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WorksheetsLecture 3-4 MEDT 491 Clinical Immunology
Total questions: 102
Worksheet time: 3hrs 51mins
Define plasma
the cell-free, fluid portion of blood which contains all the clotting factors
the fluid portion of the blood free of cells and clotting factors.
antibodies
the electrophoretic fraction of serum that contains most of the immunoglobulin classes.
Define Serum.
antibodies
the fluid portion of the blood free of cells and clotting factors.
the electrophoretic fraction of serum that contains most of the immunoglobulin classes.
the small polypeptide subunit of an antibody.
Define Immunoglobulins.
antigens
the small polypeptide subunit of an antibody.
antibodies
the large polypeptide subunit of an antibody.
Define the Gamma-globulin fraction.
the cell-free, fluid portion of blood which contains all the clotting factors.
the fluid portion of the blood free of cells and clotting factors.
is the electrophoretic segment of serum that contains most of the immunoglobulin classes.
the small polypeptide subunit of an antibody.
the large polypeptide subunit of an antibody.
Define the light-chain.
the large polypeptide subunit of an antibody.
antibodies
the cell-free, fluid portion of blood which contains all the clotting factors
the small polypeptide subunit of an antibody.
Define the heavy chain.
the cell-free, fluid portion of blood which contains all the clotting factors
is the electrophoretic fraction of serum that contains most of the immunoglobulin classes.
the large polypeptide subunit of an antibody.
the small polypeptide subunit of an antibody.
What is the region highlighted in orange (the circle)?
The variable region
the light chain
the heavy chain
the constant region
What is the region indicated in blue (the bracket)?
the constant region
the variable region
the heavy chain
the light chain
What is the region indicated in green (the large bracket)?
the variable region
the light chain
the constant region
the heavy chain
What is the region indicated in magenta (the large circle)?
the light chain
the constant region
the heavy chain
the variable region
What is the region indicated in black (the circle with the arrow)?
the hinge
the variable region
the constant region
What is the antibody associated with the heavy chain (γ)
IgM
IgA
IgE
IgD
IgG
What is the antibody associated with the heavy chain (μ)
IgG
IgB
IgE
IgM
IgD
What is the antibody associated with the heavy chain (α)
IgG
IgA
IgH
IgM
IgD
What is the antibody associated with the heavy chain (ε)
IgD
IgE
IgA
IgG
IgH
What is the antibody associated with the heavy chain (δ)
IgD
IgA
IgM
IgG
IgE
What immune benefits does an infant receive from the mother’s breast milk.
its gives the child passive immune protection
it is always at the right temperature for the baby
It helps to keep the baby's body temperature from dropping too low
Breast milk contains IgA, IgM, and IgG
breastmilk changes to meet the baby's needs
Define isotype.
the different classes of antibodies
the antigenic determinant that varies among members of a species
idiotype the set of antigenic determinants in the variable domains of an antibody or T cell receptor.
Define allotype
idiotype the set of antigenic determinants in the variable domains of an antibody or T cell receptor.
the different classes of antibodies.
the antigenic determinant that varies among members of a species.
Define idiotype.
the antigenic determinant that varies among members of a species.
the set of antigenic determinants in the variable domains of an antibody or T cell receptor.
the different classes of antibodies.
Oh thats me, I'm an idiotype. Lmao jk, don't pick this one. <3
State which two immunoglobulins are simultaneously expressed on the surface membrane of the mature B lymphocyte.
(a)
The structure of the IgG antibody is a ________.
Monomer
Dimer
Trimer
Tetramer
The structure of the IgA antibody is a ________.
Monomer
Dimer
Tetramer
Pentamer
Trimer
The structure of the IgM antibody is a ________.
Monomer
Dimer
Trimer
Tetramer
Pentamer
The structure of the IgD antibody is a ________.
Monomer
Dimer
Trimer
Tetramer
Pentamer
The structure of the IgE antibody is a ________.
Monomer
Dimer
Trimer
Tetramer
Pentamer
What is the normal serum level of an IgG antibody?
1 is 900 mg/dL
1 is 600 mg/dL
2 is 300 mg/dL
3 is 100 mg/dL,
4 is 50 mg/dL
What is the normal serum level of an IgA antibody?
1 is 300 mg/dL
1 is 150 mg/dL
2 is 50 mg/dL
2 is 3mg/dL
3 is 0.03mg/dL
What is the normal serum level of an IgM antibody?
1 is 150 mg/dL
2 is 300 mg/dL
1 is 900 mg/dL
3 is 100 mg/dL
4 is 50 mg/dL
What is the normal serum level of an IgD antibody?
1 is 100 mg/dL
1 is 3mg/dL
2 is 300 mg/dL
1 is 0.03 mg/dL
What is the normal serum level of an IgE antibody?
1 is 300 mg/dL
2 is 50 mg/dL
1 is 150 mg/dL
1 is 0.03 mg/dL
Which antibodies activate the complement system?
IgA
IgG (1, 2, and 3)
IgD
IgE
IgM
Which antibody crosses the placenta?
IgA
IgM
IgG
IgE
IgD
Define the hypervariable region (of an antibody).
some differences in sequence between antibodies sequenced
exceptionally variable in terms of what amino acids were located in certain positions in the antibody chain
the same amino acid sequence for all antibodies
Define the variable region (of an antibody).
some differences in sequence between antibodies sequenced
exceptionally variable in terms of what amino acids were located in certain positions in the antibody chain
the same amino acid sequence for all antibodies
Define the constant region (of an antibody).
the same amino acid sequence for all antibodies
some differences in sequence between antibodies sequenced
exceptionally variable in terms of what amino acids were located in certain positions in the antibody chain
Define the hinge region (of an antibody).
the portion of the antigen that is recognized and bound by an antibody or T cell/MHC molecule
the same amino acid sequence for all antibodies
a region that is rich in proline residues that allow the Fab arms to be flexible
some differences in sequence between antibodies sequenced
Define papain (of an antibody).
the portion of the antigen that is recognized and bound by an antibody or T cell/MHC molecule
digestion yields one F(ab')2 fragment, which is able to precipitate antigens. The Fc portion is digested into multiple fragments and is not recoverable.
digestion yields two identical Fab fragments [fragment antigen binding] and one Fc fragment [fragment, crystallizable]
a region that is rich in proline residues that allow the Fab arms to be flexible
Define pepsin (in regard to an antibody).
digestion yields one F(ab')2 fragment, which is able to precipitate antigens. The Fc portion is digested into multiple fragments and is not recoverable.
the portion of the antigen that is recognized and bound by an antibody or T cell/MHC molecule
digestion yields two identical Fab fragments [fragment antigen binding] and one Fc fragment [fragment, crystallizable]
the electrophoretic fraction of serum that contains most of the immunoglobulin classes.
The Fab fragment is ____________.
a region on an antibody that binds to antigens
the electrophoretic fraction of serum that contains most of the immunoglobulin classes.
the cell-free, fluid portion of blood which contains all the clotting factors.
large polypeptide subunit of an antibody.
The F(ab’)2 fragment _________
is the cell-free, fluid portion of blood which contains all the clotting factors.
is the fluid portion of the blood free of cells and clotting factors.
is the electrophoretic fraction of serum that contains most of the immunoglobulin classes
have two antigen-binding regions that are linked by disulfide bonds
The Fc fragment
the electrophoretic fraction of serum that contains most of the immunoglobulin classes
the tail region of an antibody that interacts with cell surface receptors
is the small polypeptide subunit of an antibody.
is the large polypeptide subunit of an antibody.
What is the anamnestic response?
the electrophoretic fraction of serum that contains most of the immunoglobulin classes
When drugs or their metabolites react with proteins to form a drug-protein derivative, this sets up a hapten-carrier situation, and the drug can then become an immunogen.
the rapid reappearance of antibody in the blood following introduction of an antigen to which the subject had previously developed a primary immune response
The greater the phylogenetic difference (foreignness) between species, the more immunogenic the antigen will be.
Which antibodies are involved with mucosal transport?
IgA
IgG
IgM
IgD
IgE
Which antibodies are involved in the induction of mast cell degranulation?
IgA
IgG
IgM
IgD
IgE
Which antibodies are present on the surface of mature B lymphocytes?
IgA
IgG
IgM
IgD
IgE
Define hapten.
a low molecular weight molecule that can be made immunogenic by conjugation to a suitable carrier molecule.
a substance that non-specifically enhances the immune response to an antigen.
the portion of the antigen that is recognized and bound by an antibody or T cell/MHC molecule.
Define Anadjuvant.
a low molecular weight molecule that can be made immunogenic by conjugation to a suitable carrier molecule.
the portion of the antigen that is recognized and bound by an antibody or T cell/MHC molecule.
a substance that generates an immune response
a substance that non-specifically enhances the immune response to an antigen.
Define epitope.
a substance that generates an immune response.
a low molecular weight molecule that can be made immunogenic by conjugation to a suitable carrier molecule.
a substance that non-specifically enhances the immune response to an antigen.
the portion of the antigen that is recognized and bound by an antibody or T cell/MHC molecule.
All immunogens are antigens, but not all antigens are immunogens.
True
False
What are the factors that determine whether an antigen is an immunogen or not?
The greater the phylogenetic difference (foreignness) between species, the more immunogenic the antigen will be.
All immunogens are antigens
The best immunogens tend to have a molecular mass of greater than 100k Daltons, with a sizable number of antigenic determinants.
lipids are the most potent immunogens.
In order for a polymer to have immunogenic properties, it must be composed of more than one amino acid or sugar and have a molecular weight of 30k Daltons or more.
What are the theoretical modes of action of three adjuvants?
The best immunogens tend to have a molecular mass of greater than 100k Daltons, with a sizable number of antigenic determinants.
Alum potassium sulfate results in slower release of antigen from the injection site and increases the size of the antigen, leading to phagocytosis.
Freud’s complete adjuvant allows antigen to be released slower from the injection site and muramyl dipeptide activates macrophages.
Freud’s incomplete adjuvant causes adjuvant to be released slowly from the site of infection
Freud’s incomplete adjuvant states that in order to have immunogenic properties, it must be composed of more than one amino acid or sugar and have a molecular weight of 30k Daltons or more
What are the characteristics of a B cell?
they tend to recognize highly accessible sites on the exposed surface of the immunogen.
They tend to be located in physically flexible regions of an immunogen.
they can contain sequential or non-sequential amino acids.
tend to recognize internal peptides of antigens.
recognize antigen only in combination with MHC molecules on the surface of APCs or on altered self cells.
What are the characteristics of a T cell?
They tend to recognize internal peptides of antigens.
They tend to recognize highly accessible sites on the exposed surface of the immunogen
They are generally composed of hydrophilic amino acids on the surface that are accessible to both membrane bound and free antibody.
they can recognize antigens only in combination with MHC molecules on the surface of APCs or on altered self cells.
they end to be located in physically flexible regions of an immunogen.
Patient's develop a life threatening allergy to a prescribed medication when drugs or their metabolites react with proteins to form a drug-protein derivative, this sets up a hapten-carrier situation, and the drug can then become an immunogen
True
False
What the heck are you talking about?
Describe the role IgE plays in allergies.
IgE binds to receptors on circulating basophils and tissue mast cells.
IgE stimulates a local chronic inflammatory response that results in granuloma inflammation.
Cross-linking of receptor bound IgE by antigen induces degranulation of the cell
B cell epitopes on proteins are generally composed of hydrophilic amino acids on the surface that are accessible to both membrane bound and free antibody.
Define Antibody dependent cell mediated cytotoxicity.
the movement of antibody molecules across epithelial layers mediated by the poly-Ig receptor.
the linking of antibodies bound to virus infected cells of the host with the Fc receptors of NK cells results in the NK cells causing the death of the target cell via apoptosis.
the promotion of phagocytosis of antigens by macrophages and neutrophils.
a collection of serum glycoproteins that can lyse cell membranes.
Define transcytosis.
the linking of antibodies bound to virus infected cells of the host with the Fc receptors of NK cells results in the NK cells causing the death of the target cell via apoptosis.
the movement of antibody molecules across epithelial layers mediated by the poly-Ig receptor
the promotion of phagocytosis of antigens by macrophages and neutrophils.
Define Opsonization.
the promotion of phagocytosis of antigens by macrophages and neutrophils.
the movement of antibody molecules across epithelial layers mediated by the poly-Ig receptor.
the linking of antibodies bound to virus infected cells of the host with the Fc receptors of NK cells results in the NK cells causing the death of the target cell via apoptosis.
a collection of serum glycoproteins that can lyse cell membranes.
____________ is a cancer of antibody producing plasma cells. Cells no longer are end-stage differentiated cells with a finite lifespan, but now how indefinite lives, with their ability to synthesize and secrete antibody still intact.
Multiple Myeloma
Bence-Jones
Hypercalcemia
Thrombocytopenia
Define Bence-Jones proteins
the linking of proteins bound to virus infected cells of the host with the Fc receptors of NK cells results in the NK cells causing the death of the target cell via apoptosis.
proteins that stimulate a local chronic inflammatory response that results in granuloma inflammation.
excess amounts of immunoglobulin light chains secreted by myeloma cells.The N-terminal of these proteins have different sequences.
the movement of protein molecules across epithelial layers mediated by the poly-Ig receptor.
Which of the following statements are true about the kappa and lambda light chains.
60% of light chains in humans are the kappa type.
40% of light chains in humans are the kappa type.
40% of light chains in humans are the lambda type.
60% of light chains in humans are the lambda type.
30% of light chains in humans are the lambda type and 60% of light chains in humans are the kappa type.
Which of the following are symptoms of multiple myeloma?
fatigue
thrombocytopenia
bone pain caused by hypercalcemia
fever
syncope
Define the term specificity.
is the ability of a particular antibody to combine with a specific antigen epitope.
a similarity in epitopes between two different antigens that allows one specific antibody to bind to two different, but structurally similar antigen.
the initial force of attraction between antigen and antibody.
the strength of attraction between antigen and an antibody, significantly influenced by the goodness of fit between the functional groups involved in the binding site.
Define the term cross-reactivity
is the ability of a particular antibody to combine with a specific antigen epitope.
a similarity in epitopes between two different antigens that allows one specific antibody to bind to two different, but structurally similar antigen.
the initial force of attraction between antigen and antibody.
the strength of attraction between antigen and an antibody, significantly influenced by the goodness of fit between the functional groups involved in the binding site.
Define the term affinity.
is the ability of a particular antibody to combine with a specific antigen epitope.
a similarity in epitopes between two different antigens that allows one specific antibody to bind to two different, but structurally similar antigen.
the initial force of attraction between antigen and antibody.
the strength of attraction between antigen and an antibody, significantly influenced by the goodness of fit between the functional groups involved in the binding site.
Define the term avidity.
is the ability of a particular antibody to combine with a specific antigen epitope.
a similarity in epitopes between two different antigens that allows one specific antibody to bind to two different, but structurally similar antigen.
the initial force of attraction between antigen and antibody.
the strength of attraction between antigen and an antibody, significantly influenced by the goodness of fit between the functional groups involved in the binding site.
The secondary response is _____ and ______ than the primary response due to the presence of memory cells; IgG antibodies predominate rather than the IgM antibodies of the primary response.
(a)
B cells are characterized by
CD19
CD20
CD2
CD21
CD22
Th cells are characterized by
CD2
CD5
CD56
CD3
CD4
Tc cells are characterized by CD2, CD3, CD5, and CD57
True
False
Tc cells are characterized by
CD2
CD4
CD3
CD8
CD5
NK cells are characterized by
CD2 and CD3
CD4 AND CD57
CD5 and CD16
CD56 AND CD8
CD56 and CD57
The function of a T helper cell is to
stimulate B cell growth/differentiation, macrophage activation
lyse virus-infected cells, tumor cells, and allografts. It also activates macrophages.
produce antibodies
lyse virus-infected cells
The function of a T cytotoxic cell is to
stimulate B cell growth/differentiation, macrophage activation
lyse virus-infected cells, tumor cells, and allografts. It also activates macrophages.
produce antibodies
lyse virus-infected cells
The function of a natural killer (NK) cell is to
stimulate B cell growth/differentiation, macrophage activation
lyse virus-infected cells, tumor cells, and allografts. It also activates macrophages.
produce antibodies
lyse virus-infected cells
The function of a B lymphocyte is to
stimulate B cell growth/differentiation, macrophage activation
lyse virus-infected cells, tumor cells, and allografts. It also activates macrophages.
produce antibodies
lyse virus-infected cells
The phenotypic markers of a T helper cell are
CD2+
IgF receptor
CD3+
CD4+
CD8-
The phenotypic markers of a cytotoxic T cell are
CD2+
IgF receptor
CD3+
CD4-
CD8+
The phenotypic markers of a natural killer (NK) cell are
CD2+
IgG Fc receptor
CD3+
CD4+
CD16+
The phenotypic markers of a B lymphocyte cell are
MCH class II
CD19+
CD21+
CD16+
CD4+
A T helper cell is _____% of total circulating lymphocytes
50-60
20-25
10
10-15
A cytotoxic T cell is _____% of total circulating lymphocytes
50-60
20-25
10
10-15
A natural killer (NK) cell is _____% of total circulating lymphocytes
50-60
20-25
10
10-15
A B lymphocyte is _____% of total circulating lymphocytes
50-60
20-25
10
10-15
What is the formula to calculate absolute lymphocyte count?
Absolute lymphocyte count = (% lymphocytes) ÷ (Total leukocyte count).
Absolute lymphocyte count = (Total leukocyte count) ÷ (% lymphocytes).
Absolute lymphocyte count = (Total leukocyte count) × (% lymphocytes).
State the ratio of T (helper/inducer : suppressor/cytotoxic) cells expected to be found in a healthy person.
(a)
Dysfunctions in cell-mediated immunity can be tested by checking cell-mediated response to an antigen, the number of T lymphocytes, and T helper to T cytotoxic ratios.
True
False
Dysfunctions in humoral immunity can be checked by quantifying IgM, IgG, and IgA levels or RID for individual antibodies.
True
False
Dysfunctions in phagocytic functions can be tested by absolute neutrophil count, nitroblue tetrazolium test, neutrophil oxidative burst assay, and leukocyte adhesion deficiency. LAD-1 is CD18 deficient, while LAD-2 is CD15 deficient.
True
False
Dysfunctions in cell-mediated immunity can be tested by quantifying IgM, IgG, and IgA levels or RID for individual antibodies.
True
False
Dysfunctions in humoral immunity can be checked by checking cell-mediated response to an antigen, the number of T lymphocytes, and T helper to T cytotoxic ratios
True
False
Dysfunctions in phagocytic functions can be tested by checking cell-mediated response to an antigen, the number of T lymphocytes, and T helper to T cytotoxic ratios
True
False
Based on the immunodeficiencies discussed in class, Bruton’s agammaglobulinemia is an X-linked disorder that occurs during 9-12 months of age. Which of the following is true about this disease?
IgA, IgG, and IgM levels are below normal.
IgA, IgG, and IgM levels are above normal.
B cells are virtually absent from marrow and lymphoid tissues.
Total Ig levels are above normal.
T cell function is normal.
Based on the immunodeficiencies discussed in class, Common variable immunodeficiency (CVID) is acquired agammaglobulinemia that can occur at any age, with many cases being between 20-30 years. Which of the following is true about this disease?
Increased susceptibility to infection with pyogenic pathogens.
Total Ig levels are less than normal.
Near normal or slightly decreased numbers of B lymphocytes, but don’t mature to plasma cells.
IgA, IgG, and IgM levels are above normal.
Causes congenital heart defects and facial abnormalities.
oSelective IgA deficiency causes 44% of patients to have antibodies against their own IgA, causing frequent mucosal infections. Can occur or evolve into CVID.
True
False
oSelective IgA deficiency causes 88% of patients to have antibodies against their own IgE, causing frequent mucosal infections. Cannot occur or evolve into CVID.
True
False
Immunodeficiency with Hyper IgM is usually detected within the first ____ years of life and is characterized by a lack of CD40L, impairing immunoglobulin class switching. Also, it is caused by __________________.
The first 2 years
Low IgA, IgG, and IgE levels, but normal to high IgM levels.
The first 3 years
high IgA, IgD, and IgE levels, but low to normal IgM levels.
The first 6 years
______ is characterized by an extreme susceptibility to EBV.
Chronic mucocutaneous candidiasis (CMC)
DiGeorge’s syndrome
Duncan’s disease
SCID
_______ is caused by the failure of progenitor cells to mature into functional lymphocyte precursors. Lack of both B and T cells and inability to synthesize antibodies.
SCID
DiGeorge’s syndrome
Duncan’s disease
Common variable immunodeficiency (CVID
Ataxia-telangiectasia is T cell deficiency with defect in DNA repair. What are three characteristics of this disease?
Low levels of IgG2, IgA, IgE, and T lymphocytes.
Congenital heart defects and facial abnormalities.
High risk of malignancy.
Low number of platelets.
Clumsy, uncoordinated movements.
Wiskott-Aldrich syndrome is a rare, X-linked recessive disease and is usually lethal in childhood due to infection, malignancy, or hemorrhage. What are the characteristics of this disease?
Low IgM levels, with other Ig normal or high.
Congenital heart defects and facial abnormalities.
Low number of platelets.
Can occur or evolve into CVID.
