Section 1
Immunology
1)
From the most abundant to the least abundant immunoglobulin, which is CORRECT?
a)
b)
c)
d)
e)
2)
Regarding IgM, which statement is INCORRECT?
a)
b)
c)
d)
e)
3)
it has a molecular weight of about 150,000
it crosses the placenta
it accounts for most ABO blood group antibodies
it is the most commonly produced immunoglobulin in myeloma
it accounts for about 80% of all immunoglobulin
Regarding immunoglobulins, which statement is INCORRECT?
a)
b)
c)
d)
e)
5)
it is the first immunoglobulin to appear in the infant
it exists as a pentamer
it reaches adult levels by about one year of age
it cannot be produced by the foetus
it is the third most abundant immunoglobulin
Regarding IgG, which statement is INCORRECT?
a)
b)
c)
d)
e)
4)
G, D, M, A, E
M, A, G, D, E
G, E, M, D, A
M, G, A, D, E
G, A, M, D, E
their classification is based on the heavy chains present
IgG is produced early in the primary immune response
chromosome 14 carries the gene for heavy chains
IgA is present in sero-mucus secretions
the J-chain binds together two or more immunoglobulin monomers
Which of the following is NOT a major property conferring antigenicity?
a)
b)
c)
d)
e)
negative charge
large molecular weight
organic nature
protein structure
polymeric structure
6)
What percentage of lymphocytes are T cells?
a)
b)
c)
d)
e)
7)
Regarding CD4+ T cells:
a)
b)
c)
d)
e)
8)
they recognise antigens only in the context of MMCII
HIV infection raises the CD4 : CD8 ratio
CD8 is expressed on more cells than CD4
CD4 positive cells have little role other than as cytotoxic cells
CD4 cells are formed by the equal cleavage of two CD8s or the binding of two CD2s
Which of the following is NOT an AIDS defining illness?
a)
b)
c)
d)
e)
9)
35%
40%
50%
65%
90%
cervical intraepithelial neoplasia
primary cerebral lymphoma
non-Hodgkin’s lymphoma
oral hairy carcinoma
Kaposi’s sarcoma
Which of the following is NOT an AIDS defining illness?
a)
b)
c)
d)
e)
pneumocytosis carinii pneumonia
cryptosporidium enteritis
pulmonary tuberculosis
cryptococcal meningitis
CMV encephalitis
10) Regarding the course of HIV infection, which statement is INCORRECT?
a) disappearance of persistent generalised lymphadenopathy (PGL) is a poor prognostic
sign
b) viral replication occurs mainly within the spleen during period of asymptomatic infection
c) seroconversion illness usually occurs 2-4 weeks after viral transmission
d) primary cerebral lymphoma is usually a very late event
e) up to 90% have central nervous system pathology at autopsy
11) Hypersensitivity reactions:
a)
b)
c)
d)
e)
are not preventable
can occur in response to exogenous and endogenous antigens
include acute inflammation
are never just localised
fall into three categories
12) Goodpasture’s syndrome is an example of which form of hypersensitivity?
a)
b)
c)
d)
e)
anaphylactic type
cytotoxic type
immune complex disease
cell mediated (delayed)
none of the above
13) Regarding the structure of the HIV virion, which statement is INCORRECT?
a)
b)
c)
d)
e)
core contains reverse transcriptase
envelope is composed of a spherical lipid bilayer
core contains p24
core contains one strand of single stranded RNA
envelope is studded by glycoproteins, including gp120 and gp41
14) With respect to type II hypersensitivity, which is INCORRECT?
a)
b)
c)
d)
e)
myasthenia gravis is one manifestation
complement can be involved
macrophages can be involved
CD4 cells can be involved
natural kill cells can be involved
15) Regarding immunodeficiency with predominantly T-cells defects, what is/are the most
commonly associated infection(s)?
a)
b)
c)
d)
e)
recurrent pyogenic infections
pneumocystis carinii pneumonia
viral infections
candidiasis
tuberculosis
16) Regarding immunodeficiency with predominantly antibody defects, what is/are the most
commonly associated infection(s):?
a)
b)
c)
d)
e)
viral infections
recurrent pyogenic infections
giardiasis
pneumocystis carinii pneumonia
systemic fungal infections
17) Anticentromere antibodies are found in approximately 90% of patients with:
a)
b)
c)
d)
e)
limited sclerodema – CREST
SLE
sjogrens syndrome
systemic sclerosis – diffuse
inflammatory myopathies
18) Regarding type IV hypersensitivity, which statement is INCORRECT?
a)
b)
c)
d)
e)
reactivity can be transferred from sensitised to non-sensitised individual
maximal 48-72 hours after challenge
most cytotoxic T cells carry CD8+
major effect of lymphokines is chemotaxis and activation of macrophages
forms the basis of the lepromin test (Fernandez reaction)
19) Which of the following is NOT a cause of autoimmune disease?
a)
b)
c)
d)
e)
molecular modification
molecular mimicry
T cell suppression
bypass of T cell tolerance
genetic factors
20) Regarding type III hypersensitivity, which statement is INCORRECT?
a)
b)
c)
d)
e)
serum sickness occurs due to antigen excess in proportion to antibody
immune complexes bind to blood vessel walls and basement membranes
arthus reaction is maximal at 4-8 hours after exposure to antigen
pigeon fancier’s lung is an example of an arthus reaction
jarisch-herxheimer reaction is an example of serum sickness
21) Regarding type II hypersensitivity, which statement is INCORRECT?
a)
b)
c)
d)
e)
includes anti-receptor antibodies (formerly type V hypersensitivity)
mediates some cases of graft rejection
involves the complement cascade
receptor antibodies are usually IgM
may be associated with diabetes mellitus
22) The body can defend itself against parasites by all of the following mechanisms EXCEPT:
a)
b)
c)
d)
e)
innate immunity
cell-mediated immunity
humoral immunity
antibody dependant cellular cytotoxicity
action of eosinophils
23) Regarding type I hypersensitivity, which statement is INCORRECT?
a)
b)
c)
d)
e)
IgE binds to both mast cells and basophils
“late phase reaction” occurs without additional exposure to antigen
histamine causes more bronchospasm than SRS-A
up to 50% of atopic individuals have a positive family history of allergy
initial tissue response subsides within 60 minutes
24) Regarding type I hypersensitivity reactions, which of the following is NOT a secondary
mediator?
a)
b)
c)
d)
e)
SRS-A
trypsin
leukotriene E4
prostaglandin D2
leukotriene B4
25) Regarding type I hypersensitivity reactions, which of the following is NOT preformed
primary mediator?
a)
b)
c)
d)
e)
platelet activating factor
eosinophil
histamine
neutrophil chemotactic factor
heparin
26) Which of the following is NOT a T cell subpopulation produced following exposure to an
antigen?
a)
b)
c)
d)
e)
inducer-helper cells
memory cells
lymphokine secreting cells
cytotoxic-suppressor cells
natural kill cells
27) The most common blood transfusion reaction type is of:
a)
b)
c)
d)
e)
type I hypersensitivity
type II hypersensitivity
type III hypersensitivity
type IV hypersensitivity
all of the above
28) Which of the following is NOT a mechanism by which antibodies directly attack an
invader?
a)
b)
c)
d)
e)
agglutination
precipitation
neutralisation
opsonisation
lysis
29) Regarding the forces binding antigens to antibodies, which does NOT occur?
a)
b)
c)
d)
e)
hydrogen bonding
ionic forces
covalent bonding
Van der Waals forces
hydrophobic bonding
30) Regarding IgE, which statement is INCORRECT?
a)
b)
c)
d)
e)
mediates type I hypersensitivity reactions
increased amounts present in fungal infections
molecular weight of about 200,000
allergens cause cross-linkage of IgE molecules
least abundant immunoglobulin
31) Regarding IgA, which statement is INCORRECT?
a)
b)
c)
d)
e)
exists as a monomer
accounts for about 13% of all Ig
reaches adult levels by age 10 to 14 years
second most abundant Ig
plays an important innate immunity role in the respiratory tract
32) Eosinophils:
a)
b)
c)
d)
e)
make up 30% of all leukocytes
play a role on parasitic infections
are responsible for releasing histamine in type I hypersensitivity reactions
are strongly phagocytic
become plasma cells in the extravascular space
33) In HIV infection:
a) transmission is only via sexual contact or parenteral inoculation
b) AIDS is recognised when there is a specified secondary infection or malignant
neoplasm
c) IV drug users constitute the largest group with HIV infection in the USA
d) CD4 cells offer no predictive value in determining the subsequent development of
AIDS
e) Kaposi’s sarcoma is more common in IV drug users than in homosexuals
34) In a healthy individual over the age of 5 years, lymphocytes are mainly found in:
a)
b)
c)
d)
e)
bone marrow, thymus, spleen
liver, thymus, spleen
lymph nodes, spleen, thymus
bone marrow, spleen, liver
liver, spleen, pancreas
35) Blood transfusion reaction is an example of which type of hypersensitivity reaction?
a)
b)
c)
d)
e)
type I
type II
type III
type IV and III
none of the above
36) With regard to natural killer lymphocytes:
a)
b)
c)
d)
e)
they constitute less than 5% of blood lymphocytes
they require opsonisation to enable their killing of cells
they have a prime role in defence against parasites
they require prior sensitisation to be effective
they have an innate ability to lyse tumour cells and virally affected cells
37) An anaphylactoid reaction:
a)
b)
c)
d)
e)
is a localised form of an anaphylactic reaction
is an example of an immune complex mediated reaction (type III hypersensitivity)
occurs without prior sensitisation to an antigen
does not involve the release of histamine from mast cells
results from IgE mediated mechanisms
38) With regard to B lymphocytes:
a) they constitute 50% of circulating lymphocytes
b) they are found in germinal centres in the red pulp of the spleen
c) they are genetically programmed to recognise specific antigens by means of antigen
specific cell surface receptors
d) they release chemical mediators when attached to IgE in type I hypersensitivity
reactions
e) they are not affected by HIV infection
39) MHC class I molecules are:
a)
b)
c)
d)
e)
co-receptors on the CD8 molecule
co-receptors to the CD4 molecule
present on T lymphocytes only
couples to peptide products of extracellular antigens
identical in fraternal twins
40) Transplant rejection involves:
a)
b)
c)
d)
e)
type IV hypersensitivity only
type IV and III hypersensitivity only
type IV, III and II hypersensitivity only
type IV and II hypersensitivity only
type II and III hypersensitivity only
41) With respect to macrophages, which of the following is NOT true?
a)
b)
c)
d)
e)
they can produce TNF and IL-4 both of which cause fever
they have direct tissue toxicity due to the ability to release hydrogen peroxide
they have oxygen dependent mibrobicidal activity
they have cytotoxicity against tumour cells
they process antigens and act as antigen presenting cells to activate lymphocytes
42) With regard to Langerhan’s cells in the immune system, which of the following is NOT
true?
a)
b)
c)
d)
e)
they are dendritic cells
they possess large numbers of cell surface class II molecules
they are found primarily in the epidermis
they are strongly phagocytic
they are involved in delayed hypersensitivity reactions
43) Regarding the complement system:
a) complement factors D and B are crucial to activation of the classical pathway
b) polysaccharide molecules on bacterial cell membranes can activate the classical
pathway
c) enzyme precursors of the complement system are released by activated macrophages
d) activation of the classical pathway occurs as a result of the antigen – antibody reaction
e) when the alternative pathway is activated, fragments C3a, C4a and C5a are NOT
produced
44) Which of the following are phagocytic?
a)
b)
c)
d)
e)
CF4 and helper T cells
natural killer cells
CD8 and cytotoxic T cells
all of the above
none of the above
45) Monocytes:
a)
b)
c)
d)
e)
have a half-life of 6 hours in plasma
have a cytoplasm containing biologically active granules
may convert to mast cells
may convert to kupffer cells in the liver
undergo cell division under the influence of erythropoietin
46) Poison ivy dermatitis is an example of:
a)
b)
c)
d)
e)
type I hypersensitivity
type II hypersensitivity
type III hypersensitivity
type IV hypersensitivity
none of the above
47) With regard to T lymphocytes:
a)
b)
c)
d)
e)
plasma cells are activated by T lymphocytes
T cells become activated on binding to free antigen
normally, 60% of T cells bear the cell marker CD8+
CD4+ T cells are MHC class II restricted
T helper I cells primarily secrete IL-4 and IL-5
48) With regard to IgE:
a)
b)
c)
d)
e)
it exists as a hexamer in blood
it is the least common immunoglobulin in the blood stream
it is mainly found in tears and mucosal secretions
it is produced by T lymphocytes
it can initiate complement fixation once bound to antigen
49) With regard to patients with AIDS, which of the following is NOT true?
a)
b)
c)
d)
e)
P. carinii pneumonia is the presenting feature in approximately 50% of cases
CD4+ T cell counts in blood are reasonably accurate prognosticators
Kaposi’s sarcoma is the most common neoplasm seen in AIDS patients
decreased humoral immunity increases the risk of recurrent bacterial pneumonias
titres of HIV fall as CD4+ T cell counts fall
50) With respect to the complement system:
a) it can only be activated once an antibody binds to an antigen
b) it is inhibited by polyfructose in bacterial cell membrane
c) its activation can result in pore forming molecules being inserted into target cell
membranes
d) is activated by sites on the variable portion of IgG immunoglobulin
e) it inhibits granulocyte release from neutrophils
51) Successful immune response to HIV during the acute phase of infection results from:
a)
b)
c)
d)
e)
increase in the CD4+ lymphocyte numbers
appearance of anti-HIV antibodies
type III hypersensitivity reaction
lymphoid tissue based destruction of infected cells
development of CD8+ virus specific cytotoxic cells
52) With regard to the transmission of HIV infection, which of the following is NOT true?
a) risk of seroconversion from a needlestick injury from a HIV positive patient is
approximately 30%
b) heterosexual transmission is the dominant mode of HIV infection in Asia
c) female-male sexual transmission is about half as efficient as male-female spread
d) the rate of vertical transmission from mother to child is less than 50%
e) all of the above are true
53) Cytokines:
a) are usually only produced by one cell type
b) activate a large number of immunocompetent cells because they do not require
specific receptors
c) have narrow ranges of action and specific effects because of the high-affinity receptors
on target cells
d) such as IL-Z are crucial to graft vs host reactions
e) do not produce effects in the cell-type that secretes them
54) Which of the following is TRUE of a healthy adult?
a)
b)
c)
d)
e)
T lymphocytes constitute 40% of peripheral lymphocytes
CD4++ T lymphocytes are directly cytotoxic
B lymphocytes constitute 15% of peripheral lymphocytes
NK cells are characterised by CD3 and CD16 surface molecules
B lymphocytes are characterised by CD3 and IgM surface molecules
55) Concerning hypersensitivity:
a)
b)
c)
d)
e)
type II reactions depend upon activation of phagocytic cells
eosinophils are predominant in type I early phase reactions
type III reactions are less likely in conditions of antibody excess
leukotrienes are released by mast cells as preformed mediators of type I reactions
Grave’s disease is a good example of type III reactions
56) Organ transplant rejection reactions:
a) are predominantly type II hypersensitivity reactions
b) are characterised by acute rejection vasculitis which occur in the first few months
following transplantation
c) are usually directed against organ parenchyma
d) most commonly demonstrate an acute vasculitic reactions, known as “acute rejection
vasculitis”
e) are restricted to the transplanted organ
57) Mononuclear phagocytes:
a)
b)
c)
d)
e)
are the predominant cells in three day old wounds
are common in liver, spleen and pancreas
produce fibroblast growth factor
secrete interferon Y
have a half-life of one day
58) The following are primary mediators of type I hypersensitivity reactions EXCEPT:
a)
b)
c)
d)
e)
adenosine
neutrophil chemotactic factor
heparin
platelet activating factor
acid hydrolases
59) Type I hypersensitivity:
a)
b)
c)
d)
e)
involves sensitised T lymphocytes
involves phagocytosis of target cells by activated macrophages
involves formation of cytotropic (IgE) antibody
histamine is a secondary mediator
proteases are secondary mediators
Section 1
Immunology – Answers
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
E
D
C
B
A
D
A
D
C
B
B
B
D
D
C
B
A
A
C
E
D
C
C
B
A
E
C
D
C
B
A
B
B
C
B
E
C
C
A
C
A
D
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
D
E
D
D
D
E
E
C
E
A
D
C
C
B
C
D
C
Section 2
Immune System
1) Which of the following is correct regarding T lymphocytes?
a)
b)
c)
d)
e)
in the blood T cells constitute 50% of peripheral lymphocytes
CD8-CD4 ratio in normal healthy persons is 2:1
CD4 molecules bind to class 1 MHC molecules
The TH subset of CD4+ T cells synthesizes and secretes IL-2 and IFN-γ
CD4+ T cells act primarily as cytotoxic cells
2) Which of the following is correct?
a) dendritic cells are confined to the lymphoid tissue
b) B cells cannot be activated by soluble antigens
c) The TH2 subset of CD4+ T cells secrete cytokines facilitating macrophage-dependent
immune responses
d) natural killer cells are CD3+
e) natural killer cells can lyse some virally infected cells without prior sensitisation
3) Ankylosing spondylitis is associated with the HLA type:
a)
b)
c)
d)
e)
DR3
DR4
A3
BW47
B27
4) Transplant rejection is an example of primarily which type of hypersensitivity reaction?
a)
b)
c)
d)
e)
anaphylactic type
cytotoxic type
immune complex disease
cell mediated hypersensitivity
none of the above
5) Type I hypersensitivity reactions are mediated by formation of which immunoglobulin?
a)
b)
c)
d)
e)
IgG
IgA
IgE
IgM
Igor
6) Mast cells can be activated by:
a)
b)
c)
d)
e)
IgE
C5a
C3a
all of the above
none of the above
7) Which immune cell does NOT act predominantly by phagocytosis?
a)
b)
c)
d)
e)
eosinophils
monocytes
lymphocytes
neutrophils
basophils
8) Lymphocytes comprise what percent of the white blood count in normal blood?
a)
b)
c)
d)
e)
5%
2.3%
30%
62%
0.4%
9) Which is TRUE?
a)
b)
c)
d)
e)
the majority of the body’s lymphocytes are in circulation at any one time
granulocytes are formed in bone marrow and spleen
there is a months store of WBC in bone marrow
monocytes are only formed in bone marrow
megakaryocytes are formed in lymphoid tissue
10) Which has the shortest lifespan in the absence of severe infection?
a)
b)
c)
d)
e)
lymphocytes in tissues
macrophages in tissues
granulocytes in tissues
monocytes in blood
granulocytes in blood
11) Which is most effecting against invading bacteria?
a)
b)
c)
d)
e)
eosinophils
macrophages
monocytes
basophils
neutrophils
12) The reticuloendothelial system refers to:
a)
b)
c)
d)
the monocyte-macrophage system
the tissue-fixed macrophage population
the granulocyte development system
the lymphocyte recirculating system
13) Regarding eosinophils:
a)
b)
c)
d)
they are strongly phagocytic of parasites
do not respond to chemotactic signals
are attracted to allergic tissues by macrophage released inflammatory mediators
ingest and destroy allergen-antibody complexes in allergic tissue
14) Regarding lymphocytes:
a) T cells are preprocessed in the thymus, removal of which diminishes but not abolishes
T cell immunity
b) B cells are entirely preprocessed in the bone marrow during foetal life
c) T cells have greater antigenic diversity than the B cell population
d) T cells are responsible for humoral immunity
15) Regarding T lymphocytes:
a)
b)
c)
d)
e)
they produce antibodies when stimulated
T-suppressor cells are the most abundant subgroup
release lymphokines from T-helper cells
interferon γ is a potent amplifier of cytotoxic and suppressor T cell production
constitute 40% of lymphocytes
16) The T cell recognition complex:
a) in the majority of cells is a heterodimer of a γ/δ polypeptide
b) is associated with the CD4/CD8 complex which is constant but acts in transduction of
signal from the TCR
c) CD8 T cells are the target of the HIV virus, the cells have mainly cytotoxic functions
d) CD4 molecules are co-receptors that recognise MHC II complexes on target cells
17) Which is NOT an Ag-presenting cell?
a)
b)
c)
d)
neutrophils
macrophages
dendritic cells
Langerhan’s cell
18) Regarding hypersensitivity:
a) all type I reactions are IgE mediated
b) basophils act in a similar manner to mast cells and are found near blood vessels,
nerves and subepithelial sites where type I reactions are likely to occur
c) type I reactions are mediated via CD4+ T-helper cells which is required at the initial
exposure for IgE production
19) Which inflammatory mediator is more abundant in the initial transition phase of type I
hypersensitivity than in the late phase?
a)
b)
c)
d)
platelet activating factor
histamine
major basic protein
TNF α
20) Which is a type II complement-dependent hypersensitivity reaction?
a)
b)
c)
d)
e)
bee sting allergy
post streptococcal glomerulonephritis
arthus reaction
erythromblastosis foetalis
myasthenia gravis
21) Which is a hypersensitivity reaction as a result of localised Ag-Ab complex formation?
a)
b)
c)
d)
type II localised reaction
arthus reaction
tuberculin reaction
type IV hypersensitivity
22) Which cell type is responsible for hyperacute graft rejection:
a)
b)
c)
d)
B-cells
T cells CD4+
T cells CD8+
macrophages
23) In the western world:
a)
b)
c)
d)
HIV-I is less prevalent than HIV-2
IV drug use constitutes the highest rate of mode of transmission
increased rates of sexual transmission are seen in patients with other STDs
seroconversion after accidental needlestick injury is 1% lower than for hepatitis B
24) In HIV:
a) macrophages and monocytes are refractory to HIV cytopathic effects and play little role
in viral pathogenesis
b) viral lipid coat glycoprotein GP41 acts as the antigen for CD8 on T-cells allowing viral
entry
c) after internalisation into the T cell the virus causes rapid onset lysis causing a depletion
in CD4 count
d) T cell memory is lost early in AIDS
Section 2
Immune System – Answers
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
D
E
E
D
C
D
C
C
D
E
B
A
D
A
C
D
A
C
B
D
B
A
C
D
Section 3
1) SCID – all are true EXCEPT:
a)
b)
c)
d)
e)
is due to a T cell differentiation defect
most commonly is X-linked
presents with oral candidiasis, diaper rash and failure to thrive
without bone marrow transplantation, death occurs within one year
lymphoid tissue is hypoplastic and the thymus is small and devoid of lymphoid cells
2) Sjogren syndrome is characterised by - which is FALSE:
a)
b)
c)
d)
e)
also known as sicco syndrome
xerostomia
most commonly associated with thyroiditis
keratoconjunctivitis sicca
lymphocyte infiltration of lachrymal and salivary glands
3) AIDS – which is TRUE:
a)
b)
c)
d)
e)
heterosexual transmission is now the dominant mode of transmission in America
cell mediated immunosuppression is the hallmark of AIDS
associated with severe loss of CD8+ T cells
macrophages and dendritic cells are not targeted by HIV infection
histioplasmosis is the most common fungal infection in patients with HIV
4) Which is true for hypersensitivity reactions?
a) in type I formation of IgG antibody results in histamine release from basophils
b) an example of a type II reaction is erythroblastosis foetalis
c) in type III IgG or IgM binds to antigen or target cells and res?????? in phagocytosis or
cell lysis
d) in cell-mediated hypersensitivity, sensitised B-cells produce a granulomatous reaction
e) all the above are true
Section 3
1
2
3
4
A
C
B
B
Section 4
Immunity
1) Which is a secondary mediator in type I hypersensitivity?
a)
b)
c)
d)
e)
histamine
eosinophil chemotactic factors
platelet activating factor
neutral proteases
heparin
2) Acute serum sickness is what type of hypersensitivity reaction?
a)
b)
c)
d)
e)
type I
type II
type III
type IV
type V
3) How long after initial antigen administration does the acute inflammatory reaction of serum
sickness occur?
a)
b)
c)
d)
e)
1 day
2 days
5 days
10 days
20 days
4) An example of a type IV hypersensitivity reaction is?
a)
b)
c)
d)
e)
hayfever
transplant rejection
Good Pasture syndrome
arthus reaction
SLE
5) Regarding HIV infection:
a)
b)
c)
d)
e)
HIV-2 is the most common subtype
CD8 molecule is a high affinity receptor for HIV
HIV is carried to the brain by infected T lymphocytes
50-70% will be symptomatic in the early acute phase
pulmonary tuberculosis is a sign of AIDS
6) Regarding B lymphocytes:
a)
b)
c)
d)
e)
constitute 40% of peripheral lymphocytes
found in the red pulp of the spleen
bind antigens by IgM on the cell surface
are not infected by Epstein-Barr virus
influence the function of virtually all other cells of the immune system
7) Which is the most common manifestation of SLE?
a)
b)
c)
d)
e)
haematologic
arthritis
skin
renal
pericarditis
8) Which is an abnormality of immune function in AIDS?
a)
b)
c)
d)
e)
increased CD4:CD8 ratio
hypogammaglobulinaemia
increased delayed-type hypersensitivity
decreased spontaneous secretion of IL-1, TNF-6 and IL-6
decreased chemotaxis and phagocytosis
9) Which neoplasm is NOT associated with AIDS?
a)
b)
c)
d)
e)
cervical carcinoma
Kaposi sarcoma
non-Hodgkin lymphoma
primary cerebral lymphoma
testicular seminoma
10) In type I hypersensitivity:
a)
b)
c)
d)
e)
heparin is a secondary mediator
eosinophils are not involved
there is a familial predisposition
it is mediated by IgG and IgM antibodies
tissue basophils play a role
Section 4
Immunity – Answers
1
2
3
4
5
6
7
8
9
10
C
C
D
B
D
C
A
E
E
C
Section 5
1) Regarding hypersensitivity disorders, which is correctly paired?
a)
b)
c)
d)
e)
type I – IgM formation
type II – sensitised T lymphocytes
type III – antibody/antigen complexes
type IV – IgE formation
transplant rejection – IgG formation
2) In anaphylaxis:
a)
b)
c)
d)
e)
histamine is the most potent vasoactive agent
secondary mediators are stored with mast cell granules
synthesis of IgE is dependent on TH2 helper cells
leukocyte infiltration occurs during initial response
prostaglandin D2 is the most abundant primary mediator
3) Histamine:
a)
b)
c)
d)
e)
is rapidly synthesised and released in acute inflammation
is stored in platelets
causes arteriolar constriction
acts on the microcirculation mainly via H2 receptors
release is inhibited by C3a and C5a
4) Inhibitors of the complement cascade include:
a)
b)
c)
d)
e)
collectins
properidin P
MAC
DAF
C5 convertase
5) Activated Hagerman factor (XIIa) initiates all EXCEPT:
a)
b)
c)
d)
e)
prostaglandin generation
kinin system
coagulation cascade
complement activation
production of plasmin
6) Regarding cellular mediators, which is CORRECT?
a)
b)
c)
d)
e)
Mediator
nitric oxide
serotonin
lysosomal enzymes
prostaglandins
PAF
Source
mast cells
all leukocytes
macrophages only
all leukocytes and platelets
platelets
7) Regarding arachidonic acid metabolism:
a)
b)
c)
d)
e)
????? lipoxygenase is inhibited by glucocorticoids
thromboxane A2 inhibitis platelet aggregation
leukotriene B4 is a potent chemotactic agent
prostaglandin D2, E2, and F2 cause bronchospasm
prostacyclin is a vasoconstrictor
8) Chronic inflammation is characterised by all EXCEPT:
a)
b)
c)
d)
e)
mononuclear cell infiltration
fibrosis
angiogenesis
oedema
tissue destruction
9) Macrophages release:
a)
b)
c)
d)
e)
growth factors
elastases
complement components
nitric oxide
all of the above
(No answers to these questions – just page references)