Immunology Module 3

A 25 year old man who underwent a kidney transplant three weeks ago is noted to have an acute rise in serum creatinine. A renal biopsy shows acute cellular rejection.

Which immune cell population is the primary mediator of cellular rejection?

T lymphocytes

Correct Incorrect Correct answer

B lymphocytes

Correct Incorrect Correct answer

Monocytes

Correct Incorrect Correct answer

Natural killer cells

Correct Incorrect Correct answer

Plasma cells

Correct Incorrect Correct answer

A 15 year old male presents with acute onset of upper airway obstruction.Has a positive family history of hereditary angioneurotic edema.

Which of the following is the most appropriate treatment?

C1 inhibitor concentrate

Correct Incorrect Correct answer

Histamine antagonist

Correct Incorrect Correct answer

IV hydrocortisone

Correct Incorrect Correct answer

Cryoprecipitate

Correct Incorrect Correct answer

Intramuscular adrenaline

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A 15 year old male presents with recurrent attacks of angioedema. He had a previous abdominal surgery when he presented with an acute abdominal pain a year ago but there was no surgical cause found.

Lab findings:

C4 reduced
C3 normal
C1-Inhibitor reduced
C1q levels are normal.

What is the most likely diagnosis?

Acquired angioedema Type I

Correct Incorrect Correct answer

Hereditary angioedema Type I

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Hereditary angioedema Type II

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Hereditary angioedema Type III

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Acquired acquired angiodema Type II

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Which one of the following biologically active components of the complement cascade is most directly responsible for the formation of transmembrane channels leading to cell lysis?

C5b-9

Correct Incorrect Correct answer

C3a

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C3b

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C4a

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C5a

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Which of the following immunoglobulins fix complement when they bind to antigen?

IgG and IgM

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Only IgG

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IgG and IgA

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IgG, IgA and IgM

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Only IgM.

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Which one of the following major immunoglobulin classes in the human fixes the alternate complement pathway?

IgA

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IgD

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IgE

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IgG

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IgM

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The protein shared by the alternate and classical complement systems is:

C3

Correct Incorrect Correct answer

C1

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C2

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Properdin

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C4b

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A defect of which component of immune function is most likely to be associated with gingivitis?

Neutrophils

Correct Incorrect Correct answer

B cells.

Correct Incorrect Correct answer

Complement.

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Natural killer cells.

Correct Incorrect Correct answer

T cells.

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A 26-year-old newly qualified nurse presents as she has developed a bilateral erythematous rash on both hands. She has recently emigrated from the Philippines and has no past medical history of note. A diagnosis of contact dermatitis is suspected.

What is the most suitable to test to identify the underlying cause?

Skin patch test

Correct Incorrect Correct answer

Radioallergosorbent test (RAST)

Correct Incorrect Correct answer

Latex IgM levels

Correct Incorrect Correct answer

Skin prick test

Correct Incorrect Correct answer

Urinary porphyrins

Correct Incorrect Correct answer

Which primary disorder is characterized by absence of B cells?

X-linked agammaglobulinemia

Correct Incorrect Correct answer

chronic granulomatous disease

Correct Incorrect Correct answer

common variable immunodeficiency

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Di George Syndrome

Correct Incorrect Correct answer

X-linked lymphoproliferative disease

Correct Incorrect Correct answer

For antigen recognition, the T cell requires the antigen to be processed and expressed with HLA.

Which HLA class does the T cell require for CD4 cells?

Class II

Correct Incorrect Correct answer

Class I

Correct Incorrect Correct answer

Class III

Correct Incorrect Correct answer

Class IV

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Class V

Correct Incorrect Correct answer

Which one of the following is NOT an antigen presenting cell?

NK cell

Correct Incorrect Correct answer

Dendritic cells

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Macrophages

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B-cells

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MHC class 1 positive cells

Correct Incorrect Correct answer

How does the Herpes Simplex virus escapes from being recognized by the APC?

By producing a TAP inhibitor protein

Correct Incorrect Correct answer

Producing a protein that anchors MHC in the ER

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Prevent surface expression of MHC

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Accelerates transport of peptide out of the ER

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Accelerates transport of peptide into the ER

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The following are effects of Dendritic cell activation except?

Downregulation of molecules involved in T cell interaction.

Correct Incorrect Correct answer

Upregulation of MHC-I,II and CD1.

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Increased antigen processing activity

Correct Incorrect Correct answer

Production of IL-12,TNF,IL-10,IL-6,IFN Type 1

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Recruitment of DC precursors to the periphery.

Correct Incorrect Correct answer

All of the following cells express HLA class I except?

Red blood cells

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Eosinophils

Correct Incorrect Correct answer

Platelets

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Neutrophils

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Basophils

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The following statements are TRUE regarding dendritic cells except?

Mature DCs lack co-stimulatory molecules

Correct Incorrect Correct answer

It is a superb antigen presenting cell.

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Present in epidermis and mucosa as langerhans cells.

Correct Incorrect Correct answer

Initiate immune response by activating quiescent naive and memory T and B cells

Correct Incorrect Correct answer

Captures antigen and expresses co-stimulatory molecules

Correct Incorrect Correct answer

Which one of the following is associated with a Type 1 allergy?

Anaphylactic reaction to Penicillin

Correct Incorrect Correct answer

Serum sickness

Correct Incorrect Correct answer

Contact dermatitis

Correct Incorrect Correct answer

Hemolytic anemia

Correct Incorrect Correct answer

Neutropenia

Correct Incorrect Correct answer

Serum tryptase is only helpful if collected within hour many hours following an IgE mediated reaction?

3 hours

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5 hours

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12 hours

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24 hours

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48 hours

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The following drugs are commonly known to cause an anaphylactoid reaction except?

Penicillin

Correct Incorrect Correct answer

Aspirin

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Radiopaque contrast media

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Opiates

Correct Incorrect Correct answer

NSAIDs

Correct Incorrect Correct answer

The following are chemical mediators released by mast cells in anaphylaxis except?

TNF-alpha

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Histamine

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Leukotriene

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Prostaglandins

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Bradykinin

Correct Incorrect Correct answer

Which one of the following test is the most specific for the diagnosis of NSAIDs hypersensitivity?

Basophil activation test

Correct Incorrect Correct answer

Skin prick test

Correct Incorrect Correct answer

Eosinophil activation test

Correct Incorrect Correct answer

RAST

Correct Incorrect Correct answer

Serum Tryptase

Correct Incorrect Correct answer

Skin prick testing is useful for the following conditions except for the testing of an allergy to?

Aspirin

Correct Incorrect Correct answer

Penicillin

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Peanuts

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Latex

Correct Incorrect Correct answer

Shellfish

Correct Incorrect Correct answer

The following are risk factors for radioiodine contrast allergy except?

Seafood allergy

Correct Incorrect Correct answer

Previous reaction to contrast

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Severe asthma

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Cardiac disease

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Use of B-blocker

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A 5 year old boy collapses with wheeze and hypotension during an imaging procedure. He responds quickly to resuscitation.

On review two hours later, which test would be most helpful for confirming a reaction to contrast media?

Tryptase

Correct Incorrect Correct answer

Complement 3 (C3).

Correct Incorrect Correct answer

Eosinophil count

Correct Incorrect Correct answer

Histamine

Correct Incorrect Correct answer

Specific immunoglobulin E (IgE) to the contrast media.

Correct Incorrect Correct answer

Which of the following cytokines is most likely to result in hepatic formation of inflammatory markers such as the CRP?

IL-6

Correct Incorrect Correct answer

IL-12

Correct Incorrect Correct answer

INF-gamma

Correct Incorrect Correct answer

IL-17

Correct Incorrect Correct answer

TGF-Beta

Correct Incorrect Correct answer

Which of the following acute phase proteins decreases with inflammation?

Transcortin

Correct Incorrect Correct answer

CRP

Correct Incorrect Correct answer

Ferritin

Correct Incorrect Correct answer

Mannose binding protein

Correct Incorrect Correct answer

Ceruloplasmin

Correct Incorrect Correct answer

Which of the following cytokine is not responsible for the hepatic formation of inflammatory markers such as the CRP?

IL-12

Correct Incorrect Correct answer

IL- 1

Correct Incorrect Correct answer

IL-6

Correct Incorrect Correct answer

IL-8

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TNF-α.

Correct Incorrect Correct answer

A patient with Sjogren’s syndrome presents with acute pancreatitis. This condition is most likely to respond to steroids if:

IgG4 expressing plasma cells are present in a pancreatic sample

Correct Incorrect Correct answer

The serum IgG4 level is elevated

Correct Incorrect Correct answer

Rheumatoid factor is positive

Correct Incorrect Correct answer

SSB is positive

Correct Incorrect Correct answer

Total IgG is elevated

Correct Incorrect Correct answer

Which of the following statement is correct regarding CTLA-4?

Anti-CTLA4 stimulates the immune response by blocking CTLA4

Correct Incorrect Correct answer

CTLA4-Ig stimulates the immune response by blocking B7

Correct Incorrect Correct answer

CTLA4-Ig stimulates the immune response by blocking CTLA4

Correct Incorrect Correct answer

CTLA4-Ig blocks the immune response by blocking CTLA4

Correct Incorrect Correct answer

Anti-CTLA4 blocks the immune response by blocking CTLA4

Correct Incorrect Correct answer

Expression of which of the following cell surface molecules best defines a stem cell?

CD34

Correct Incorrect Correct answer

CD1a

Correct Incorrect Correct answer

CD10

Correct Incorrect Correct answer

CD13

Correct Incorrect Correct answer

CD19

Correct Incorrect Correct answer

Which of the following HLA chain shows the least allelic polymorphism?

HLA-DR alpha chain

Correct Incorrect Correct answer

HLA-A

Correct Incorrect Correct answer

HLA-B

Correct Incorrect Correct answer

HLA-C

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HLA-DR beta chain

Correct Incorrect Correct answer

A 14 year old boy presents with recurrent facial and lip swelling.These episodes are associated with abdominal pain, diarrhea and vomiting.No urticaria.

Which of the following is the most appropriate investigation to establish the diagnosis?

Functional C1 inhibitor assay

Correct Incorrect Correct answer

Serum tryptase

Correct Incorrect Correct answer

Peanut specific IgE

Correct Incorrect Correct answer

Serum C3

Correct Incorrect Correct answer

Serum C1q

Correct Incorrect Correct answer

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Immunology Module 3

Study Materials

Immunology Study Notes

Cellular and Molecular Immunology

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