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Fall 2022: Biomed Exam 1

Total questions: 89

Worksheet time: 49mins

Name
Class
Date
1.

The term vaccination was first described by which of the following scientists?

a)

Robert Koch

b)

Edward Jenner

c)

Louis Pasteur

d)

Francis Crick

2.

Variolation was practiced in China and India in ancient times particularly against which of the following infectious disease?

a)

Small pox

b)

Cholera

c)

AIDS

d)

Malaria

3.

What is varilolation? How is it practiced in ancient China?

a)

method used to immunize people against small pox

b)

Used lesions from patients already affected

c)

Powdered crusts were scratched into the skin of uninfected people

d)

Powdered crusts were inhaled by uninfected poeple

4.

Which of the following are not correct with regard to cow pox/smallpox?

a)

Cowpox is a less severe form of the disease than smallpox

b)

When the patient recovers from cow pox, he/she is immune to smallpox

c)

Louis Pasteur is the English physician credited to have introduced vaccines against smallpox.

d)

WHO declared the world as free from smallpox in 1979

5.

T/F: Innate immunity relies on the recognition of pathogen associated molecule patterns (PAMPs) by pattern recognition receptors (PRRs)

a)

True

b)

False

6.

Which of the following are hallmarks of adaptive immune response?

a)

Self-nonself recognition

b)

Antigenic specificity

c)

Antibody diversity

d)

Division of labor (Equally important contributions of B-lymphocytes)

e)

Immunological memory

7.

T/F: Humoral immune response and cellular immune response are both part of the innate immune response.

a)

True

b)

False

8.

Which of the following are considered as first line of defenses?

a)

Skin and mucosal barrier

b)

Low pH in the stomach

c)

Lysozyme in the tears

d)

Microbial flora in the intestine

e)

All of the above

9.

T/F: Fc region of the antibody is the antigen binding site and located in the carboxy-terminal region of the antibody.

a)

True

b)

False

10.

Between 1917 and 1918, which infection / disease caused the death of nearly 675,000 Americans (immediately after the World War I)?

a)

AIDS

b)

Smallpox

c)

Bubonic Plague

d)

Influenza

11.

Which of the following represents or examples of first line of defense?

a)

Skin

b)

Mucus

c)

Low pH in stomach

d)

High pH in intestine

e)

All of the above

12.

Which of the following enzymes are/is present in the saliva that can act on peptidoglycan layer on bacterial cell wall?

a)

Amylases

b)

Trypsin

c)

Pepsin

d)

Lysozyme

13.

T/F: Lysozyme is present in both saliva and in tears.

a)

True

b)

False

14.

What is psoriasin?

a)

A protein secreted by the stomach in order to neutralize pH

b)

A small molecular weight protein secreted from skin cells that inhibits the growth of E. coli bacteria.

c)

A molecular weight proteins secreted by the pancreas to aid in the production of enzymes

d)

A protein secreted by the liver to help combat alcoholism effects

15.

Which of the following is/are not considered as a lymphocyte

a)

Helper T cells

b)

Cytotoxic T cells

c)

Natural Killer cells

d)

Macrophage

16.

Which of the following are not correct with regard to antibodies?

a)

The two amino-terminal regions of the light and heavy chain –form the antigen binding sites.

b)

The carboxy-terminal region of the antibody contains binding sites for immunoglobulin receptors as well as the binding sites for complement receptors.

c)

The constant region in the heavy chain is divided into three sections named CH1, CH2 and CH3, whereas the light chain has only one constant region named CL.

d)

A given antibody molecule (one antibody molecule) can have two different types of light chains

e)

There are 5 types of mammalian Ig heavy chain- a, d, e, g, and m.

17.

Which of the following classes of immunoglobulin is present in the blood in the largest amounts?

a)

IgG

b)

IgM

c)

IgD

d)

IgA

e)

IgE

18.

Which of the following immunoglobulin classes is mainly found in physiological fluids such as tears, saliva, GI fluids and milk?

a)

IgG

b)

IgD

c)

IgA

d)

IgE

19.

Which of the following immunoglobulin classes can exist as a pentamer?

a)

IgG

b)

IgM

c)

IgD

d)

IgA

e)

IgE

20.

Which of the following is incorrect with regard to IgA?

a)

It represents 15 to 20% of the serum immunoglobulins.

b)

IgA is often present in milk, supports neonatal immunity

c)

IgA is an important antibody in mucosal immunity where it prevents colonization of pathogens in the gut, respiratory and urogenital tract.

d)

The transfer of IgA from mother to baby through milk is an example of passive immunity.

e)

None of the above are incorrect.

21.

T/F: IgA is important for neonatal immunity

a)

True

b)

False

22.

Which of the following is not correct with regard to IgE?

a)

It represents less than 1% of the serum immunoglobulins.

b)

High affinity IgE receptors are found on the surface of mast cells and basophils.

c)

IgE immunoglobulins are involved in allergic reactions

d)

IgE can exist as a dimer

23.

T/F: IgM contains delta heavy chain.

a)

True

b)

False

24.

Which of the following antibodies are provided by passive immunization by the mother to the fetus/ or the infant?

a)

IgM and IgD

b)

IgA and IgG

c)

IgD and IgE

d)

IgD and IgG

25.

Which of the following is true with regard to a hapten?

a)

Hapten is a small molecule compound which can elicit an immune response.

b)

An example of a hapten is hydralazine

c)

In order to elicit an immune response, the haptens must bind to a protein and then processed by the APCs.

d)

All of the above.

26.

T/F: The heavy chain is encoded by VDJ and C gene regions in the chromosome.

a)

True

b)

False

27.

Ability of our body to make millions and millions of antibodies (each unique antibody to a specific antigen) from limited number of genes through DNA rearrangement, cell division, differentiation and affinity maturation.

a)

Antibody Diversity

b)

Antibody variability

c)

Auto-antibodies

28.

Name the professional antigen presenting cells in the human body

a)

B cells

b)

Dendritic cells

c)

Macrophages

d)

basophils

29.

What are the 3 drugs that you studied that can elicit auto-antibody production in certain patients?

a)

benzocaine

b)

Hydralazine

c)

procainamide

d)

isoniazid

30.

Hydralazine is used as a -

a)

anti-cancer

b)

anti-hypertensive

c)

anti-tuberculosis

d)

gout treatment

31.

Antigen stimulation of the B cells causes cell division and proliferation. Approximately how much mutation is/are observed per cell division in the hypervariable region of the heavy / light chains?

a)

1

b)

10

c)

25

d)

215

32.

Which of the following Ig subclass mainly appears on the B cell membrane as it is released from the bone marrow?

a)

IgG

b)

IgM

c)

IgD

d)

IgE

e)

IgA

33.

B cell affinity maturation is dependent on which of the following?

a)

Exposure and binding of antigen to antibodies on the B cell surface

b)

VDJ gene rearrangement in the heavy chain locus

c)

VJ gene rearrangement in the light chain locus

d)

All of the above

34.

Antibody diversity is possible due to____

a)

VDJ gene rearrangement

b)

VJ gene rearrangement

c)

Antigen-induced B cell proliferation

d)

Somatic hyper-mutation during B- cell proliferation

35.

T/F: In adults, hematopoiesis occurs in the bone marrow and also in the liver.

a)

True

b)

False

36.

Which of the following cell types can be produced from myeloid progenitor as well as lymphoid progenitor cells?

a)

Neutrophils

b)

Basophils

c)

RBCs

d)

Dendritic cells

37.

Which of the following is not a myeloid progenitor cell?

a)

Neutrophils

b)

Natural Killer cells

c)

eiosinophils

d)

macrophages

38.

T/F: Neutrophil is not an example of mononuclear phagocytic cell

a)

True

b)

False

39.

Which of the following granulocytes is mainly involved in fighting against infection by parasites?

a)

Neutrophils

b)

Eosinophils

c)

Basophils

d)

Macrophages

40.

T/F: Mast cells are involved in allergic reactions.

a)

True

b)

False

41.

Which of the following is not correct with regard to macrophages?

a)

Macrophages are derived from monocytes

b)

Macrophages represent the majority of WBCs in the blood.

c)

Macrophages can live in the tissues (outside blood vessels) for months

d)

Macrophages can present antigen to T cells

42.

T/F: Spleen is a secondary lymphoid organ.

a)

True

b)

False

43.

Which of the following is/are the primary lymphoid organs?

a)

Bone marrow

b)

Thymus

c)

Lymph nodes

d)

Tonsils

44.

It is a congenital birth defect where thymus fails to develop. Patients have no circulating T cells.

a)

Cerebral Palsy

b)

DiGeorge syndrome

c)

Antiphospholipid antibody syndrome

d)

Multiple sclerosis

45.

T/F: Thymus size increases from teen years to 65 years

a)

True

b)

False

46.

Which of the following is/are not true with regard to the neutrophils?

a)

Neutrophils are phagocytes

b)

They have multilobulated nuclei (2-5 segments)

c)

Neutrophil is a professional antigen presenting cell (APC)

d)

The primary granules in the neutrophils contain defensins and lysozyme; both are bactericidal peptides/proteins.

47.

Which of the following immune cells are mainly involved in causing allergic reactions?

a)

Macrophages

b)

Neutrophils

c)

Mast cells/basophils

d)

Monocytes

e)

RBCs

48.

CD4 (Clusters of differentiation 4) protein is expressed in which of the following cell types?

a)

Helper T cells

b)

Cytotoxic T cells

c)

B cells

d)

Eosinophils

49.

T/F: Natural killer cells are important mediators of innate immune response; but they also have the ability to increase the efficiency of adaptive immune response.

a)

True

b)

False

50.

Compounds and molecules are in the surface of pathogens, and which are recognized by cells of the innate immune system.

a)

macrophages

b)

NKs

c)

PAMPs

d)

dendritic cells

51.

T/F: Opsonins that coat the pathogens are examples of pathogen associated molecular patterns (PAMPs)

a)

True

b)

False

52.

Which of the following are correct with regard to pattern recognition receptors (PRR)

a)

PRR are important for innate immune response

b)

PRR are important for phagocytosis

c)

PRR recognize pathogen associated molecular patters (PAMPs

d)

All of the above

53.

T/F: Naïve B cells mean that these B cells have not been exposed to antigens.

a)

True

b)

False

54.

T/F: The production of B cells in the bone marrow and release into the blood stream is an antigen independent process.

a)

True

b)

False

55.

T/F: The process of affinity maturation and B cell proliferation that occur in the secondary lymphoid organs is an antigen-dependent process.

a)

True

b)

False

56.

Give two examples of passive immunity that occurs naturally.

a)

Transfer of IgA from mother milk to the infant

b)

Transfer of the IgG from the mother to the fetus through the placenta

c)

Transfer of IgD from mother milk to the infant

d)

Transfer of the IgM from the mother to the fetus through the placenta

57.

T/F: In an antibody, antigen binds to the amino-terminal region of the heavy and light chains.

a)

True

b)

False

58.

Regarding monocytes, which of the following is incorrect?

a)

They are myeloid in origin.

b)

Monocytes contain multilobulated nucleus and in their cytoplasm have granules.

c)

Monocytes are found in the blood circulation and spend 8-72 hours before they migrate into tissues

d)

Differentiated monocytes are called macrophages.

59.

Which of the following are secondary lymphoid organs/tissues?

a)

Lymph nodes

b)

Spleen

c)

MALT

d)

All the above

60.

Paracortex of the lymph nodes contain which of the following cell types?

a)

T cells

b)

Dendritic cells

c)

B cells

d)

RBCS

61.

What is the difference between an antigen and an immunogen-

a)

An antigen is an antibody generator and elicits the production of an antibody.

b)

An immunogen may or may not elicit the production of an antibody.

c)

An immunogen may simply elicit a cell-mediated immune response or a humoral response.

d)

All of the above

62.

What is the difference between affinity and avidity?

a)

Avidity-overall strength (accumulated strength of multiple affinities) due to interaction between antibody and multiple epitopes.

b)

Affinity-strength due to interaction between antibody and single epitope.

c)

Avidity - strength due to interaction between antibody and single epitope.

d)

Affinity - overall strength (accumulated strength of multiple affinities) due to interaction between antibody and multiple epitopes.

63.

T/F: All antigens can elicit the production of an antibody.

a)

True

b)

False

64.

an autoimmune disease where the patients have overactive T cells and release cytokines which in turn cause excessive inflammation and proliferation of skin cells.

a)

Cerebral Palsy

b)

Multiple sclerosis

c)

psoriasis

d)

sickle cell anemia

65.

Complementarity determining region (CDR) is located in which part of an antibody molecule?

a)

Amino terminal portion

b)

Carboxy-terminal region

c)

Not present in an antibody

d)

Near the framework region

66.

NK cells have the ability to cause antibody-mediated cellular cytotoxicity because___

a)

NK cells have FcgRIII receptors which are receptors for IgG

b)

NK cells can bind to opsonized (IgG bound) pathogen infected cell

c)

NK cells, through interactions with target cells can infuse proteases to kill the target cell

d)

All of the above

67.

Mucosa associated lymphoid tissue (MALT) can be found in______

a)

Walls of the bronchi (respiratory tract)

b)

Walls of the pharynx (tonsils)

c)

Walls of the intestine (Peyer’s patch)

d)

Walls of the appendix

e)

Walls of the genitourinary tract

68.

Which of the following is/are correct with regard to hapten?

a)

They combine with large proteins to make new epitopes

b)

Examples of drugs that can act as haptens include- hydralazine, isoniazid and procainamide.

c)

Haptens bound to proteins are taken up by antigen-presenting cells for presentation of antigens to T cells.

d)

All of the above

69.

Which of the following are correct with regard to pattern recognition receptors (PRR)?

a)

PRR recognize pathogen associated molecular patters (PAMPs

b)

PRR are important for innate immune response

c)

PRR are present in the cell surface involved in phagocytosis

d)

All of the above

70.

Immunoglobulins protect the body by which of the following mechanisms?

a)

Agglutination of the pathogens by clumping

b)

Compliment activation to cause bacterial lysis

c)

Neutralization of toxins

d)

Opsonization and assist in macrophage-mediated phagocytosis

71.

Examples of mononuclear agranulocytes are____

a)

Monocytes

b)

Macrophages

c)

Lymphocytes

d)

Dendritic cells

72.

Which of the following is not correct with regard to thymus and/or its functions?

a)

Thymus is located in the abdominal cavity in the left quadrant of the abdomen.

b)

In the thymus, immature T cells mature into cytotoxic T cells and helper T cells.

c)

The thymus function is maximum at puberty; but decreases significantly after puberty

d)

In a person who is 65 years old, the T cell output is about 2% as compared to the T cell output in a newborn infant; and hence they (elderly) are more prone to infection.

73.

During the development of B cells from the immature to mature state (still naïve = not exposed to new antigens); which of the following immunoglobulin isotypes is mainly expressed first on the cell surface?

a)

IgM

b)

IgE

c)

IgA

d)

IgG

74.

The lymphatic system is a one way system and lymph always flows away from the heart.

a)

True

b)

False

75.

Lymph leaves a lymph node via ______

a)

Afferent lymphatic vessels

b)

Efferent lymphatic vessels

c)

The cortical sinus’

d)

The subscapular sinus

76.

Peyer’s patches are found in the ______

a)

stomach

b)

small intestine

c)

large intestine

d)

spleen

77.

Small organs associated with lymphatic vessels are termed ____

a)

Lymphoid follicles

b)

Lymph Nodes

c)

Axillary Nodes

d)

Spleen

78.

The main functions of immune system include

a)

Survey tissues for foreign material

b)

Differentiate self from non-self (antigens)

c)

Trapping and destroy foreign antigens

d)

Store memory cells so that a second immune reaction upon infection can be mounted with rapid and greater response.

79.

Which of the following are considered polymorphonuclear granulocytes?

a)

Neutrophils

b)

Eosinophils

c)

Basophils

d)

Macrophages

80.

Which of the following antibodies can activate complements?

a)

IgG

b)

IgD

c)

IgE

d)

IgA

81.

Which of the following is an anaphylatoxin?

a)

C1s

b)

C3a

c)

C3b

d)

C2b

82.

Which of the following are the effector functions of complements?

a)

Opsonization

b)

Formation of membrane attack complex in target cells such as bacterial cells.

c)

Activation of inflammatory responses

d)

Assist in the clearance of anti-gen-antibody complexes

83.

Which of the following pathway(s) can activate complements without the mediation of antibodies?

a)

Lectin pathway

b)

Alternative pathway

c)

classical pathway

d)

Prolactin pathway

84.

sites present in the secondary lymphoid follicles, lymph nodes, spleen and other lymphoid tissues where mature B cells undergo rapid proliferation upon binding to antigens. It is in the germinal centers B cells undergo proliferation, somatic hyper-mutation, differentiation, affinity maturation to give plasma cells that are capable of secreting antibodies.

a)

neuronal centers

b)

germinal centers

c)

nephron cleft

d)

mutation center

85.

As the B cells are released from the bone marrow into the blood stream, what immunoglobulin class is mainly expressed on the cell surface?

a)

IgM

b)

Small amounts of IgD

c)

IgE

d)

IgA

86.

Is the maturation of B cells (express only IgM on the plasma membrane) in the bone marrow before their release into the blood circulation, an antigen dependent process or antigen independent process?

a)

antigen dependent process

b)

antigen independent process

87.

Is the expression of the IgE, IgD and IgG by B cells which occur in the peripheral tissues (lymphoid organs/tissues), an antigen dependent or independent process?

a)

antigen dependent process

b)

antigen independent process

88.

When lymphoid progenitor cells undergo differentiation to give B cells expressing IgM class immunoglobulins, they undergo VDJ recombination in the heavy chain genes and the VJ recombination in the light chain genes. In which lymphoid organ, this recombination event occurs?

a)

Liver

b)

Bone Marrow

c)

Spleen

d)

Pancreas

89.

Affinity maturation of B cells occur In which lymphoid organs/lymphoid tissues?

a)

primary lymphoid tissues

b)

secondary lymphoid tissues