Anemias, coagulation disorders, leukemias/lymphomas, and immunology. This category has 114 original questions in the full StepExamPrep bank — here are 3 samples with complete explanations.
A virally infected cell releases interferon-alpha, which acts on neighboring uninfected cells. Which of the following best describes the effect of this signaling?
Type I interferons (alpha/beta), released by virally infected cells, act on neighboring cells to induce an antiviral state — upregulating enzymes (like RNase L and PKR) that degrade viral RNA and inhibit protein synthesis, limiting the ability of the virus to replicate and spread.
An elderly patient is found to have an isolated, asymptomatic elevated lymphocyte count on routine bloodwork. Peripheral smear shows small, mature-appearing lymphocytes with smudge cells. Which of the following is the most likely diagnosis?
Chronic lymphocytic leukemia, typically affecting older adults, often presents as an incidental finding of elevated mature-appearing small lymphocytes with characteristic "smudge cells" on peripheral smear (fragile cells damaged during smear preparation).
A T cell receives antigen recognition (signal 1) without adequate costimulation (signal 2, e.g., CD28-B7 interaction). Which of the following outcomes is most likely?
When a T cell receives antigen recognition without adequate costimulation, it becomes anergic — a state of functional unresponsiveness — a key peripheral tolerance mechanism helping prevent autoimmunity.
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