Therapy for autoimmune diseases does NOT include

Correct Answer: E

Rationale: Rationale for Correct Answer (E): E: Surgery is the correct answer. Surgery is not typically used as a primary therapy for autoimmune diseases. Autoimmune diseases are usually treated with medications such as immuno-suppressive drugs (A), anti-inflammatory drugs (B), and targeted therapies like anti-TNF (C) and anti-CD20 (D) to manage symptoms and control the immune response. Surgery is only considered in specific cases when other treatments have failed or for complications related to the autoimmune disease. Therefore, surgery is not a standard therapy for autoimmune diseases. Summary of Incorrect Choices: A: Immuno-suppressive drugs like cortisone are commonly used in autoimmune disease treatment. B: Aspirin is an anti-inflammatory drug that can help manage symptoms in some autoimmune diseases. C: Anti-TNF therapy targets specific molecules involved in the immune response in autoimmune diseases. D: Anti-CD20 therapy targets B cells to modulate the immune response in autoimmune diseases.

Correct Answer: D

Rationale: The correct answer is D because all the choices contribute to the vascular instability observed in severe sepsis. A: Systemic release of cytokines like TNF-α and IL-1β leads to vasodilation and increased capillary permeability. B: Complement activation causes inflammation and vasodilation. C: Release of high levels of lipid mediators like prostaglandins and leukotrienes further exacerbates vasodilation and vascular permeability. Therefore, all these mechanisms combined lead to the vascular instability seen in severe sepsis.

Correct Answer: B

Rationale: The correct answer is B because TLR4 is not a phagocytic receptor, but rather a pattern recognition receptor involved in recognizing pathogen-associated molecular patterns (PAMPs). A: Correct, TLR4 is expressed on dendritic cells and macrophages. C: Correct, TLR4 is expressed on the membrane in complex with MD2. D: Correct, mice resistant to endotoxic shock have a mutation in TLR4, indicating its role in the immune response to endotoxins.

Correct Answer: C

Rationale: The correct answer is C because inducing antibodies that can recognize the less variable regions of the Hemagglutinin (HA) protein across different strains allows for cross-protection against various flu strains. This approach is effective as it targets conserved regions of the virus, increasing the likelihood of providing broad immunity. Option A focuses on cytotoxic T cell response, which primarily targets infected cells and may not prevent viral entry into uninfected cells. Option B, on the other hand, is limited to highly strain-specific neutralizing antibodies, which may not provide adequate protection against evolving flu strains. Therefore, option C is the most effective in producing better flu vaccines by targeting less variable regions of HA for broader immunity.

Correct Answer: D

Rationale: The correct answer is D: Allowed to mature and enter the periphery. In this scenario, since the developing B cell has no binding affinity for self-antigens in the bone marrow, it will not undergo clonal deletion or anergy. Therefore, it will be allowed to mature and enter the periphery where it can encounter foreign antigens and participate in the immune response. Choices A and B are incorrect because clonal deletion and anergy are mechanisms used to eliminate or inactivate self-reactive B cells to prevent autoimmunity. Choice C is incorrect because a B cell without self-binding affinity is not a cause of autoimmunity in the periphery.