IMMUNOLOGY

IMMUNOLOGY d. Severe combined

immunodeficiency
Basics of Immune System

1. Adenosine deaminase deficiency is seen in the Server Combined Immunodeficiency

following
A. Common variable immunodeficiency - Includes syndromes with severe combined

B. Severe combined immunodeficiency deficiency of both humoral and cell mediated

C. Chronic granulomatous disease immunity, inherited in autosomal recessive

D. Nezelof syndrome mode.

- Defects are at the level of early precursors of
Ans:- B Severe combined immunodeficiency immunocompetent cells in the fetal liver and
Ref:- Ananthanarayan 7/e p 153 bone marrow
Explanation:- - Some important types include
 Swiss type agammaglobulinemia:
Immunodeficiency
Basic defect is at the level of lymphoid
- Primary immunodeficiency syndrome- stem cell
genetically determined  Reticular dysgenesis of Dewaal:
- Secondary immunodeficiency syndrome eg Defect is at the level of multipotent
AIDS hemopoietic stem cell, as a result of
which there is total failure of
Classification of important immunodeficiency
myelopoeisis leading to leucopenia,
syndrome
thrombocytopenia and
Name of syndrome Defect  Adenosine deaminase deficiency:
i.Humoral immunodeficiency (B Range of immunodeficiency varies
cell defects) from complete absence to mild
a. X linked -Mutation in abnromalities of B and T cell
agammaglobulinemia bruton tyrosine
functions.
b. Common variable kinase
immunodeficiency -Pre/pro B cell- B
cell 2. Which of the following statements is true about
c. Immunodeficiency Mutation in hapten?
with hyper IgM CD40 ligand A. It induces brisk immune response
gene B. It needs carrier to induce immune response
ii.Combined immunodeficiency C. It is a T-independent antigen
(T cell defect)
D. It has no association with MHC
a. Thymic hypoplasia (Di Failure of
George’s syndrome) development of Ans:- B It needs carrier to induce immune
3rd and 4th
response
pharyngeal
Ref:- Ananthanarayan 7/e p 80
pouch
Explanation:-
(hypoplasia of
thyroid ad Haptens
parathyroid
also) - Substances that are incapable of inducing
iii.Combined immunodeficiency antibody formation by themselves but can react
(B and T cell defect) specifically with antibodies
a. Cellular Abnormal T cell
- Haptens become immunogenic on combining
immunodeficiency maturation in
with a larger molecule or carrier
with abnormal : Ig thymus with
synthesis (Nezlof normal ↓ or ↑ Ig - They are of two types
syndrome)  Complex hapten: Precipitate with
b. Ataxia telengiectasia DNA repair specific antibody
defect  Simple hapten: Non precipitating
c. Wiskott-Aldrich WASP gene
syndrome mutation
3. IL-I produces
(secondary ↓ of
A. T-lymphocyte activation
T lymphocytes)
Variable defect B. Delayed wound healing
 IMMUNOLOGY
C. Increased pain perception BM cell
D. Decreased PMN release from bone marrow proliferation
IL-2 TH1 cells Growth and
Ans:- A T-lymphocyte activation differentiation
Ref:- Ananthanarayan 7/e p 144 and T and B cells;
Explanation:- cytotoxicity of T
and NK cells
IL-1 IL-3 T cells Stimulation of
hematopoietic
- Formerly called as the leucocyte activating progenitors
factor (LAF) and as the B-cell activating factor IL-4 TH2 cells Proliferation of B
(BAF) and cytotoxic T
- Stable polypeptide; secreted by macrophages cells; ↑ IgG1 and
and monocytes but can be produced by most IgE production; ↑
other nucleated cells also MHC class II and
IgE receptor
- Presence of antigens, toxins, injury and
IL-5 TH2 cells Proliferation of
inflammation, stimulates is production, while
eosinophil; ↑IgA
cyclosporis A, corticosteroids and and IgM
prostaglandins inhibits it. production
IL-6 TH1, Promote B cell
TNF/IL-1 macrophage differentiation,
s, IgA production,
Local effects
Acute phase
proteins
IL-7 Spleen, BM B and T cell
Vascular Leukocytes Fibroblasts stromal cells growth factor
endothelium
-Expression -Activation -
of leukocyte - Proliferation 4. Regarding NK cells, false statement is
-Adhesion Production -↑ collagen A. It is activated by IL-2
molecules of cytokines B. Expresses CD3 receptor
-Production cytokines C. It is a variant of large lymphocyte
of IL-1 D. There is antibody induced proliferation of NK
-↑
cells
Procoagulant
and ↓
Ans:- D There is antibody induced proliferation of
anticoagulant
NK cells
activity
↓ ↓ Ref:- Harrison 17/e p 2028
Inflammation Repair Explanation:-

NK cell activity is non-immune; MHC unrestricted;

non antibody mediated killer of target cells which
Systemic effects are usually malignant cells types; transplanted
Fever foreign cells or virus infected cells
Leukocytes
Acute-phase Thus NK cells play an important role in immune
proteins surveillance and destruction of malignant and
↓ Appetite virally infected host cells.
↑ Sleep
- NK cells accounts for 5-10% of peripheral
blood lymphocytes. They are non adherent,
non phagocytic cells with large azurophillic
Interleuki Main source Major function cytoplasmic granules.
ns - NK cells express surface receptors for the Fc
IL-1 (α+β) Macrophage Proliferation and portion of IgG (CD-16) and for CD-56. Many
differentiation of NK cells express CD8, where as some NK cells
TB cells; (Called as NK/T cells) express CD-3
pyrogenic; ↑acute
phase reactants;
 IMMUNOLOGY
- NK cells proliferate in response to IL-2. NK Ans:- C CD3
cells arise in both bone marrow and thymic Ref:- Ananthanarayan 7/e p 125
microenvironment Explanation:-
- Three molecules of NK cells NKp46; NK p30
Stimulus T cell B cell
and NKp44 are collectively reffered as natural
Anti CD-3 + -
cytotoxicity receptors (NCRs) and mediate NK Anti Ig - +
cell activation against target cells. PHA + -
(Phytohemagglutinin)
5. All of the following are glycoproteins except Concanavalin A + -
A. Blood antigen Endotoxins - +
B. Albumin S-aureus (cowan - +
strain)
C. Immunoglobulin
EB virus - +
D. HCG

Ans:- B Albumin Note + means proliferation occurs and

Ref:- Harper 25/e p 675 - means no proliferation
Explanation:-
8. NK cells kill the viral infected cells due to
Glycoprotein are proteins to which usually 2-10 A. Increased expression of MHC class I molecules
oligosaccharides are covalently attached e.g
B. Decreased expression of MHC class I molecules
-IG -Glycophorin C. Increased expression of MHC class II molecules
-Mucin -Blood group D. Decreased expression of MHC class II
-Lectin antigen molecules
-Globular proteins except -Selectin
albumin -Secreted Ans:- A Increased expression of MHC class I
-hCG, TSH enzymes and molecules
-HLA class I, II proteins Explanation:-
-Transferring, ceruloplasmin -Collagen
-Alkaline Target cell killing by NK cell is
phosphatase
-IFN β and γ - Inversely related to target cell expression of
MHC class I molecule.
6. Diagnosis of ABO incompatibility can be from all So, it kills the cell that expresses little or no
of the following except HLA class I molecule (provide
A. Sweat immunosurveillance) such as virus infected
B. Saliva cells, certain tumor cells and allogenic cells.
C. Semen - Non- immune, i.e. without previous
D. CSF sensitization, MHC unrestricted and non-
antibody mediated.
Ans:- D CSF - It kills host cell infected with intracellular
Ref:- Reddy 5/e p 378 bacteria eg Mycobacteria, TB, Listeria,
Explanation:- Monocytogens.

ABO group specific substances are found in high - Not kill cells which express class I MHC (all
concentration in saliva, semen, vaginal secretion normal nucleated cells express it)
and gastric juice and while in low concentration in
sweat, tears and urine, so it is possible to determine 9. Which is not a macrophage?
blood group from an examination of these A. Monocyte
secretions. B. Microglia
C. Kupffer cells
Thus, they are present in all tissues except CSF.
D. Lymphocytes
7. The type of receptors present on T cells are
A. IgG Ans:- D Lymphocytes
Ref:- Ananthanarayan 8/e p 131
B. IgD
Explanation:-
C. CD3
D. Prostaglandins
 IMMUNOLOGY
Macrophages For examination purpose, only professional
Activation into Differentiation into APC’s are considered as APC.
Activated macrophages Microglia (CNS) 11. A women with infertility receives an ovary
Epitheloid cells Kupffer (liver) cells transplant from her sister who is an identical
Giant cells (Fusion type) Alveolar macrophages
twin. What type of graft is it?
(lung)
A. Xenograft
Osteoclast (bone)
B. Autograft
Sinus histiocytes (spleen
and lymph node) C. Allograft
D. Isograft

10. All of these are antigens presenting cells except Ans:- D Isograft
A. T cells Ref:- Ananthanarayan 8/e p 178
B. B cells Explanation:-
C. Fibroblasts
Terminology of grafts
D. Dendritis cells
Donor Term Synonyms
E. Langerhans cells
Self Autograft Autogenous or
autogenic graft
Ans:- A and C
Different Isograft Isologous or
Ref:- Robbins 8/e p 192 individual, syngeneic graft
Explanation:- genetically or syngraft
identical with
Antigen presenting cells are
recipient
- Macrophages Identical twin
- B cells or member of
same inbred
- Dendritic cells (most potent)
strain
- Activated T cells
Genetically Allograft Allogeneic
unrelated graft. Formerly
Antigen presenting cell
member of called
- An antigen presenting cell (APC) can be same species homograft
Different Xenograft Xenogeneic.
defined as any cell that expresses MHC or
species Formerly
related molecule (eg CD1) that can bind
called
antigenic components such as peptide, and can heterograft
be recognized by one or another class of T-cell.
T-cell can not recognize and therefore can’t
Types of graft
react to free antigen. T cell can only see antigen
which has been processed or presented by - Orthotopic graft: Graft applied in anatomically
antigen presenting cells. Broadly on the basis of normal site, e.g. skin graft
MHC class II expression APC can be divided - Heterotopic graft: Graft applied in
into: anatomically abnormal site eg thyroid tissues
transplanted in subcutaneous pocket.
A. Professional APC’s: APC’s that express
MHC II molecules, they are very efficient 12. Neonatal thymectomy leads to
cells and include A. Decreased size of germinal center
- Macrophages – Dendritic cells B. Decreased size of paracortical areas
- Certain activated epithelial cells- Few B-cells C. Increased antibody marrow production by B
cells
B. Non professional APC: They do not D. Increased bone marrow production of
express MHC II molecule constituitively lymphocytes
but only upon stimulation by certain
cytokines. They include Ans:- B Decreased size of paracortical areas
- Fibroblast-Thymic epithelial cells-Thyroid Ref:- Ananthanarayan 7/e p 80
epithelial Cells Explanation:-
- Glial cells- pancreatic beta cells- vascular - Neonatal thymectomy leads to depletion of
endothelial cells thymus dependent areas.
 IMMUNOLOGY
- Peripheral lymphoid tissue is of two types  Interdigitating dendritic cells
 Follicular dendritic cells
Features Thymus Bone marrow - Interdigitating dendritic cells or just dendritic
dependent dependent
cells are the most important antigen presenting
(Contain T (contain B
cells for initiating primary immune response
lymphocytes) lymphocytes
Spleen Periarterial Perifollicular against protein angigens. This is due to
lymphoid region, following reasons.
collection Germinal  These cells are located at the right
known as center, mantle place to capture antigens, i.e. under
malpighian layer epithelia, in the intestitia of all tissue
corpuscles in
 They express variety of receptors (
white pulp
including TLR, mannose) for
Lymph node Paracortical Corticle follicles
areas between with germinal capturing microbes.
cortical follicles center  In response to microbes dendiritic
and medullary medullary cells express the same chemokine
cords. cords receptors as to naïve T cells
 They express high levels of MHC class
- B cells also found in tonsils, extralymphoid II molecules as well as co-stimulatory
organs such as GIT. molecules B.7-1 and B.7-2 or in other
words they possess all the machinery
13. Which of the following best denotes classical needed for presenting antigens to and

complement pathway activation in immune- activating CD4 + T cells

inflammatory condition?  On the other hand follicular dendritic

A. C2,C4 and C3 decreased cells (does not arise from bone

B. C2, and C4 normal, C3 is decreased marrow) are present in the germinal

C. C3 normal and C2 C4 decreased centres of lymphoid follicles where
D. C2, C4,C3 all are elevated they trap antigens bound to
antibodies or complement. Follicular
Ans:- A C2, C4, C3 decreased dendritic cells plays a role in ongoing
Ref:- Jawetz 25/e p 136 immune response by presenting
Explanation:- antigens to B-cells and selecting the B-
cells and have the highest affinity for
Complements are activated by 3 pathways
the antigen.
- Classic pathway
- Lectin pathway 15. IL-2 is produced by
- Alternate pathway A. T cells
B. B cells
14. Which of the following cell types are the most C. Monocytes
potent activator of T-cell? D. Neutrophils
A. Bell
B. Follicular dendritic Cells Ans:- A T cells
C. Mature dendritic cells Ref:- Ananthanarayan 7/e p 144
D. Macrophages Explanation:-

Already explained
Ans:- C Mature Dendritic cells
Ref:- Robins 8/e p 192 16. Helper cells belong to
Explanation:- A. T cells
B. Macrophages
Mature dendritic cells are the most potent activator
of native T cell C. B cells
D. Monocytes
Dendritic cells
Ans:- A T cells
- Bone marrow derived cells Ref:- Ananthanarayan 8/e p 130
- There are two types of cells with dendritic Explanation:-
morphology
 IMMUNOLOGY
Classification of T cells C. Macrophages
Type of cells Surface Target Functions D. T cells
marker cells
s Ans:- D T cells
Helper/ CD4 MHC Growth of T Ref:- Harrison 17/e p 2021,2031
Inducer cell class II cells and Explanation:-
(TH) restrictio macrophage
n s Components of the Adaptive Immune System
Suppressor T CD8 MHC Down
cell (Ts) class I regulate the Cellular Thymus derived T lymphocytes-T cell
immune precursors in the thymus; naïve
response mature T lymphocytes before antigen
exposure; memory T lymphocytes after
Cytotoxic/ CD8 MHC Kill and lyse
antigen contact; helper T lymphocytes
Cytolytic/kill class I target
for B and T cell responses; cytotoxic T
er T cell (Tc) carrying
lymphocytes that kill pathogen
foreign
infected target cells
antigen
Humoral Bone marrow derived B lymphocytes-
Memory cells CD4 MHC Provide
B cell precursors in bone marrow;
™ and class I memory
naïve B cells prior to antigen
CD8 and
recognition memory B cells after
anamnestic
antigen contact; plasma cells that
response
secrete specific antibody
Cytokines Soluble proteins that direct focus and
17. What enhances multiplication of T cells in regulate specific T versus B
culture? lymphocyte immune responses
A. Phytohemagglutinin
B. Chemotactic factor Major components of the Innate Immune System
C. Leukotrienes
D. Prostaglandins Pattern C type lectins, leucine-rich
recognition proteins, scavenger receptors,
Ans:- A Phytohemagglutinin receptors pentraxins, lipids transferases;
(PRR) integrins
Ref:- Ananthanarayan 7/e p 123
Antimicrobial A defensins, B defensins, cathelin
Explanation:-
peptides protegrin, granulsyin,histatin,
Blast transformation or proliferation stimuli are secretory leukoprotease inhibitor,
and probiotics
Stimulus T cell B cell Cells Macrophages dendritic cells, NK
Anti CD-3 + - cells, NK-T cells, neutrophils,
Anti Ig - + eosinophils, mast cells, basophils,
PHA + - and epithelial cells
(Phytohemagglutinin) Complement Classic and alternative
Concanavalin A + - components complement pathway, and
Endotoxins A - + proteins that bind complement
S-aureus (cowan - + components
strain) Cytokines Autocrine, paracrine, endocrine
EB virus - + cytokines that mediate host
defence and inflammation, as well
as recruit, direct, and regulate
Note: + means proliferation and – means no adaptive immune responses.
proliferation

19. Common between B and T cells

A. Origin form same cell lineage
B. Site differentiation
C. Antigenic marker
D. Both humoral and cellular immunity
18. All of the following are part of innate immunity
E. Further differentiation seen
except
A. Complement Ans:- A and E
B. NK cells Ref:- Ganong 22/e p 525
 IMMUNOLOGY
20. Apart from B cells, and T cells, there is a 3rd 22. IL-1 is produced by
distinct type of lymphocyte. This is A. Macrophage
A. MHC cell B. Helper T lymphocytes
B. Nk cell C. B cells
C. Macrophage D. Cytotoxic T cells
D. Neutrophil
E. Microglia Ans:- A Macrophage
Ref:- Ananthanarayan 7/e p 144
Ans:- B NK cell Explanation:-
Ref:- Harrison 17/e p 2024
Already Explained
Explanation:-
23. Which complement component is involved in
Lymphoid precursor
both classical and alternate pathway?
- Bone marrow B cell-CD8+ T-cell A. C1
- Thymus T cell –CD4 T-cell B. C2
- Null cells –K cells & Nk Cells-(LAK cells , C. C3
NK/T cells (NK cells which express CD-3) D. All
- Plasmacytoid dendritic cells
Ans:- C C3
Null cells: A smallproprotion (5%) of lymphocyte Ref:- Jawetz 25/e p 136
that lack phenotypic markers B or T lymphocytes Explanation:-

Killer cells cells: these are large lymphocytes Already explained

containing azurophilic granules in the cytoplasm.
24. Which of the following features is not shared
They are therefore cells known as large granular
between T cells and B cells?
lymphocytes (LgL)
A. Positive selection during development
NK/T cells: These are CD3+ve NKcells, that can B. Class I MHC expression
recognize lipid molecules of intracellular bacteria C. Antigen specific receptors
when presented in the context of CD-1 molecules D. All of the above
on APC.
Ans:- A positive selection during development
21. Perforins are produced by
Ref:- Internet
A. Cytotoxic T cells
Explanation:-
B. Suppressor T cells
C. Memory helper T cells Mechanism of central tolerance
D. Plasma cells
- B cell: The recognition of antigens by the
E. NK cells
immature B-cells in the bone marrow is critical

Ans:- A Cytotoxic T cells to the development of immunological tolerance

Ref:- Robbin’s 8/e p 208
Explanation:-
Mechanism of CD-8 + T-cell cytotoxicity
a. Perforin- granzyme dependent killing:
Cytotoxic lymphocytes (CTL) secrete a
complex consisting of perforin, granzymes and
a protein called serglycin, which enters the
target cells by endocytosis. In the cytoplasm of
target cell perforin facilitates the release of
granzymes from the complex. Granzymes in
turn cleaves and activates caspases, which
induce apoposis of the target cells.
b. Fas-Fas ligand dependent killing: Activated
CTL also express fas ligand which can bind to
fas ligand on target cells and trigger apoptosis.
to self. For proper immunological function it is
essential B cell do not recognize self antigen
and should recognize antigen derived from
pathogens .
- T cells tolerance.
T cells are selected for survival more rigorously
than B cells. They undergo both positive and
negative selection to produce T cells that
recognizes self MHC but do not recognizes self
peptides. T cell tolerance is induced in thymus.
- Positive selection
- Negative selection
25. First chemical barrier encountered by
microorganism for common exposed sites
A. Lysozyme
B. Acidic pH
 IMMUNOLOGY
C. Skin Ans: B
D. Lactose Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 91
Ans:- B Acidic PH Explanation
Ref:- Jawetz 25/e 124 • Smallest unit of antigenicity –
Explanation:- epitope/antigenic determined
• Paratope – combining area on the
Physiological barriers at the portal of entry antibody molecule corresponding to
the epitope
a. Skin: Skin provide the very efficient barrier • Hapten – substances that are incapable
against all sort of microbes, and only few of inducing antibody formation
bacteria can penetrate the skin. Sweat and themselves but can react specifically
sebaceous secretions by virtue of their acidic with antibodies.
pH and certain chemical substances (fatty • Idiotope – specific antigenic determinant
on paratope
acids) have antimicrobial including antifungal
properties.
b. Mucous membrane
29. A test that can be used for typing of
- In the respiratory tract a film of mucous covers
class I histocompatibility antigens is
the surface. Bacterial tend to stick to this film.
A. Cell mediated lympholysis (CML)
In addition t here are lysozyme, and other B. Donor–recipient mixed lymphocyte
antimicrobial substance. response
- Saliva contains many enzyme C. Primed lymphocyte typing
- Gastric acidity kills almost all bacteria, D. Antibody and complement
mediated cytotoxicity
ingested.
Ans: D
Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 134
26. Which of the following does NOT
present antigens? 30. Tuberculin test screens for
A. NK cells (Natural killer cells) A. Humoral immunity
B. Dendritic cells B. Cell mediated immunity
C. Langerhans’ cells C. Complement function
D. Macrophages D. Phagocyte dysfunction
Ans: A
Ref: Ananthanarayan and Panicker’s Ans: B
Textbook of Microbiology, 8/E, p. 134 Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 168

27. Alternative pathway of complement

activation begins with
31. Same or closely related antigens present
A. C1
in different biological species are
B. C2
known as
C. C3
A. Sequestrated antigens
D. C4
B. Isoantigens
Ans: C C. Haptens
Ref: Ananthanarayan and Panicker’s D. Heterophile antigens
Textbook of Microbiology, 8/E, p. 119 Ans: D. Heterophile antigens
Explanation Ref: Textbook of microbiology,
• The activation of C3 without prior Ananthnarayan and Panicker, 8/E, p. 93
participation of C1,4,2 in known as the
alternative pahway
32. CD4 cells recognize the antigens in
association with
A. MHC I
28. The term epitope refers to B. MHC II
A. Complete antigen molecule C. MHC III
B. Smallest antigenic determinant D. B cell receptors
C. Hapten
D. Immunogen Ans: B. MHC II
Ref: Textbook of microbiology,
 IMMUNOLOGY
Ananthnarayan and Panicker, 8/E, p. 132 IgG

- Most abundant serum immunoglobulin (80%)

33. Negative phase is seen in .......... with molecular weight of 1,50,000 and half-life
immunity of 21 days.
A. Active - Distributed equally between extravascular and
B. Passive intravascular compartment
C. Herd
- Carbohydrate content is less if compared to
D. Local
Ans: A other Ig.
Ref: Ananthanarayan and Panicker’s - IgG is divalent.
Text, Book of Microbiology, 8/E, p. 87 - IgG has subclasses IgG1 to IgG4 based on
antigenic difference in the H-chain (gamma
chain) and on the number and location of
34. The earliest identifiable cells of T-cell
disulfide bonds
lineage during maturation are
- They are distributed as G1> G2>G3>G4
A. CD7+Pro-T-cells
B. CD4+Pre-T-cells - IgG2 is directed against polysaccharide
C. CD8+Pro-T-cells antigen, so it is important in defence against
D. CD8+Pre-T-cells encapsulated bacteria.
Ans: A - IgG is produced in secondary response of
Ref: Ananthanarayan and Panicker’s immunity.
Text Book of Microbiology, 8/E, p. 128

Remember
- Most abundant Ig in newborne-IgG
35. Salivary protein which prevents transmission
- Only immunoglobulin which crosses placenta-
of human immunodeficiency
IgG
virus via saliva is
A. Sialoperoxidase - Basic structure of all Ig is 2 pairs of
B. Secretory IgA polypepticide chains (2H and 2L)
C. Salivary leukocyte proteinase
inhibitor 38. All of the following forces are involved in antigen
D. Histidine rich proteins antibody reaction except
Ans: C
A. Van der Waals forces
Ref: Burket, 11/E, p. 207
B. Electrostatic bond
C. Hydrogen bond
36. In primary immune deficiency, the D. Covalent bond
fraction of plasma protein reduced is
A. α –1–globulin Ans:- D Covalent bond
B. α–2–globulin Ref:- Ananthanarayan 7/e p 93
C. β–globulin Explanation:-
D. γ–globulin
Combination between Ag and Ab is firm but
Ans: D reversible, effected by the weaker intermolecular
Ref: Ananthanarayan and Panicker’s forces such as van der waals forces, lonic bonds and
Text Book of Microbiology, 8/E, p. 156 hydrogen bonding, not by the firmer covalent
bonds.

Antigen and Antibody - The firmness of the union is influenced by

37. The serum concentration of which of the affinity and avidity

following human IgG subclasses is maximum? - Affinity is the intensity of attraction between

A. IgG1 antigen and antibody while avidity is the

B. IgG2 strength of bond after the formation of antigen-

C. IgG3 antibody complex.

D. IgG4
39. Which precipitates at 50◦C-60◦C but disappears on
Ans:- A IgG1 heating?
Ref:- Jawetz 25/e p 130 A. Heavy chain
Explanation:- B. Light chain
 IMMUNOLOGY
C. Both - Fluorescent dyes commonly used are
D. None of the above fluorescein Isothiocynate and lissamine-
rhodamine
Ans:- B Light chain
Ref:- Ananthanarayan 7/e p 90 Immunofluorescence may be
Explanation:- Direct IF test Indirect IF test
Antigen +labeled -Antigen +Antibody
- BJP are identified in urine by its characteristic
antibodies -Antigen-Antibody
property of coagulation when heated at 50◦C ↓ complex+fluorescent
and dissolved at 70◦C. Antigen-Antibody conjugated
- BJP (abnormal Ig) are light chain of Ig (so may complex is antiglobulin serum
fluorescent e.g. -Final product is
occur as kappa of lambda form) found
detection of rabies fluorescent e.g.
typically in multiple myeloma.
virus again in brain fluorescent
- But in one patient, chain is either kappa or smears treponemal antibody
lambda, never both. test for syphilis
Disadvantage- -Advantage-A single
40. Prozone phenomenon is due to separate fluorescent antihuman globulin
A. Antigen excess conjugates have to fluorescent conjugate
be prepared against can be used for
B. Antibody excess
each antigen to be detecting human
C. False +ve reaction
tested antibody to any
D. False –ve reaction
antigen

Ans:- B and D
Ref:- Ananthanarayan 7/e p 94 - Fluorescent dyes can also be conjugated with
Explanation:- complement.

Zone phenomenon (seen in agglutination and - Labelled complement can be used for detection
precipitation)consists of 3 parts of antigen or antibody.
- Antibody is detected by sandwich technique
- Prozone=Ab excess=weak or absent - Major disadvantage of immunofluorescence is
precipitation reaction=false –ve frequent occurrence of nonspecific fluorescence
- Zone of equivalence=peak amount of in tissues and other materials.
precipitation  RADIOIMMUNOASSAY (RIA)=BINDER
- Post zone=Ag excess=weak or absent LIGAND ASSAYS
precipitation reaction. Principle: Labels (MC radioisotopes and
enzymes) conjugated to antigen/antibody=
41. The following methods of diagnosis utilize labelled reactant which measure antigen and
labeled antibodies except antibodies.
A. ELISA - The substance (antigen) whose concentration is
B. Hemagglutination inhibition test to be determined is termed the analyte or
C. Radioimmunoassay ligand.
D. Immunofluorescence - Binding protein (usually antibody) which
binds to ligand is called the binder.
Ans:- B Hemagglutination inhibition test
- RIA measure analytes up to picgram 10-12g
Ref:- Ananthanarayan 7/e p104,108,503-04
quantities.
Explanation:-
- RIA has application in quantitation of
Following serological test, use labeled antibodies hormones, drugs, tumor markers, IgE and viral
antigens.
 IMMUNOFLUORESCENCE
- Fixed amount of antibody reacts with
(IF)=FLUORESCENT ANTIBODY
radiolabelled antigen as well as varying known
TECHNIQUE
amount of unlabelled (test) antigen
- Principle: labels (fluorescent dyes) conjugated
competitively.
with antibodies of serum= labelled antibodies
- Concentration of test antigen and antibodies as
which is used to locate and identify antigens in
serological reagents, for the assay of antibodies
tissues.
and antigens.
 ENZYME IMMUNOASSAYS (EIA)
 IMMUNOLOGY
- It is the most widely used procedure in clinical Ans:- D IgA and IgG2 deficiency
serology. Ref:- Harrison 18/e p 2704
- It uses enzyme labelled antigen and antibodies Explanation:-
as serological reagents, for the assay of
IgG subclass deficiency may be suspected in
antibodies and antigens.
children and adults who have a history of recurrent
- It is of two types infections of the ears, sinuses, bronchi or lungs
i. Homogenous EIA (one step test)
Used only for assay of haptens such as Antibodies against the polysaccharide, coating
drugs (opiates, cocaine, etc) (capsule) of certain disease-producing bacteria (e.g.
the pneumococcus and haemophilus influenza) are
ii. Heterogenous EIA (multistep test)
predominantly of the IgG2 type. These patients are
- Major type of heterogenous EIA is ELISA
unable to produce protective levels of antibody
which involves the use of immunosorbent
when immunized with unconjugated
specific for one of the components of reaction
polysaccharide vaccines against streptococcus
the antigen or antibody
pneumonia (the pneumococcus) or Haemophilus
- Immunosorbent may be particulate or solid influenza bacteria and are prone for infections by
plates, capsulated bacteria.
- ELISA, is usually done on 96 well-microtiter
plates. IgG2 deficiency is frequently associated with
deficiency of IgA.
 CHEMILUMINESCENCE IMMUNOASSAY
(CLIA) Note: Overall IgA deficiency is the most common
Uses chemiluminescent compounds (such as primary immunodeficiency.
luminal or acridinium esters) as the label to
43. All of the following statements about
provide signal during antigen-antibody
carbohydrates antigens are true except
reaction
A. Good memory response
 IMMUNOELECTROBLOT TECHNIQUES
B. Poor immunogenicity
e.g. western blot test
C. T-cell independent immunity
 IMMUNOCHROMATOGRAPHIC TESTS
D. Polyclonal response
Test system is a small cassette containing
membrane impregnated with anti-HbsAg Ans:- A Good memory response
antibody-colloidal gold dye conjugate, E.g Ref:- Understand the immune system Elgert
HBsAg detection. Explanation:-

 IMMUNOFERRITIN TEST Polysaccharide antigens are ineffective in

producing immunogenic memory and this is the
Antibody conjugate with ferritin
reason behind the protein conjugation of
 IMMUNOENZYME TEST
polysaccharide vaccines
Stable enzyme like peroxidase conjugates with
antibodies . Carbohydrate polysaccharide antigens
Remember: Hemagglutination inhibition test-
- T-cell independent antigens, hence they do not
convenient method for detection and
evoke T-cell response which is essential for
quantitation of antibody to the virus.
memory response.
- Usually present in bacterial cell wall and
capsule
- Stimulates B-cell directly without involving
42. In a 5-year old boy who has history of recurrent antigen presenting cells, or else produce
pyogenic infections by bacteria with polyclonal activation of B-cells
polysaccharide-rich capsules; which of the - Considerably less immunogenic in comparison
following investigations should be done to peptide antigen
A. IgA deficiency - Don’t exhibit delayed type hypersensitivity
B. IgG1 deficiency - In large doses induce tolerance.
C. IgG2 deficiency
D. IgA and IgG2 deficiency 44. Vaccination is based on the principle of
A. Agglutination
B. Phagocytosis
 IMMUNOLOGY
C. Immunological memory Ans:- B and C
D. Clonal detection Explanation:-

Ans:- C Immunological memory MHC class genes is classified as Class I, Class II,
Ref:- See below Class III
Expalnation:-
Products of Soluble protein C2 and c4 of
- During the development of a primary immune class III of complement classical
system pathway
response to a pathogen,memory cells are
Genes Properdin Heat shock
produced
includes: factor B of protein
- These lie dormant in the lymphatic system for alternative
many years. pathway
- If they detect the same pathogen later on, they TNF alpha and
can clone rapidly and secrete antibodies. Beta
- So, secondary exposure to a pathogen produces
a much enhanced and rapid secondary 47. Antigen binding site on antibody is
response which kills the bacteria before clinical A. Hinge region
symptom appear B. Constant region
- Vaccine takes advantage of this secondary C. Variable region
response effect. D. Hypervariable region
- Vaccine contains antigen from pathogens, E. Idiotype region
which induces the production of memory cells-
giving protection from the small pathogen, if Ans:- D and E
encountered later on in life. Ref:- Harper 24/e p 746
Explanation:-
45. C-reactive protein is
- Each H and L chain of Ig consists of variable
A. An antibody as a result of pneumococcal
(V) region /domain and constant (C)
infection
region/domain.
B. Derived from pneumococci
- H has 1 VH and 3 (CH1, CH2, CH3) constant
C. Detected by precipitation reaction
region
D. Increased in pneumococcal infection
- L has 1 VL and 1CL region
- VH and VL domain (formed by amino terminal
Ans:- D Increased in pneumococcal infection
Ref:- Ananthanarayan 7/e p 218 portion) is specific antigen binding region (=
Explanation:- Fab) ( not antibody binding regions as given in
Harrison p 1922
- CRP (beta 1 globulin, not antibody) is acute - Idiotype is specific region of Fab portion to
phase reactant (produced by hepatocytes). Its which antigen binds
production is increased in bacterial infections, - CH2 of IgG binds C1q in classical component,
malignancies, tissue inflammation, rheumatic CH3 domain mediates adherence to monocyte
fever, etc (ie, non-specific inflammatory surface
protein) - The area of H chain in C region between CH1
- C-reactive protein enhance phagocytosis by and CH2 is hinge region which cleaves by
binding phospholipase, activates complement. papain to form 1Fc and 2 Fab fragments.
In certain situation CRP stimulates thrombosis
and promotes of inflammatory cytokine 48. Classic complement is activated by
production. A. IgG
- CRP is detected by passive agglutination using B. IgA
latex particles. C. IgM
D. IgE
46. MHC class III genes encode E. IgD
A. Complement component C3
B. Tumor necrosis factor-alpha Ans:- A and C
C. Tumor necrosis factor-beta Ref:- Harrison 17/e p 2036
D. Interleukin2 Explanation:-
E. Beta 2 microglobulin
 IMMUNOLOGY
- Classic complement pathway is not activated Ans:- A Polysaccharide
by IgG4 subtype. Ref:- Ananthanarayan 7/e p 81
- Alternate complement pathway is activated by Explanation:-
IgA, IgD, IgG4.
- Most naturally Ag are proteins and
polysaccharides
49. True of the following is
- Proteins are better Ag than polysaccharides
A. IgA crosses placenta
- All proteins except gelatin is antigenic
B. Half life of IgG is 23 days
- Lipids and nucleic acids are also antigenic, so
C. IgD is heat stable
their antigenicity is increased by combining
D. IgE has highest carbohydrate content
with proteins.
E. IgG induces leukotrienes release during
inflammation.
53. Which of the following is true about isotypic
variation
Ans:- B,C,D
Ref:- Ananthanarayan 7/e p 87 A. Subtle amino acid changes due to allelic
Explanation:- difference
B. Changes in a heavy and light chain in variable
IgD has highes percent of carbohydrate but region
according to Harrison (17/e p 2036) it is IgE
C. Changes in heavy and light chain in constant
Half life of Ig: IgG 23d> IgA 6d> IgM 5d> IgD> IgE region responsible for class and subtype
D. These are areas in antigen that bind specifically
50. C.reactive proteins are to antibody
A. Alpha-globulin
B. Beta-1 globulin Ans:- C Changes in heavy and light chain in
C. Alpha-2 globulin constant region responsible for class and subtype
D. Non-specific inflammatory protein Ref:- Ananthanarayan 8/e p 101
Explanation:-
Ans:- B and D
Ref:- Ananthanarayan 7/e p 218 Isotopic specificities
Explanation:- - The antigenic specificities which distinguish
Already explained between the different classes and subclasses of
immunoglobulin present in all individual of a
51. True about secondary immune response is species, e.g Antigen specificity of IgA and IgG.
A. Long latent period - They are located on (Constant) domains of Ig
B. Usually of low titer chains in all individual.
C. Antibodies appear in short time
D. Persist for long Other immunoglobulin specificity

Ans:- C and D - Idiotypic specificity

Ref:- Ananthanarayan 7/e p 134-35 Specificity of greatest biological importance is
Explanation:- idiotypic specificity, pertaining to the nature of
antigen binding site.
Secondary immune response is characterized by
These are located on V region.
- Prompt, powerful, prolonged response- - Allotypic- specificity
- Short, negligible lag phase Antigenic specificity which distinguishes
- Much higher level of antibodies that last for immunoglobulins of the same class, between
long periods different groups of individual in the same
- Ab is predominantly IgG. species.

52. Which of the following is very difficult to induce 54. Antigen antibody precipitation is maximally seen
antibody in which of the following
A. Polysaccharide A. Excess of antibody
B. Protein B. Excess of antigen
C. Antigens C. Equivalent of antibody and antigen
D. Repeated infection D. Antigen-Hapten interaction
 IMMUNOLOGY
Ans:- C Equivalent of antibody and antigen
Ref:- Ananthanarayan 8/e p 104
Explanation:-
Amount of precipitate formed is greately influenced
by the relative proportions of antigen and
antibodies. Precipitation reaction is rapid and
abundant when antigen and antibody are present in
optimal or equivalent proportion.
Prozone: Zone of antibody excess
Peak: Zone of equivalence
Post zone: Zone of antigen excess
55. Which portion of MHC 1 complex forms the
component of antigen presenting part
A. Between alpha 1 – beta 2 microglobulin
B. Distal part of alpha chain
C. Proximal part of alpha chain
D. Between as and b2 microglobulin
Ans:- B Distal part of alpha chain
Ref:- Ananthanarayan 8/e p 133
Explanation:-
MHC I/HLA I
- Class 1 molecule consists of a three domains of
heavy alpha peptide chain (a1, a2, a3) which
are non-covalently linked to smaller B2
microglobulin peptide.
- The distal domain (alpha 1 and alpha2) of
MHC 1 have highly variable amino acid
sequences and are folded to form a cavity or
groove. Protein antigens are bound to this
groove for presentation to CD8 T cells.
MHC II/HLA II
- MHC II antigens are heterodimer consisting of
an alpha and beta chain. Each chain has two
domain proximal one is constant and distal one
is variable.
- Both class 1 and class 2 are members of
immunoglobulin gene super family.
C. IgE
D. IgD
Ans:- B IgM
Ref:- Jawetz 25/e p 130
Explanation:-
IgM is the first antibody formed in every response
Though ovaalbumin is an allergin, its initial
injection would produce IgM first, then IgE. If it is
injected against IgE production would be first
response.
57. Synthesis of an immunoglobulin in membrane
bound or secretary from is determined by
A. One turn to two turn joining rule
B. Class switching
C. Differential RNA processing
D. Alletic exclusion
Ans:- C Differential RNA processing
Ref:- Internet
Explanation:-
Membrane bound versus secreted immunoglobulin
- A primitive B-cell (virgin B cell) bears IgM (and
possibly IgD) in its membrane; however after
stimulation, it begins to secrete IgM into its
surrounding environment.
These two form of IgM are different
- The secreted form of IgM has a different C-
terminal sequence which, lacks a membrane
anchoring region.
- Membrane bound IgM is not capable of
associating with J chain and forming its normal
pentameric structure. So, membrane bound
IgM remains exclusively in monomeric form.
These two forms differs basically in their mu-
chain which is synthesized to via an alternative
splicing scheme.
Note such switching is unidirectional, i.e. once
IgM cell begin to secrete IgG, it cant go back to
secrete IgM.

58. The earliest immunoglobulin to be synthesized by

MHC III/ HLA III
the fetus is
- MHC III are heterogenous they include
A. IgA
complement components involved in the
B. IgG
formation of C3 convertase, heat shock protein
C. IgE
and tumor necrosis factor.
D. IgM

56. Ova albumin antigen was injected into a rabbit. Ans:- D IgM
What antibody will it produce initially? Ref:- Ananthanarayan 8/e p 99
A. IgG Explanation:-
B. IgM
 IMMUNOLOGY
- Main immunoglobulin produced early in the
primary response.
- IgM, composed of five H2L2 and 1 J chain and
is heaviest immunoglobulin with molecular
weight of 1000,000 (hence called millionaire
molecule)
- It has valency of 10 (effective valency-5, due to
steritic hindrance)
- Ig increase in secondary immune response and
is opsonizing antibody
- Only Ig which crosses placenta so its presence
in fetus indicates immunity not infection
- Exhibits strong precipitation and neutralization
reaction
IgE

- Its presence in the serum indicates recent - Ig increase in parasitic infection, allergic
infection (primary response) response
- IgM is present on the surface of virtually all - Only heat labile Ig
uncommitent B - Max carbohydrate conc.
- It is the most efficient immunoglobin for
agglutinations, complement fixation IgA
- It has highest avidity among all Ig.
- Only Ig which is secreted by seromucinous
- By 20th week, fetus produce IgM, IgD and
gland such as saliva, tears, colostrums,
receives maternal IgG so IgA and IgE are not
respiratory and gastrointestinal secretions.
present.
- Phylogenetically is the oldest immunoglobulin
60. Bence Jones proteins are best described as
class.
A. M chains
- Treatment of serum with 0.12 m M2
B. B chains
mercaptoethanol selectively destroys IgM. This
C. Kappa and lambda chains
is a simple method for differential estimation
D. Fibrin split products
of IgG and IgM.
Ans:- C Kappa and Lambda chains
59. Which of the following statements concerning Ref:- Ananthanarayan 8/e p 100
immunoglobulins is wrong? Explanation:-
A. IgM does not cross placenta
Already explained
B. IgE is decreased in parasitic infection
C. IgM increased in primary response 61. A single immunoglobulin molecule contains
D. Fetal infection is characterized by increase in A. 1 light chain, 1 heavy chain
IgG B. 2 heavy chains, 1 light chain
C. 2 light chains, 2 heavy chain
Ans:- D Fetal infection is characterized by increase
D. 2 light chains, 1 heavy chain
in IgG
Ref:- Ananthanarayan 7/e p 87-9 Ans:- C 2 light chains, 2 heavy chain
Explanation:- Ref:- Ananthanarayan 8/e p 96
Explanation:-
As IgM doesn’t cross placenta, presence of IgM in
fetus indicates fetal infection Already explained

IgM

- Antigen receptor on B cells 62. Which of the following is class specific antigenic
- Useful for diagnosing congenital infections determinants of an Ig?
- Earliest Ig to be synthesized by fetus A. L-chain
- Increased in primary response B. H-chain
- Max sedimentation coefficient, max molecular C. J-chain
weight and max intravascular distribution. D. Variable region
- Exhibits strong classical complement fixation,
opsonization, agglutination, lysis, Ans:- B H chain
immunohemolysis. Ref:- Ananthanarayan 7/e p 86
Explanation:-
IgG It is the class of heavy chain (H) which determines
- Max serum conc. And half-life class of Ig eg gamma, alpha, mu, delta, epsilon,are
H chain of IgG, IgA , IgM, IgD, IgE, respectively.
 IMMUNOLOGY
63. The most avidly complement fixing antibody is n arthritis
A. IgA
Widal test Tube Typhoid
B. IgG
agglutination
C. IgM
Weil-Felix test Heterophile tube Rickettsiae
D. IgE agglutination
Wasserman Complement Syphilis
Ans:- C IgM
reaction fixation test
Ref:- Harrison 17/e p 2036
Explanation:-
65. The reaction between antibody and soluble
Already explained antigen in demonstrated by
A. Agglutination
64. Which of the following is true
B. Precipitation
A. Paul Bunnell test is used to diagnose measles
C. Complement fixation
B. Rose waller test is a complement fixation test
D. Hemagglutination test
C. Indirect hemagglutination test is less sensitive
than gel diffusion test Ans:- B Precipitation
D. Antigen, antibody reaction cannot occur in Ref:- Ananthanarayan 7/e p 94-101
absence of electrolytes Explanation:-

Ans:- D Antigen, antibody reaction cannot occur Serological reactions type

in absence of electrolytes Precipitation Agglutination
Ref:- Ananthanarayan 7/e p 98 Pre-requisite Soluble Particulate
Explanation:- antigen, antigen,
antibody, antibody,
General features of Ag-Ab reaction electrolytes, at electrolytes at
suitable suitable
- Reaction is specific, though specificity is not temperature temperature
absolute. and pH and pH
- Entire molecules do not fragment but combine Optimal Precipitation is Occur
in the presence of electrolytes at specific PH proportion abundant and optimally
and temperature rapid if antigen when antigens
and antibody and antibodies
- Combination occurs at the surface
are present in react in
- It is firm but reversible, firmness depends on
optimal or equivalent
affinity (intensity of attraction) and avidity equivalent proportion
(strength of bond) proportion
- Ab are generally bivalent while Ag may have Application Sensitive test Slide
valency up to hundred. for detection of agglutination
antigen (can for blood
detect as tittle grouping and
Remember these tests
as 1µg protein) cross
Serological test Type Used to
Therefore used matching.
diagnose
in forensic Tube
applications agglutination
Ascolis Ring Anthrax
for is standard
thermoprecipiti precipitation
identification method for
n test
of blood and quantitative
Lancefield test Ring Grouping of
seminal stains, assessment of
precipitation streptococci
testing for food antibodies
adultrants
Kahn Tube Syphilis
Limitation Relatively less More sensitive
flocculation test precipitation
sensitive for than
VDRL test Slide Syphilis
detection of precipitation
precipitation
antibody for detection of
Paul Bunnel Tube Infectious
antibodies
Test agglutination mononucleosi
s
- Hemagglutination is a type of agglutination
Rose waller test Passive Rheumatoid
- Agglutination is more sensitive than
hemagglutinatio
precipitation for antibody detection.
 IMMUNOLOGY
Ans:- D Plasma cells
66. Antibody diversity is due to Ref:- Ananthanarayan 7/e p 125
A. Gene rearrangement Explanation:-
B. Gene translocation
- IgE is antibody and all antibodies are produced
C. Antigenic variation
by plasma cells which are oval, twice the size
D. CD40 molecules
of small lymphocyte with eccentric nucleus
E. Mutation
containing large blocks of chromatin
peripherally (cart wheel appearance). They are
Ans:- C Antigenic variation
Ref:- Harrison 17/e p 2035 formed from B cells.
Explanation:- - Don’t get confused with Eosinophils because
eosinophils are activated by IgE, not produce
Learn it it.
67. Acute phase reactants (APR) in acute
inflammation are 69. The secretory component of IgA molecule is
A. Albumin A. Formed by epithelial cell of lining mucosa
B. Fibrinogen B. Formed by plasma cell
C. Haptoglobulin C. Formed by epithelial cell and plasma cell
D. Gammaglobulin D. Secreted by bone marrow

Ans:- B and C Ans:- C Formed by epithelial cell and plasma cell

Ref:- Ananthanarayan 8/e p 86 Ref:- Ananthanarayan 7/e p 88
Explanation:- Explanation:-

Acute phase reactants (APR) IgA is of two types

APR is the generic name given to a approx. 30
biochemically different and functionally unrelated
proteins which are synthesized and secreted by
hepatocytes. Their level in the serum are either
increased ( positive APR) or reduced (negative
APR), approx. 90 minutes after the onset of
systemic inflammatory reaction. Some important
APR includes.
- Serum IgA- Monomeric, synthesized by plasma
cells
- Secretory IgA (SigA)-2 monomers joined by J
chain
Both J chain and dimeric SIgA are synthesized by
plasma cells situated near the mucosal or glandular
epithelium.

i. C-reactive protein (B1 globulin) 70. Which of the following immunoglobulins can
ii. A 1 Antitrypsin cross placenta?
iii. Haptoglobin (A2 glycoprotein) A. IgA
iv. Mannose binding protein B. IgM
v. Serum anyloid C. IgG
vi. A1 acid glycoprotein (orosomucoid) D. IgD
vii. Fibrinogen
Ans:- C IgG
viii. Pre albumin
Ref:- Ananthanarayan 8/e p 100
ix. Albumin
Explanation:-
x. Transferring
Already explained
These acute phase reactants enhance host
resistance, prevent tissues injury, promotes repair 71. Which is not heterophile agglutination test
of inflammatory lesions. A. Weil-Felix test
B. Widal test
68. IgE is secreted by C. Paul-Bunnel, test
A. Mast cell D. Streptococcus MG
B. Basophils
C. Eosinophils Ans:- B Widal test
D. Plasma cells Ref:- Ananthanarayan 7/e p 82
E. Neutrophils Explanation:-
 IMMUNOLOGY
The same or closely related antigen may sometimes (glycoprotei cells cells macrophage
occur in different biological species etc. it is called n) or NK and NK cells
heterogenetic or heterophile antigen eg immune cells activation
IFN Stimulates Ig
- Forssamn antigen for pneumococcus,
secretion by B
salmonella
cells induction
- Paul Bunnel test in infectious mononucleosis
of class II
- Streptococcus MG agglutination
histocompatibil
- Weil Felix reaction (between proteus and
ity antigens
Rickettsia)
TH1 T cell
- Cold agglutination test in primary atypical
differentiation
pneumonia.
- Antigen between E.coli and human RBC of B

73. True regarding clonal selection

72. True about interferon is
A. Specific
A. It is a synthetic antiviral agent
B. Secondary response is rapid
B. Inhibits viral replication in cells
C. Variable region of Ig is involved in Ab
C. Is specific for particular virus
production
D. None
Ans:- A,B,C
Ans:- B Inhibits viral replication in cells
Ref:- Ananthanarayan 7/e p 150
Ref:- Ananthanarayan 7/e p 145
Explanation:-
Explanation:-
Clonal selection theory of immune response
- Interferon (host coded protein) has no direct
action on viruses but inhibit viral replication by - During development B and T cells acquire
selectively inhibiting translation of viral m- specific cell surface receptor that commit them
RNA without affecting cellular m-RNA to a single antigen specificity. The lymphocytes
- IFN are not virus specific but species specific. are activated when they bind to their specific
- It is of 3 types. antigen.
- The lymphocyte reactives to any particular
Type Cell Cell Biological antigen, are only a small proportion of the total
sourc targe activity pool.
e t - When an antigen is encountered, the cell
IFN α All All Antiviral specific for that antigen gets activated, and
(protein or cells cells activity; trigger proliferation of cells with an identical
leukocyte stimulates T genetic makeup (clones). This phenomenon is
IFN cell, called as clonal selection.
macrophages - During embryonic life the lymphocyte clones
and NK cell acting against self receptor are eliminated, such
activity clones are called forbidden clones.
- For the mechanism of regulation of antibody
IFN β All All Direct response network hypothesis was postulated,
(glycoprotei cells cells antitumor according to which variable region of Ig
n) or effects carrying the antigen binding site is different in
Fibroblast Upregulates different antibodies. The distinct AA sequence
IFN MHC class I at the Ag combining sites and the adjacent part
antigen of variable region are termed idotype. The
expression, idiotype in turn acts as antigenic determinant
used and can induce antidiotypic antibodies. These,
therepeutically in turn can induce antibodies against them and
in viral and so on forming an idiotype network.
autoimmune - Immunological memory is another
disease consequence of clonal selection, due to which
secondary response is rapid and heightened.
IFN γ T All Regulates
 IMMUNOLOGY
- Genetic basis of all this can be explained by - Immune electron microcopy tests
split genes.
76. C in C-reactive protein stands for
A. Capsular polysaccharide of S. pneumonia
74. Superantigens true statement is B. Concanavalin-A
A. They bind to the cleft of the MHC C. Calretinin
B. Needs to be processed before presentation D. Cellular
C. They are presented by APC’s to T-cells
D. Directly attached to lateral aspect of TCR β Ans:- A Capsular polysaccharide of S. pneumonia
Ref:- Ananthanarayan 8/e p 221
chain
Explanation:-
Ans:-D Directly attached to lateral aspect of TCR β
C reactive protein
chain
Ref:- Ananthanarayan 8/e p 145 An abnormal protein (beta 1 globulin) that
Explanation:- precipitates with the somatic C antigen of
pneumococci, appears in the acute phase of
Superantigen
pneumonia and disappears during c onvalescence.
- Superantigens are certain antigens that can This protein found in other conditions also is called
interact with antigen presenting cells and T- as c-reactive protein, where c stands for the c
cells in non-specific manner. substance of pneumococci. This C-RP is not an
antibody, rat her a acute phase reactant synthesized
- Conventional antigens binds to the αβ
in liver in response to bacterial infection,
heterodimer groove of the MHC molecule
inflammation.
through the V regions of TCR α and β chains,
super antigens bind directly to the lateral 77. Role of adjuvant in vaccine are
aspect of the TCR β chain. Moreover, this A. Stimulation of toll like receptors
activity does not involve the endocytic B. Activate B-lymphocyte only
processing required for typical antigen C. Increase both adaptive and innate immune
presentation. response
- This interaction activates a larger number of T D. Activate both B and T lymphocyte
–cells (10%) than conventional antigen (about E. Ensure prolonged delivery of antigen
1%) resulting in massive cytokine expression
and immune-modulation Ans:- A,C,D and E
Ref:- Ananthanarayan 8/e 143-44
- Various superantigens include: Staphylococcal
Explanation:-
enterotoxin, toxic shock syndrome toin, etc
Role of Adjuvants
75. Antigen-antibody complexes are detected by
- Adjuvants are substances that stimulate the
A. Western blot
immune response. They enhance the
B. Southern blot
immunogenicity of a vaccines for example, by
C. Northern blot
facilitating uptake into antigen presenting cells
D. ELISA
- Adjuvants are essential for enhancing and
Ans:- A,D directing the adaptive immune response to
Ref:- Ananthanarayan 8/e p 103-113 vaccine antigens, which is mediated by both B
Explanation:- and T cells.
- Due to the variety of mechanism and links
- Agglutination
between the innate and adaptive immune
- Precipitation
response, an adjuvant enhanced innate
- ELISA
immune response results is an enhanced
- Immunofluorescene (Director/ indirect)
adaptive immune response.
- Compliment fixation
- Adjuvants exert their immune-enhancing
- Radioimmunoassay
effects by following immune functional
- Chemiluminescence immunoassay (CLIA)
activities
- Immunoblot techniques eg western blot
i. Adjuvants help in the translocation of
- Immunochromatographic test
antigens to the lymph nodes where
they can be recognized by T cells.
 IMMUNOLOGY
They by producing greater T cell Ans: A
activity. Ref: Ananthanarayan and Panicker’s
ii. Adjuvants provide physical Text Book of Microbiology, 8/E, p. 139
Explanation
protection to antigens which grants
• Primary immune response – Ig M
the antigen a prolonged delivery. This
• Secondary immune response – Ig G
means that the cell will be exposed to
the antigen for a longer duration.
iii. They increase the capacity to cause
80. The following immunoglobulin is not
local reactions at the injection site known to fix complement
(during vaccination), inducing greater A. IgE
release of danger signals like B. IgM
chemokines C. IgA
iv. They induce the release of D. IgG

inflammatory cytokines which helps Ans: A

to not only recruit B and T cells at Ref: Ananthanarayan and Panicker’s
sites of infection but also to increase Text Book of Microbiology, 8/E, p. 100
transcriptional events leading to a net
increase of immune cells as a whole.
v. Finally they are believed to increase 81. The cells which produce antibodies are
the innate immune response to A. Plasma cells
antigen by interacting with pattern B. Helper T cells
C. Macrophages
recognition receptors (PRRs),
D. Natural killer cells
specifically Toll-like receptors (TLRs),
on accessory cells. Ans: A
Ref: Ananthanarayan and Panicker’s
78. Immunoglobulin bound on the surface of bacteria Text Book of Microbiology, 8/E, p. 140
Explanation
mediates phagocytosis by
• Immune response is brought by 3
A. C3b and Fc
cells,
B. Receptor mediated endocytosis 1. T cells
C. Oxidase action 2. B cells
D. Lysosomal burst 3. Antigen presenting cells

Ans:- A C3b and Fc

Ref:- Robbins 8/e 202 82. Type of immunological response in
Explanation:- transplant rejection is
A. Type I
- Cells coated by antibodies are cleared through
B. Type II
phagocytosis. These bacterial cells are
C. Type III
recognized by phagocytic Fc receptors. D. Type IV
- In addition when IgM on IgG antibodies are
deposited on the surfaces of cells they may Ans: D
Ref: Ananthanarayan and Panicker’s
activate the complement system by the classical
Text Book of Microbiology, 8/E, p. 145
pathway and generates C3b and C4b
- C3b and c4b gets deposited over the surface of
bacterial cell and are recognized cell and are
83. Erythroblastosis fetalis can be prevented
recognized by the phagocytes. The net result is
if the mother is injected at
phagocytosis. parturition, with an antibody called
A. Blocking antibody
B. Rh (D) Immunoglobulin
C. Antilymphocyte globulin
79. The antibody produced during primary
D. Antithymocyte serum
immune response is
A. IgM Ans: B
B. IgG Ref: Ananthanarayan and Panicker’s
C. IgA Text Book of Microbiology, 8/E, p. 190
D. IgE
 IMMUNOLOGY
• Bence Jones protein is an abnormal
immunoglobulin found in multiple
84. The binding site for complement on the myeloma
immunoglobulin molecule is in the • It can be identified in urine by its
A. VL domain characteristic property of coagulation
B. CL domain when heated to 50°C but re dissolving
C. CH–1 domain at 70°C
D. CH–2 domain

Ans: D
Ref: Ananthanarayan and Panicker’s 88. Immunoglobulin molecule which
Text Book of Microbiology, 8/E, p. 97 mediates in anaphylaxis is
Explanataion A. Ig M
• VL and VH–responsible for formation B. Ig G
of a specific antigen binding site C. Ig E
D. Ig A
CH2 – binds C1q in the classical
complement sequence Ans: C
• CH3 – mediates adherence to the Ref: Ananthanarayan and Panicker’s
monocytes surface. Text Book of Microbiology, 8/E, p. 100

85. Human immunoglobulins are divided 89. All of the following are biologic
based on properties of IgG EXCEPT
A. Functional differences A. Passes the placental barrier
B. Antigenic affinity B. Neutralizes bacterial toxins
C. Complement fixation C. Binds with organisms enhancing
D. Structural differences phagocytosis
D. Most efficient activator of
Ans: B complement system
Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 101 Ans: D
Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 97
to 98

90. Which of the following are correctly

86. Which of the following immunoglobulin
matched?
is responsible for allergic
A. Transfer of antibody from mother to
reactions
child is through colostrum and
A. IgG
acquired passive immunity naturally
B. IgE
B. Injection of antibodies (hepatitis) is
C. IgM
artificially acquired passive immunity
D. IgD
C. Antigenic stimulus given by vaccine
Ans: B (polio) is artificial active immunity
Ref: Ananthanarayan and Panicker’s D. All of the above
Text Book of Microbiology, 8/E, p. 100

Ans: D
87. Bence Jones protein found in the urine Ref: Ananthanarayan and Panicker’s
may be suggestive of Text Book of Microbiology, 8/E,
A. Hyperparathyroidism pp. 86, 87
B. Hodgkins disease Explanation
C. Multiple myeloma Active Immunity Passive Immunity
D. Christian‘s syndrome Produced actively by Received passively,
host’s immune system no active host participation
Induced by infection Readymade antibody
or by immunogens transferred
Ans: C
Durable, effective Transient, less effective
Ref: Ananthanarayan and Panicker’s
protection
Text Book of Microbiology, 8/E, p. 100
Immunological No memory
Explanation
memory present
 IMMUNOLOGY
Negative phase may No negative phase • Children living in insanitary conditions and high load of
occur intestinal parasite have high serum
Not applicable in the Applicable in the levels of IgE
immunoimmunodeficient • Deficiency of IgE is associated with IgA deficiency
deficient • Responsible for “anaphylactic’ type of hypersensitivity
Immunity effective Only immediate immunity IgD
after lag period • Resemble IgG structurally
• Half-life: 3 days
• IgD, IgM: Surface of B-lymphocyte
In General
• IgG protect: Body fluids
91. The following is a secretory antibody: • IgA protect: Body surfaces
A. IgG
B. IgM IgM protect: Blood stream
C. IgA • IgE Mediate: Hypersensitivity reaction
D. IgD • IgD: Recognition molecule on lymphocyte.
Ans: C. IgA
Ref: Ananthanarayan, 8/E, p. 98
Explanation
92. IgE is released from surface of?
• IgA second most abundant class of serum immunoglobulins
A. Mast cell
• Normal levels: 0.6–4.2 mg/ml
• Half life: 6–8 days B. Lymphocytes
• IgA: exists two forms C. Pro t cells
D. NK cells
Serum IgA Secretory IgA
Ans: B
Monomers Dimers (2 monomers joined by J-chain)
Mucosal surface Secretions Hypersensitivity
Synthesized by plasma cells
Additional Information 93. Examples of type I hypersensitivity is
IgG A. Lepromin test
• Major serum immunoglobulin B. Tuberculin
• Half-life: 23days
C. Casoni’s test
• Both intravascular and extra vascular
D. Arthus reaction
• Only maternal immunoglobulin to cross placenta
• IgG is late antibody (IgM-early/initial antibody)
Ans:- C Casoni’s test
• IgG—“4” classes:
– IgG1– 65% Ref:- Taylor 3/e p 107
– IgG2– 23% Explanation:-
– IgG3–8%
Type I HSN (IgE Type II HSN (IgG and
– IgG4 – 4%
mediated) IgM mediated)
• Normal serum cone: 8–16 mg/ml
-Eczema -Blood transfusion
IgM
-Hay fever reactions
• 5–8% of total immunoglobulin
-Asthma (atopy) -Erythroblastosis fetalis
• Normal serum level: 0.5–2mg/ml
-Urticaria -Al hemolytic anemia or
• Half-life: 5 days
-Anaphylactic shock agranulocytosis or
• Oldest immunoglobulin class
-Acute dermatitis thrombocytopenia
• Earliest to be synthesized by fetus (20 weeks of age)
- smith phenomenon -Pemphigus vulgaris
• Cannot be transported through placenta—presence of IgM in
-PK (Prausnitz kunster) -Bullous pemphigoid
fetes indicate infection
reaction -Pernicious anemia
• Mostly intravascular (over 80%)
-Casoni’s skin test -Acute rheumatic fever
• Joined by j-chain (IgM)
-Schultz dale -Diabetes mellitus
• Susceptible to mercaptoethanol
phenomenon -Graves disease
• IgM deficiencies often associated with septicemias
-Myasthenia gravis
IgE
Type III HSN (IgM or Type IV HSN (cell
• It is an 8S molecule
IgG mediated ) mediated)
• Half-life: 2 days
• Resemble Ig structurally -Local-Arthus reaction -Tuberculin skin test
• Heat labile (inactivated at 56°C in one hour) -Systemic-serum -Lepromin skin test
• It exhibit homocytotrophism sickness -Contact dermatitis
• Mediate Prausnitz-Kustner reaction -Lepromin skin test -Jones mote reaction
• Susceptible to mercaptoethanol (IgM also) -Schick skin test (cutaneous basophilic
• Mostly extra vascular -PAN HSN)
-Rheumatoid arthritis -TB
 IMMUNOLOGY
-SLE -Sarcoidosis 96. Hemolytic disease of newborn is which type of
-Acute viral hepatitis -Temporal arteritis hypersensitivity reaction?
-Penicillamine toxicity -Patch test A. Type-I
-Hyperacute toxicity -Granulomatous
B. Type-II
-Type 2 lepra reaction inflammation
C. Type-III
(ENL) -Type I lepra reaction
-Hypersensitivity D. Type-IV
pneumonitis E. Type-V

Ans:- B Type II
94. Which of the following is an example of type IV Ref:- Taylor 3/e p 107
hypersensitivity Explanation:-
A. Arthus reaction
Already explained
B. Serum sickness
C. Schwartzman reaction 97. Skin test is used for which hypersensitivity
D. Granulomatous reaction reaction
A. I
Ans:- D Granulomatous reaction
B. II
Ref:- Ananthanarayan 7/e p 167
C. III
Explanation:-
D. IV
Schwartzman reaction is not an immune reaction
but alteration in factor (e.g. massive activation of Ans:- A,C,and D
complement) affecting intravascular coagulation, Ref:- Taylor 3/e p 107
e.g. purpuric rashed of meningococcal septicemia; Explanation:-
water house Friderichsen syndrome.
Already explained
95. Which of the following is false? 98. Skin test based on neutralization reaction are
A. Theobald-smith phenomenon is a type I hyper
A. Casoni test
sensitivity reaction B. Lepromin test
B. Serum sickness is a type II hypersensitivity
C. Tuberculin test
reaction
D. Schick test
C. Allograft rejection is a type IV hypersensitivity
reaction Ans:- D Schick test
D. Transfusion reaction is a type II Ref:- Ananthanarayan 7/e p 103
hypersensitivity reaction Explanation:-

Ans:- B Serum sickness is type II HSN Neutralization test

Ref:- Taylor 3/e p 119 - Virus – plaque inhibition test
Explanation:-
- Bacteria
Type of rejection Type of HSN Target sites in a. In vivo-e.g. schick test
transplantation b. In vitro-ASO test
Hyperacute Type II Small blood
rejection cytotoxi vessels in donor Bacteria exotoxin can be neutralized (e.g
(preformed Ab Type III tissues diphtheria, tetanus) while endotoxins cant be
against donor HSN neutralized by antitoxin.
transplantation
Ag) 99. Type-1 hypersensitivity includes all of the
Acute rejection Type II Parenchymal following except
cytotoxic cells A. Autoimmune hemolytic anemia
Type III Small blood B. Anaphylaxis
HSN vessels C. Extrinsic asthma
Chronic Type III Small blood
D. Hay fever
rejection HSN vessels
Type IV
Ans:- A Autoimmune hemolytic anemia
HSN
Explanation:-

HSN involving blood components are usually Type

II HSN. (It is not the rule, it is just for remembering)
 IMMUNOLOGY
100. True about anaphylaxis reactions in which type a single dose
A. Type-1 reaction of the antigen can act as both the
B. Large amount of histamine released sensitizing and shocking dose
A. Anaphylaxis
C. Cytokines like IL4, IL-5 and IL-6 and GMCSF
B. Arthus reaction
are released
C. Serum sickness
D. Mediated through allergen specific IgE. D. Contact dermatitis

Ans:- A,B,C and D Ans: C

Ref:- Robbins 8/e p 19 Ref: Ananthanarayan and Panicker’s
Explanation:- Text, Book of Microbiology, 8/E, p. 121

Type I reaction large amount of histamine released

cytokines like IL-4, IL-5, IL-6, GMCSF are released
and Mediated through allergen specific IgE.
101. Anaphylaxis refers to the
A. Severe reaction following reinfection
of protein solutions in a sensitized
individual
B. Severe reaction followings primary
infection of protein solutions
C. State of immunity developed by
repeated infection of any foreign
substance
D. Severe reaction resulting from
sensitivity to common allergens
Ans: A
Ref: Ananthanarayan and Panicker’s
Textbook of Microbiology, 8/E, p. 163
105. Post streptococcal acute glomerulonephritis
is an example for
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
Ans: C
Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 210
Explanation
• In acute glomerulonephritis, the
pathogenesis may be due to antigenic
cross relations/antibodies formed
against streptococci cross react with
glomerular basement membrane and
result in damage. It is more often an
immune complex disease. This is
clearly type III hyper sensitivity
reaction.

102. The distinguishing characteristic

feature of a positive delayed type
hypersensitivity skin test is
A. Erythema
B. Necrosis
C. Induration
D. Vasculitis

Ans: A
Ref: Ananthanarayan and Panicker’s
Text Book of Microbiology, 8/E, p. 168

103. Mast cell secretion during an immediate

hypersensitivity reaction is
stimulated when antigens combine
with
A. IgD antibodies
B. IgG antibodies
C. IgM antibodies
D. IgA antibodies

Ans: B. IgG antibodies

Ref: Textbook of microbiology,
Ananthnarayan and Panicker, 8/E, p. 162

104. Out of the following hypersensitivity