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Section 1

Immunology

1) From the most abundant to the least abundant immunoglobulin, which is CORRECT?

a) G, D, M, A, E

b) M, A, G, D, E

c) G, E, M, D, A

d) M, G, A, D, E

e) G, A, M, D, E

2) Regarding IgM, which statement is INCORRECT?

a) it is the first immunoglobulin to appear in the infant

b) it exists as a pentamer

c) it reaches adult levels by about one year of age

d) it cannot be produced by the foetus

e) it is the third most abundant immunoglobulin

3) Regarding IgG, which statement is INCORRECT?

a) it has a molecular weight of about 150,000

b) it crosses the placenta

c) it accounts for most ABO blood group antibodies

d) it is the most commonly produced immunoglobulin in myeloma

e) it accounts for about 80% of all immunoglobulin

4) Regarding immunoglobulins, which statement is INCORRECT?

a) their classification is based on the heavy chains present

b) IgG is produced early in the primary immune response

c) chromosome 14 carries the gene for heavy chains

d) IgA is present in sero-mucus secretions

e) the J-chain binds together two or more immunoglobulin monomers

5) Which of the following is NOT a major property conferring antigenicity?

a) negative charge

b) large molecular weight

c) organic nature

d) protein structure

e) polymeric structure

6) What percentage of lymphocytes are T cells?

a) 35%

b) 40%

c) 50%

d) 65%

e) 90%

7) Regarding CD4+ T cells:

a) they recognise antigens only in the context of MMCII

b) HIV infection raises the CD4 : CD8 ratio

c) CD8 is expressed on more cells than CD4

d) CD4 positive cells have little role other than as cytotoxic cells

e) CD4 cells are formed by the equal cleavage of two CD8s or the binding of two CD2s

8) Which of the following is NOT an AIDS defining illness?

a) cervical intraepithelial neoplasia

b) primary cerebral lymphoma

c) non-Hodgkin’s lymphoma

d) oral hairy carcinoma

e) Kaposi’s sarcoma

9) Which of the following is NOT an AIDS defining illness?

a) pneumocytosis carinii pneumonia

b) cryptosporidium enteritis

c) pulmonary tuberculosis

d) cryptococcal meningitis

e) CMV encephalitis

10) Regarding the course of HIV infection, which statement is INCORRECT?

a) disappearance of persistent generalised lymphadenopathy (PGL) is a poor prognostic sign

b) viral replication occurs mainly within the spleen during period of asymptomatic infection

c) seroconversion illness usually occurs 2-4 weeks after viral transmission

d) primary cerebral lymphoma is usually a very late event

e) up to 90% have central nervous system pathology at autopsy

11) Hypersensitivity reactions:

a) are not preventable

b) can occur in response to exogenous and endogenous antigens

c) include acute inflammation

d) are never just localised

e) fall into three categories

12) Goodpasture’s syndrome is an example of which form of hypersensitivity?

a) anaphylactic type

b) cytotoxic type

c) immune complex disease

d) cell mediated (delayed)

e) none of the above

13) Regarding the structure of the HIV virion, which statement is INCORRECT?

a) core contains reverse transcriptase

b) envelope is composed of a spherical lipid bilayer

c) core contains p24

d) core contains one strand of single stranded RNA

e) envelope is studded by glycoproteins, including gp120 and gp41

14) With respect to type II hypersensitivity, which is INCORRECT?

a) myasthenia gravis is one manifestation

b) complement can be involved

c) macrophages can be involved

d) CD4 cells can be involved

e) natural kill cells can be involved

15) Regarding immunodeficiency with predominantly T-cells defects, what is/are the most commonly associated infection(s)?

a) recurrent pyogenic infections

b) pneumocystis carinii pneumonia

c) viral infections

d) candidiasis

e) tuberculosis

16) Regarding immunodeficiency with predominantly antibody defects, what is/are the most commonly associated infection(s):?

a) viral infections

b) recurrent pyogenic infections

c) giardiasis

d) pneumocystis carinii pneumonia

e) systemic fungal infections

17) Anticentromere antibodies are found in approximately 90% of patients with:

a) limited sclerodema – CREST

b) SLE

c) sjogrens syndrome

d) systemic sclerosis – diffuse

e) inflammatory myopathies

18) Regarding type IV hypersensitivity, which statement is INCORRECT?

a) reactivity can be transferred from sensitised to non-sensitised individual

b) maximal 48-72 hours after challenge

c) most cytotoxic T cells carry CD8+

d) major effect of lymphokines is chemotaxis and activation of macrophages

e) forms the basis of the lepromin test (Fernandez reaction)

19) Which of the following is NOT a cause of autoimmune disease?

a) molecular modification

b) molecular mimicry

c) T cell suppression

d) bypass of T cell tolerance

e) genetic factors

20) Regarding type III hypersensitivity, which statement is INCORRECT?

a) serum sickness occurs due to antigen excess in proportion to antibody

b) immune complexes bind to blood vessel walls and basement membranes

c) arthus reaction is maximal at 4-8 hours after exposure to antigen

d) pigeon fancier’s lung is an example of an arthus reaction

e) jarisch-herxheimer reaction is an example of serum sickness

21) Regarding type II hypersensitivity, which statement is INCORRECT?

a) includes anti-receptor antibodies (formerly type V hypersensitivity)

b) mediates some cases of graft rejection

c) involves the complement cascade

d) receptor antibodies are usually IgM

e) may be associated with diabetes mellitus

22) The body can defend itself against parasites by all of the following mechanisms EXCEPT:

a) innate immunity

b) cell-mediated immunity

c) humoral immunity

d) antibody dependant cellular cytotoxicity

e) action of eosinophils

23) Regarding type I hypersensitivity, which statement is INCORRECT?

a) IgE binds to both mast cells and basophils

b) “late phase reaction” occurs without additional exposure to antigen

c) histamine causes more bronchospasm than SRS-A

d) up to 50% of atopic individuals have a positive family history of allergy

e) initial tissue response subsides within 60 minutes

24) Regarding type I hypersensitivity reactions, which of the following is NOT a secondary mediator?

a) SRS-A

b) trypsin

c) leukotriene E4

d) prostaglandin D2

e) leukotriene B4

25) Regarding type I hypersensitivity reactions, which of the following is NOT preformed primary mediator?

a) platelet activating factor

b) eosinophil

c) histamine

d) neutrophil chemotactic factor

e) heparin

26) Which of the following is NOT a T cell subpopulation produced following exposure to an antigen?

a) inducer-helper cells

b) memory cells

c) lymphokine secreting cells

d) cytotoxic-suppressor cells

e) natural kill cells

27) The most common blood transfusion reaction type is of:

a) type I hypersensitivity

b) type II hypersensitivity

c) type III hypersensitivity

d) type IV hypersensitivity

e) all of the above

28) Which of the following is NOT a mechanism by which antibodies directly attack an invader?

a) agglutination

b) precipitation

c) neutralisation

d) opsonisation

e) lysis

29) Regarding the forces binding antigens to antibodies, which does NOT occur?

a) hydrogen bonding

b) ionic forces

c) covalent bonding

d) Van der Waals forces

e) hydrophobic bonding

30) Regarding IgE, which statement is INCORRECT?

a) mediates type I hypersensitivity reactions

b) increased amounts present in fungal infections

c) molecular weight of about 200,000

d) allergens cause cross-linkage of IgE molecules

e) least abundant immunoglobulin

31) Regarding IgA, which statement is INCORRECT?

a) exists as a monomer

b) accounts for about 13% of all Ig

c) reaches adult levels by age 10 to 14 years

d) second most abundant Ig

e) plays an important innate immunity role in the respiratory tract

32) Eosinophils:

a) make up 30% of all leukocytes

b) play a role on parasitic infections

c) are responsible for releasing histamine in type I hypersensitivity reactions

d) are strongly phagocytic

e) become plasma cells in the extravascular space

33) In HIV infection:

a) transmission is only via sexual contact or parenteral inoculation

b) AIDS is recognised when there is a specified secondary infection or malignant neoplasm

c) IV drug users constitute the largest group with HIV infection in the USA

d) CD4 cells offer no predictive value in determining the subsequent development of AIDS

e) Kaposi’s sarcoma is more common in IV drug users than in homosexuals

34) In a healthy individual over the age of 5 years, lymphocytes are mainly found in:

a) bone marrow, thymus, spleen

b) liver, thymus, spleen

c) lymph nodes, spleen, thymus

d) bone marrow, spleen, liver

e) liver, spleen, pancreas

35) Blood transfusion reaction is an example of which type of hypersensitivity reaction?

a) type I

b) type II

c) type III

d) type IV and III

e) none of the above

36) With regard to natural killer lymphocytes:

a) they constitute less than 5% of blood lymphocytes

b) they require opsonisation to enable their killing of cells

c) they have a prime role in defence against parasites

d) they require prior sensitisation to be effective

e) they have an innate ability to lyse tumour cells and virally affected cells

37) An anaphylactoid reaction:

a) is a localised form of an anaphylactic reaction

b) is an example of an immune complex mediated reaction (type III hypersensitivity)

c) occurs without prior sensitisation to an antigen

d) does not involve the release of histamine from mast cells

e) results from IgE mediated mechanisms

38) With regard to B lymphocytes:

a) they constitute 50% of circulating lymphocytes

b) they are found in germinal centres in the red pulp of the spleen

c) they are genetically programmed to recognise specific antigens by means of antigen specific cell surface receptors

d) they release chemical mediators when attached to IgE in type I hypersensitivity reactions

e) they are not affected by HIV infection

39) MHC class I molecules are:

a) co-receptors on the CD8 molecule

b) co-receptors to the CD4 molecule

c) present on T lymphocytes only

d) couples to peptide products of extracellular antigens

e) identical in fraternal twins

40) Transplant rejection involves:

a) type IV hypersensitivity only

b) type IV and III hypersensitivity only

c) type IV, III and II hypersensitivity only

d) type IV and II hypersensitivity only

e) type II and III hypersensitivity only

41) With respect to macrophages, which of the following is NOT true?

a) they can produce TNF and IL-4 both of which cause fever

b) they have direct tissue toxicity due to the ability to release hydrogen peroxide

c) they have oxygen dependent mibrobicidal activity

d) they have cytotoxicity against tumour cells

e) they process antigens and act as antigen presenting cells to activate lymphocytes

42) With regard to Langerhan’s cells in the immune system, which of the following is NOT true?

a) they are dendritic cells

b) they possess large numbers of cell surface class II molecules

c) they are found primarily in the epidermis

d) they are strongly phagocytic

e) they are involved in delayed hypersensitivity reactions

43) Regarding the complement system:

a) complement factors D and B are crucial to activation of the classical pathway

b) polysaccharide molecules on bacterial cell membranes can activate the classical pathway

c) enzyme precursors of the complement system are released by activated macrophages

d) activation of the classical pathway occurs as a result of the antigen – antibody reaction

e) when the alternative pathway is activated, fragments C3a, C4a and C5a are NOT produced

44) Which of the following are phagocytic?

a) CF4 and helper T cells

b) natural killer cells

c) CD8 and cytotoxic T cells

d) all of the above

e) none of the above

45) Monocytes:

a) have a half-life of 6 hours in plasma

b) have a cytoplasm containing biologically active granules

c) may convert to mast cells

d) may convert to kupffer cells in the liver

e) undergo cell division under the influence of erythropoietin

46) Poison ivy dermatitis is an example of:

a) type I hypersensitivity

b) type II hypersensitivity

c) type III hypersensitivity

d) type IV hypersensitivity

e) none of the above

47) With regard to T lymphocytes:

a) plasma cells are activated by T lymphocytes

b) T cells become activated on binding to free antigen

c) normally, 60% of T cells bear the cell marker CD8+

d) CD4+ T cells are MHC class II restricted

e) T helper I cells primarily secrete IL-4 and IL-5

48) With regard to IgE:

a) it exists as a hexamer in blood

b) it is the least common immunoglobulin in the blood stream

c) it is mainly found in tears and mucosal secretions

d) it is produced by T lymphocytes

e) it can initiate complement fixation once bound to antigen

49) With regard to patients with AIDS, which of the following is NOT true?

a) P. carinii pneumonia is the presenting feature in approximately 50% of cases

b) CD4+ T cell counts in blood are reasonably accurate prognosticators

c) Kaposi’s sarcoma is the most common neoplasm seen in AIDS patients

d) decreased humoral immunity increases the risk of recurrent bacterial pneumonias

e) titres of HIV fall as CD4+ T cell counts fall

50) With respect to the complement system:

a) it can only be activated once an antibody binds to an antigen

b) it is inhibited by polyfructose in bacterial cell membrane

c) its activation can result in pore forming molecules being inserted into target cell membranes

d) is activated by sites on the variable portion of IgG immunoglobulin

e) it inhibits granulocyte release from neutrophils

51) Successful immune response to HIV during the acute phase of infection results from:

a) increase in the CD4+ lymphocyte numbers

b) appearance of anti-HIV antibodies

c) type III hypersensitivity reaction

d) lymphoid tissue based destruction of infected cells

e) development of CD8+ virus specific cytotoxic cells

52) With regard to the transmission of HIV infection, which of the following is NOT true?

a) risk of seroconversion from a needlestick injury from a HIV positive patient is approximately 30%

b) heterosexual transmission is the dominant mode of HIV infection in Asia

c) female-male sexual transmission is about half as efficient as male-female spread

d) the rate of vertical transmission from mother to child is less than 50%

e) all of the above are true

53) Cytokines:

a) are usually only produced by one cell type

b) activate a large number of immunocompetent cells because they do not require specific receptors

c) have narrow ranges of action and specific effects because of the high-affinity receptors on target cells

d) such as IL-Z are crucial to graft vs host reactions

e) do not produce effects in the cell-type that secretes them

54) Which of the following is TRUE of a healthy adult?

a) T lymphocytes constitute 40% of peripheral lymphocytes

b) CD4++ T lymphocytes are directly cytotoxic

c) B lymphocytes constitute 15% of peripheral lymphocytes

d) NK cells are characterised by CD3 and CD16 surface molecules

e) B lymphocytes are characterised by CD3 and IgM surface molecules

55) Concerning hypersensitivity:

a) type II reactions depend upon activation of phagocytic cells

b) eosinophils are predominant in type I early phase reactions

c) type III reactions are less likely in conditions of antibody excess

d) leukotrienes are released by mast cells as preformed mediators of type I reactions

e) Grave’s disease is a good example of type III reactions

56) Organ transplant rejection reactions:

a) are predominantly type II hypersensitivity reactions

b) are characterised by acute rejection vasculitis which occur in the first few months following transplantation

c) are usually directed against organ parenchyma

d) most commonly demonstrate an acute vasculitic reactions, known as “acute rejection vasculitis”

e) are restricted to the transplanted organ

57) Mononuclear phagocytes:

a) are the predominant cells in three day old wounds

b) are common in liver, spleen and pancreas

c) produce fibroblast growth factor

d) secrete interferon Y

e) have a half-life of one day

58) The following are primary mediators of type I hypersensitivity reactions EXCEPT:

a) adenosine

b) neutrophil chemotactic factor

c) heparin

d) platelet activating factor

e) acid hydrolases

59) Type I hypersensitivity:

a) involves sensitised T lymphocytes

b) involves phagocytosis of target cells by activated macrophages

c) involves formation of cytotropic (IgE) antibody

d) histamine is a secondary mediator

e) proteases are secondary mediators

Section 1

Immunology – Answers

1. E

2. D

3. C

4. B

5. A

6. D

7. A

8. D

9. C

10. B

11. B

12. B

13. D

14. D

15. C

16. B

17. A

18. A

19. C

20. E

21. D

22. C

23. C

24. B

25. A

26. E

27. C

28. D

29. C

30. B

31. A

32. B

33. B

34. C

35. B

36. E

37. C

38. C

39. A

40. C

41. A

42. D

43. D

44. E

45. D

46. D

47. D

48. E

49. E

50. C

51. E

52. A

53. D

54. C

55. C

56. B

57. C

58. D

59. C

Section 2

Immune System

1) Which of the following is correct regarding T lymphocytes?

a) in the blood T cells constitute 50% of peripheral lymphocytes

b) CD8-CD4 ratio in normal healthy persons is 2:1

c) CD4 molecules bind to class 1 MHC molecules

d) The TH subset of CD4+ T cells synthesizes and secretes IL-2 and IFN-γ

e) CD4+ T cells act primarily as cytotoxic cells

2) Which of the following is correct?

a) dendritic cells are confined to the lymphoid tissue

b) B cells cannot be activated by soluble antigens

c) The TH2 subset of CD4+ T cells secrete cytokines facilitating macrophage-dependent immune responses

d) natural killer cells are CD3+

e) natural killer cells can lyse some virally infected cells without prior sensitisation

3) Ankylosing spondylitis is associated with the HLA type:

a) DR3

b) DR4

c) A3

d) BW47

e) B27

4) Transplant rejection is an example of primarily which type of hypersensitivity reaction?

a) anaphylactic type

b) cytotoxic type

c) immune complex disease

d) cell mediated hypersensitivity

e) none of the above

5) Type I hypersensitivity reactions are mediated by formation of which immunoglobulin?

a) IgG

b) IgA

c) IgE

d) IgM

e) Igor

6) Mast cells can be activated by:

a) IgE

b) C5a

c) C3a

d) all of the above

e) none of the above

7) Which immune cell does NOT act predominantly by phagocytosis?

a) eosinophils

b) monocytes

c) lymphocytes

d) neutrophils

e) basophils

8) Lymphocytes comprise what percent of the white blood count in normal blood?

a) 5%

b) 2.3%

c) 30%

d) 62%

e) 0.4%

9) Which is TRUE?

a) the majority of the body’s lymphocytes are in circulation at any one time

b) granulocytes are formed in bone marrow and spleen

c) there is a months store of WBC in bone marrow

d) monocytes are only formed in bone marrow

e) megakaryocytes are formed in lymphoid tissue

10) Which has the shortest lifespan in the absence of severe infection?

a) lymphocytes in tissues

b) macrophages in tissues

c) granulocytes in tissues

d) monocytes in blood

e) granulocytes in blood

11) Which is most effecting against invading bacteria?

a) eosinophils

b) macrophages

c) monocytes

d) basophils

e) neutrophils

12) The reticuloendothelial system refers to:

a) the monocyte-macrophage system

b) the tissue-fixed macrophage population

c) the granulocyte development system

d) the lymphocyte recirculating system

13) Regarding eosinophils:

a) they are strongly phagocytic of parasites

b) do not respond to chemotactic signals

c) are attracted to allergic tissues by macrophage released inflammatory mediators

d) ingest and destroy allergen-antibody complexes in allergic tissue

14) Regarding lymphocytes:

a) T cells are preprocessed in the thymus, removal of which diminishes but not abolishes T cell immunity

b) B cells are entirely preprocessed in the bone marrow during foetal life

c) T cells have greater antigenic diversity than the B cell population

d) T cells are responsible for humoral immunity

15) Regarding T lymphocytes:

a) they produce antibodies when stimulated

b) T-suppressor cells are the most abundant subgroup

c) release lymphokines from T-helper cells

d) interferon γ is a potent amplifier of cytotoxic and suppressor T cell production

e) constitute 40% of lymphocytes

16) The T cell recognition complex:

a) in the majority of cells is a heterodimer of a γ/δ polypeptide

b) is associated with the CD4/CD8 complex which is constant but acts in transduction of signal from the TCR

c) CD8 T cells are the target of the HIV virus, the cells have mainly cytotoxic functions

d) CD4 molecules are co-receptors that recognise MHC II complexes on target cells

17) Which is NOT an Ag-presenting cell?

a) neutrophils

b) macrophages

c) dendritic cells

d) Langerhan’s cell

18) Regarding hypersensitivity:

a) all type I reactions are IgE mediated

b) basophils act in a similar manner to mast cells and are found near blood vessels, nerves and subepithelial sites where type I reactions are likely to occur

c) type I reactions are mediated via CD4+ T-helper cells which is required at the initial exposure for IgE production

19) Which inflammatory mediator is more abundant in the initial transition phase of type I hypersensitivity than in the late phase?

a) platelet activating factor

b) histamine

c) major basic protein

d) TNF α

20) Which is a type II complement-dependent hypersensitivity reaction?

a) bee sting allergy

b) post streptococcal glomerulonephritis

c) arthus reaction

d) erythromblastosis foetalis

e) myasthenia gravis

21) Which is a hypersensitivity reaction as a result of localised Ag-Ab complex formation?

a) type II localised reaction

b) arthus reaction

c) tuberculin reaction

d) type IV hypersensitivity

22) Which cell type is responsible for hyperacute graft rejection:

a) B-cells

b) T cells CD4+

c) T cells CD8+

d) macrophages

23) In the western world:

a) HIV-I is less prevalent than HIV-2

b) IV drug use constitutes the highest rate of mode of transmission

c) increased rates of sexual transmission are seen in patients with other STDs

d) seroconversion after accidental needlestick injury is 1% lower than for hepatitis B

24) In HIV:

a) macrophages and monocytes are refractory to HIV cytopathic effects and play little role in viral pathogenesis

b) viral lipid coat glycoprotein GP41 acts as the antigen for CD8 on T-cells allowing viral entry

c) after internalisation into the T cell the virus causes rapid onset lysis causing a depletion in CD4 count

d) T cell memory is lost early in AIDS

Section 2

Immune System – Answers

1. D

2. E

3. E

4. D

5. C

6. D

7. C

8. C

9. D

10. E

11. B

12. A

13. D

14. A

15. C

16. D

17. A

18. C

19. B

20. D

21. B

22. A

23. C

24. D

Section 3

1) SCID – all are true EXCEPT:

a) is due to a T cell differentiation defect

b) most commonly is X-linked

c) presents with oral candidiasis, diaper rash and failure to thrive

d) without bone marrow transplantation, death occurs within one year

e) lymphoid tissue is hypoplastic and the thymus is small and devoid of lymphoid cells

2) Sjogren syndrome is characterised by - which is FALSE:

a) also known as sicco syndrome

b) xerostomia

c) most commonly associated with thyroiditis

d) keratoconjunctivitis sicca

e) lymphocyte infiltration of lachrymal and salivary glands

3) AIDS – which is TRUE:

a) heterosexual transmission is now the dominant mode of transmission in America

b) cell mediated immunosuppression is the hallmark of AIDS

c) associated with severe loss of CD8+ T cells

d) macrophages and dendritic cells are not targeted by HIV infection

e) histioplasmosis is the most common fungal infection in patients with HIV

4) Which is true for hypersensitivity reactions?

a) in type I formation of IgG antibody results in histamine release from basophils

b) an example of a type II reaction is erythroblastosis foetalis

c) in type III IgG or IgM binds to antigen or target cells and res?????? in phagocytosis or cell lysis

d) in cell-mediated hypersensitivity, sensitised B-cells produce a granulomatous reaction

e) all the above are true

Section 3

1. A

2. C

3. B

4. B

Section 4

Immunity

1) Which is a secondary mediator in type I hypersensitivity?

a) histamine

b) eosinophil chemotactic factors

c) platelet activating factor

d) neutral proteases

e) heparin

2) Acute serum sickness is what type of hypersensitivity reaction?

a) type I

b) type II

c) type III

d) type IV

e) type V

3) How long after initial antigen administration does the acute inflammatory reaction of serum sickness occur?

a) 1 day

b) 2 days

c) 5 days

d) 10 days

e) 20 days

4) An example of a type IV hypersensitivity reaction is?

a) hayfever

b) transplant rejection

c) Good Pasture syndrome

d) arthus reaction

e) SLE

5) Regarding HIV infection:

a) HIV-2 is the most common subtype

b) CD8 molecule is a high affinity receptor for HIV

c) HIV is carried to the brain by infected T lymphocytes

d) 50-70% will be symptomatic in the early acute phase

e) pulmonary tuberculosis is a sign of AIDS

6) Regarding B lymphocytes:

a) constitute 40% of peripheral lymphocytes

b) found in the red pulp of the spleen

c) bind antigens by IgM on the cell surface

d) are not infected by Epstein-Barr virus

e) influence the function of virtually all other cells of the immune system

7) Which is the most common manifestation of SLE?

a) haematologic

b) arthritis

c) skin

d) renal

e) pericarditis

8) Which is an abnormality of immune function in AIDS?

a) increased CD4:CD8 ratio

b) hypogammaglobulinaemia

c) increased delayed-type hypersensitivity

d) decreased spontaneous secretion of IL-1, TNF-6 and IL-6

e) decreased chemotaxis and phagocytosis

9) Which neoplasm is NOT associated with AIDS?

a) cervical carcinoma

b) Kaposi sarcoma

c) non-Hodgkin lymphoma

d) primary cerebral lymphoma

e) testicular seminoma

10) In type I hypersensitivity:

a) heparin is a secondary mediator

b) eosinophils are not involved

c) there is a familial predisposition

d) it is mediated by IgG and IgM antibodies

e) tissue basophils play a role

Section 4

Immunity – Answers

1. C

2. C

3. D

4. B

5. D

6. C

7. A

8. E

9. E

10. C

Section 5

1) Regarding hypersensitivity disorders, which is correctly paired?

a) type I – IgM formation

b) type II – sensitised T lymphocytes

c) type III – antibody/antigen complexes

d) type IV – IgE formation

e) transplant rejection – IgG formation

2) In anaphylaxis:

a) histamine is the most potent vasoactive agent

b) secondary mediators are stored with mast cell granules

c) synthesis of IgE is dependent on TH2 helper cells

d) leukocyte infiltration occurs during initial response

e) prostaglandin D2 is the most abundant primary mediator

3) Histamine:

a) is rapidly synthesised and released in acute inflammation

b) is stored in platelets

c) causes arteriolar constriction

d) acts on the microcirculation mainly via H2 receptors

e) release is inhibited by C3a and C5a

4) Inhibitors of the complement cascade include:

a) collectins

b) properidin P

c) MAC

d) DAF

e) C5 convertase

5) Activated Hagerman factor (XIIa) initiates all EXCEPT:

a) prostaglandin generation

b) kinin system

c) coagulation cascade

d) complement activation

e) production of plasmin

6) Regarding cellular mediators, which is CORRECT?

Mediator Source

a) nitric oxide mast cells

b) serotonin all leukocytes

c) lysosomal enzymes macrophages only

d) prostaglandins all leukocytes and platelets

e) PAF platelets

7) Regarding arachidonic acid metabolism:

a) ????? lipoxygenase is inhibited by glucocorticoids

b) thromboxane A2 inhibitis platelet aggregation

c) leukotriene B4 is a potent chemotactic agent

d) prostaglandin D2, E2, and F2 cause bronchospasm

e) prostacyclin is a vasoconstrictor

8) Chronic inflammation is characterised by all EXCEPT:

a) mononuclear cell infiltration

b) fibrosis

c) angiogenesis

d) oedema

e) tissue destruction

9) Macrophages release:

a) growth factors

b) elastases

c) complement components

d) nitric oxide

e) all of the above

(No answers to these questions – just page references)

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