Immunopathology Practice Questions

Q: Graves disease is an example of which type of immunologic response?

Type I. **Explanation:** **Graves’ Disease** is a classic example of **Type II Hypersensitivity (Antibody-mediated)** [1]. Specifically, it is a sub-type often referred to as "Type V" or "Stimulatory Hypersensitivity." In this condition, B cells produce autoantibodies (Thyroid Stimulating Immunoglobulins - TSI) that bind to the **TSH receptor** on thyroid follicular cells [1]. Instead of causing cell destruction, these antibodies mimic the action of TSH, leading to the overproduction of thyroid hormones (Hyperthyroidism) [1]. **Analysis of Options:** * **Type II (Correct):** Involves antibodies (IgG or IgM) directed against antigens on specific cell surfaces or tissues [1]. In Graves, the "antigen" is the TSH receptor. * **Type I:** This is an **IgE-mediated** immediate hypersensitivity (e.g., Anaphylaxis, Asthma) [1]. It involves mast cell degranulation and is not the mechanism in Graves. * **Type III:** This involves the deposition of **Ag-Ab (Immune) complexes** in tissues, leading to complement activation (e.g., SLE, Post-streptococcal Glomerulonephritis). * **Type IV:** This is **Cell-mediated (Delayed)** hypersensitivity involving T-lymphocytes, not antibodies (e.g., Mantoux test, Contact dermatitis). **High-Yield Clinical Pearls for NEET-PG:** * **Triad of Graves:** Hyperthyroidism, Exophthalmos (due to retro-orbital inflammation), and Pretibial Myxedema. * **Antibody Marker:** TSI (Thyroid Stimulating Immunoglobulin) is the most specific [1]. * **Morphology:** Diffuse hypertrophy and hyperplasia of follicles with **scalloping** of colloid edges. * **Other Type II Examples:** Myasthenia Gravis (blocking antibodies), Goodpasture syndrome, and Hemolytic disease of the newborn [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of the Immune System, pp. 208-214.

Question 1

A neonate develops spastic contractions on the second postpartum day. Laboratory studies show hypocalcemia. MRI studies demonstrate aplasia of the thymus and parathyroid glands. What is the appropriate diagnosis?

Accepted Answer

DiGeorge syndrome

Answer

Transient hypogammaglobulinemia of infancy

Answer

Adenosine deaminase deficiency

Answer

Common variable immunodeficiency

Question 2

When tissue pretreated with potassium permanganate is stained with Congo-red stain, the apple-green birefringence is abolished. The tissue is likely to contain which type of amyloid?

Accepted Answer

AA amyloidosis

Answer

AL amyloidosis

Answer

Primary amyloidosis

Answer

Hereditary amyloidosis

Question 3

Which of the following is true about Type II hypersensitivity reactions?

Accepted Answer

Antigen-antibody mediated

Answer

Immune complex mediated

Answer

Arthus phenomenon

Answer

Granulomatous reaction

Question 4

c-ANCA is characteristic for which condition?

Accepted Answer

Wegener's Granulomatosis

Answer

Polyarteritis Nodosa

Answer

Rapidly Progressive Glomerulonephritis (RPGN)

Answer

Henoch-Schonlein Purpura

Question 5

What type of immunologic injury is seen in autoimmune hemolytic anemia (AIHA)?

Accepted Answer

Type II

Answer

Type I

Answer

Type III

Answer

Type IV

Question 6

Graves disease is an example of which type of immunologic response?

Accepted Answer

Type I

Answer

Type II

Answer

Type III

Answer

Type IV

Question 7

Toll-like receptors recognize bacterial products and stimulate an immune response by:

Accepted Answer

Transcription of nuclear factor mediated by NF-κB, which recruits cytokines

Answer

Perforin and granzyme mediated apoptosis

Answer

FADD ligand apoptosis

Answer

Cyclin

Question 8

Which of the following is the most common form of primary immunodeficiency?

Accepted Answer

Selective IgA immunodeficiency

Answer

Acquired immunodeficiency syndrome (AIDS)

Answer

Wiskott-Aldrich syndrome

Answer

Common variable immunodeficiency

Question 9

Hereditary angioneurotic edema is due to a deficiency of which of the following?

Accepted Answer

C1 esterase inhibitor

Answer

C1 deficiency

Answer

C2 and C4 deficiency

Answer

C9 deficiency

Question 10

Nucleotidase deficiency is associated with which of the following?

Accepted Answer

Humoral immunity deficiency

Answer

Acquired immunity deficiency

Answer

Severe combined immunodeficiency (SCID)

Answer

Cell mediated immunity deficiency

Immunopathology — MCQs

Immunopathology — MCQs

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