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CH 16 immuno
| Question | Answer |
|---|---|
| Which response is the type of allograft rejection associated with vascular and parenchymal injury with lymphocyte infiltrates? a. hyperacute rejection b. acute cellular rejection c. acute humoral rejection d. chronic rejection | hyperacute rejection |
| Antigen receptors on T lymphocytes bind HLA class II + peptide complexes with the help of which accessory molecule? a. CD2 b. CD3 c. CD4 d. CD8 | CD4 |
| Patients who have received the following types of grafts are at risk for graft-versus-host disease except for recipients of: a. bone marrow transplants b. lung transplants c. liver transplants d. irradiated leukocytes | irradiated leukocytes |
| Which of the following properties are not exhibited by HLA molecules? a. they belong to the immunoglobulin superfamily b. they are heterodimeric c. they are integral cell membrane glycoproteins d. they are monomorphic | they are monomorphic |
| Kidney allograft loss from intravascular thrombosis w/o cellular infiltration 5 days post-transplant may indicate: a. Hyperacute rejection b. Accelerated humoral rejection c. acute humoral rejection d. acute cellular rejection | accelerated humoral rejection |
| Which reagents would be used in a direct (forward) donor-recipient crossmatch test? a. donor serum and recipient lymphocytes + rabbit serum complement b. recipient serum and donor lymphocytes + rabit serum complment | recipient serum and donor lymphocytes + rabit serum complment |
| The indirect allorecognition pathway involves which? a. processed peptides from polymorphid donor proteins restricted by recipient HLA class II moleculs b. processed peptides from polymorphic recipient protiens restricted by donor HLA class 1 molecules | Processed peptides from polymorphic donor proteins restricted by recipient HLA class 2 molecules |
| Which immunosuppressive agent selectively inhibits IL-2 receptor-mediated activation of T cells and causes clearance of activated T cells from the circulation? a. Mycophenolate mofetil b. Daclizumab c .Cyclosporine mofetil d. Corticosteroids | Daclizumab |
| Phenotyping for HLA class 2 antigens requires B lymphs because: a. B lymphs express HLA class 2 antigens b.B lymphs do not express HLA class 1 antigens c. B lymphs are exquisitely sensitive to complement-mediated lysis | B lymphocytes express HLA class 2 antigens |
| A renal transplant candidate was crossmatched with a donor that was mismatched for only the HLA-B35 antigen. Candidate was known to have an antibody specific for HLA-B35. What combinations of T and B-cell flow cytometric crossmatch results are expected | T cell positive, B cell positive |
| Which of the following donors would be the most appropriate, based on ABO compatibility, for a renal transplant candidate with the ABO type = O? a. O b. A c. B d. AB | O |
| Suppose a 30-year old man was found to be a suitable donor for a kidney transplant to his younger sister. This would be an example of: a. autograft b. allograft c. isograft d. xenograft | allograft |
| The classical (transplant) antigens, also known as _______. | MHC - major histocompatibility complex antigens |
| MHC antigens are composed of the _____ and ______. | Class 1 and 2 portines |
| Class 1 proteins include: | HLA-A HLA-B HLA-C |
| Class 2 proteins include: | HLA-DR HLA-DQ HLA-DP |
| Class 1 proteins are expressed on: | all nucleated cells |
| Class 2 protiens are expressed on: | antigen-presenting cells APCs |
| Differences between HLA antigens on a graft donor and recipient induce immune responses that lead to: | graft rejection |
| Tissue transfer in the same individual is known as: | autograft |
| Transfer of cells or tissues to a genetically identical individual is known as: | Isograft |
| Graft between genetically nonidentical individuals of the same species | Allograft |
| Transplant between member of different species is known as: | Xenograft |
| Example of graft: Saphenous vein in cardiac bypass | Autograft |
| Example of graft: Transplant between identical twins | Isofraft |
| Example of graft: Graft from an unrelated cadaver donor | Allograft |
| Example of graft: transplant of pig valve into human heart | Xenograft |
| Cytotoxic T cells from the recipient bind directly to foreign HLA antigens on cells of the allograft and release cytotoxic factors | Direct Allorecognition |
| Host APCs present foreign MHC antigens on graft cells to recipient Th cells | Indirect Allorecognition |
| The recipient's immune system recognizes foreign HLA proteins on graft cells by two mechanisms: | direct and indirect allorecognition |
| What are the major types of graft rejection? | -hyperacute -accelerated -acute -chronic |
| This type of graft rejection occurs minutes to hours after the transplant. | Hyperacute |
| This type of graft rejection occurs several days after the transplant | Accelerated |
| This type of graft rejection occurs days to months after the transplant | Acute |
| This type of graft rejection occurs 1 year or more after the transplant | Chronic |
| Lymphoid cells in graft mount immune response against recipient's histocompatibility antigens; caused by immune response of T cells in donor HSC, lung, or liver transplants | GVHD (graft-versus-host-disease) |
| Involves massive cytokine release, inflammation, and destruction of various tissues | GVHD |
| When does GVHD occurs? | 100 days or more after transplant |
| What are the 4 types of testing for HLA antibodies? | 1. HLA typing by CDC method 2. ELISA 3. Flow cytometry 4. Crossmatching |
| What are the alternatives to the CDC method in the screening and identification of HLA antibodies? | ELISA and flow cytometry |
| HLA haplotypes are inherited in a _____ fashion; thus, siblings may be good organ donors. | Mendelian |
| _________ are needed to suppress rejection of HLA-mismatched grafts. | immunosuppressive agents |
| The ______ is an in vitro correlate of direct allorecognition. | MLR (mixed lymphocyte reaction) |
| ABO, HLA, and certain endothelieal antigens may elicit: | hyperacute rejection |
| _____ rejection involves intravascular thrombosis and necrosis of donor tissue. | accelerated rejection |
| _____ rejection results from a process of graft arteriosclerosis characterized by progressive fibrosis and scarring with narrowing of the vessel lumen caused by proliferation of smooth muscle cells. | Chronic |
| HLA typing methods are now commonly employed in histocompatibility laboratories because: | their higher resolution, reagent quality, and amenability to higher throughput formats overcome the limitations of CDC-based methods |
Created by:
Vlandon98