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Kaplan Qbank USMLE



Author9 Posts
  #1

A baby with a defect in CD40 ligand which prevents proper interaction with B cells would still be able to initiate an antibody response to which of the following antigens? Click on the circle next to your answer choice
A. Escherichia coli flagellin
B. Escherichia coli porin
C. HIV gp120
D. Penicillin




  #2

ok that's a tough one.
i only know that a defect in CD40L results in Hyper IgM syndrome, because class switch does not work anymore. so we have more than enough IgM but none of the other Ig classes. so now we have to figure out which antibody response of the above would be IgM.
suggestions?
i would go for D, cause it sounds reasonable, i don't know. i don't see any difference between A and B, and for C we certainly would ---
WAIT now that i think about it i would go for C - they produce anti-gp120 IgM first, right?
not sure now. but i say C. what do you guys think?

  #3

the right answer is A.

  #4

Is it b/c the extracellular surface "flagellin" activates the alternate pathway of the complement system, whereas the penicillin, gp120, and Ecoli "porin" all require TCELL-BCELL interaction via the CD40ligand.?

  #5

This is what I have found:Mammals tend to have a strong immune system response to flagellin since it's one of the most common proteins in some disease-causing bacteria. In mammals, there is a specific T-cell receptor for flagellin. Bacteria, of course, respond by trying to overcome the response; some can switch between different flagellin genes to try to trick mammalian immune cells.

  #6

got it:

there is no t-cell receptor for flagellin but a specific toll like receptor -> TLR5
so the immune response to flagellin has nothing to do with antibody production,
the !innate! immune system responds when recognizing flagellin via TLR5.



  #7

I know this q has been answered, but can somebody clear something up for me? I read somewhere that gp120 antigen is constantly changing its antigenicity; so the IgM titer for gp120 stays high in HIV ppl even when the CD4 count is low because it's B-cell mediated. Am I just confused about this?

  #8

good q

___________________
The Key to Succeed is Patience.

  #9

NADIABARATI. COULD U PLEASE TELL ME THE SOURCE OF YOUR QUESTION. i AM TRYING TO FIND MORE BUT COULD'T?







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