Here you can find a collection of the most important MCQs (past years not suggested) and it's

highly recommended to study them :)

1) Which of those can stimulate apoptosis? a) TNF b) ICAM c) CD 40 b) LFA e) CD 154

2) Which of these is not a cause of secondary immune deficiency? a) Genetic disorders b) HIV infections c) B cell malignancy d) drugs e) diabetes

3) The most common deficient antibody in CVID: a) IgG b) IgA c) IgM d) IgD e) IgE

4) Which cell produces IL-12? a) Macrophages b) T cell c) NK cell d) Eosinophils e) hepatocytes

5) ALL of these drugs are immunosuppressive except: a) Imiquimod b) corticosteroids c) tacrolimus d) basiliximab e) azathioprine

6) MHC restriction means: a) T cells recognize peptides that are bound to self MHC molecules b) T cells recognize peptides that are bound to non self MHC molecules c) B cells recognize peptides that are bound to self MHC molecules d) B cells recognize peptides that are bound to non self MHC molecules e) none of the above

7) Tetanus toxoid vaccine: a) Artificial active immunity b) Artificil passive immunity

c) aquired active immunity

8) Which of the following tumor antigens is a developmental protein? a) Carcinoembryonic antigen b) Bcr-Abl fusion protein c) melanoma d) EBV protiens e) none of the above

9) Cyclosporin blocks: a) Calcineurin b) immunophilins c) ZAP-70 d) Btk e) non of the above

10) Anti-horse serum antibodies cause: a) Serum sickness b) SCID c) recurrency of infections d) septic shock

11) Aspirin inhibits: a) Prostaglandin (cyclooxygenase pathway) b) Thromboxane (cyclooxygenase pathway)

c) leukotrienes (lipoxygenase pathway) d) PAF (lipoxygenase pathway) e) all of the above

12) First test to check in transplantation: a) ABO Compatibility b) HLA cross-matching c) HLA typing d) none of the above

13) Which part of the HIV binds both CD4 & chemokine receptor? a) gp120 b) gp 41 c) RNA genome d) reverse transcriptase e) a and b

14) In which stage of T cell development commitment to gamma delta lineage occurs: a) Double negative stage b) Double positive stage c) single positive stage d) T cell progenitor e) mature naive T cell

15) Best stem cells source: a) Cord blood b) bone marrow c) peripheral blood stem cells d) immature lymphocytes e) none of the above

16) Mismatch: a) Human Herpes Virus 8 >> lymphoma b) Helicobacter pylori >> gastric lymphoma c) EBV >> Burkitt's lymphoma d) Human Herpes Viris 8 >> kaposi's sarcoma

17) Severest stage of T-cell depletion is associated with infection with: a) M. avium b) reactivation of herpes infections c) tuberculosis d) pneumocystis e) HHV8 / kaposi's sarcoma

18) Disadvantage of using mouse monoclonal antibody: a) Production of human anti-mouse antibodies b) Production of low-affinity antibodies c) antibodies produced are of low amounts

d) a and b e) a and c

19) HER-2: a) Breast Cancer b) Burkitt's lymphoma c) kaposi's sarcoma d) gasrtic ulcers

20) Low IgG and IgA, high IgM [Hyper-IgM syndrome]: a) CD40 ligand mutation b) CD154 c) ICAM1 d) LFA e)a and b

21) Reduce risk of human anti-mouse antibodies production: a) Use of chimeric and humanized antibodies b) by adding PEG molecule c) by combining the specificities of two different antibodies d) none of the above

22) Oligoclonal bands in CSF electrophoresis that are not present in serum electrophoresis is a strong finding of: a) Multiple sclerosis

b) Rheumatoid arthritis c) HIV infection d) SLE

23) ALL (Acute Lymphoblastic leukemia): a) Pre B cells b) plasma cells c) T cells d) mature B cells

24) Complement deficiency that results in repeat infection caused by Neisseria: a) C5-C9 b) C3-C6 c) C1 inhibitor d) C3a

25) Not involved in the respiratory burst: a) Phospholipase C b) NAPDH c) nitric oxide d) hydrogen peroxide e) hypochlorus acid

26) Which association is false?

a)TH2 cell >> IL-4 b) Mast cell >> IL-10 c) TH1 cell >> IL-INF-gamma d) TH2 cell >> IL-5

27) MHC down-regulation activates: a) NK cells b) Macrophages c) CTL d) dendritic cells e) eosinophils

28) Case: eczema, low platelets, infection, and malignancy: a) Wiskott-Aldrich syndrome b) SLE c) IDDM d) angioedema e) contact dermatitis

29) Used for detecting antibodies against donor HLA: a) HLA cross matching b) HLA typing c) ABO compatibility d) recombinant technology

30) Which virus infection is associated with Burkitt's lymphoma? a) EBV b) HHV8 c) Helicobacter pylori d) a and b

31) The most difficult transplantation procedure and requires the best HLA matching: a) Bone marrow transplantation b) stem cell transplantation c) solid organ transplantation d) corneal transplantation

32) Person had a rare pan-T-cell deficiency. In the FACS machine, which cell marker will be the least in number? a) CD3 b) CD28 c) CD40 d) CD154

33) How can we increase the cytokines' half-life in the body? a) Adding PEG molecule to IFN- alpha b) Adding PEG molecule to IL-2 c) using combination of cutokines

d) all of the above

34) The gene that is related to cancer: a) Oncogene b) antigene c) pathogen d) a and c

35) Cyclosporin and Tacrolimus are part of which class of drugs: a) T cell signaling blockade b) corticosteroids c) Interleukin-2 blockade d) antiproliferatives

36) ALL are true about TCR EXCEPT: a) Undergoes somatic hyper-mutation to get better-fit receptors b) Undergoes gene rearrangement in the thymus c) Junctional diversity created by imprecise joining and addition of nucleotides by TdT enzyme d) Undergoes random combination of chains

37) If we were to produce a drug that blocks Ag expression on MHC I, this drug should interfere with: a) TAP molecules b) PEG molecules c) ZAP-70

d) Btk

38) ALL about IgG are true EXCEPT: a) the source of child immunity up to 2 years b) transported through an active process to placenta c) transported to the fetus in the last month of pregnancy d) bind to Fc receptors on the placenta Answer: Not sure! ALL these seem to be true!

39) In Di George syndrome, the most affected part of the lymph node is: a) Paracortex b) collagenous capsule c) cortex d) medulla e) germinal center

40) ALL of the following can help in production of memory cell EXCEPT: a) Binding of epitope of Class II MHC to B cell receptor. b) IL-2 production c) CD28 and B7 d) CD40 and CD40 L e) Cross linking of B-cells receptor with polymeric antigen.

41) Involved in the signaling of IL-2:

a) JAK5 + STAT1 + STAT3 b) JAK1 + STAT3 + STAT5 c) JAK3 + STAT 1 + STAT 5 d) JAK 3 + STAT3

42) Case: with cANCA , autoantibodies that react with protienase3 : a) Wegners' Granulomatosis b) Grave's disease c) SLE d) multiple sclerosis

43) Case: Pain in the hand and the wrist + ESR (high) + CRP (high) + Rheumatic factor; whats the antibody involved in the pathogenesis of the disease? a) IgM anti-IgG aAb b) IgG anti-IgM aAb c) IgG antibasement membrane d) antiprotienase 3 IgG

44) Transplantation between individuals of same species: a) Allogenic b) Autologus c) Syngeneic d) Xenotransplantation

45) Which of these causes Adult T cell lymphoma: a) HTLV-1 b) EBV c) heicobacter pylori d) tuberculosis

46) B cell activation needs: a) Ag and cytokines b) MHC and Ag c) MHC , Ag and cytokines d) MHC and cytokines

47) Clinically useful as anti-IL-2 receptor: a) Baciliximab b) tacrolimus c) cyclosporin d) mycophenolte motefil

48) Celiac disease is associated with: a) HLA-DQ2 b) HLA-DR2 c) HLA- B27 d) none of the above

49) Isn't associated with T cell signaling:

a) TdT b) PLC c) DAG d) IP3 e) Lck

50) In which disease the serum contains anti-endomysial IgA: a) Celiac disease b) IDDM c) contact dermatitis d) Hay fever

51) IgG can be expressed on the surface of a B-cell only when: a) Surface IgM is selected and the genes is switched to the gamma genes b) Gamma chain gene is selected following isotype switching and the development of memory cells. c) A naive cell is exposed to an antigen for the first time. d) Clonally selected B cell that recognize non peptide antigen. e) The question is wrong: one B-cell express only one heavy chain isotype.

52) Which one takes the longest time to develop after exposure to the antigen? a) Contact dermatitis b) Hay fever c) poststreptococcal glomerulonephritis

d) drug-induced hemolysis

53) TLR: a) Used in recognition of G-ve bacteria b) found on APCs c) different TLRs have overlapping rules d) initiate an intracellular signal leading to cytokine production e) all of the above

54) Case: 10-year-old child, lung & skin infection, staph. aureus with normal PMN count: a) complement deficiency b) low Igs with absent B cells c) low Igs with normal B cells d) abnormal NBT test

55) A defect in the hypochlorus acid will affect: a) The acidity of the lysosomes b) T cell signaling c) B cell signalingb d) inflammatory processes

56) Case: an immunologist developed a dye to detect a protein present on developing T cells; which of the following will glow the most: a) Thymus

b) bone marrow c) lymph nodes d) none of the above

61) When we do a cross match between donor's RBCs and recipient's serum we do: Indirect Coomb's test (IAT)

58) In MS, we have CD4+ involvement; which one is expected: a) IL-2, IL-4, IF-gamma b) TGF-B c) IFN-gamma, IL-2 d) IL-4, IL-5 e) IL-10

59) RAG-1 and RAG-2 are down-regulated in some stages of B-cell development, so that each B cell will only have one specificity. The underlying mechanism is: a) somatic hypermutation b) class switching c) affinity maturation d) allelic exclusion

60) In which of the following actin is affected:

a) Wiskott-Aldrich syndrome b) Di-George syndrome c) chronic granulomatous disease d) IDDM

61) MHC class I and II share this characteristic: a) Constitutively expressed by B-cells b) Constitutively expressed by T-cells C) Constitutively expressed by macrophages d) Constitutively expressed by NK cells

62) C4: a) cleaves C5 b) can be activated by the MBL c) C4a is the most potent anaphylatoxin d) C1q can only activate C4

63) Which of these is used in active treatment of cancer? a) BCG vaccine b) radiation c) chemotherapy d) anti-CD20 antibodies

64) ALL of the following can happen when thymus independent antigen cross

link B cell receptor EXCEPT: a) It is the major principle of vaccine development b) Antigen processing and presentation will not take place c) Low affinity Abs are produced d) Only IgM antibodies are produced e) Signaling through the B cell receptor can pass through Answer: Not sure about it! Most probably the answer is a

65) M. tuberculosis is best eliminated by a) TNF alpha b) IL-4 c) IL-5 d) IL-8

66) Tumor correct except a) tyrosinase melanoma b) CEA & GI cancer c) Viral EBV Lymphoma d) BCR-Abl fusion protein multiple myeloma e) Alpha- feto protein hepatoma

67) The most common primary immuno deficiency a) X- linked agammagloblolinemia b) Selective deficiency IgG subclass c) IgA deficiency

d) Transient hypogammagloblulinemia

68) all participate in PTK cascade, except a) Terminal TdT b) Ca+2 c) Phospholipase C gamma d) DAG e) Protein kinase C1

69) function similar to stem cell factor (SCF) a) Il-1 b) Il-7 c) Il-4 d) Il-2 e) Il-5

70) doesn't fix complement a) IgG2 b) IgG3 c) IgG4 d) IgG1

71) suppressor Th2 a) INF gamma b) TNF

c) IL-1 d) IL-3 e) IL-5

72) HIV virus infects which cell? a) NK b) CD-8 c) B cell d) Glial cell e) Basophile

73)diagnostic of IgA pepsin , except a) (VH, CH1) X 2 b) (VH, CH1, VL, CL) X 2?? c) (VH, CH1, CH2, CH3) X 2 d) (VL, CL) X 2

74) Factor B a) Is the enzymatic part of the C3 convertase in the alternative pathway b) Only component of complement pathway that circulate active enzyme c) Bind covalently to pathogen through thioster bond d) Has no potential enzymatic activity e) Cleavage factor D

75) Cytokine important in control dissemination of M. leprosy

a) TNF-alpha b) IL-4 c) IL 8 d) Th2 cytokines e) IL-5

76) mostly affected by INF type I (INF alpha and beta) a) Aspergellus b) Plasmodium c) Listeria bacteria d) Staphylococcus bacteria e) Influenza virus

77) immune system evasion except a) direct killing immuno competent cell b) MHC I inhibition c) Point mutation d) HLA-G Product e) Viral product inhibitory cytokines

78) The enzyme needed in liberation of HIV from infected cell a) Gp120 b) Protease c) Reverse transcriptase d) Integrase

e) Collagenase

79) Blood group receptor for plasmodium vivax protozoa a) P system b) Lewis-secretor c) MNS system d) Kidd e) Duffy Fya- Fyb

80) Active immunity cancer except a) Vaccination by tumor antigen b) BCG local injections c) Anti-CD20 infusion d) Vaccination by whole cell e) IL-2 infusion

81) serum sickness except a) C-factor b) Monovalent antigen c) Persistence immune complex d) Nutrophils e) Equivalence of antigen and antibody

82) viruses and malignancy except a) Human papilloma virus- cervical cancer

b) EBV lymphoma c) Human herpes virus 8 and lymphoma d) HTLV-1 acute T lymph-leukemia e) EBV nasopharyngeal

83) CD 4 molecules a) .Tyrosine kinase b) Cannot be expressed on surface of cytotoxic T cell c) Include cytoplasmic domain that has tyrosine kinase activity d) Can interact with MHC I on the B cell if CD 4 molecules is expressed on surface of cytotoxic T cell

84) elimination of bacteria by opsonization a) neutralization of bacterial toxin b) recognition of bacteria bound antibodies by Fc receptor on macrophage c) prevention of bacteria adhesion to endothelial cell d) binding antibodies Fc on bacteria e) class 1 MHC antigen

85) used by HIV for cell penetration beside CD4 a) CR2 b) Chemokine receptor c) Fc d) CD3 e) MHC I

86) factor other than CD4 T cell count vest to give prognosis of HIV infected patient a) CD8 T cell b) Anti HIV IgM level c) IgG level d) PPD skin test e) Viral protein count

87) Successful active immunotherapy by general immune system active locally except a) IL-2 in cancer b) Lymphokine activated killer cell for hypernephroma c) Cancer vaccine for lung cancer d) BCG for urinary bladder cancer e) Anti CD20 for B cell lymphoma

88) Difference between primary and secondary immune response except a) antig- C needed < primary response b) binding affinities much lower than primary response c) Lag phase is higher than primary response d) Concentration of IgG is much higher than primary e) Concentration of IgM is the same as in primary

89) recombination signal sequence best describes a) sequence that contain ITAM- signaling B cell

b) sequence recognized by RAG1 RAG2 c) sequence responsible for type switching in B cell d) sequence encodes signal peptide responsible Ig e) sequence RNA splicing event IgM/IgD

90) best bronchial asthma allergic rhinitis as allergic a) food allergy b) atopic dermatitis c) drug allergy d) urticaria e) Conjunctivitis

91) NADPH oxidase lack which of the macrophages bactericidal mechanism a) H2O2 b) Acidification c) Defensin d) Lactoferrin

92) MHC I and MHC II a) Constituvely expressed by most cells in the b) expressed by Macrophage and dentritic cell c) Constituvely associated hapten d) Expressed INF gamma

93) Injecting Complement C killing antigen-Ab in patient lacks C3 a) Depress level of serum factor B b) Increased chemotactic C5a serum level c) Increased serum level of C8 d) Decreased level of C2

94) Trophoblast . Immunological phenomenon except a) antibody against paternal antigens b) Increased HLA- G antigens c) Decreased MHC I d) Blocking antibody e) Increased CD8- T recognition

95) All induces memory except a) IL-2 b) CD28 and B7 c) .on class II MHC to B cell d) CD40 / CD40L e) Crosslinking of B cell with polymeric antigen

96) Signal transduction of B cell involves all except a) Zeta b) Ig alpha c) Ig beta

d) Syk e) Tyrosine kinase

97) Which one is false? a) Mast cell : IL 12 b) TH2 : IL6 c) TH1 : INF gamma d) Eosinophil : IL 5

98) Anaphylacoid non IgE mediated a) Bee sting allergy b) Penicillin allergy c) Radio contrast allergy d) Food allergy e) House dust mite allergy

99) CD 19 marker is found on all of these except a) Hematopietic stem cell b) Mature B cell c) Pro B cell d) Pre B cell e) Immature B cell

100) C4, which one is true a) C4 binds and cleaves C5

b) C4 cleaves C2 c) C4a fragment anaphylatoxin d) C4 binds only C1q e) Deletion of C4 allele is associated with SLE

101) Which one has J chain? a) IgD, IgA2 b) IgG2, IgE c) IgE, IgM d) IgG3, IgA1 e) IgA1, IgM

102) Not found on mature resting T cell a) CD5 b) MHC II c) MHC I d) CD2 e) CD3

103) HLA-B35 and HLA-A2 refer to a) 2 alleles found on 1 locus b) 2 alleles found on 2 loci on chromosome 6 c) one allele found on one locus d) one allele found on two loci

104) Regarding pregnancy, which is wrong? a) Androgen suppress T/B cells b) Estrogen suppress T cells c) Placenta TH1 suppress T cell d) NK cell suppressed by increased HLA-G

105) A 10 years old boy has recurrent skin and lung infections by staphylococcus aureus, what can be found at his diagnosis a) Low IgM, absence of B cell b) Low Ig low B cell c) Low terminal complement d) Abnormal NBT test

106) Which type of Ab is involved in SLE with recurrent mid trimester abortion and DVT and abnormal PTT test a) Anti Sm antibodies b) Anti Ds DNA antibodies c) Anti nuclear Ab d) Anti phospholipid Ab e) Rheumatic Ab

107) Recognition receptor functions as secreted receptor a) Mannan binding lectin b) CD 14

c) Toll like receptor

108) Activation of mature B cell requires two signals a) An antigen and T cell help b) TCR occupancy and T cell help c) Antigen and cytokines??? d) TCR occupancy and cytokines

109) The BM transplantation is the most difficult .. a) Hyperacute b) Acute rejections c) GVHD d) Tolerance

110) Macrophages secretes all except a) IL- 6 b) IL-8 c) INF gamma d) TNF alpha e) IL-7

111) Remission state in pregnancy happens in, except a) SLE

b) Type I diabetes c) Contact dermatitis d) Arteritis

112) Causes tolerance rather the immunity a) Insoluble antigen b) Heterologous antigen c) Particulate antigen d) Antigen injected subcutaneously e) Injecting antigen to fetus in development

113) Autoimmune disease a) Shows HLA association b) Run a steady clinical course c) Affect both sexes equally d) are triggered by different antigen in different individuals

114) Candidate Immuno suppression by malnutrition of a) Thyroxin b) Insulin c) Leptin d) Glucagon

115) Not used as an evading mechanism by viruses

a) Mutation b) Production of cytotoxic Abs c) Downregulatin of MHC class I molecules d) Destroying the immune system

116) Regarding HIV vaccine candidates which one is wrong? a) Mucous and gp120 b) IM gp120 c) Recombinational vaccine was tried d) IM peptide e) DNA vaccine is practical

117) Complement activation a) Activate hapten b) Active C1q binds antigen-antibody complex c) C3 convertase C4bc2b d) C3 convertase C3bBb e) Regulate factor H

118) Which one in the HIV genome is associated with Low Virulence? a) NEF gene b) POL gene c) GAG gene d) ENV gene

119) M. tuberculosis is best eliminated by a) TNF alpha b) IL-4 c) IL-5 d) IL-8

120) all participate in PTK cascade, except a) Terminal TdT b) Ca+2 c) Phospholipase C gamma d) DAG e) Protein kinase C1

121) diagnostic of IgA pepsin , except a) (VH, CH1) X 2 b) (VH, CH1, VL, CL) X 2 c) (VH, CH1, CH2, CH3) X 2 d) (VL, CL) X 2

122) mostly affected by INF type I (INF alpha and beta) a) Aspergellus b) Plasmodium c) Listeria bacteria d) Staphylococcus bacteria e) Influenza virus

123) immune system evasion except a) direct killing immuno competent cell b) MHC I inhibition c) Point mutation d) HLA-G Product e) Viral product inhibitory cytokines

124) The enzyme needed in liberation of HIV from infected cell a) Gp120 b) Protease c) Reverse transcriptase d) Integrase e) Collagenase

125) Blood group receptor for plasmodium vivax protozoa a) P system b) Lewis-secretor c) MNS system d) Kidd e) Duffy Fya- Fyb

126) Active immunity cancer except a) Vaccination by tumor antigen b) BCG local injections

c) Anti-CD20 infusion d) Vaccination by whole cell e) IL-2 infusion

127)ABOUT serum sickness what is wrong: a) C-factor b) Monovalent antigen c) Persistence immune complex d) Nutrophils e) Equivalence of antigen and antibody

128) viruses and malignancy except a) Human papilloma virus- cervical cancer b) EBV lymphoma c) Human herpes virus 8 and lymphoma d) HTLV-1 acute T lymph-leukemia

129) factor other than CD4 T cell count vest to give prognosis of HIV infected patient a) CD8 T cell b) Anti HIV IgM level c) IgG level d) PPD skin test e) Viral protein count

130) Successful active immunotherapy by general immune system active locally except a) IL-2 in cancer b) Lymphokine activated killer cell for hypernephroma c) Cancer vaccine for lung cancer d) BCG for urinary bladder cancer e) Anti CD20 for B cell lymphoma

131) Injecting Complement C killing antigen-Ab in patient lacks C3 a) Depress level of serum factor B b) Increased chemotactic C5a serum level c) Increased serum level of C8 d) Decreased level of C2

132) Anaphylacoid non IgE mediated a) Bee sting allergy b) Penicillin allergy c) Radio contrast allergy d) Food allergy e) House dust mite allergy

133) Regarding pregnancy, which is wrong? a) Androgen suppress T/B cells b) Estrogen suppress T cells c) Placenta TH1 suppress T cell

d) NK cell suppressed by increased HLA-G

134) Which type of Ab is involved in SLE with recurrent mid trimester abortion and DVT and abnormal PTT test a) Anti Sm antibodies b) Anti Ds DNA antibodies c) Anti nuclear Ab d) Anti phospholipid Ab

135) Recognition receptor functions as secreted receptor a) Mannan binding lectin b) CD 14 c) Toll like receptor

136) Remission state in pregnancy happens in, except a) SLE b) Type I diabetes c) Contact dermatitis d) Arteritis 137) Causes tolerance rather the immunity a) Insoluble antigen b) Heterologous antigen c) Particulate antigen d) Antigen injected subcutaneously e) Injecting antigen to fetus in development

138) Autoimmune disease a) Shows HLA association b) Run a steady clinical course c) Affect both sexes equally d) are triggered by different antigen in different individuals

139) Candidate Immuno suppression by malnutrition of a) Thyroxin b) Insulin c) Leptin d) Glucagon

140) Involved in stopping lymphocyte in HEV a) L-selectin b) LFA-1

141) Complement activation a) Activate hapten b) Active C1q binds antigen-antibody complex c) C3 convertase C4bc2b d) C3 convertase C3bBb e) Regulate factor H

142) Which isotype is primarily responsible for the tissue damage

associated with Type III Hypersentivity? a. IgA b. IgD c. IgE d. IgG e. IgM 143) A reaction to poison ivy is an example of which type of Hypersentivity? a. Type I b. Type II c. Type III d. Type IV e. Type V

144) Hemolytic disease of the newborn (Rh incompatibility) dose not occur when: a. An Rh positive mother conceives an Rh positive child. b. An Rh negative mother conceives an Rh negative child. c. An Rh positive mother conceives an Rh negative child. d. All of the above. e. None of the above.

145) Contact dermatitis generally occurs against substances that are too small to induce an immune response. How do these substances induce an immune response?

a. These substance form depots and are then slowly released into the blood. b. These low molecular weight substances react with liver enzymes and are difficult to eliminate. c. These substances bind to tissue and cells resulting in a larger total antigenic size which can then stimulate an immune response. d. The substance triggers the complement cascade and cause neutrophils to accumulate and the serve as antigen presenting cells. e. A and c.

146) Erythrocytes from a patient with hemolytic anemia show a positive indirect Coombs test. The patients plasma dose not produces observable direct agglutination of his own erythrocytes, at either body temperature or room temperature. Which of the following is most likely to be correct? a. Antierythrocyte antibodies are abundant in plasma but little antibody is bound to red cells. b. The antierythrocyte antibodies are IgG isotype. c. The patient is of blood type O. d. The antierythrocyte antibodies are incapable of complement activation of opsonization.

147)A 23yearold woman becomes dizzy and sweaty while dining at a seafood restaurant. She ultimately faints and is taken to the Emergency Room of a local hospital where epinephrine is administered. She responds

quickly, which of the following best describes the immunological mechanisms underlying her illness? a. Crosslinking of IgE antibodies on mast cells/basophils by seafood antigen. b. Formation of soluble immune complexes in plasma and activation of complement. c. Binding of seafood antigen to erythrocytes where they induce hemolysis by antibodies and complement. d. Release of inflammatory cytokines by seafoodantigenspecific T cells in the intestinal mucosa. e. Ingestion of bacterial endotoxin along with her seafood.

148) A patient is diagnosed with Brutons Agammaglobulinemia. Which aspect of immune-system histology would you except to be normal?

A. Concentration of surface-Ig positive lymphocyte in peripheral blood. B. Primary follicles in lymph nodes. C. Germinal centers in lymph nodes. D. Number of plasma cells in bone marrow. E. Cellularity of paracortical areas of lymph nodes

149) A professional handler of poisonous snakes is bitten by a cobra and receives anti-venom equine antiserum. Four days later he develops malaise, fever, chills, muscle andjoint pain, and proteinuria.

Laboratory tests reveal decreased concentration of Complement components C3 and C4. Which of the following is the most likely cause of his illness? A. A delayed Hypersentivity reaction (Type IV) to equine serum proteins. B. An immediate-hypersensitivity reaction (Type I) to snake venom components. C. Formation of immune complexes which contain human antibodies and equine serum proteins. D. Formation of immune complexes which contain equine antibodies and snake venom proteins. E. Direct lysis of patients erythrocytes by equine antibodies.

150)In the previous question, which of the following is most likely to have predisposed the patient to this illness? A. A genetic defect in complement system. B. A genetic defect in antibody production. C. A prior immune response to snake-venom proteins. D. A prior episode of immunization with equine antiserum.

151) Uninfected, normal, nucleated human cells are not attacked by Natural Killer (NK) cells of the immune system. What feature of their plasma membrane protectes cells form NK attack? A. Absence of class I MHC. B. Presence of class I MHC which lack bound peptides.

C. Presence of class I MHC/self peptide complexes. D. Absence of class II MHC. E. Presence of class II MHC which lacks bound peptides. F. Presence of classII MHC/self peptide complexes

152)Some human plasma cell malignancies produce antibodies which bind to antigens on human erythrocytes. In one such case erythrocytes coated with myeloma antibody were lysed by complement and myeloma antibody also facilitated phagocytosis of erythrocytes by neutrophils. Of what isotype was this myeloma antibody? A. IgA B. IgG C. IgM D. IgD E. IgE

153) During the primary phase of HIV infection, manifestation include: a. Opportunistic infection. b. Lymphoadenopahty. c. Encephalopathy. d. Wasting syndrome

154) The lag phase of the primary response is longer that n the secondary response because: a. The assays for detecting a primary response are not as sensitive. b. The primary response requires considerable cell proliferation and

differentiation to achieve a critical mass of cells to produce immunity. c. Of the lack of cytokines produced during the primary response. d. A & d. e. None of the above.

155) Complement damage may be directed against host tissues, as well as pathogens because: a. Long half-lives of the activated complement components. b. Very low concentrations of the inactivated complement components in serum. c. The inability to activate the system in the presence of IgG antibodies. d. Once activated, the destructive activities of complement are nonspecific. e. None of the above

156) Many pathogenic bacteria are killed outright by contact with normal cell-free human serum, even if the donor had never previously been exposed to the particular bacterium used in the experiment. In this situation, which component of serum is most likely to be responsible for killing bacteria? a. Complement. b. IgG antibodies. c. IgA antibodies. d. Acute-phase proteins. e. Interleukin-2 and -interferon.

f. Tumor necrosis factor. g. Chemokines

157) Many isolates of the bacterium Neisseria meningitides can produce mucosal infections but cannot survive in the bloodstream. Cells of such bacteria are killed by contact with cell-free plasma or serum, even from persons who have never previously been exposed to Neisseria. Which mechanism is most likely to be responsible for the killing? a. Activation of complement by the alternate pathway. b. Activation of complement by the classical pathway. c. Binding of IgG. d. Binding of IgM. e. Binding of IgA.

158) One of the indicator of systemic inflammatory response is the presence of acute phase proteins, produced by the liver. A good example of these would be: a. IgM b. C-reactive protein c. Serum-albumin. d. IL-4 e. None-of the above

159) A child has a history of recurrent infections with organisms having polysaccharide antigens (i.e., Streptococcus pneumoniae & Hemophilus influenzae). This susceptibility can be

explained by a deficiency of: a. C3 b. C5 c. IgG subclass 2 d. Myeloperoxidase in phagocytic cells e. Secretory IgA

160) A 28-year-old mother gives birth to her first child. The father is homozygous Rh D positive & the mother is homozygous Rh D negative. The baby is born without any complications,but the mother is not given RhoGAM (anti-Rh IgG) following the delivery. Eighteen months later she delivers another child, who is anemic, slightly jaundiced, & has an enlarged spleen & liver. Which type of hypersensitivity best describes this condition? a. Atopic disease b. Cytotoxic disease c. Delayed hypersensitivity d. Immediate hypersensitivity e. Immune complex disease

161) Five minutes after the initiation of an allergic skin reaction, you would expect to see which of the following at that site? 1. Complement fixation. 2. Plasma cells secreting IgE 3. Accumulation of eosinophils 4. Vasodilation 5. None-of the above

162) Your patient is a pregnant woman in the middle of her third trimester, & you have determined that her fetus shows serious consequence of Rh incompatibility. Which of the following treatments would be most beneficial? a. Parenatal transfusion of Rh+ RBCs b. Postnatal transfusion of RH+ RBCs c. Parental transfusion of Rh- RBCs d. Immediate administration of RhoGam e. None of the above is likely to be helpful.

163) CD4 T cell depletion is the hallmark of HIV disease, it occurs as a result of: a. CD4 cell apoptosis. b. Destruction of HIV infected CD4 T cells by HIV specific cytotoxic lymphocytes. c. Lysis of HIV infected CD4 T cell, as a direct result of intracellular HIV replication. d. The destruction of CD4+ T cell precursors. e. All of the above.

164) HIV causes: a. Hypogammaglobulinemia b. Thymic inflammation, involution & fibrosis c. B cell depletion d. Loss of memory B cells.

e. All of the above

165) Progressive tumor growth in cancer patients may be enhanced by: a. The presence of tumor specific serum "blocking" antibodies & antigen: antibody immune complexes. b. The infiltration of the tumor with activated natural killer cells. c. The activation of tumor-associated Th2 lymphocyte that produce IL-10 d. The activation of tumor-associated Th1 lymphocyte that produce IL-2 & IFN e. All of the above. f. A + C

166) Antibody dependent cellular cytotoxicity (ADCC): a. Is mediated by B-lymphocyte b. Is mediated by T-lymphocyte c. Is mediated by IgM antibodies & complement d. Is mediated by natural killer lymphocytes e. All or none of the above f. A + b

167) The initiation of a graft versus Host (GVH) disase: a. Requires a lack of responsiveness on the part of the recipient to the histocompatibilty antigens of the donor. b. Requires a graft of immunocompetent donor cells. c. May result from the infusion of blood or blood products that contain

viable lymphocytes into an immunologically incompetent or compromised recipient. d. Requires the activation of B-cells for pathology to be evident. e. All or none of the above. f. A + B + C

168)The rejection of an allograft can be slowed or prevented by: a. Careful matching of the MHC-class I histocompatibility antigens using antibodies to the cell surface molecules. b. By grafting to a privileged site. c. By treating the recipient with immunosuppressive drugs. d. By passive immunization of the recipient with antibodies against the MHC class II antigens of the donor e. All or none of the above. f. A + B but not C + D

169) In the generation of human cytolytic T-cells against allogeneic cellular tissue antigens (grafts), the vast majority of CD8+ cytotoxic T-cell receptors in the recipient recognize & bind: a. Endogenous cellular peptides presented by the major histocompatibility antigens of the allogeneic graft cells. b. The foreign HLA-D alloantigens of the cells of the graft. c. Antigen specific helper T-cell factors & cytokines of the recipient d. The foreign HLA-A, B & C molecules o the cells of the graft. e. All or none of the above

170)The graft versus host reaction is most easily induced: a. In immunocompetent adult animals b. With thymic epithelial cells. c. In immunodeficient recipients (adult or infant) d. With the help of an adjuvant e. When lymphocytes from a hybrid donor (a/b) are transfused into a parental recipient (a/a).

171) Rheumatoid arthritis is an example of: a. Type I hypersensitivity b. Type II hypersensitivity c. Type III hypersensitivity d. Type IV hypersensitivity e. Arthus reaction

Hussein Qasim