MCQs at the bottom
Name the cytokine produced by Th1 cells that are
responsible for activating macrophages.
The immunoglobulin that is considered the
default immunoglobulin is
What binds to neutrophils during inflamation that
causes them to start to roll?
What leads neutrophils to push through the endothelium,
and move towards the antigen-infected cells during an inflammatory
Neutrophils are brought closer to the surface by what substance
that is produced by the endothelial cells?
What antibody-mediated disease attacks non collagenous protein
in basement membranes of kidney and lung glomeruli?
a. Antibasment membraneosis
b. Goodpastures sytndrome
c. Pemphigus vulgaris
d. Pernicious anemia
Which two immunoglobulins are the antigen receptors for
mature B cells?
PRRS and TLRs have the same function
The main function of dendritic cells is to process antigen material
and present it on their cell surface to offer to:
a. T cells
b. B cells
Following is from this source:
1 Defects in neutrophil NADPH oxidase system produce:
A Chronic granulomatous disease.
B Chediak-Higashi disease.
C Leukocyte adhesion deficiency.
D Hashimoto’s disease.
E Streptococcal infection.
Correct. There is a failure to make reactive oxygen intermediates and to raise the pH in the phagocytic vacuole which facilitates microbicidal action.
4 X-linked agammaglobulinemia results from a mutation in:
A IFNg receptor.
B The CIITA promoter protein.
C An HLA gene.
D CD40L (CD154).
E A tyrosine kinase gene.
Correct. Mutations occur in the Bruton’s tyrosine kinase (Btk) gene.
5 Di George syndrome results from a defect in:
A Purine nucleoside phosphorylase.
C Thymic development.
D DNA repair.
Correct. Stem cells are unable to differentiate to mature T-cells in the absence of the thymic microenvironment.
6 Mutations in the gammac chain of the receptors for IL-2, 4, 7, 9 and 15 lead to:
A Reticular dysgenesis.
B Bare lymphocyte syndrome.
C Hyper–IgM syndrome.
D Severe combined immunodeficiency (SCID).
E Build-up of toxic nucleotide metabolites.
Correct. In particular, the receptor for IL-7 is the most crucial for lymphocyte differentiation.
8 Poor skin tests to a range of microbial antigens such as tuberculin and mumps indicate a deficiency of:
A NK cells.
Correct. These are delayed type hypersensitivity skin tests which are mediated by T-cells.
9 HIV binds to:
B IL-2 receptor.
C NF kappa B.
D Reverse transcriptase.
E TNF receptors.
Correct. The HIV envelope protein gp120 binds to CD4. This targets the virus to this T-cell subset.
10 A coreceptor for HIV is:
Correct. CXCR4 is a chemokine receptor which HIV utilizes as a coreceptor for entry into naive CD4+ T-cells and mature dendritic cells. Another chemokine receptor, CCR5, is used particularly for entry of HIV into immature dendritic cells, macrophages and activated effector or memory CD4+ T-cells.
11 Which of the following is not helpful in the diagnosis of AIDS:
A CD4 numbers.
B CD8 numbers.
C Skin tests to bacterial antigens.
D Lymph node biopsy.
E Serum p24 antigen.
Correct. CD8 numbers are largely unaffected. It is the ratio of CD4:CD8 that falls dramatically.
13 Primary immunodeficiency producing susceptibility to infection by viruses and molds is due to:
A B-cell deficiency.
B T-cell deficiency.
C Phagocyte deficiency.
D Complement deficiency.
E Eosinophil deficiency.
Correct. Production of cytokines and of cytotoxic T-cells are important in the protective response.
14 Deletions in the T-cell CD154 (CD40L) gene produce:
A The hyper–IgM syndrome.
B Congenital X-linked agammaglobulinemia.
C IgA deficiency.
D Wiskott–Aldrich Syndrome.
E Deficiency in cytotoxic T-cell activity.
Correct. Lack of CD154 (CD40L) prevents signalling to the B-cell CD40 to bring about Ig class-switching away from IgM.
2 Which one of the following mast cell products is not preformed and therefore has to be newly synthesized?:
B Prostaglandin D2.
D Neutral protease.
E Eosinophil chemotactic factor (ECF).
Correct. Prostaglandins and thromboxanes are newly synthesized by the mast cell using the cyclo-oxygenase pathway. The leukotrienes B4, C4 and D4 (slow reacting substance of anaphylaxis, SRS-A) are also newly synthesized by the mast cell, in this instance using the lipoxygenase pathway.
1 Which of the following is a non-organ-specific (systemic) autoimmune disease:
A Myasthenia gravis.
B Systemic lupus erythematosus (SLE).
C Hashimoto’s thyroiditis.
D Pernicious anemia.
E Insulin-dependent diabetes mellitus.
Correct. SLE is a disease involving antibodies to non-organ specific antigens such as DNA and induces immune complexes which deposit in the vascular bed causing kidney, skin, joint and cerebral lesions.
2 Which of the following antibodies are of most use for the diagnosis of pernicious anemia:
A Anti-parietal cell.
B Anti-thyroid peroxidase.
D Anti-IgG Fc
E Anti-TSH receptor.
Correct. Parietal cell antibodies detected by immunofluorescence on stomach sections are important markers of inflammatory atrophic gastritis and the subsequent pernicious anemia which can develop. Antibodies to intrinsic factor are even stronger confirmation.
3 Which of the following antibodies are useful for the diagnosis of Sjögren’s syndrome:
B Anti-neutrophil cytoplasm (ANCA).
C Anti-SS-A(Ro), anti-SS-B(La).
E Anti-glomerular basement membrane.
Correct. They give a speckled nuclear fluorescence pattern.
4 The disease most frequently seen in association with pernicious anemia is:
A Addison’s disease of the adrenal.
B Multiple sclerosis.
C Autoimmune hemolytic anemia.
D Rheumatoid arthritis.
E Graves’ disease.
Correct. Graves’ disease is a fairly frequent organ-specific disease and is often found in association with pernicious anemia
5 Which of the following models is an example of a spontaneous organ-specific autoimmune disease:
A (NZB × W)F1:
C Experimental autoallergic encephalomyelitis.
D Thyroiditis induced by early thymectomy and irradiation.
E Non-obese diabetic (NOD) mouse.
Correct. These mice spontaneously develop an inflammatory attack on the islets of Langerhans and production of antibodies to a variety of islet cell antigens.
6 The high concordance rate for monozygotic vs dizygotic twins in type 1 diabetes indicates:
A A strong environmental element.
B A strong genetic element.
C A major influence of sex.
D The influence of HLA.
E That microbial infection cannot be involved.
Correct. The higher concordance rate for genetically identical monozygotic compared to the genetically non-identical dizygotic twins brought up in the same environment clearly favours a strong genetic element.
7 The undue tendency for closely linked genes on a chromosome to remain associated rather than undergo genetic randomisation, is termed:
A Tandem duplication.
B Meiotic crossover.
C Relative risk.
D Linkage disequilibrium.
E Gene conversion.
Correct. As a result of linkage disequilibrium, a disease associated with a particular gene could also show an association with a second gene which was in linkage disequilibrium with the first.