Immunology Final Qs - Part #3

7/29/2019 Immunology Final Qs - Part #3

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## the answers are at the last page##

1) Deficiency complement component c5-c8 lead to

a) Neisseria infection

2) Tumor correct except

a) tyrosinasemelanoma

b) CEA & GI cancer

c) Viral EBVLymphoma

d) BCR-Abl fusion proteinmultiple myeloma

e) Alpha- feto proteinhepatoma

3) all participate in PTK cascade, except

a) Terminal TdT

b) Ca+2


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c) Phospholipase C gamma

d) DAG

e) Protein kinase C1

4) diagnostic of IgA pepsin , except

a) (VH, CH1) X 2

b) (VH, CH1, VL, CL) X 2

c) (VH, CH1, CH2, CH3) X 2

d) (VL, CL) X 2

5) mostly affected by INF type I (INF alpha and beta)

a) Aspergellus

b) Plasmodium

c) Listeria bacteria

d) Staphylococcus bacteria

e) Influenza virus

6) immune system evasion except

a) direct killing immuno competent cell

b) MHC I inhibition

c) Point mutation

d) HLA-G Producte) Viral product inhibitory cytokines

7) The enzyme needed in liberation of HIV from infected cell

a) Gp120


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b) Protease

c) Reverse transcriptase

d) Integrase

e) Collagenase

8) Blood group receptor for plasmodium vivax protozoa

a) P system

b) Lewis-secretor

c) MNS system

d) Kidd

e) Duffy Fya- Fyb

9) Active immunity cancer except

a) Vaccination by tumor antigen

b) BCG local injections

c) Anti-CD20 infusion

d) Vaccination by whole cell

e) IL-2 infusion

10)ABOUT serum sickness what is wrong:

a) C-factor

b) Monovalent antigen

c) Persistence immune complex

d) Nutrophils

e) Equivalence of antigen and antibody

11) viruses and malignancy excepta) Human papilloma virus- cervical cancer

b) EBVlymphoma

c) Human herpes virus 8 and lymphoma

d) HTLV-1acute T lymph-leukemia


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e) EBVnasopharyngeal

12) factor other than CD4 T cell count vest to give prognosis of HIVinfected patient

a) CD8 T cell

b) Anti HIV IgM level

c) IgG level

d) PPD skin test

e) Viral protein count

13) Successful active immunotherapy by general immune system active

locally except

a) IL-2 in cancer

b) Lymphokine activated killer cell for hypernephroma

c) Cancer vaccine for lung cancer

d) BCG for urinary bladder cancer

e) Anti CD20 for B cell lymphoma

14) best bronchial asthma allergic rhinitis as allergic

a) food allergy

b) atopic dermatitis

c) drug allergy

d) urticaria

e) Conjunctivitis???

15) Injecting Complement C killing antigen-Ab in patient lacks C3

a) Depress level of serum factor B


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b) Increased chemotactic C5a serum level

c) Increased serum level of C8

d) Decreased level of C2

16) How does entamoeba evades the immune system

a) By shedding

17) Trophoblast . Immunological phenomenon except

a) antibody against paternal antigens

b) Increased HLA- G antigens

c) Decreased MHC I

d) Blocking antibody

e) Increased CD8- T recognition

18) Toll-like

a) Recognizes grambacteria cell

19) Anaphylacoid non IgE mediated

a) Bee sting allergy

b) Penicillin allergy

c) Radio contrast allergy

d) Food allergy

e) House dust mite allergy

20) Regarding pregnancy, which is wrong?

a) Androgen suppress T/B cellsb) Estrogen suppress T cells

c) Placenta TH1 suppress T cell

d) NK cell suppressed by increased HLA-G


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21) A 10 years old boy has recurrent skin and lung infections by

staphylococcus

aureus, what can be found at his diagnosis

a) Low IgM, absence of B cellb) Low Ig low B cell

c) Low terminal complement

d) Abnormal NBT test

22) Which type of Ab is involved in SLE with recurrent mid trimester

abortion and

DVT and abnormal PTT test

a) Anti Sm antibodies

b) Anti Ds DNA antibodies

c) Anti nuclear Ab

d) Anti phospholipid Ab

23) Recognition receptor functions as secreted receptor

a) Mannan binding lectin

b) CD 14c) Toll like receptor

24) Pulmonary edema that follows incompatible transfusion results in

a) Donor WBC antibodies against recipient granulocytes

25) The BM transplantation is the most difficult ..

a) Hyperacute

b) Acute rejectionsc) GVHD

d) Tolerance

26) Tumor, except

a) Dysregulation of metabolism


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b) Dysregulation of respiration

27) Remission state in pregnancy happens in, except

a) SLE

b) Type I diabetes

c) Contact dermatitis

d) Arteritis

28) Causes tolerance rather the immunity

a) Insoluble antigen

b) Heterologous antigen

c) Particulate antigend) Antigen injected subcutaneously

e) Injecting antigen to fetus in development

29) Autoimmune disease

a) Shows HLA association

b) Run a steady clinical course

c) Affect both sexes equally

d) are triggered by different antigen in different individuals

30) Candidate Immuno suppression by malnutrition of

a) Thyroxin

b) Insulin

c) Leptin

d) Glucagon

31) Regarding Parasitic infection, which one is false

a) Complement is usually effective??

32) Antibodies against sperms results in

a) Idiopathic infertility


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33) Pooled from normal human except

a) Antivenom

34) Which one in the HIV genome is associated with Low Virulence?

a) NEF gene

b) POL gene

c) GAG gene

d) ENV gene

35) Involved in stopping lymphocyte in HEV

a) L-selectin

b) LFA-1

36) Complement activation

a) Activate hapten

b) Active C1q binds antigen-antibody complex

c) C3 convertase C4bc2b

d) C3 convertase C3bBb

e) Regulate factor H

.37) Which isotype is primarily responsible for the tissue damage

associated with Type III Hypersentivity?

a. IgA

b. IgD

c. IgE

d. IgG

e. IgM

38) A reaction to poison ivy is an example of which type of Hypersentivity?

a. Type I

b. Type II


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c. Type III

d. Type IV

e. Type V

39) Hemolytic disease of the newborn (Rh incompatibility) dose not occur

when:

a. An Rh positive mother conceives an Rh positive child.

b. An Rh negative mother conceives an Rh negative child.

c. An Rh positive mother conceives an Rh negative child.

d. All of the above.e. None of the above.

40) Contact dermatitis generally occurs against substances that are too

small to induce an immune response. How do

these substances induce an immune response?

a. These substance form depots and are then slowly released into the blood.

b. These low molecular weight substances react with liver enzymes and are

difficult to eliminate.

c. These substances bind to tissue and cells resulting in a larger total

antigenic size which can then stimulate an

immune response.

d. The substance triggers the complement cascade and cause neutrophils to

accumulate and the serve as

antigen presenting cells.

e. A and c.

41) Erythrocytes from a patient with hemolytic anemia show a positive

indirect Coombs test. The patients plasma


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dose not produces observable direct agglutination of his own erythrocytes,

at either body temperature or room

temperature. Which of the following is most likely to be correct?

a. Antierythrocyte antibodies are abundant in plasma but little antibody isbound to red cells.

b. The antierythrocyte antibodies are IgG isotype.

c. The patient is of blood type O.

d. The antierythrocyte antibodies are incapable of complement activation

of opsonization.

42)A 23yearold woman becomes dizzy and sweaty while dining at a

seafood restaurant. She ultimately faints and is

taken to the Emergency Room of a local hospital where epinephrine is

administered. She responds quickly, which

of the following best describes the immunological mechanisms underlying

her illness?

a. Crosslinking of IgE antibodies on mast cells/basophils by seafood

antigen.

b. Formation of soluble immune complexes in plasma and activation of

complement.

c. Binding of seafood antigen to erythrocytes where they induce hemolysis

by antibodies and complement.

d. Release of inflammatory cytokines by seafoodantigenspecific T cells in

the intestinal mucosa.

e. Ingestion of bacterial endotoxin along with her seafood.

43) A patient is diagnosed with Brutons Agammaglobulinemia. Which

aspect of immune-system histology

would you except to be normal?


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A. Concentration of surface-Ig positive lymphocyte in peripheral blood.

B. Primary follicles in lymph nodes.

C. Germinal centers in lymph nodes.

D. Number of plasma cells in bone marrow.E. Cellularity of paracortical areas of lymph nodes

44) A professional handler of poisonous snakes is bitten by a cobra and

receives anti-venom equine

antiserum. Four days later he develops malaise, fever, chills, muscle and

joint pain, and proteinuria.

Laboratory tests reveal decreased concentration of Complement

components C3 and C4. Which of the

following is the most likely cause of his illness?

A. A delayed Hypersentivity reaction (Type IV) to equine serum proteins.

B. An immediate-hypersensitivity reaction (Type I) to snake venom

components.

C. Formation of immune complexes which contain human antibodies and

equine serum proteins.

D. Formation of immune complexes which contain equine antibodies and

snake venom proteins.

E. Direct lysis of patients erythrocytes by equine antibodies.

45)In the previous question, which of the following is most likely to have

predisposed the patient to this

illness?

A. A genetic defect in complement system.B. A genetic defect in antibody production.

C. A prior immune response to snake-venom proteins.

D. A prior episode of immunization with equine antiserum.


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46) Uninfected, normal, nucleated human cells are not attacked by Natural

Killer (NK) cells of the immune

system. What feature of their plasma membrane protectes cells form NK

attack?A. Absence of class I MHC.

B. Presence of class I MHC which lack bound peptides.

C. Presence of class I MHC/self peptide complexes.

D. Absence of class II MHC.

E. Presence of class II MHC which lacks bound peptides.

F. Presence of classII MHC/self peptide complexes

47)Some human plasma cell malignancies produce antibodies which bind

to antigens on human

erythrocytes. In one such case erythrocytes coated with myeloma antibody

were lysed by complement

and myeloma antibody also facilitated phagocytosis of erythrocytes by

neutrophils. Of what isotype

was this myeloma antibody?

A. IgAB. IgG

C. IgM

D. IgD

E. IgE

48) During the primary phase of HIV infection, manifestation include:

a. Opportunistic infection.

b. Lymphoadenopahty.

c. Encephalopathy.

d. Wasting syndrome


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49) The lag phase of the primary response is longer that n the secondary

response because:

a. The assays for detecting a primary response are not as sensitive.

b. The primary response requires considerable cell proliferation anddifferentiation to achieve a critical mass of

cells to produce immunity.

c. Of the lack of cytokines produced during the primary response.

d. A & d.

e. None of the above.

50) Complement damage may be directed against host tissues, as well as

pathogens because:

a. Long half-lives of the activated complement components.

b. Very low concentrations of the inactivated complement components in

serum.

c. The inability to activate the system in the presence of IgG antibodies.

d. Once activated, the destructive activities of complement are non-specific.

e. None of the above

51) Many pathogenic bacteria are killed outright by contact with normal

cell-free human serum, even if the donor

had never previously been exposed to the particular bacterium used in the

experiment. In this situation, which

component of serum is most likely to be responsible for killing bacteria?

a. Complement.

b. IgG antibodies.

c. IgA antibodies.

d. Acute-phase proteins.

e. Interleukin-2 and -interferon.

f. Tumor necrosis factor.

g. Chemokines


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52) Many isolates of the bacterium Neisseria meningitides can produce

mucosal infections but cannot survive in the

bloodstream. Cells of such bacteria are killed by contact with cell-free

plasma or serum, even from persons who

have never previously been exposed to Neisseria. Which mechanism is

most likely to be responsible for the

killing?

a. Activation of complement by the alternate pathway.

b. Activation of complement by the classical pathway.

c. Binding of IgG.

d. Binding of IgM.

e. Binding of IgA.

53) One of the indicator of systemic inflammatory response is the presence

of acute phase proteins, produced by the

liver. A good example of these would be:

a. IgM

b. C-reactive protein

c. Serum-albumin.

d. IL-4

e. None-of the above

54) A child has a history of recurrent infections with organisms havingpolysaccharide antigens (i.e., Streptococcus

pneumoniae & Hemophilus influenzae). This susceptibility can be

explained by a deficiency of:

a. C3


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b. C5

c. IgG subclass 2

d. Myeloperoxidase in phagocytic cells

e. Secretory IgA

55) A 28-year-old mother gives birth to her first child. The father is

homozygous Rh D positive & the mother is

homozygous Rh D negative. The baby is born without any complications,

but the mother is not given RhoGAM

(anti-Rh IgG) following the delivery. Eighteen months later she delivers

another child, who is anemic, slightly

jaundiced, & has an enlarged spleen & liver. Which type of hypersensitivity

best describes this condition?

a. Atopic disease

b. Cytotoxic disease

c. Delayed hypersensitivity

d. Immediate hypersensitivity

e. Immune complex disease

56) Five minutes after the initiation of an allergic skin reaction, you would

expect to see which of the following at

that site?

1. Complement fixation.

2. Plasma cells secreting IgE

3. Accumulation of eosinophils

4. Vasodilation

5. None-of the above

57) Your patient is a pregnant woman in the middle of her third trimester,

& you have determined that her fetus


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shows serious consequence of Rh incompatibility. Which of the following

treatments would be most beneficial?

a. Parenatal transfusion of Rh+ RBCs

b. Postnatal transfusion of RH+ RBCsc. Parental transfusion of Rh- RBCs

d. Immediate administration of RhoGam

e. None of the above is likely to be helpful.

.

58) CD4 T cell depletion is the hallmark of HIV disease, it occurs as a result

of:a. CD4 cell apoptosis.

b. Destruction of HIV infected CD4 T cells by HIV specific cytotoxic

lymphocytes.

c. Lysis of HIV infected CD4 T cell, as a direct result of intracellular HIV

replication.

d. The destruction of CD4+ T cell precursors.

e. All of the above.

59) HIV causes:

a. Hypogammaglobulinemia

b. Thymic inflammation, involution & fibrosis

c. B cell depletion

d. Loss of memory B cells.

e. All of the above

60) Progressive tumor growth in cancer patients may be enhanced by:

a. The presence of tumor specific serum "blocking" antibodies & antigen:

antibody immune complexes.

b. The infiltration of the tumor with activated natural killer cells.


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c. The activation of tumor-associated Th2 lymphocyte that produce IL-10

d. The activation of tumor-associated Th1 lymphocyte that produce IL-2 &

IFN

e. All of the above.f. A + C

61) Antibody dependent cellular cytotoxicity (ADCC):

a. Is mediated by B-lymphocyte

b. Is mediated by T-lymphocyte

c. Is mediated by IgM antibodies & complement

d. Is mediated by natural killer lymphocytes

e. All or none of the above

f. A + b

62) The initiation of a graft versus Host (GVH) disase:

a. Requires a lack of responsiveness on the part of the recipient to the

histocompatibilty antigens of the donor.

b. Requires a graft of immunocompetent donor cells.

c. May result from the infusion of blood or blood products that containviable lymphocytes into an

immunologically incompetent or compromised recipient.

d. Requires the activation of B-cells for pathology to be evident.

e. All or none of the above.

f. A + B + C

63)The rejection of an allograft can be slowed or prevented by:

a. Careful matching of the MHC-class I histocompatibility antigens usingantibodies to the cell surface

molecules.

b. By grafting to a privileged site.

c. By treating the recipient with immunosuppressive drugs.


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d. By passive immunization of the recipient with antibodies against the

MHC class II antigens of the donor

e. All or none of the above.

f. A + B but not C + D

64) In the generation of human cytolytic T-cells against allogeneic cellular

tissue antigens (grafts), the vast

majority of CD8+ cytotoxic T-cell receptors in the recipient recognize &

bind:

a. Endogenous cellular peptides presented by the major histocompatibility

antigens of the allogeneic graft cells.

b. The foreign HLA-D alloantigens of the cells of the graft.

c. Antigen specific helper T-cell factors & cytokines of the recipient

d. The foreign HLA-A, B & C molecules o the cells of the graft.

e. All or none of the above

65)The graft versus host reaction is most easily induced:

a. In immunocompetent adult animals

b. With thymic epithelial cells.c. In immunodeficient recipients (adult or infant)

d. With the help of an adjuvant

e. When lymphocytes from a hybrid donor (a/b) are transfused into a

parental recipient (a/a).

66) Rheumatoid arthritis is an example of:

a. Type I hypersensitivity

b. Type II hypersensitivity

c. Type III hypersensitivity

d. Type IV hypersensitivity

e. Arthus reaction


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THANK YOU

** these Qs may include some information from chs. 33/34/35**

** we want to thank everyone who share us with his/her ideas &

suggestions**

GOOD LUCK 4 ALL

DONE BY:

FATIMAH T. ALADIM & WEJDAN Y. ALQURAN>>

ATYAF FAMILY .

1 A 9 C 17 E 25 C 33 A

2 D 10 B 18 A 26 B 34 A

3 A 11 C 19 C 27 A 35 A

4 B 12 E 20 C 28 E 36 B

5 E 13 D 21 D 29 A 37 D

6 D 14 E 22 D 30 C 38 D

7 B 15 D 23 A 31 A 39 D

8 E 16 A 24 A 32 A 40 C

41 49 B 57 B 65 C


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42 50 D 58 66 C

43 E 51 A 59

44 C 52 A 60 F

45 D 53 61 D46 C 54 C 62 F

47 B 55 B 63 E

48 B 56 64 D

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Immunology Final Qs - Part #3