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WorksheetsImmunology EXAM
Total questions: 94
Worksheet time: 47mins
1. Exposure to an allergen activates B cells to form IgE
secreting plasma cells.
A. a later exposure to the same allergen cross-links
the membrane-bound IgE on sensitized mast cells
and basophils, causing degranulation of these cells
B. primary exposure to the allergen leads to
crosslinking of the bound IgE, triggering the release of
pharmacologically active mediators, vasoactive
amines, from mast cells and basophils.
C. second exposure to the allergen leads to
crosslinking of the bound IgE, triggering the release of
pharmacologically active mediators, vasoactive
amines, from mast cells and basophils.
correct answers are A + C
correct answers are B + C
Atopic individuals have abnormally high levels
of circulating IgE and also more than normal
numbers of:
circulating eosinophils
circulating mast cells
circulating basophils
circulating monocytes
Type II (cytotoxic) immune tissue injury results
from the recognition of cell-or tissue-bound
antigens by IgG and IgM antibodies
A. Tissue damage generally requires hours or
days to become evident
B. IgM and IgG antibodies active complement through the classical pathway (initiate by formation of an Ag-Ab complex)
C. IgE active mast cells
A + B answers are correct
All answers are uncorrect
Type IV (delayed-type) immune tissue injury is a
manifestation of cell-mediated immunity to haptens
or protein antigens
The immunologically specific component of
delayed-type hypersensitivity (DTH) is the Th1 cell
The immunologically specific component of
delayed-type hypersensitivity (DTH) is the Th2 cell
The immunologically specific component of
delayed-type hypersensitivity (DTH) is the Th17 cell
The immunologically specific component of
delayed-type hypersensitivity (DTH) is the Tregs cell
The immunologically specific component of
delayed-type hypersensitivity (DTH) is the Th8 cell
Hypereosinophilia is typical for:
A. pulmonary disorders
B. mononucleosis & tuberculosis
C. allergic diseases
B + C are correct
A + B + C are correct
Prick-to-prick, prick-prick, native-prick are:
A. tests performed when contact dermatitis is
suspected
B. used for food allergy diagnosis (performed
with fresh food samples)
C. recommended as the first tests when allergy is
suspected
correct answers A + B
correct answers B + C
The seasonal allergy is caused by:
molds and grass pollens
tree pollens and food allergens
food allergens and molds
molds and occupational allergens
weed pollens and food allergens
Which of the following is NOT part of the
innate immune response to extracellular
bacteria:
complement activation by lipopolysaccharide
complement activation by mannose
natural killer cell activation
activation of phagocytes by Toll-like receptors
inflammation
Patch test is:
A. performed in cases of suspected eczema
B. performed when type IV hypersensitivity
reaction is suspected
C. the first test recommended when atopy is
suspected
answers A + B are correct
answers B + C are correct
The perennial allergy is caused by:
occupational allergens and feathers
weed pollens and feathers
food allergens and grass pollens
tree pollens and dust mites
food allergens and weed pollens
Type II cytotoxic hypersensitivity is
characterised by:
A. recognition of cell-tissue antigen bond by IgE
B. tissue damage occurs after hours or days
C. haemolytic anemia is typical for this reaction
correct answers B + C
correct answers A, B + C
Type IV delayed hypersensitivity is characterized by:
specific component Th2 cells
clinical manifestation in 24-48 hours
clinical presentation includes i.e. contact dermatitis
presence od immune complexes of IgG and soluble antigens
all of above
Type IV delayed hypersensitivity is characterized by:
A. recognition of cell/tissue bond antigen by IgG and IgM
B. specific component Th1 cells
C. clinical manifestations in 48-96 hours and includes i.e. contact dermatitis
B + C are correct
A + C are correct
All of the following are key mediators of immediate hypersensitivity reactions EXCEPT:
Mast cells
Basophils
IgE
Macrophages
Th2 cells
Immediate hypersensitivity differs from delayed-type hypersensitivity in which one of the following ways?
Immediate hypersensitivity is a CD4+ T cell–
mediated disease.
Immediate hypersensitivity does not require
previous exposure to an antigen.
Immediate hypersensitivity does not involve
inflammation.
Immediate hypersensitivity is driven by
cytokines such as interleukin (IL)-4, IL-5, and IL-13.
Immediate hypersensitivity typically leads to
granuloma formation.
Which one of the following diseases has been
completely eradicated world-wide?:
Measles
Smallpox
Tuberculosis
Cowpox
Psittacosis
A potential disadvantage of immunological
protection using passive transfer of horse
globulins is:
Serum sickness
Irreversible protection
Lack of antibody-mediated immune response
Type IV hypersensitivity reactions
Immunodeficiency
Herpes simplex virus:
A. is one of the leading factor that causes
neonatal sepsis
B. can cause central nervous system disease
C. clinical manifestation is related with increased
production of inflammatory cytokines
B+C are correct
A+B+C are correct
Type III hypersensitivity is characterised by:
A. inflammation induced by IgG bound to Ag on
cell surface
B. presence of immune complexes IgG + soluble
Ag
C. may manifest with i.e. glomerulonephritis or
rheumatoid arthritis
A + C are correct
B + C are correct
Rhesus hemolytic disease of the newborn
involves:
IgE
Antibody to erythrocyte surfaces.
Soluble immune complexes.
Cytokine release from T-cells.
Stimulatory antibodies.
Septic shock associated with Gram-negative
bacteria is primarily due to:
Lipopolysaccharide.
Enterotoxin superantigen.
Platelet aggregation.
Switch off of cytokine release.
Peptidoglycans.
Neutrophil chemotaxis is mediated by:
C5b
IL-8
C3a
CCL2
E-selectin
Opsonization of bacteria occurs through
coating bacteria just with:
C3b
C8
Membrane attack complex
F(ab')2 IgG
IgM
Extracellular bacteria are optimally killed by:
Macrophages.
Complement
Antibody
Macrophages plus complement.
Macrophages plus antibody plus complement.
Passive immunization consist in:
A. immune response of the body after natural
entering Ag
B. transfer of maternal serum IgG from the
mother to fetus, mainly IgA to offspring
C. generation of immune response for Ag
derived from vaccines
A+B are correct
B+C are correct
Toxins are neutralized by:
Complement
Antibody
Toxoids
PGE2
T lymphocytes
Bacteria growing within macrophages can
be killed by:
Complement.
Reactive oxygen and nitrogen intermediates.
Antibody.
Cytotoxic T-cells.
Directly by cytokines released from Th1 cells.
Intracellular parasites within macrophages
are killed more readily in the presence of:
Antibody
Kinins
Properdin
Gamma-interferon
Anaphylatoxin
Diseases which cause the elevation of serum
IgE levels include:
A. allergic rhinitis,
B. parasitic diseases,
C. atopic dermatitis,
correct answer A + C
A + B + C are correct
Which of the following types of vaccines typically do NOT require boost doses?
A. Vaccine conjugated with protein
B. Vaccine with strong adjuvant
C. Live vaccine
D. Vaccine conjugated with protein + strong adjuvant
C + D
Choose the true statement about naturally pasive immunization:
Only IgG could be naturally transferred
Only IgM could be naturally transferred
Only IgE could be naturally transferred
Only IgD could be naturally transferred
None of them are correct
Herd immunity threshold of Measles require to provide Herd immunity are about:
95%
65%
75%
85%
55%
What Is An Universal Blood Donor?
AB Rh+
AB Rh-
0 Rh-
0 Rh+
none of them
What is an universal plasma donor?
A
B
AB
A + B
None of them
Rh disease caused by anti - D antibodies can occur in 25 yo woman with no history of blood transfusion:
During 1st pregnancy with Rh + fetus
During 2st pregnancy (1st delivered boy was Rh-, now fetus is Rh +)
During 2st pregnancy (1st delivered boy was Rh+ , now fetus is Rh -)
During 3 st pregnancy (1st delivered boy was Rh+ , second child was Rh -, now fetus is Rh+)
all of above
Choose the true statements about Innate Immune Response:
1. Have a rapid response to antigens
2. Have same intensity every time
3. It is stronger and faster upon re-infection
4. Require more time (days) to develop
5. Is evolutionary older
1, 2, 3
2, 3
2, 5
1, 4
1, 5
Which of the following cells are not APC?
Dendric cells
B cells
macrophages
endothelium
T cells
Which of the following signals on a bacterial pathogen is mainly recognized by toll-like receptor 4?
Uric acid
Advanced glycation endproducts
Lipopolysaccharide
Mannose
High mobility group box 1 protein
Pattern recognition receptors (PRRs) can be present in all of the following forms EXCEPT which of the following?
As a secreted soluble receptor
Within the cell nucleus
Membrane-bound
Within the cytoplasm
As a cell surface molecule
Choose the right sentence about C1inh:
A. His function is to inhibit C1r and C1s serine protease activity
b) Deficiency of C1inh leads to chronic granulomatous disease
c) Deficiency of C1inh leads to hereditary angioedema
A+B+C
A+C
Choose the common features for neutrophils and macrophages:
Can phagocytosis
Express of MHC class II on their surface
Can release immunoglobulins
May release cytokines
Can create reactive oxygen species (ROS)
1, 2, 5
1, 3, 5
1, 4, 5
2, 3, 4
2, 4, 5
Cyclic neutropenia is recognise when patient have:
<5000/μl (even <2000/μl) (per 3-5 days)
<500/μl (even <200/μl) (per 3-5 days)
<5000/μl (even <2000/μl) (per 3-5 weeks)
<500/μl (even <200/μl) (per 3-5 weeks)
<5000/μl (even <2000/μl) (per 3-5 monts)
CGD – chronic granulomatous disease
In this disease, there is a lack of abscesses
Patients will not occur granulomas
The cause is an improper function of T lymphocytes
The cause is the improper function of killing microbes in an oxygendependent way
The cause is an improper function of killing microbes in an oxygenindependent way
Opsonins are:
IgG, LPS, C3b, MBL
IgG, C3a, C5a, CRP
IgG, C3b, C5b, MBL
IgA, CRP, LPS, C6
IgG, CR1, MBL, C5a
What is the function of C5a?
a) Opsonisation
b) Mast cell and basophil degranulation
c) Neutrophil chemotaxis factor
A+B+C
B+C
Which of the following can be recognized by pattern recognition receptors?
Damage-associated molecular patterns and pathogen-associated molecular patterns
Damage-associated molecular patterns on pathogens
Pathogen-associated molecular patterns on host cells
Neither damage-associated molecular patterns or pathogenassociated molecular patterns
Toll-like receptors
Activators of the classical pathway of the Complement system are:
a) CRP
b) IgG4
c) IgM
A + B + C
A + C
C3 convertase of classical pathway are:
C2b2a
C4b2a
C2b4a
C3b4a
C4b4a
Which is a factor that prevents the formation of the MAC?
C1inh
C5b
CD59
CD11
CR1
Choose the similarities between adaptive immune response and complement system
a) Opsonisation
b) Antigen recognition
c) Activation of immune cells
A+B+C
A+C
MHC class I shows peptides to:
CD8+ cells
CD4+ cells
CD9+ cells
B cells
epithelium cells
TCR – T-cell receptor recognise:
a) PAMPs
b) DAMPs
c) MHC type I
A+B
A+B+C
Which antibody is characterized by the ability to complement activation in a classical way, enhancing phagocytosis, ADCC and neutralizing pathogens?
IgM
IgA
IgG
IgE
IgD
Which cells can kill infected cells by fas-fasL and/or perforin-granzyme pathways?
a) NK cells (natural killer)
b) CTL (cytotoxic T cells)
c) B cells
d) Neutrophils
A + B
Which cells modulate the immune system to maintain tolerance to selfantigens?
NK cells
Th17
Th1
Th2
T regs (T regulatory cells)
Characteristics of γδT cells include:
a) constitute around 5% of circulating T cells
b) have specificity for recognition Ag such as heat shock proteins, phospholipids
c) are found in the gut mucosa, skin, lungs and uterus
d) recognize Ag only in association with classical MHC class I and II
correct answer are A & B & C
C reactive protein:
protein found in blood plasma, whose circulating concentrations rise in response to inflammation
it is an acute-phase protein of hepatic origin that increases following interleukin-6 secretion by macrophages and T cells
it is a member of the pentraxin family of proteins.
CRP is synthesized by the liver and activate the complement system via C1q
all answers are correct
The first cell type to respond to most infections are:
ymphocytes B
lymphocytes T
neutrophils
monocytes
dendritic cells
Choose the group of molecules where only DAMP (damage-associated molecular patterns) are listed:
a) Uric acid, extracellular ATP, viral RNA, HSP
b) Uric acid, extracellular DNA, HSP, LPS
c) Uric acid, extracellular ATP, HSP, extracellular DNA
d) Uric acid, mannose, viral RNA, HSP
A + B
Phagocytic receptors are:
TCR, PRR, TLR, FcR
TLR, PRR, FcR, CR
TCR, BCR, PRR, FcR
CR, BCR, TLR, MBL
CRP, MBL, IL6, LPS
Main function of CR – complement receptors are:
facilitating binding and phagocytosis by phagocytic cells of particles or cells coated with antibodies
removal of immune complexes
regulation (mainly inhibition) of complement activation
participation in several types of immune response.
All of the above
Differentiation of naive T cells into Th2 is mediated by:
IL – 1
IL – 2
IL – 3
IL – 4
IL – 5
Which of the following Interleukins role is to increase body temperature:
IL - 1 and IL – 3
IL - 1 and IL – 5
IL - 4 and IL – 5
IL - 1 and IL – 6
IL - 2 and IL - 5
Choose the right information about Polymorphonuclear cells:
1. Are the most numerous blood cell in blood sample
2. are capable of phagocytosis
3. Are able to present antigens to T-helper cells
4. Have a PRR receptors which only PAMPs molecule
5. Can kill pathogens in oxygen-dependent way
6. Are able to create NETs - neutrophil extracellular traps
1, 2, 5, 6
1, 3, 5, 6
2, 4, 6, 1
1, 2, 5, 3
The blood sample from newborn with HDN (Hemolytic disorder of newborns) were taken and tested. Which of the following laboratory results belong to this child?
Anemia, hyperbilirubinemia, Direct Coombs test (positive)
Polycythemia, hyperbilirubinemia, Direct Coombs test (positive)
Anemia, hyperbilirubinemia, indirect Coombs test (positive)
Polycythemia, hyperbilirubinemia, indirect Coombs test (positive)
None of them are correct
what are specific and non-specific type of prevention of HDN (hemolytic disorders of the newborn):
A. Avoid blood transfusion, especially with blood group type incompatibility
B. Avoid intravenous drugs - heroin etc.
C. Anti - D immunoglobulin (RhoGAM)
A+B
A+B+C
Severe hemolytic disease of newborn are treated with: (RBC - Red Blood Cells)
Exchange transfusion with AB Rh negative RBC and phototeraphy
Exchange transfusion with AB Rh positive RBC and phototeraphy
Exchange transfusion with O Rh negative RBC and phototeraphy
Exchange transfusion with O Rh positive RBC and phototeraphy
only phototeraphy are needed
Natural killer T cells (NKT cells) - choose the FALSE statement:
NKT cells make up approximately 10% of the lymphocytes
They express T cell antigen receptors
Have a cytotoxic ability
Play role in regulation of immunological system
None is true
Severe combined immunodeficiency (SCID) is a group of rare disorders caused by mutations in different genes involved in the development and function of infection-fighting immune cells. Infants with SCID appear healthy at birth but are highly susceptible to severe infections the most prevalent type of SCID is:
Omenn syndrome
XSCID
ADA deficiency
RAG1 or/and RAG2 deficiency
CVID
Which of the following receptor are involved in ADCC?
A. FcγRIII
B. FcγRI
C. FcγRII
A + B
A + B + C
MHC class II shows peptides to:
CD8+ cells
CD4+ cells
CD9+ cells
B cells
epithelium cells
Which of the following does NOT contain C3b?
A. classic-pathway C5 convertase
B. alternative-pathway C5 convertase
C. classic-pathway C3 convertase
D. alternative-pathway C4 convertase
C and D
A hematopoietic stem cell is:
A. a cell isolated from the blood or bone marrow
B. can renew itself
C. can differentiate to a variety of specialized cells
D. undergo programmed cell death
all answers
Each of the following statements concerning haptens is correct EXCEPT:
Haptens must be processed by CD8+ cells to become immunogenic.
The hapten-carrier complex, unlike free hapten, can act as an immunogen
In both penicillin-induced anaphylaxis and poison ivy, the allergens are haptens
A hapten cannot induce an antibody by itself; rather, it must be bound to a carrier protein to be able to induce antibody
A hapten can combine with (bindto) an antibody
Natural killer cells are:
able to kill virus-infected cells without prior sensitization.
Professional antigen presenting cells
Increased by immunization
Cytotoxic T cells
B cells that can kill without complement
Cytokines secreted by PAMP-stimulated cells acting on B cells, CD4+ T cells, and CD8+ cells;
A. IL-1, IL-6 stimulate the differentiation of naive CD4+ T cells to the Th17 subset of...
B. IL-12 stimulates the differentiation of naive CD4+ T cells to the Th1 subset of effector....
C. IL-15 promotes the survival of mempry CD8+ T cells
A + B + C
A + B
Professional APCs are:
monocytes, macrophages and neutrophils
dendritic cells, B lymphocytes and Kuppfer cells
B cells, dendritic cells and basophils
B cell, T cells and NK cells
monocytes, neutrophils, B cells
C3 is cleaved to form C3a and C3b by C3 convertase. C3b is involved in all of the following EXCEPT
altering vascular permeability
promoting phagocytosis
forming alternative-pathway C3 convertase
forming C5 convertase
is potent in opsonization
Costimulation molecules (second signal) is important in the induction of immune response. They involved: B7 family molecules expressed on antigen presenting cells, CD28 and CTLA-4 on T-cells
true, however moreimportant is ICOS and GITR
false, costimulation involves HLA class II and T-cell receptor
true, CD28 has a positive costimulatory effect and CTLA-4 negative
first sentence is true, second is false
first sentence is false, second is true
Characteristics of γδT cells includes:
A. constitute around 5% of circulating T cells
B. have specificity of recognition Ag such as: heat shock proteins, phospholipids
C. are found in the gut mucosa, skin, lungs and uterus
D. recognize Ag only in association with classical MHC class I and II
A + B + C
BCR
A. is an immunoglobulin receptor and can recognize peptides, proteins, nucleic acids, carbohydrates, lipids and small chemicals
B. is an immunoglobulin-like receptor and can recognize only short linear peptides
C. consists of two identical heavy (H) chains & two identical light (L) chains
D. circulating antibodies are structorally identical tl the primary B cell antigen receptors
A + C + D
The lymphocyte antigen receptor repertoire is mostly generated
By cutting and splicing V,D J or D gene segments
mutation of the TCR
in the periphery following exposure to antigen
following vaccination
mutation of BCR and immunoglobulins
Adhesion molecules can control leucocyte migration by
binding to specific antigen
changing lymphocyte
Binding to ligands on the vascular endothelium
agglutinating pathogens in the tissues
binding of opsonizing antibodies to phagocyte
Subset of Th1 cells
A. produced mainly IFN gamma that stimulate macrophages to phacytosis and to antigen presentation
B. produced mainly IL-4, IL-13 and IL-5 that promote the B cells differentiation
C. produces mainly IL-1 and IL-6 that stimulates neutrophils to phagocytosis
B + C
all are false
MHC class I:
A. found on surface of all nucleated cells
B. found on surface of professional antigen presenting cells only
C. include 3 genes called: HLA-A, HLA-B, HLA-C
D. include 4 genes called: HLA-DR, HLA-DM, HLADP, HLA-DQ
A + C
CRP:
A. is an acute phase protein
B. is an opsonine and supress the phagocytosis
C. is the pattern recognition receptor and initiate the classical pathway complement
incorrect answer is B
Correct answer are A + B + C
Adaptive immunity:
A. can be transferred from an immune host to a naive recipient
B. transfer of antibodies is called active immunization
transfer of immune cells is called passive immunization
A + B
A + B + C
Which of the following statements is true about the IgM of humans?
IgM can cross the placenta
IgM can protect the mucosal surface
IgM is produced by high affinity plasma cells
IgM is primarily restricted in the circulation
IgM can induce the process called ADCC
Which one of the following statements concerning immunoglobulin allotypes is CORRECT?
Allotypes are found only on heavy chains
Allotypes are determined by class I MHC genes
Allotypes are confined to the variable regions
Allotypes are due to genetic polymorphism within a species
Allotypes are confined to the IgG superfamily protein
Which one of the following is FALSE?
bone marrow produces B cells, pre-T cells and NK
thymus gland produce T-cells
secondary lymphatic organs is a site of most immune responses
lymph nodes and spleen are surrounded by connective tissue capsule
lymphatic nodules are surrounded by capsule
Neutrophils
A. are the majority of the blood leukocytes and develop from the same early precursors as monocytes and macrophages
B. are the first type of leukocyte to be recruited from the blood into a site of infection or tissue injoury
A + B
C. are the professional antigen presenting cells
A + B + C
Spleen white pulp:
A. contains T cells, B cells and accessory cells
B. at the edge of the T zone is a region known as the marginal zone where larger mechanical filtration of red blood cells
C. lymphocytes & antigen presenting dendritic cells are located
D. reserved of monocytes
A + C
In human, the lymph node marginal zone does not develop fully until 2 years of age. The functional consequence of this delay in developement of the marginal zone is:
reduced ability to respond to blood-bone infections with encapsulated bacteria
reduced ability to respond to infections with fungi
reduced ability to respond to infections with viruses
all answers correct
all answers are false
Innate immune system serves:
A. initial respons to microbes that prevents, controla, or eliminates infection of the host by many microbes
B. recognize the products of damaged & dead host cells & severe to eliminate these cells & to initiate the process of tissue repair
C. is the first line of defense against infections and recognizes molecular structures that are characteristic of mammalian cells
A + B
all answers correct
