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CLINICAL IMMUNOLOGY
QUESTIONS ON TESTS
E1. List five types of hypersensitivity reactions
E2. What immunologic mechanism most likely account for a person developing each
of the following reactions following an insect bite?
a, Within 12 min after being bitten, swelling and redress appear at the site and then
disappear by 1 hr.: ......................
b, 68 hrs later swelling and redness again appear and persist for 24 hrs.:
..........................................
c, 72 hrs later the tissues becomes inflamed, and tissue necrosis follows:
........................................
E3. Which of the following statements is (are) characteristic of contact sensitivity?
a, ( ) The best therapy is administration of the antigen.
b, ( ) Patch testing with the allergen is commonly used for diagnosis.
c, ( ) Sensitisation can be passively transferred with serum from an allergic individual.
d, ( ) Some chemicals acting as haptens induce sensitivity by covalently binding to host
proteins acting as carriers.
E4. Circulating immune complexes are etiological factors in the following diseases:
a, ( ) Systemic lupus erythematosus
b, ( ) Hyper IgM syndrome.
c, ( ) Anaphylactic shock
d, ( ) Post-streptococcal glomerulonephritis
E5.Type III hypersensitivity reactions are the direct result of interaction between
sensitised T-lymphocytes and antigens
a, true
b, false
E6. Delayed hypersensitivity (type IV) can be mediated by
a, ( ) IgE
c, ( ) T-lymphocytes
b, ( ) IgG
d, ( ) complement
E7. IgE antibodies play an important role in protections against helminths infections
a, true
b, false
E8. Which of cell types play important roles in the pathogenesis of allergic contact
dermatitis
a, ( ) B lymphocytes
c, ( ) mast cells
b, ( ) NK cells
d, ( ) Langerhans cells
E9. Systemic anaphylaxis can be caused by
a, ( ) bee venom
c, ( ) heterologous serum
b, ( ) penicillin
d, ( ) autologous serum
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E10. A 9-month-old baby was vaccinated against smallpox virus. He developed a
progressive necrotic lesion of the skin, muscles, and subcutaneous tissue
at the site of inoculation. The vaccination reaction probably resulted from:
a, ( ) B-lymphocyte deficiency
b, ( ) Reaction to adjuvant
c, ( ) Complement deficiency
d, ( ) T-lymphocyte deficiency
E11. Autoimmune disease due to antibody may occur as
a, ( ) a consequence of formation of antigen-antibody complexes,
b, ( ) a result of antibody blocking of a cell receptor,
c, ( ) a result of antibody-induced complement mediated lysis,
d, ( ) a consequence of C1-inhibitor deficiency.
E12. Rhematoid factor found in synovial fluid of patients with rheumatoid arthritis is
most frequently:
a, ( ) antibody to DNA
b, ( ) antibody to collagen
c, ( ) IgE reacting with bacterial antigens
d, ( ) IgM reacting with H-chain determinants of IgG
E13. Haemolytic anaemia may result from
a, ( ) passive transfer of maternal Rh antibody to the foetus,
b, ( ) production of cold agglutinins after certain viral infections,
c, ( ) production of antibody to certain drugs,
d, ( ) transfusion of autologous stored red cells
E14. Systemic lupus erythemathosus
a, ( ) is due to a mutation in double-stranded DNA
b, ( ) has multiple symptoms and affects many organs
c, ( ) is an example of a T cell mediated autoimmune diseases
d, ( ) results from formation of immune aggregates
E15. Blood from group AB donors can be transfused to a recipient without causing a
transfusion reaction if
a, ( ) the recipient is AB
b, ( ) the recipient is A
c, ( ) the recipient is B
d, ( ) the recipient is O
e, ( ) the recipient and donor are siblings
E16. A type A, Rh-positive woman gave birth to a type O, Rh-negative baby. Therefore,
all of the following statements are true, except:
a, ( ) The mother must be heterozygous for Rh antigen
b, ( ) The mother does not have the AA genotype
c, ( ) The father could have the B0, Rh+ genotype
d, ( ) The baby may have the A0 genotype
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E17. Primary immunodeficiency diseases can result from
a, ......................................................
b, ......................................................
c, ......................................................
d, ......................................................
E18. The most common clinical consequence(s) of C3 deficiency is (are):
a, ( ) increased incidence of tumours
b, ( ) increased susceptibility to viral infections
c, ( ) increased susceptibility to fungal infections
d, ( ) increased susceptibility to bacterial infections
E19. Which of the following immune deficiency disorders is associated exclusively with
an abnormality of the humoral immune response?
a, ( ) Bruton,s disease
b, ( ) Di George syndrome
c, ( ) Hereditary angioneurotic oedema
d, ( ) Common variable immunodeficiency
E20. Granulocytes from patients with Leucocyte adhesion deficiency (LAD) express
greatly reduced amounts of three integrins: LFA-1, Mac-1, CR4.
a, What is the nature of the defect that results in decreased expression ?
b, Would you expect LAD patients to exhibit normal levels of specific antibody following
antigenic challenge?
F1. Transplantation between HLA-identical siblings belongs to
a, ( ) allogeneic transplantation
c, ( ) autologous transplantation
b, ( ) syngenic transplantation
d, ( ) xenogenic transplantation
F2. Bone marrow transplantation between HLA-mismatched siblings results in:
a, ( ) GvH reaction
b, ( ) HvG reaction
F3. Write three prerequisite conditions for a successful kidney transplantation
(concerning the immunogenetic and immunologic relationships between donor and
recipient).
a, .............................. b, ..................... c, …………………………..
F4. Which of the following substances do belong to immunosuppressive drugs?
a, ( ) interleukin 2
c, ( ) FK506
d, ( ) inteferon gama
b, ( ) Cyclosporin A
F5. In clinical transplantation, cytotoxic antibodies
a, ( ) cause delayed rejection of the transplant
b, ( ) are responsible for hyperacute rejection
c, ( ) cause rejection when present in the donor
d, ( ) may be directed against HLA antigens
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F6. Indicate whether each of the following statements is true (+) or false (-).
a, ( ) Cancer cells divide much more rapidly than normal cells
b, ( ) LAK cells are tumour-specific
c, ( ) Multiple copies of cellular oncogenes are sometimes observed in cancer cells
d, ( ) Viral integration into the cellular genome may convert a proto-oncogene into
a transforming oncogene
e, ( ) All oncogenic retroviruses carry viral oncogenes
f, ( ) The immune response a virus-induced tumour protects against another tumour induced
by the same virus.
F7. Difference between v-oc and c-onc
a, ( ) All v-onc code for growth factor receptors whereas c-onc code for growth factors.
b, ( ) All v-onc code for growth factors, whereas c-onc code for growth factor receptors.
c, ( ) c-onc are normal cellular genes whereas v-onc are carried by acute transforming
retroviruses.
d, ( ) c-onc are carried by acute transforming retroviruses whereas v-onc are carried by nonacute transforming retroviruses.
F8. Various cytokines have been evaluated for use in tumour immunotherapy. List 4 of
them that have been shown to enhance antitumor immunity
F9. Tumour progression is favoured by
a, ( ) cytotoxic T lymphocytes,
b, ( ) suppressor factors released by tumour cells,
c, ( ) presence of interferon-,
d, ( ) presence of "blocking" antibodies.
F10. Rejection of a tumour may involve which of the following?
a, ( ) T cell mediated cytotoxicity.
b, ( ) ADCC
c, ( ) Complement-dependent cytotoxicity
d, ( ) Destruction of tumour cells by phagocytic cells
F11. Because of vaccination one from the listed infectious diseases was totally eradicated
worldwide. Which one? (Underline):
a, variola b, diphteria c, poliomyelitis d, pertussis
F12. The vaccine against tetanus is:
a, ( ) toxoid
b, ( ) anatoxin
c, ( ) attenuated vaccine
d, ( ) contains killed bacteria
F13. The administration of vaccines is not without hazard. Of the following, which is
least likely to affect adversely an immunocompromised host?
a, ( ) measles vaccine,
b, ( ) pneumococcal vaccine,
c, ( ) BCG,
d, ( ) mumps vaccine,
e, ( ) Sabin poliomyelitis vaccine
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F14. Explain what does the acronym “HAART” mean
F15. Would you expect to see much p17 and p24 in the blood of HIV-infected individuals
in the asymptomatic latency period?
a, Yes
b, No
F16. What does it mean when p24 levels begin to increase dramatically in the blood of
HIV-infected individuals in the asymptomatic latency period?
F17. African trypanosomes, plasmodium, and influenza each have unique mechanisms
allowing them to escape the immune response. Which ones?
F18. Indicate whether each of the following statements is true (+) or false (-).
a, ( ) HIV-1 and HIV-2 are more closely related to each other than to SIV.
b, ( ) HIV-1 causes immune suppression in both humans and chimpanzees
c, ( ) SIV is endemic in the African green monkey
d, ( ) The nef gene of HIV appears to increase proviral transcription.
F19. Indicate whether each of the following statements is true (+) or false (-).
a, ( ) T-cell activation increases transcription of the HIV proviral genome
b, ( ) HIV can only infect cells expressing CD4
c, ( ) Patients with advanced stages of AIDS always have detectable antibody to HIV
d, ( ) The polymerase chain reaction is a sensitive test that can be used to detect antibodies to
HIV
F20. Describe the nonspecific defences that operate when a disease-producing
microorganism enters the body
F21. Some microorganisms produce enzymes that can degrade the Fc portion of
antibodies. Why would such enzymes be advantageous for the survival of
microorganisms that possess them?
F22. Antigenic shift refers to
a, ( ) A series of spontaneous mutations leading to minor changes in virus protein
antigeneicity
b, ( ) A series of spontaneous mutations resulting in a diminished antibody response to virus
antigens.
c, ( ) A major antigenic change due to genetic reassortment following co-infection of a cell
with influenza viruses from different species.
d, ( ) A major antigenic change due to genetic reassortment following co-infection of a cell
with influenza viruses from the same species.