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29.5.12 Immune and Infectious disease 1,Which pairing is incorrect between disease and type of immune response a. b. c. d. Myasthenia gravis : Type II Good pastures: Type IV SLE: Type III Contact dermatitis : Type IV 2, Which is not a peripheral lymphoid organ a. b. c. d. Thymus Lymph nodes Spleen Mucosal lymph tissue 3. Natural killer cells a. Need prior exposure /activation by tumour or infected cells to be able to kill them b. Are involved in the early line of defence against viral infections and intracellular microbial infection c. Express TCR d. Are smaller than most lymphocytes 4. Regarding cells of the immune system a. T cells recognise antigens on the MHC2 antigen presenting cells b. Dendritic cells are phagocytic c. Natural kiler cells recognize self class I MHC molecules on healthy cells and hence do not attack them d. Macrophages function as APC ( antigen presenting cells) in B cell activation 5. Which inflammatory disease is not associated with the HLA B27 allele a. b. c. d. Ankylosing spondylitis Post gonnococcal arthritis Rheumatoid arthritis Acute anterior uveitis 6 .Regarding different cytokines a. Cytokine IFN-Y is a potent IgE producer and plays a role in allergies b. Cytokine IL4 is involved in macrophage activation and is strongly involved in immune mediated inflammatory disease c. IL17 is involved in the recruitment of neutrophils and monocytes and is the host defense against extracellular bacteria and fungi d. None of the above 7. Which is true a. b. c. d. Cell mediated immunity implies B lymphocyte activation Humoral immunity implies B lymphocyte activation IgG and IgM activate the complement system by the classical pathway IgA is important in crossing the placenta to protect the newborn 8. Regarding immediate hypersensitivity reactions a. b. c. d. It is mediated by IgM antibodies Susceptibilty to immediate hypersensitivity reactions is genetically determines Cytokines play an important role in the early stages of the reaction The Immediate phase is associated with eosinophil infiltration 9. In systemic immune complex disease a. The introduction of a protein Ag triggers an immune reaction and antibody formation around 2 days later b. The principle morphological manifestation of this immune complex injury is caseous inflammation c. The prototype disease of this is the Arthus reaction d. The most pathogenic antigen –antibody complexs are those which are medium sized formed in slight Ag excess 10. Complement activation is involved in a. b. c. d. Type I hypersensitivity Type II hypersensitivity Type III hypersensitivity Type II and Type III hypersensitivity 11. In Systemic lupus erythematousis a. b. c. d. It is less common in the black population The antinuclear antibodies test is specific for this disease Paients are hypercoagulable and develop primary antiphospholipid antibody syndrome Can have a false +ve syphilis test 12. Scleroderma a. b. c. d. Develop microvascular disease late in the disease course 20% of patients have Raynauds phenomena 20% patients develop rapid malignant hypertension Is associated with CD8+ cells responding to an unknown antigen 13. The hyperacute form of graft rejection is mediated by a. b. c. d. Preformed antibodies Antibody dependent cell mediated cytotoxicity Necrotising vasculitis Tissue macrophages 14. The incidence of HIV in the Western world is growing fastest in a. b. c. d. Homosexuals Heterosexuals Iv drug users Haemophiliacs 15. Regarding the HIV virion a. It is surrounded by a viral core which contains the important glycoproteins gp41 and gp120, important for HIV cell infection b. It contains 3 important genes , pol, gag and env, of which gag and pol are important targets for antiviral drug mechanism c. The core is what the humoral immune response targets d. Is known to have 3 subgroups, of which the O subgroup is most common worldwide 16.. In HIV a. b. c. d. 10% of untreated patients will develop a malignancy The central nervous system is the most common extranodal site for lymphomas Body cavity lymphomas constitute 80% of all aids related lymphoma Primary CNS lymphomas are 50 times more common in AIDs patients c.f the general population 17. Measles a. b. c. d. Are a single stranded DNA virus Cause an antibody mediated immunity which is what protects against reinfection Virus initially multiplies in lymphoid tissue The rash is less common in people with cell mediated immunity deficiencies 18. Regarding Mumps a. b. c. d. In 50%of cases the parotiditis occurs bilaterally The sterility is secondary to scarring and atrophy of the testicle Aseptic meningitis is a rare extra-salivary complication occurring in 1% of cases Is a DNA virus 19. Which is a Gram positive bacterium? a. b. c. d. Diphtheria Neisseria Bordetella Pseudomonas 20. Which is true? a. b. c. d. Chlamydia is the most frequent cause of infectious blindness Rickettsia injure epithelial walls causing a rash Gram negative bacteria have thick cell walls surrounding the cell membrane Gram positive bacteria have a thin cell wall found between 2 phospholipid bilayer membranes 21. Regarding exotoxins a. b. c. d. Clostridium tetani releases super antigens that lead to a mass T proliferation V. cholera releases a neurotoxin that degrades the epidermis Botulism is due to clostridium botulinum releasing a neurotoxin that kills neurons Toxic shock is caused by staph. Aureus 22. Which of the following is a virulence factor of Pseudomonas Aeruginosa? a. b. c. d. Pili and adherence proteins The secretion of a mucoid exopolysaccharide that protects it from antibodies The secretion of a exotoxin that inhibits protein synthesis All the above are 23. Which is true about scarlet fever? a. b. c. d. It usually affects 3-6year olds It is caused by a Group B streptococcal infection The Rash is predominately only on the face and trunk The Rash usually spares the mouth 24. Regarding diphtheria a. b. c. d. It is caused by a gram negative corynebacterium sp. It is often associated with distant lymph node hyperplasia If you are immunised it will prevent you getting colonized with C. diptheriaes It is clinically seen as a white superficial membrane 25.. Candidiasis a. b. c. d. Does not result in disseminated intravascular coagulation Usually causes acute granulomatous reactions Virulence is dependent on aspartyl proteinase and adenosine Is a rare cause of fungal endocarditis 26. Neisseria infections a. b. c. d. Requires the bacterial pile to bind to the CD46 human protein Are more common in people lacking immunoglobulin IgA Result from adherence and invasion of ciliated epithelial cells at the site of entry Result from the adherence of short pili to the surface of the bacterium 27. Regarding syphilis a. b. c. d. Is caused by Treponium pallidum subspecies portenue Results in tertiary syphilis in 33% of untreated patients Gumma formation is commonly seen in the brain The causative bacterium is a gram positive rod 28. Regarding the pathogenesis of gastrointestinal infections, which agents virulence is caused primarily due to an exotoxin? a. b. c. d. Vibrio. Cholera Salmonella typhi Giardia lamblia Enterogenic E coli 29. Scrofula is the term associated with tuberculosis infection in which body part? a. b. c. d. Meninges Cervical nodes Vertebrae Fallopian tubes 30. Shigella infection a. b. c. d. A large number of bacteria are required to cause disease Is accountable for 25% of diarrhoeal deaths Is associated with haemolytic uraemic syndrome Is a commonly found in farm cattle