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