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What is the hapten-carrier effect? ✔✔Small-molecule antigen requires covalent linkage to a larger carrier to stimulate adaptive immune response. The process is achieved in collaboration between hapten-specific B cells and carrier-specific T cells. This is the basis of developing conjugated vaccines. What are the common superantigens and related diseases? ✔✔SEB and SEC from Staphylococcus aureus cause food poisoning. TSST from Staphylococcus aureus and SPE-C from Streptococus pyogenes cause toxic shock syndrome. Which type of T cell recognizes lipid antigens and what molecule is involved? ✔✔Natural killer T (NKT) cells recognize lipid antigens, and the CD1 molecule is involved. Which antigens are T-cell dependent and which are T-cell independent? ✔✔Protein antigens are T-cell dependent. Polysaccharide, nucleic acid, and lipids are T-cell independent.
2025 ACAAI Review for the Allergy &
Immunology Boards Flash Cards ALL
CHAPTERS with Verified Solutions
What is the binding site for CD4 on the MHC class I molecule? What is the binding site for CD on the MHC class II molecule? ✔✔On the MHC class I molecule, α3 is the binding site for CD8. On the MHC class II molecule, β2 is the binding site for CD Which chain makes up the peptide binding cleft in MHC class I molecules? Which chain makes up the peptide binding cleft in MHC class II molecules? ✔✔On the MHC Class I molecule, α and α2 make up the peptide binding cleft. On the MHC class II molecule, α1 and β1 make up the peptide binding cleft. MHC class I molecule presents which type of antigens and where does the antigen-MHC class I loading happen? ✔✔An MHC class I molecule presents both intracellular antigens (e.g., viral antigen in cytoplasm) and extracellular antigens (via cross-presentation). The loading site is endoplasmic reticulum (ER). In which chromosomal region are the TAP proteins located? ✔✔The MHC class II locus. They are involved in peptide processing for MHC class I however. MHC class II molecule presents which type of antigen? Where does the antigen-MHC class II loading happen? ✔✔The MHC class II molecule presents extracellular antigens (e.g., antigens from phagocytosed bacteria). The loading site is phagolysosome.
Immunosuppressant cyclosporine binds to which molecule in T-cell signaling pathway? ✔✔Cyclosporine binds to cyclophilin, which are proteins also called immunophilins. The drug- protein complex inhibits calcineurin and therefore NFAT translocation to the nucleus. What CD molecules are in the BCR coreceptor? ✔✔CD21, CD19, and CD Which chemokine receptor is associated with WHIM (warts, hypogammaglobulinemia, infections, amd myelokathexis) syndrome? ✔✔CXCR Which integrin molecule is important for gut homing by binding to MAdCAM? ✔✔α4β Upon first exposure to a medication, when might a patient develop symptoms of serum sickness? ✔✔ 4 - 10 days Which component is shared by IL- 4 and IL-13 receptors? ✔✔IL- 4 Rα, which is targeted by dupilumab What is the result of IFNγ receptor deficiency? ✔✔IFNγ receptor deficiency results in susceptibility to Mycobacterium tuberculosis and other intracellular bacteria.
What interleukin is excessively produced in cryopyrinopathies? ✔✔IL-1β What disease presents with early onset hypogammaglobulinemia with autoimmunity and immune dysregulation? ✔✔Lipopolysaccharide responsive beige-like anchor protein (LRBA) deficiency What is the function of LRBA? ✔✔It maintains intracellular stores of CTLA4, which can stop T- cell activation. Which complement deficiency is inherited as X-linked? ✔✔Properidin What two molecules inhibit MAC formation? ✔✔CD 59 and S protein Which complement receptor is implicated in PNH (paroxysmal nocturnal hemoglobinuria)? ✔✔CD 55 and CD 59 What is the main source of Factor D? ✔✔Adipose tissue
How do receptors of the innate immune system recognize microorganisms? ✔✔PAMPS What receptor is involved with the inflammasome? ✔✔NODs Which TLR does not signal through MyD88? ✔✔TLR 3 Which TLR can signal through both MyD88 dependent and independent pathways? ✔✔TLR 4 Which TLRs are present in the intracellular compartment and implicated in HSV1 encephalitis? ✔✔TLR 3, 7, 8, and 9 How do PAMPS differ from DAMPs? ✔✔PAMPs are conserved microbial sequences from microorganisms whereas DAMPs are endogenous molecules derived from damaged or dying cells. Which TLR binds lipopolysaccharide (LPS) on gram-negative bacteria? ✔✔TLR 4 Which cytokines induce development of Th17 cells? ✔✔IL-6, TGFβ, IL-1, IL-21, and IL- 23
Which enzyme is responsible for adding nucleotides during junctional diversity? ✔✔TdT At which stage does signaling through the pre-B-cell receptor occur? ✔✔Pre B cell Where does negative selection occur for T cells? ✔✔The medulla, which is also where the AIRE protein functions What known mutations can lead to ALPS? ✔✔Fas (CD95), FasL, caspase 10 What CD molecule can be used to distinguish monocytes and macrophages from other cells? ✔✔CD14; macrophages also express CD Which subset of dendritic cells produces type I IFN during viral infections? ✔✔Plasmacytoid (pDCs) What is the most important chemoattractant that guides neutrophil to inflammation? ✔✔Chemokine CXCL8 (IL-8)
Where is the molecular defect in LAD I versus LAD II? ✔✔LAD I: CD18; LAD II: CD15s Which mast cell mediator is both preformed and produced in the late phase? ✔✔TNFα What is contained in eosinophil primary granules? ✔✔Charcot-Leyden crystals What primary immunodeficiencies are associated with high IgE levels ✔✔Hyper-IgE syndrome, Wiskott-Aldrich syndrome, Omenn syndrome, IPEX, atypical complete DiGeorge syndrome What mediators can be elevated in a 24 - hour urine collection after mast cell activation? ✔✔Urine N-methylhistamine or prostaglandin D2 (11-β-prostaglandin F2 is a metabolite of prostaglandin D2) What cytokines promote eosinophilia? ✔✔IL-5, CCL11, TSLP, IL-25, IL- 33 What is the major cytokine that drives basophil development? ✔✔IL- 3 What immunoglobulin-like lectin is found on human eosinophils? ✔✔SIGLEC- 8
Dysregulation of which eotaxin has been associated with eosinophilic esophagitis? ✔✔Eotaxin- 3 Which cytokine produced by bone marrow and thymic stromal cells is a growth factor required for development of B cells and T cells? ✔✔Interleukin 7 (IL-7) What process results in the apoptosis of autoreactive or nonfunctional lymphocytes? ✔✔Negative selection What diseases are associated with congenital thymic aplasia or hypoplasia in humans? ✔✔DiGeorge syndrome, SCID, CHARGE, infant of a diabetic mother Hypogammaglobulinemia and thymoma are associated with what condition in adults? ✔✔Good's syndrome What pathogen is frequently associated with gastric MALT lymphoma? ✔✔Chronic Helicobacter pylori infection is associated in 72-98% of cases
What syndrome is characterized by ciliary dyskinesia, situs inversus, bronchiectasis, and chronic sinusitis? ✔✔Kartagener's syndrome; 50% of individuals with PCD have Kartagener's syndrome Identify structures A, B, C, and D in Figure 3 - 2. (Click on Show Figures for Chapter 3 below this window.) ✔✔(A) maxillary sinus; (B) ethmoid sinus; (C) concha bullosa; (D) inferior turbinate Identify structures E and F in Figure 3 - 3. (Click on Show Figures for Chapter 3 below this window.) ✔✔(E) sphenoid sinus; (F) posterior ethmoid sinus Which sinuses are present at birth? Which is the last to develop? ✔✔Maxillary and ethmoid sinuses are present at birth. The frontal sinus is last to develop, when a child is around 6 years old. What is the name of the ethmoid air cells found in the infraorbital area? ✔✔Haller cells What are displaced sphenoethmoid air cells called? ✔✔Onodi cells
What is the name of the anterior ethmoid air cells found above the middle turbinate? ✔✔Agger nasi cells What constitutes the structures in Fig 3 - 4 and name the condition they are associated with. (Click on Show Figures for Chapter 3 below this window.) ✔✔These are Curschmann's spirals, which are found in asthma. They are twists of condensed mucus. What constitutes the structures in Fig 3 - 5 and name the condition they are associated with. (Click on Show Figures for Chapter 3 below this window.) ✔✔These are the creola bodies, which are found in asthma. They are clusters of surface epithelial cells. What constitutes the structures in Fig 3 - 6 and name the condition they are associated with. (Click on Show Figures for Chapter 3 below this window.) ✔✔These are the Charcot-Leyden crystals, which are found in asthma. They are eosinophil cell and granule membrane lysophospholipase What are the pathologic features of airway remodeling? ✔✔Airway wall thickening with increased collagen deposition and airway smooth muscle, goblet cell hyperplasia, subepithelial fibrosis, and angiogenesis
A 4 - year-old boy presents with an itchy rash characterized by small blisters on his elbows and knees. His mother mentions that he also has chronic diarrhea. What conditions does he likely have? ✔✔Dermatitis herpetiformis and celiac disease What is a diagnostic biopsy characteristic for eosinophilic esophagitis (EoE)? ✔✔Greater than 15 eosinophils per high powered field while on a proton pump inhibitor (PPI) for 8 weeks. Which types of studies are subject to recall bias? ✔✔Cross-sectional and case control What type of study samples subjects at one point in time for presence or absence of exposure and disease? ✔✔Cross-sectional What parametric test compares means between two groups? ✔✔Student t test What type of error occurs when the null hypothesis is falsely rejected? ✔✔Alpha error Define relative risk (risk ratio) ✔✔(Risk of disease or death among people who are exposed)/(Risk of disease or death among people who are not exposed)
Define prevalence. ✔✔A measure of disease present as one point in time Define sensitivity. ✔✔True positive / (True positive + False negative) X is assumed to cause Y, when in truth Z is common also and causes X and Y. What is Z? ✔✔Confounding variable What category of evidence uses evidence from at least one randomized controlled trial? ✔✔Ib Define beneficence. ✔✔Maximizing the benefits for the research project while minimizing the risks to the research subjects What are the primary mechanisms of early- and late-phase allergic rhinitis? ✔✔Early-phase mechanisms are allergen-induced mast cell secretion of histamine, prostaglandins, and leukotrienes; late-phase mechanisms are eosinophil chemotaxis, caused by chemical mediators produced in the early reaction Intranasal corticosteroids block which phase(s) of the allergic response? ✔✔They block both the early-phase (rhinorrhea, sneezing) and late-phase (congestion) responses
What lab values can be monitored to assess interval progression of AFRS s/p FESS? ✔✔Increases of IgE >10% in a patient's postsurgical IgE correlate with increased risk of recurrence Does serum-specific IgE to fungal element correspond to species of fungus found in allergic mucin of patients with AFRS? ✔✔No, studies have found poor correlation What value of total serum IgE is necessary to diagnose AFRS? ✔✔Total serum IgE level is not one of the Bent and Kuhn diagnostic criteria for AFRS In a patient with recurrent sinusitis and CT findings of pansinusitis and inspissated mucin, what role(s) does skin-prick testing to aeroallergens play? ✔✔Identification of fungal sensitization and preparation for post-FESS allergen immunotherapy to fungal and nonfungal allergens What is ciliary flushing, and in which conditions is it found? ✔✔Ciliary flushing is an injection of the deep episcleral vessels, causing redness around the cornea. It is seen in corneal inflammation, iridocyclitis, and acute glaucoma. What is the treatment of choice for mild to moderate allergic conjunctivitis? ✔✔Histamine H receptor antagonist + mast cell stabilizer
A 10 - year-old boy is brought into your clinic because of redness in his eyes. His medical history is notable for seasonal allergic rhinitis and asthma. His main complaints include significant ocular pruritus, sensitivity to light, and feeling like something is stuck in his eye. On exam his sclera are injected and his R eyelid is lower than his Left. What is the diagnosis? ✔✔Vernal keratoconjunctivitis A 45 - year-old woman presents with ocular pruritis. Other symptoms include redness in her eyes, difficulty with light, and sometimes pain. When going through her history she reports that she always feels dry and has problems with dry skin. Her eyes feel like leather, and you notice that she has lost her eyelashes. She denies any vision problems requiring glasses or contacts. What is the diagnosis? ✔✔Atopic keratoconjunctivitis In which of the following is filaggrin expressed (a) anterior vestibulum of nose; (b) transitional nasal epithelium; (c) respiratory nasal epithelium; (d) human bronchial epithelium? ✔✔(a) Anterior vestibulum of nose Which cytokine is primarily associated with pruritus in atopic dermatitis? ✔✔IL- 31 What can a person with eczema develop after smallpox vaccination? ✔✔Eczema vaccinatum
