Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 1: Fundamentals of Medicine
04 Clinical immunology MCQs
Davidson's Medicine - Part 1: Fundamentals of Medicine · Davidson's Principles of Medicine · 13 practice questions
- Immune deficiency patterns
- Periodic fever
- Inflammation
- Inflammation and cytokines
- Complement
- Biologic therapy
- Primary antibody deficiency
- Immunotherapy
1. A kidney transplant recipient has rapid graft destruction within minutes of reperfusion; another develops rejection at 2 weeks. Which mechanisms fit in order?
- APre-existing antibodies against donor HLA, then T-cell-mediated acute rejection
- BT-cell-mediated, then antibody-mediated hyperacute
- CChronic vascular, then hyperacute
- DImmune complex, then complement-mediated
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A. Pre-existing antibodies against donor HLA, then T-cell-mediated acute rejection Hyperacute rejection is mediated by pre-formed antibodies against donor HLA.
2. A child has haematuria, oedema, low C3 and low C4 ten days after streptococcal pharyngitis. Which mechanism and management are correct?
- AImmune complex activation of the classical pathway; supportive care with salt restriction and diuretics
- BComplement gene deficiency; plasma exchange
- CIgE mediated; antihistamines
- DT-cell mediated; steroids
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A. Immune complex activation of the classical pathway; supportive care with salt restriction and diuretics Circulating immune complexes consume complement; antibiotics are rarely needed because the disease follows resolution of infection.
3. A patient with AIDS-like T-cell deficiency has cough, bilateral ground-glass shadowing and CMV viraemia. Which organisms are characteristic of T-cell deficiency in the text's table?
- ANeisseria meningitidis and Neisseria gonorrhoeae
- BStreptococcus pneumoniae and Haemophilus influenzae
- CPneumocystis jirovecii, CMV, EBV and Mycobacterium tuberculosis
- DGiardia lamblia and Cryptosporidia alone
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C. Pneumocystis jirovecii, CMV, EBV and Mycobacterium tuberculosis T-lymphocyte deficiency predisposes to viruses, fungi and mycobacteria; antibody deficiency to encapsulated bacteria and enteric protozoa.
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