130Immunologyquestionsandanswers

FromMedicalMicrobiology&Immunology

Examination&BoardReview,6thed.,2000

W.Levinson&E.Jawetz

Directions(Questions387474):SelecttheONEletteredanswerthatisBESTineach
question.

387.WhichcategoryofhypersensitivityBESTdescribeshemolyticdiseaseofthenewborn
causedbyRhincompatibility?

A.atopicoranaphylactic

B.cytotoxic

C.immunecomplex

D.delayed

388.Theprincipaldifferencebetweencytotoxic(typeII)andimmunecomplex(typeIII)
hypersensitivityis

A.theclass(isotype)ofantibody.

B.thesitewhereantigenantibodycomplexesareformed.

C.theparticipationofcomplement.

D.theparticipationofTcells.

389.Achildstungbyabeeexperiencesrespiratorydistresswithinminutesandlapsesinto
unconsciousness.Thisreactionisprobablymediatedby

A.IgEantibody.

B.IgGantibody.

C.sensitizedTcells.

D.complement.

E.IgMantibody.

390.Apatientwithrheumaticfeverdevelopsasorethroatfromwhichbetahemolytic
streptococciarecultured.Thepatientisstartedontreatmentwithpenicillin,andthesore
throatresolveswithinseveraldays.However,7daysafterinitiationofpenicillintherapythe
patientdevelopsafeverof103F,ageneralizedrash,andproteinuria.ThisMOSTprobably
resultedfrom

A.recurrenceoftherheumaticfever.

B.adifferentinfectiousdisease.

C.anIgEresponsetopenicillin.

D.anIgGIgMresponsetopenicillin.

E.adelayedhypersensitivityreactiontopenicillin.

391.Akidneybiopsyspecimentakenfromapatientwithacuteglomerulonephritisand
stainedwithfluoresceinconjugatedantihumanIgGantibodywouldprobablyshow

A.nofluorescence.

B.uniformfluorescenceoftheglomerularbasementmembrane.

C.patchy,irregularfluorescenceoftheglomerularbasementmembrane.

D.fluorescentBcells.

E.fluorescentmacrophages.

392.Apatientwithsevereasthmagetsnorelieffromantihistamines.Thesymptomsare
MOSTlikelytobecausedby

A.interleukin2.


B.slowreactingsubstanceA(leukotrienes).

C.serotonin.

D.bradykinin.

393.Hypersensitivitytopenicillinandhypersensitivitytopoisonoakareboth

A.mediatedbyIgEantibody.

B.mediatedbyIgGandIgMantibody.

C.initiatedbyhaptens.

D.initiatedbyTh2cells.

394.Arecipientofa2haplotypeMHCmatchedkidneyfromarelativestillneeds
immunosuppressiontopreventgraftrejectionbecause

A.graftversushostdiseaseisaproblem.

B.minorhistocompatibilityantigenswillnotbematched.

C.minorhistocompatibilityantigenswillnotbematched.

D.complementcomponentswillnotbematched.

395.Bonemarrowtransplantationinimmunocompromisedpatientspresentswhichmajor
problem?

A.potentiallylethalgraftversushostdisease

B.highriskofTcellleukemia

C.inabilitytousealivedonor

D.delayedhypersensitivity

396.WhatistheroleofclassIIMHCproteinsondonorcellsingraftrejection?

A.Theyarethereceptorsforinterleukin2,whichisproducedbymacrophageswhenthey
attackthedonorcells.

B.TheyarerecognizedbyhelperTcells,whichthenactivatecytotoxicTcellstokillthe
donorcells.

C.Theyinducetheproductionofblockingantibodiesthatprotectthegraft.

D.TheyinduceIgEwhichmediatesgraftrejection.

397.Graftsbetweengeneticallyidenticalindividuals(i.e.,identicaltwins)

A.arerejectedslowlyasaresultofminorhistocompatibilityantigens.

B.aresubjecttohyperacuterejection.

C.arenotrejected,evenwithoutimmunosuppression.

D.arenotrejectedifakidneyisgrafted,butskingraftsarerejected.

398.Penicillinisahapteninbothhumansandmice.Toexplorethehaptencarrier
relationship,amousewasinjectedwithpenicillincovalentlyboundtobovineserumalbumin
and,atthesametime,witheggalbumintowhichnopenicillinwasbound.Ofthefollowing,
whichonewillinduceasecondaryresponsetopenicillinwheninjectedintothemouse1
monthlater?

A.penicillin

B.penicillinboundtoeggalbumin

C.eggalbumin

D.bovineserumalbumin

399.AIDSiscausedbyahumanretrovirusthatkills

A.Blymphocytes.


B.lymphocytestemcells.

C.CD4positiveTlymphocytes.

D.CD8positiveTlymphocytes.

400.Chemicallyinducedtumorshavetumorassociatedtransplantationantigensthat

A.arealwaysthesameforagivencarcinogen.

B.aredifferentfortwotumorsofdifferenthistologictypeevenifinducedbythesame
carcinogen.

C.areverystrongantigens.

D.donotinduceanimmuneresponse.

401.Polyomavirus(aDNAvirus)causestumorsin"nudemice"(nudemicedonothavea
thymus,becauseofageneticdefect)butnotinnormalmice.theBESTinterpretationisthat

A.macrophagesarerequiredtorejectpolyomavirusinducedtumors.

B.naturalkillercellscanrejectpolyomavirusinducedtumorswithouthelpfromT
lymphocytes.

C.Tlymphocytesplayanimportantroleintherejectionofpolyomavirusinducedtumors.

D.Blymphocytesplaynoroleinrejectionofpolyomavirusinducedtumors.

402.C3iscleavedtoformC3aandC3bbyC3convertase.C3bisinvolvedinallofthe
followingEXCEPT

A.alteringvascularpermeability.

B.promotingphagocytosis.

C.formingalternativepathwayC3convertase.

D.formingC5convertase.

403.Afterbindingtoitsspecificantigen,aBlymphocytemayswitchits

A.immunoglobulinlightchainisotype.

B.immunoglobulinheavychainclass.

C.variableregionoftheimmunoglobulinheavychain.

D.constantregionoftheimmunoglobulinlightchain.

404.Diversityisanimportantfeatureoftheimmunesystem.Whichoneofthefollowing
statementsaboutitisINCORRECT?

A.Humanscanmakeantibodieswithabout108differentVHXVLcombinations.

B.AsinglecellcansynthesizeIgMantibody,thenswitchtoIgAantibody.

C.Thehematopoieticstemcellcarriesthegeneticpotentialtocreatemorethan104
immunoglobulingenes.

D.AsingleBlymphocytecanproduceantibodiesofmanydifferentspecificities,buta
plasmacellismonospecific.

405.C3aandC5acancause

A.bacteriallysis.

B.vascularpermeability.

C.phagocytosisofIgEcoatedbacteria.

D.aggregationofC4andC2.

406.Neutrophilsareattractedtoaninfectedareaby

A.IgM.

B.vascularpermeability.

C.phagocytosisofIgEcoatedbacteria.

D.aggregationofC4andC2.

407.Complementfixationrefersto

A.theingestionofC3bcoatedbacteriabymacrophages.

B.thedestructionofcomplementinserumbyheatingat56Cfor30minutes.

C.thebindingofcomplementcomponentsbyantigenantibodycomplexes.

D.theinteractionofC3bwithmastcells.

408.TheclassiccomplementpathwayisinitiatedbyinteractionofC1with

A.antigen.

B.factorB.

C.antigenIgGcomplexes.

D.bacteriallipopolysaccharides.

409.PatientswithseverelyreducedC3levelstendtohave

A.increasednumbersofsevereviralinfections.

B.increasednumbersofseverebacterialinfections.

C.lowgammaglobulinlevels.

D.frequentepisodesofhemolyticanemia.

410.IndividualswithageneticdeficiencyofC6have


A.decreasedresistancetoviralinfections.

B.increasedhypersensitivityreactions.

C.increasedfrequencyofcancer.

D.decreasedresistancetoNeisseriabacteremia.

411.Naturalkillercellsare

A.Bcellsthatcankillwithoutcomplement.

B.cytotoxicTcells.

C.increasedbyimmunization.

D.abletokillvirusinfectedcellswithoutpriorsensitization.

412.Apositivetuberculinskintest(adelayedhypersensitivityreaction)indicatesthat

A.ahumoralimmuneresponsehasoccurred.

B.acellmediatedimmuneresponsehasoccurred.

C.boththeTandBcellsystemsarefunctional.

D.onlytheBcellsystemisfunctional.

413.Reactiontopoisonivyorpoisonoakis

A.anIgGmediatedresponse.

B.anIgEmediatedresponse.

C.acellmediatedresponse.

D.anArthusreaction.

414.Achilddisturbsawaspnest,isstungrepeatedly,andgoesintoshockwithinminutes,
manifestingrespiratoryfailureandvascularcollapse.ThisisMOSTlikelytobedueto

A.systemicanaphylaxis.

B.serumsickness.

C.anArthusreaction.

D.cytotoxichypersensitivity.

415."Isotypeswitching"ofimmunoglobulinclassesbyBcellsinvolves

A.simultaneousinsertionofVHgenesadjacenttoeachCHgene.

B.successiveinsertionofasingleVHgeneadjacenttodifferentCHgenes.

C.activationofhomologousgenesonchromosome6.

D.switchingoflightchaintypes(kappaandlambda).

416.Whichoneofthefollowingpairsofgenesislinkedonasinglechromosome?

A.VgeneforlambdachainandCgeneforkappachain

B.CgeneforgammachainandCgeneforkappachain

C.VgeneforlambdachainandVgeneforheavychain

D.CgeneforgammachainandCgeneforalphachain

417.Idiotypicdeterminantsarelocatedwithin

A.hypervariableregionsofheavyandlightchains.

B.constantregionsoflightchains.

C.constantregionsofheavychains.

D.thehingeregion.

418.Aprimaryimmuneresponseinanadulthumanrequiresapproximatelyhowmuchtime
toproducedetectableantibodylevelsintheblood?

A.12hours

B.3days

C.1week

D.3weeks

419.ThemembraneIgMandIgDonthesurfaceofanindividualBcell

A.haveidenticalheavychainsbutdifferentlightchains

B.areidenticalexceptfortheirCHregions

C.areidenticalexceptfortheirVHregions

D.havedifferentVHandVLregions

420.DuringthematurationofaBlymphocyte,thefirstimmunoglobulinheavychain
synthesizedisthe

A.Muchain.

B.gammachain.

C.epsilonchain.

D.alphachain.

421.Intheimmuneresponsetoahaptenproteinconjugate,inordertogetantihapten
antibodiesitisessentialthat

A.thehaptenberecognizedbyhelperTcells.

B.theproteinberecognizedbyhelperTcells.

C.theproteinberecognizedbyBcells.

D.thehaptenberecognizedbysuppressorTcells.

422.Inthedeterminationofseruminsulinlevelsbyradioimmunoassay,whichoneofthe
followingisNOTneeded?

A.isotopelabeledinsulin

B.antiinsulinantibodymadeingoats

C.antigoatgammaglobulinmadeinrabbits

D.isotopelabeledantiinsulinantibodymadeingoats

423.Whichoneofthefollowingsequencesisappropriatefortestingapatientforantibody
againsttheAIDSviruswiththeELISAprocedure?(Theassayiscarriedoutinaplasticplate
withanincubationandawashstepaftereachadditionexceptthefinalone.)

A.patient'sserum/enzymesubstrate/HIVantigen/enzymelabeledantibodyagainstHIV

B.HIVantigen/patient'sserum/enzymelabeledantibodyagainsthumangamma
globulin/enzymesubstrate

C.enzymelabeledantibodyagainsthumangammaglobulin/patient'sserum/HIV
antigen/enzymesubstrate

D.enzymelabeledantibodyagainstHIV/HIVantigen/patient'sserum/enzymesubstrate

424.TheBESTmethodtodemonstrateIgGontheglomerularbasementmembraneina
kidneytissuesectionisthe

A.precipitintest.

B.complementfixationtest.

C.agglutinationtest.


D.indirectfluorescentantibodytest.

425.Awomanhadahighfever,hypotension,andadiffusemacularrash.Whenallcultures
showednobacterialgrowth,adiagnosisoftoxicshocksyndromewasmade.Regardingthe
mechanismbywhichthetoxincausesthisdisease,whichoneofthefollowingisLEAST
accurate?

A.Thetoxinisnotprocessedwithinthemacrophage.

B.ThetoxinbindstoboththeclassIIMHCproteinandtheTcellreceptor.

C.ThetoxinactivatesmanyCD4positiveTcells,andlargeamountsofinterleukinsare
released.

D.ThetoxinhasanABsubunitstructuretheBsubunitbindstoareceptor,andtheA
subunitentersthecellsandactivatesthem.

426.Apatientwithacentralnervoussystemdisorderismaintainedonthedrug
methyldopa.Hemolyticanemiadevelops,whichresolvesshortlyafterthedrugiswithdrawn.
ThisisMOSTprobablyanexampleof

A.atopichypersensitivity.

B.cytotoxichypersensitivity.

C.immunecomplexhypersensitivity.

D.cellmediatedhypersensitivity.

427.WhichoneofthefollowingsubstancesisNOTreleasedbyactivatedhelperTcells?

A.interleukin1

B.gammainterferon

C.interleukin2

D.interleukin4


428.Adelayedhypersensitivityreactionischaracterizedby

A.edemawithoutacellularinfiltrate.

B.aninfiltratecomposedofneutrophils.

C.aninfiltratecomposedofhelperTcellsandmacrophages

D.aninfiltratecomposedofeosinophils.

429.Twodissimilarinbredstrainsofmice,AandB,arecrossedtoyieldanF1hybridstrain,
AB.IfalargedoseofspleencellsfromanadultAmouseisinjectedintoanadultABmouse,
whichoneofthefollowingisMOSTlikelytooccur?Anexplanationoftheanswertothis
questionisgivenonp.24.

A.Thespleencellswillbedestroyed.

B.Thespleencellswillsurviveandwillhavenoeffectintherecipient.

C.Thespleencellswillinduceagraftversushostreactionintherecipient.

D.ThespleencellswillsurviveandinducetoleranceofstrainAgraftsintherecipient.

430.Thisquestionisbasedonthesamestrainsofmicedescribedinthepreviousquestion.
IfadultABspleencellsareinjectedintoanewbornBmouse,whichoneofthefollowingis
MOSTlikelytooccur?Anexplanationoftheanswertothisquestionisgivenonp.24.

A.Thespleencellswillbedestroyed.

B.Thespleencellswillsurvivewithoutanyeffectontherecipient.

C.Thespleencellswillinduceagraftversushostreactionintherecipient.

D.ThespleencellswillsurviveandinducetoleranceofstrainAgraftsintherecipient.

431.Theminorhistocompatibilityantigensoncells

A.aredetectedbyreactionwithantibodiesandcomplement.


B.arecontrolledbyseveralgenesinthemajorhistocompatibilitycomplex.

C.areunimportantinhumantransplantation.

D.inducereactionsthatcancumulativelyleadtoastrongrejectionresponse.

432.WhichoneofthefollowingisNOTtrueofclassIMHCantigens?

A.Theycanbeassayedbyacytotoxictestthatusesantibodyandcomplement.

B.Theycanusuallybeidentifiedinthelaboratoryinafewhours.

C.Theyarecontrolledbyatleastthreegenelociinthemajorhistocompatibilitycomplex.

D.TheyarefoundmainlyonBcells,macrophages,andactivatedTcells.

433.Anantigenfoundinrelativelyhighconcentrationintheplasmaofnormalfetusesanda
highproportionofpatientswithprogressivecarcinomaofthecolonis

A.viralantigen.

B.carcinoembryonicantigen.

C.alphafetoprotein.

D.heterophil

434.AnantibodydirectedagainsttheidiotypicdeterminantsofahumanIgGantibody
wouldreactwith

A.theFcpartoftheIgG.

B.anIgMantibodyproducedbythesameplasmacellthatproducedtheIgG.

C.allhumankappachains.

D.allhumangammachains.

435.WhichoneofthefollowingisNOTtrueofthegenesegmentsthatcombinetomakeup
aheavychaingene?

A.ManyVregionsegmentsareavailable.

B.SeveralJsegmentsandseveralDsegmentsareavailable.

C.V,D,andJsegmentscombinetoencodetheantigenbindingsite.

D.AVsegmentandaJsegmentarepreselectedbyanantigentomakeupthevariable
regionportionofthegene.

436.Whenimmunecomplexesfromtheserumaredepositedonglomerularbasement
membrane,damagetothemembraneiscausedmainlyby

A.gammainterferon.

B.phagocytosis.

C.cytotoxicTcells.

D.enzymesreleasedbypolymorphonuclearcells.

437.IfanindividualwasgeneticallyunabletomakeJchains,whichimmunoglobulin(s)
wouldbeaffected?

A.IgG

B.IgM

C.IgA

D.IgGandIgM

E.IgMandIgA

438.Theantibodybindingsiteisformedprimarilyby

A.theconstantregionsofHandLchains.


B.thehypervariableregionsofHandLchains.

C.thehypervariableregionsofHchains.

D.thevariableregionsofHchains.

E.thevariableregionsofLchains.

439.Theclassofimmunoglobulinpresentinhighestconcentrationinthebloodofahuman
newbornis

A.IgG.

B.IgM.

C.IgA.

D.IgD.

E.IgE.

440.IndividualsofbloodgrouptypeAB

A.areRh(d)negative.

B.are"universalrecipients"oftransfusions.

C.havecirculatingantiAandantiBantibodies.

D.havethesamehaplotype.

441.CytotoxicTcellsinducedbyinfectionwithvirusAwillkilltargetcells

A.fromthesamehostinfectedwithanyvirus.

B.infectedbyvirusAandidenticalatclassIMHClociofthecytotoxicTcells.

C.infectedbyvirusAandidenticalatclassIIMHClociofthecytotoxicTcells.

D.infectedwithadifferentvirusandidenticalatclassIMHClociofthecytotoxiccells.


E.infectedwithadifferentvirusandidenticalatclassIIMHClociofthecytotoxiccells.

442.AntigenpresentingcellsthatactivatehelperTcellsmustexpresswhichoneofthe
followingontheirsurfaces?

A.IgE

B.gammainterferon

C.classIMHCantigens

D.classIIMHCantigens

443.WhichoneofthefollowingdoesNOTcontainC3b?

A.classicpathwayC5convertase

B.alternativepathwayC5convertase

C.classicpathwayC3convertase

D.alternativepathwayC3convertase

444.WhichoneofthefollowingisNOTtrueregardingthealternativecomplementpathway?

A.Itcanbetriggeredbyinfectiousagentsinabsenceofantibody.

B.ItdoesnotrequireC1,C2,orC4.

C.ItcannotbeinitiatedunlessC3bfragmentsarealreadypresent.

D.Ithasthesameterminalsequenceofeventsastheclassicpathway.

445.Insettingupacomplementfixationtestforantibody,thereactantsshouldbeaddedin
whatsequence?(Ag=antigenAb=antibodyC=complementEA=antibodycoated
indicatorerythrocytes.)


A.Ag+EA+C/wait/+patient'sserum

B.C+patient'sserum+EA/wait/+Ag

C.Ag+patient'sserum+EA/wait/+C

D.Ag+patient'sserum+C/wait/+EA

446.Proteinsfromtwosamplesofanimalblood,AandB,weretestedbythedouble
diffusion(Ouchterlony)testinagaragainstantibodytobovinealbumin.Whichsample(s)
containhorseblood?Anexplanationoftheanswertothisquestionisgivenonp[dse2].24.

A.sampleA

B.sampleB

C.bothsamples

D.neithersample

447.Complementlysescellsby

A.enzymaticdigestionofthecellmembrane.

B.activationofadenylatecyclase.

C.insertionofcomplementproteinsintothecellmembrane.

D.inhibitionofelongationfactor2.

448.Graftandtumorrejectionaremediatedprimarilyby

A.noncomplementfixingantibodies.

B.phagocyticcells.

C.helperTcells.

D.cytotoxicTcells.

449.WhichoneofthefollowingpropertiesofantibodiesisNOTdependentonthestructure
oftheheavychainconstantregion?

A.abilitytocrosstheplacenta

B.isotype(class)

C.abilitytofixcomplement

D.affinityforantigen

450.InwhichoneofthefollowingsituationswouldagraftversushostreactionbeMOST
likelytooccur?(MousestrainsAandBarehighlyinbredABisanF1hybridbetweenstrain
AandstrainB.)

A.newbornstrainAspleencellsinjectedintoastrainBadult

B.xirradiatedadultstrainAspleencellsinjectedintoastrainBadult

C.adultstrainAspleencellsinjectedintoanxirradiatedstrainABadult

D.adultstrainABspleencellsinjectedintoastrainAnewborn

451.Inamixedlymphocyteculture,lymphocytesfrompersonX,whoishomozygousfor
theHLADw7allele,areirradiatedandthenculturedwithlymphocytesfrompersonZ.Itis

foundthatDNAsynthesisisNOTstimulated.Theproperconclusiontobedrawnisthat

A.personZishomozygousforHLADw7.

B.personZishomozygousorheterozygousforHLADw7.

C.personZisheterozygousforHLADw7.

D.personZdoesnotcarrytheHLADw7allele.

452.Apatientskintestedwithpurifiedproteinderivative(PPD)todetermineprevious
exposuretoMycobacteriumtuberculosisdevelopsindurationattheskintestsite48hours
later.Histologically,thereactionsitewouldMOSTprobablyshow

A.eosinophils.

B.neutrophils.

C.helperTcellsandmacrophages.

D.Bcells.

453.HemolyticdiseaseofthenewborncausedbyRhbloodgroupincompatibilityrequires
maternalantibodytoenterthefetalbloodstream.Therefore,themediatorofthisdiseaseis

A.IgEantibody.

B.IgGantibody.

C.IgMantibody.

D.IgAantibody.

454.AnRhnegativewomanmarriedtoaheterozygousRhpositivemanhasthreechildren.
TheprobabilitythatallthreeoftheirchildrenareRhpositiveis

A.1:2.

B.1:4.


C.1:8.

D.zero.

455.WhichoneofthefollowingstatementsBESTexplainstherelationshipbetween
inflammationoftheheart(carditis)andinfectionwithgroupAbetahemolyticstreptococci?

A.Streptococcalantigensinduceantibodiescrossreactivewithhearttissue.

B.StreptococciarepolyclonalactivatorsofBcells.

C.StreptococcalantigensbindtoIgEonthesurfaceofhearttissueandhistamineis
released.

D.Streptococciareingestedbyneutrophilsthatreleaseproteasesthatdamagehearttissue.

456.Yourpatientbecameill10daysagowithaviraldisease.Laboratoryexamination
revealsthatthepatient'santibodiesagainstthisvirushaveahighratioofIgMtoIgG.What
isyourconclusion?

A.Itisunlikelythatthepatienthasencounteredthisorganismpreviously.

B.ThepatientispredisposedtoIgEmediatedhypersensitivityreactions.

C.Theinformationgivenisirrelevanttopreviousantigenexposure.

D.Itislikelythatthepatienthasanautoimmunedisease.

457.IfyoumeasuretheabilityofcytotoxicTcellsfromanHLAB27persontokillvirusX
infectedtargetcells,whichoneofthefollowingstatementsisCORRECT?

A.AnyvirusXinfectedtargetcellwillbekilled.

B.OnlyvirusXinfectedcellsofHLAB27typewillbekilled.

C.AnyHLAB27cellwillbekilled.

D.NoHLAB27cellwillbekilled.


458.Youhaveapatientwhomakesautoantibodiesagainsthisownredbloodcells,leading
tohemolysis.WhichoneofthefollowingmechanismsisMOSTlikelytoexplainthe
hemolysis?

A.PerforinsfromcytotoxicTcellslysetheredcells.

B.Neutrophilsreleaseproteasesthatlysetheredcells.

C.Interleukin2bindstoitsreceptorontheredcells,whichresultsinlysisoftheredcells.

D.Complementisactivated,andmembraneattackcomplexeslysetheredcells.

459.YourpatientisachildwhohasnodetectableTorBcells.Thisimmunodeficiencyis
mostprobablytheresultofadefectin

A.thethymus.

B.thebursalequivalent.

C.TcellBcellinteraction.

D.stemcellsoriginatinginthebonemarrow.

460.Theroleofthemacrophageduringanantibodyresponseisto

A.makeantibody.

B.lysevirusinfectedtargetcells.

C.activatecytotoxicTcells.

D.processantigenandpresentit.

461.ThestructuralbasisofbloodgroupAandBantigenspecificityis

A.asingleterminalsugarresidue.

B.asingleterminalaminoacid.


C.multipledifferencesinthecarbohydrateportion.

D.multipledifferencesintheproteinportion.

462.Complementcanenhancephagocytosisbecauseofthepresenceonmacrophagesand
neutrophilsofreceptorsfor

A.factorD.

B.C3b.

C.C6.

D.properdin.

463.Themainadvantageofpassiveimmunizationoveractiveimmunizationisthat

A.itcanbeadministeredorally.

B.itprovidesantibodymorerapidly.

C.antibodypersistsforalongerperiod.

D.itcontainsprimarilyIgM.

464.OnJanuary15,apatientdevelopedanillnesssuggestiveofinfluenza,whichlasted1
week.OnFebruary20,shehadasimilarillness.Shehadnoinfluenzaimmunizationduring
thisperiod.HerhemagglutinationinhibitiontitertoinfluenzaAviruswas10onJanuary18,
40onJanuary30,and320onFebruary20.WhichoneofthefollowingistheMOST
appropriateinterpretation?

A.ThepatientwasillwithinfluenzaAonJanuary15.

B.ThepatientwasillwithinfluenzaAonFebruary20.

C.Thepatientwasnotinfectedwithinfluenzavirus.

D.Thepatienthasanautoimmunedisease.


465.AnindividualwhoisheterozygousforGmallotypescontainstwoallelicformsofIgGin
serum,butindividuallymphocytesproduceonlyoneofthetwoforms.Thisphenomenon,
knownas"allelicexclusion,"isconsistentwith

A.arearrangementofaheavychaingeneononlyonechromosomeinalymphocyte.

B.rearrangementsofheavychaingenesonbothchromosomesinalymphocyte.

C.arearrangementofalightchaingeneononlyonechromosomeinalymphocyte.

D.rearrangementsoflightchaingenesonbothchromosomesinalymphocyte.

466.EachofthefollowingstatementsconcerningclassIMHCproteinsiscorrectEXCEPT:

A.Theyarecellsurfaceproteinsonvirtuallyallcells.

B.TheyarerecognitionelementsforcytotoxicTcells.

C.Theyarecodominantlyexpressed.

D.TheyareimportantintheskintestresponsetoMycobacteriumtuberculosis.

467.WhichoneofthefollowingistheBESTmethodofreducingtheeffectofgraftversus
hostdiseaseinabonemarrowrecipient?

A.matchingthecomplementcomponentsofdonorandrecipient

B.administeringalphainterferon

C.removingmatureTcellsfromthegraft

D.removingpreBcellsfromthegraft

468.RegardingTh1andTh2cells,whichoneofthefollowingisLEASTaccurate?

A.Th1cellsproducegammainterferonandpromotecellmediatedimmunity.

B.Th2cellsproduceinterleukin4and5andpromoteantibodymediatedimmunity.


C.BothTh1andTh2cellshavebothCD3andCD4proteinsontheiroutercellmembrane.

D.BeforenaveThcellsdifferentiateintoTh1orTh2cells,theyaredoublepositivesi.e.,
theyproducebothgammainterferonandinterleukin4.

469.Eachofthefollowingstatementsconcerningthevariableregionsofheavychainsand
thevariableregionsoflightchainsinagivenantibodymoleculeiscorrectEXCEPT:

A.Theyhavethesameaminoacidsequence.

B.Theydefinethespecificityforantigen.

C.Theyareencodedondifferentchromosomes.

D.Theycontainthehypervariableregions.

470.EachofthefollowingstatementsconcerningclassIIMHCproteinsiscorrectEXCEPT:

A.TheyarefoundonthesurfaceofbothBandTcells.

B.Theyhaveahighdegreeofpolymorphism.

C.Theyareinvolvedinthepresentationofantigenbymacrophages.

D.TheyhaveabindingsiteforCD4proteins.

471.Whichoneofthefollowingstatementsconcerningimmunoglobulinallotypesis
CORRECT?

A.Allotypesarefoundonlyonheavychains.

B.AllotypesaredeterminedbyclassIMHCgenes.

C.Allotypesareconfinedtothevariableregions.

D.Allotypesareduetogeneticpolymorphismwithinaspecies.

472.EachofthefollowingstatementsconcerningimmunologictoleranceiscorrectEXCEPT:

A.Toleranceisnotantigenspecifici.e.,paralysisoftheimmunecellsresultsinafailureto
producearesponseagainstmanyantigens.

B.ToleranceismoreeasilyinducedinTcellsthaninBcells.

C.Toleranceismoreeasilyinducedinneonatesthaninadults.

D.Toleranceismoreeasilyinducedbysimplemoleculesthanbycomplexones.

473.EachofthefollowingstatementsconcerningahybridomacelliscorrectEXCEPT:

A.Thespleencellcomponentprovidestheabilitytoformantibody.

B.Themyelomacellcomponentprovidestheabilitytogrowindefinitely.

C.TheantibodyproducedbyahybridomacellisIgM,becauseheavychainswitchingdoes
notoccur.

D.Theantibodyproducedbyahybridomacellishomogeneousi.e.,itisdirectedagainsta
singleepitope.

474.EachofthefollowingstatementsconcerninghaptensiscorrectEXCEPT:

A.Ahaptencancombinewith(bindto)anantibody.

B.Ahaptencannotinduceanantibodybyitselfrather,itmustbeboundtoacarrier
proteintobeabletoinduceantibody.

C.Inbothpenicillininducedanaphylaxisandpoisonivy,theallergensarehaptens.

D.HaptensmustbeprocessedbyCD8+cellstobecomeimmunogenic.

Answers(Questions387474):

387.D

388.B

389.A

390.D

391.C

392.B

393.C

394.C

395.A

396.B

397.C

398.D

399.C

400.B

401.C

402.A

403.B

404.D

405.B

406.C

407.C

408.C

409.B

410.D

411.D

412.B

413.C

414.A


415.B

416.D

417.A

418.C

419.B

420.A

421.B

422.D

423.B

424.D

425.D

426.B

427.A

428.C

429.C

430.D

431.D

432.D

433.B

434.B

435.D

436.D

437.E

438.B

439.A

440.B

441.B

442.D

443.C

444.C

445.D

446.B

447.C

448.D

449.D

450.C

451.B

452.C

453.B

454.C

455.A

456.A

457.B

458.D

459.D

460.D

461.A

462.B

463.B

464.A

465.A

466.D

467.C


468.D

469.A

470.A

471.D

472.A

473.C

474.D

Directions(Questions475535):SelecttheONEletteredoptionthatisMOSTclosely
associatedwiththenumbereditems.Eachletteredoptionmayselectedonce,morethan
one,nornotatall.

Questions475480

A.Tcells

B.Bcells

C.Macrophages

D.Bcellsandmacrophages

E.Tcells,Bcells,andmacrophages

475.Majorsourceofinterleukin1

476.Actedonbyinterleukin1

477.Majorsourceofinterleukin2

478.ExpressclassIMHCmarkers

479.ExpressclassIIMHCmarkers

480.Expresssurfaceimmunoglobulin

Questions481484

A.Primaryantibodyresponse

B.Secondaryantibodyresponse

481.Appearsmorequicklyandpersistslonger

482.RelativelyricherinIgG

483.RelativelyricherinIgM

484.Typicallytakes710daysforantibodytoappear

Questions485488

A.BloodgroupA

B.BloodgroupO

C.BloodgroupsAandO

D.BloodgroupAB

485.PeoplewiththistypehavecirculatingantiAantibodies.

486.PeoplewiththistypehavecirculatingantiBantibodies.

487.Peoplewiththistypearecalled"universaldonors."

488.Peoplewiththistypearecalled"universalrecipients."

Questions489494

A.Variableregionoflightchain

B.variableregionofheavychain


C.Variableregionsoflightandheavychains

D.Constantregionofheavychain

E.Constantregionsoflightandheavychains

489.Determinesimmunoglobulinclass

490.Determinesallotypes

491.Determinesidiotypes

492.BindingofIgGtomacrophages

493.FixationofcomplementbyIgG

494.Antigenbindingsite

Questions495498

Thefollowingdoubleimmunodiffusionplatecontainsantibodypreparedagainstwhole
humanseruminthecenterwell.Identifythecontentsofeachperipheralwellfromthe
followinglist(eachwelltobeusedonce).Anexplanationoftheanswertothisquestionis
givenonp.24[dse3].

495.Wholehumanserum


496.HumanIgG

497.BaboonIgG

498.Humantransferrin

Questions499501

A.Immediatehypersensitivity

B.Cytotoxichypersensitivity

C.Immunecomplexhypersensitivity

D.Delayedhypersensitivity

499.IrregulardepositionofIgGalongglomerularbasementmembrane

500.Involvesmastcellsandbasophils

501.Mediatedbylymphokines

Questions502505

A.IgM

B.IgG

C.IgA

D.IgE

502.Crossestheplacenta

503.CancontainapolypeptidechainnotsynthesizedbyaBlymphocyte

504.Foundinthemilkoflactatingwomen

505.Bindsfirmlytomastcellsandtriggersanaphylaxis

Questions506509

A.Agglutination

B.Precipitintest

C.Immunofluorescence

D.Enzymeimmunoassay

506.ConcentrationofIgGinserum

507.SurfaceIgMoncellsinabonemarrowsmear

508.Growthhormoneinserum

509.TypeAbloodgroupantigenonerythrocytes

Questions510513

A.IgA

B.IgE

C.IgG

D.IgM

510.Presentinhighestconcentrationinserum

511.Presentinhighestconcentrationinsecretions

512.Presentinlowestconcentrationinserum

513.Contains10heavyand10lightchains

Questions514517


Inthisdoublediffusion(Ouchterlony)assay,thecenterwellcontainsantibodyagainstwhole
humanserum.Theperipheral(numbered)wellscontainoneofthefollowingproteins[dse4]
:

A.Humanserumalbuminatlowconcentration

B.Humanserumalbuminathighconcentration

C.Humanserumtransferrin

D.Sheepserumalbumin

514.WhichproteinispresentinwellNo.1?

515.WhichproteinispresentinwellNo.2?

516.WhichproteinispresentinwellNo.3?

517.WhichproteinispresentinwellNo.4?

Anexplanationoftheanswertothisquestionisgivenonp.24.

Questions518521

A.ClassIMHCproteins

B.ClassIIMHCproteins

518.InvolvedinthepresentationofantigentoCD4positivecells

519.InvolvedinthepresentationofantigentoCD8positivecells

520.InvolvedinantibodyresponsestoTdependentantigens

521.InvolvedintargetcellrecognitionbycytotoxicTcells

Questions522525

A.FabfragmentofIgG

B.FcfragmentofIgG

522.Containsanantigencombiningsite

523.Containshypervariableregions

524.Containsacomplementbindingsite

525.Iscrystallizable

Questions522525

A.Severecombinedimmunodeficiencydisease(SCID)

B.Xlinkedhypogammaglobulinemia

C.Thymicaplasia

D.Chronicgranulomatousdisease

E.Hereditaryangioedema

526.Causedbyadefectintheabilityofneutrophilstokillmicroorganisms

527.CausedbyadevelopmentdefectthatresultsinaprofoundlossofTcells


528.CausedbyadeficiencyinaninhibitoroftheC1componentofcomplement

529.CausedbyamarkeddeficiencyofBcells

530.CausedbyavirtualabsenceofbothBandTcells

Questions531535

A.Systemiclupuserythematosus

B.Rheumatoidarthritis

C.Rheumaticfever

D.Graves'disease

E.Myastheniagravis

531.Associatedwithantibodytothethyroidstimulatinghormone(TSH)receptor

532.AssociatedwithantibodytoIgG

533.Associatedwithantibodytotheacetylcholinereceptor

534.AssociatedwithantibodytoDNA

535.Associatedwithantibodytostreptococci

Answers(Questions475535):

475.C

476.A

477.A

478.E

479.D

480.B

481.B

482.B

483.A

484.A

485.B

486.C

487.B

488.D

489.D

490.E

491.C

492.D

493.D

494.C

495.D

496.C

497.A

498.B

499.C

500.A

501.D

502.B

503.C

504.C

505.D

506.D


507.C

508.D

509.A

510.C

511.A

512.B

513.D

514.B

515.A

516.D

517.C

518.B

519.A

520.B

521.A

522.A

523.A

524.B

525.B

526.D

527.C

528.E

529.B

530.A

531.D

532.B

533.E

534.A

535.C

ExplanationofQuestion429:SpleencellsfromtheadultdonorAwillrecognizetheB
antigenontherecipient'scellasforeign.Spleencellsfromtheadultdonorwillcontain
matureCD4andCD8cellsthatwillattacktherecipientcells,causingagraftversushost
reactiontherefore,answerCiscorrect.BecausetherecipientistoleranttoantigenA,the
donorAspleencellswillnotbedestroyedtherefore,answerAisincorrect.AnswerBis
incorrectbecause,althoughthedonorcellswillsurvive,theywillhaveaneffectonthe
recipient.AnswerDisincorrectbecausetherecipientisalreadytoleranttoantigenA.

ExplanationofQuestion430:BecausethedonorABspleencellswillnotseeanyforeign
antigenintherecipient,nograftversushostreactionwilloccurtherefore,answerCis
incorrect.Theimmunecellsofthenewbornmousedonothavethecapabilitytokillthe
donorcellstherefore,answerAisincorrect.AnswerDismorecorrectthananswerB
becausethedonorcellswillsurviveandinducetolerancetoantigenAinthenewborn
recipient.

ExplanationofQuestion446:ThereisalineofidentitybetweensampleAandbovine
albumin,therefore,sampleAisbovinealbumin.ThereisalineofidentitybetweensampleB
andhorsealbumin,therefore,sampleBishorsealbumin.Theanswertothequestionis,
therefore,B.NotethatthereisaspurformedbetweenthewellscontainingsampleAand
horsealbuminandbetweenthewellscontainingsampleBandbovinealbumin.Thespur
indicatespartialidentitybetweenthetwoproteins.Partialidentitymeansthatthereare
epitopessharedbetweenthetwoalbuminsbutthat,becausetheyarefromdifferent
species,thereareepitopesuniquetoeachprotein,also.Aspurisformedbytheinteraction
ofthesubsetofantibodiesintheantibovineserumwiththeuniqueepitopesinbovine
albumin.Theotherlinesareformedbytheinteractionofthesubsetofantibodiesinthe
antibovineserumwiththeepitopessharedbythetwoalbumins.

ExplanationofQuestions495498:Thecenterwellcontainsantibodyagainstwholehuman
serumtherefore,wellDmustcontainwholehumanserumbecausetherearemultiplelines
representingsomeofthemanyproteinsinwholehumanserum.Thereisalineofidentity
betweenwellCandaproteininwholehumanserumandalineofpartialidentitywiththat
sameproteinandwellA.ThisindicatesthatwellCcontainshumanIgGandwellAcontains
baboonIgG.Theconceptofpartialidentityisexplainedaboveinthediscussionofquestion
446.ThereisalineofnonidentitybetweenwellsBandCtherefore,wellBcontainshuman
transferrin,aproteinimmunologicallydistinctfromhumanIgG.


ExplanationofQuestions514517:Thereisalineofidentitybetweenwells1and2
therefore,theycontainhumanserumalbumin(HAS).Notethatthelineof
immunoprecipitateisveryclosetowell2.Thislinewouldnotformifwell2containedthe
highconcentrationofHASbecauseitwouldbeazoneofantigenexcess,andthelineonly
formsinazoneofequivalence.Therefore,well2containsthelowconcentrationandwell1
containsthehighconcentrationofHAS.Thereisalineofpartialidentitybetweenwell2and
3,therefore,well3containssheepserumalbumin(SSA).Thereisalineofnonidentity
betweenwells1and4andwells3and4,therefore,well4containshumantransferrinwhich
isimmunologicallydistinctfromHASandSSA.