Pathophysiology for Pharmacy Students
Review Questions
Course Introduction
Pathophysiology for Pharmacy Students explores the physiological mechanisms underlying common diseases and disorders, emphasizing their relevance to pharmaceutical care and therapeutic decision-making. The course delves into alterations in normal biological processes, integrating foundational concepts in anatomy, physiology, and biochemistry with clinical manifestations of disease. Students will gain a comprehensive understanding of the etiology, progression, and systemic effects of various pathologies, preparing them to assess patient conditions, evaluate drug therapy options, and communicate effectively within healthcare teams. Real-world case studies and evidence-based approaches are used throughout to strengthen critical thinking and problem-solving skills essential for future pharmacists.
Recommended Textbook
Immunology for Pharmacy 1st Edition by Dennis Flaherty PhD
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26 Chapters
300 Verified Questions
300 Flashcards
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Chapter 1: Cells and Organs of the Immune System
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Q1) The __________________ serves as a filter to trap infections in the tissues.
A) Spleen
B) Thymus
C) Bone marrow
D) Lymph system
Answer: D
Q2) All T cells express which of the following CD markers?
A) CD3
B) CD4
C) CD8
D) CD16
Answer: A
Q3) The main purpose of diapedesis is to:
A) Aid neutrophils in granule release
B) Capture antigens for presentation to lymphocytes
C) Allow immune cells to travel to the site of infection
D) Activate macrophages for more effective phagocytosis
Answer: C
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Chapter 2: Innate Immunity
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Q1) Cathelicidins perform which of the following functions?
I. Chemotaxis
II. Neutralization of endotoxins
III. Broad spectrum antimicrobial activity
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Answer: E
Q2) Activation of a phagocyte by Toll-like receptors (TLRs) bound to a pathogen triggers what innate immune response?
A) Phagocytosis
B) Complement activation
C) Cathelicidin production
D) Decrease in body temperature
Answer: A
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Chapter 3: Immunogenicity and Antigenicity
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Sample Questions
Q1) Which of the following drugs can react with red blood cells (RBCs) to cause hemolysis?
A) Penicillin
B) Tetracycline
C) Tolbutamide
D) Procainamide
Answer: D
Q2) Which of the following is an example of an endogenous antigen?
A) Viral protein
B) Fungal cell wall
C) Protein exotoxins
D) Bacterial endotoxin
Answer: A
Q3) Which of the following represents a conformational epitope?
A) A mannose residue
B) Primary sequence of a short peptide
C) Long chain carbon segment of a lipid
D) Segment of two neighboring loops of a hemoglobin molecule
Answer: D
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Chapter 4: Antigen Presenting Molecules
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Q1) Why are HLA heterozygotes more resistant to disease than homozygotes?
A) They have more single nucleotide polymorphisms.
B) They have a more diverse range of minor HLA loci.
C) They have more diversity in the antibodies they produce.
D) They have a more varied repertoire of antigen-presenting HLA molecules.
Q2) HLA class III genes produce:
A) Stress molecules
B) Complement components
C) Antigen presenting molecules
D) Receptors that activate natural killer (NK) cells
Q3) HLA class II molecule consists of:
A) Three glycosylated a-chains
B) Heavily glycosylated a- and b-chain
C) Two glycosylated a-chains and three b-chains
D) A single glycosylated a-chain bound to b2-microglobulin
Q4) Individuals who express HLA-DR13:
A) Can more easily clear hepatitis B virus
B) Are more susceptible to tuberculosis infection
C) Are more susceptible to Candida albicans infections
D) Can more easily eliminate respiratory syncytial virus (RSV)
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Chapter 5: Antigen Presenting Cells
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Q1) The purpose of the invariant chain is to:
A) Aid in receptor-mediated endocytosis in B cells
B) Guide MHC class II molecules to the endosome
C) Release antigen to stimulate memory cell formation
D) Aid in movement of the early endosome to a late endosome
Q2) Which type of dendritic cell activates both NK cells and CD8 T cells (CTLs) in response to a viral infection?
A) Follicular dendritic cells
B) Interstitial dendritic cells
C) Plasmacytoid dendritic cells
D) Interdigitating dendritic cells
Q3) The _________________ is the vacuole in a B cell where an endocytosed antigen is located.
A) Iccosome
B) Endosome
C) Phagosome
D) Phagolysosome
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Chapter 6: Surface Interactions Between T Cells and Antigen-Presenting
Cells
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Q1) How does alefacept function to reduce lesions in plaque psoriasis?
A) By blocking CD28/B7 interactions and causing T cell apoptosis
B) By blocking CTLA-4/B7 interactions and causing T cell apoptosis
C) By blocking CD2/CD58 interactions and preventing T cell activation
D) By binding to CD3 on activated T cells and preventing T cell activation
Q2) CD4 molecules on T cells bind to:
A) CD40
B) B7 molecules
C) MHC class I molecules
D) MHC class II molecules
Q3) Why are the g/d T cells more similar to the innate immune response than the adaptive immune response?
A) They can present antigen to other T cells.
B) They are able to phagocytose pathogens.
C) They do not require activation to eliminate pathogens.
D) They recognize general features of pathogens rather than a specific epitope.
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Chapter 7: Intracellular Signaling and T Cell Activation
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Q1) The activation of inositol-1,4,5-triphosphate (IP ) signaling results in:
A) Activation of NF-kB signaling
B) Release of intracellular calcium
C) Phosphorylation of downstream targets
D) Formation of the immunological synapse
Q2) Which of the following is an example of autocrine signaling?
A) An NK cell responding to IL-12 produced by a macrophage.
B) A macrophage responding to TNF made by the same macrophage.
C) A T helper cell responding to IL-2 produced by a neighboring T cell.
D) A neutrophil responding to IL-1 produced by vascular endothelial cell.
Q3) What is the purpose of adaptor proteins in signal transduction?
A) Activate transcription
B) Facilitate dimerization of receptors
C) Anchor the receptor to the membrane
D) Carry the signal from the membrane into the cytoplasm
Q4) The Rac/JNK pathway activates which signaling component?
A) Fos
B) Jun
C) AP-1
D) NF-kB
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Chapter 8: B Cell Activation and Signaling
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Q1) Which two cytokines are the main stimuli for B cell differentiation into plasma cells?
A) TNF and IL-1
B) TACI and BLyS
C) BLyS and APRIL
D) TLR-4 and Lipid A
Q2) X-linked agammaglobulinemia results from a defect in:
A) IL-7 gene
B) BTK gene
C) BLyS gene
D) CD22 gene
Q3) Belimumab is a monoclonal antibody directed against:
A) BLyS
B) CD22
C) Bruton's kinase
D) BLyS and APRIL
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Chapter 9: Antibodies
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Sample Questions
Q1) Antibodies with high affinity will be able to:
A) Tightly bind lower concentrations of antigen and quickly eliminate infection
B) Tightly bind higher concentrations of antigen and quickly eliminate infection
C) Loosely bind to lower concentrations of antigen and slowly eliminate infection
D) Loosely bind to higher concentrations of antigen and slowly eliminate infection
Q2) Fab fragments can be used clinically to treat:
A) Job syndrome
B) Digoxin overdose
C) Multiple myeloma
D) Common variable immunodeficiency (CVID)
Q3) A patient has bone pain, high calcium levels, high immunoglobulin levels, and Bence Jones proteins in their urine. The most likely diagnosis for this patient is:
A) Job syndrome
B) Multiple myeloma
C) Waldenstrom's macroglobulinemia
D) Common variable immunodeficiency (CVID)
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Chapter 10: Antibody Diversity
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Sample Questions
Q1) Which of the following represents possible antibody conformations?
I. One l light chain, one k light chain, two g heavy chains
II. Two l light chains, one g heavy chain, one m heavy chain
III. Two k light chains, two m heavy chains
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) Somatic mutation theory of antibody diversity states that:
A) A limited number of genes undergo mutations
B) Separate genes exist for each antibody molecule
C) A limited number of genes undergo genetic rearrangements
D) The many genes inherited from both parents undergo a few mutations
Q3) Mutations in which genes in germinal center B cells lead to the production of higher affinity antibodies?
A) V genes
B) D genes
C) J genes
D) C genes
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Chapter 11: Complement
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Q1) Which of the following are methods by which the C3 complement component can be cleaved?
I. Factor D
II. C3 convertase
III. Spontaneous cleavage
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) What is the role of C9 in the complement pathways?
A) Creates pore
B) C3 convertase
C) C5 convertase
D) Binds to antibodies on microbe surface
Q3) Which of the following complement components acts as a chemoattractant?
A) C2a
B) C3a
C) C4b
D) C5b
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Chapter 12: Phagocytosis and Intracellular Killing
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Q1) Why is enzyme replacement therapy with imiglucerase an effective treatment for some forms of Gaucher's disease?
A) Imiglucerase breaks down glucocerebroside.
B) Imiglucerase regenerates deficient myeloperoxidase.
C) Imiglucerase facilitates the production of active cytochromes.
D) Imiglucerase breaks down fungi when the body is not able to.
Q2) Some bacteria can avoid oxygen-dependent phagocytic killing by producing:
A) Catalase
B) Defensins
C) Singlet oxygen
D) Superoxide dismutase
Q3) Following phagocytic ingestion of a pathogen, which of the following occurs?
A) Pinocytosis
B) Phagosome fusion with granules
C) Binding to antibody by Fc receptor on phagocyte
D) Binding to complement fragments by complement receptors
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Chapter 13: Antibodies and in Vivo Therapy
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Q1) A monoclonal antibody used as a drug has a name that ends in what suffix?
A) U
B) Ab
C) Mab
D) Imm
Q2) Low platelet count and antibodies to platelets are signs of:
A) Serum sickness
B) Kawasaki disease
C) Erythroblastosis fetalis
D) Idiopathic thrombocytopenic purpura (ITP)
Q3) Which of the following is an example of active immunity?
A) Antibody used therapeutically to treat lymphoma
B) Immunity to pneumococcal infection after exposure to the organism
C) Immunity acquired in a child by passage of antibodies from the mother's milk
D) Administration of pooled immunoglobulins from patients that had recovered from cytomegalovirus (CMV) to patients that currently have the disease
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Chapter 14: Antibodies and in Vitro Research and Diagnostic Assays
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Q1) In flow cytometry, side scatter is a measure of:
A) Cell size
B) Protein content
C) Granularity of a cell
D) Expression of CD markers
Q2) A patient with acquired immunodeficiency syndrome (AIDS) is having lab work, and the doctor orders flow cytometry. What is flow cytometry used to detect most often in AIDS patients?
A) B cell levels
B) NK cell levels
C) CD4 T cell levels
D) CD8 T cell levels
Q3) When testing for HIV, patients can give a false positive ELISA result if the patient has which disorder?
A) Rheumatoid arthritis
B) Mantle cell lymphoma
C) Systemic lupus erythematosus
D) B cell chronic lymphocytic leukemia
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Chapter 15: Immediate Allergic Reactions
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Q1) Which of the following is/are responsible for class switching to IgE production in allergic reactions?
I. IL-5
II. IL-4
III. IL-13
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) The radioallergosorbent (RAST) assay is used to test which individuals for allergies?
A) All individuals get a RAST test
B) Individuals younger than the age of 12
C) Individuals who are at risk for anaphylaxis during other types of testing
D) Individuals who have had no response to previous allergy testing but still appear to have allergies
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Chapter 16: Autoimmunity
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Q1) Most patients with Hashimoto's thyroiditis have antibodies to:
A) T and T
B) Thyroglobulin
C) TSH receptors
D) TRH receptors
Q2) Which of the following is a symptom of Graves' disease?
A) Bulging eyes
B) Double vision
C) Blurred vision
D) Drooping eyelids
Q3) Plasmapheresis is an effective treatment for:
A) Graves' disease
B) Myasthenia gravis
C) Goodpasture syndrome
D) Systemic lupus erythematosus (SLE)
Q4) Which of the following autoimmune disorders involves a complement defect?
A) Rheumatic fever
B) Goodpasture syndrome
C) Autoimmune hemolytic anemia
D) Systemic lupus erythematosus (SLE)
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Chapter 17: Transplantation
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Q1) Which immunosuppressive agent causes redistribution of CD4 T cells from the peripheral blood to the spleen and bone marrow?
A) Corticosteroids
B) Monomurab-CD3
C) Calcineurin inhibitors
D) Antiproliferative agents
Q2) One of the steps taken to avoid graft-versus-host disease (GVHD) is:
A) Immunostimulation
B) Matching minor histocompatibility
C) Removing all T cells from the graft
D) Removing all B cells from the graft
Q3) The main immune response in a case of acute rejection of a transplanted organ is:
A) B cell activation
B) Both B and T cell activation
C) Allospecific T cell activation
D) Attack of organ by pre-existing antibodies
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Chapter 18: Antigen Presentation for Cell-Mediated Response
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Q1) Which of the following is most likely to generate a CD8 T cell response?
A) Tapeworm infection
B) Influenza virus infection
C) Fungal infection causing athlete's foot
D) Group A Streptococcus infection (Strep throat)
Q2) MHC class I molecules present antigen to:
A) NK cells
B) CD8 T cells
C) CD4 Th1 cells
D) CD4 Th2 cells
Q3) Which of the following is an example of an immune response following cross-priming?
I. An NK cell killing a tumor cell.
II. A CD8 cell killing a tumor cell.
III. A macrophage ingesting a tumor cell.
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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Chapter 19: Delayed Type Hypersensitivity Reactions
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Q1) Which of the following is/are considered a genetic factor that increases susceptibility to mycobacterial infections?
I. Defect in TNF-a receptor
II. Defect in vitamin D receptor
III. Defect in interferon-g receptor
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q2) What is the cause of photo contact dermatitis?
A) Soap
B) Acids
C) Poison ivy
D) Drugs or drug metabolites
Q3) Why are Mycobacterium avium complex (MAC) infections more difficult to treat?
A) Antibiotic resistance
B) Antibiotics cannot reach the site of infection
C) The antibiotics are so toxic that patients will not take them
D) MAC organisms can form spores that protect them from an immune response
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Chapter 20: Cytotoxic T Cells
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Q1) Tumor infiltrating lymphocytes (TILs) found in a solid tumor or melanoma may indicate:
A) A good prognosis due to small tumor size
B) A bad prognosis due to an aggressive cancer
C) A good prognosis due to a vigorous immune response
D) A bad prognosis due to damage to surrounding tissue by the immune system
Q2) Which of the following is a method that tumors use to evade the immune response?
A) Producing IL-2 analogs
B) Reducing TAP function
C) Upregulating MHC class I molecules
D) Engaging Fas receptors on T cells to cause T cell death
Q3) The main immunological defect in familial erythrophagocytic lymphohistiocytosis type 2 is:
A) Inability to synthesize perforin
B) Production of nonfunctional granzymes
C) Inability to secrete perforin and granzymes
D) Production of reduced amounts of cathepsin C
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Chapter 21: Natural Killer Cells
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Q1) Which is the main surface molecule on NK cells that is involved in antibody-dependent cell-mediated cytotoxicity (ADCC)?
A) CD3
B) CD16
C) CD56
D) CD94
Q2) Which of the following is true concerning natural killer (NK) cells?
A) NK cells never express CD16.
B) NK cells never express CD56.
C) NK cells express both B and T cell markers.
D) NK cells do not express B or T cell markers.
Q3) Which of the following cell types may play a role in allergic reactions, particularly in relation to asthma?
A) NK CD56dim cells
B) NK CD56bright cells
C) NKT type I cells
D) NKT type II cells
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Chapter 22: Factors That Influence the Immune Response
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Q1) What is the immune response to high doses of antigen?
A) T cells are inactivated.
B) B cells are inactivated.
C) NK cells are inactivated.
D) Macrophages are inactivated.
Q2) Defects in Fas:FasL engagement and signaling may contribute to which disease?
A) Graves' disease
B) Rheumatoid arthritis
C) Type II diabetes mellitus
D) Systemic lupus erythematosus (SLE)
Q3) Which of the following is the outcome of T cell interaction with immature dendritic cells that do not express costimulatory molecules?
A) Anergic T cell response
B) Only CD8 T cells respond
C) Only CD4 T cells respond
D) Uncontrolled T cell response
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Chapter 23: Cytokines and Biological Modifiers
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Q1) Which of the following is an outcome of IL-1 release from activated immune cells?
A) Cleavage of viral RNA
B) Prevention of microbial growth
C) Increased production of antibodies
D) Downregulation of adhesion molecules
Q2) Recombinant IL-2 administration is appropriate for the treatment of:
A) HIV
B) Cancer
C) Arthritis
D) Transplant patients
Q3) What is one role that type I interferons play in the eradication of viral infections?
A) Inhibit viral uncoating
B) Inhibit viral protein synthesis
C) Block viral entry into host cells
D) Block release of viral progeny from host cells
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25
Chapter 24: Vaccines in Theory and Practice
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Q1) Which type of vaccine may revert to a virulent form of the organism?
A) Cholera vaccine
B) Pertussis vaccine
C) Salk polio vaccine
D) Influenza vaccine (subcutaneous version)
Q2) Which of the following adjuvants is/are capable of enhancing mucosal immunity?
I. Squalene
II. Cholera toxin
III. Monophosphoryl lipid A
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
Q3) What is the difference between Freund's Incomplete Adjuvant (FIA) and Freund's Complete Adjuvant (FCA)?
A) FIA does not contain water.
B) FIA does not contain mineral oil.
C) FIA does not contain killed mycobacteria.
D) FIA does not contain mannide monooleate.
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Chapter 25: Vaccine-Preventable Diseases
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Q1) Gardasil and Cervarix are vaccines that protect against papilloma viruses that may cause:
A) Breast cancer
B) Uterine cancer
C) Ovarian cancer
D) Cervical cancer
Q2) Corynebacterium diphtheriae colonizes:
A) Heart and liver
B) Muscle and liver
C) Tonsils and pharynx
D) Kidneys and adrenal glands
Q3) Which of the following are pathogens that cause meningitis?
I. Polio virus
II. Rubeola virus
III. Haemophilus influenzae type b
A) I only
B) III only
C) I and II
D) II and III
E) I, II, and III
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Chapter 26: Acquired Immune Deficiency Syndrome
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Q1) What protein protects viral RNA from degradation by host cell cytoplasmic enzymes?
A) gp120
B) RNase
C) Vif protein
D) Rev protein
Q2) What is the mechanism of HIV-induced death of follicular dendritic cells (FDCs)?
A) TNF released by CD8 cells
B) Lysis following virus production
C) Fas expression upregulated on FDCs
D) Perforin/granzyme-induced apoptosis
Q3) Which of the following drugs binds directly to HIV reverse transcriptase to inhibit activity?
A) Nevirapine
B) Zalcitabine
C) Raltegravir
D) Didanosine
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