Download Name - Medical Mastermind Community

IMMUNOLOGY MIDTERM EXAM
MULTIPLE CHOICE: CHOOSE THE BEST ANSWER
1. A typical quantitative precipitation reaction is BEST characterized by which of the
following?
A. Constant amounts of antigen are used in each tube in the assay.
B. Molar concentrations of antibody and antigen are equivalent
C. Constant amounts of carbohydrate are used in each tube in the assay.
D. In the antibody excess zone, all antibody is in the precipitate.
E. Constant amounts of antibody are used in each tube in the assay.
2. Atopic dermatitis (AD) is a chronic inflammatory skin disease in which T cells are
induced to secrete cytokines following the highly specific binding between the T cell
receptor (TCR) and the MHC/antigen peptide complex. Which of the following
statements is FALSE regarding MHC-specific T cell activation?
A. Cytotoxic T lymphocytes recognize antigen presented on infected target cells.
B. Adhesion molecules aid in the interaction of T helper lymphocytes with antigen
presenting cells.
C. The TCR interacts with MHC Class 11 molecules and a peptide antigen of
approximately 12-25 amino residues.
D. Gamma-delta T cells require co-stimulation through binding of the CD-3 with the
Fc receptor on the antigen presenting cell.
E. All of the above are true
3. Which statement BEST describes T helper 3 type (Th3) lymphocytes?
A. They are also known as Natural Killer cells.
B. They do not express functional CD3 molecules.
C. They primarily secrete IL-4 and IL-10.
D. They predominate in the MALT, causing B cell class switching to IgA.
E. They upregulate CD4 on B cells.
MATCHING: Choose the single BEST answer. Each answer may be used once, more than
once, or not at all.
4. T cell mediated
5. IgE mediated
6. Soluble antigen-antibody immune
complex mediated
7. Cytotoxic antibody mediated
A. Type I Hypersensitivity
B. Type 11 Hypersensitivity
C. Type III Hypersensitivity
D. Type IV Hypersensitivity
E. Type V Hypersensitivity
-1-
8. Which statement below is FALSE:
A. B cells constitutively express Class II MHC molecules.
B. T lymphocytes cells are derived from pluripotent hematopoietic stem cells in the
bone marrow, and mature in the thymus.
C. Neutrophils developing in the presence of MHC molecules undergo apoptosis.
D. B lymphocytes are derived from pluripotent hematopoietic stem cells in the bone
marrow, and undergo VDJ rearrangement prior to encounter with antigen.
E. Lymphoid cells can undergo clonal selection to give progeny with identical
antigenic specificity.
9. Neutraphils are attracted to an infected area by:
A. C2 and C4
B. 1gM
C. C5a
D. Factor D
E. C3a
10. Regarding the structure of the MHC Class II molecule:
A. The complex with Beta-2-Microglobulin (ß2M) contains a total of five
immunoglobulin-like domains with the ß2M juxtaposed near the cell surface membrane.
B. The peptide-binding site is shared by the two domains nearest to the cell
membrane.
C. It is composed of two transmembrane polypeptides, each containing two
extracellular domains.
D. It is a transmembrane polypeptide containing three intracellular domains (αl, α2,
α3).
E. The molecule is expressed at the cell surface in a non-covalent association with
an invariant polypeptide.
11. Synthesis of MHC Class I and Class II molecules occurs:
A. In the rough endoplasmic reticulum.
B. In the phagosome.
C. In the nucleus.
D. In the mitochondria.
E. In the Golgi apparatus.
12. Which factor listed in the groups below will NOT influence outcome of immunization:
A. HLA type
B. Antigen dose
C. Nutritional status
D. ABO blood group type
13. The MAJOR properties of the acquired immune system include:
A. Presenting non-processed antigens to lymphocytes.
B. Specificity, memory, adaptiveness, and discrimination between self and non-self.
C. The ability to induce lymphocyte apoptosis.
D. Secreting immunoglobulins specific for autoantigens.
E. Producing complement components.
-2-
14. All of the following can affect the antigen-binding region of the T cell receptor EXCEPT:
A. Insertion of nucleotides at the D-J junction by terminal deoxynucleotide transferase
B. Somatic mutation
C. Random selection of V, D, and J gene segments
D. Pairing of different alpha and beta chain V regions
E. Insertion of nucleotides at the V-J junction by terminal deoxynucleotide transferase
15. The cell type most commonly found in inflammation:
A. B cell
B. Oligodendrocytes
C. Eosinophil
D. Transitional epithelial cell
E. Neutrophil
16. The convertase for C3 in the Alternate Complement pathway is:
A. C4b2b3b
B. C4b
C. C5b
D. C3bBb3b
E. C3bBb
17. A spleen contains the following:
A. Hassall's corpuscles
B. Pacinian corpuscles
C. Parafollicular cells
D. Red and white pulp
E. High endothelial venules
18. All T cell receptors form a complex on the surface of T lymphocytes with:
A. CD3
B. CD28
C. CD2
D. CD8
E. CD4
19. A patient with immune-complex disease is found to have a complete absence of C1q.
Which complement-mediated functions would remain intact in this patient?
A. Generation of the C4a anaphylatoxin peptide
B. Generation of the C2a anaphylatoxin peptide
C. Activation of the classical pathway
D. Activation of the alternative pathway
E. None of the above
-3-
20. Which of the following occurs BEFORE antigen exposure?
A. Differentiation of B cells into plasma cells
B. Affinity maturation
C. Switching from IgM to IgA1 expression
D. Coexpresson of surface 1gM and IgD
E. Somatic hypermutation
21. In the process of antigen presentation, CD8+ T cells recognize:
A. Exogenous peptides associated with MHC class II molecules..
B. Endogenous peptides associated with MHC class I molecules.
C. Exogenous peptides associated with invariant chain ß2M.
D. Exogenous peptides associated with MHC class I molecules.
E. Endogenous peptides associated with MHC class II molecules.
22. Pattern Recognition Receptors of the innate immune system recognize broad structural
motifs that at highly conserved within microbial species. These receptors include all
EXCEPT:
A. Lymphokine receptors
B. Complement receptors
C. Toll-like (TLR) receptors
D. Mannose-binding receptors
E. Scavenger receptors
23. Regarding B cell class switching, which event is possible?
A. Switch from IgE to IgG.
B. Switch from IgG to IgE.
C. Switch from IgG to IgM.
D. Switch from IgA to IgG
E. Switch from IgA to IgE.
24. Which of the following is NOT a property of superantigens:
A. It binds to common regions of the major histocompatability molecule antigen
presenting cells.
B. It is a glycosylated lipid of small molecular weight.
C. It does not require processing by accessory cells for function.
D. It directly activates naive T cells.
E. It binds to the T cell receptor Vbeta chain.
25. Regarding the structural features of immunoglobulin, which statement is FALSE:
A. IgA, IgD, and IgE have hinge regions
B. IgG demonstrates heavy chain glycosylation
C. IgA and IgM can have a kappa or a lambda light chain, but not both
D. IgD can not fix complement
E. IgA has a molecular weight of approximately 160,000 daltons
-4-
26. Which statement is TRUE regarding the complementarity determining regions (CDRs)?
A. The proteins Rag-1 and Rag-2 are not required for formation of CDR3.
B. The CDRs are important in determining the overall variable region structure, but
are not directly involved in antigen binding.
C. They are located in the CH2 domain of the immunoglobulin heavy chain.
D. The joining of the V and D gene segments is important in determining the
sequence of CDR2.
E. V, D, and J gene segments contribute to the diversity of CDR3 in heavy chains.
27. Patients with multiple myeloma can occasionally present with two M-components in
their blood. When this occurs, which two components are MOST LIKELY to be
present?
A. IgD and IgM
B. IgD and IgA
C. IgG 1 and IgG2
D. IgM and IgG
E. IgE and IgM
28. The T cell receptor on a CD4+ cell:
A. Recognizes nonsequential protein epitopes
B. Has four hypervariable regions that comprise its paratope.
C. Is a transmembrane homodimer composed of two identical disulfide-linked
polypeptide chains
D. Recognizes antigen in the form of peptides bound in the groove on MHC Class I
molecules
E. Recognizes antigen in the form of peptides bound in the groove on MHC Class II
molecules.
29. Professional antigen presenting cells include all EXCEPT:
A. T lymphocytes
B. Monocytes
C. Langerhans cells
D. Follicular dendritic cells
E. B lymphocytes
30. Which statement is TRUE regarding immunoglobulin genes and expression?
A. A single B cell can express multiple kappa and lambda light chains
simultaneously.
B. Lack of the surrogate light chain protein lambda-5 can arrest B cell development
and result in immunodeficiency.
C. The kappa locus undergoes rearrangement first, followed by the lambda and
heavy chain loci.
D. The kappa and lambda light chain loci utilize the same set of V and J gene
segments.
E. The transition from membrane-bound IgG1 to secreted IgG1 expression involves
DNA rearrangement.
-5-
31. Regarding T cell receptor (TCR) gene rearrangement events:
A. If the α (alpha) and ß (beta) chain genes do not rearrange successfully, then the
δ (delta) chain genes begin to rearrange.
B. The TCR genes of mature T cells are all in the germline configuration
C If the γ (gamma) and δ (delta) chain genes do not rearrange successfully, then
the α (alpha) chain genes begin to rearrange.
D. The α (alpha) and δ (delta) chain genes rearrange simultaneously
E. The γ (gamma) and δ (delta) chain genes rearrange simultaneously
32. C3b is involved in all of the following EXCEPT:
A. Alteration of vascular permeability
B. Formation of C5 convertase
C. Enhancement of humoral immune responses
D. Covalent attachment to bacteria
E. Opsonization and phagocytosis of bacterial pathogens
MATCHING: Choose the single BEST answer. Each answer may be used once, more than once,
or not at all.
33. Greatest ability for placental transfer
34. Highest molecular weight
35. Can contain secretory piece
A. IgM
B. IgD
C. IgG
D. IgE
E. IgA
MATCHING: Choose the single BEST answer. Each answer may be used once, more than
once, or not at all.
36. Involves binding of antigen-antibody
complexes to phagocytic cells
37. Involves reaction of antigen with
antibody, and detection with enzyme
labeled immunoglobulin
38. Requires gel diffusion for
antigen-antibody interactions
A. ELISA
B. Precipitation
C. Hapten inhibition
D. Opsonization
E. Ouchterlony
39. The percent of T lymphocytes which undergo apoptosis in the thymus is:
A. Between 1 and 5%
B. Greater than 25%
C. Less than 1%
D. Between 10% and 25%
E. Between 5 and 10%
40. Which statement BEST describes T helper 2 type (Th2) lymphocytes:
A. They primarily secrete IL-2 and Interferon-gamma upon activation
B They are the primary T cell in delayed type hypersensitive responses
C. They primarily secrete TGF-beta upon activation
D. They suppress cytotoxic T cells
E. They give help to B cells to produce IgG
-6-
IMMUNOLOGY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
E
D
D
D
A
C
B
C
C
C
A
D
B
B
E
E
D
A
D
D
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
B
A
B
B
A
E
D
E
A
B
C
A
C
A
E
D
A
E
B
E
-7-