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Physiology MCQ > Immunology MCQ > Flashcards

Immunology MCQ Flashcards

1
Q 
1.	Pt presents with right iliac fossa pain; diagnosed with pyogenic inflammation of the appendix.
Mediator of Innate Immunity:
A. IFN Type 1
B. MBL
C. IgG
D. CTLs
E. Eosinophils
A

B. MBL

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2
Q
  1. Immunoglobulin isotope switching from IgM to IgA involves
    A. Activated RAG
    B. Pairing with alternate light chain
    C. Peptide presentation by HLA class II
    D. CD4+ T cell help
    E. Formation of alternate variable domain
A

D. CD4+ T cell help

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3
Q 
3.	Metastatic carcinoma cells are MOST likely to become lodged in which regions of the lymph node? 
A. Subcapular sinus
B. Follicles 
C. Paracortex
D. High endothelial venules
E. Medulla
A

A. Subcapular sinus

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4
Q 
4.	Increased capillary permeability as a result of complement activation is MOST likely due to
A) depletion of C1
B) formation of anaphylatoxins
C) formation of C3b 
D) formation of c5 convertase
E) formation of membrane attack complex
A

B) formation of anaphylatoxins

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5
Q
  1. Which of the following are major antigens recognized by alloreactive T cells that mediate acute graft-versus-host rejection following haematopoietic stem cell transplantation?
    A. ABO blood antigen
    B. Rhesus antigens
    C. Tissue specific antigens not expressed in thymus
    D. T cell receptor
    E. Human Leukocyte Antigen
A

E. Human Leukocyte Antigen

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6
Q 
6.	A novel strain of influenza H7N9 has emerged. Which immune cell provides rapid first line response?
A. CD4+ T lymphocyte
B. CD8+ T lymphocyte 
C. Natural Killer Cells
D. Neutrophils
E. Eosinophils
A

C. Natural Killer Cells

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7
Q
  1. Following an immunization with Hemophilus Influenzae conjugate vaccine, which of the following is MOST likely to protect the immunized patient against severe disease when exposed to H. Influenzae?
    A. CD4+ T cells specific for capsule polysaccharides
    B. CD8+ T cells specific for capsule polysaccharides
    C. Complement c3
    D. IgM antibodies specific for capsule polysaccharides
    E. IgG antibodies specific for capsule polysaccharides
A

E. IgG antibodies specific for capsule polysaccharides (conjugate vaccines trigger IgG production for encapsulated bacteria)

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8
Q
  1. Prior to renal transplant, mix donor’s lymphocytes with recipient’s serum. What are you checking for?
    A. Donor specific antibodies in recipient serum
    B. Alloreactive T cells in recipient
    C. Check for anti CMV antibodies in recipient serum
    D. Check for anti HIV antibodies in recipient serum
    E. Recipients specific T cells in donors lymphocytes
A

A. Donor specific antibodies in recipient serum

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9
Q
  1. Which of the following is the most likely mechanism of protection mediated by neutralising antibodies against viruses?
    A. Destruction of viruses by antibody dependent cellular cytotoxicity
    B. Interferes with entry of viruses into target cells
    C. Complement activation via classical pathway
    D. Stimulation of type 1 interferon production
    E. Antigen dependent activation of CTLs
A

B. Interferes with entry of viruses into target cells

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10
Q
  1. Which of the following best explains why a pregnant woman with poorly controlled Graves’ disease might be at risk of giving birth to a child with symptoms of hyperthyroidism
    A. Transplacental transfer of triiodothyronine to fetus
    B. Transplacental transmission of TSH to fetus
    C. Transplacental transmission of pathogenic antibodies to fetus
    D. Transplacental trafficking of pathogenic cd4+ T cells into fetal circulation
    E. Maternal CTLs are alloreactive against fetal thyroid antigens
A

C. Transplacental transmission of pathogenic antibodies to fetus

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11
Q
  1. What is the most likely action of IL-4
    A. Activates complement pathway
    B. Neutralise allergens
    C. Triggers mast cells
    D. Th2 cells proliferation and differentiation
    E. Binding to self antigen
A

D. Th2 cells proliferation and differentiation

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12
Q 
13.	Which of the following does not describe asthma correctly:
A. Irreversible obstruction of airways
B. Air wall edema
C. Shortness of breath
D. Airway hypersensitivity
E. Reversible obstruction of airways
A

A. Irreversible obstruction of airways

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13
Q 
14.	Which of the following are used to test for immunity against Mycobacterium TB?
A. Skin prick test
B. Red Blood Cell Haemagglutination test
C. Mantoux test
D. Allergen specific IgG
E. T cell assays
A

C. Mantoux test

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14
Q 
15.	What causes viral clearance?
A. B cell
B. CD4 T cell
C. Eosinophils
D. Cytotoxic CD8 T cell
E. NK cell
A

D. Cytotoxic CD8 T cell

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15
Q 
16.	Which of the following cells do NOT express MHC 1? 
A. T cell
B. Dendritic cells
C. RBC
D. Macrophage
E. Virus-infected cells
A

C. RBC

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16
Q 
17.	Affinity maturation occurs in 
A. Primary Follicle
B. Secondary Follicle 
C. Parafollicular cortex
D. Medullary
E. Trabeculae
A

B. Secondary Follicle (in the germinal centre of secondary follicle. Primary follicle does not have germinal center)

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17
Q 
18.	What best describes IgE action?
A. Activate complement
B. Neutralize antigens
C. Trigger mast cells
D. Activate Th2 cells
E. Bind to self-antigens
A

C. Trigger mast cells

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18
Q
  1. An individual with blood group B was transfused with group A blood for the first time. Which following reactions is the main mechanism for hemolysis?
    A. Anti-A IgM bound to A antigen to trigger membrane attack complex.
    B. Anti-A IgM bound to A antigen to trigger formation of anaphylatoxins
    C. Anti-A IgM bound to A antigen to trigger opsonin deposition on RBC and to be phagocytosed
    D. Anti-A IgG bound to A antigen to trigger formation of membrane attack complex
    E. Anti-A IgG bound to A antigen to trigger formation of anaphylatoxins
    F. CD8 T cells from the recipient attack the RBCs
    G. CD8 T cells from the donor cause graft vs host reaction
    H. NK cells from the recipient kill the RBCs
A

A. Recipient Anti-A IgM bind to A antigen on donor RBCs, activating complement pathway and resulting in a membrane attack complex that lyse the RBCs.

option C / Donor RBCs activate complement pathway, causing opsonisation and eventually phagocytosis –> doesn’t cause hemoLYSIS

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19
Q 
20.	Which of the following confers protection following administration of oral vaccine against rotavirus?
A. Anti-rotavirus IgA
B. Anti-rotavirus IgE
C. Anti-rotavirus IgG
D. Anti-rotavirus IgM
E. Anti-rotavirus IgD
A

A. Anti-rotavirus IgA

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20
Q 
21.	CD4+ T helper cells are essential for the following B cell processes except:
A. Affinity maturation
B. Clonal expansion
C. Somatic recombination
D. Formation of plasma cells
E. Formation of memory cells
A 
21.	CD4+ T helper cells are essential for the following B cell processes except:
A. Affinity maturation
B. Clonal expansion
C. Somatic recombination
D. Formation of plasma cells
E. Formation of memory cells
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21
Q 
22.	Which of the following is NOT associated with allergenic asthma?
A. Eosinophils
B. Th2 CD4 T cells
C. Mast cells
D. Neutrophils
E. IgE
A

D. Neutrophils

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22
Q 
24.	Which is the least likely to involve type 2 hypersensitivity?
A. Haemolytic disease of the newborn
B. Diabetes
C. TB 
D. Goodpasture’s syndrome
E. Graves’ disease
A

C. TB (TB is type IV)

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23
Q
  1. Thymic education of T cell precursors consists of the following except:
    A. Affinity maturation
    B. MHC restriction
    C. Negative selection of T cells that recognize self-antigens expressed by the thymus
    D. Negative selection of T cells that recognize self-antigens expressed by the liver
    E. Formation of regulatory T cells
A

A. Affinity maturation

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24
Q
  1. A woman with myasthenia gravis gave birth to a full-term baby. The baby has signs of muscle weakness. Which of the following statements regarding neonatal myasthenia gravis is most probably correct?
    A. Pathogenic Ig bind to the muscarinic receptors of the neuromuscular junction
    B. Pathogenic Ig has a half-life of 3 weeks
    C. CD4+ T cells in the neonate are able to aid in affinity maturation of pathogenic Ig in the neonate
    D. An inherited defect in self-tolerance led to activation of pathogenic CD8+ T cells that attacked the motor end-plate
    E. Pathogenic Ig belong to an isotype which forms pentamers with J-chain
A

B. Pathogenic Ig has a half-life of 3 weeks
A not ans: wiki says myasthenia gravis involves nicotinic receptors (the nicotinic receptors are the main ones, muscarinic ones in muscle are for regulation)

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25
Q
  1. The different specificities of the immunoglobulins produced in our body is:
    A. Entirely inherited from our parents
    B. Due to somatic recombination occurring in the V, D and J segments of the light chain
    C. Determined by both the heavy and light chain
    D. Due to somatic hypermutation and isotype switching
    E. Due to genetic variation of the MHC allele
A

C. Determined by both the heavy and light chain

B not ans: light chain doesn’t hv D segments

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26
Q 
29.	What is associated with eosinophilia? 
A. Bacillus in gram negative stain
B. Predominance of Th1 cells
C. Mammillated eggs in stools 
D. Owl’s eye inclusions
E. Lewy bodies in CSF
A

C. Mammillated eggs in stools (such as fertilized eggs of Ascaris, in ascariasis)

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27
Q
  1. Which of the statements below is FALSE?
    A. Molecules >=2500kDa in weight are more antigenic than smaller molecules
    B. Soluble proteins are more antigenic than particulate ones
    C. Complex compounds are more antigenic than simple ones
    D. Denatured proteins are more antigenic than those in their natural form
    E. Antigens administered subcutaneously are more antigenic than those administered systemically
A

B. Soluble proteins are more antigenic than particulate ones (particulate proteins are more immunogenic)
E not ans: subcutaneous = higher epitope density

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28
Q
  1. Which one of the statements was the most true about hyperacute transplantation rejection?
    A. Recipient’s serum mixed with donor’s lymphocytes
    B. Antibodies will activate an antibody-mediated cellular cytotoxicity by activating macrophages
    C. The antibodies will activate the complement system by activating mannose binding lectin
    D. Injection of thymic-inhibiting antibodies will diminish the rejection
    E. Rejection occurs within minutes of transplantation
A

E. Rejection occurs within minutes of transplantation

B. Antibodies will activate an antibody-mediated cellular cytotoxicity by activating macrophages (MAY be an answer, online search reveals that macrophages can do ADCC though can’t confirm if this is a major mechanism of hyperacute rejection!)

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29
Q 
33.	Allergic rhinitis is not associated with the following?
A. Mast cell degranulation
B. IgE cross linking on effector cells
C. Histamine binding on H2 
D. Blood vessel dilation
E. IL-4 secreted by C4+ T cell
A

C. Histamine binding on H2 (H1 Receptor rather than H2)

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30
Q 
34.	The process of immature T cells with some ability to recognise antigens in context of self HLA occurs in the:
A. Fetal liver
B. Thymus
C. Lymph node
D. Spleen
E. Kidney
F. Bone marrow
A

B. Thymus

note: negative selection of T cells also occurs in thymus

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31
Q 
35.	What is a feature of dendritic cell (APC) maturation?
A. Upregulation of phagocytosis
B. Downregulation of MHC-1 molecules
C. Upregulation of B7 molecules
D. Downregulation of cytokines secretion
E. Chemotaxis to site of infection
A

C. Upregulation of B7 molecules

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32
Q
  1. Which of the following statements about microbe specific antibody levels is most likely to be true?
    A. A two fold rise in microbe specific Ab levels between acute and convalescent levels is indicative of an infection
    B. The lymphocyte proliferation assay is useful for detecting the presence of an infection
    C. IgM levels are indicative of exposure to the microbe antigen in the distant past
    D. The ELISA test makes use of anti-human antibody against microbe specific antibody to amplify the signal
    E. A four-fold rise in microbe specific Ab levels is to be expected between samples taken at 3 and 4 weeks after infection begins
A

D. The ELISA test makes use of anti-human antibody against microbe specific antibody to amplify the signal

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33
Q
  1. Which of the following happens in chronic granulomatous disease?
    A. Failure of neutrophil to kill pathogens
    B. Failure of chemotaxis
    C. Cell-mediated immunity defects
    D. Humoral immunity defects
    E. Failure of opsonisation
A

A. Failure of neutrophil to kill pathogens (CGD is a hereditary disease, in which neutrophils and macrophages have difficulty forming the reactive oxygen compounds (most importantly, the superoxide radical) used to kill certain ingested pathogens)

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34
Q
  1. All of the following are likely to be caused by type II hypersensitivity except:
    A. Antibodies to platelets resulting in autoimmune thrombocytopenic purpura
    B. Haemolytic disease of the newborn
    C. Injection of antigens resulting in Arthus reaction
    D. Antibodies to Ach receptor resulting in myasthenia gravis
    E. Antibodies to islet cell antigens resulting in diabetes
A

C. Injection of antigens resulting in Arthus reaction (Typical of most mechanisms of the type III hypersensitivity, Arthus manifests as local vasculitis due to deposition of IgG-based immune complexes in dermal blood vessels)

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35
Q
  1. Which of the following is least likely to activate the complement system?
    A. IgG to antigen
    B. IgM to antigen
    C. C reactive protein to pneumococcus
    D. Mannose binding lectin binding to bacterial mannose
    E. Spontaneous cleavage of C3 complement
A

C is ans
A. IgG to antigen (classical pathway)
B. IgM to antigen (classical pathway)
C. C reactive protein to pneumococcus
D. Mannose binding lectin binding to bacterial mannose (lectin pathway)
E. Spontaneous cleavage of C3 complement (alternative pathway)

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36
Q 
40.	What is the pattern recognition receptor for bacterial LPS?
A.	TLR3
B.	TLR4
C.	TLR7
D.	Fc gamma 1
E.	Complement receptor 1
A

B. TLR4

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37
Q
  1. Which of the following statements is likely to be false for the structure of IgG?
    A. It is composed of two identical light and two identical heavy chains
    B. Both the light and heavy chain form part of the antigen binding component
    C. Both the light and heavy chains form part of the component that binds to complement C1qrs
    D. Both heavy chains are joined by intermolecular disulphide bonds
    E. Each heavy chain is stabilized by intramolecular disulphide bonds
A

C. Both the light and heavy chains form part of the component that binds to complement C1qrs (only Fc component of heavy chain binds to complement)

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38
Q 
42.	What type of immunoglobulin does the neonatal Fc receptor bind and transport across the placenta?
A.	IgA
B.	IgE
C.	IgG
D.	IgD
E.	IgM
A

C. IgG

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39
Q 
43.	The following molecules are expressed by cytotoxic T lymphocytes when they encounter cognate antigen on target cells and contribute to cell mediated immunity, except: 
A.	Perforin
B.	Granzyme
C.	FAS 
D.	IFN-alpha 
E.	TRAIL
A

D. IFN-alpha (typically anti-viral, from monocytes and fibroblasts. not sure, but it could be a trick because we think of TNF-alpha and IFN-gamma but NOT IFN-alpha when looking at cytotoxic T cells)
C not ans: FAS (Fas-induced apoptosis and the perforin pathway are the two main mechanisms by which cytotoxic T lymphocytes induce cell death in cells expressing foreign antigens.)
E not ans: TRAIL = TNF-related apoptosis-inducing ligand

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40
Q 
44.	The T helper cell has many accessory cell-surface molecules to help it undergo activation. The following are all involved, except:
A.	CD4
B.	CD20
C.	CD28
D.	IL-2R
E.	LFA-1
A

B. CD20

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41
Q
  1. The following are associated with dendritic cell maturation except
    A. Increased phagocytosis
    B. Increased expression of cell surface CD 86
    C. Increased expression of cell surface MHC class 1 peptide complex
    D. Migration to regional lymph nodes via afferent lymph vessels
A

A. Increased phagocytosis

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42
Q 
47.	Clonal lymphoid malignancies derived from a progenitor tumor cell that has undergone VDJ recombination has the recombined gene as a tumour-specific marker. Which of the following assays is the most sensitive in detecting residual disease following therapy?
A.	Western blot
B.	ELISA
C.	PCR
D.	FISH
E.	Flow cytometry
A

C. PCR

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43
Q

All of the following are true with respect to IgM antibodies EXCEPT which one
A. they fix complement
B. they occur on the surface of lymphocytes
C. they predominate in the primary response to antigen
D. they are glycoproteins
E. they mediate allergic reaction

A

E. they mediate allergic reaction

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44
Q

One principal function of complement is to
A. inactivate perforins
B. mediate the release of histamine
C. Bind antibodies attached to cell surfaces and to lyse these cells
D. phagocytize antigens
E. cross link allergens

A

C. Bind antibodies attached to cell surfaces and to lyse these cells

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45
Q

One principal function of the Class I and Class II major histocompatibility complex S proteins is to
A. transduce the signal to the T-cell interior following antigen binding
B. mediate immunoglobulin class switching
C. present antigen for recognition by the T-cell antigen receptor
D. stimulate production of interleukins
E. bind complement

A

C. present antigen for recognition by the T-cell antigen receptor

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46
Q

The major role of the complement system is to work in conjunction with
A. antibodies to lyse cells via the C8 and C9 components
B. the major histocompatibility complex for cell recognition
C. antibodies to opsonize cells
D. the T-cell receptor for production of lymphokines
E. antibodies to lyse cells via the perforin molecules

A

A. antibodies to lyse cells via the C8 and C9 components

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47
Q

T-cell antigen receptors are distinguished from antibodies by which of the following
A. T-cell receptors are glycosylated
B. T-cell receptors must interact with antigen uniquely presented by other cells but not with free antigen
C. T-cell receptors bind various cytokines
D. T-cell receptors bind complement to lyse cells
E. T-cell receptors are mediators of allergic reactions

A

B. T-cell receptors must interact with antigen uniquely presented by other cells but not with free antigen

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48
Q

T-cell receptors or antibodies react with antigens
A. because both are made by lymphocytes
B. because of complementary of molecular fit of both with antigen
C. because both ‘have light chain and heavy chain polypeptides
D. cause histamine release
E. facilitate perforin release

A

B. because of complementary of molecular fit of both with antigen

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49
Q 
All of the following are true of antigen EXCEPT which one of the following? 
A.	They contain epitopes. 
B.	They will react with antibodies. 
C.	They contain antigenic determinants. 
D.	They can elicit an immune response. 
E.	They contain paratopes.
A

E. They contain paratopes.

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50
Q

All of the following are true with respect to IgE molecules, EXCEPT which one?
A. They are the principal immunoglobulin class involved in allergic reactions.
B. They are involved in mediating anti-parasitic immune responses.
C. They will cross the placenta and fix complement.
D. They can effect the release of histamine and other chemical mediators.
E. They are the least abundant immunoglobulin in the serum.

A

C. They will cross the placenta and fix complement.

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51
Q 
Which of the following immunoglobulins is present normally in plasma at the highest concentration? 
A.	IgG 
B.	IgM 
C.	IgA 
D.	IgD 
E.	IgE
A

A. IgG

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52
Q

All of the following are true about antibodies, EXCEPT which one?
A. They fix complement.
B. They occur on the surface of B-lymphocyte
C. They predominate the primary immune response to antigen.
D. They are glycoproteins.
E. They are molecule with a single, defined amino acid sequence.

A

E. They are molecule with a single, defined amino acid sequence.

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53
Q 
The major immunoglobulin family to which a particular immunoglobulin belongs can be determined by sequential analysis of the 110 amino acids beginning from the 
A.	Amino terminus of the light chain. 
B.	Carboxy terminus of the light chain. 
C.	Amino terminus of the heavy chain. 
D.	Carboxy terminus of the heavy chain. 
E.	None of the above
A

D. Carboxy terminus of the heavy chain.

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54
Q

The immunoglobulin Joining chain (J-chain) is
A. only produced by T-Cells
B. only produced by neutrophils
C. associated with only multimeric forms of lgM and IgA
D. associated with IgE for histamine release
E. only produced by mast cells

A

C. associated with only multimeric forms of lgM and IgA

55
Q

. All of the following are true EXCEPT
A. An epitope is a small portion of a macromolecule
B. the variable region domains contain the antigen recognition site
C. an antigenic determinant is a paratope
D. The class of an immunoglobulin is determined by its heavy chain
E. An IgG antibody is bivalent

A

C. an antigenic determinant is a paratope

56
Q 
Which immunoglobulin is the principal one found in secretions such as milk? 
A.	IgG 
B.	IgM 
C.	IgA 
D.	IgD 
E.	IgE
A

C. IgA

57
Q 
Individuals unable to make the J protein found in certain immunoglobulins would be expected to have frequent infections of the 
A.	brain. 
B.	blood. 
C.	liver. 
D.	pancreas. 
E.	intestinal tract.
A

E. intestinal tract.

58
Q

Which of the following statements best characterizes an antibody?
A. An antibody contains high molecular weight RNA as its basic structure.
B. An antibody is composed of protein and cannot be distinguished from the albumin fraction of the serum proteins.
C. An antibody is composed of four identical protein subunits which may be caused to dissociate by treatment with urea.
D. An antibody contains protein as its major chemical component and its synthesis may be elicited by the administration of a foreign protein or polysaccharide.
E. An antibody contains mucopolysaccharides as its major chemical component and the synthesis of these may be elicited by the administration of a foreign protein or polysaccharide.

A

D. An antibody contains protein as its major chemical component and its synthesis may be elicited by the administration of a foreign protein or polysaccharide.

59
Q 
The immunoglobulin class which is the least abundant in the normal adult is 
A.	IgG 
B.	IgA 
C.	IgM 
D.	IgD 
E.	IgE.
A

E. IgE.

60
Q

Class switching of immunoglobulins occurs
A. Usually with booster immunizations, going from IgM to IgG
B. binds complement
C. causes the histamine release
D. mediates immunoglobulin class switching
E. results in the glycosylation of immunoglobulins

A

A. Usually with booster immunizations, going from IgM to IgG

61
Q 
When a B-cell undergoes immunoglobulin class switching 
A.	the variable region of the light chain changes, but its constant region remains the same 
B.	the variable region of the light chain remains the same, but its constant region changes 
C.	the variable region of the heavy chain remains the same but its constant region changes 
D.	the variable region of the heavy chain changes but its constant region remains the same 
E.	both the variable and constant regions change
A

C. the variable region of the heavy chain remains the same but its constant region changes

62
Q

The class of an immunoglobulin is determined by
A. the variable region
B. Class I and Class II major histocompatibility complex proteins
C. the carbohydrate attached to the light chain
D. the antigen
E. the heavy chain type
F. the J-chain
G. the T3 polypeptide complex

A

E. the heavy chain type

63
Q 
. Light chains are 
A.	specific for each class of antibody 
B.	not specific for each class of antibody 
C.	reactive with antigen 
D.	have only a constant region 
E.	are composed only of carbohydrate
A

B. not specific for each class of antibody

64
Q

Each of the following is a characteristic of antibodies, EXCEPT which one?
A. they are proteins with variable and constant regions
B. they contain carbohydrates
C. they are only secreted by T-cells
D. they can combine very specifically with antigen
E. they are structurally organized in globular domains

A

C. they are only secreted by T-cells

65
Q

The T3 complex of the T-cell receptor
A. probably functions to transduce a signal to the cell’s interior following binding of complexed antigen
B. binds complement
C. causes the histamine
D. mediates Immunoglobulin class switching
E. results in the glycosylation of immunoglobuiins

A

A. probably functions to transduce a signal to the cell’s interior following binding of complexed antigen

66
Q
  1. Cytokines are produced by cells of the immune system in response to various physiological stimuli
    A. modulate cell function through subsequent cell differentiation or cell proliferation
    B. facilitate cell lysis
    C. cause glycosylation of Immunoglobins
    D. cause histamine release
    E. facilitate perforin release
A

A. modulate cell function through subsequent cell differentiation or cell proliferation

67
Q
  1. Which of the following uniquely distinguishes the T-cell receptor (TCR) from an antibody?
    A. The TCR can bind an antigen fragment only in a trimolecular complex with either the class I or class II surface proteins of the major histocompatibility complex
    B. The TCR can function as a cell surface antigen receptor
    C. The TCR is composed of two different types of polypeptide chains
    D. The TCR is capable of participating in a cytotoxic reaction.
    E. The TCR polypeptide is composed of domains - an amino terminal variable portion at determines the binding specificity and a constant portion that determines the class of the polypeptide chain.
A

A. The TCR can bind an antigen fragment only in a trimolecular complex with either the class I or class II surface proteins of the major histocompatibility complex

68
Q
  1. Which of the following is NOT true of interleukins?
    A. They are cytokines which can be produced by various cells of the immune system.
    B. They are hormones which allow one cell to communicate with another cell.
    C. They are in need of receptors on the target cell in order to mediate their effects.
    D. They are able bind antigen with a high level of specificity.
    E. They are able to modulate various aspects of the B-cell arm of immune system.
A

D. They are able bind antigen with a high level of specificity.

69
Q
  1. Which of the following is NOT true of T4 and T8 cell markers?
    A. These are both surface glycoproteins expressed on T-cells.
    B. These serve to distinguish different types of T-cells, e.g., helper, suppressor and cytotoxic, from each other.
    C. These are not found associated with immunoglobulins.
    D. The T4 proteins serve both to mediate T-cell helper function as well as the receptor for the AIDS virus.
    E. Both of the markers are present on ALL T-cells.
A

E. Both of the markers are present on ALL T-cells.

70
Q
  1. Which of the following is NOT true of the ability of the T-cell receptor (TCR) to specifically recognize antigen?
    A. The antigen must be “processed” first by an accessory cell of immune system in order for it to bind to the TCR.
    B. The recognition of the antigen by the TCR can mediate helper, suppressor or cytotoxic function.
    C. The recognition of antigen by the TCR can result in cytokine secretion and/or an increase in cell proliferation within the immune system.
    D. The antigen is recognized by the T3-TCR complex only when it is associated with a protein of the major histocompatibility complex
    E. Only the alpha chain of the TCR is necessary for antigen
A

E. Only the alpha chain of the TCR is necessary for antigen

71
Q

True/False: Complement fixation can be modified by the Cholera toxin

A

False

72
Q

True/False: Complement fixation has intrinsic Guanylate cyclase activity

A

True

73
Q

True/False: Complement fixation can be desensitized by phosphorylation

A

F

74
Q

True/False: Complement fixation is an effector function of IgG and IgM following antigen binding

A

T

75
Q

True/False: IgE is the least abundant immunoglobulin in the plasma

A

T

76
Q

True/False: IgE binds to mast cells.

A

T

77
Q

True/False: IgE can cross the placental barrier

A

F

78
Q

True/False: IgM and IgG can fix complement

A

T

79
Q

True/False: IgA is a secretory Ig

A

T

80
Q

True/False: IgE mediates immediate hypersensitivity

A

T

81
Q

True/False: Antibodies are glycoproteins

A

T

82
Q

True/False: The antigenic determinate is the combining site of an antibody

A

T

83
Q

True/False: The antigenic determinate is usually no more than 5 or 6 aas of the antigen.

A

T

84
Q

True/False: The antigenic determinate is the paratope.

A

F

85
Q

True/False: The antigenic determinate consists of a small topological feature of the antigen / a small topological feature of a large macromolecule such as a protein or carbohydrate .

A

T

86
Q

True/False: An antigenic determinant is specifically recognized by a epitope.

A

F

87
Q

True/False: An antigenic determinant is specifically recognized by a paratope.

A

T

88
Q

True/False: An antigenic determinant is specifically recognized by the T4 protein.

A

F

89
Q

A critical property of an antigen is

  1. Its ability to stimulate an immune response
  2. a unique topotogical feature called an paratope
  3. a unique topological feature called an epitope
  4. not a unique topological feature called an antigenic determinant
A
  1. Its ability to stimulate an immune response
90
Q

True/False: The basic monomeric Immunoglobulin is only an integral membrane protein and never secreted.

A

T

91
Q

True/False: The basic monomeric immunoglobulin unit is composed of four polypeptides chains

A

T

a tetramer consisting of two light and two heavy chains

92
Q

True/False: The basic monomeric immunoglobulin unit is representative of a single protein type for all antibody classes

A

T

93
Q

True/False: The basic monomeric immunoglobulin unit is able to associate with J- chain to form multimers in some cases

A

T

eg. is associated with J-chain in the IgD

94
Q

True/False: The basic monomeric immunoglobulin unit is the same structure as the T-cell antigen receptor

A

F

95
Q

True/False: The basic monomeric immunoglobulin unit can occur as multimers with IgA and IgM

A

T

96
Q

True/False: The basic monomeric immunoglobulin unit exists only on the cell surface of B-cells

A

F

97
Q

True/False: Class II MHC proteins are used to participate in helper function

A

T

98
Q
  1. The major histocompatibility complex proteins function to
  2. degrade T4 and T8 polypeptides
  3. bind antibody for lymphokine production
  4. bind complement for cell lysis
  5. bind antigen fragments for presentation to T-cells
A
  1. bind antigen fragments for presentation to T-cells
99
Q
  1. Which Is TRUE for BOTH the T-cell antigen receptor and the antibody
  2. They undergo class switching
  3. They can be secreted
  4. They possess J-chains
  5. They can exist as cell surface receptor, integral membrane proteins.
A
  1. They can exist as cell surface receptor, integral membrane proteins.
100
Q
  1. The T-cell antigen receptor and antibody share the following features
  2. They contain variable and constant region domains
  3. They both possess paratopes that can recognize epitopes
  4. They are associated with accessory proteins necessary for signal transduction after antigen recognition
  5. They are multivalent
A
  1. They contain variable and constant region domains

3. They are associated with accessory proteins necessary for signal transduction after antigen recognition

101
Q
  1. The antigen combining site of the T-cell receptor and antibody are
  2. located at the amino terminal of the structures
  3. a pocket complementary’ to the epitope
  4. capable of combining with a single antigenic determinant
  5. identified by light chain kinase
A
  1. located at the amino terminal of the structures
  2. a pocket complementary’ to the epitope
  3. capable of combining with a single antigenic determinant
102
Q
  1. The specific type of functional activity of a T-cell following antigen recognition is determined by the
  2. antigen receptor
  3. Type of MHC class protein presenting the antigen fragment
  4. carbohydrate side chains
  5. T4 (CD4 ) or T8 (CD8) associated polypeptides
A
  1. Type of MHC class protein presenting the antigen fragment
  2. T4 (CD4 ) or T8 (CD8) associated polypeptides
103
Q
  1. The domain unit of an immunoglobulin or T-cell antigen receptor
  2. only include the variable regions
  3. only recognizes the paratope
  4. only fixes complement
  5. is typically about 110 amino acids long
A
  1. is typically about 110 amino acids long
104
Q
  1. Which of the following are MOST closely related to each other
  2. Antigen
  3. Allergen
  4. Epitope
  5. Antibody
A
  1. Antigen
  2. Allergen
  3. Epitope
105
Q
  1. Immunoglobulins are produced by
  2. Plasma cells
  3. T-cells
  4. B-cells
  5. Macrophages
A
  1. Plasma cells
  2. T-cells
  3. B-cells
106
Q
  1. Antibodies are distinguished from antigens, because they
  2. can only be proteins
  3. always have carbohydrate attached to their heavy chains
  4. can only be made by B-cells and plasma cells
  5. contain nucleic acids
  6. because they are not normally recognized as “foreign”
A
  1. can only be proteins
  2. always have carbohydrate attached to their heavy chains
  3. can only be made by B-cells and plasma cells
  4. because they are not normally recognized as “foreign”
107
Q
  1. Antigen-antibody reactions can result in the following:
  2. Agglutination
  3. complement fixation
  4. virus neutralization
  5. allergic reactions
A

all of the above

108
Q
  1. Effector functions of immunoglobulins are
  2. The property of the constant region domains of L-chains
  3. The property of the constant region domains of J-chains
  4. The property of the variable region domains of H-chains
  5. The property of the constant region domains of H-chains
A
  1. The property of the constant region domains of H-chains
109
Q
  1. Effector functions of Immunoglobulins are
  2. Involved in complement fixation by IgM and IgG
  3. the property of constant region domains of heavy chains
  4. illustrated by placental transfer of IgG to the fetus
  5. not the property of constant region domains of the light chains
A

all of the above

110
Q
  1. Domains of immunoglobulins are
  2. units of approximately 110 amino acids in length
  3. found in constant regions and variable regions
  4. compact globular units of heavy and light polypeptide chains
  5. the carbohydrate side chain
A
  1. units of approximately 110 amino acids in length
  2. found in constant regions and variable regions
  3. compact globular units of heavy and light polypeptide chains
111
Q
  1. Variable region domains are
  2. located at the N-terminus of immunoglobulin light and heavy chains.
  3. about 110 amino acids in length
  4. the specific recognition site for the antigen
  5. different and unique for each B-cell producing them
A

all of the above

112
Q
  1. Variable regions domains are:
  2. needed to bind complement to initiate this cascade
  3. located at the N-terminal of light and heavy chains
  4. necessary to facilitate transport across the placenta
  5. necessary for specific recognition of antigen
A
  1. located at the N-terminal of light and heavy chains

4. necessary for specific recognition of antigen

113
Q
  1. The two type of light chains of antibodies are distinguished
  2. by their constant region amino acid sequence
  3. by their variable region domains
  4. as kappa or lambda types
  5. by the J-chains that bind to them
A
  1. by their constant region amino acid sequence

3. as kappa or lambda types

114
Q
  1. The two type of light chains of antibodies are
  2. able to associate specifically with T4 orT8 proteins
  3. normally not glycosylated
  4. the basis of the five major classes of antibodies
A

none of the above

115
Q
  1. The J-chain
  2. is made only by epithelial cells
  3. is responsible for immunoglobulin multimer formation
  4. Is present in monomeric forms of immunoglobulin
  5. facilitates secretion of pentameric lgM
A
  1. is responsible for immunoglobulin multimer formation

4. facilitates secretion of pentameric lgM

116
Q
  1. Immunoglobulin class switching is a phenomenon that
  2. Changes the heavy chain constant region without changing the variable region
  3. always goes from IgM to another immunoglobulin class
  4. is Influenced in part by cytokines produced by T-cells following a booster immunization
  5. changes effector function without altering specific antigen recognition
A

all of the above

117
Q
  1. Fc receptors
  2. Occur on the cell surface of cells of the immune system
  3. recognize the variable region domains of the immunoglobulin heavy chain
  4. recognize the constant region domains of the immunoglobulin heavy chain
  5. recognize the constant region domains of the immunoglobulin light chain
A
  1. Occur on the cell surface of cells of the immune system

3. recognize the constant region domains of the immunoglobulin heavy chain

118
Q
  1. The T3 or CD3 component of the T-cell receptor
  2. Is composed of three polypeptide chains
  3. specifically recognizes antigen bound to class 1 and class ii MHO proteins
  4. participates in transducing the antigen recognition signal to the T-cells interior
  5. occurs only on accessory cells such as macrophages
A
  1. Is composed of three polypeptide chains

3. participates in transducing the antigen recognition signal to the T-cells interior

119
Q
  1. The T-cell receptor
  2. Is composed of four polypeptide chains
  3. is secreted into the plasma by the T-cell
  4. Is the recognition element of the humoral arm of the immune system
  5. recognizes antigen fragments via the alpha and beta chains
A
  1. recognizes antigen fragments via the alpha and beta chains
120
Q
  1. Killer T-cells effect their killing
  2. by antibodies with specific recognition capabilities
  3. by Inserting the complement components, CS and C9, into the target cell membrane
  4. by the T- cell antigen receptor and Class MHC proteins
  5. By inserting a pore forming protein called perforin into the target cell membrane
A
  1. By inserting a pore forming protein called perforin into the target cell membrane
121
Q
  1. The functional activity of the T-cell
  2. Is dictated by the T4 or T8 associated polypeptides
  3. occurs after recognition of an epitope by a paratope
  4. can be mediated through cytokines
  5. requires only the alpha and beta chains of the T- cell receptor
A
  1. Is dictated by the T4 or T8 associated polypeptides
  2. occurs after recognition of an epitope by a paratope
  3. can be mediated through cytokines
122
Q
  1. Target cell lysis and destruction can be achieved by
  2. Cytotoxic T-cells recognizing specific epitopes on the target cell surface
  3. perforin released from antigen-specific cytotoxic T-cells
  4. Complement binding to IgG and IgM type antibodies which have bound to epitopes on the target cell surface
  5. Complement binding to IgE type antibodies which have bound to epitopes on the cell surface
A
  1. Cytotoxic T-cells recognizing specific epitopes on the target cell surface
  2. perforin released from antigen-specific cytotoxic T-cells
  3. Complement binding to IgG and IgM type antibodies which have bound to epitopes on the target cell surface
123
Q
  1. Which of the followings are TRUE?
  2. Class 1 proteins bind antigen fragments and are recognized by the T-cell receptor and the T8 or CD8 protein
  3. Class I proteins generally occur on all cells of the immune system
  4. Class II proteins bind antigen fragments and are recognized by the T-cell receptor and the T4 or CD4 protein
  5. Class II proteins carrying antigen fragments identity normal cells as foreign and result in their cytotoxic destruction
A
  1. Class 1 proteins bind antigen fragments and are recognized by the T-cell receptor and the T8 or CD8 protein
  2. Class I proteins generally occur on all cells of the immune system
  3. Class II proteins bind antigen fragments and are recognized by the T-cell receptor and the T4 or CD4 protein
124
Q
  1. Cytokines
  2. are polypeptide hormones synthesized by specialized cells
  3. are lymphokines
  4. are monokines
  5. help to control and regulate the immune response
A

all of the above

125
Q
  1. Cytokines are
  2. Produced by cells of the immune system in response to various physiological stimuli
  3. able to stimulate an increase in antibody production
  4. able to activate T-cells
  5. able to increase B-cell proliferation
A

all of the above

126
Q
  1. Lymphokines
  2. can stimulate immunoglobulin class switching
  3. can stimulate increase antibody production
  4. can stimulate maturation of immature cytotoxic T-cells
  5. are a specific class of cytokines
A

all of the above

127
Q
  1. The major purpose of lymphokines is to
  2. bind to class I major histocompatibility molecules for cytotoxic function
  3. specifically recognize antigens or their fragments
  4. stimulate the production of complement
  5. help control and regulate the cells of the Immune system
A
  1. help control and regulate the cells of the Immune system
128
Q
  1. Immediate hypersensitivity reactions
  2. Are experienced if the antigen is an allergen
  3. result from histamine and other chemical mediator release
  4. mediated through antigen specific IgE and mast cells
  5. are a consequence of antigen-antibody reactions
A

all of the above

129
Q
  1. Which immune dysfunctions result in clinical abnormalities of the
  2. leukemia, multiple myeloma and lymphoma
  3. autoimmune diseases
  4. acquired immunodeficiency disease (AIDS) caused by HIV
  5. Bruton’s agammaglobulinemia, DiGeorge Syndrome and Severe Combined Immunodeficiency
A

all of the above

130
Q
  1. Clinical abnormalities of the Immune system can result from
  2. deficiency diseases
  3. abnormal lymphocyte proliferation
  4. HIV Infection
  5. autoimmune disease
A

all of the above

131
Q
  1. Which of the following represent immune system dysfunctions
  2. Severe immunodeficiency (Swiss agammaglobulmemia)
  3. Bruton’s agammaglobulinemia
  4. DiGeorge syndrome
  5. acquired immune deficiency syndrome
A

all of the above

132
Q
  1. The immune response
  2. is mediated via the humoral and/or cellular arms of the immune system
  3. can be facilitated through antibodies
  4. can be facilitated through T-cells
  5. can be facilitated through cells of the reticuloendothelial system
A

all of the above

133
Q
  1. Which of the followings are TRUE regarding an Immune response
  2. the principal function of the T3 complex is signal transduction to the cell’s interior after recognition of the molecular complex with antigen
  3. the T8 protein serves an auxiliary role with MHC class I proteins in cytotoxic reactions
  4. the T4 protein serves an auxiliary role with MHC class II proteins in helper cell reactions
  5. lymphokines are produced by T-cells in response to antigen presentation by Ig molecules
A

1,2, 3 NOT 4 (for 4, antigen presentation is NOT by Ig molecules)

Physiology MCQ (8 decks)

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