I7: C

Question 1

Which of the following is a potential negative outcome of excessive or poorly controlled inflammation

Answer 1

B. Tissue damage via reactive oxygen species ROS and proteases

Question 2

The presence of persistent antigens such as ________ in the stomach can lead to chronic inflammation like gastritis

Answer 2

Helicobacter pylori

Question 3

Which of the following are recognized reasons why inflammation may persist and become chronic

Answer 3

A C D

Question 4

Explain how metabolic dysregulation in obesity contributes to chronic inflammation

Answer 4

Obesity causes adipose tissue to release pro inflammatory cytokines creating chronic low grade inflammation which contributes to diseases like type 2 diabetes and MASLD

Question 5

In the activation of a naive T cell what constitutes Signal 1

Answer 5

C. Interaction of the TCR with the peptide HLA class II complex on an APC

Question 6

Signal 2 for T cell activation involves the engagement of co stimulatory molecules ________ on the dendritic cell with CD28 on the T cell

Answer 6

CD80 and CD86

Question 7

Which of the following are required for full activation and proliferation of naive T cells

Answer 7

A B C

Question 8

Describe the three signal model of naive T cell activation

Answer 8

Signal 1 is TCR recognition of peptide MHC on APC Signal 2 is CD28 binding to CD80 or CD86 on the APC These signals induce IL2 production which drives T cell proliferation differentiation and survival

Question 9

Unlike T cells B cells do not require which of the following to bind antigen

Answer 9

B. Antigen presenting cell

Question 10

Activated CD4 T helper cells produce cytokines that cause B cells to multiply and differentiate into ________ which produce antibodies

Answer 10

plasma cells

Question 11

Which cytokines may be produced by CD4 T helper cells to activate B cells

Answer 11

A B C

Question 12

Describe the mechanism of B cell activation

Answer 12

B cells bind antigen via the BCR internalize it and present it to CD4 T helper cells These helper cells release cytokines which stimulate B cell proliferation and differentiation into antibody secreting plasma cells

Question 13

Which T cell type clears antigens by releasing granzymes to induce apoptosis

Answer 13

B. CD8 cytotoxic T cell

Question 14

CD4 T helper cells do not directly kill infected cells but instead ________ the immune response

Answer 14

coordinate

Question 15

What happens to the effector T cell population after infection is resolved

Answer 15

A C

Question 16

Contrast the action of CD8 and CD4 T cells

Answer 16

CD8 cytotoxic T cells directly kill infected or cancerous cells using perforin and granzymes CD4 helper T cells regulate immune responses by releasing cytokines that activate other immune cells

Question 17

Which transcription factor drives differentiation of Th1 cells

Answer 17

C. T bet

Question 18

Differentiation into Th2 cells is driven by the transcription factor ________

Answer 18

GATA3

Question 19

Th17 differentiation is associated with which of the following

Answer 19

A B

Question 20

Match T helper subsets to pathogens and transcription factors

Answer 20

Th1 uses T bet and responds to intracellular pathogens Th2 uses GATA3 and responds to parasites and allergens Th17 uses RORgt and responds to extracellular bacteria and fungi

Question 21

Which enzyme is the first line antioxidant defense against ROS

Answer 21

B. Superoxide dismutase

Question 22

________ and glutathione peroxidase break down hydrogen peroxide into water and oxygen

Answer 22

Catalase

Question 23

Which enzymes help prevent ROS damage

Answer 23

A C D

Question 24

Explain the synergistic mechanism of SOD and CAT or GPX in controlling oxidative stress

Answer 24

SOD converts superoxide radicals into hydrogen peroxide Catalase and glutathione peroxidase then convert hydrogen peroxide into water and oxygen preventing oxidative tissue damage

Question 25

Which cytokine acts on adrenocortical cells to influence cortisol release

Answer 25

B. IL6

Question 26

Cortisol suppresses inflammation by antagonizing the translocation of ________

Answer 26

NF kB

Question 27

Effects of the cortisol glucocorticoid receptor complex include

Answer 27

A C D

Question 28

Describe how adrenaline acts as an endogenous immunosuppressive strategy

Answer 28

Adrenaline binds beta2 adrenergic receptors increasing cAMP This inhibits lymphocyte activation proliferation chemotaxis and release of ROS from phagocytes

Question 29

Which organ produces acute phase reactants such as CRP

Answer 29

C. Liver

Question 30

C reactive protein is elevated in inflammatory diseases such as ________ ________

Answer 30

rheumatoid arthritis

Question 31

Clinical uses of CRP measurement include

Answer 31

A B

Question 32

Describe the protective role of alpha 1 antitrypsin

Answer 32

Alpha 1 antitrypsin neutralizes proteases such as neutrophil elastase preventing tissue damage in organs like the lungs and liver

Question 33

A deficiency of alpha 1 antitrypsin leads to which disease

Answer 33

B. COPD

Question 34

CTLA 4 binds with high affinity to ________ to induce T cell anergy

Answer 34

CD80 or CD86

Question 35

Which cells express CTLA 4

Answer 35

A C

Question 36

Explain how CTLA 4 downregulates T cell activation

Answer 36

CTLA 4 competes with CD28 for binding to CD80 or CD86 on APCs Because CTLA 4 has higher affinity it prevents costimulation leading to T cell anergy

Question 37

Abatacept treats rheumatoid arthritis by doing what

Answer 37

B. Blocking T cell binding to B7

Question 38

Ipilimumab is an anti CTLA 4 antibody used as a ________ drug

Answer 38

melanoma

Question 39

Which are complement activation pathways

Answer 39

A C D

Question 40

What are the three outcomes of complement activation

Answer 40

Inflammatory cell recruitment via C3a and C5a Opsonization via C3b Pathogen lysis through membrane attack complex formation

Question 41

Deficiency of C1 esterase inhibitor causes which condition

Answer 41

C. Hereditary angioedema

Question 42

The most serious manifestation of hereditary angioedema is respiratory obstruction and ________

Answer 42

asphyxiation

Question 43

Consequences of uncontrolled complement activation in C1 esterase inhibitor deficiency include

Answer 43

A B D

Question 44

How is hereditary angioedema diagnosed

Answer 44

Diagnosis involves measuring circulating C1 esterase inhibitor levels in serum

Question 45

Which drug class is the most powerful broad spectrum anti inflammatory

Answer 45

C. Corticosteroids

Question 46

Glucocorticoids primarily work by blocking ________ production

Answer 46

cytokine

Question 47

Which drugs prevent lymphocyte proliferation

Answer 47

A B C

Question 48

Describe the formation of the membrane attack complex MAC

Answer 48

C5b binds C6 and C7 forming a complex that inserts into the membrane C8 then binds and multiple C9 molecules polymerize to form a pore causing osmotic lysis

Question 49

Which complement component mediates opsonization

Answer 49

B. C3b

Question 50

Normal mitochondrial metabolism produces the ________ anion radical as a byproduct

Answer 50

superoxide