Immunology & Serology

1. Which is immunoglobulin is transported efficiently across mucosal epithelium

IgA

IgD

IgE

IgG

IgM

2. The most abundant type of leukocyte in human peripheral blood is

Eosinophil

Basophil

Monocyte

Neutrophil

Lymphocyte

3. Which of the following pairs is mismatched

Erythrocyte: oxygen transport

Natural killer cell: kills virus-infected cells

Macrophage: phagocytosis and killing of microorganisms

Eosinophil: defense against parasites

Lymphocytes: innate immune response

4. One reason that pathogenic microorganisms have an advantage in the host they infect is because they

Have previously been encountered through natural exposure

Reproduce and evolve more rapidly than the host can eliminate them

Strengthen the hosts immune response

Reproduce and evolve more slowly than the host can eliminate them

Have previously been encountered through vaccination

5. Which of the following describes the flow of lymph through a lymph node draining an infected tissue

Artery to lymph node to efferent lymphatic vessel

Afferent lymphatic vessel to lymph node to efferent lymphatic vessel

Efferent lymphatic vessel to lymph node to afferent lymphatic vessel

Venule to lymph node to efferent lymphatic vessel

Afferent lymphatic vessel to lymph node to artery

6. Which of the following is NOT associated with mucosal surfaces

White pulp

M cells

Lysozyme

Beating cilia

Mucus=secreting goblet cells

7. The antibody transported across mucosal epithelia is ___________.

IgA

IgD

IgE

IgG

IgM

8. Which immunoglobulins main function is to mediate sensitization of mast cells

IgA

IgD

IgE

IgG

IgM

9. _____ vaccines are the most effective at evokin memory responses against a virus in an immunized host

Subunit

DNA

Toxoid

Live attenuated

Killed

10. Which of the following is NOT a characteristic of inflammation

Pain

Increased vascular permeability and edema

Inactivation of macrophages

Influx of leukocytes

Vasodilation

11. Which of the following polymerizes to form a transmembrane channel that compromises the integrity of cell membranes

C5

C6

C7

C8

C9

12. Which of the following does NOT describe the actions of the coagulation system

Blood clot formation

Enhancement of dissemination of microbes into lymphatics and bloodstream

Decrease in blood loss and fluid into interstitial spaces in tissue

Release of infammatory mediators by platelets

Wound healing

13. Which of the following characteristics the B-1 cells that develop prenatally

They lack N nucleotides

They possess polyspecificity for bacterial polysaccharide antigens

They arise early in embryonic development preceding the development of the majority subset of B cells

They have little or no IgD on the cell surface

All of the above

14. Which of the following does NOT accuratley describe complement components

Soluble proteins

Made by the spleen

Located in extracellular spaces

Some function as proteases once activated

Activated by a cascade of enzymatic reactions

15. The mutational mechanism that results in the production of antibodies that bind antigen with higher affinity is called

Somatic recombination

Isotype switching

Somatic hypermutation

Clonal selection

Antigen processing

16. The antigen-binding site of an immunoglobin is formed from

The V regions of light chains only

The V regions of heavy chains only

Paired V regions of a single heavy chain and a single light chain

Paired V regions of two light chains

Paired C regions of two heavy chains

17. The function of negative selection of thymocytes in the thymus is to eliminate

Autoreactive thymocytes

Alloreactive thymocytes

Double positive thymocytes

Single positive thymocytes

Apoptotic thymocytes

18. Autoimmune polyendocrinopathycandidiasis-ectodermal dystrophy (APECED) is caused by a defect in

The production of regulatory CD4 T cells

Cathepsin L

FoxP3

A transcription factor called AIRE that regulates tissue-specific gene expression in the thymus

T cell receptor gene receptor

19. Which of the following is the membrane-bound form of C3 convertase of the alternative pathway of complement activation

IC3

C3a

C3b

IC3Bb

C3bBb

20. The enzyme responsible for recombining V, D, and J segments during somatic recombination is called

V(D)J recombinase

Terminal deoxynucleotidyl transferase

Exonuclease

DNA polymerase

DNA ligase

21. In B cells transport of immunoglobulin to the membrane is dependent on association with two invariant proteins, IG alpha and IG beta. Which of the following invariant proteins provide this function for the T cell receptor in T cells.

CD3 gamma

CD3 delta

CD3 epsilon

Zeta

All of the above

22. IgM is particularly efficient at fixing complement because ________.

It has an extra CH domain

It is made first in an immune response and therefore has first access to C1q

It has five binding sites for C1q

It is a much larger antibody than the other isotypes

It has easy access to extravascular areas

23. The risk of _____ is the primary complication in bone marrow transplants

Hyperacute rejection

Chronic rejection

Acute host-versus graft disease

Acute graft versus host disease

Cancer

24. Examples of granulocytes include all of the following except

Neutrophil

Monocyte

Basophil

Eosinophil

All of the above are examples of granulocytes

25. Which of the following statements is false

Megakaryocytes do not circulate and reside only in the bone marrow

Platelets participate in clotting reactions to prevent blood loss

During human development, hemotopoiesis takes place a different anatomical locations

Hematopoeitic stem cells are self-renewing

26. Which of the following is the predominant route by which pathogens are brought from a site of infection into a lymph node.

Efferent lymphatics

Vein

Artery

High endothelial venule

Afferent lymphatics

27. Which of the following does not describe B-cell receptors

B cell receptors are membrane bound and secreted

B cell receptors consist of a variable region and a constant region

B cell receptors lack specificity and can bind to a number of different antigen

B cell receptors possess specificity and can therefore bind only to unique epitopes

B cell receptors undergo affinity maturation as a consequence of somatic hypermutation

28. The rearrangement of V, D, and J segments to form an immunoglobulin

Monoclonal antibody production

Isotype switching

Somatic hypermutation

Opsonization

Somatic recombination

29. Which of the following does not describe B cell receptors

B cell receptors are membrane bound and secreted

B cell receptors consist of a variable region and a constant region

B cell receptors lack specificity and can bind to a number of different antigens

B cell receptors possess specificity and can therefore bind only to unique epitopes

B cell receptors undergo affinity maturation as a consequence of somatic hypermutation

30. The antigen binding site of an immunoglobulin is formed from

The V regions of light chains only

The C regions of heavy chains only

Paired V regions of a single heavy chain and a single light chain

Paired V regions of two light chains

Paired C regions of two heavy chains

31. ________ of thymocytes is necessary to produce a T cell repertoire capable of interacting with self MHC molecules

Positive selection

Apoptosis

Receptor editing

Isotype switching

Negative selection

32. The area of contact between membranes of T cell and an antigen presenting cell where a clustering of protein protein interactions occur is called a(n)

Cross-presentation center

Polarization

Granuloma

Immunoreceptor tyrosine-based activation motif (ITAM)

Immunological synapse

33. The process of ______ results in change in the constant region of the heavy-chain of antibodies, causing a change in the effector functino and transport properties of antibodies

Complement fixation

Neutralization

Isotype switching

Somatic hypermutation

Somatic recombination

34. The antigen recognition site of T cell receptors is formed by the association of which of the following domains

V alpha and C alpha

V alpha and C beta

C alpha and C beta

V alpha and C beta

V alpha and V beta

35. Which of the following cell surface glycoproteins is characteristic of stem cells, but stops being expressed when a cell has committed to the T cell developmental pathway

CD25

CD3

MHC class II

CD34

CD2

36. The ligand for CR3 and CR4 formed by the cleavage of C3b by the combined action of factors H and I is called

C3bBb

C3a

C3b2Bb

IC3b

C5b

37. Which of the following is NOT a characteristic of C-reactive protein

Acts as an opsonin by binding to phosphocholine of pathogens

Synthesized by spleen

Induced by elevated IL-6

A member of the pentraxin family

Triggers the classical pathway of complement activation

38. Which of the following statements regarding CD8 T cells is incorrect

When activated, CD8 T cells in turn activate B cells

CD8 is also known as the CD8 T-cell co-receptor

CD8 binds to MHC molecules at a site distinct from that bound by the T-cell receptor

CD8 cells kill pathogen-infected cells by inducing apoptosis

CD8 T cells are MHC class I-restricted

39. A defect in which of the following proteins blocks B cell development at the pre B cell stage, resulting in almost no circulating anitbodies in individuals with this defect

Brutons tyrosine kinase (Btk)

CD19

Terminal deoxynucleotidyltransferase (tDt)

Pax-5

IL-7 receptor

40. A conjugate vaccine is one that couples __ to _ so as to stimulate T dependent antibody responses

Adjuvant, toxoids

A protein carrier, irradiated DNA

Protein carrier, toxoids

Polysaccharide; a protein carrier

Polysaccharide, filamentous hemagglutinin

41. Which of the following characteristics is common to both T cell receptors and immuniglobulins

Somatic recombination of V,D, and J segments is responsible for the diversity of antigen-binding sites

Somatic hypermutation changes the affinity of antigen-binding sites and contribues to further diversification

Class switching enables a change in effector function

The antigen receptor is composed to two identical heavy chains and two identical light chains

Carbohydrate, lipid and protein antigens are recognized and stimulate a response

42. Pro B cells produce a surrogate light chain, which associaes with the mu chain on the cell surface. The surrogate light chain is composed of

RAG 1 and RAG 2

Ig alpha and Ig beta

E2A and EFB

VpreB and lambda 5

Pax5 and CD19

43. An important advantage of having two gene loci kappa and lambda for the light chain is

That the likelihood of a successful rearrangement of light chain genes increases

That immunoglobulins are homogeneous and not heterogeneous in mature B cells

That different effector functions are conferred by the two different light chain loci

That surrogate light chain transcription cannot compete with kappa and lambda transcription and enables B cell development

All of the above

44. The human thymus begins to degenerate as early as one year after birth. This process is called __ and is marked by the accumulation of _ once occupied by thymocytes

Negative selection: gamma delta T cells

Differentiation gamma delta T cells

Thymectomy: dendritic cells

Involution; thymic stroma

Involution: fat

45. The co-stimulatory molecule __ on professional antigen-presenting cells bind on the surface of naive T cells

MHC class II: CD4

ICAM-1; LFA-1

MHC class II: T cell receptor

B7: CD28

DC-SIGN: ICAM-3

46. ______ is the term used to describe how pathogen antigens resemble host antigens and can sometimes trigger autoimmune disease

Linkage equilibrium

Sympathetic senescence

Intermolecular epitope spreading

Intramolecular epitope spreading

Molecular mimicry

47. Which of the following pairs of association is mismatched

Monocyte: macrophages

B cell: plasma cell

Myeloid progenitor: neutrophil

Large granular lymphocyte: T cell

Megakaryocyte: platelet

48. Which of the following is NOT a charactersitc of septic shock

Organ failure

High mortality rate

Compromised blood supply to vital organs

Blood vessel constriction

Disseminated intravascular coagulation

49. Circulaating B cell that has never before encountered antigen expresses ____ on the cell surface

IgM and IgD

IgM

IgD

IgM and IgG

IgG

IgE

50. Which of the following cell surface markers differentiates hematopoietic stem cells from other cell constituents in the bone marrow

BAFF receptor

Pre B cell receptor

Membrane bound stem cell factor (SCF)

CD34

CD4

51. Stromal cells produce _________, which is a secreted B cell development growth factor influencing the progression of B cells from the late pro B cell to the pre B cell stage

VCAM-1

VLA-4

Stem cell factor

Kit

IL-7

52. Developing B cells that fail to make productive D to J heavy chain rearrangements on both homologous chromosomes

Will rearrange heavy chain loci multiple times until a productive rearrangement is made

Unpregulate expression of transcription factors E2A and EBF

Undergo clonal proliferation

Fail to rearrange V to DJ

Die to apoptosis in the bone marrow

53. Which of the following cell surface markers differentiates hematopoietic stem cells from other cells constituents in the bone marrow

BAFF receptor

Pre B-cell receptor

Membrane bound stem cell factor (SCF)

CD34

CD4

54. Native lymphocytes homing to lymphoid tissue use ____ to bind to CD34 and GlyCAM-1 on high endothelial venules

CCL21

L-selection

CD2 (LFA-2)

CD28

ICAM-1

55. The co-stimulatory molecule _ on professional antigen-presenting cells binds __ on the surface of naive T cells

MHC class II: CD4

ICAM-1: LFA-1

MHC class II: T-cell receptor

B7: CD28

DC-SIGN: ICAM-3

56. Denatured toxin molecules called _ are used to vaccinate individuals to stimulate the production of _

Toxoids; passive immunity

Toxoids; C-reactive protein

Adhesins; neutralizing antibodies

Toxoids; neutralizing IgG anitbodies

Adhesins; complement proteins

57. _______ is the vascular addressin found on endothelial cells of intestinal mucosa that binds to integrins of gut-homing effector lymphocytes

C-cadherin

CCr9

CCL25

NOD1

MAdCAM-1

58. The plasma proteins that counteract the activity of factor P by inactivating C3 convertase through the cleavage of C3b are

Factor B and factor H

Factor H and factor I

Factor B and factor I

Decay-accelerating factor and factor H

Decay-accelerating factor and membrane cofactor protein

59. An allergic reaction to poison ivy is associated with

An Arthus reaction

Eosinophil activation

Cytotoxic T cell activation

Mast cell activation

Complement activation

60. What type of hypersensitivity reaction would result from a mismatched blood transfusion

Type I

Type II

Type III

Type IV

61. A(n) _____ is an epitope that is typically not accessible to the immune system but is revealed under inflammatory or infectious states

Carrier

Regulatory peptide

Adjuvant

Cryptic epitope

Molecular mimic

62. Which of the following best describes an endogenous pyrogen

Cytokines made by pathogens that decrease body temperature

Pathogen products that decrease body temperature

Pathogen products that increase body temperature

Cytokines made by the host that decrease body temperature

Cytokines made by the host that increase body temperature

63. In most cases, adaptive immune responses rely on the initial activation of ________ in secondary lymphoid tissue

Macrophages

T cells

B cells

Dendritic cells

Epithelium

64. Which of the following characteristics permits activated CD8 T cells to destroy any cell type harboring viable and replicating pathogens such as viruses

The pathogen is located in extracellular pathogens

CD8 T cells enable macrophages to kill intracellular pathogens

Pathogen-derived peptides bind MHC Class I molecules in endocytic vesicles found ubiquitously in most cell types

MHC class II molecules are expressed ubiquitoously by most nucleated cells

MHC class I molecules are expressed ubiquitously by most nucleated cells

65. MHC Class II molecules are made up of two chains called __. whose function is to bind peptides and present them to _ T cells.

Alpha and beta; CD4

Alpha and beta 2-microglobulin; CD4

Alpha and beta; CD8

Alpha and beta 2-microglobulin; CD8

Alpha and beta; gamma delta T cells

66. Which of the following describes the sequence of events involved in the processing of peptides that will be presented as antigen with MHC class II.

Protease activity, removal of CLIP from MHC class II, binding of peptide to MHC class II, endocytosis, plasma membrane

Endocytosis, protease activity, removal of CLIP from MHC class II, binding of peptide to MHC class II, plasma membrane

Removal of CLIP from MHC class II, binding of peptide to MHC class II, protease activity, endocytosis, plasma membrane

Binding to peptide to MHC class II, endocytosis, removal of CLIP from MHC class II, protease activity, plasma membrane

Plasma membrane, endocytosis, protease activity, removal of CLIP from MHC class II, binding of peptide to MHC class II.

67. _______ involves successive rearrangement at the light-chain loci when reactivity to self antigen occurs during B-cell development

Chromosomal translocation

Receptor editing

Clonal deletion

Anergy

Somatic hhpermutation

68. Which of the following is not produced by Th2

TGF beta

CD40 ligand

IL-10

IFN gamma

IL-4

69. Lipopolysaccharide is an example of a ___ antigen that is recognized by TLR4 when bound to _.

Thymus dependent; LPS-binding protein

Thymus-independent (TI)-2; B cell co receptor

Immune complex: iccosomes

Thymus-independent (TI)-1; LPS binding protein

Thymus-dependent; MHC class II

70. The five isotypes of immunoglobulin differ from each other in there __________.

Light-chain constant regions

Heavy-chain constant regions

Light-chain variable regions

Heavy-chain variable regions

Heavy-chain variable and constant regions

71. Nucleotide changes in variable regions of immunoglobulin genes affecting affinity for antigen

Monoclonal antibody production

Isotype switching

Somatic hypermutation

Opsonization

Somatic recombination

72. Which of the following is characteristic of large pre B cell

V-J is rearranging at the light chain locus

VDJ is successfully rearranged and mu heavy chain is made

Mu heavy chain and lambda or kappa light chain is made

D-J is rearranging at the heavy chain locus

V is rearranging to DJ at the heavy chain locus

73. Lymphoblasts upregulate a transcription factor called ______ when they terminally differentiate into plasma cells

Bcl-xL

CD40

B-lymphocyte induced maturation protein 1 (BLIMP-1)

ICAM-1

NF Kappa B

74. Antibody dependent cell mediated cytotoxicity (ADCC) is carried out by __ after cross linking of IgG1 or IgG3 antibodies on receptors

Macrophages; FC gamma RIIB2

Neutrophils: Fc gamma RI

Mast cells; FC epsilon RI

NK cells; Fc gamma RI

NK cells; Fc gamma RIII

75. Individuals with an immunodeficiency affecting B cell function are more susceptible to infections caused by which of the following pathogens

Listeria Monocytogenes

Toxoplasma gondii

Haemophilus Influenzae

Mycobacterium tuberculosis

Respiratory Synctial virus

76. An example of type III hypersensitivity is _______

Asthma

Serum sickness

Allergic rhinitis

Tuberculin reaction

Contact dermatitis

77. The individual protection of unvaccinated individuals as a consequence of sufficient prevalence of vaccination in the population in which they reside is known as

Suppressive immunity

Passive immunity

Acquired immunity

Indirect immunity

Her immunity

78. Alloantibodies to blood vessel endothelium on solid organ grafts _______

Cause acute rejection

Are IgA and do not fix complement

Target endothelium for attack by NK cells

Cause hyperacute rejection

Are specific for HLA class I and class II antigens

79. Which of the following describes the sequence of events involved in processing of peptides that will be presented as antigen with MHC class I.

Plasma membrane -- TAP1/2 --- proteasome -- MHC class I -- endoplasmic reticulum

TAP 1/2 -- proteasome -- MHC class I -- endoplasmic reticulum -- plasma membrane

Proteasome -- TAP 1/2 -- MHC class I -- endoplasmic reticulum -- plasma membrane

Proteasome -- TAP 1/2 -- endoplasmic reticulum -- MHC class I -- plasma membrane

Endoplasmic reticulum -- proteasome -- MHC class I -- TAP 1/2 -- plasma membrane

80. The high degree of polymorphism in MHC class I molecules that present antigens to CD8 T cells found in _ becuase is/are monomorphic

Beta 2 microglobulin; the heavy chain

Both the alpha and beta chains; none

HLA-DO beta; HLA-DO alpha

The heavy chain; beta 2 microglobulin

HLA-E and HLA-G; HLA-F

81. Which of the following is a protein tyrosine kinase involved in T-cell activation culminating in T-cell proliferation and differentiation

Lck

NF Kappa B

NFAt

ZAP-70

AP-1

82. Binding of _ to induces T-cell proliferation and differentiation of activated T cells

LFA-1: ICAM-1

IL-2: the low affinity IL-2 receptor

CD28: B7

CD4: MHC class II

IL-2: the high-affinity IL-2 receptor

83. Naive lymphocytes homing to lymphoid tissue use ____ to bind to CD34 and GlyCAM-1 on high endothelial venules

CCL21

L-selection

CD28

CD22 (LFA-2)

ICAM-1

84. Complexes of IgG bound to soluble multivalent antigens can activate the classical pathway of complement, resulting in the deposition of on the complex, targeting it for endocytic uptake by cells bearing .

C5-9; CR1 and Fc receptors

C2a; CR2 and Toll like receptors

C3b; CR1 and Fc receptors

C3b: CR2 and Toll like receptors

C4b; CR2 and Fc receptors

85. WHich of the following deficiency syndromes affects T cell but not the B cell function

X linked agammaglobulinemia

X linked lymphoproliferative syndrome

X linked SCID

X linked hyper IgM syndrome

X linked Wiskott-Aldrich syndrome

86. A genetic defect in ____ results in the accumulation of toxic levels of nucleotide metabolites and loss of T cell function

Adenosine deaminase (ADA)

Myeloperoxidase

SH2D1A

NADPH oxidase

Glucose-6-phosphate dehydrogenase

87. The extent to which an individuals T cells respond to allogeneic HLA expressed on irradiated donor cells can be measured in vitro using _______

The transfusion effect assay

A cross match test

The mixed lymphocyte reaction

A superantigen recognition test

The panel reactive antibody test

88. Which of the following is mismatched

Immunoglobin light chain: VJ

T-cell receptor alpha chain: VJ

Immunoglobin heavy chain: VJ

T-cell recepot beta chain:VDJ

None of the above is mismatched

89. The contribute to antigen specificity of immunoglobulins, and make up the conservative flanking regions.

Hypervariable loops; framework regions

Constant domains; variable domains

Heavy chains; light chains

Variable gene segments; joining gene segments

Antigenic determinants; complementarity determing regions

90. Which of the following is the first T cell receptor complex containing the beta chain to reach the cell surface during the development of T lymphocytes

Beta CD3

Gamma beta CD3

PT alpha; beta CD3

Alpha beta CD3

Beta CD44

91. Activated T cells express __, which binds to B7 with twentyfold higher affinity for B7 than CD28 and results in of T cell activity and proliferation.

VLA-4: stimulation

Fas Ligand: stimulation

CD40L: suppression

CTLA4: suppression

High affinity IL-2 receptor stimulation

92. During infection with HIV, a person is said to undergo seroconversion when

HIV is transferred from an infected person to an uninfected recipient

The initial phase of infection is followed by clinical latency

HIV varients convert from macrophage tropic to lymphocyte tropic late in the infection

Anti HIV antibodies are detectable in their blood serum

Cellular transcription favors the production of HIV encoded RNA

93. The wheal and flare inflammatory reaction is an example of

An immediate type I allergic response

A late phase type I allergic response

A late phase type IV allergic response

An immediate type III allergic response

A late phase type III allergic response

94. Which of the following TLR3 and TLR4 adaptor proteins participates in the activation pathway that culminates iin the synthesis of type1 interferons

C-reactive protein

MyD88

LPS-binding protein

TRIF and TRAM

NFKappaB

95. In terms of V, D, and J segment arrangement, the T cell receptor alpha chain locus resembles the immunoglobulin _ locus while the T cell receptor beta chain locus resembles the immunoglobulin __ locus.

Lambda light chain; kappa light chain

Heavy chain; lambda light chain

Kappa light chain; heavy chain

Lambda light chain; heavy chain

Kappa light chain; lambda light chain

96. Which of the following statements is correct

The lambda light chain genes rearrange before the kappa light chain genes

The lambda light chain genes rearrange before the heavy chain genes

The kappa light chain genes rearrange before the heavy chain genes

The kappa light chain genes rearrange before the lambda light chain genes

The mu heavy chain genes rearrange first and then the lambda light chain genes rearrange

97. ______ is a second messenger in the T cell signaling pathway leading to the activation of NFAT

Diacylglycerol (DAG)

Fos

Inositol triphosphate

NF (kappa) B

Ras

98. What would be the outcome if a naive B cell were to simultaneously bind to pathogen coated with specific antibody made by an effector B cell in a primary immune response using Fc gamma RIIB1, and bind to the same pathogen using its B cell receptors

A positive signal leading to somatic hypermutation and production of hight affinity IgM antibodies

A negative signal leading to apoptosis

A negative signal leading to inhibition of the production of low affinity IgM antibodies

A positive signal leading to isotype switching and production of IgG, IgA, or IgE antibodies

A positive signal leading to the production of low affinity IgM antibodies

99. _____________ is a molecule expressed on NK cells and V gamma: V delta 1 T cells

CD3

NKG2D

CD94: NKG24

MIC-A

Killer cell immunoglobulin like receptor (KIR)

100. Another name for anti immunoglobulin autoantibodies is

Rituximab

C reactive protein

Infliximab

Thyroglobulin

Rheumatoid factor

Ectopic antibodies

101. Which of the following is the first stage of T cell receptor gene rearrangement in alpha beta T cells

D beta to J beta

V alpha to D alpha

V alpha to J alpha

D alpha to J alpha

V beta to D beta

102. Expression of IFN gamma is induced in a CD4 Th1 cell under the direction of the transcription factor ______

AP-1

FoxP3

GATA-3

T-bet

NFAT

103. Cytokine receptors are associated with cytoplasmic protein kinases called _____ which become activated when the cytokine receptors bind to their respective cytokines

STATs

JAKs

LcK

ZAP-70

ITAMs

104. The B-cell co receptor is composed of

CD40; MHC class II; CD19

Ig alpha; Ig beta; Lyn tyrosine kinase

CR2 (CD21); CD19; CD19

Ig alpha; Ig beta; CD19

CD14; CD19; CD18

105. A primary focus forms after a circulating naive B cell forms a conjugate pair with in the of a lymph node

TH2 cell: T cell zone

TH1 cell: B cell zone

Cytotoxic T cell: T cell zone

CD40 ligand; T cell zone

Follicular dendritic cell; germinal center

106. During the course of a successful desensitization process, the patients antibodies will change from an isotype to an _ isotype

IgA: IgM

IgE: IgM

IgG1: IgG4

IgE: IgG4

IgG4: IgE

107. The upregulation of ______ by IFN gamma can contribute to anigen specific T cell activation on thyroid epithelium

CD4

HLA class II

HLA class I

CD8

CD28

108. Which of the following is NOT a characteristic of native antigen recognized by T cells

Peptides ranging between 8 and 25 amino acids in length

Not requiring degradation for recognition

Amino acid sequences not found in host proteins

Primary, and not secondary, structure of protein

Binding to major histocompatibility complex molecules on the surface of antigen-presenting cells

109. Secretory IgA is best described as ________.

A complement activating immunoglobulin that causes destruction of invasive microflora through the membrane attack complex

An inflammatory immunoglobulin that stimulates the chemotaxis of neutrophils into mucosal surfaces

A monomeric IgA that neutralizes antigen effectively at mucosal surfaces

A non-inflammatory that restricts the passage of antigens across mucosal surfaces

An opsonizing antibody that facilitates uptake by M cells through Fc receptors

110. Regulatory T cells function by _______.

Suppressing proliferation of naive self reactive T cells

Overexpressing CD28 which blocks B7 ligands on antigen presenting cells

Disrupting T cell zones of secondary lymphoid tissues

Competing for antigen and proliferating to higher numbers than autoreactive T cells

Inducing apoptosis of autoreactive T cells

111. ______ is a T cell specific adhesion molecule expressed before the expression of a functional T cell receptor while the thymocytes are still in their double negative stage of development

CD3

CD25

CD8

CD2

CD4

112. Intracytoplasmic bacteria in enterocytes of the gastrointestinal tract are detected by ______.

MIC-A and MIC-B

Poly-Ig Receptor

Receptors for phosphoantigens

Major basic protein

NOD proteins

113. Women who are heterozygous for a defective Brutons tyrosine kinase (BtK) gene

Mount normal B cell immune responses despite having lowered levels of serum IgG

Have non random X inactivation in their B cells

Exhibit X linked agammaglobulinemia

Have a 50% chance of having a son with X linked hyper IgM syndrome

Are more susceptible to infections caused by extracellular pyrogenic bacteria

114. A mechanism by which cancer cells an evade an immune response involves an alteration in the amount of MIC on the cell surface by

Alternative mRNA splicing resulting in a truncated form of MIC that is no longer able to bind to NKG20

Cytosolic degradation of MIC in proteasomes

Decreasing the level of MIC transcription

Switching from a transmembrane form of MIC to a secreted form

Cleavage of MIC at the cell surface by a protease

115. Identify which of the following is not associated with acitvation-induced cytidine deaminase (AID) activity

Diversification of the V H sub domain but not the V L domain

Synthesized in proliferating B cells during active immune responses

Somatic hypermutation

Isotype switching

Cytosine conversion to uracil

116. The peptide binding groove of MHC class I molecules is composed of the following extracellular domains

Alpha 1, beta 1

Beta 1, beta 2

Alpha 2, beta 2

Alpha 2, alpha 2

Alpha 1, alpha 2

117. Which of the following is mismatched

Double negative CD3- thymocytes: subcapsular zone

Corticl epithelial cells: subcapsular regions

Double positive CD3+ thymocytes: cortico-medullary junction

Dendritic cells: cortico-medullary junction

Double negative CD3- thymocytes: cortico-medullary junction

118. Which of the following antibodies exhibits monovalence as a result of the exchange of IgG half molecules (one H plus one L chain) forming bispecific antibody molecules

Dimeric IgA

IgM

IgG1

IgE

IgG4

119. Proteins not expressed on normal cells but found on tumor cells are called _______

Proto oncogene products

Oncogenic antigens

Cancer stem cell antigens

Tumor specific antigens

Tumor associated antigens

120. In the secondary lymphoid tissued, which of the following routes do B cells take during their activation, proliferation and differentiation

HEV to B cell zone to T cell zone to medullary cords to light zone of the germinal center

HEV to T cell zone to dark zone of germinal center to light zone of germinal center to medullary cords

HEV to T cell zone to medullary cords to dark zone of germinal center to light zone of germinal center

HEV to medullary cords to T cell zone to dark zone of germinal cneter to light zone of germinal center

HEV to dark zone of germinal center to light zone of germinal center to T cell zone to medullary cords

121. A major attraction of immune stimulating complexes ISCOMs as an adjucant is that they _______

Form insoluble particles that resist dispersion and degradation

Bind to Toll like receptors and initiate a state of inflammation

Deliver antigen to the cytosol for presenation by MHC class I

Enhance uptake by macrophages and delivery of antigen to endosomal compartments

Bind to respiratory epithelium and mimic viral routes of entry

122. The complemtarity-determining region CDR 1 and CDR2 loops of the T cell receptor contact the ______.

Side chains of amino acids in the middle of the peptide

Co-receptors CD4 or CD8

Membrane-proximal domains of the MHC molecule

Constant regions of antibody molecules

Alpha helices of the MHC molecule

123. A feature of T cell development that may contribute to tumor development is

Positive selection

Expression of two alpha chains by the same T cell

Apoptosis

Negative selection

DNA rearrangement

124. The efficiency of treating bladder cancer is increased by introduing the BCG vaccine. The vaccine component attributing this antitumor effect is _____ which induces a state of chronic inflammation.

Peptidoglycan

Mycolic acid

Unmethylated Cpg containing DNA

Teichoic acid

Lipopolysaccharide

125. Change of immunoglobulin class but prevention of antigen specificty

Monoclonal antibody production

Isotype switching

Somatic hypermutation

Opsonization

Somatic recombination

Immunology & Serology

1. Which is immunoglobulin is transported efficiently across mucosal epithelium

2.

What first name or nickname would you like us to use?

2. The most abundant type of leukocyte in human peripheral blood is

3. Which of the following pairs is mismatched

4. One reason that pathogenic microorganisms have an advantage in the host they infect is because they

5. Which of the following describes the flow of lymph through a lymph node draining an infected tissue

6. Which of the following is NOT associated with mucosal surfaces

7. The antibody transported across mucosal epithelia is ___________.

8. Which immunoglobulins main function is to mediate sensitization of mast cells

9. _____ vaccines are the most effective at evokin memory responses against a virus in an immunized host

10. Which of the following is NOT a characteristic of inflammation

11. Which of the following polymerizes to form a transmembrane channel that compromises the integrity of cell membranes

12. Which of the following does NOT describe the actions of the coagulation system

13. Which of the following characteristics the B-1 cells that develop prenatally

14. Which of the following does NOT accuratley describe complement components

15. The mutational mechanism that results in the production of antibodies that bind antigen with higher affinity is called

16. The antigen-binding site of an immunoglobin is formed from

17. The function of negative selection of thymocytes in the thymus is to eliminate

18. Autoimmune polyendocrinopathycandidiasis-ectodermal dystrophy (APECED) is caused by a defect in

19. Which of the following is the membrane-bound form of C3 convertase of the alternative pathway of complement activation

20. The enzyme responsible for recombining V, D, and J segments during somatic recombination is called

21. In B cells transport of immunoglobulin to the membrane is dependent on association with two invariant proteins, IG alpha and IG beta. Which of the following invariant proteins provide this function for the T cell receptor in T cells.

22. IgM is particularly efficient at fixing complement because ________.

23. The risk of _____ is the primary complication in bone marrow transplants

24. Examples of granulocytes include all of the following except

25. Which of the following statements is false

26. Which of the following is the predominant route by which pathogens are brought from a site of infection into a lymph node.

27. Which of the following does not describe B-cell receptors

28. The rearrangement of V, D, and J segments to form an immunoglobulin

29. Which of the following does not describe B cell receptors

30. The antigen binding site of an immunoglobulin is formed from

31. ________ of thymocytes is necessary to produce a T cell repertoire capable of interacting with self MHC molecules

32. The area of contact between membranes of T cell and an antigen presenting cell where a clustering of protein protein interactions occur is called a(n)

33. The process of ______ results in change in the constant region of the heavy-chain of antibodies, causing a change in the effector functino and transport properties of antibodies

34. The antigen recognition site of T cell receptors is formed by the association of which of the following domains

35. Which of the following cell surface glycoproteins is characteristic of stem cells, but stops being expressed when a cell has committed to the T cell developmental pathway

36. The ligand for CR3 and CR4 formed by the cleavage of C3b by the combined action of factors H and I is called

37. Which of the following is NOT a characteristic of C-reactive protein

38. Which of the following statements regarding CD8 T cells is incorrect

39. A defect in which of the following proteins blocks B cell development at the pre B cell stage, resulting in almost no circulating anitbodies in individuals with this defect

40. A conjugate vaccine is one that couples ______ to _____ so as to stimulate T dependent antibody responses

41. Which of the following characteristics is common to both T cell receptors and immuniglobulins

42. Pro B cells produce a surrogate light chain, which associaes with the mu chain on the cell surface. The surrogate light chain is composed of

43. An important advantage of having two gene loci kappa and lambda for the light chain is

44. The human thymus begins to degenerate as early as one year after birth. This process is called ______ and is marked by the accumulation of _____ once occupied by thymocytes

45. The co-stimulatory molecule ______ on professional antigen-presenting cells bind ____ on the surface of naive T cells

46. ______ is the term used to describe how pathogen antigens resemble host antigens and can sometimes trigger autoimmune disease

47. Which of the following pairs of association is mismatched

48. Which of the following is NOT a charactersitc of septic shock

49. Circulaating B cell that has never before encountered antigen expresses ____ on the cell surface

50. Which of the following cell surface markers differentiates hematopoietic stem cells from other cell constituents in the bone marrow

51. Stromal cells produce _________, which is a secreted B cell development growth factor influencing the progression of B cells from the late pro B cell to the pre B cell stage

52. Developing B cells that fail to make productive D to J heavy chain rearrangements on both homologous chromosomes

53. Which of the following cell surface markers differentiates hematopoietic stem cells from other cells constituents in the bone marrow

54. Native lymphocytes homing to lymphoid tissue use ____ to bind to CD34 and GlyCAM-1 on high endothelial venules

55. The co-stimulatory molecule _____ on professional antigen-presenting cells binds ______ on the surface of naive T cells

56. Denatured toxin molecules called _____ are used to vaccinate individuals to stimulate the production of _____

57. _______ is the vascular addressin found on endothelial cells of intestinal mucosa that binds to integrins of gut-homing effector lymphocytes

58. The plasma proteins that counteract the activity of factor P by inactivating C3 convertase through the cleavage of C3b are

59. An allergic reaction to poison ivy is associated with

60. What type of hypersensitivity reaction would result from a mismatched blood transfusion

61. A(n) _____ is an epitope that is typically not accessible to the immune system but is revealed under inflammatory or infectious states

62. Which of the following best describes an endogenous pyrogen

63. In most cases, adaptive immune responses rely on the initial activation of ________ in secondary lymphoid tissue

64. Which of the following characteristics permits activated CD8 T cells to destroy any cell type harboring viable and replicating pathogens such as viruses

65. MHC Class II molecules are made up of two chains called ________. whose function is to bind peptides and present them to _______ T cells.

66. Which of the following describes the sequence of events involved in the processing of peptides that will be presented as antigen with MHC class II.

67. _______ involves successive rearrangement at the light-chain loci when reactivity to self antigen occurs during B-cell development

68. Which of the following is not produced by Th2

69. Lipopolysaccharide is an example of a _______ antigen that is recognized by TLR4 when bound to _____.

70. The five isotypes of immunoglobulin differ from each other in there __________.

71. Nucleotide changes in variable regions of immunoglobulin genes affecting affinity for antigen

72. Which of the following is characteristic of large pre B cell

73. Lymphoblasts upregulate a transcription factor called ______ when they terminally differentiate into plasma cells

74. Antibody dependent cell mediated cytotoxicity (ADCC) is carried out by ______ after cross linking of IgG1 or IgG3 antibodies on ____ receptors

75. Individuals with an immunodeficiency affecting B cell function are more susceptible to infections caused by which of the following pathogens

76. An example of type III hypersensitivity is _______

77. The individual protection of unvaccinated individuals as a consequence of sufficient prevalence of vaccination in the population in which they reside is known as

40. A conjugate vaccine is one that couples __ to _ so as to stimulate T dependent antibody responses

44. The human thymus begins to degenerate as early as one year after birth. This process is called __ and is marked by the accumulation of _ once occupied by thymocytes

45. The co-stimulatory molecule __ on professional antigen-presenting cells bind on the surface of naive T cells

55. The co-stimulatory molecule _ on professional antigen-presenting cells binds __ on the surface of naive T cells

56. Denatured toxin molecules called _ are used to vaccinate individuals to stimulate the production of _

65. MHC Class II molecules are made up of two chains called __. whose function is to bind peptides and present them to _ T cells.

69. Lipopolysaccharide is an example of a ___ antigen that is recognized by TLR4 when bound to _.

74. Antibody dependent cell mediated cytotoxicity (ADCC) is carried out by __ after cross linking of IgG1 or IgG3 antibodies on receptors

80. The high degree of polymorphism in MHC class I molecules that present antigens to CD8 T cells found in _ becuase is/are monomorphic

82. Binding of _ to induces T-cell proliferation and differentiation of activated T cells

84. Complexes of IgG bound to soluble multivalent antigens can activate the classical pathway of complement, resulting in the deposition of on the complex, targeting it for endocytic uptake by cells bearing .

89. The contribute to antigen specificity of immunoglobulins, and make up the conservative flanking regions.

91. Activated T cells express __, which binds to B7 with twentyfold higher affinity for B7 than CD28 and results in of T cell activity and proliferation.

95. In terms of V, D, and J segment arrangement, the T cell receptor alpha chain locus resembles the immunoglobulin _ locus while the T cell receptor beta chain locus resembles the immunoglobulin __ locus.

105. A primary focus forms after a circulating naive B cell forms a conjugate pair with in the of a lymph node

106. During the course of a successful desensitization process, the patients antibodies will change from an isotype to an _ isotype