MCQs in IMMUNOLOGY

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1.         IgM

a.         is the largest of all immunoglobulins.

b.         is the second most abundant immunoglobulin in the human serum.

c.         crosses the placenta because of attraction to receptor on the Fc portion of the molecule.

d.        antibody in most cases appear before IgG antibody.

e.         is synthesized in plasma cells.

f.          fixes complement.

g.         u chain is the same length as light chain.

h.         in most cases appear before IgG following infection or immunization in animal and man.

 

  2.         We would expect no IgA in the saliva of:

a.         new-born infant.

b.         congenital X-linked hypogammaglobulineamia (Bruton’s disease).

c.         patients suffering from influenza.

d.         patients with DiGeorge’s syndrome.

e.         healthy adult with serum IgA deficiency.

 

3.            Immunological memory cells:

a.         are plasma cells.

b.         are T cells.

c.         are B cells.

d.         cannot be killed irradiation.

e.         will always produce lymphokines when stimulated by the corresponding antigen.

 

4.         A patient requiring a renal transplant is blood group O and his mother is B. His father could be:

a.         blood group A

b.         blood group B

c.         blood group AB

d.         blood group O

 

5.            Fragment ab of the antibody molecule:

a.            contains the antigen binding site.

b.            contains the binding sites to mast cells.

c.             has no light chains.

d.            contains hypervariable regions.

e.         has the same amino acid sequence for all antibody classes to the same antigen.

 

6.         Which of the following are mediators of type I hypersensitivity?

a.            histamine.

b.            anaphylatoxins.

c.            slow reacting substance of anaphylaxis.

d.            macrophage migration inhibitor factor.

e.             5-hydroxytryptamine.

 

  7.         In the secondary antibody response:

a.         the latent or induction period is shorter than that in the primary response.

b.         no IgM antibodies are produced.

c.         more IgG antibodies are produced than the primary response.

d.         the antibody peak persists for a longer period than in the primary response.

e.         more antibody are produced than the primary response but at a slower rate.

 

  8.         Most of the serum immunoglobulins of a normal infant at birth is:

a.            immunologically inactive.

b.         derived from the mother.

c.         IgG.

d.         IgM.

e.         IgD.

 

9.            Sensitized T lymphocytes which have become activated by contact with antigen liberate:

a.            lymphokines.

b.           slow reacting substance of anaphylaxis.

c.            serotonin.

d.            macrophage inhibitory factors.

e.            interferon.

 

10.       The following allergic reactions are identifiable by serum antibodies:

a.         hay fever.

b.         serum sickness.

c.         Arthus reaction.

d.         contact dermatitis.

e.            tuberculin sensitivity.

 

 

11.       A patient was injected with a large dose of horse antitoxin to diphtheria. Seven days after injection, the patient developed serum sickness.

a.         the injected foreign serum acting as an antigen to initiate an immune response.

b.            activation of B lymphocytes cytotoxic to the renal glomerular basement membrane.

c.            attachment of IgE antibodies to mast cells with subsequent liberation of histamine.

d.            formation of soluble antigen-antibody complexes which become deposited in vessel walls of glomeruli.

e.         antigen-antibody complexes of diphteria toxin and antitoxins.

 

12.       In vitro tests of cell-mediated immunity include:

a.            lymphocyte cytotoxicity by tetanus toxin.

b.            production of macrophage migration inhibition factor.

c.         number of rosette cells.

d.         skin test for antigens.

e.            lymphocyte transformed by antigen.

 

  13.       The important reason(s) for a fall-off in Ab production following antigen stimulation is/are:

a.            depletion or exhaustion of antibody forming cells.

b.            catabolism of antibody.

c.            depletion of macrophages.

d.         removal of antigens by antibody.

e.            generation of helper T cells.

 

  14.       The classical complement pathway induced cell membrane lesions in ‘holes ‘ and pits’ observed by electron microscopy are associated with which stage of complement activation?

a.         C1

b.         C4 & C2

c.         C3

d.         C6 & C9

e.         C3a & C5a

 

  15.       Complement:

a.         IgM fixes complement more efficiently than IgG.

b.         the site for complement fixation is situated on the Fc portion of the IgA

            molecule.

c.            anaphylactic hypersensitivity can occur in the absence of complements.

d.            complement products are involved in phagocytosis of bacteria.

e.         C3a may be present without activation of C3.

 

  16.            Development of glomerulonephritis in a kidney grafted from one ‘identical twin' into another implies:

a.         slight histocompatibility difference.

b.         pre-existing disease in donor kidney.

c.            acquisition of original disease by transplanted kidney.

d.         disease induced by immunosuppressive drugs.

e.         HLA matching in kidney transplant is absolutely necessary.

 

  17.       IgG:

a.         is the most abundant immunoglobulin in human serum.

b.            antibody can cross the placenta from maternal circulation into fetal circulation.

c.            antibody always appear before IgM antibody following infection of immunization in animals and men.

d.            antibody fixes complement.

 

  18.       IgA:

a.         does not occur in serum.

b.         is the chief immunoglobulin found in exocrine secretions.

c.            antibody is not synthesized in the plasma cell.

d.            antibody fixes complement.

 

19.       IgE:

a.         is present in trace amounts in human serum.

b.         shows a particular affinity for the surface of lymphocytes.

c.         shows a particular affinity for the surface of basophils.

d.         is elevated in majority of patients with allergic rhinitis.

e.         level is reduced in majority of patients with parasitic infections.

f.          found only in allergy.

g.         is the least abundant Ig in normal serum.

h.         can have kappa or lambda chains.

i.          shows particular affinity for surface of K cells.

j.            produced by plasma cells.

 

  20.       The following is/are important in preventing graft rejection:

a.         ABO red cell antigens.

b.            measuring local serum immunoglobulin level.

c.         HLA typing.

d.         T cell number by E Rosettes.

 

  21.       In the primary antibody response:

a.         the antibody produced initially consists of IgM.

b.         the IgM antibody produced reach much higher levels than the IgG antibodies.

c.         IgG antibodies decline earlier than IgM antibodies.

d.         the antibody peak persists for a longer period than in the secondary response.

e.         the latent period is much longer than in the secondary response.

 

  22.       In agglutination:

a.            particulate antigens are cross-linked by specific antibodies.

b.         IgG antibodies are more efficient than IgM in agglutinating antigens.

c.         excess antibody may cause inhibition of agglutination.

d.         soluble antigens can also be used if these are coated onto particles like sheep erythrocytes.

e.         only detect antibodies.

 

  23.       In precipitations, soluble antibody-antigen complexes are formed when:

a.         all of the antigen-binding sites of an antibody are occupied by individual antigen molecules.

b.         all available antigenic determinants of an antigen molecule are bound by individual antibody molecules.

c.         there is extensive cross-linking of antigen and antibody molecules resulting in the formation of large complexes.

d.         antigen and antibody are at equivalence.

e.         IgA is the immunoglobulin involved.

 

  24.       Cell mediated immunity can be quantified by:

a.            counting the percentage of blast cells in vitro.

b.            measuring the uptake of radio-labelled thymidine by PHA stimulated lymphocytes.

c.            measuring total serum immunoglobulin levels.

d.            measuring the inhibition of migration of macrophages in cultue.

e.            cytotoxicity.

 

  25.       A delayed type of hypersensitivity skin reaction:

a.         is mediated by cytotoxic antibodies.

b.         can occur in a bursectomized chicken.

c.         is known as Arthus reaction.

d.         is due to the interaction of sensitized lymphocytes with antigen.

 

  26.            Difference between T & B cells lie in:

a.                con A stimulation.

b.                size

c.              presence of microvilli.

d.            reaction with sheep erythrocytes.

 

 

27.            Vaccines:

a.         usually not specific.

b.         are non-antigenic unless used with adjuvants.

c.         can be infectious in certain conditions.

d.         are effective in man but not in experimental animals.

e.         period of protection varies between different vaccines.

 

  28.            Haptens:

a.         it has immunogenicity but no reactivity.

b.         it is usually a small molecule.

c.         can only be tested in vivo.

d.         can be made into a complete antigen by coupling to a carrier.

e.         reaction with corresponding Ab is usually specific.

 

 

29.            Immunoglobulins:

a.         all subclasses of IgG fixes complement equally well.

b.         all IgM molecules are 5 times more efficient in binding antigens than an IgG molecule.

c.         IgG is the major serum protein in normal individuals.

d.         the hypervariable sequence of the Fab segments account for the specificity of the molecule.

e.         papain splits the Ig molecule into 2 segments.

 

  30.       The difference between killed & attenuated vaccines lie in:

a.            immunogenicity of the vaccine.

b          length of protection.

c.            requirement of booster doses.

d.            administration to immunosuppressed patients.

 

  31.       HLA antigens:

a.         are found on all cells.

b.         are found on long arm of chromosome 6.

c.            determine the immune response.

d.         are all alloantigens.

 

  32.            Macrophages are involved in the following immunological reactions:

a.            presents antigen to T cells together with HLA class I antigen.

b.            secretes interleukin-1.

c.            secretes interferon when activated by any antigens.

d.            secretes interleukin-2.

e.         delayed hypersensitivity.

 

33.       IgM & IgG are different in terms of:

a.         size

b.         light chains of the Ig.

c.         number of disulfide bonds.

d.         J-chain.

 

  34.       A normal C4 level but decreased C3 level indicates:

a.            activation of the alternative pathway of the complement system.

b.            deficiency of C3.

c.            deficiency of C3 inactivation.

d.            activation of classical pathway of complement system.

 

  35.            Tolerance:

a.         is more easily induced in neonates and in adults.

b.         is broken by the administration of anti-T3 compounds.

c.         can be induced in serum transfer from an affected person to a non-affected person.

d.         can be induced by transferring of lymphocytes from an affected person to a non-affected person.

 

  36.       The paracortical regions of the lymph nodes are devoid of cells in:

a.         patients with DiGeorge’s syndrome.

b.         patients with B cell leukemia.

c.         patients with Bruton’s aggamaglubulinemia.

d.         Swiss type of aggamaglobulinemia.

 

  37.       In transplantation, the following grafts are rejected:

a.            autografts.

b.            isografts.

c.            allografts.

d.            xenografts

 

  38.       The functions of macrophage include:

a.         cell mediated immunity.

b.            opsonization

c.            presentation of antigens to T cell along with HLA type I antigen.

 

  39.       B lymphocytes:

a.            undergo maturation in the thymus.

b.         not found in spleen & lymph nodes.

c.         have Ab receptors for antigen on surface.

d.         only plasma cells secrete Ab.

 

  40.            Suppressor T cells:

a.         contain T4 markers.

b.         are stimulated by antigens.

c.         are found in greater numbers than T helper cells.

 

  41.       The Fab portion participates in:

a.            agglutination.

b.            complement fixation.

c.            stimulation of antibody.

 

  42.       The heavy chain:

a.         has hinge region.

b.         has carbohydrate component.

c.         is coded by variable genes.

d.         has hypervariable regions.

 

  43.            Acquired immunity:

a.         may result from infection with artificial infection.

b.         can be transferred from mother to fetus in utero.

c.         is not obtained in apparent and subclinical infections.

d.         can be mediated by antibody or by cellular resistance.

e.         can be induced by vaccination.

 

  44.       IgM:

a.         appears earlier in evolution than IgG.

b.         can be bound by staphylococcus protein A.

c.         has 2 subtypes.

d.         fixes complement better than IgA by the classical pathway.

 

  45.       True for autoimmune disease:

a.         not genetically related.

b.            myocardial infarct is an autoimmune disease because anti-cardiac antibody is present.

c.         ILA-B8 is associated with autoimmune disease in Caucasians.

d.         more common in males than females.

 

46.            Selective IgA deficiency:

a.            incompatible with good health.

b.         best treated with parenteral immune serum globulins which are IgA.

c.            commonest primary immune deficiency disorder.

d.         due to a specific defect in the J component.

e.         usually takes the form of low secretory IgA but normal serum IgA levels.

 

  47.       Which of the following are mediators of Type I hypersensitivity:

a.            histamine.

b.            anaphylatoxins (C3a, C5a)

c.             SRS-A

d.            macrophage MIF

e.            eosinophil chemotactic factor.

 

  48.            Following are alloantigens:

a.         lambda chain.

b.         blood group A.

c.         Gm.

d.         alpha chain.

e.         HLA class I.

 

  49.       Found in isotype portion of a heavy chain:

a.            disulphide bands.

b.            carbohydrates.

c.            hypervariable segments.

d.            constant portion of the light chain.

e.            allotype.

 

  50.            Fragments ab of the antibody molecule:

a.            contains the antigen binding site.

b.            contains the binding sites to mast cells.

c.           has no light chains.

d.            contains hypervariable regions.

e.         has the same amino acid sequence for all antibody classes to the same antigen.

f.            complement fixation.

 

  51.       Some of the methods in which pathogens escape the host defence systems:

a.            incorporation of host proteins onto surface of pathogens.

b.            stimulate preferentially B cell response.

c.            staphylococcus protein A which binds IgM.

d.            gonococcus producing protease which cleaves IgM.

e.         immune suppression of host.

 

  52.       The following cannot be transferred passively by serum:

a.         Arthus reaction.

b.         contact dermatitis to nickel.

c.            anaphylactic reaction to penicillin.

d.         delayed hypersensitivity.

e.         serum sickness.

 

53.            Complement:

a.         CF text affected by Mg concentrations.

b.         CH50 gives a good idea of the function of the complement system.

c.            alternative pathway cannot be activated by Ig.

d.         IgG can pass the placenta because of its complement receptors.

e.         Ig can activate the alternative pathway of complement.

 

  54.       Cell-mediated immunity:

a.            transferred by injection of plasma cells.

b.            important for TB.

c.            amplified by lymphokines.

d.         2 repeated Mantoux test will stimulate a mantoux negative person.

e.         is antigen non-specific because it activates macrophages.

 

  55.            Secondary immune reaction:

a.            antibody specificity is the same as primary immune response.

b.         Ab avidity is the same as primary immune response.

c.         no IgM is produced.

d.         cells were transferred.

e.         route of injection of antigen must be the same as that eliciting a primary immune response.

 

56.            Vaccines:

a.            example of passive immunity.

b.         should not be given to immunosuppressed patients.

c.         less effective in immunocompromised patients.

d.         period of protection varies between vaccine types.

e.         usually given intravenously.

 

57.            Following cells mediate ADCC:

a.            lymphocytes

b.            basophils

c.         mast cells

d.         killer cells

e.            macrophages

 

58.       The following are examples of Type III hypersensitivity:

a.         primary rejection of allografts.

b.            hyperacute rejection of allografts.

c.         reaction to horse anti-tetanus toxoid.

d.            hayfever

e.            vasculitis.

 

59.       Type II hypersensitivity:

a.         can be detected using skin testing.

b.            detection of Ig on cell surface indicate hypersensitivity.

c.         may be prevented by exchange transfusion.

d.         antigens may be passively attached to cells.

e.         may deplete serum complement.

 

60.       Graft enhancement mediated by:

a.         cell mediated immunity.

b.            complement.

c.         humoral immunity

d.            lympokines

e.            interleukin-1

 

61.            Classical and alternate complement pathways differ in:

a.         heat sensitivity

b.            dependency of Mg

c.            methods of activation

d.            triggering of terminal membrane attack

e.            activation of C4

 

62.       Factors predisposing to infection:

a.            production of protein A by gonnococcus.

b.         loss of cilia of respiratory tract mucosa.

c.            increase motility of GIT.

d.            decrease pH of vagina.

e.         binding of IgG by secreted protein A.

 

63.            Eosinophils:

a.         cannot be distinguished from neutrophils.

b.         may be involved in type I hypersensitivity reaction.

c.            decrease in blood of patient with parasitic infection.

d.            suppress the immune response.

e.         reacts with IgE in ADCC response against worms.

 

64.       B lymphocytes:

a.            stimulated by pokeweed mitogen.

b.            undergo maturation in the thymus.

c.         not found in spleen and lymph nodes.

d.         have antibody receptors for antigens on surfaces.

e.         only plasma cells secrete antibodies.

 

65.       T lymphocytes:

a.         are found in the peripheral blood.

b.         in the lymph node occupy the cortical areas.

c.         after maturation migrate to the red pulp of spleen.

d.         can be distinguished from B lymphocytes by difference in size.

 

66.       Gamma globulins are useful in the prevention of the following infections:

a.            rheumatic fever

b.         gas gangrene

c.         typhoid

d.         rabies

e.          tuberculosis

 

67.      Activation of complement may be induced by:

a.         IgD

b.         IgE

c.         IgG

d.         IgM

e.         IgA

 

  68.       T-cell function can be assessed by:

a.            complement fixation tests.

b.            polyacrylamide gel electrophoresis.

c.         skin testing.

d.            agglutination tests.

e.            lymphocyte proliferation.

 

69.       B cell function can be assessed by:

a.         plasma cell examination by biopsy.

b.         the limulus test.

c.         white blood cell counts.

d.         serum immunoglobulin levels.

e.         C-reactive protein estimation.

 

  70.       C-reactive protein (CRP):

a.         is a non-specific serum protein.

b.         levels increase significantly in acute viral infections.

c.         is secreted by macrophages.

d.         can be measured by complement fixation tests.

e.            activates complement by the classical pathway.

 

  71.       The secretory IgA class of antibody:

a.         is response for type I hypersensitivity.

b.          activates complement by the classical pathway.

c.         is found in saliva and tears.

d.         confers immunity on mucosal surface.

e.         appears as a dimer at the site of action.

 

  72.         Methods used for detecting serum antibodies include:

a.         indirect immunofluorescence.

b.            congulase test

c.            haemagglutination inhibition

d.            complement fixation

e.            polymerase chain reaction

 

  73.       Cell-mediated responses (type 4 hypersensitivity):

a.         evolve within 24 hours.

b.         are important in controlling fungal disease of the skin.

c.         are influenced by local chemotactic factors.

d.         are diminished by treatment with steroids.

e.         are characterized by a predominantly polymorphonuclear cell reaction locally after 48 hours.

 

 

74.      Acute and convalescent sera are required to make a definitive serological diagnosis of infection because:

a.         non-specific antibodies may be present in the first serum.

b.         one serum may not possess sufficient complement.

c.         high levels of antibodies must be demonstrated in both sera.

d.         a rising antibody titre is significant.

e.         one serum may contain an antibiotic.

 

 

75.       Are the following true or false?

a.            transplacental transfer of antibody results in natural active immunity in the fetus.

b.            administration of toxoid results in artificial active immunity.

c.            administration of antitoxin results in artificial passive immunity.

d.            subclinical infection results in natural passive immunity.

e.            administration of gamma globulin results in artificial passive immunity.

 

 

76.       True for complement:

 

a.            involved in type 2 and 3 hypersensitivity reactions.

b.         is the amplication system for cell-mediated immunity.

c.            components are heat-labile.

d.         can be activated without antibodies.

e.         is important for resistance against bacterial infection.

 

 

77.       Class-specific antigenic determinants of immunoglobulin:

a.         L chain

b.         Fc fragments

c.         variable regions of H chains

d.         H chains

e.            idiotypes

 

 

78.            Antibody specificity for a particular B cell:

a.         is encoded in the genome of B cell.

b.         may switch from one isotype to another during differentiation.

c.         induced by interaction with antigen.

d.         is fixed before DNA rearrangement.

e.            determines idiotype of antibody.

 

 

79.       In the secondary immune response:

a.         latent period is shorter than that of the primary response.

b.         only IgG is produced.

c.            response is faster due to preformed memory cells.

d.            antibodies are produced faster and in greater quantities.

e.         IgG production precede IgM.

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