is given directly into the veins

ex: ISG

substance which enhances the activity of the vaccine components (prolongs antigen retention at the site)

increases the immune response

common adjuvants include:

- vitamins

- alum

- Freund's adjuvant

- extracts

- B and C only

- all of the above

periodic vaccinations to boost the immune response

anamnestic response

booster

Hep A and B, Measles-Mumps-Rubella (MMR), Meningococcal vaccine, Meningococcal, Tetanus-Diphtheria vaccines

What vaccine is the first vaccine that is given to babies when they are born

Two kinds of Specific immune response

undesirable reactions produced by a normal immune systemwhich reslut in exaggerated immune responses that injuries or inflames tissues.

- requires a pre-sensitized state of the host

types 1 through 4

- the type of hypersensitivity that occours in in seconds/15-30 minutes.

- IgE, mast cells, ad eosinophils are all involved

- some triggers include: peanuts, latex, pollen, pencillin

- common reactions incude; urticaria, asthma, angioedema, anaphylaxis

- type of hypersensitivity that occours in seconds/minutes to hours

- IgG, complement, and phagocytic cells are all involved

- reactions associated with this include: immune-mediated hemolysis; hemolytic disease of the newborn

- RBC are usually distroyed

- type of hypersensitivity that occours within hours/3-8hours

- IgG, complement, and neutrophils are all involved

- causes deposition of immune complexes in kidney, joints, and skin

- reactions include: arthus reaction; serum sickness

- Type of hypersensitivity which occours within 2-3 days/48-72 hours

- T-cells and macrophages are involved

- contact dermatitis is commonly classified as this

- only class that does not involve antibodies

this kind of trigger of hypersensitivity includes dust, food, and drugs

________immunodeficiency diseases have a genitic bases, are relatively rare, and can be B or T cell defects, both, phagocytic defects, complement defects

- a primary imunodefeiciency disease where there are low levels of B cells and antibodies

- it is more likely to affect a single class of Ig (i.e.IgA)

- This type of defent causes an increase in bacterial infections

without any immunoglobulin

Thymic aplasia (DiGeorge Syndrome) is this type of primary immunodeficiency disease characterized by low set deformed earlobes, wide set slanted eyes, small bowlike mouth and absence of a philtrum

- associated with congenital cardiac abnormalities

- children are highly suseotible to infections with fungi, viruses, and protozoa

This type of primary immunodeficiency is highly asseptable to infections from viruses, fungi, and protozoa

- usually a geneti defect in the development of the lymphpos cell line

- a seviere form in SCIDs

Aseptic lie, Fetal stem cells, Bone marrow transplants, Transfustions of blood containing missing ADA enzyme, and Gene therapy are all ways of managing this type of immunodeficiency disease

- causes person to have a shortened life span

type of immunodeficiency diseace in which there is increased incidence of bacterial infections

- there is no change in incidence or severity of viral or fungal diseases.

- disease that may be associated with an increased incidence of bacterial infections, but not always

- may relate to deficiency of complement components

- may relate to deficiency of complement regulators

-ex: hereditary angiodema

- complement related deficiency of C1 inhibitor

- causes laryngeal obstruction and asphyxia

- have a unique structure - NOT cells

- only can replicate with a host cells

- no metabolism, can not generate energy

- no independant protein system

- not susceptable to antibiotics

- have DNA or RNA as a genome

contains a nucleic acid genome (either DNA or RNA), a protein coat (capsid), and an envelope (membrane)

protein coat of the virus

- protects the nucleic acid

- on the external surface of naked virons

-derived from host cell membranes - except in poxviridae

- viral-encoded matrix protein

- has glycoprotein spikes - peplomers which function in attachment

-2 months

- 4 to 6 years

- 11 to 12 years

- enveloped, positive strand of RNA viruses

- contains two identical copies of the genome

Two major HIV viruses:

- When the envelope is distroyed, this is no longer viable.

 - easier to get rid of than non

- first identified in 1984

- primary cause of AIDS

- causes nearly all U.S. cases of AIDS

- most prevalent in the western world

- first identified in 1986

- predominantly found in Africa

- infection progress to AIDS is the slowest

T-helper lymphocytes (CD4+)

Macrophages

Monocytes

- this occurs 1-4 weeks following exposure

-has flu-like or mononucleosis-like symptoms: fever, malase, lymphadenopathy

When testing for HIV in the within the first 1-4 weeks of infection, the tests will come back as _______

But, high levels of HIV are detectable in the ______

- patient is asymptomatic but HIV replication continues

- T cell destruction also continues during this stage

latent period

(stage of progression of HIV-1 infection)

- stage of progression when the patient is termed ARC (aids related complex) or PGL (progressive generalized lymphadenopathy)

- the CD4 count is < 450-500ul

Early symptomatic disease

(stage of progression of HIV-1 infection)

- stage of progression where the CD4 count is          < 200/ul

- AIDS defining illness

- AIDS

(stage of progression of HIV-1 infection)

- primarily a consequence of continuous, high level HIV-1 replication

- leads to viral and immune-mediated killing of CD4+ lymphocytes

- results inultimate destruction of host cellular immunity capabilities

AIDS

Aquired Immunodeficiency Syndrome

- increase in HIV release in the blood

- p24 increases

- continued CD4+ cell decline

- life threatening Oppourtunistic Infections

HIV is transmitted by all of the following EXCEPT:

- Sexual contact

- Exposure to contaminated blood and blood products

- Perinatally to newborns

- Kissing/causal contact

Factors that affect the transmission of HIV include:

- expousre rate

- type of body fluid (blood, semen, vaginal secretions)

- viral load in fluid

- length of exposure

- all of the above

True or False:

- HIV does NOT survive well outside the body

True or False:

HIV is unable to replicate outside the body

True or False:

No one has ever been found infected with HIV from environmental surface contact

A person who has HIV antibodies:

- is protected against reinfection with HIV

- will never develop AIDS

- has been infected with HIV

- is not at risk of transmitting infection to others

DNA transcribed from viral RNA of HIV:

- remains in the host cell cytoplasm

- is present in the nucleus as an episome

- is integrated into the host cell's genome

- is rapidly destroyed by host cell enzymes

- none of the above 

The strain of HIV which is responsible for most cases of HIV infection and AIDS in North America and Europe is:

- HIV-1

- HIV-2

- HIV-3

- HIV-4

HIV binds to ______ receptors on_______

- CD2/epithelial cells and T-helper lymphocytes

- CD3/cytotoxic T cells and macrophages

- CD4/T-helper cells and macrophages

- CD4/B and T lymphocytes

- CD8/T-lymphocytes

The initial attachment of HIV to host cells is via which of the following?

- gp41

- gp120

- p17

- p24

There has only been one instance of patients infected with HIV by a health care worker (HCW) in the U.S. This HCW was a:

- dental hygenist

- dentist

- nurse

- nurse's aid

- physician

Acute HIV syndrome typically:

- is accompanied by high levels of HIV in the blood

- manifestsas a flu-like illness

- occours within a month following infection 

- both B and C only

- A, B, and C

Which of the following is NOT an indicator disease of AIDS in a patient with HIV infection?

- atypical mycobacterial disease

- candidiasis limited to the oral cavity

- disseminated HSV infection

- oral hairy leukoplakia

- toxoplasmosis of the brain

The genome of the HIV virion is composed of:

- DNA 

- RNA

- both A and B

- neither A nor B

A patient infected with HIV is diagnosed with AIDS when:

- they develop "flu-like" symptoms

- they develop herpes labialis (fever blisters) 

- their CD4 cell count drops below 400/ul

- their CD4 cell count drops below 200/ul

Which of the following body fluids/secretions from an HIV-infected individual would be expected to have the least amount of HIV?

- blood

- semen

- saliva

Health care workers who have seroconverted following documented occupational exposures to HIV include all of the following EXCEPT:

- dentists and dental hygienists

- nurses

- clinical laboratory workers

- physicians

- all of the above

What portion of the immune system is most affected in a patient infected with HIV?

- inate immune system

- humoral immunity 

- cell-mediated immunity 

- both A and B

- both B and C

The HVI antigen, gp120, binds to:

- CD4 receptors

- CD8 receptors 

- both A and B

- neither A nor B

The first symptomatic evidence of HIV-infection may be:

- repeated opportunistic infections

- a "flu-like" illness

- either A or B

- neither A nor B