PART V Immunotropic & Antiallergic Agents
01. Immune system is the integrated body system of organs, tissues, cells, and cell products that differentiates self from nonself and neutralizes potentially pathogenic organisms or substances. This consideration is:
a) True
b) False
02. Antigen is any of various substances, including toxins, bacteria, and the cells of transplanted organs, that when introduced into the body stimulate the production of antibodies. It is also called an allergen or immunogen. This consideration is:
a) True
b) False
03. Antibody is a protein substance produced in the blood or tissues in response to a specific antigen, such as a bacterium or a toxin that destroys or weakens bacteria and neutralizes organic poisons, thus forming the basis of immunity. This consideration is:
a) True
b) False
04. Innate immunity refers to:
a) Antigen-nonspecific defense mechanisms that a host uses immediately or within several hours after exposure to an antigen. This is the immunity one is born with and is the initial response by the body to eliminate microbes and prevent infection
b) Antigen-specific defense mechanisms that take several days to become protective and are designed to react with and remove a specific antigen. This is the immunity one develops throughout life
05. Adaptive (acquired) immunity refers to:
a) Antigen-nonspecific defense mechanisms that a host uses immediately or within several hours after exposure to an antigen. This is the immunity one is born with and is the initial response by the body to eliminate microbes and prevent infection
b) Antigen-specific defense mechanisms that take several days to become protective and are designed to react with and remove a specific antigen. This is the immunity one develops throughout life
06. Allergic reaction is:
a) A local or generalized reaction of an organism to internal or external contact with a specific allergen to which the organism has been previously sensitized
b) A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes a loss of function
07. Immediate allergy reaction (type I allergic reaction) is:
a) An allergic or immune response that begins within a period lasting from a few minutes to about an hour after exposure to an antigen to which the individual has been sensitized
b) An allergic reaction that becomes apparent only hours after contact
c) An allergic reaction that results from the formation of antigen-antibody complexes between a foreign antigen and IgM or IgG immunoglobulins. (It occurs during blood transfusion reactions and in hemolytic disease of the newborn)
d) An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes that cause tissue damage
08. Delayed allergy reaction (type IV allergic reaction) is:
a) An allergic or immune response that begins within a period lasting from a few minutes to about an hour after exposure to an antigen to which the individual has been sensitized
b) An allergic reaction that becomes apparent only hours after contact
c) An allergic reaction that results from the formation of antigen-antibody complexes between a foreign antigen and IgM or IgG immunoglobulins. (It occurs during blood transfusion reactions and in hemolytic disease of the newborn)
d) An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes that cause tissue damage
09. Immunodeficiency:
a) A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes a loss of function
b) A disorder or deficiency of the normal immune response
c) A disease resulting from an immune reaction produced by an individual’s white blood cells or antibodies acting on the body’s own tissues or extracellular proteins
d) All of the above
10. Anaphylactic shock is a severe, sometimes fatal allergic reaction characterized by a sharp drop in blood pressure, urticaria, and breathing difficulties that is caused by exposure to a foreign substance, such as a drug or bee venom, after preliminary or sensitizing exposure. This consideration is:
a) True
b) False
11. H1 histamine receptor subtype is distributed in:
a) Smooth muscle, endothelium and brain
b) Gastric mucosa, cardiac muscle, mast cells and brain
c) Presynaptically in brain, mesenteric plexus and other neurons
d) All of the above
12. H2 histamine receptor subtype is distributed in:
a) Smooth muscle, endothelium and brain
b) Gastric mucosa, cardiac muscle, mast cells and brain
c) Presynaptically in brain, mesenteric plexus and other neurons
d) All of the above
13. Most tissue histamine is sequestered and bound in:
a) Granules in mast cells or basophils
b) Cell bodies of histaminergic neurons
c) Enterochromaffin-like cell of the fondus of the stomach
d) All of the above
14. These categories of histamine H1 antagonists are noted for sedative effects, EXCEPT:
a) Piperidines; i.e. Loratadine, Fexofenadine
b) Ethanolamines (aminoalkyl ethers); i.e. Dimedrol, Clistin
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Diprazine, Promethazine
15. Which category of histamine H1 antagonists is noted for the best antiemetic action?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Ethanolamines (aminoalkyl ethers); i.e. Doxylamine
c) Piperazines; i.e. Hydroxyzine, Cyclizine
d) Ethylenediamines; i.e. Suprastine
16. These categories of histamine H1 antagonists are noted for the anticholinergic effect, EXCEPT:
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Piperazines; i.e. Hydroxyzine, Cyclizine
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Diprazine, Promethazine
17. Which category of histamine H1 antagonists is noted for the alpha-adrenoreceptor-blocking effect?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Ethanolamines (aminoalkyl ethers); i.e. Doxylamine, Dimedrol
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Diprazine, Promethazine
18. Which category of histamine H1 antagonists is noted for the highest local anesthetic effect?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Piperidines; i.e. Loratadine, Fexofenadine
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Promethazine
19. Which category of histamine H1 antagonists is recognized for as second-generation antihistamines?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Piperidines; i.e. Loratadine, Fexofenadine
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Promethazine
20. These histamine H1 antagonists are recognized for as second-generation antihistamines, EXCEPT:
a) Astemizole
b) Loratadine (Claritin)
c) Cetirizine (Zyrtec)
d) Suprastine
21. Which of histamine H1 antagonists is noted for the serotonin-blocking effect?
a) Brompheniramine
b) Cyproheptadine
c) Suprastine
d) Dimedrol
22. Which of the following histamine H1 antagonists is a long-acting (up to 24-48 h) antihistamine drug?
a) Diazoline
b) Diprazine
c) Suprastine
d) Dimedrol
23. Which of histamine H1 antagonists is noted for the ulcerogenic effect?
a) Diazoline
b) Loratadine
c) Suprastine
d) Dimedrol
24. Indication for administration of histamine H1 antagonists is:
a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)
b) Motion sickness and vestibular disturbances
c) Nausea and vomiting in pregnancy (“morning sickness”)
d) All of the above
25. Indications for administration of histamine H1 antagonists are the following EXCEPT:
a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)
b) Management of seizure states
c) Nausea and vomiting in pregnancy (“morning sickness”)
d) Treatment of sleep disorders
26. Side effect of first-generation histamine H1 antagonists is:
a) Aplastic anemia
b) Vomiting, tinnitus, decreased hearing
c) Sedation
d) Gastric ulcers and upper gastrointestinal bleeding
27. For those first-generation histamine H1 antagonists that cause significant sedation, addition of other drugs that cause central nervous system depression produces additive effects and is contraindicated while driving or operating machinery. This consideration is:
a) True
b) False
28. Immunosuppressive drug is any of a variety of substances used to prevent production of antibodies, protein produced by the immune system in response to the presence in the body of antigens: foreign proteins or polysaccharides such as bacteria, bacterial toxins, viruses, or other cells or proteins. This consideration is:
a) True
b) False
29. Immunosupressive effect of glucocorticoids is caused by
a) Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages and other antigen-presenting cells
b) Suppression of cyclooxygenase II expression that results in reducing amount of an enzyme available to produce prostoglandins
c) Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis
d) All of the above
30. Antiallergic effect of glucocorticoids is caused by:
a) Suppression of leukocyte migration and stabilizing lysosomal membranes
b) Reverse the capillary permeability associated with histamine release
c) Suppression of the immune response by inhibiting antibody synthesis
d) All of the above
31. The Immunosuppressive agent is:
a) Corticosteroids
b) Cyclosporine
c) Tacrolimus (FK 506)
d) All of the above
32. Class of cyclosporine A is:
a) Interferons
b) Immunosuppressive agents
c) Monoclonal antibodies
d) Immunoglobulins
33. Mechanism of action of cyclosporine A is:
a) Complement-mediated cytolysis of T lymphocytes
b) ADCC towards T lymphocytes
c) Inhibits calcineurin
d) Compete for Fc receptors with autoantibodies
34. Side effect of cyclosporine A is:
a) Tremor
b) GI disturbance
c) Hepatotoxicity
d) All of the above
35. Side effect of cyclosporine A is:
a) Tremor
b) Anorexia
c) Chills
d) Myalgia
36. Side effect of cyclosporine A is:
a) Diarrhea
b) Headache
c) GI disturbance
d) Immunosuppression
37. Indication of cyclosporine A is:
a) Secondary immunodeficiency
b) Hairy cell leukemia
c) Primary immunodeficiency
d) Idiopathic nephrotic syndrome
38. Half-life of cyclosporine A is:
a) 25-35 minutes
b) 21 days
c) 4 – 16 hours
d) 19 hours
39. Class of I.V. IgG preparation is:
a) Monoclonal antibodies
b) Immunosuppressive agents
c) Interferons
d) Immunoglobulins
40. Mechanism of action of I.V. IgG preparation is:
a) Inhibits CD3 receptor
b) Inhibits calcineurin
c) Complement-mediated cytolysis of T lymphocytes
d) Compete for Fc receptors with autoantibodies
41. Half-life of I.V. IgG preparation is:
a) 25-35 minutes
b) 19 hours
c) 4 – 16 hours
d) 21 days
42. Indication for I.V. IgG preparation administration is:
a) Kaposi’s sarcoma
b) Acute rejection of organ transplant
c) Condyloma acuminatum
d) Prophylaxis of certain infections
43. Cytotoxic agents are the following EXCEPT:
a) Azathioprine
b) Cyclosporine
c) Leflunomide
d) Cyclophosphamide
44. Class of sirolimus (rapamycin) is:
a) Immunoglobulins
b) Interferons
c) Immunosuppressive agents
d) Monoclonal antibodies
45. Mechanism of action of sirolimus (rapamycin) is:
a) Anti-idiotype antibodies against autoantibodies
b) Modulation of CD3 receptor from the cell surface
c) Inhibits calcineurin
d) ADCC towards T lymphocytes
46. Monoclonal antibodies is:
a) Trastuzumab
b) Rituximab
c) OKT-3
d) All of the above
47. Class of OKT-3 is:
a) Immunosuppressive agents
b) Monoclonal antibodies
c) Interferons
d) Immunoglobulins
48. Half-life of OKT-3 is:
a) 18-24 hours
b) 25-35 minutes
c) 4 – 16 hours
d) 21 days
49. The indication for interferon gamma administration is:
a) Idiopathic nephrotic syndrome
b) Hepatitis C virus infection
c) Chronic granulomatous disease
d) Hairy cell leukemia
50. The side effect of interferon gamma is:
a) Hypertension
b) Pulmonary edema
c) Nephrotoxicity
d) Fatigue
51. Half-life of interferon gamma is:
a) 21 days
b) 19 hours
c) 4 – 16 hours
d) 25-35 minutes
52. Half-life of interferon alpha is:
a) 18-24 hours
b) 4-16 hours
c) 25-35 minutes
d) 21 days
53. The indication for interferon alpha administration is:
a) Hepatitis C virus infection
b) Kaposi’s sarcoma
c) Condyloma acuminatum
d) All of the above
54. Indication for interferon alpha administration is:
a) Autoimmune diseases
b) Rheumatoid arthritis
c) Organ transplantation
d) Hepatitis C virus infection
55. Indication for interferon alpha administration is:
a) Prophylaxis of sensitization by Rh antigen
b) Rheumatoid arthritis
c) Kaposi’s sarcoma
d) Chronic granulomatous disease
56. Class of tacrolimus (FK-506) is:
a) Immunoglobulins
b) Immunosuppressive agents
c) Interferons
d) Monoclonal antibodies
57. Mechanism of action of tacrolimus (FK-506) is:
a) Inhibits CD3 receptor
b) Complement-mediated cytolysis of T lymphocytes
c) Substitution for patient’s defiecient immunoglobulins
d) Inhibits calcineurin
58. Immunomodulating agent is:
a) Sirolimus (rapamycin)
b) Levamisole
c) Tacrolimus (FK 506)
d) All of the above
59. Immunomodulating agents are the following EXEPT:
a) Cytokines
b) Levamosole
c) BCG (Bacille Calmette-Guérin)
d) Tacrolimus (FK-506)
60. Mechanism of action of levamisole is:
a) Inhibits CD3 receptor
b) Complement-mediated cytolysis of T lymphocytes
c) Substitution for patient’s defiecient immunoglobulins
d) Increase the number of T-cells
