wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

immunology

Total questions: 100

Worksheet time: 8hrs 20mins

Name
Class
Date
1.

Which of the following responses is not the results of co-stimulator interaction occurs between CD40:CD40L

a)

Activation of B cells to produce high-affinity isotype-switched antibodies

b)

Upregulation of CTLA-4 expression

c)

Activation of macrophages and killing of phagocytosed microbes

d)

Upregulation of B7 expression

e)

Enhance T cell proliferation and differentiation

2.

Which of the following cytokines plays a role in terminating inflammatory responses?

a)

TGF-B

b)

IFN-a

c)

IL-2

d)

IL-17

e)

IL-4

3.

Question: Cytomegalovirus escapes the imhune system by which mechanism

a)

produce M protein to block C3 binding to bacterial membrane

b)

produce capsule

c)

produce catalase and peroxidase enzymes

d)

down regulation of MHC class I expression of the immune cells

e)

Inhibit C3 and C5 convertases

4.

Please fill in the gap: Cytotoxic T cells (CTLs) recognize........................-associated peptides of cytoplasmic microbes in infected cells and induce apoptosis.

a)

CD8+

b)

T cell receptor

c)

class II MHC

d)

class I MHC

e)

CD4+

5.

Which one is incorrect about lymphatic System?

a)

Remove antigens from the body

b)

Production of lymphocytes and antibodies

c)

Circulate from lymphatic vessel to lymph node and then to lymphatic capillary

d)

Connect to blood system via lymph capillaries

e)

Exposes antigens to the immune system

6.

Which one can reduce the immune function ?

a)

Practice meditation 20 minutes per day for every day

b)

Living with happiness and joyful life

c)

Consuming yogurt consisting of Bifidobacterium bifidum as probiotic and vegetable as prebiotic

d)

Increasing stress and study hard at night time because environment is so quiet

e)

Thinking positive and having good exercise everyday

7.

A 34-year old male was hospitalized by hepatitis B viral infection and develops toxic shock syndrome. A toxin secreting Staphylococcus is isolated from the patient. What will happen to the immune response of this patient ?

a)

TNF-a, IL-1, Il-6 and IFN-y appear in the blood

b)

Activate B-cell to produce antibody

c)

Inducing the massive cytokines production called cytokine storm

d)

The toxin acts as superantigen to induce T cell activation

e)

All choices are correct

8.

What is the limitation of the normal T-independent B cell activation ?

a)

Incapable of produce antibody and immunological B cell memory

b)

not recognize pathogens that are missed by T-cells

c)

Have no antibody isotype switching and affinity maturation

d)

Cannot detect non-peptide antigen

e)

All choices are correct

9.

Why is it so important to do herd immunity in a population?

a)

To protect the person injected with the vaccine

b)

It is not so important to waste that much money to do the herd immunity.

c)

To protect family members from emerging diseases

d)

To protect a rapid transmission of infections from infected persons to healthy

e)

To protect transmission from infected persons to healthy people who live in another city far away from the community

10.

Which of the following immunological tests is a specific diagnostic test for autoimmune hemolytic anemia?

a)

Indirect antiglobulin test

b)

ELISA

c)

Latex agglutination

d)

Flow cytometry

e)

Precipitation

11.

Which of the following immune cells are generated from the progeny of antigen-stimulated lymphocytes, survive for long periods in the absence of antigen. They do not perform effector functions unless stimulated by antigen. When these cells encounter the same antigen, they rapidly respond to initiate secondary immune responses.

a)

Memory cells

b)

Antigen Presenting Cells

c)

Naïve T lymphocytes

d)

Effector CD8+ lymphocytes

e)

Effector CD4+ lymphocytes

12.

Which of the following transcriptional factors (TFs) is not activated by Zap-70 signaling pathways during the T cell activation?

a)

AP-1

b)

NEAT

c)

All TFs are activated during T cell activation

d)

NF-kB

e)

ICOS

13.

A 45-year old female is hospitalized by chronic lung (pulmonary) conditions of tuberculosis. Her lung appear air spaces (cavities) and infected with aspergillus. The fungus fibers have been found in the cavities and grow into tangled masses (fungus balls) known as aspergillomas. What can happen to her immune system ?

a)

Th2 cell secrete IFN-y and induce inflammation to eliminate the fungus

b)

Neutrophil secrete Il-5 to recruit eosinophils to the site of infection

c)

Th1 secrete IL-4 to induce mast cell activation

d)

Th17 secrete IL-22 to recruit neutrophils to the site of infection

e)

Macrophage induce apoptosis of the fungal infected cell

14.

Which one is correct for the B-1 B cells

a)

Have a more extensive antigen recognition repertoire

b)

Express more IgD than IgM on their cell surfaces

c)

Require interaction with T-cells for their activation

d)

Appear later than B-2 B cell in the development of B cell population

e)

Function in the innate immunity

15.

Which of the following events is most associate to the function of Thelper 2 (TH2)?

a)

Recharge NK cells, enabling them to kill pathogens more efficient

b)

Defend fungal and some intracellular bacterial infections

c)

Produce cytokines to influence B cells to class switch to produce IgE

d)

Recruit massive numbers of neutrophils to the site of infections

e)

Produce cytokine to activate macrophages

16.

Which is not the effector B cell function ?

a)

Produce and secrete IFN-a and GM-CSF to activate macrophage

b)

Regulation of inflammation and immune function

c)

Function as professional antigen presenting cell (APC)

d)

Function in HIR which can work with innate and adaptive CMIR

e)

Produce and secrete antibodies

17.

Antigen fragments of a cytoplasmic pathogen Jare presented to T-cells by

a)

Dendritic cell phagocytose and present antigen to CD4+ T-cell

b)

B-cell recognize antigen and present the antigen to T cell

c)

T cell direct recognized antigen by it's T-cell receptor

d)

Macrophage phagocytose and present antigen via MHC class II to T-cell

e)

Antigen presenting cell presents antigen to CD8+ T-cell via MHC class I

18.

Streptococcus gr. A escapes the immune system by which mechanism ?

a)

produce M protein to block C3 binding to bacterial membrane

b)

produce capsule× PNCUMO

c)

produce catalase and peroxidase enzymes ✗ Staphylococci

d)

down regulation of MHC class I expression of the immune cells

e)

Inhibit C3 and C5 convertases

19.

A small molecule that cannot stimulate the immune response by itself but it can stimulate the production of antibody molecules only when conjugated to a larger molecule as carrier molecule. This small molecule called

a)

Hapten

b)

Idiotypic antigen

c)

Adjuvant

d)

Antigen

e)

Allergen

20.

Which one is not characteristics of the innate immunity?

a)

composed of humoral and cellular immune responses

b)

pathogen-specific immunity and can be enhanced by secondary antigen exposure

c)

poorly effective without adaptive immunity

d)

Present from birth and has no memory

e)

non-specific immunity

21.

Which one is not the immune protection against viral infection?

a)

Cytotoxic T-cell activation

b)

Th1 produce IFN-y to activate NK cells

c)

Th1 secrete IL-4 to activate NK cells

d)

Dendritic cell secrete IFN to induce viral infected cell death

e)

NK-cell induce apoptosis of infected cell

22.

Which one is not a regulatory B-cell function?

a)

Induce the differentiation of immunosuppressive T cells

b)

Secrete TGF-ß to inhibit Th17 proliferation

c)

Secrete IL-10 to block CD8+ cytotoxic T cell function

d)

Secrete IFN-y to suppress IL-12 producing dendritic cells

e)

Secrete IL-10 to inhibit Th1 activation

23.

What is most likely not the immune response to COVID-19 infection?

a)

NK cell-mediated killing

b)

Antibody - dependent cell-mediated cytotoxicity (ADCC)

c)

Cytotoxic T-cell killing

d)

CD4+ T cells activate antibody production

e)

Produce IFN- to inhibit protein synthesis of viral infected cell

24.

Which of the following events is most associate to the function of T helper 17 (TH17)?

a)

Activate Eosinophils

b)

Produce powerful mechanisms against parasites

c)

Defend fungi and some extracellular bacteria

d)

Influence B cells during class switching

e)

Produce growth factor to stimulate proliferation of NK cells and TH1

25.

Let's say you are building a BioTech Company aiming to invent a new vaccine for Covid-19 prevention,what is the most important properties of your newly invented vaccine you should consider?

a)

Specificity and Memory

b)

Efficient adjuvants

c)

Sensitivity and Specificity

d)

Safe for immunocompromised hosts

e)

Diversity of antigen components

26.

The process that increase phagocytic cell uptaking of bacterial cell tagged by antibodies bound C3b or C4b complement called

a)

Neutralization

b)

Agglutination

c)

Complement Activation

d)

Opsonization

e)

Antibody - dependent cell-mediated cytotoxicity (ADCC)

27.

Question: Neisseria meningitidis escapes the immune system by which mechanism

a)

produce M protein to block C3 binding to bacterial membrane

b)

produce capsule

c)

produce catalase and peroxidase enzyme

d)

down regulation of MHC class I expression of the immune cells

e)

Inhibit C3 and C5 convertases

28.

Which of the following events would produce an active immunity?

a)

Feeding breast milk containing IgA for infants

b)

Transferring IgG from a mother to a fetus through placenta during pregnancy

c)

Exposure to infectious scars from your chickenpox infected roommate

d)

. Injection of neutralizing antibodies produced from a horse to a human

e)

A SARS-CoV2 infected person receives serum containing antibodies produced from cured SARSCoV2 infected individuals

29.

Which of the following cytokines act as a chemokine factor?

a)

IL-6

b)

IL-4

c)

IL-8

d)

IL-2

e)

IL-1

30.

How Herpes simplex virus evade the immune response?

a)

produce M protein to block C3 binding to bacterial membrane

b)

produce capsule

c)

produce catalase and peroxidase enzymes

d)

down regulation of MHC class I expression of the immune cells

e)

Inhibit C3 and C5 convertases

31.

Which mechanism that innate immune cells utilize to recognize pathogen

a)

Toll-like receptor-7 recognize protein of virus

b)

Toll-like receptor-2 recognize PGN of gram negative bacteria

c)

Toll-like receptor-9 recognize nucleic acid of virus

d)

Toll-like receptor-3 recognize LPS of virus

e)

Toll-like receptor-4 recognize LPS of gram positive bacteria

32.

A 21-year-old male patient is diagnosed with an acute viral infection. His blood leukocytes count was 25,000 cells per microliter (reference range = 4500-12500 per microliter). The predominant cell type found in increased numbers in this patient's blood is

a)

CD8 Lymphocytes

b)

CD4 Lymphocytes

c)

Neutrophils

d)

Monocytes

e)

Eosinophils

33.

Which one is not the immune response to extra-bacterial infection?

a)

Th2 cells promote B cell activation, differentiation and antibody production

b)

Th1 cells promote inflammation at the site of infection

c)

Complement activation and macrophage phagocytosis

d)

Th1 activate CD8+ T cell function

e)

Generate B-cell memory and T-cell memory population

34.

Which is not the function of C3a, C4a, C5a complements?

a)

Epithelial cell activation

b)

Form membrane-attack complex

c)

Inflammation

d)

Platelet activation

e)

recruitment of immune cells

35.

What is the immune evasion mechanism of encapsulated bacteria

a)

poorly activate complement

b)

antibody cannot opsonize this bacteria

c)

block NET formation of neutrophil

d)

block NET formation of neutrophil

e)

all choices are correct

36.

Which one is incorrect ?

a)

Positive and negative selection of B cell occur in bone marrow

b)

Intracellular infection utilize TAP-1 and TAP-2 in an antigen processing

c)

The overall strength of binding between an antigen with many determinants and multivalent antibodies called Avidity

d)

Concanavalin A work as mitogen to induce lymphocyte proliferation

e)

Alloantigen is a common antigen that found in all human, animal and microbes

37.

Antigen recognition by T cells in the absence of co-stimulation results in ...........

a)

a. T cell proliferation

b)

b. Upregulation of B7

c)

c. T cell anergy

d)

d. All events can occur

e)

e. Expression of the high-affinity IL-2 receptor

38.

A 15-year old boy exhibits anemia condition. He also has a skin rash and itchy, weight loss, loss of appetite, stomach pain, and diarrhea. The eggs of Hookworm have been found in his feces examination. What is the immune response against this parasitic infection ?

a)

Antibody - dependent cell-mediated cytotoxicity (ADCC)

b)

Complement activation

c)

Eosinophil produce peroxidase enzyme to kill the parasite

d)

Mast cell degranulation

e)

All choices are correct

39.

During the T lymphocyte development, there are different stages of thymocytes. Which of the following lymphoid organs is the location where the thymocytes express either CD4+ and CD8+ single-positive (SP) T cells?

a)

Cortex of thymus

b)

Bone marrow

c)

Medulla of thymus

d)

Fetal liver

e)

All locations contain either CD4+ and CD8+ single-positive (SP) T cells

40.

Which statement Is incorrect ?

a)

normal cells can escape from NK cell killing by inhibitory receptor engagement

b)

macrophages secrete IFN-y to call NK cells travelling from the blood circulation to the site of infection

c)

Terpene can protect immune destruction by free radicals

d)

macrophage destroys bacteria by free radicals that produced in the Phagolysosome system

e)

All choices are incorrect

41.

Which of the following antibody isotypes facilitate the sequential binding of the C1, C4, C2 and C3 components of the complement system?

a)

IgA and IgD

b)

IgM and IgE

c)

IgG and IgA

d)

IgE and IgA

e)

IgM and IgG

42.

Which one is incorrect ?

a)

Consuming of bee propolis can increase human immunity

b)

The immune cells in myeloid lineage including neutrophil, macrophage, eosinophil, dendritic cell, natural killer cell and monocyte

c)

The immune system can repair and improve itself effectively during 9-12 p.m. according to the human biological clock system

d)

The human immune system is affected by 70 % from body directly and 30 % from the mind

e)

All choices are incorrect

43.

What is the advantage(s) of Adenovirus used in the production of AstraZeneca vaccine for SARSCoV2?

a)

Trigger desired immune responses

b)

Help transferring viral antigens into host cells

c)

Are easy to manipulate genetically

d)

Cause mild infections in humans

e)

All are correct

44.

The infant immune system can be decreased by

a)

eat food containing preservative compound

b)

birth by a cesarean section procedure

c)

Watching cartoon and other programs from mobile phone 5 hours per day

d)

drink cow milk rather than his/her own mother milk

e)

all choices are correct

45.

Which one is correct about neutrophil function?

a)

response to bacterial infection

b)

Generate NET formation system

c)

Secrete cytokines to activate other immune cells

d)

All choices are correct o e. mediated cell apoptosis

46.

When IL-2 is secreted by antigen-specific T cells activated due to presentation of antigen by Antigen- Presenting Cells (APCs), what happens to naïve antigen-nonspecific T cells nearby?

a)

They proliferate due to their exposure to IL-2

b)

They secrete cytokines associated with their T helper phenotypes.

c)

Nothing happens.

d)

They begin to express IL-2 receptors.

e)

They often undergo apoptosis.

47.

A 8-year old boy fall down on the ground during running and playing with her friend. Her knee obtained an injury and a wound. She received the bacterial infection though the wound. Which immune cells are likely increase in her blood circulation ?

a)

Monocytes

b)

Megakaryocytes

c)

Neutrophils

d)

Lymphocytes

e)

Eosinophils

48.

A 20-year old male student who later developed an allergy to a bee pollen, the initial response to the antigen consisted of IgM class. However, about 2 weeks later, IgE exhibit as predominate antibody in his blood. The alteration of the IgM to IgE response is caused by which mechanism ?

a)

Affinity maturation

b)

Isotype switching

c)

Somatic Hypermutation

d)

Apoptosis of IgM producing cells

e)

Tolerance

49.

The picture below shows the result interpretation of rapid diagnostic test, which of the following results you can report for positive test?

a)

b, c, e

b)

a,b,c,e

c)

a, e

d)

b,c

e)

a,b

50.

.The molecule that capable to activate up to 20% of the body T-cells which causes a massive immune response that is not specific to any particular epitope on this antigen. This molecule called

a)

Hypermutated antigen

b)

Allergen

c)

Hapten

d)

Mitogen

e)

Super Antigen

51.

Which of the following cytokines can prevent the internalization of viral particles to other host cells nearby?

a)

IFN-Y

b)

TNF-a

c)

IFN-a

d)

IFN-B

e)

IFN-a and IFN-B

52.

Which is the mechanism of Rapamycin action?

a)

. Induce hematopoiesis

b)

Inhibit macrophage function

c)

Block T cell proliferation

d)

Inhibit cytokine production from NK cell

e)

Mitotic inhibitor for NK cell

53.

Which condition can decrease peripheral tolerance?

a)

Lower level of CTLA-4

b)

Lower level of B7 in antigen presenting cells

c)

Increased level of Fas and fas-ligand in T cells

d)

Lower IgE leve

e)

Increased anti-apoptosis activity in T cell

54.

.Which of the following statement is not true?

a)

Hematopoietic stem cells can be differentiated into neural cells

b)

To produce the bone graft with proper shape from stem cells, scaffold is usually

c)

iPS cells can be produced by transfer of Oct3/4, Sox2, C-Myc, Klf4 to fibroblast cells

d)

ICSI can be made by getting out of genetic material from egg cell before fertilization

e)

hematopoietic stem cells isolated form cord blood have lower antigenic determinant as compared with those isolated from bone marrow

55.

Which condition can enhance tumor cells clearance by immune system?

a)

TGF-B secretion by tumor cells

b)

Increased expression of mutant protein in tumor cells

c)

Decreased MHC class II expression in tumor cells

d)

Decreased MHC class I expression in tumor cells

e)

All choices are correct

56.

Which agent is used for chronic viral hepatitis B treatment?

a)

Cyclosporine

b)

Steroid

c)

IL-1

d)

IL-8

e)

Interferon- alpha

57.

What is the mechanism of cyclosporine action?

a)

Induce IL-4 secretion

b)

Induce T cell destruction by phagocytosis

c)

Inhibit B7 expression in APC (antigen presenting cell)

d)

Inhibit cytokine secretion by T cells

e)

Inhibit cytokine secretion by macrophages

58.

Which mechanism underlines acute hemolytic transfusion reaction?

a)

T cell stimulation by donor alloantigen

b)

Binding between preformed Ab to antigen on donor red blood cells

c)

Binding between preformed Ab to antigen on donor leukocytes

d)

Type I hypersensitivity reaction

e)

Induce T cell destruction by phagocytosis

59.

The tumor cells can escape the immune surveillance by which mechanism?

a)

IL-2 secretion

b)

Interferon-y secretion

c)

TGF-B secretion

d)

Induction of MHC class I molecule expression

e)

IL- 3 secretion

60.

Which of the following is not the property of stem cell?

a)

Can be induced to differentiate into different cell lineages

b)

Limitless cell division

c)

Is not in terminal differentiation stage

d)

Has symmetrical manner of cell division

e)

Has high telomerase activity

61.

Mast Cells play a crucial role in which type of hypersensitivity ?

a)

Type I hypersensitivity

b)

Type IV hypersensitivity

c)

Type III hypersensitivity

d)

Type II hypersensitivity

e)

All choices are correct

62.

Which of the following condition is consideredto be specific immunotherapy?

a)

.BCG administration for bladder carcinoma treatment

b)

Cell therapy with dendritic cells which are immunologically stimulated by tumor antigen

c)

Steroid administration

d)

Induction of B7 expression in antigen presenting cell

e)

IL-2 administration

63.

Which mechanism underlines chronic rejection?

a)

Binding between antibody and alloantigen on endothelium cells

b)

Hypersensitivity type I

c)

Destruction of graft endothelium cell by cytotoxic T cells

d)

Thrombus formation by the antibody

e)

Fibroblast activation by cytokines secreted by T helper cells

64.

A 4-year-old girl come to the hospital with fever, bleeding ulcers of the rectum and vagina. The complete blood cell count showed a severe reduction of basophils, eosinophils and neutrophils. These findings support a diagnosis of which disease?

a)

Agranulocytosis

b)

Chediak-Higashi syndrome

c)

Wiskott-Aldrich syndrome

d)

Bruton's Agammaglobulinemia

e)

Chronic granulomatous disease

65.

Which disease is associated with Epstein's Barr virus infection?

a)

chronic lymphocytic leukemia

b)

Hepatocellular carcinoma

c)

Burkitt's lymphoma

d)

Chronic myelogenous (granulocytic) leukemia

e)

multiple myeloma

66.

Which is the effect of loving-kindness and compassion meditation on the body and emotion?

a)

Decrease T cell function

b)

Decrease IL-5 production and increase C-reactive protein level

c)

Decrease fear and increase bravery

d)

Stimulate sympathetic nerve system

e)

Stimulate mast cells and NK cells activity

67.

Which are the common symptoms of inflammation ?

a)

pain, fever, hypotension, swelling

b)

redness, hypertension, pain, fever

c)

headache, fatigue, weight loss, swelling

d)

swelling, heat, redness, pain

e)

headache, hypotension, weight loss, fever

68.

A 17-month-old female infant has recurrent bacterial infection and is found to have an impair macrophage killing ability. What disease is most responsible for this illness ?

a)

Severe combined immunodeficiency disease (SCID)

b)

Chronic granulomatous disease

c)

Leukocyte-adhesion deficiency (LAD)

d)

Bruton's Agammaglobulinemia

e)

Chediak-Higashi syndrome

69.

Which of the following statement explains the pathogenesis of Grave disease?

a)

Autoimmune disease associated with HLA gene DR6

b)

Type III hypersensitivity associated with HLA gene Cw6

c)

Type I hypersensitivity

d)

Immune deficiency associated with HLA gene DR2

e)

Autoimmune disease associated with HLA gene B27

70.

A 10-month old infant suffered from bacterial pneumonia and acute lymphadenitis. CBC shows elevated white blood cell count in the peripheral blood. The genetic analysis shows a defect in betaintegrin protein. Which of the following is the most likely diagnosis

a)

Chediak-Higashi syndrome

b)

Chronic granulomatous disease

c)

Leukocyte-adhesion deficiency (LAD)

d)

LAD type 2

e)

Agranulocytosis

71.

Chronic inflammation is mediated by

a)

magakaryocytes

b)

macrophages

c)

Th1 cells

d)

cytotoxic T cells

e)

Th2 cell

72.

Peripheral B cell tolerance can be induced by which condition?

a)

Lacking stimulation from helper T cell

b)

Receptor editing in B cell

c)

Elevation of anti-apoptosis protein in B cell

d)

By self antigen in the peripheral lymphoid tissue

e)

Liver injury

73.

A 45-year-old man has been plagued by mild chronic diarrhea and increased numbers of minor respiratory tract infections for most of his life. Following a motor vehicle accident with multiple lacerations to the lower leg, he has a significant blood loss requiring transfusion of blood products. During the transfusion, he is noted to have an anaphylactic transfusion reaction.

Which of the following diseases is he most likely to have?

a)

Selected IgG deficiency

b)

Amyloidosis

c)

Selective IgA deficiency

d)

Systemic lupus erythematosus

e)

Niemann-Pick disease

74.

The 60-year-old female with history of hepatitis C infection presents with decrease renal function, hypertension and anemia. Laboratory findings reveal decrease serum CC) Her urine sediment contain leukocytes, erythrocytes, and red blood cell casts (a proteinaceous mold of the renal tubules that includes erythrocytes). Her renal biopsy is consistent with glomerulonephritis. These findings suggest which type of hypersensitivity ?

a)

Type IV hypersensitivity

b)

Type II hypersensitivity

c)

Type III hypersensitivity

d)

Type I hypersensitivity

e)

All choices are correct

75.

Which of the following is true concerning central tolerance?

a)

Caused by increased level of self-antigen in Thymus

b)

Occur upon repeated stimulation of T cell by self antigen

c)

Enhanced by increased B7 protein in antigen presenting cell

d)

Occurs in the lymph node

e)

Lower IgA level

76.

What is the effect of glucocorticoid and catecholamine on immune function produced during chronic stress?

a)

Stimulate wound healing

b)

Decrease wound healing and antibody production

c)

Decrease the function of viral specific T-cell and stimulate dendritic cell activity

d)

Improve T-cell function

e)

Enhance neutrophil superoxide production and IgE production

77.

Which one is incorrect about acute inflammation?

a)

Acute inflammation stimulates hypothalamus to increase fat metabolism and fever

b)

Th2 response activated by macrophage is a major mechanism

c)

Exhibit pain swell red heat

d)

C5a complement can initiate local inflammatory response

e)

Can exhibit swelling, heat,redness and pain

78.

Which one is mechanism of bone destruction in ( Rheumatoid arthritis)

a)

Autoantibody against osteocytes

b)

Autoantibody against bone stem cells

c)

osteoclast activation by RANK ligands

d)

osteoclast stimulation by IL1

e)

Synovial cell proliferation

79.

A 35-year-old man has lost 8 kg over the past three years. During that time he has had pain and swelling ariund the small joints of his hands and feet. He has had a series of upper respiratory tract infections, with organisms including Staphylococcus aureus, Streptococcus pneumoniae, and Pseudomonas aeruginosa cultured. He has a chronic diarrhea. A stool specimen is found to have Giardia lamblia cysts. His antinuclear antibody test is negative. Quantitative serum immunoglobulins show low IgA, low IgG, and low IgM.By flow cytometry there are normal numbers of T cells and slightly reduced numbers of B cells. What disease that this man likely has

a)

Systemic lupus erythematosus (SLE)

b)

Selected IgA deficiency

c)

Hyper-IgM syndrome

d)

Common variable immunedeficiency

e)

X-linked agammaglobulinemia

80.

A 6-year-old boy appears in the hospital with angioedema. Which one is a major cause of angioedema in this patient ?

a)

C9 deficiency

b)

C5 deficiency

c)

C1 deficiency

d)

DAF deficiency

e)

C1 IHN deficiency

81.

What is the effect of mindful breathing?

a)

Increases level of parasympathetic nerve fiber in lymphoid tissue

b)

Enhances adaptive immune function

c)

Enhances innate immune functions

d)

Enhances NK cells activity

e)

All choices are correct

82.

Which is the function of corticosteroid therapy ?

a)

induction of apoptosis in lymphocytes and eosinophil

b)

increase phospholipase A2

c)

increase GM-CSF

d)

increase adhesion molecules on endothelial cells of the vessels

e)

inhibit transcription process of T cells

83.

Which of the following statement is true concerning molecular mimicry?

a)

Rota virus can induce severe muscle pain by molecular mimicry mechanism

b)

Influenza virus can induce multiple sclerosis by molecular mimicry mechanism

c)

Autoantigen inducing the immune-mediated-injury in Guillain-Barre syndrome is myelin basic protein

d)

Coxsakie virus can induce encephalitis by molecular mimicry mechanism

e)

Autoantigen inducing the immune-mediated-injury in Rheumatic fever is cardiac Actin

84.

Which mechanism can induce autoimmunity by infection?

a)

Induce secretion of IL-10 from T cell

b)

Inhibit CD28 expression in T cell

c)

Induce the expression of B7 in antigen presenting cell

d)

Inhibit the regulatory T cell formation

e)

All choices are correct

85.

Which statement is correct?

a)

Peripheral blood stem cell transplantation (PBSCT) is of proven benefit for acute lymphoblastic leukemia treatment

b)

The monoclonal antibody anti-CD25 (Basiliximab) is increasingly being used in the treatment of transplant rejection to target macrophages

c)

Anemia is a major symptom of graft rejection

d)

Low platelet count is laboratory finding typical of acute graft-versus-host disease

e)

HLA class II is the major target of hyperacute rejection

86.

Which of the following statement is incorrect concerning chronic lymphocytic leukemia?

a)

Originates from B cell rather than T cells

b)

Is associated with autoimmune hemolytic anemia

c)

Can be treated by bone marrow transplantationCan be treated by bone marrow transplantation

d)

Has rapid disease progression and frequently transforms to acute leukemia within 5 years

e)

Causes patients death during blast crisis

87.

A 50 year-old man who was treated with kidney transplantation develops oliguria, fever, hypertension and flank pain 4 weeks after the operation. Which immunologic process causes his clinical problems?

a)

Chronic rejection

b)

Hyperacute rejection

c)

Selective IgA deficiency

d)

Acute rejection

e)

Autoimmunity

88.

A 3-year-old boy has a small deletion in chromosome 22 He has impaired thymus development with a significant deficiency in the number of functional T cells. Which of the following is the most likely diagnosis?

a)

Chediak-Higashi syndrome

b)

DiGeorge Syndrome

c)

Severe combined immunodeficiency disease (SCID)

d)

Wiskott-Aldrich syndrome

e)

Bruton's Agammaglobulinemia

89.

Which is the treatment of anaphylactic transfusion reaction?

a)

Continue blood transfusion and give steroid to the patient

b)

Stop transfusion followed by steroid administration

c)

Stop transfusion followed by anti-histamine administration

d)

Stop transfusion followed by epinephrine administration

e)

Steroid administration and continue blood transfusion

90.

A 25-year-old woman presents with malar rash and arthritis for 2 months. Investigations reveal anemia and presence of anti-nuclear antibody. Which is the most likely diagnosis and mechanism for disease development?

a)

Myasthenia gravis: autoimmunity associated HLA gene DR3

b)

Systemic lupus erythematosus: autoantibody to chromosomal proteins

c)

Hyper IgM: defect in B cell development

d)

Rheumatoid arthritis: immune deficiency associated with HLA gene DR4

e)

Reiter syndrome: immune mediated cell injury associated with HLA gene B27

91.

A 5-year old boy suffered from repeated bacterial infections. The genetic analysis found mutation in gene encoding a lysosomal trafficking regulatory protein. Which of the following is the most likely diagnosis?

a)

Chronic granulomatous disease

b)

Chediak-Higashi syndrome

c)

Wiskott-Aldrich syndrome

d)

Bruton's Agammaglobulinemia

e)

Agranulocytosis

92.

A 30-year-old man presents with paresthesia and weakness of his arms and legs and blurred vision for 2 months. Investigations show multiple areas of demyelination within the central nervous system. What is the most likely diagnosis?

a)

Multiple sclerosis

b)

Hashimoto thyroiditis

c)

Systemic lupus erythematosus

d)

LAD type I

e)

Reactive arthritis

93.

A-5-year-old boy with an X-linked defect in the Bruton tyrosine kinase (BTK) gene is Immunologically impaired by which of the following mechanism ?

a)

B cell development

b)

antibody-mediated bacterial immune response

c)

T cell maturation

d)

Both T and B cell developments

e)

formation of membrane attack complex

94.

.Which is the effect of yoga on immune system?

a)

lower CD4+:CD8+ T-cells ratio

b)

Enhances ACTH, cortisol, pro-inflammatory cytokines production

c)

Increases CD8+ T-cells level

d)

Enhances mast cell and B-cell function

e)

Stimulates NK cells function against cancer stem cells

95.

Which protein is able to induce the development of red blood cells from hematopoietic stem cells?

a)

M-CSF

b)

ЕРО

c)

G-CSF

d)

IL-4

e)

IL-7

96.

Listening to relaxing music as a part of music therapy has what effect on immune function?

a)

Increases saliva IgA level

b)

Decreases histamine production in food allergy patients and decrease IFN-1, IL-6, IL-10 level

c)

Enhance NK cell function

d)

Increases CD4+ T-cells and memory T-cells level

e)

All choices are correct

97.

Which statement is true concerning direct allorecognition occurring in graft rejection process?

a)

Donor CD4+ T cell bind to alloantigen on host APC

b)

Donor antibody bind to alloantigen on host cell

c)

Host CD4+ cell bind to alloantigen on donor APC

d)

Donor CD8+ T cell bind to alloantigen on host cell

e)

Host Megakaryocyte cells bind to alloantigen on donor APC

98.

Which is the best treatment for agranulocytosis?

a)

giving IVIG to patient

b)

giving G-CSF to patient

c)

giving antibiotic to patient

d)

giving fresh frozen plasma to patient

e)

Giving IgM to patient

99.

A 35-year-old male presents with headache,fatigue,light-headedness,dyspnea (diffculty in breathing) and tachycardia (rapid heart rate). Laboratory findings reveal decreased hemoglobin and a positive direct Coombs test (presence of antibodies on erythrocytes surface ). The patient is currently talking an antibiotic for symptoms of upper respiratory infection. These finding suggest which type of hypersensitivity ?

a)

Type IV hypersensitivity

b)

Type III hypersensitivity

c)

.Type I hypersensitivity

d)

Type V hypersensitivity

e)

Type II hypersensitivity

100.

.A 19 years old medical student frequently practices sitting meditation and is successful in the practice, what will happen in his body?

a)

Enhances telomerase activity

b)

Decreases pro-inflammatory cytokines; TNF, IL-1, 1L-6

c)

Enhance analytical thinking performance

d)

Gets a thicker forebrain

e)

All choices are correct