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Week 6 MCP

Total questions: 20

Worksheet time: 40mins

Name
Class
Date
1.

A 6-year-old boy presents with recurrent Neisseria infections. Flow cytometry shows absent CD55 and CD59 expression on red blood cells. Which complement regulatory defect best explains his disease?

a)

Failure of factor H binding

b)

Mutation in PIGA gene

c)

Absence of C3 convertase

d)

Deficiency of C1 esterase inhibitor

e)

Mutation in mannose-binding lectin

2.

A 2-year-old with chronic diarrhea and recurrent viral infections is found to have a defect in MyD88. Which of the following is most impaired?

a)

NF-κB–mediated cytokine production

b)

IRF-mediated type I interferon production

c)

Fas–FasL apoptosis signaling

d)

NOD2 inflammasome activation

e)

Granzyme B release

3.

A researcher is studying phagocyte respiratory burst. Which enzyme is directly responsible for generating superoxide radicals in neutrophils?

a)

iNOS

b)

NADPH oxidase

c)

Myeloperoxidase

d)

Catalase

e)

Vacuolar ATPase

4.

A patient with pneumonia shows activated NK cells releasing IFN-γ. Which of the following best describes the reciprocal effect of IFN-γ?

a)

Activates eosinophils to release granules

b)

Increases macrophage phagocytic killing

c)

Stimulates mast cells to release histamine

d)

Induces Treg differentiation

e)

Induces epithelial defensin production

5.

A 24-year-old woman develops fever and facial edema after taking lisinopril. Which cytokine released by mast cells is most responsible for the acute vascular changes?

a)

IL-1

b)

IL-4

c)

IL-5

d)

IL-6

e)

Histamine

6.

A newborn has absent B cells on flow cytometry. Which immunoglobulin isotype is primarily responsible for protection in the first months of life?

a)

IgM

b)

IgA

c)

IgE

d)

IgD

e)

IgG

7.

A patient with chronic parasitic infection shows elevated IL-4 and IL-5 production. Which antibody isotype is most likely increased?

a)

IgA

b)

IgE

c)

IgG

d)

IgM

e)

IgD

8.

A mutation in RAG1 causes failure of V(D)J recombination. Which of the following immune cell receptors is directly impaired?

a)

MHC Class I

b)

B cell receptor

c)

CD80

d)

LFA-1

e)

ICAM-1

9.

A 34 year old man with HIV has low CD4+ T cells. Which type of antigen presentation is most impaired?

a)

Intracellular peptides on MHC I

b)

Extracellular peptides on MHC II

c)

Lipids presented by CD1 molecules

d)

Self-DNA sensed by cGAS-STING pathway

e)

Viral RNA sensed by RIG-I

10.

A 50-year-old renal transplant patient experiences acute rejection. Which property of HLA molecules most directly explains this outcome?

a)

Co-dominant expression

b)

Allelic polymorphism

c)

Positive selection

d)

Somatic hypermutation

e)

Junctional diversity

11.

A researcher isolates an MHC I molecule with a closed peptide binding cleft. Which type of antigen is this molecule most likely presenting?

a)

Bacterial polysaccharide

b)

Viral peptide, 9 amino acids

c)

Fungal glycoprotein

d)

Lipid antigen

e)

Bacterial exotoxin

12.

A child with recurrent viral infections is found to have Bare Lymphocyte Syndrome type I. Which molecule is deficient?

a)

MHC1

b)

MHC2

c)

CD40

d)

TCR

e)

CD28

13.

A patient receives a melanoma vaccine designed to enhance CD8+ T cell activity. Which co-stimulatory interaction is most critical for productive T cell activation?

a)

TCR-MHC binding

b)

CD28-CD80/86 binding

c)

Fas-FasL binding

d)

ICOS-CD275 binding

e)

PD-1-PD-L1 binding

14.

A patient develops disseminated tuberculosis. Which CD4+ T cell subset is primarily responsible for protective immunity?

a)

Th1

b)

Th2

c)

Th17

d)

Tfh

e)

Treg

15.

A patient with asthma has increased IL-4 and IL-5. Which transcription factor is the master regulator of this CD4+ T cell subset?

a)

T-bet

b)

GATA3

c)

RORγT

d)

FoxP3

e)

NFAT

16.

A biopsy of a colon lesion shows Th17 cells producing IL-17 and IL-22. Which is the primary effector function of these cytokines?

a)

Recruitment of eosinophils

b)

Activation of macrophages

c)

Activation of B cell isotype switching

d)

Recruitment of neutrophils

e)

Induction of CTL cytotoxicity

17.

A 45-year-old man with hepatocellular carcinoma is treated with checkpoint inhibitor therapy blocking PD-1. Which is the expected mechanism?

a)

Prevents T cell exhaustion

b)

Enhances Treg function

c)

Inhibits NK cell cytotoxicity

d)

Blocks IL-2 receptor signaling

e)

Inhibits clonal expansion

18.

A patient with lymphoma receives CAR-T therapy. Which modification best describes the engineered receptor?

a)

Antibody Fc fused to cytokine

b)

TCR variable domain fused to CD3

c)

Antibody variable domain fused to TCR zeta chain and CD28

d)

IgM pentamer fused to CD40

e)

MHC molecule fused to Fas ligand

19.

A patient with recurrent fungal infections has impaired IL-17 signaling. Which immune defect best explains this?

a)

Defective Th1 differentiation

b)

Defective Th2 differentiation

c)

Defective Th17 differentiation

d)

Impaired CTL cytotoxicity

e)

Defective NK cell function

20.

A researcher blocks CTLA-4 in a mouse model. Which immune outcome is most likely observed?

a)

Decreased T cell activation

b)

Increased T cell activation

c)

Increased Treg suppression

d)

Impaired B cell isotype switching

e)

Decreased NK cytotoxicity