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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Immunology
|MainCategory=Immunology
Line 20: Line 20:
|MainCategory=Immunology
|MainCategory=Immunology
|SubCategory=Pulmonology
|SubCategory=Pulmonology
|Prompt=A 7-year-old boy was brought to the emergency department for severe cough since three hours.  The mother reports that her son woke up from sleep and started coughing non-stop to an extent that she noticed his color became blue.  The mother mentions that this is not the first time it happens with him as he has been having severe bouts of cough at night or following his exercise classes at school.  A diagnosis of asthma is suspected. Which of the following mediators is involved in the class switching of immunoglobulin to IgE which is involved in the pathophysiology of the patient's condition?
|Prompt=A 7-year-old boy is brought to the emergency room for a severe cough lasting three hours.  The mother reports that when her son woke up he started coughing non-stop and subsequently turned a shade of blue.  The mother mentions that this is not the first occurance, as he has been having severe coughing fits at night and following gym class.  He is diagnosed with asthma. Which of the following mediators is involved in the class switching of immunoglobulin to IgE which is involved in the pathophysiology of the patient's condition?
|Explanation=The patient is suffering from symptoms of cough at night and following exercise, which are consistent with a diagnosis of asthma. Both interleukins 4 and 5 are involved in [[asthma]].  Interleukin 4 pronotes class switching of immunoglobulin into [[IgE]] and Interleukin 5 plays a role in the activation and the proliferation of [[eosinophil]]s.


Educational objective:
|Explanation=The patient is suffering from coughing fits at night and following exercise, which are consistent with a diagnosis of asthma. Both interleukin 4 and 5 are involved in [[asthma]].  Interleukin 4 pronotes class switching of immunoglobulin into [[IgE]] and Interleukin 5 plays a role in the activation and proliferation of [[eosinophil]]s.
Shown below is an image summarizing the roles of interleukins and the cells that secrete them.


|EducationalObjective= The image displayed below summarizes the roles of interleukins and the cells that secrete them.
[[File:Interleukin.png]]
[[File:Interleukin.png]]
|References= First Aid 2014 page 205
|AnswerA=Interleukin 1
|AnswerA=Interleukin 1
|AnswerAExp=Interleukin 1 affects the activity of [[hypothalamus]], the thermoregulatory center, which leads to a raise of a body temperature, so called [[fever]].  That is why [[IL-1]] is called endogenous [[pyrogen]].  Interleukin 1 is not involved in [[asthma]].
|AnswerAExp=Interleukin 1 impacts the activity of [[hypothalamus]], the thermoregulatory center, which leads to a raise of a body temperature.  Interleukin 1 is not involved in [[asthma]].
|AnswerB=Interleukin 2
|AnswerB=Interleukin 2
|AnswerBExp=Interleukin 2 is necessary for the growth, proliferation, and differentiation of [[T cells]] to become 'effector' T cells. It is secreted by the T helper cells.  Interleukin 2 is not involved in [[asthma]].
|AnswerBExp=Interleukin 2, secreted by helper T-cells, is necessary for the growth, proliferation, and differentiation of [[T cells]] to become 'effector' T cells. Interleukin 2 is not involved in [[asthma]].
|AnswerC=Interleukin 3
|AnswerC=Interleukin 3
|AnswerCExp=Interleukin 3 is secreted by [[basophil]]s and activated [[T cells]] to support growth and differentiation of T cells from the [[bone marrow]] in an immune response.  Interleukin 3 is not involved in [[asthma]].
|AnswerCExp=Interleukin 3, secreted by [[basophil]]s and activated [[T cells]], supports growth and differentiation of T cells from [[bone marrow]] in an immune response.  Interleukin 3 is not involved in [[asthma]].
|AnswerD=Interleukin 4
|AnswerD=Interleukin 4
|AnswerDExp=Interleukin 4 induces [[B-cell]] class switching to [[IgE]], and up-regulates MHC class II production. IL-4 decreases the production of Th1 cells, macrophages, IFN-gamma, and dendritic cell IL-12.
|AnswerDExp=Interleukin 4 induces [[B-cell]] class switching to [[IgE]], and up-regulates MHC class II production. IL-4 decreases the production of Th1 cells, macrophages, IFN-gamma, and dendritic cell IL-12.
|AnswerE=Interleukin 5
|AnswerE=Interleukin 5
|AnswerEExp=Interleukin 5 is a major regulator of [[eosinophil]] accumulation in tissues, and can modulate eosinophil behavior at every stage from maturation to survival.  Interleukin 5 is not involved in [[asthma]].
|AnswerEExp=Interleukin 5 is a major regulator of [[eosinophil]] accumulation in tissues, and can modulate eosinophil behavior at every stage from maturation to survival.
|RightAnswer=D
|RightAnswer=D
|WBRKeyword=Interleukin, asthma, immunoglobulin
|WBRKeyword=Interleukin, asthma, immunoglobulin, respiratory system, eosinophil, coughing,
|Approved=No
|Approved=Yes
}}
}}

Revision as of 18:17, 29 July 2014
Author [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Immunology
Sub Category SubCategory::Pulmonology
Prompt [[Prompt::A 7-year-old boy is brought to the emergency room for a severe cough lasting three hours. The mother reports that when her son woke up he started coughing non-stop and subsequently turned a shade of blue. The mother mentions that this is not the first occurance, as he has been having severe coughing fits at night and following gym class. He is diagnosed with asthma. Which of the following mediators is involved in the class switching of immunoglobulin to IgE which is involved in the pathophysiology of the patient's condition?]]
Answer A AnswerA::Interleukin 1
Answer A Explanation [[AnswerAExp::Interleukin 1 impacts the activity of hypothalamus, the thermoregulatory center, which leads to a raise of a body temperature. Interleukin 1 is not involved in asthma.]]
Answer B AnswerB::Interleukin 2
Answer B Explanation [[AnswerBExp::Interleukin 2, secreted by helper T-cells, is necessary for the growth, proliferation, and differentiation of T cells to become 'effector' T cells. Interleukin 2 is not involved in asthma.]]
Answer C AnswerC::Interleukin 3
Answer C Explanation [[AnswerCExp::Interleukin 3, secreted by basophils and activated T cells, supports growth and differentiation of T cells from bone marrow in an immune response. Interleukin 3 is not involved in asthma.]]
Answer D AnswerD::Interleukin 4
Answer D Explanation [[AnswerDExp::Interleukin 4 induces B-cell class switching to IgE, and up-regulates MHC class II production. IL-4 decreases the production of Th1 cells, macrophages, IFN-gamma, and dendritic cell IL-12.]]
Answer E AnswerE::Interleukin 5
Answer E Explanation [[AnswerEExp::Interleukin 5 is a major regulator of eosinophil accumulation in tissues, and can modulate eosinophil behavior at every stage from maturation to survival.]]
Right Answer RightAnswer::D
Explanation [[Explanation::The patient is suffering from coughing fits at night and following exercise, which are consistent with a diagnosis of asthma. Both interleukin 4 and 5 are involved in asthma. Interleukin 4 pronotes class switching of immunoglobulin into IgE and Interleukin 5 plays a role in the activation and proliferation of eosinophils.

Educational Objective:
References: First Aid 2014 page 205]]

Approved Approved::Yes
Keyword WBRKeyword::Interleukin, WBRKeyword::asthma, WBRKeyword::immunoglobulin, WBRKeyword::respiratory system, WBRKeyword::eosinophil, WBRKeyword::coughing
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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