Case 7 Questions 1-10

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Question 1

What is the first line treatment for a patient in anaphylaxis

  1. 0.5mLs of 1/1000 adrenaline, IM
  2. 5mls of 1/10000 adrenaline, IV
  3. Nebulised salbutamol
  4. 10L of oxygen in a non-rebreather mask
  5. Watch and wait for further signs

The correct answer is option a 0.5mLs of 1/1000 adrenaline, IM

Correct dose of adrenaline and method of delivery
b. Incorrect, it is IM, not IV and should be a 1/1000 solution
c. Whilst may be given it is not first line
d. 15L, not 10 and adrenaline is first line
e. In anaphylaxis treatment should be given without delay

Question 2

What is the MOA and effect of salbutamol?

  1. LABA, causing bronchodilation
  2. LABA, causing bronchoconstriction
  3. SABA, causing bronchoconstriction
  4. SABA, causing bronchodilation
  5. SAMA, causing bronchodilation

The correct answer is option b SABA, causing bronchodilation

Correct, salbutamol is a short acting beta agonist, causing bronchodilation
a. Correct effect, but is a SABA, not a LABA
b. Causing bronchodilation and is short acting
c. Causes bronchodilation, not bronchoconstriction
e. Is a beta agonist, not a muscarinic antagonist

Question 3

Which of these does not come from a myeloid progenitor cell?

  1. Megakaryocyte
  2. Basophil
  3. Neutrophil
  4. Myeloblast
  5. Natural killer cell

The correct answer is option b Natural killer cell

Correct, as this is from a lymphoid progenitor
a. Incorrect as this is from the myeloid progenitor
b. Incorrect as this is from the myeloid progenitor
c. Incorrect as this is from the myeloid progenitor
d. Incorrect as this is from the myeloid progenitor

Question 4

What type of immunity are vaccines?

  1. Innate
  2. Artificial active
  3. Artificial passive
  4. Natural active
  5. Natural passive

The correct answer is option b Artificial active

This is correct as vaccines are not seen in nature and cause an immune response
a. This is incorrect and not important in this question
c. Incorrect, an example of this is antibody infusions
d. Incorrect, an example of this would be an infection
e. Incorrect, an example of this would be antibodies in a mothers breastmilk

Question 5

A 7 year old has contracted a rhinovirus infection and in response creates antibodies. What is the name of the site on the antigen that their antibodies bind to?

  1. Alloantibody
  2. Autoantibody
  3. Epitope
  4. Paratope
  5. Antitope

The correct answer is option b Epitope

Correct and also includes the antigen binding site of T-cell receptors too!​
a. Incorrect, An antibody formed in response to pregnancy, transfusion, or transplantation targeted against a blood group antigen that is not present on the pregnant person’s or recipients red blood cells.​
b. This is an antibody that targets “self” antigens​
d. An alternative term for the antigen binding site
e. This is fake and is a red herring

Question 6

Which of the following are not 1 of the 4 “R’s” describing the functions of the immune system?

  1. Recognition
  2. Retention
  3. Regulation
  4. Renewal
  5. Reaction

The correct answer is option b Renewal

Correct as this is not a step of the immune system
a. This is step 1 and is for the recognition of antigens
b. This is step 4 and allows long lasting protection
c. This controls the immune system to protect the self-cells
e. This is step 2 and contains and eliminates infections and toxins

Question 7

Which of the following statements is a false statement about the differences between B cells and T cells?

  1. B cells are capable of producing antibodies by differentiating into plasma cells, while T cells cannot
  2. T cells can only recognise “processed antigens” that are presented on MHC-2 complexes while B cells can recognise native antigens
  3. B cells are created in the bone marrow while T cells are created in the thymus
  4. T cells are capable of producing much more cytokines than B cells
  5. Both T cells and B cells can become memory cells

The correct answer is option b B cells are created in the bone marrow while T cells are created in the thymus

Both B and T cells are created in the bone marrow. But B cells undergo maturation in the bone marrow, while T cells mature in the thymus!​
a. Incorrect as B cells are capable of producing antibodies by differentiating into plasma cells, while T cells cannot
b. Incorrect as T cells can only recognise “processed antigens” that are presented on MHC-2 complexes while B cells can recognise native antigens
d. Incorrect as T cells are capable of producing much more cytokines than B cells
e. Incorrect as Both T cells and B cells can become memory cells​

Question 8

Which of the following inflammatory mediators are not capable of causing blood vessel vasodilation to aid the extravasation of immune cells?

  1. Plasma proteins created by the liver​
  2. Histamine created by mast cells and basophils
  3. Prostaglandins created by mast cells, neutrophils and basophils
  4. Cytokines created by mast cells and macrophages
  5. Leukotrienes created by mast cells, neutrophils and basophils

The correct answer is option b Leukotrienes created by mast cells, neutrophils and basophils

Correct as these not cause vasodilation
a. Incorrect as these can cause vasodilation
b. Incorrect as these can cause vasodilation
c. Incorrect as these can cause vasodilation
e. Incorrect as these can cause vasodilation

Question 9

Select the statement which best describes atopy?

  1. Immunological hypersensitivity triggered by certain allergens
  2. Failure of the system that suppresses cellular/humoral immune responses
  3. Decreased immune tolerance
  4. Tendency to develop allergic disease
  5. Associated with a triad of intrinsic asthma, infectious rhinitis and eczema

The correct answer is option b Tendency to develop allergic disease

Correct as it is a tendancy towards getting a response, but not the actual reaction
a. This is an allergic reaction, not atopy
b. This describes allergy, not atopy
c. This describes allergy, not atopy
e. It is extrinsic asthma and allergic rhinitis

Question 10

Montelukast is a medication used in the management of Asthma. What is its mechanism of action?

  1. SABA
  2. Bronchodilator
  3. Leukotriene receptor agonist
  4. SAMA
  5. LABA

The correct answer is option b Leukotriene receptor agonist

Correct class of drug
a. Incorrect, an example of this is salbutamol
b. General term for drugs that widen the bronchi
d. Incorrect, an example of this is ipratropium
e. Incorrect, an example of this is salmeterol