Autoimmune Disorders (DS)

Question: What is the primary affected organ in Hashimoto's thyroiditis?

A)Adrenal glands
B)Pancreas
C)Thyroid
D)Stomach

Answer: C)Thyroid

Question: In Hashimoto's thyroiditis, the levels of T3 and T4 are typically:

A)High
B)Low
C)Normal
D)Variable

Answer: B)Low

Question: Which autoantibodies are most characteristic of Hashimoto's thyroiditis?

A)Anti-acetylcholine receptor antibodies
B)Anti-TPO and anti-thyroglobulin antibodies
C)Anti-intrinsic factor antibodies
D)Anti-SSA and anti-SSB antibodies

Answer: B)Anti-TPO and anti-thyroglobulin antibodies

Question: The primary treatment for Hashimoto's thyroiditis is:

A)Radioactive iodine
B)Thyroid hormone replacement therapy (levothyroxine)
C)Methimazole
D)Vitamin B12 injections

Answer: B)Thyroid hormone replacement therapy (levothyroxine)

Question: Addison's disease is characterized by autoimmune destruction of which part of the adrenal gland?

A)Adrenal medulla
B)Adrenal cortex
C)Zona reticularis
D)All of the above

Answer: B)Adrenal cortex

Question: A patient with Addison's disease would be expected to have:

A)High cortisol, low ACTH
B)Low cortisol, high ACTH
C)High cortisol, high ACTH
D)Low cortisol, low ACTH

Answer: B)Low cortisol, high ACTH

Question: A classic symptom of Addison's disease is:

A)Heat intolerance
B)Salt cravings
C)Weight gain
D)Exophthalmos

Answer: B)Salt cravings

Question: Pernicious anemia results from autoimmune destruction of which stomach cells?

A)G cells
B)Chief cells
C)Parietal cells
D)Mucous cells

Answer: C)Parietal cells

Question: The deficiency caused by the loss of intrinsic factor in pernicious anemia is:

A)Iron
B)Folate
C)Vitamin B12
D)Vitamin D

Answer: C)Vitamin B12

Question: Vitamin B12 absorption occurs primarily in the:

A)Stomach
B)Duodenum
C)Jejunum
D)Ileum

Answer: D)Ileum

Question: Myasthenia Gravis is caused by autoantibodies against:

A)Thyroid peroxidase
B)Acetylcholine receptors
C)Intrinsic factor
D)Adrenal cortex enzymes

Answer: B)Acetylcholine receptors

Question: A key symptom of Myasthenia Gravis is muscle weakness that:

A)Improves with activity
B)Worsens with activity and improves with rest
C)Is constant regardless of activity
D)Is only present at night

Answer: B)Worsens with activity and improves with rest

Question: Which drug class is used to treat Myasthenia Gravis by improving neuromuscular transmission?

A)Corticosteroids
B)Acetylcholinesterase inhibitors
C)Immunosuppressive drugs
D)NSAIDs

Answer: B)Acetylcholinesterase inhibitors

Question: The most specific serological marker for Rheumatoid Arthritis is:

A)Rheumatoid Factor (RF)
B)Antinuclear Antibody (ANA)
C)Anti-cyclic citrullinated peptide (anti-CCP)
D)Anti-Sm antibody

Answer: C)Anti-cyclic citrullinated peptide (anti-CCP)

Question: The cytokine primarily responsible for promoting bone destruction in Rheumatoid Arthritis is:

A)IL-10
B)TGF-beta
C)TNF-alpha
D)IL-4

Answer: C)TNF-alpha

Question: The abnormal layer of tissue formed in the joints in RA, composed of fibroblasts and immune cells, is called:

A)A granuloma
B)A pannus
C)A plaque
D)A node

Answer: B)A pannus

Question: Which HLA allele is most strongly associated with Rheumatoid Arthritis?

A)HLA-B27
B)HLA-DR3
C)HLA-DR4
D)HLA-DQ2

Answer: C)HLA-DR4

Question: Non-specific indicators of inflammation commonly elevated in RA include:

A)Anti-CCP and RF
B)ESR and CRP
C)TSH and T4
D)Cortisol and ACTH

Answer: B)ESR and CRP

Question: A first-line Disease-Modifying Antirheumatic Drug (DMARD) for RA is:

A)Ibuprofen
B)Prednisone
C)Methotrexate
D)Rituximab

Answer: C)Methotrexate

Question: Sjögren's Syndrome primarily affects which glands?

A)Thyroid and parathyroid
B)Adrenal glands
C)Salivary and lacrimal glands
D)Pancreatic islets

Answer: C)Salivary and lacrimal glands

Question: The two most characteristic autoantibodies in Sjögren's Syndrome are:

A)Anti-dsDNA and Anti-Sm
B)Anti-TPO and anti-thyroglobulin
C)Anti-SSA/Ro and anti-SSB/La
D)Anti-CCP and RF

Answer: C)Anti-SSA/Ro and anti-SSB/La

Question: A common test used to diagnose dry eyes in Sjögren's Syndrome is:

A)Schirmer's test
B)Patch testing
C)Sialography
D)Electromyography

Answer: A)Schirmer's test

Question: Granulomatosis with Polyangiitis (Wegener's) is strongly associated with which ANCA pattern?

A)p-ANCA (MPO)
B)c-ANCA (PR3)
C)Peripheral ANA
C)Anti-glomerular basement membrane

Answer: B)c-ANCA (PR3)

Question: The primary target of c-ANCA/PR3-ANCA in Granulomatosis with Polyangiitis is:

A)The nucleus of neutrophils
B)The cytoplasm of neutrophils (Proteinase 3)
C)The myeloperoxidase in neutrophils
D)The cell membrane of endothelial cells

Answer: B)The cytoplasm of neutrophils (Proteinase 3)

Question: A key renal finding in Granulomatosis with Polyangiitis is:

A)Glycosuria
B)Crescent formation in the glomerulus
C)Renal calculi
D)Hydronephrosis

Answer: B)Crescent formation in the glomerulus

Question: Type 1 Diabetes Mellitus is caused by autoimmune destruction of:

A)Alpha cells in the pancreas
B)Beta cells in the pancreas
C)Delta cells in the pancreas
D)Acini in the pancreas

Answer: B)Beta cells in the pancreas

Question: Which autoantibody is most commonly detectable in Type 1 DM, often before symptoms appear?

A)Anti-IA2
B)Anti-ZnT8
C)Anti-GAD65
D)Islet Cell Antibodies (ICA)

Answer: C)Anti-GAD65

Question: The hallmark of Grave's disease is the presence of antibodies that stimulate the:

A)Thyroglobulin
B)Thyroid peroxidase
C)TSH receptor
D)Insulin receptor

Answer: C)TSH receptor

Question: In Grave's disease, laboratory findings typically show:

A)High TSH, High T3/T4
B)Low TSH, High T3/T4
C)High TSH, Low T3/T4
D)Low TSH, Low T3/T4

Answer: B)Low TSH, High T3/T4

Question: A distinctive clinical sign of Grave's disease is:

A)Hyperpigmentation
B)Exophthalmos
C)Mask-like facies
D)Slurred speech

Answer: B)Exophthalmos

Question: Systemic Lupus Erythematosus (SLE) is characterized by the production of autoantibodies primarily directed against:

A)Cytoplasmic enzymes
B)Cell surface receptors
C)Components of the cell nucleus
D)Neurotransmitters

Answer: C)Components of the cell nucleus

Question: The "butterfly rash" in SLE is typically located on the:

A)Chest
B)Back
C)Face
D)Extremities

Answer: C)Face

Question: Which autoantibody is highly specific for SLE?

A)Anti-SSA/Ro
B)Anti-SSB/La
C)Anti-Smith (Anti-Sm)
D)Rheumatoid Factor (RF)

Answer: C)Anti-Smith (Anti-Sm)

Question: A common trigger for SLE flares is:

A)High-salt diet
B)Exposure to ultraviolet (UV) light
C)High caffeine intake
D)Heavy exercise

Answer: B)Exposure to ultraviolet (UV) light

Question: In SLE, immune complex deposition in the kidneys most commonly leads to:

A)Renal calculi
B)Glomerulonephritis
C)Hydronephrosis
D)Renal artery stenosis

Answer: B)Glomerulonephritis

Question: The classical pathway of complement activation is frequently triggered in SLE by:

A)Antigen-antibody complexes
B)Alternate pathway activation
C)Lectin binding to microbial surfaces
D)Direct tissue damage

Answer: A)Antigen-antibody complexes

Question: During active SLE, complement levels (C3, C4) are typically:

A)Elevated
B)Low
C)Normal
D)Variable

Answer: B)Low

Question: The term "horror autotoxicus," referring to the immune system attacking the host, was coined by:

A)Robert Koch
B)Louis Pasteur
C)Paul Ehrlich
D)Elie Metchnikoff

Answer: C)Paul Ehrlich

Question: Central tolerance for T-cells primarily occurs in the:

A)Bone marrow
B)Thymus
C)Spleen
D)Liver

Answer: B)Thymus

Question: The process where strongly self-reactive T-cells are eliminated in the thymus is called:

A)Positive selection
B)Negative selection
C)Clonal expansion
D)Receptor editing

Answer: B)Negative selection

Question: For B-cells that recognize self-antigens in the bone marrow, which process can alter their receptor to reduce self-reactivity?

A)Apoptosis
B)Anergy
C)Receptor editing
D)Clonal deletion

Answer: C)Receptor editing

Question: Peripheral tolerance serves as a:

A)Primary mechanism for T-cell development
B)Backup mechanism for self-reactive cells that escape central tolerance
C)Process for generating memory cells
D)Mechanism for antibody class switching

Answer: B)Backup mechanism for self-reactive cells that escape central tolerance

Question: Regulatory T-cells (Tregs) suppress immune responses by releasing cytokines such as:

A)IL-1 and TNF-alpha
B)IL-10 and TGF-beta
C)IL-2 and IFN-gamma
D)IL-4 and IL-13

Answer: B)IL-10 and TGF-beta

Question: Which of the following is a key genetic factor associated with Ankylosing Spondylitis?

A)HLA-DR3
B)HLA-DR4
C)HLA-B27
D)HLA-DQ2

Answer: C)HLA-B27

Question: The HLA alleles DR3 and DR4 are associated with an increased risk for:

A)Systemic Lupus Erythematosus
B)Rheumatoid Arthritis
C)Type 1 Diabetes Mellitus
D)Multiple Sclerosis

Answer: C)Type 1 Diabetes Mellitus

Question: Which of the following is an example of an environmental trigger for autoimmunity?

A)High carbohydrate diet
B)Ultraviolet radiation
C)Low fluid intake
D)High altitude

Answer: B)Ultraviolet radiation

Question: Molecular mimicry refers to a situation where:

A)Immune cells mimic tissue cells
B)Foreign antigens resemble self-antigens
C)Antibodies mimic hormones
D)Cytokines mimic neurotransmitters

Answer: B)Foreign antigens resemble self-antigens

Question: A mechanism of tissue damage in autoimmune diseases where antibodies bind to cells and lead to their destruction by phagocytes or NK cells is called:

A)Immune complex deposition
B)Cytotoxic T-cell mediated killing
C)Antibody-mediated cell destruction
D)Granuloma formation

Answer: C)Antibody-mediated cell destruction

Question: In which autoimmune disease is immune complex deposition a central mechanism of tissue injury?

A)Myasthenia Gravis
B)Type 1 Diabetes Mellitus
C)Systemic Lupus Erythematosus
D)Grave's Disease

Answer: C)Systemic Lupus Erythematosus

Question: Which cell is primarily responsible for the direct cytotoxic attack on beta cells in Type 1 Diabetes?

A)B-cells
B)CD4+ T-helper cells
C)CD8+ cytotoxic T-cells
D)Macrophages

Answer: C)CD8+ cytotoxic T-cells

Question: A state of immune unresponsiveness to a specific self-antigen is known as:

A)Immunodeficiency
B)Autoimmunity
C)Tolerance
D)Hypersensitivity

Answer: C)Tolerance

Question: In peripheral tolerance, self-reactive lymphocytes that receive signal without proper co-stimulation become:

A)Activated
B)Anergic
C)Memory cells
D)Plasma cells

Answer: B)Anergic

Question: Which of the following celebrities was mentioned as having multiple autoimmune disorders?

A)Selena Gomez
B)Lady Gaga
C)Kris Aquino
D)Both A and C

Answer: D)Both A and C

Question: The drug Procalnamide is known to induce symptoms similar to:

A)Rheumatoid Arthritis
B)Systemic Lupus Erythematosus
C)Myasthenia Gravis
D)Multiple Sclerosis

Answer: B)Systemic Lupus Erythematosus

Question: Which vitamin deficiency leads to megaloblastic anemia in Pernicious Anemia?

A)Vitamin A
B)Vitamin B12
C)Vitamin C
D)Vitamin D

Answer: B)Vitamin B12

Question: The term "achlorhydria" in Pernicious Anemia refers to:

A)Absence of gastric acid
B)Absence of intrinsic factor
C)Presence of gastric ulcers
D)Overproduction of gastrin

Answer: A)Absence of gastric acid

Question: Which antibody is associated with a perinuclear (p-ANCA) staining pattern and targets myeloperoxidase?

A)PR3-ANCA
B)Anti-GBM
C)MPO-ANCA
D)Anti-dsDNA

Answer: C)MPO-ANCA

Question: In Myasthenia Gravis, what diagnostic test shows a decrease in muscle response with repeated stimulation?

A)Schirmer's test
B)Electromyography (EMG)
C)Nerve conduction study
D)Sialography

Answer: B)Electromyography (EMG)

Question: A common treatment for severe cases of Granulomatosis with Polyangiitis is:

A)Levothyroxine
B)Pyridostigmine
C)High-dose corticosteroids and cyclophosphamide
D)Hydroxychloroquine

Answer: C)High-dose corticosteroids and cyclophosphamide

Question: The primary function of intrinsic factor is to facilitate the absorption of:

A)Iron
B)Folate
C)Vitamin B12
D)Vitamin D

Answer: C)Vitamin B12

Question: Which of the following is NOT a common symptom of Sjögren's Syndrome?

A)Dry mouth (xerostomia)
B)Dry eyes (keratoconjunctivitis sicca)
C)Joint pain (arthralgia)
D)Heat intolerance

Answer: D)Heat intolerance

Question: Raynaud's phenomenon, often associated with SLE and Sjögren's, involves:

A)Bulging of the eyes
B)Narrowing of blood vessels in fingers and toes
C)Butterfly-shaped rash
D)Muscle weakness

Answer: B)Narrowing of blood vessels in fingers and toes

Question: The hormone responsible for stimulating the adrenal cortex to produce cortisol is:

A)TSH
B)ACTH
C)ADH
D)FSH

Answer: B)ACTH

Question: In Addison's disease, the skin darkening (hyperpigmentation) is due to:

A)Accumulation of bilirubin
B)Increased ACTH stimulating melanocytes
C)Deposition of immune complexes
D)Vitamin B12 deficiency

Answer: B)Increased ACTH stimulating melanocytes

Question: Which of the following is a treatment for Pernicious Anemia?

A)Oral iron supplements
B)Vitamin B12 injections
C)Thyroid hormone replacement
D)Corticosteroids

Answer: B)Vitamin B12 injections

Question: The main autoantibody in Myasthenia Gravis targets:

A)Muscle fibers
B)Acetylcholinesterase enzyme
C)Acetylcholine receptors
D)Voltage-gated calcium channels

Answer: C)Acetylcholine receptors

Question: A surgical procedure sometimes performed in Myasthenia Gravis is:

A)Thyroidectomy
B)Adrenalectomy
C)Thymectomy
D)Gastrectomy

Answer: C)Thymectomy

Question: Which cytokine in RA promotes the production of osteoclasts?

A)IL-4
B)IL-10
C)TNF-alpha
D)TGF-beta

Answer: C)TNF-alpha

Question: The cytokine RANKL in RA is primarily responsible for:

A)Inhibiting osteoblasts
B)Activating osteoclasts
C)Stimulating B-cells
D)Promoting angiogenesis

Answer: B)Activating osteoclasts

Question: Which of the following is a biologic therapy used in RA that targets TNF-alpha?

A)Methotrexate
B)Infliximab
C)Hydroxychloroquine
D)Azathioprine

Answer: B)Infliximab

Question: In Sjögren's Syndrome, a salivary gland biopsy typically shows:

A)Amyloid deposits
B)Lymphocytic infiltration
C)Granuloma formation
D)Fibrosis

Answer: B)Lymphocytic infiltration

Question: Which virus is commonly implicated as a trigger for Sjögren's Syndrome?

A)Human Immunodeficiency Virus (HIV)
B)Epstein-Barr Virus (EBV)
C)Hepatitis B Virus (HBV)
D)Varicella-Zoster Virus (VZV)

Answer: B)Epstein-Barr Virus (EBV)

Question: The autoantibodies anti-SSA/Ro and anti-SSB/La in Sjögren's target proteins involved in:

A)DNA replication
B)RNA processing
C)Protein synthesis
D)Cell division

Answer: B)RNA processing

Question: In Granulomatosis with Polyangiitis, granulomas commonly form in the:

A)Liver and spleen
B)Sinuses, lungs, and nasal passages
C)Skin and joints
D)Brain and spinal cord

Answer: B)Sinuses, lungs, and nasal passages

Question: A patient with Granulomatosis with Polyangiitis might present with a deformity of the nose known as:

A)Saddle nose
B)Hook nose
C)Roman nose
D)Button nose

Answer: A)Saddle nose

Question: The treatment for Grave's disease may include all EXCEPT:

A)Methimazole
B)Radioactive iodine
C)Levothyroxine
D)Thyroid surgery

Answer: C)Levothyroxine

Question: The HLA association for Grave's disease is:

A)HLA-DR3
B)HLA-B27
C)HLA-DR4
D)HLA-DQ2

Answer: A)HLA-DR3

Question: Which autoantibody is associated with a more aggressive form of Type 1 Diabetes?

A)Anti-GAD65
B)Anti-IA2
C)ICA
D)IAA

Answer: B)Anti-IA2

Question: A new serological marker for Type 1 Diabetes is:

A)Anti-ZnT8
B)Anti-TPO
C)Anti-TTG
D)Anti-CCP

Answer: A)Anti-ZnT8

Question: In SLE, the ANA test is most commonly performed using which technique?

A)Western Blot
B)Enzyme-Linked Immunosorbent Assay (ELISA)
C)Indirect Immunofluorescence (IIF)
D)Flow Cytometry

Answer: C)Indirect Immunofluorescence (IIF)

Question: A symptom characterized by the feeling of "sand" in the eyes is associated with:

A)Grave's disease
B)Myasthenia Gravis
C)Sjögren's Syndrome
D)Addison's disease

Answer: C)Sjögren's Syndrome

Question: The term "sicca" in keratoconjunctivitis sicca means:

A)Inflammation
B)Dryness
C)Pain
D)Redness

Answer: B)Dryness

Question: Which of the following is NOT a typical symptom of Hashimoto's thyroiditis?

A)Weight gain
B)Cold intolerance
C)Tachycardia
D)Fatigue

Answer: C)Tachycardia

Question: In a patient with suspected Addison's disease, a lab finding that would support the diagnosis is:

A)Hyperglycemia
B)Hyponatremia
C)Hyperkalemia
D)Both B and C

Answer: D)Both B and C

Question: The initial site of iron absorption in the gastrointestinal tract is the:

A)Stomach
B)Duodenum
C)Jejunum
D)Ileum

Answer: B)Duodenum

Question: Folate absorption occurs primarily in the:

A)Stomach
B)Duodenum
C)Jejunum
D)Ileum

Answer: C)Jejunum

Question: The mnemonic "FBI - JID" helps remember the absorption sites for:

A)Fat, Bile, Iron
B)Folate, B12, Iron
C)Fluid, Bicarbonate, Iodine
D)Fructose, B12, Iodine

Answer: B)Folate, B12, Iron

Question: Which cell in the stomach produces gastrin?

A)Chief cells
B)Parietal cells
C)G cells
D)D cells

Answer: C)G cells

Question: In Myasthenia Gravis, the autoantibody is typically of which class?

A)IgA
B)IgM
C)IgG
D)IgE

Answer: C)IgG

Question: The drug Pyridostigmine used in Myasthenia Gravis works by:

A)Blocking acetylcholine receptors
B)Inhibiting acetylcholinesterase
C)Suppressing antibody production
D)Stimulating thymic function

Answer: B)Inhibiting acetylcholinesterase

Question: Which of the following is a common immunosuppressive drug used in Myasthenia Gravis?

A)Azathioprine
B)Levothyroxine
C)Hydrochloroquine
D)Methimazole

Answer: A)Azathioprine

Question: The primary genetic association for Type 1 Diabetes is:

A)HLA-B27
B)HLA-DR2
C)HLA-DR3/DR4
D)HLA-DQ8

Answer: C)HLA-DR3/DR4

Question: In SLE, anti-dsDNA antibodies are associated with which major organ involvement?

A)Heart
B)Lungs
C)Kidneys
D)Skin

Answer: C)Kidneys

Question: A patient with SLE and glomerulonephritis would most likely have which finding on urinalysis?

A)Glucosuria
B)Hematuria and proteinuria
C)Ketonuria
D)Bilirubinuria

Answer: B)Hematuria and proteinuria

Question: The complement component often found to be low during active SLE is:

A)C1
B)C2
C)C3
D)C9

Answer: C)C3

Question: Hydroxychloroquine is commonly used in SLE to manage:

A)Kidney disease
B)Skin and joint symptoms
C)Central nervous system involvement
D)Cardiac complications

Answer: B)Skin and joint symptoms

Question: The pathophysiology of SLE involves impaired clearance of:

A)Immune complexes
B)Bacteria
C)Viruses
D)Toxins

Answer: A)Immune complexes

Question: Which of the following is a known environmental trigger for SLE?

A)Smoking
B)Estrogen
C)UV light
D)All of the above

Answer: D)All of the above

Question: The presence of which HLA alleles increases the risk for SLE?

A)HLA-DR1 and DR2
B)HLA-DR2 and DR3
C)HLA-DR3 and DR4
D)HLA-DR4 and DR5

Answer: B)HLA-DR2 and DR3

Question: In the context of autoimmunity, "anergy" refers to:

A)Excessive immune response
B)Immune cell proliferation
C)Functional unresponsiveness of lymphocytes
D)Antibody production

Answer: C)Functional unresponsiveness of lymphocytes