WorksheetsImmunology Exam 2: Lectures 5-6
Total questions: 92
Worksheet time: 5hrs 32mins
What are the differences between a T cell receptor (TCR) and B cell receptor (BCR)?
TCR variable domains have three hyper-variable regions
BCR need an MHC molecule to present an antigen
TCR need an MHC molecule to present an antigen
BCR can bind directly to an antigen
TCR can bind directly to an antigen
Name a molecule commonly seen in the immune system that is structurally related to the T cell receptor.
(a)
Define the two abilities that allow the CD4 and CD8 membrane molecules to be classified as “co-receptors” in the T- lymphocyte.
TCR variable domains have three hyper-variable regions, making them similar to immunoglobulin binding sites
Ability to participate in signal transduction
Ability to recognize the peptide-MHC complex
The TCR transmembrane segments contain positively charged amino acids which allow them to interact with chains of a signal transducing complex on the cell membrane known as CD3
Describe the role co-receptor molecules play in the TCR binding affinity.
CD4+ will allow them to bind to cytokines
CD3 provides the ability to recognize the peptide-MHC complex and is allographic
CD8+ will respond to altered cells
CD3 provides the ability to participate in signal transduction and is allographic
____________ means denoting, relating to, or involving tissues or cells that are genetically dissimilar and hence immunologically incompatible, although they are from individuals of the same species.
Allogenic
Allograft
Binding affinity
HLA Haplotype
_________ means a tissue graft from a donor of the same species as the recipient but not genetically identical to them.
Allogenic
Allograft
Binding affinity
HLA Haplotype
_________ are viral or bacterial proteins that bind simultaneously to crosslink both the cell receptor and the MHC class II molecule, nonspecifically stimulating the cell.
Allogenins
Superantigens
Signal transducing particles
Receptor antigens
Describe the two signals necessary for naive T cell activation.
Signal 1 is generated by the interaction of an antigenic peptide with the T-Cell receptor-CD3 complex
Signal 1 plus co-stimulatory signal 2 causes expression of IL-2 and the IL-2 receptor on the T cell surface leading to cell division and differentiation to form a population of effector and memory cells
Signal 1 is provided by interactions between CD28 molecule on the T cell and members of the B7 family of molecules on antigen presenting cells
Signal 2 is provided by interactions between CD28 molecule on the T cell and members of the B7 family of molecules on antigen presenting cells
Signal 2 is generated by the interaction of an antigenic peptide with the T-Cell receptor-CD3 complex
Which of the following is/are an Exogenous superantigen(s)?
staphylococcal enterotoxin
cell membrane proteins encoded by certain viruses
toxic shock syndrome toxin
streptococcal pyrogenic exotoxins
Which of the following is/are an Endogenous superantigen(s)?
staphylococcal enterotoxin
cell membrane proteins encoded by certain viruses
toxic shock syndrome toxin
streptococcal pyrogenic exotoxins
Thymus independent antigens do not require direct contact with T helper cells to activate them.
True
False
The following statement describes what process?
- - LPS activates a B cell and causes it to proliferate and produce non-specific antibodies.
How thymus independent antigens are able to activate T cell receptors
Naive T cell activation
How thymus dependent antigens are able to activate B cell receptors
TCR β-chain rearrangement
The following statement describes what process?
- - bacterial flagellin and capsular polysaccharides could cause activation of the B cells for non-specific binding
How thymus independent antigens are able to activate T cell receptors
Naive T cell activation
How thymus dependent antigens are able to activate B cell receptors
TCR β-chain rearrangement
A type ____ thymus independent antigen is defined as a bacterial flagellin and capsular polysaccharides that could cause activation of the B cells for non-specific binding.
1
2
3
β
A type ____ thymus independent antigen is defined as a LPS that could activate B cells and cause them to proliferate and produce non-specific antibodies.
1
2
3
β
Each naive T cell re-circulated from the blood to the lymph nodes and back again every (a) hours
(a) T cells divide 2-3 times per day for 4-5 days in order to produce a progeny of cells which differentiate into either memory or effector cells.
True or False: Correct the statement if it is false.
IL-10 is necessary for the development and maturation of T-cells
True
False, IL-2
False, B-cells
False, IL-12
True or False: Correct the statement if it is false.
T-cells begin differentiation when their TCR-CD3 complex interacts with an antigenic peptide.
True
False, interacts directly with a pathogen
False, when their MHC Class II molecule
False: B-cell, BCR-CD3 complex
“Professional antigen presenting cells” express the _______________.
MHC II glycoproteins
MHC I glycoproteins
CD28
CD13
Extracellular (exogenous) antigens are eliminated by ____ and processed via the _______. It is presented with MHC II molecules.
endocytic pathway
cytotoxic T cells
secreting antibodies
cytosolic pathway
Intracellular (endogenous) antigens are eliminated by ________ and processed via the _________. It is presented on the membrane with MHC I molecules
endocytic pathway
cytotoxic T cells
secreting antibodies
cytosolic pathway
A progenitor B cell __________
proliferates producing 32-64 descendant cells prior to light chain gene rearrangement in order to produce an increased variation in specificity in the antigen binding site.
Expresses mIgM on the cell, single antigenic specificity; also has surface markers CD19, HSA (CD24), CD45R, Ig-⍺, Ig-β
Expresses mIgM and IgD on the cell surface; also has surface markers CD19, CD23, HSA (CD24), CD45R, Ig-⍺, Ig-β
Needs productive immunoglobulin heavy chain gene rearrangement to differentiate, it binds to a pre-surrogate light chain.
A precursor B cell ________
proliferates producing 32-64 descendant cells prior to light chain gene rearrangement in order to produce an increased variation in specificity in the antigen binding site.
Expresses mIgM on the cell, single antigenic specificity; also has surface markers CD19, HSA (CD24), CD45R, Ig-⍺, Ig-β
Expresses mIgM and IgD on the cell surface; also has surface markers CD19, CD23, HSA (CD24), CD45R, Ig-⍺, Ig-β
Needs productive immunoglobulin heavy chain gene rearrangement to differentiate, it binds to a pre-surrogate light chain.
An immature B cell _______
proliferates producing 32-64 descendant cells prior to light chain gene rearrangement in order to produce an increased variation in specificity in the antigen binding site.
Expresses mIgM on the cell, single antigenic specificity; also has surface markers CD19, HSA (CD24), CD45R, Ig-⍺, Ig-β
Expresses mIgM and IgD on the cell surface; also has surface markers CD19, CD23, HSA (CD24), CD45R, Ig-⍺, Ig-β
Needs productive immunoglobulin heavy chain gene rearrangement to differentiate, it binds to a pre-surrogate light chain.
A mature B cell __________.
proliferates producing 32-64 descendant cells prior to light chain gene rearrangement in order to produce an increased variation in specificity in the antigen binding site.
Expresses mIgM on the cell, single antigenic specificity; also has surface markers CD19, HSA (CD24), CD45R, Ig-⍺, Ig-β
Expresses mIgM and IgD on the cell surface; also has surface markers CD19, CD23, HSA (CD24), CD45R, Ig-⍺, Ig-β
Needs productive immunoglobulin heavy chain gene rearrangement to differentiate, it binds to a pre-surrogate light chain.
In regard to the process of activation of B cells by T cells, _______________ induces the first signal which leads to increased expression of class II MHC and co-stimulatory B7 on a B cell.
Interaction of CD40 and CD40L
Antigen cross-linkage of mIg
The binding of cytokines released from the TH cell
B-7-CD28 gives co-stimulation to the TH cell which
True/False. Correct the statement if false.
TH cells recognize antigen MHC II on the B-cell membrane in addition to co-stimulatory signals which activate the TH cell
True
False, B cells recognize...
False, MHC I on the B-cell...
False, which activate the B cell
In regard to the process of activation of B cells by T cells, after TH activation, it expresses CD40L. _______________ provides a signal in which B-7-CD28 gives co-stimulation to the TH cell.
Interaction of CD40 and CD40L
Antigen cross-linkage of mIg
The binding of cytokines released from the TH cell
The B cell receptor-CD3 complex
In regard to the process of activation of B cells by T cells; After B-7 CD28 gives co-stimulation to the TH cell, The B cell then expresses receptors for various cytokines. _______________ sends signals that support the progression of the B cell to DNA synthesis.
Interaction of CD40 and CD40L
Antigen cross-linkage of mIg
The binding of cytokines released from the TH cell
The B cell receptor-CD3 complex
During the antigenic stimulation response, there are primary and secondary responses. The lag phase represents the time in which _________ undergo clonal selection, proliferation and differentiation into plasma cells and memory cells.
naive B cells
Precursor B cells
Naive T cells
During the antigenic stimulation response, there are primary and secondary responses. During the lag phase ____ is secreted first then switches to the _____ isotype. The primary response can last a few days to weeks
IgM, then IgG
IgG, then IgM
IgA, then IgG
IgM, then IgA
IgG, then IgA
During the antigenic stimulation response, there are primary and secondary responses. The secondary response is generated via ________.
Naive B cells
naive T cells
Memory B and T cells.
mIg antibodies
True/False. Correct if the statement is false.
The antibody secreted in the memory response also has a lower affinity for the antigen and is predominantly the IgG antibody
True
False; higher affinity
False; predominantly the IgM
False; predominantly the IgA
Naive B cells secrete ____________ during an antigenic simulation response.
IgM first and then IgG. IgM is greater in amount.
both IgM and IgG. IgG is significantly larger than the IgM secretion.
IgG first and then IgM. IgG is greater in amount
both IgM and IgA. IgA is significantly larger than the IgM secretion.
Memory B cells secrete ____________ during an antigenic simulation response.
IgM first and then IgG. IgM is greater in amount.
both IgM and IgG. IgG is significantly larger than the IgM secretion.
IgG first and then IgM. IgG is greater in amount
both IgM and IgA. IgA is significantly larger than the IgM secretion.
Relate the circumstances of in vivo activation and differentiation of B cells in peripheral body sites.
Tissue antigens are filtered by the spleen
Blood borne pathogens are filtered by the spleen
Tissue antigens are filtered by regional lymph nodes
Blood borne pathogens are filtered by regional lymph nodes
Define the term “Major histocompatibility complex."
It is a tightly linked cluster of genes on chromosome 6 in humans that presents antigens and discriminates between self. Also referred to as the HLA complex
A complex responsible for degrading proteins in the cytoplasm beginning with attachment of ubiquitin to the protein
Antigens pass through various compartments of the pathway with increasingly lower pHs where it is degraded into peptides about 13-18 amino acids in length by this complex
______________ trigger humoral immune response by the binding of B lymphocytes to an antigen.
Intracellular pathogens
Extracellular pathogens
Intracellular antigens are eliminated via (a) . The endogenous peptide antigen epitopes are bound to the class I MHC.
Extracellular antigens are eliminated via (a) . The exogeneous antigenic epitopes are bound to class II MHC in the endocytic compartments
_____________ trigger a cell-mediated immune response and a delayed hypersensitivity response by T lymphocytes and NK cells.
Intracellular pathogens
Extracellular pathogens
What are three ways the immune system defends against bacterial adhesion and entry into the body.
Tears wash away pathogens
Secretory plasma cells concentrate aline in the epithelium of mucus membranes and produce 5-15g of sIgM into mucus secretions per day.
Saliva, mucus, and cilia trap and expel bacteria
Secretory plasma cells concentrate aline in the epithelium of mucus membranes and produce 5-15g of sIgA into mucus secretions per day.
There are several methods bacterial pathogens have developed to avoid destruction by the host immune system. One of them is to Evade IgA by secreting proteases that cleave sIgA at the hinge region yielding shortened half life molecules incapable of agglutinating microorganisms. What organism(s) accomplish this?
N. gonorrhoeae
S. pyrogenes
N. meningitidis
S. pneumoniae
H. influenza
There are several methods bacterial pathogens have developed to avoid destruction by the host immune system. One of them is to Evade IgA by rotating expressed cell surface antigens. What organism(s) accomplish this?
N. gonorrhoeae
S. pyrogenes
N. meningitidis
S. pneumoniae
L. monocytogenes
There are several methods bacterial pathogens have developed to avoid destruction by the host immune system. One of them is to Evade phagocytosis by production of M protein (inhibits phagocytosis). What organism(s) accomplish this?
N. gonorrhoeae
S. pyrogenes
N. meningitidis
S. pneumoniae
M. avium
There are several methods bacterial pathogens have developed to avoid destruction by the host immune system. One of them is to Evade phagocytosis by expression of a capsule. What organism(s) accomplish this?
N. gonorrhoeae
S. pyrogenes
N. meningitidis
S. pneumoniae
L. monocytogenes
There are several methods bacterial pathogens have developed to avoid destruction by the host immune system. One of them is to Evade destruction by interfering with the inflammatory response. What organism(s) accomplish this?
N. gonorrhoeae by secreting elastase which inactivates C3a and C5a
S. pyrogenes by secreting elastase which inactivates C4a and C5b
N. meningitidis by secreting elastase which inactivates C4a and C5b
S. pneumoniae by secreting elastase which inactivates C3a and C5a
Pseudomonas species by secreting elastase which inactivates C3a and C5a
There are several methods bacterial pathogens have developed to avoid destruction by the host immune system. One of them is to Evade destruction by the ability to survive within phagocytic cells. What organism(s) accomplish this?
L. monocytogenes by escaping the phagolysosome
M. avium by blocking fusion of the lysosome and phagolysosome
M. avium by escaping the phagolysosome
L. monocytogenes by blocking fusion of the lysosome and phagolysosome
What factors that increase infectious disease risk in the population?
Individuals with a compromised immune system
Prevalence in the population
Virulence of the organism
The portal of entry
Smoking history of certain individuals
What are the symptoms of primary syphilis?
Headache, sore throat, fever, generalized malaise
a painless chancre that develops at the site of inoculation 10-15 after exposure
a maculopapular rash on the genitals, palms/soles of hands/feet
No symptoms
Aneurysm in the aorta, stroke, dementia, personality changes, and delusional states.
What is the test/specimens of choice for primary Syphilis?
Darkfield microscopy is the test of choice
Dark Field microscopy, RPR, or VDRL tests are the test of choice
Swab from chancre site is the specimen of choice
Blood/Serum is the specimen of choice
CSF (cerebrospinal fluid) is the specimen of choice
What is the test/specimens of choice for secondary Syphilis?
Darkfield microscopy is the test of choice
Dark Field microscopy, RPR, or VDRL tests are the test of choice
Swab from chancre site is the specimen of choice
Blood/Serum is the specimen of choice
CSF (cerebrospinal fluid) is the specimen of choice
What is the test/specimens of choice for latent Syphilis?
Darkfield microscopy is the test of choice
Dark Field microscopy, RPR, or VDRL tests are the test of choice
Swab from chancre site is the specimen of choice
Blood/Serum is the specimen of choice
ELISA, MHA-TP, FTA-ABS or DFA fluorescent tests are the test of choice
What is the test/specimens of choice for tertiary Syphilis?
Darkfield microscopy is the test of choice
CSF (cerebrospinal fluid)
IgM ELISA is the test of choice
The only acceptable screening is a VDRL assay
Blood/serum
What is the test/specimens of choice for congenital Syphilis?
Darkfield microscopy is the test of choice
CSF (cerebrospinal fluid)
IgM ELISA is the test of choice
The only acceptable screening is a VDRL assay
Blood/serum
What are the symptoms of secondary syphilis?
aneurysm in the aorta, stroke, dementia, personality changes, and delusional states
Headache, sore throat, fever, generalized malaise
Tabes dorsalis yields stabbing pains, diminished ankle/knee reflexes, staggering, and wide-based gait
a maculopapular rash on the genitals, palms/soles of hands/feet
a painless chancre that develops at the site of inoculation that appears 10-15 after exposure
What are the symptoms of latent syphilis?
aneurysm in the aorta, stroke, dementia, personality changes, and delusional states
Headache, sore throat, fever, generalized malaise
There are none
a maculopapular rash on the genitals, palms/soles of hands/feet
a painless chancre that develops at the site of inoculation that appears 10-15 after exposure
What are the symptoms of tertiary syphilis?
aneurysm in the aorta, stroke, dementia, personality changes, and delusional states
Headache, sore throat, fever, generalized malaise
Tabes dorsalis yields stabbing pains, diminished ankle/knee reflexes, staggering, and wide-based gait
a maculopapular rash on the genitals, palms/soles of hands/feet
a painless chancre that develops at the site of inoculation that appears 10-15 after exposure
What are the symptoms of congenital syphilis?
aneurysm in the aorta, stroke, dementia, personality changes, and delusional states
Headache, sore throat, fever, generalized malaise
hutchinson teeth, interstitial keratitis, skeletal lesion, collapse of nasal bones
a maculopapular rash on the genitals, palms/soles of hands/feet
Tabes dorsalis yields stabbing pains, diminished ankle/knee reflexes, staggering, and wide-based gait
What are some possible modes of transmission of syphilis
Kissing
Sharing a bed with an infected person
Blood transfusion/sexual intercourse
Placental transfer
Breathing in cough or sneeze droplets
In a VDLR Assay, Serum must be heated to (a) °C for 30min to inactivate the proteolytic enzymes.
True or false: Correct the statement if false
In a VDLR assay, the antigen must be used within 30 minutes of making it
True
False; the antigen can be used until the expiration date on the bottle
False; the antigen must be used on the same day (within 8 hrs)
In a VDLR Assay, what aspects need to be quality controlled?
Serum temperature/water bath temperature
Dispensing needle (60+/-2) and rotator speed 100rpm
Dispensing needle (60+/-2) and rotator speed 180rpm
Room temperature must be 30°C
What can cause a false positive of a VDLR assay?
Old age
Pregnancy
Infancy
Autoimmune disorders/malignancy
Viral infections
The room temperature for an RPR assay must be done between (a) °C with a rotator speed of 100rpm.
What can cause a false positive in a FTA-ABS assay?
Malignancy
Pregnancy
drug addiction
Pinta, Yaws, and Bejel
Systemic lupus erythematosus (SLE) and leprosy
What organism is responsible for syphilis?
T. pallidum ssp. pallidum
T. pallidum ssp. pertenue
T. pallidum ssp. endemicum
T. carateum
What organism is responsible for yaws?
T. pallidum ssp. pallidum
T. pallidum ssp. pertenue
T. pallidum ssp. endemicum
T. carateum
What organism is responsible for Bejel?
T. pallidum ssp. pallidum
T. pallidum ssp. pertenue
T. pallidum ssp. endemicum
T. carateum
What organism is responsible for Pinta?
T. pallidum ssp. pallidum
T. pallidum ssp. pertenue
T. pallidum ssp. endemicum
T. carateum
The causative organism of Lyme's disease is:
Trypanosoma cruzi
Toxoplasma hydrocephali
Babesia bicroti
Borrelia burgdorferi
Entamoeba histolytica
True/False: Correct if False
According to the CDC, the presence of an erythema migrans, or a bullseye rash, is enough to diagnose a patient with lymes disease
True
False; in addition a western blot needs to be performed
False; cardiovascular, musculoskeletal, or neurologic disease must be present in addition to the rash
False; a painless chancre is enough to diagnose a patient with lyme's disease
Stage 1 of lymes disease is characterized by:
erythema migrans rash
cardiac or neurologic disease
flu-like symptoms
chronic neurologic disease and arthritis
Stage 2 of lymes disease occurs weeks to months later followed by _______________.
erythema migrans rash
cardiac or neurologic disease in some untreated individuals
chronic neurologic disease and arthritis
Stage 3 of lymes disease occurs weeks to years after onset of the initial disease. Symptoms consist of ______________.
an erythema migrans rash
cardiac or neurologic disease
flu-like symptoms
chronic neurologic disease and arthritis
Identify the bands on IgM Western blot analysis that could indicate a positive Lyme disease confirmation by their presence?
21-24 kDa (OspC)
18 kDa
39 kDa (BmpA)
30 kDa
41 kDa (Fla)
Identify the bands on IgG immunoblot analysis that could indicate a positive Lyme disease confirmation by their presence?
18 kDa, 21-24 kDa (OspC)
28 kDa, 30 kDa
GoEL, 58kDA
39 kDa (BmpA), 41 kDa (Fla)
45 kDa, 58 kDa (not GroEL)
Human monocytic ehrlichiosis is caused by the organism
Ehrlichiosis chaffeensis
Anaplasma phagocytophilum
Human granulocytic ehrlichiosis is caused by the organism __________.
Ehrlichiosis chaffeensis
Anaplasma phagocytophilum
What are the disease vector of human ehrlichiosis?
blacklegged ticks
the lone-star tick
Anopheles mosquitoes
Ixodes scapularis
What are the Symptoms of human ehrlichiosis?
fever/chills
dizziness or global numbness
nausea/vomiting, anorexia
shortness of breath
headache
What tests are used to diagnose human ehrlichiosis?
Indirect fluorescent antibody assay (IFA) can be used to confirm both human monocytic ehrlichiosis and human granulocytic ehrlichiosis
RPR
Enzyme-linked immunosorbent assay (ELISA)
VLDR
PCR
_________ can be used to confirm both human monocytic ehrlichiosis and human granulocytic ehrlichiosis as antibodies become detectible within 2-3 weeks after onset of symptoms.
Indirect fluorescent antibody assay (IFA)
Enzyme-linked immunosorbent assay (ELISA)
PCR
RPR/VLDR
Both human monocytic ehrlichiosis and human granulocytic ehrlichiosis can be treated with a course of ____________.
Ciprofloxacin
Doxycycline
Penicillin
Strepomycin
What is the vector of Babesiosis?
Ixodes scapularis
Plasmodium falciparum
Anaplasma phagocytophilum
Ehrlichiosis chaffeensis
What is the incubation period for Babesiosis?
7-21 days
16-20 days
1-2 weeks
1 month
What are the symptoms of Babesiosis?
fever, fatigue, hemolytic anemia, hemoglobinuria
fever, chills, headache, nausea, vomiting, anorexia
erythema migrans and flu-like symptoms
chronic neurologic disease and arthritis
__________ can be diagnosed with a blood smear as some RBC have a parasitic ring or a “maltese cross”
Bezeliosis
Babesia
Pinta
Yaws
Bejel
Regarding the disease caused by the Babesiosis parasite, an IgG titer greater than 1: (a) is considered diagnostic of an acute infection.
If the RBC smear is unsuccessful in identifying a maltese cross, _____ can be used to distinguish between babesia vs plasmodium due to the fact that the ring forms of these two parasites otherwise appear similar
PCR
ELISA
IFA
FTA-ABS
Some drugs used in malaria, ___________ and __________ have been found to be effective in cases of Babesiosis
Doxycycline
Clindamycin
Penicillin
Oral Quinine
