26malik
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A 42-year-old Nigerian in the United States visiting his brother comes to the clinic with complaints of several months of weight loss, night sweats, sputum production, and occasional spitting up blood. His physician places a tuberculin skin test and the results are positive. This positive tuberculin test indicates which of the following?
A. A cell-mediated immune response has occurred
B. A humoral immune response to TB is positive
C. The B and T cell systems are functional
D. The B cell system is functional
E. The phagocytic neutrophilic system is functional
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| robin082006
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B?
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| doc179
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A
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| robin082006
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doc179, this is a delayed reaction and relates to CD4
I'm not sure but please review Goljan 2004 page 27
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| robin082006
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doc179, this is a delayed reaction and relates to CD4
I'm not sure but please review Goljan 2004 page 27
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| doc179
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robin yes I found caseous necrosis in that page and it also says that its cell mediated ...CD4 is a helper T cell and delayed hypersensitivity or type IV hypersensitivity reactions are cell mediates ...humoral means B cell response when antibodies are involved. pls correct me if I am wrong.
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| dr_sarim
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its A
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| general malaise
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its A, type IV hypersensitivity or cell mediated
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| robin082006
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Goljan says that type 4 hyperactivity has two subtypes: delayed reaction and cell-mediated.
Cell-mediated is to kill neoplastic cell, and infectious organisms.
In tuberculin test, we use a substance of TB, and reaction occurs because of cytokines, so I think B.
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| robin082006
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My preference is Goljan Rapid review, 500 page, 2004, page 27
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| 26malik
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Answer is : A
The tuberculin skin test is a delayed type hypersensitivity test. This type IV
hypersensitivity is a cell-mediated immune response involving CD4 T helper 1 (TH1) lymphocytes.
Elimination of tuberculosis, like all intracellular bacterial infections, is not dependent on a humoral (antibody) response (choice B). This patient could have antibody to tuberculosis, but recovery is entirely dependent on cell-mediated immunity.
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