1.

a hapten
stimulates T cell responses
stimulates B cell responses
enhances the antibody response by forming a depot for the
antigen
activates macrophages for increased phagocytosis
requires a carrier to initiate an immune response
2. Binding of antigen to antibody

Is usually unaffected by molecular rigidity.

Is unaffected by the presence or absence of water
molecules.
Involves covalent bonding.
Is optimized by spatial complementarity.
Is usually unaffected by pH.
3. The intermolecular forces which contribute to the interaction between antibody and
antigen:

Are all electrostatic.

Are all van der Waals.
Are all hydrophobic.
Are all hydrogen bonds.
Rely on a combination of the
above.
4. class II HLA molecules

present peptidic epitopes to CD4+ T helper

cells
present peptidic epitopes to CD8+ T helper
cells
"are not encoded by the gene regions DP,
DQ, DR"
appear on the membranes of most nucleated
cells
are characterized by each of the above

5. The processed peptide binding to the MHC class I groove:

Is usually more than 11 amino acids long.
Hangs over the ends of the groove.
Usually binds to the groove through 2 anchor residues.
Is mainly recognized by the CDR2 of the T-cell receptor
chains.
Is derived from exogenous protein taken in by
endocytosis.
 6. TCR recognition of peptide-MHC class II depends on:

Covalent binding.
Very high affinity interactions.
CDR-mediated binding.
A minimum of 2 peptides occupying the binding groove of each MHC
molecule.
The presence of beta2 microglobulin.

1.

CD1:

Is encoded in the MHC region.

Structurally is most similar to MHC class II molecules.
"Can present antigens to gamma delta, but not alpha beta,
T-cells. "
Can present lipid antigens.
Is encoded by a single gene.

1.

A discontinuous antigen epitope is:

Presented by MHC molecules.

Usually concave.
Representative of only a minority of B-cell epitopes.
Produced by a continuous linear peptide sequence.
Produced by amino acid residues on non-adjacent polypeptide
sequences.

1.
 Superantigens:

Do not cause pathology.

Are not mitogenic for T-cells.
Bind to MHC class III.
Bind to all members of a given V beta T-cell receptor
family.
Have to be processed before recognition by the T-
cell.

10

1.

Alpha beta T-cell receptors recognize:

Native antigen.
Free linear antigenic peptide.
MHC beta2-microglobulin.
Linear antigen peptide in the MHC groove.
Lipid and glycolipid antigens associated with
the MHC.

11

1.

Peptides produced by processing of cytosolic proteins largely:

Are generated in late endosomal vacuoles.

Enter the endoplasmic reticulum by diffusion.
Are presented at the cell surface with MHC class II to CD4 T-
helpers.
Are presented at the cell surface with MHC class II to CD8
cytotoxic T-cells.
Are presented at the cell surface with MHC class I to CD8 cytotoxic
T-cells.

12
 1.

Differentiation of antibody classes is a property of

VL chain
region
VH chain
region
CL chain
region
CH chain
region
hinge region

13

1.

The immunoglobulin that has four subclasses is

IgM
IgG
lgA
lgE
lgD

14

1.

The secretory piece

Facilitates passage of IgA out of the plasma cell

Facilitates the formation of the IgM pentamer
?Joins the two molecules of IgA formation the dimmer
?Is a poly Ig receptor on the membranes of mucosal
epithelial cells
"?Is released by IgE, causing excessive nasal secretions"

1
 15

1.

Antiserum developed in rabbits against pooled human IgA will react with human

Kappa light
chains
IgG
lgM
J chain
Each of the
above

16

1.

The antigenic determinants defining the 5 Ig isotypes are associated with

Kappa light
chain
Lambda light
chain
Heavy chains
J chains
di-sulphide
bonds

17

1.

The basic Ig unit is composed of:

2 identical heavy and 2 identical light

chains.
2 identical heavy and 2 different light
chains.
2 different heavy and 2 identical light
chains.
2 different heavy and 2 different light
chains.
 Non-covalently bound polypeptide
chains.

18

1.

The Fc fragment of an IgG antibody:

can attach to a receptor on macrophages.

permits passage through the placenta.
can participate in the activation of
complement.
determines the catabolic rate of IgG.
is characterized by all of the above.

19

1.

The complementarity determining regions:

Are restricted to light chains.

Are in the constant part of the Ig molecule.
Bind to Fc receptors.
Are concerned in antigen recognition.
Occur at the C-terminal end of the Ig peptide
chains.

20

1.

A Fab fragment:

Is produced by pepsin treatment.

Is produced by separation of heavy and light
chains.
Binds antigen.
 Lacks light chains.
Has no interchain disulfide bonds.

21

1.

Cleavage of IgG by papain produces:

Divalent antigen binding

fragments.
?Isolated light chains.
Isolated heavy chains.
?F(ab')2.
Fab.

22

1.

Which class Ig can form a dimer?

lgA
lgE
lgD
lgG
lg
M

23

1.

___ is the natural antibodies against blood cell determinants.

lgA
lgE
lgD
 lgG
lg
M

24

1.

The mucosal surfaces of the body are initially protected by free:

lgG
lgM
lgE
Secretory
IgA.
IgD.

25

1.

Secretory IgA protects external mucosal surfaces by:

Triggering mast cells.

Recruiting phagocytic cells.
Preventing microbial adherence to the
mucosa.
Binding to epithelial cells.
Its secretory piece.

26

1.

IgM:

Is usually of high affinity.

Is most commonly tetrameric.
Has the same number of constant domains
 as IgG.
Is a weak bacterial agglutinator.
Is the main class of the 'natural antibodies'.

27

1.

IgD:

Is pentameric.
Is resistant to proteolytic degradation.
Is present mainly as a surface receptor on
B-cells.
Is present with unusual frequency in
myelomas.
Is abundant in milk

28

1.

The mononuclear phagocyte system does not include:

Monocytes.
Kupffer cells.
Kidney mesangial cells.
Lymph node medullary
macrophages.
Endothelial cells.

29

1.

A polymorphonuclear neutrophil (PMN):

Is a bone marrow stem cell.

Is closely similar to a mast cell.
 Contains microbicidal cytoplasmic
granules.
Is not a professional phagocytic cell.
Has granules which stain with eosin.

30

1.

The membrane attack complex of complement system consists of:

C1qrs.
B factor
"C3b3b,Bb"
"C5b,6,7,8,
9"
"C3a, C5a"

31

1.

C3b

Is chemotactic.
Is an anaphylatoxin.
Opsonizes bacteria.
Directly injures
bacteria.
Is the inactive form of
C3.

32

1.

Lysozyme:

Is a cytoplasmic
organelle.
Activates complement.
 Is a proteolytic
enzyme.
Splits peptidoglycan.
Is released by mast
cells.

33

1.

Virally infected cells can be killed directly by:

C5a
Interferon
NK cells
Eosinophils
C-reactive
protein

34

1.

The specialized cell type involved in the entry of lymphocytes into lymph nodes are called:

M-cells
Mesangial cells
PALS
HEV endothelial
cells
Selectins

35

1.

The spleen is largely involved with the response to antigens which are in the:

 Tissues
Blood
Gut
Lungs
Urogenital
tract

36

1.

The germinal centers found in the cortical region of lymph nodes and peripheral region of
splenic periarteriolar lymphatic tissue

support the development of immature B and T cells.

Function in the removal of dammaged erythrocytes from the circulation
Act as the major source of stem cells and thus help maintain hematopoiesis
Provide an infrastructure that on antigenic stimulation contains large population of B
lymphocytes and plasma cells.
Are the sites of NK cell differentiation.

37

1.

The development of self-tolerance in the T-cell compartment is important for the prevention
of autoimmunity. Which of the following results in T-cell self-tolerance?

allelic exclusion
somatic
hypermutation
thymocyte
proliferation
positive selection
negative selection

38

1.

Where are B-lymphocytes developed?



Bone
marrow
Lymph
nodes
Liver
Spleen
MALT

39

1.

The function of the B-cell receptor (BCR) is to

bind to growth factors

(cytokines)
bind to the co-receptor
kill infected host cells
recognize foreign antigens
bind to complement fragment

40

1.

____ is the most important co-stimulatory molecule during B cell activation?

CD19/21/8
1
CD40
CD45
CD80
CD86

41

1.

Stages of B cell development in bone marrow does NOT include:



Pro-B
Pre-B
Immature
B
Mature B
Plasma B

42

1.

Which molecule is responsible for triggering a cascade of biochemical signal after mIg binds
to specific antigen?

CD19/21/8
1
CD40
CD45
CD80/86
CD79a/79
b

43

1.

"During maturation, B cell check and dispose self-reactive B cells at ( ) stages."

Pro-B
Pre-B
Immature
B
Mature B
Plasma B

1
 44

1.

Which molecule of B-1 and B-2 is different?

CD5
CD20
CD40
CD45
CD79a/79
b

45

1.

Cytokines always act:

by binding to specific receptors.

in an autocrine fashion.
at high concentration
antagonistically with other
cytokines.
synergistically with other
cytokines.

46

1.

Cytokines are NOT:

synthesized for a long time

capable of activating more than one cell type.
 made by lymphocytes.
small protein molecules.
synthesized in response to antigen or other
cytokines.

47

1.

Which cytokine plays an important role in innate immunity to combat viral replication?

ILs
TNF-a
IFNs
Chemkines
growth
factors

48

1.

B1 cells express which of the following molecule?

CD
2
CD
3
CD
4
CD
5
CD
8

49

1.

Which of the following molecule is essential for B cell activation?

 CD2
8
B7
CD4
0
CD8
0
CD8
6

50

1.

"During primary antibody response, B cells initially produce which type of antibody?"

IgA
IgD
IgE
IgG
IgM

51

1.

"On the B cell surface, receptors for antigen are associated with"

CD3
CD4
CD8
Ig and
Ig
MHC

52

1.

Which of the following is not feature of the immune response to TD antigens?



Mainly IgM production

class switching
T cell dependent
do not require repeating
epitopes
Mainly IgG production

53

1.

Which of the following is not feature of plasma cells?

secretion of
antibodies
BCR expression
no MHC-I
expression
no proliferation
no growth

54

1.

Which of the following is not right for isotype switching?

Change in CH genes
No change in V
regions
Change of Ab
isotype
Directed by
cytokines
Change in VH genes

55

1.
 Which of the following is right for somatic hypermutation?

Change in CH genes
Change of Ab isotype
Point mutations of VH or VL
gene
no change in BCR
No change in V regions

56

1.

Which of the following is not right for primary immune response?

lower antibody titer

slow to reach a plateau
phase
Shorter plateau phase
mainly IgG production
low-affinity antibodies

57

1.

Which of the following description is right for memory B cells?

long-lived
high-proliferating
slow activation
no BCR
no MHC-
expression

58

1.
 Which cell type is most potent antigen-presenting cells

T cell
Dendritic
cell
Macrophag
e
B cells
NK cell

59

1.

Which cell type could initiate immune response

T cell
Dendritic
cell
Macrophag
e
B cells
NK cell

60

1.

Antigen presentation does not need:

T cell
APC
MHC
peptide
antibod
y

61

1.
 The principle function of immature dendritic cell is:

antigen
presentation
antigen capture
cytokines
secretion
antibody
production
activation of T
cells

62

1.

The principle function of mature dendritic cell is:

antigen
presentation
antigen capture
cytokines
secretion
antibody
production
antigen
processing

63

1.

Which cell type could be target APC

T cell
Tumor cell
Macrophag
e
B cells
epithelia
cell

1
 64

1.

Which cell type belong to migratory dendritic cell:

splenic DC
thymic DC
langerhans
cells
pDC
infammatory
DC

65

1.

Which molecule could present lipid antigen:

MHC-I
MHC-II
CD1a
CD4
CD8

66

1.

Which is wrong for the following statements about immunoregulation:

? Immunoregulation including positive regulation and negative

regulation.
Immunoregulation just occurs in the immune system.
Neuroendocrine system is involved in the immunoregulation.
High concentration of antibody is involved in the
immunoregulation.
Idiotype and anti-idiotype network is involved in the
immunoregulation.
1

67

1.

The character of inhibitory Th-cell is :

The activation doesnt need antigen.

Suppress the activated Th cell through directed
contact.
Suppress the activated Th cell through secretory
cytokines.
Just suppress cell immune response.
Just suppress humoral immune response.

68

1.

The targeted cell of T cell inhibitory factor (TsF):

CD4+Th1 cell
Activated CD4+Th
cell
B cell
CD8+Tc cell
CD4+Th2 cell

69

1.

Which is wrong about Th1 and Th2 in the following statements?

Th1 and Th2 were differentiated from Th0

Cytokines produced by Th1 cells inhibit Th2 cells
Different population of Th cells are specialized for different helper function
"Once an immune response develops along one pathway, it becomes increasingly
polarized in that direction"
Th1 and Th2 can be switched each other
1

70

1.

Whats wrong about immune tolerance in the following?

Induced by antigen
Has the character of specificity and memory
is the synonym to immune inhibitory
The maintenance of immune tolerance dependent on the continuous existence
of Tolergen
The destroy of self-tolerance leads to autoimmune disease

71

1.

The antigen-injection manner which easily leads to cause immune tolerance

"vein injection subcutaneous, muscular

peritoneal"
"peritoneal subcutaneous, muscular vein
injection"
"peritoneal vein injection subcutaneous,
muscular"
"vein injection peritoneal subcutaneous,
muscular"
"subcutaneous, muscular peritoneal vein
injection "

72

1.

The natural immune tolerance usually refers to:

Body has no response to any antigen

Body has no response to itself changed
component
Body has no response to itself component
 Body has no response to nonself antigen
Body has no response to some specific
antigen

73

1.

B cell form the immune tolerance:

Inducible time is short

Maintanence time is short
Need low dose TD antigen to induce
Need low dose TI antigen to induce
No association with the amount of
antigen

74

1.

Which cell is the easiest cell to be induced to immune tolerance:

B cell
T cell
NK cell
Macrophage
Neutrophil
cell

75

1.

Defects in neutrophil NADPH oxidase system produce:

Chronic granulomatous
disease.
Chediak-Higashi disease.
 Leukocyte adhesion
deficiency.
Hashimoto's disease.
Streptococcal infection.

76

1.

Paroxysmal nocturnal hemoglobulinuria results from deficiency in:

?Myeloperoxidase.
Decay accelerating factor.
(DAF).
Classical pathway C
components.
C1 inhibitor.
?C8.

77

1.

X-linked agammaglobulinemia results from a mutation in:

?IFNg receptor.
The CIITA promoter protein.
An HLA gene.
CD40L (CD154).
Bruton's tyrosine kinase (Btk)
gene

78

1.

Di George syndrome results from a defect in:

Purine nucleoside
 phosphorylase.
WASP.
Thymic development.
DNA repair
CD3.

79

1.

"Mutations in the gammac chain of the receptors for IL-2, 4, 7, 9 and 15 lead to:"

Reticular dysgenesis.
Bare lymphocyte syndrome
HyperCIgM syndrome.
Severe combined immunodeficiency
(SCID).
?Build-up of toxic nucleotide
metabolites.

80

1.

Poor skin tests to a range of microbial antigens such as tuberculin and mumps indicate a
deficiency of:

NK cells.
T-cells.
B-cells.
?
Phagocytosis
.
Opsonization
.

81

1.

HIV binds to:



CD4.
IL-2 receptor.
NF kappa B.
Reverse
transcriptase.
TNF receptors.

82

1.

A coreceptor for HIV is:

?
RANTES
CD8
CD54
??CR5
CXCR4

83

1.

Which of the following HIV antigens provides a potential target for neutralizing antibody:

U3
??gp120
Reverse
transcriptase
Protease
tat

84

1.

Primary immunodeficiency producing susceptibility to infection by viruses and molds is due

to:


B-cell deficiency.
T-cell deficiency.
Phagocyte
deficiency.
Complement
deficiency.
Eosinophil deficiency.

85

1.

Which of the following is not helpful in the diagnosis of AIDS:

CD4 numbers.
CD8 numbers.
Skin tests to bacterial
antigens.
Lymph node biopsy.
Serum p24 antigen.

86

1.

Deletions in the T-cell CD154 (CD40L) gene produce:

The hyperCIgM syndrome.

Congenital X-linked
agammaglobulinemia.
IgA deficiency.
WiskottCAldrich Syndrome.
?Deficiency in cytotoxic T-cell
activity.

87

1.
 Which of the following have not provided examples of secondary immunodeficiency:

Viral infection.
??Lymphoproliferative
disorders.
Cytotoxic drugs.
High fat diet.
?Low iron diet.

88

1.

?A graft between members of the same species is termed an:

?Autograft.
?Isograft.
Xenograft.
Allograft.
None of the
above.

89

1.

Which one of the following statements is false. Rejection of a second (set) skin graft from the
same allogeneic donor:

Can be blocked by azathioprine (an antimitotic

agent).
?Proceeds at the same speed as the first graft
rejection.
Shows specificity for the graft donor.
Can be transferred to a naive recipient with
lymphocytes.
??Involves recognition of MHC differences.

90
 1.

The human major histocompatibility complex:

Provokes the most intense allograft reactions.

?Is termed H-2.
Contains only class I and class II genes.
Is not expressed as codominant antigens on the cell surface.
Encodes the human leukocyte antigens (HLA) expressed only on
leukocytes.

91

1.

Mitosis occurs when mixing lymphocytes of two individuals:

In presence of mitomycin C.
In presence of anti-CD4.
Who are identical twins.
Of differing MHC class II haplotype.
"Of differing MHC class I, but identical MHC class II,
haplotype. "

92

1.

Non-specific suppression of graft rejection can be achieved with:

?Ricin A chain.
?Anti-IL-5.
Anti-NF kappa
B
Anti-CD34.
Anti-CD3

93
 1.

?Pigs have been proposed as a source of organs for xenotransplantation to humans because:

They do not pose a risk of zoonoses.

"Their cell surface glycoproteins bear galactose a-1,3-galactose structures. "
They lack endogenous virus sequences.
Their hearts are an appropriate size and the pigs can be genetically modified to limit the
possibility of hyperacute rejection.
Their organs are not susceptible to hyperacute rejection because they become coated
with the natural antibodies normally present in humans.

94

1.

Graft vs host disease often accompanies transplantation of:

Cartilage.
Kidney.
?Bone
marrow.
Heart.
Pancreas.

95

1.

?The very rapid response to a second allogeneic graft is:

Specific for antigens of the major histocompatibility

complex (MHC).
Dependent on minor histocompatibility antigens.
Transferred by macrophages to a naive recipient.
Transferred by platelets.
?Transferred by IgA.

96
 1.

"Concerning MHC class II antigen differences between 2 individuals, which of the following is
untrue:"

They produce mixed lymphocyte reactions.

They stimulate formation of helpers to generate cytotoxic
T-cells.
They cause graft vs host disease.
There are MHC class II antigens on all of cells in
individuals
None of the above.

97

1.

Hyperacute graft rejection is caused by:

Preformed antibody.
CD4 lymphocytes.
CD8 lymphocytes.
Platelets
Circulating immune
complexes.

98

1.

Which of the following allogeneic grafts does not require immunosuppression:

Kidney.
Heart.
?Liver.
Bone
marrow.
?Cartilage.

1
 99

1.

The single best chance of a tissue graft being accepted in a human recipient is if it is:

An isograft
An allograft given under the cover of potent
immunosuppression
A xenograft from a pig
Given to a recipient that is treated with anti-CD3
From a living sibling donor

100

1.

"Out of the following, the cadaveric organ with the best survival 10-years post-transplant is:"

Lung
Pancrea
s
Liver
Intestin
e
Kidney

101

1.

Type-I hypersensitivity is mediated by

IgA
IgD
IgE
IgG
IgM

1
 102

1.

Immediate hypersensitivity usually involves

Mast cells
IgG
antibodies to mast
cells
Th1 cells
platelets

103

1.

Therapy of allergic disease does not include

Inhibition of IgE synthesis

Inhibition of IgE binding to
receptor
Inhibition of mast cell mediator
release
Inhibition of mediator action
Increase T cells making IL-4

104

1.

Hemolytic disease of the newborn is

 Type-I
hypersensitivity
Type-II
hypersensitivity
Type-III
hypersensitivity
Type-IV
hypersensitivity
Delayed
hypersensitivity

105

1.

The response of delayed hypersensitivity

Can be passively transferred by antibody

Shows erythema (redness) and induration 1-2 days after injection of
the antigen
Depends upon the attachment of IgE antibody to mast cells
Is mediated by B lymphocytes
Is mediated by complement system

106

1.

Which of the following factor is not usually involved in Type-I hypersensitivity

IgG
IL-4
Basophil
Eosinoph
il
FcR

107

1.

Which of the following disease is systemic hypersensitivity?



allergic rhinitis
Anaphylaxis
shock
Food allergies
atopic
dermatitis
asthma

108

1.

Which of the following factor is not usually involved in Type-III hypersensitivity

IgG
IgM
complement
immune
complex
Th1 cells

109

1.

Which of the following disease is not Type-III Hypersensitivity

Arthus reaction
Hypersensitivity pneumonitis
Immune complex-mediated
glomerulonephritis
PPD skin test
Serum sickness

110

1.

Which of the following factor is not usually involved in Type-IV hypersensitivity



Th1 cell
IFN-
TNF-
CD8+ T
cells
IgG

111

1.

Which disease is caused by the accumulation of autoantigen-antibody complex?

Grave's disease
Systemic lupus
erythematosis
IDDM
multiple sclerosis
myasthenia gravis

112

1.

Which disease is caused by the IgG antibody against cellular receptor?

Grave's disease
Systemic lupus
erythematosis
IDDM
multiple sclerosis
sympathetic ophthalmia

113

1.

Anti-nuclear antibodies (ANA) are diagnostic for

 Grave's disease
Systemic lupus
erythematosis
IDDM
multiple sclerosis
sympathetic ophthalmia

114

1.

Autoimmune hemolytic anemia is mediated by

autoantibody against cell membrane

autoantibody against cell receptor
autoantibody against soluble antigen
auto-antigen and auto-antibody
complexes
T lymphocytes

115

1.

Which of the following auto-immune diseases belong to the systemic autoimmune diseases?

Grave's disease
Systemic lupus
erythematosis
IDDM
multiple sclerosis
Goodpasture's syndrome

116

1.

Multiple sclerosis is mediated by

 autoantibody against cell membrane
autoantibody against cell receptor
autoantibody against soluble antigen
auto-antigen and auto-antibody
complexes
T lymphocytes

117

1.

Which of the following statements on autoimmune diseases is wrong?

often chronic and irreversible

Women have a higher incidence in all diseases than
men
Older people are more prevalent than children
Genetic predisposition
Damage can be caused by autoantibody or
autoreactive T-cell