Chapter 15 – Autoimmunity – Review Questions
Antibody to TSHR
1. All of the following may contribute to
autoimmunity except
a. clonal deletion of self-reactive T cells.
b. molecular mimicry.
c. increased expression of class II MHC
antigens.
d. polyclonal activation of B cells.
2. Which of the following would be considered an
organ-specific autoimmune disease?
a. SLE
b. RA
c. GPA
d. Hashimoto’s thyroiditis
3. SLE can be distinguished from RA on the basis
of which of the following?
a. Joint pain
b. Presence of antinuclear antibodies
c. Immune complex formation with
activation of complement
d. Presence of anti-dsDNA antibodies
4. Which of the following would support a diagnosis
of drug-induced lupus?
a. Antihistone antibodies
b. Antibodies to Smith antigen
c. Presence of RF
d. Antibodies to SS-A and SS-B antigens
5. A peripheral pattern of staining of the nucleus on
IIF is caused by which of the following antibodies?
a. Anti-Sm antibody
b. Anti-SSA/Ro antibody
c. Centromere antibody
d. Anti-dsDNA
6. Which of the following would be considered a
significant finding in Graves disease?
a. Increased TSH levels
b.
c. Decreased T3 and T4
d. Antithyroglobulin antibody
7. Destruction of the myelin sheath of axons
caused by the presence of antibody is
characteristic of which disease?
a. MS
b. MG
c. Graves disease
d. Goodpasture’s syndrome
8. Blood was drawn from a 25-year-old woman with
suspected SLE. A FANA screen was performed
and a speckled pattern resulted. Which of the
following actions should be taken next?
a. Report out as diagnostic for SLE
b. Report out as drug-induced lupus
c. Perform an assay for specific ANAs
d. Repeat the test
9. Which of the following is a mechanism used to
achieve peripheral tolerance?
a. Negative selection of autoreactive T cells
in the thymus
b. Apoptosis of autoreactive B cells in the
bone marrow
c. Editing of B-cell receptors that weakly
recognize self-antigens in the bone marrow
d. Lack of a costimulatory signal to
autoreactive T cells in the lymph nodes
10. Epitope spreading refers to
a. post-translational modifications to self-
antigens.
b. modifications in gene expression that are
not caused by changes in DNA sequence.
c. expansion of the immune response to
unrelated antigens.
d. cross-reaction of the immune response
to a pathogen with a similar self-antigen.
11. Anti-CCP (cyclic citrullinated proteins) is c. Primary biliary cirrhosis
specifically associated with which autoimmune
d. Goodpasture’s syndrome
disease?
a. RA
b. MG
c. Autoimmune hepatitis
d. Goodpasture’s syndrome
12. Which autoantibodies are strongly associated
with granulomatosis with polyangiitis (Wegener’s
granulomatosis)?
a. ANA
b. ANCA
c. AMA
d. SMA
13. A technologist performs an IIF test for ANCAs
and observes that there is an intense fluorescent
staining of the nuclear lobes of the neutrophils.
How can this type of staining be differentiated from
a peripheral ANA pattern?
a. Perform the test on formalin-fixed
leukocytes
b. Perform IIF with HEp-2 cells
c. Perform an ELISA for ANCAs
d. All of the above
14. A 20-year-old woman made an appointment to
see her physician because she was experiencing
intermittent diarrhea. Laboratory testing revealed
that she also had an iron deficiency anemia. To
determine if the patient has celiac disease, her
doctor should order which of the following
laboratory tests?
a. Anti-tTG
b. Antigliadin
c. Antigluten
d. All of the above
15. Antimitochondrial antibodies are strongly
associated with which disease?
a. Autoimmune hepatitis
b. Celiac disease