Immunobiology Biol 3312

Fall 2018 Exam 1

Name: __________________________

1. Kupffer cells are found in the?

A) liver.
B) lungs.
C) blood.
D) lymph nodes.
E) kidneys.

2. B cells require these cells to development in the bone marrow?

A) Stromal cells.
B) Follicular dendritic cells.
C) Macrophages.
D) T cells.
E) Thymus cells.

3. The lymphatic system returns fluid to the blood via?

A) Thoracic duct.
B) Lymph nodes.
C) Clavian vein.
D) Kidneys.
E) Thymus.

4. Germinal centers contain high numbers of plasma cells?

A) True
B) False

5. The process of attracting cells via released chemicals?

A) Chemotaxis.
B) Phagocytosis.
C) Pinocytosis.
D) Oncolysis.
E) Apoptosis.

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 6. A technique that can be used to isolated antibody-producing cells?
A) ELISPOT.
B) ELISA.
C) FACS.
D) PAGE.
E) SDS-PAGE.

7. Failure of the immune system?

A) Immunopathology.
B) Cytopathology.
C) Hyposensitivity.
D) Sensitivity.
E) Apoptosis.

8. Fc receptors on macrophages bind?

A) Antibodies.
B) Complement.
C) Bacteria.
D) Viruses.
E) None of the answers is correct.

9. The cortex region of a lymph node contains mostly T cells?

A) True
B) False

10. The T cell receptor recognizes?

A) MHC and peptide.
B) Antigens.
C) MHC.
D) Bacteria.
E) Viruses.

11. The PALS region is located in the?

A) Spleen.
B) Liver.
C) Kidney.
D) Thymus.
E) Peyer patches.

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12. M cells are associated with the spleen?
A) True
B) False

13. This Ig is normally associated with a secretory component?

A) IgA.
B) IgG.
C) IgM.
D) IgE.
E) IgD.

14. The CD4 molecule recognizes?

A) the MHC molecule.
B) the T cell receptor.
C) the B cell receptor.
D) the Fc receptor.
E) most antibodies.

15. An IgG molecule may be composed of two identical heavy chains and a kappa and
lambda light chain with identical variable regions.
A) True
B) False

16. Fetuses produce this Ig?

A) IgM.
B) IgG.
C) IgA.
D) IgE.
E) Infants do not produce Ig's.

17. Composition of the T cell receptor?

A) VC and VC.
B) VC and VC
C) VC and VC
D) VC and VC
E) VC and VC

18. The human genome encodes three classes of MHC molecules?

A) True
B) False

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19. The classic element of the inflammatory response, tumor (or swelling) is most directly
brought about by the _______the site of the infection.
A) release of hydrolytic enzymes into the surrounding healthy tissue near
B) migration of phagocytes to
C) apoptosis of infected cells at
D) accumulation of blood plasma at
E) hydrolysis and activation of fibrinogen at

20. Which of the following is NOT a function of macrophages?

A) Phagocytosis.
B) Antigen presentation.
C) Production and secretion of Complement factors.
D) Production and secretion of cytokines.
E) Production and secretion of immunoglobulins.

21. This complement component triggers assembly of the MAC?

A) C3b.
B) C3a.
C) C4.
D) C5.
E) C8.

22. The specificity of an immunoglobulin is determined by the constant regions of the

heavy and light chains.
A) True
B) False

23. The main function of dendritic cells is:

A) Phagocytosis.
B) Cytotoxicity.
C) Antibody production.
D) Antigen presentation.
E) Cytokine production.

24. The Peyer’s patches are a type of:

A) Antigen’s chemical composition.
B) Antigen’s molecular size.
C) Host’s genotype.
D) Antigen processing center.
E) Antigen’s susceptibility to presentation.

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25. VJ and VDJ rearrangement, combinatorial association and somatic mutation all
contribute to the generation of antibody diversity.
A) True
B) False

26. When cells die by apoptosis, as compared to by necrosis, they are much less likely to
produce inflammation and damage to the surrounding tissue because they ________.
A) do not break open and release the cytoplasmic contents
B) are not subsequently phagocytized by macrophages and neutrophils
C) generally migrate into the blood stream prior to death
D) are rarely malignant, infected with virus or otherwise unhealthy
E) recycle their membrane components to prevent display of antigen on MHC I

27. Adaptive immunity is characterized by the following, EXCEPT:

A) Self/non-self discrimination.
B) Immunological memory.
C) First line of defense.
D) High diversity.
E) High variability.

28. The marginal zone of the spleen’s white pulp is populated mainly by:
A) Basophils.
B) B lymphocytes.
C) Monocytes.
D) T lymphocytes.
E) Old erythrocytes.

29. Indicate which of the following cells is the most active in phagocytosis:
A) Neutrophils.
B) Basophils.
C) Eosinophils.
D) Mast cells.
E) Erythrocytes.

30. The most abundant immunoglobulin class in external secretions is:

A) IgA.
B) IgG
C) IgD.
D) IgM.
E) Both C and D are correct.

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31. Antibodies and B cells can recognize both conformational and sequence determinants.
A) True
B) False

32. In naive T cell recirculation, entry of the cells into peripheral lymph nodes occurs
through which specialized vessel?
A) Efferent lymphatic
B) Thoracic duct
C) Central artery
D) High endothelial venule
E) Sinusoid

33. The strength of binding between a single antigen-binding site of an Ig molecule and an
antigen, which is quantitatively expressed as the dissociation constant, is called:
A) Avidity
B) Stickiness
C) Velcrocity
D) Affinity
E) Complementarity

34. Tissue macrophages are derived from which type of circulating blood cell?
A) Polymorphonuclear leukocyte
B) Small lymphocyte
C) Monocyte
D) Basophil
E) Lymphoblast

35. Which of the following is a unique property of the adaptive immune system?
A) Highly diverse repertoire of specificities for antigens
B) Self-nonself discrimination
C) Recognition ofmicrobial structures by both cell-associated and soluble receptors
D) Protection against viral infections
E) Responses that have the same kinetics and magnitude on repeated exposure to the
same microbe

36. Which type of white blood cell is most numerous in normal human blood?
A) Basophil
B) Lymphocyte
C) Monocyte
D) Neutrophil
E) Eosinophil

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37. A typical immunoglobulin molecule is composed of:
A) Two light chains and one heavy chain
B) Two light chains and two heavy chains.
C) One light chain and one heavy chain.
D) Two heavy chains.
E) Two light chains.

38. At 15 months of age, a child received a measles-mumps-rubella vaccine (MMR). At age

22, she is living with a family in Mexico that has not been vaccinated and she is
exposed to measles. Despite the exposure, she does not become infected. Which of the
following properties of the adaptive immune system is best illustrated by this scenario?
A) Specificity
B) Diversity
C) Specialization
D) Memory
E) Nonreactivity to self

39. Which of the following is the generative lymphoid organ for T lymphocytes?
A) Bone marrow
B) Spleen
C) Lymph node
D) Thymus
E) Tonsil

40. Which of the following statements about antibodies is NOT true?

A) They serve as membrane-bound antigen receptors on the surface of B cells.
B) In secreted form, they serve as effector molecules that facilitate the elimination of
microbes or toxins.
C) They are specific for proteins and polysaccharides exclusively.
D) They bind antigen with average higher affinity than do T cell receptors.
E) They are present in most biologic fluids in the body.

41. Which of the following immunoglobulin classes functions in mast cell degranulation?
A) IgE.
B) IgA.
C) IgD.
D) IgG.
E) IgM.

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Match each of the descriptions in the questions below with the correct lettered antibody isotype
(A-E). (Answers may be used more than once.)

42. The isotype found predominantly in A) IgD

mucosal secretions
43. The most abundant Ig isotype in the B) IgE
blood
44. The isotype most closely associated with C) IgG
immediate hypersensitivity (allergic)
disease
45. The secreted form of this isotype forms D) IgA
pentamers around a J chain
46. The isotype only found in membrane-
bound form on naive B cells

Match each description in the questions below with the appropriate lettered term.

47. A three-dimensional shape, formed by a A) Hinge region

portion of a macromolecule, to which an
antibody binds
48. The proteolytic fragment of an antibody B) Conformational determinant
molecule that contains the heavy chain
constant region
49. A proteolytic fragment of an antibody C) Fab
molecule that contains an intact antigen-
binding site
50. A region of an antibody molecule that D) Fc
permits bivalent binding of antibodies to
pairs of surface epitopes varying in
distance from one another

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Answer Key
1. A
2. A
3. B
4. A
5. A
6. A
7. A
8. A
9. B
10. A
11. A
12. B
13. A
14. A
15. B
16. A
17. A
18. A
19. D
20. E
21. A
22. B
23. D
24. D
25. A
26. A
27. C
28. B
29. A
30. A
31. A
32. D
33. D
34. C
35. A
36. D
37. B
38. D
39. D
40. C
41. A
42. D
43. C
44. B

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45. B
46. A
47. B
48. D
49. C
50. A

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 Immunobiology Biol 3312/5310
Exam 2 Fall 2018

Name:_________________________

1. Dendritic cells are only present lymph nodes.

A) True
B) False

2. Antigen binding to the B-cell receptor?

A) transduces a signal through the antigen-binding chains.
B) invariably leads to B-cell activation.
C) transduces a signal through the Igα and Igβ molecules.
D) results in macrophage activation.
E) leads to cytokine synthesis, which activates T cells.

3. T helper (TH) lymphocytes are characterized by:

A) Expression of MHC class II molecules on the cell membrane.
B) Expression of CD4 in the cell membrane.
C) Secretion of immunoglobulins.
D) Phagocytic activity.
E) Cytotoxic activity.

4. Within a lymph node these cells can present viral antigens when infected with the
virus?
A) Dendritic cells.
B) B cells.
C) T cells.
D) Follicular cells.
E) Reticular cells.

5. Which of the following is NOT a function of macrophages?

A) Phagocytosis.
B) Antigen presentation.
C) Production and secretion of Complement factors.
D) Production and secretion of cytokines.
E) Production and secretion of immunoglobulins.

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 6. CD8 T cells are also cytotoxic T cells.
A) True
B) False

7. Kidney transplantation was performed using a kidney from a donor who was matched
to the recipient by serologic tissue typing. However, within a few months the kidney
was rejected. Assuming no technical problems with the surgical procedure, one reason
for the rejection may be that
A) there was insufficient blood supply to the graft.
B) there could have been a mismatch, which would have been detected by a
lymphocyte stimulation test.
C) the recipient developed blocking antibodies.
D) the recipient also suffered from Wiskott —Aldrich syndrome.
E) the donor was agammaglobulinemic.

8. B cells can prevent apoptosis by expressing?

A) Bcl-2.
B) FDC.
C) IL-2.
D) MMDX-2.
E) More than one answer is correct.

9. A Tc cell can be induced to mount a cytotoxic attack on a viral-infected cell if it binds to

a cell displaying _______.
A) insufficient MHCI
B) insufficient MHCII
C) MHC I bearing foreign antigen
D) MHC II bearing foreign antigen
E) A and C are correct

10. Activation of macrophages to destroy intracellular bacteria requires?

A) Antigen presentation via MHC II.
B) Antigen presentation via MHC I.
C) IL-2.
D) IL-6.
E) Fas expression.

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11. Activation of macrophages to destroy intracellular bacteria requires?
A) Antigen presentation via MHC II.
B) Antigen presentation via MHC I.
C) IL-2.
D) IL-6.
E) Fas expression.

12. CD4 T cells are also Helper T cells.

A) True
B) False

13. After phagocytosis, the production of a phagolysosome results in a respiratory burst.

This rapid oxygen uptake most directly facilitates _________.
A) breakdown of pathogenic proteins
B) formation of poisonous reactive molecules
C) preventing the phagolysosome from expanding in volume
D) increase in ATP needed for the synthesis of MHC II
E) dispersal of defensive peptides

14. Isotype switching

A) changes the leader sequence exon so the antibody is secreted.
B) improves the antigen binding specificity of an Ig molecule.
C) increases the affinity of antibodies in a process called affinity maturation.
D) increases the functional diversity of Ig molecules.
E) occurs randomly between switch regions.

15. Which of the following is not a method to activate a CD8(+) T cell?

A) Dentritic cells that express high levels of B7 and antigen via MHC I.
B) Initial activation of APC by CD4(+) T cell followed by expression of B7.
C) Initial activation of APC by CD4(+) T cell followed by release of IL-2 and activation
of a CD8(+) T cell.
D) Initial activation of APC by CD4(+) T cell followed by release of IL-6 and antigen
via MHC I.

16. When cells die by apoptosis, as compared to by necrosis, they are much less likely to
produce inflammation and damage to the surrounding tissue because they ________.
A) do not break open and release the cytoplasmic contents
B) are not subsequently phagocytized by macrophages and neutrophils
C) generally migrate into the blood stream prior to death
D) are rarely malignant, infected with virus or otherwise unhealthy
E) recycle their membrane components to prevent display of antigen on MHC I

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17. An immune response with increase in activity of IgG- and IgM-mediated complement
fixation would most likely be protective against which of the following?
A) Beta2-Microglobulin.
B) Streptococcus pneumonia.
C) Ferruginous bodies of asbestosis.
D) Filarial pathogen.
E) Dysplastic melanocytes.

18. The primary and secondary antibody responses differ in

A) the predominant isotype generated.
B) the number of lymphocytes responding to antigen.
C) the speed at which antibodies appear in the serum.
D) the biologic functions manifested by the Ig isotypes produced.
E) All of the above.

19. Activation of T cells specific for nonbacterial protein antigens requires?

A) Co-processing and presentation of bacterial and nonbacterial proteins by one
macrophage.
B) Co-processing and presentation of bacterial and nonbacterial proteins by two
macrophages.
C) Processing and presentation of nonbacterial proteins by one macrophage.
D) Processing and presentation of bacterial proteins by one macrophage.
E) Processing and presentation of nonbacterial proteins by two macrophages.

20. An advantage of adaptive recognition over innate recognition is that it

A) is faster.
B) cannot result in the recognition of the body's own tissues.
C) triggers an inflammatory response.
D) targets specific strains of potential pathogens.
E) requires less energy to produce the defensive response.

21. Adaptive (or specific) immunity is characterized by the following, EXCEPT:

A) Self/non-self discrimination.
B) Immunological memory.
C) First line of defense.
D) High diversity.
E) High variability.

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22. Which one of the following statements about primary and secondary antibody
responses is NOT true?
A) Antibodies in primary responses generally have lower affinity for antigen than those
produced in secondary responses.
B) Secondary responses reach peak levels more quickly than primary responses.
C) Primary responses require higher concentrations of antigen for initiation than
secondary responses.
D) Primary responses occur to all types of antigens,but secondary responses mostly
occur only to protein antigens.
E) Primary responses are characterized by IgG antibodies, whereas secondary
responses are dominated by IgM antibodies.

23. A molecule that is an antigen but is not an immunogen is called a(n)

A) adjuvant.
B) carrier.
C) hapten.
D) mitogen.
E) superantigen.

24. The membrane-bound immunoglobulins serve as antigen receptor on the surface of B

lymphocytes. A single B cell expressing mIgM and mIgD will
A) Be specific for two different antigens.
B) Bind two different epitopes on the same antigen.
C) Bind identical epitopes on the same antigen.
D) Bind different epitopes on the same antigen.

25. TH2 cells?

A) General activation of B cells to produce antibodies.
B) B cell activation to produce IgG1.
C) Macrophage activation.
D) T cell activation.
E) Activation of CD4(+) T cells only.

26. T-independent antigens are capable of activating T cells?

A) True
B) False

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27. Activation of B cell receptors requires?
A) Receptor crosslinking with antigens.
B) Multivalant antigen.
C) IgM binding first.
D) IgG binding first
E) More than one answer is correct.

28. Which of the following is not a method to activate a CD8(+) T cell?

A) Dentritic cells that express high levels of B7 and antigen via MHC I.
B) Initial activation of APC by CD4(+) T cell followed by expression of B7.
C) Initial activation of APC by CD4(+) T cell followed by release of IL-2 and activation
of a CD8(+) T cell.
D) Initial activation of APC by CD4(+) T cell followed by release of IL-6 and antigen
via MHC I.

29. Activation of non-specific B cells is a property of TI-2 cells

A) True
B) False

30. A bacterial infection would be expected to result in the production of IgG antibodies to
the protein components, IgM antibodies to the polysaccharide components and IgG
antibodies to the lipid components of the bacteria.
A) True
B) False

31. Indicate which of the following cells is the most active in phagocytosis:
A) Neutrophils.
B) Basophils.
C) Eosinophils.
D) Mast cells.
E) Erythrocytes.

32. A lymphocyte stimulation test is designed to detect?

A) HLA differences.
B) MHC class I differences.
C) MHC class II differences.
D) Both MHC class I and class II differences.
E) HLA identity.

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33. In the cytosolic pathway of antigen processing, proteins are degraded into small
peptides by:
A) The invariant chain.
B) The proteosome.
C) Calnexin.
D) Calreticulin.
E) Tapasin.

34. The main function of dendritic cells is:

A) Phagocytosis.
B) Cytotoxicity.
C) Antibody production.
D) Antigen presentation.
E) Cytokine production.

35. Which of the following is a feature of MHC class I molecules?

A) Are exclusively expressed by Antigen Presenting Cells.
B) Present antigenic peptides to CD8+ T cells.
C) Are secreted in the lumen of the gut.
D) Their main function is to activate the complement.
E) Induce fever.

36. Immunoglobulin class switching refers to:

A) Changing constant regions of heavy chains that have the same antigenic
specificity.
B) Joining V and D gene segments together.
C) Joining V and J gene segments together.
D) Joining V, D, and J gene segments together.
E) Switching a V gene segment for another V gene segment.

37. CD8 T cells are also cytotoxic T cells.

A) True
B) False

38. Th cells deliver help to B cells using

A) Cytokines and CD40L.
B) Cytokines and CD8.
C) Selectins and CD8.
D) Kinetoblasts and complement.
E) Cytokines and complement.

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39. The Fas ligand is expressed by?
A) Cytotoxic T cells.
B) TH1 cells.
C) TH2 cells.
D) CD4(+) T cells.
E) Most B cells.

40. Which of the following DOES NOT characterize MHC class II molecules?
A) Are expressed by self-altered cells (e.g., virus-infected cells).
B) Present peptides to CD4+ T cells.
C) Are highly polymorphic.
D) In humans are encoded in chromosome 6.
E) They are classified as classical and nonclassical.

41. What is the primary function of CLIP during processing of exogenous peptides?
A) To degrade antigenic peptides.
B) To stabilize MHC molecules until they are expressed on the cell surface.
C) To transport peptides inside the endoplasmic reticulum.
D) To prevent endogenous peptides from binding the peptide-binding cleft of MHC I
molecules.
E) To prevent endogenous peptides from binding the peptide-binding cleft of MHC II
molecules.

42. Intact virus particels can be neutralized by?

A) Antibody binding to viral receptor.
B) Antibody binding to the cellular receptor.
C) Neutralization of viral enzyme.
D) Destruction of viral nucleic acid.
E) More than one answer is correct.

43. What is the co-stimulatory signal required to activate a naive T cell?

A) B7-CD28 binding.
B) CD4-MHCII binding.
C) LFA1-ICAM1 binding.
D) CD1-LFA3 binding.
E) CD2-LFA3 binding.

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44. Dendritic cells express LFA3 that binds to?
A) CD2.
B) LFA1.
C) ICAM3.
D) ICAM2.
E) DC-SIGN.

45. In order for a B cell to receive T cell help, the B cell must
A) Secrete TNF and IL-2.
B) Express CD28.
C) Secrete antibody.
D) Present peptides via MHC I.
E) Present peptides via MHC II.

46. B cell activation via a Thymus-dependent antigen requires cognate T cell help by?
A) Helper TH2 cell.
B) Helper TH1 cell.
C) CD8(+) T cell.
D) Cytotoxic TH1 cell.
E) More than one answer is correct.

47. Administration of a hapten will not result in the production of anti-hapten antibodies but
administration of a mixture of a hapten and a protein would.
A) True
B) False

48. The following are killing mechanisms of macrophages, EXCEPT:

A) Production of reactive oxygen intermediaries (ROIs).
B) Production of hydrolytic enzymes.
C) Production of nitric oxide (NO.)
D) Production of defensins.
E) Production of histamine.

49. Several friends who went on a picnic together developed vomiting and diarrhea from
eating potato salad contaminated with Staphylococcus aureus enterotoxin. Effects of
the toxin could best be counteracted by
A) antibody binding and neutralization of the toxin.
B) antibody opsonization and phagocytosis of S. aureus.
C) antibody opsonization and phagocytosis of the toxin.
D) B cell binding to S. aureus.
E) cytotoxic T cell binding and lysis of S. aureus.

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50. Activation of T cells specific for nonbacterial protein antigens requires?
A) Co-processing and presentation of bacterial and nonbacterial proteins by one
macrophage.
B) Co-processing and presentation of bacterial and nonbacterial proteins by two
macrophages.
C) Processing and presentation of nonbacterial proteins by one macrophage.
D) Processing and presentation of bacterial proteins by one macrophage.
E) Processing and presentation of nonbacterial proteins by two macrophages.

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Answer Key
1. B
2. C
3. B
4. A
5. E
6. A
7. B
8. A
9. C
10. A
11. A
12. A
13. B
14. D
15. D
16. A
17. B
18. E
19. A
20. D
21. C
22. E
23. C
24. C
25. A
26. B
27. A
28. D
29. B
30. B
31. A
32. A
33. B
34. D
35. B
36. A
37. A
38. A
39. A
40. A
41. E
42. E
43. A
44. A

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45. E
46. A
47. A
48. E
49. A
50. A

Page 12
 Immunobiology Biol 3312/5310
Exam 3 Fall 2018

Name:_________________________

1. An individual does not make an immune response to a self-protein because?

A) self-proteins cannot be processed into peptides.
B) peptides from self-proteins cannot bind to MHC class I.
C) peptides from self-proteins cannot bind to MHC class II.
D) lymphocytes that express a receptor reactive to a self-protein are inactivated by deletion or anergy.
E) developing lymphocytes cannot rearrange V genes required to produce a receptor for self-
proteins.

2. Which of the following is incorrect concerning immune tolerance?

A) Tolerance induction is antigen-specific.
B) Tolerance results from inactivation and/or elimination of B and/or T cells.
C) Tolerance can be induced in both young and old individuals.
D) Immature neutrophils are more susceptible to tolerance than mature neutrophils.
E) The breakdown of tolerance can result in autoimmunity.

3. Which of the following statements is incorrect concerning the immune response to antigens?
A) Reactivity is influenced by extremes of age.
B) Greater immune responses are produced when antigen is given with adjuvant.
C) Impaired nutrition depresses immunity.
D) The presence of preexisting antibody does not affect the subsequent response to antigen.
E) Different protein antigens stimulate different levels of antibody production.

4. All of the following procedures would be likely to induce tolerance to a protein antigen except?
A) intramuscular injection of the antigen in adjuvant.
B) intravenous injection of deaggregated protein.
C) injection of cyclosporine with the antigen.
D) injection of antigen at a stage in development before mature lymphocytes appear.
E) intravenous injection of small amounts of antigen.

5. When a tolerogenic injection of a protein antigen is given experimentally, it can be shown that?
A) B-cell tolerance is more rapidly induced than T-cell tolerance.
B) B-cell tolerance is lost as new B cells come from the bone marrow.
C) B-cell tolerance can be induced only when low doses are used.
D) T-cell tolerance can be induced only when high doses are used.
E) T-cell tolerance is shorter lasting than B-cell tolerance.

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 6. Blocking any of the following processes can result in peripheral tolerance in mature T cells except?
A) the interaction of costimulatory molecules on T cells with their ligands on APC.
B) intracellular signal transduction mechanisms.
C) negative selection of thymocytes.
D) activation of the IL-2 gene.
E) the binding of antigen with MHC molecules.

7. An individual with a defect in CTLA-4 (CD152) will be most likely to have which of the following?
A) Type I hypersensitivity
B) immunodeficiency
C) recurrent Neisseria infections
D) lymphoproliferative disease

8. An IgA antibody to a red blood cell antigen is unlikely to cause autoimmune hemolytic anemia
because?
A) it would be made only in the gastrointestinal tract.
B) its Fc region would not bind receptors for Fc on phagocytic cells.
C) it can fix complement only as far as C1, C4, C
D) it has a too-low affinity.
E) it requires secretory component to work.

9. The lesions in immune complex-induced glomerulonephritis?

A) are dependent on erythrocytes and complement.
B) result in increased production of urine.
C) require both complement and neutrophils.
D) are dependent on the presence of macrophages.
E) require all nine components of complement.

10. The final damage to vessels in immune complex-mediated arthritis is due to?
A) cytokines produced by T cells.
B) histamine and SRS-A.
C) the C5, C6, C7, C8, C9 membrane attack complex.
D) lysosomal enzymes of polymorphonuclear leukocytes.
E) cytotoxic T cells.

11. Type II hypersensitivity?

A) is antibody-independent.
B) is complement-independent.
C) is mediated by CD8+ T cells.
D) requires immune complex formation.
E) involves antibody-mediated destruction of cells.

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12. Which of the following does not involve cell-mediated immunity?
A) contact sensitivity to lipstick
B) rejection of a liver graft
C) serum sickness
D) tuberculin reaction
E) immunity to chicken pox

13. A positive delayed-type hypersensitivity skin reaction involves the interaction of?
A) antigen, complement, and cytokines.
B) antigen, antigen-sensitive lymphocytes, and macrophages.
C) antigen —antibody complexes, complement, and neutrophils.
D) IgE antibody, antigen, and mast cells.
E) antigen, macrophages, and complement.

14. Cell-mediated immune responses are?

A) enhanced by depletion of complement.
B) suppressed by cortisone.
C) enhanced by depletion of T cells.
D) suppressed by antihistamine.
E) enhanced by depletion of macrophages.

15. Delayed skin reactions to an intradermal injection of antigen may be markedly decreased by?
A) exposure to a high dose of X-irradiation.
B) treatment with antihistamines.
C) treatment with an antineutrophil serum.
D) removal of the spleen.
E) decreasing levels of complement.

16. Patients with DiGeorge syndrome who survive beyond infancy would be capable of?
A) rejecting a bone marrow transplant.
B) mounting a delayed-type hypersensitivity response to dinitrochlorobenzene.
C) resisting intracellular parasites.
D) forming antibody to T-dependent antigens.
E) None of the above.

17. Positive skin tests for delayed-type hypersensitivity to intradermally injected antigens indicate that?
A) a humoral immune response has occurred.
B) a cell-mediated immune response has occurred.
C) both T cell and B cell systems are functional.
D) the individual has previously made IgE responses to the antigen.
E) immune complexes have been formed at the injection site.

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18. T cell-mediated immune responses can result in?
A) formation of granulomas.
B) induration at the reaction site.
C) rejection of a heart transplant.
D) eczema of the skin in the area of prolonged contact with a rubberized undergarment.
E) All of the above.

19. Most autoimmune diseases are caused by a?

A) single genetic defect.
B) known infectious organism.
C) constellation of genetic and environmental events.
D) hormonal dysregulation.
E) B-cell defect.

20. Identifying an autoimmune disease in humans is often accomplished by?

A) finding an antibody against self-components.
B) passively transferring specific T cells from a patient to a healthy individual.
C) showing that T cells or antibodies are the cause of the tissue damage.
D) circumstantial evidence, such as MHC association and clinical improvement, with
immunosuppressive drugs.
E) finding the definitive agent or agents responsible for the disease.

21. The following is/are possible mechanism(s) for the recognition of self-components by the immune
system in autoimmune diseases?
A) alteration of a self-antigen so it is recognized as foreign
B) leakage of sequestered self-antigen
C) loss of suppressor cells
D) infection with a microorganism that carries a cross-reactive antigen
E) Any of the above.

22. Rheumatoid factor, found in synovial fluid of patients with rheumatoid arthritis, is most frequently
found to be?
A) IgM reacting with L chains of IgG.
B) IgM reacting with H-chain determinants of IgG.
C) IgE reacting with bacterial antigens.
D) antibody to collagen.
E) antibody to DNA.

23. The pathology in autoimmune diseases due to antibody may be a result of?
A) the formation of antigen —antibody complexes.
B) antibody blocking a cell receptor.
C) antibody-induced phagocytosis.
D) antibody-induced complement mediated lysis.
E) Any of the above.

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24. Autoimmune hemolytic anemia?
A) is usually due to warm agglutinins belonging to the IgM class directed against Rh antigens on red
blood cells
B) may be due to the production of either cold agglutinins after viral infection or autoantibodies
following drug treatment.
C) is the result of cytotoxic T cells lysing red blood cells
D) does not generally involve complement components in red blood cell lysis
E) can be characterized by a negative Coombs test

25. Systemic lupus erythematosus?

A) is due to a mutation in double-stranded DNA.
B) is a classic example of a T-cell-mediated autoimmune disease.
C) has multiple symptoms and affects many organs.
D) results from antibodies specific to thyroid.
E) affects only skin epithelial cells.

26. Diseases in which TH cells and cytotoxic CD8+ T cells probably play major roles in their pathology
include all of the following except ?
A) myasthenia gravis.
B) Hashimoto's thyroiditis.
C) rheumatoid arthritis.
D) multiple sclerosis.
E) insulin-dependent diabetes mellitus.

27. Hashimoto's thyroiditis?

A) is due primarily to antibodies formed to thyroid-stimulating hormone receptors.
B) mimics an animal model in which the disease is induced by immunization with thyroglobulin.
C) can be transplacentally transmitted causing a neonatal form of the disease.
D) is an autoimmune disease which affects males and females equally.
E) is characterized by immune complex deposition in the thyroid.

28. Immunodeficiency disease can result from?

A) a developmental defect of T lymphocytes.
B) a developmental defect of bone marrow stem cells.
C) a defect in phagocyte function.
D) a defect in complement function.
E) All of the above.

29. A 9-month-old baby was vaccinated against smallpox with attenuated smallpox virus. He developed a
progressive necrotic lesion of the skin, muscles, and subcutaneous tissue at the site of inoculation. The
vaccination reaction probably resulted from?
A) B-lymphocyte deficiency.
B) reaction to the adjuvant.
C) complement deficiency.
D) T-cell deficiency.
E) B- and T-lymphocyte deficiency.

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30. An 8-month-old baby has a history of repeated gram-positive bacterial infections. The most probable
cause for this condition is that?
A) the mother did not confer sufficient immunity on the baby in utero.
B) the baby suffers from erythroblastosis fetalis (hemolytic disease of the newborn).
C) the baby has a defect in the alternative complement pathway.
D) the baby is allergic to the mother's milk.
E) None of the above.

31. A 50-year-old worker at an atomic plant who previously had a sample of his own bone marrow
cryopreserved was accidentally exposed to a minimal lethal dose of radiation. He was subsequently
transplanted with his own bone marrow. This individual can expect?
A) to have recurrent bacterial infections.
B) to have serious fungal infections due to deficiency in cell-mediated immunity.
C) to make antibody responses to thymus-independent antigens only.
D) All of the above.
E) None of the above.

32. The MHC contains all of the following except?

A) genes that encode transplantation antigens.
B) genes that encode immunoglobulins.
C) genes that regulate immune responsiveness.
D) genes that encode some components of complement.
E) genes that encode class I and class II antigens.

33. Which of the following statements regarding GVH disease is incorrect?

A) GVH can result from MHC differences between donor and recipient.
B) GVH requires immunocompetent donor cells.
C) GVH may result from infusion of blood products that contain viable lymphocytes into an
immunologically incompetent recipient.
D) GVH requires natural killer cells.
E) GVH may occur in an immunosuppressed individual.

34. Transplant rejection may involve?

A) cell-mediated immunity.
B) type III (immune complex) hypersensitivity.
C) complement-dependent cytotoxicity.
D) the release of IFN-g.
E) All of the statements are correct.

35. The appearance of many primary lymphoreticular tumors in humans has been correlated with?
A) hypergammaglobulinemia.
B) acquired hemolytic anemia.
C) BCG treatment.
D) resistance to antibiotics.
E) impairment of cell-mediated immunity.

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36. Tumor antigens have been shown to cross-react immunologically in cases of?
A) tumors induced by chemical carcinogens.
B) tumors induced by RNA viruses.
C) all tumors.
D) tumors induced by irradiation with ultraviolet light.
E) tumors induced by the same chemical carcinogen on two separate sites on the same individual.

37. Which of the following is not considered a mechanism by which cytokines mediate antitumor effects?
A) They enhance the expression of MHC class I molecules.
B) They activate LAK and TIL cells.
C) They have direct antitumor activity.
D) They induce complement-mediated cytolysis.
E) They increase activity of cytotoxic T cells, macrophages, and NK cells.

38. Rejection of a tumor may involve which of the following?

A) T-cell-mediated cytotoxicity
B) ADCC
C) complement-dependent cytotoxicity
D) destruction of tumor cells by phagocytic cells
E) All are correct.

39. Immunotoxins are?

A) toxic substances released by macrophages.
B) cytokines.
C) toxins completed with the corresponding antitoxins.
D) toxins coupled to antigen-specific immunoglobulins.
E) toxins released by cytotoxic T cells.

40. It has been shown that a B-cell lymphoma could be eliminated with anti-idiotypic serum. The use of
this approach to treat a plasma cell tumor would not be warranted because?
A) plasma cell tumors have no tumor-specific antigens.
B) plasma cell tumors are not expected to be susceptible to ADCC.
C) plasma cell tumors can be killed in vivo only by cytotoxic T lymphocytes that bear the same A, B,
and C transplantation antigens.
D) the plasma cells do not have surface Ig.
E) the idiotype on the plasma-cell surface is different from that on the B-cell surface.

41. The usual sequence of events in the development of an effective immune response to a viral infection
is?
A) interferon secretion, antibody synthesis, cellular immune response, NK cell ADCC.
B) antibody synthesis, interferon secretion, NK cell ADCC, cellular immune response.
C) NK cell ADCC, interferon secretion, antibody synthesis, cellular immune response
D) interferon secretion, cellular immune response, antibody synthesis, NK cell ADCC.
E) cellular immune response, interferon secretion, antibody synthesis, NK cell ADCC.

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42. Differences between gram-positive and gram-negative bacteria include?
A) staining with crystal violet.
B) ability of complement to lyse cells.
C) thickness of the peptidoglycan layer.
D) endotoxin in the cell walls of gram-negative bacteria.
E) All of the above.

43. Antigenic variation is a mechanism of immune evasion that results in?

A) interference with attachment to host receptors.
B) induction of immune suppression.
C) alterations in important surface antigens such that escape variants arise as a result of immune
selection.
D) mutations in surface antigens.
E) destruction of antigens by proteolytic enzymes.

44. The best way to provide immunologic protection against tetanus neonatorum (of the newborn) is to?
A) inject the infant with human tetanus antitoxin.
B) inject the newborn with tetanus toxoid.
C) inject the mother with toxoid within 72 hours of the birth of her child.
D) immunize the mother with tetanus toxoid before or early in pregnancy.
E) give the child antitoxin and toxoid for both passive and active immunization.

45. Active, durable immunization against poliomyelitis can be accomplished by oral administration of
attenuated vaccine (Sabin) or by parenteral injection of inactivated (Salk) vaccine. These vaccines are
equally effective in preventing disease because?
A) both induce adequate IgA at the intestinal mucosa, the site of entry of the virus.
B) antibody in the serum protects against the viremia that leads to disease.
C) viral antigen attaches to the anterior horn cells in the spinal cord, preventing attachment of virulent
virus.
D) both vaccines induce formation of interferon.
E) both vaccines establish a mild infection that can lead to formation of antibody.

46. The administration of vaccines is not without hazard. Of the following, which is least likely to affect
adversely an immunocompromised host?
A) measles vaccine
B) pneumococcal vaccine
C) bacille Calmette-Gu;aaerin
D) mumps vaccine
E) Sabin poliomyelitis vaccine

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47. The administration of foreign (e.g., equine) antitoxin for passive protection in humans can lead to
serum sickness, which is characterized by all of the following except?
A) production by host of antibody to foreign antibody.
B) onset in 24—48 hours.
C) use of homologous antitoxin.
D) deposition of antigen—antibody complexes at various sites in the host.
E) although delayed, the reaction is not a cell-mediated, delayed, type IV immune response.

48. The pneumococcal polysaccharide vaccine should be administered to all except?

A) individuals with chronic cardiorespiratory disease.
B) elderly (over 60 years of age) persons.
C) children (under 2 years of age).
D) persons with chronic renal failure.
E) individuals with sickle-cell disease.

49. The following statements about human immune serum globulin (ISG) are true except?
A) The source is human placenta.
B) The globulins are obtained by precipitation with cold ethanol.
C) The concentration of IgG is more than 10-fold greater than in plasma.
D) IgA and IgM are present in concentrations slightly lower than in plasma.
E) The ethanol precipitation does not render preparation of globulin free of hepatitis virus.

50. In order to prevent Rhesus hemolytic disease of the newborn developing in babies that are at risk
because of the parents' blood group types, to whom and at what time should Rhogam (anti-Rhesus) be
administered?
A) The baby should be transfused once with Rhogam in utero as soon as the procedure is feasible
B) The mother should receive it within 3 days of birth
C) The mother should receive it before pregnancy and again as soon as she knows she is pregnant
D) The mother should receive it immediately after the baby is born and then again within about 2-3
weeks
E) The newborn baby should receive it within 24 hours of delivery

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Answer Key
1. D
2. D
3. D
4. A
5. B
6. C
7. D
8. B
9. C
10. D
11. E
12. C
13. B
14. B
15. A
16. E
17. B
18. E
19. C
20. D
21. E
22. B
23. E
24. B
25. C
26. A
27. B
28. E
29. D
30. E
31. E
32. B
33. D
34. E
35. E
36. B
37. D
38. E
39. D
40. D
41. D
42. E
43. C
44. D
45. B
46. B
47. B
48. C
49. E
50. B

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