Topic 5. Allergy

1. Pain in the heart and joints and pneumonia appeared in a patient three weeks later acute myocardial infarction. What is the main mechanism of development of post-infarction Dressler’s syndrome?

A. Ischemia of myocardium

B. Resorption of enzymes from necrotized area of myocardium

C. Secondary infection

D. Thrombosis of vessels

E. Autoimmune inflammation

2. A patient addressed to a dentist with complaints of redness and edema of mucous membrane of his mouth a month later dental prosthesis. Allergic stomatitis was diagnosed in this patient. What type of allergic reaction by Gell and Cumbs underlies this disease?

A. Cytotoxic

B. Delayed-type hypersensitivity

C. Immune complex-mediated

D. Anaphylactic

E. Stimulating

3. Anaphylactic shock developed in a patient with botulism after second injection of antitoxic antibotulinus serum mixture. What is the main mechanism of anaphylaxis?

A. Interaction of T-lymphocytes with mediators

B. Interaction of antigen with IgM

C. Interaction of macrophages with antigens

D. Interaction of antigen with IgE

E. Interaction of T-lymphocytes with tissue basophils

4. In a 27-years-old man tuberculin test was carried out. Following was observed 24 hours later: infiltration with size of 40x35 mm at the site of injection and hyperemia of skin above it. What group of biologic active substances causes development of allergic inflammation in this patient?

A. Lymphokines

B. Biogenic amines

C. Prostaglandins

D. Leukotriens

E. Kinins

5. Purulent endometritis developed in a woman after delivery. Treating with antibiotics - inhibitors of murein synthesis was ineffective. Wide spectrum bactericidal antibiotic was administered to her. 6 hours later temperature rapidly increased up to 40^oC with shivering, pains in muscles appeared, BP dropped down to 70/40 mmHg, and oligura developed in this woman. What is the main reason for this condition development?

A. Endotoxic shock

B. Toxic effect of preparation

C. Internal bleeding

D. Anaphylactic shock

E. Bacteremia

6. A 24-years-old patient has edema of face and increase in BP, which appeared 1.5 weeks later severe streptococcus tonsillitis. The patient has hematuria and proteinuria of 1.2 g/L. Anti-streptococcus antibodies and decrease in content of compliment system components were revealed in patient’s blood. Which microvessels do deposits of immune complexes localize in and cause nephropathy?

A. Proximal tubules

B. Glomerule

C. Descendent tubules

D. Loop of Henle

E. Pyramids

7. Nausea, fatigue, stomachache, palpitation, difficult respiration, and skin blisters developed in a patient 25 minutes later injection of antibiotics. What stage of allergic reaction is observed in this patient?

A. Pathochemical

B. Biochemical

C. Pathophysiological

D. Immunological

E. Sensibilization

8. Skin tuberculin test was carried out in a patient with chronic lung tuberculosis. Local hyperemia and edema appeared in the site of inracutaneous introduction of tuberculin preparation within 24-48 hours. What cells are primary effectors in mechanism of this reaction?

A. Neutrophils

B. T-lymphocytes

C. B-lymphocytes

D. Endotheliocytes

E. Smooth muscle cells of microvessels

9. Hyperemia, swelling and then necrosis of tissue, their rejection and ulcer (Arthus phenomenon) develop at the rabbit in the place of secondary intracutaneus injection of a substance with strongly pronounced antigenic properties (for example horse serum). What factors play the main role in pathogenesis of this phenomenon?

A. Antibodies presented by IgE

B. Antibodies presented by IgD

C. Antibodies presented by IgA

D. Antibodies presented by IgG and/or IgM

E. Specific T-lymphocytes-effectors

10. Skin rash, itching, swelling and pain in joints, increase in body temperature, and proteinuria appeared in a patient in 5-8 days after use lots of medical serum. Serum sickness was diagnosed. What is the main factor in pathogenesis of this syndrome?

A. Primary systemic accumulation of circulating immune complexes in the blood

B. Primary systemic degranulation of mast cells in the organism

C. Primary systemic activation of T-killers

D. Primary systemic activation of endoteliocytes

E. Primary systemic cytolysis of blood cells

11. Allergic diagnostic tests are used for the diagnosis of many infectious diseases (tuberculosis, brucelosis, tularemia etc). Diagnosis is confirmed if papula and redness appear in the place of the allergen injection. Antigens interaction reaction is conditioned by:

A. IgE and lymphokines

B. IgM and macrophages

C. T-lymphocytes and lymphokines

D. IgE and T-lymphocytes

E. IgM and tissue basophiles

12. Catarrhal inflammation of bulbar conjunctiva and nose mucous membrane develop in patient every year in spring and early summer, when trees and flowers are in blossom. Production of specific antibodies to pollen underlies this syndrome. What cells activate and develop exocytosis in this syndrome?

A. Neutrophils

B. Macrophages

C. Lymphocytes

D. Mast cells

E. Throbocytes

13. An 18-year-old man with shoulder phlegmon got intramuscular injection of penicillin. Tachycardia, thread-like pulse; decrease in BP down to 80/60 mmHg occur after that. What kind of pharmacologic reaction develops?

A. Potentiation

B. Reflex action

C. Central action

D. Anaphylaxis

E. Peripheral action

14. Patient has been wearing removable dental prosthesis for 7 days. Soreness, swelling and hyperemia of prosthesis bed appear in the patient after that. Inflammation subsides after prosthesis taking off and develops again after prosthesis putting on. What process underlies the inflammation development?

A. Mechanical irritation

B. Hypersalivation

C. Hyposalivation

D. Resorption

E. Secretion

15. Thyrotoxicosis was diagnosed in a patient. Antithyroid antibodies were found in his blood. Which type of allergic reaction is observed at development of this disease?

A. Immune complex-mediated

B. Stimulating

C. Anaphylactic

D. Cytotoxic

E. Delayed type hypersensitivity

16. Hives, itching of the skin, swelling of the skin and mucous membranes, swelling of lymphatic nodes develop in the patient in 9 days after injection of medicinal serum. What disease develops?

A. Pollinosis

B. Serum sickness

C. Shwartzman’s phenomenon

D. Overy phenomenon

E. Quincke’s edema

17. Dressler’s syndrome was diagnosed at the patient 1.5 month later myocardium infarction. It is characterized by pericarditis, pleurisy, and pneumonia. What is the reason for this syndrome?

A. Sensitization of the organism by myocardium antigens

B. Decrease in resistance to microorganisms

C. Activation of saprophytic microflora

D. Intoxication of organism by products of necrosis

E. Release of myocardial enzymes to the blood

18. It is known that bronchial asthma develops by mechanism of immediate hypersensitivity, which includes 3 sequential stages:

A. Immunological, pathochemical, pathophisiological

B. Pathochemical, pathophisiological, immunological

C. Pathochemical, immunological, pathophisiological

D. Pathophisiological, immunological, pathochemical

E. Pathophisiological, pathochemical, immunological

19. A 20-year-old man has injury of the right testicle. What danger does it brings for the left (healthy) testicle?

A. Mimicry of antigens and development of antibody-mediated damage

B. Development of infectious process

C. Development of atrophy

D. Development of hypertrophy

E. No danger

20. Guinea-pig’s nephrocytotoxic serum was injected to the rabbit under the experiment. What human disease is modeled in this case?

A. Nephrotic syndrome

B. Acute pyelonephritis

C. Chronic renal insufficiency

D. Acute diffuse glomerulonephritis

E. Chronic pyelonephritis

21. Acute glomerulonephritis appeared in the patient 2 weeks later purulent tonsillitis. Antibodies against microorganism antigens were found at the patient. Which microorganism are these antibodies against?

A. Hemolytic streptococcus

B. Staphylococcus

C. Pneumococcus

D. Mycobacterium tuberculosis

E. Meningococcus

22. Severe edema of soft tissues of upper and lower jaws, rash on the skin of face, redness, and itching appear in the patient in response to using anesthetic drag at tooth extraction. Which pathological process underlies the reaction to anesthetic?

A. Inflammation

B. Drag toxic action

C. Allergy

D. Insufficiency of blood circulation

E. Disorder of lymph outflow

23. Novocain was injected by dentist for anesthesia at tooth extraction. Symptoms of anaphylactic shock appeared at the patient few minutes later. Patient has drop of BP, tachypnea, loss of consciousness and convulsions. What type of reaction is it?

A. Immediate type hypersensitivity

B. Cytolytic or cytotoxic reactions

C. Arthus phenomenon reactions

D. Delayed type hypersensitivity

E. Stimulating allergic reaction

24. Man with the caries is subjected to constant sensitization by streptococcus antigen. What disease can appear due to this etiological factor?

A. Glomerulonephritis

B. Pancreatitis

C. Myocarditis

D. Pulpits

E. Periodontitis

25. Antitoxic diphtheria serum was introduced to a child suffering from diphtheria. Skin eruption accompanied by itching, increase in body temperature to 38^oC, and pain in joints occurred in patient 10 days later. What is the reason for these symptoms?

A. Contact allergy

B. Serum sickness

C. Atopy

D. Anaphylactic reaction

E. Delayed type hypersensitivity

26. Tuberculin was injected intraperitoneally to animal, which was sensitized by it. Venous hyperemia and peritoneal edema were revealed 24 hours later in laparotomy. High quantity of lymphocytes and monocytes were found in peritoneum smears. What pathological process does the animal have?

A. Fibrinous inflammation

B. Allergic inflammation

C. Aseptic inflammation

D. Serous inflammation

E. Purulent inflammation

27. A dentist injected ultracain to a patient before tooth extraction for the purpose of anesthesia. Sensitivity test was not made. Anaphylactic shook developed in the patient in few minutes after drag injection. What cells produce reagins, which take part in development of anaphylactic reaction?

A. Plasma cells

B. B-lymphocytes

C. T-lymphocytes

D. Mast cells

E. Eozinophiles

28. Tooth was extracted in a teenager under Novocain anesthesia. Paleness of skin, dyspnea and hypotension occurred in the patient 10 minutes later. What type of allergic reaction is it?

A. Anaphylactic

B. Cytotoxic

C. Arthus phenomenon type

D. Delayed type hypersensitivity

E. Stimulating

29. Tooth was extracted in a teenager under Novocain anesthesia. Paleness of skin, dyspnea and hypotension occurred in the patient 10 minutes later. What substance does allergen react with on the surface of mast cells?

A. IgE

B. T-lymphocytes

C. IgA

D. IgD

E. IgM

30. A 27-year-old woman instilled drops with penicillin to the eyes. Itching and burning pain of skin, edema of lips and eyelids, cough with whistling, decreasing in BP occur in her some minutes later. What immunoglobulin participates in development of these allergic reactions?

A. IgE

B. IgG and IgM

C. IgA

D. IgM

E. IgG

31. A 43-year-old woman is suffering from pneumonia. She began complaining of weakness, face and arms burning pain in 10 minutes after ampicillinum injection. Cough, dyspnea, pain in the chest developed in her. At clinical examination patient has cyanosis, eyelids swelling, face red rashes, heart rate – 120 per minute, BP – 120 mmHg, muffled heart sounds, hypopnoe and tachypnea, respiration with different moist rales. What is the reason for worsening of patient’s condition?

A. Anaphylactic shook

B. Urticaria

C. Quincke’s edema

D. Attack of asthma

E. Pulmonary thromboembolism

32. 0.1 ml of horse serum was injected to the guinea-pig for sensitization. What are external signs of sensitization?

A. No external signs

B. Skin rashes

C. Joints swelling

D. Increase in body temperature

E. Pain

33. A 15-year-old girl is suffering from bronchial asthma. Severe attack of expiratory dyspnea develops in her during the spring blossoming period. What biological active substance causes spasm of bronchial smooth muscle in this case?

A. Leukotriene

B. Thromboxane A2

C. Prostacyclin

D. Bradykinin

E. Serotonin

34. Patient addressed to a doctor with complaints of headache, rhinitis, weakness, and increase in body temperature developing every spring in blossoming period. What type of allergic reaction by Gell and Cumbs underlies this disease?

A. Anaphylactic

B. Cytotoxic

C. Antibody-dependent cell-mediated cytotoxicity

D. Immune complex-mediated

E. Delayed type hypersensitivity

35. Weakness, itching of skin, acute spasmodic pain in the abdomen, hyperemia and rash on skin, tachycardia, and decrease in BP down to 70/40 mm Hg suddenly developed in a patient few minutes later Novocain injection by the dentist. Which type of allergic reactions does this pathology belong to?

A. Anaphylactic

B. Cytotoxic

C. Stimulating

D. Cell-mediated

E. Immune complex-mediated

36. Contact dermatitis of upper extremities developed in the nurse, who has been working in manipulation room for 20 years. Which type of allergic reactions does this pathology belong to?

A. Delayed-type hypersensitivity

B. Primary immunodeficiency

C. Immediate type hypersensitivity

D. B-cells immunodeficiency

E. T-cells immunodeficiency

37. Pain in the joints and loins, hemorrhagic eruptions on the skin, and increase in body temperature occur in the patient with toxemic stage of burn disease in 2 hours after allogenic plasma transfusion. What allergic reaction takes place in this case?

A. Serum sickness

B. Urticaria

C. Quincke’s edema

D. Anaphylactic

E. Autoimmune vasculitis

38. Hyperergic inflammation form of upper respiratory tract (larynx, trachea, bronchi) develops at 6-year-old child. Threat of respiratory impairment develops and then necessity of using anti-inflammatory hormones occurs. Which hormone has anti-inflammatory property?

A. Cortisol

B. Adrenaline

C. Growth hormone

D. Testosterone

E. Insulin

39. Swelling, increased BP, proteinuria, hematuria, decreased urine excretion were revealed in the patient, which suffered severe tonsillitis before. These symptoms are typical of acute glomerulonephritis, resulting from damage of glomerular basement membrane. What is mechanism of this disease?

A. Anaphylactic allergic reactions

B. Cytotoxic allergic reactions

C. Immune complex-mediated allergic reaction

D. Delayed-type hypersensitivity

E. Stimulating allergic reaction

40. An 18-year-old patient has insulin-dependent diabetes mellitus I type. What type of allergic reactions underlies beta cells damage?

A. II type, cytotoxic

B. I type, anaphylactic

C. III type, immune complex-mediated

D. IV type, delayed-type hypersensitivity

E. Pseudoallergic reaction

ANSWERS: 1-E, 2-B, 3-D, 4-A, 5-A, 6-B, 7-C, 8-B, 9-D, 10-A, 11-C, 12-D, 13-D, 14-D, 15-B, 16-B, 17-A, 18-A, 19-A, 20-D, 21-A, 22-C, 23-A, 24-A, 25-B, 26-B, 27-A, 28-A, 29-A, 30-A, 31-A, 32-A, 33-A, 34-A, 35-A, 36-A, 37-A, 38-A, 39-C, 40-A.

Дата добавления: 2015-07-25