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-Immunology Questions-

Questions 1-5

1.  In an antibody, the variable light and heavy chains are

A. both at the amino terminal

B. both at the carboxy terminal

C. both in the Fc fragment

D. both in the Fab fragment

2. Bacterial antigen is presented by ______ to _______ T cells.

A. MHC class II, CD4+

B. MHC class II, CD8+

C. MHC class I, CD4+

D. MHC class I, CD8+

3. Which of the following is a Type III hypersensitivity reaction?

A. hay fever

B. erythroblastosis fetalis

C. hypersensitivity pneumonitis

D. Guillan-Barre syndrome

E. Graft vs host disease

4. The antibody produced in largest amounts at the Peyer's patch is

A. IgA

B. IgE

C. IgM

D. IgG

E. IgD

5. A 5 year old boy is seen by his pediatrician for a cold.  He has a history of multiple bacterial and viral respiratory tract infections and eczema. Non-palpable purpura are on his skin. Serum IgE is normal, IgM is decreased, and platelets are decreased.

Which of the following is the most likely diagnosis?

  A. SCID   

  B. Ataxia telangiectasia            

  C.  DiGeorge syndrome            

  D. Selective IgA deficiency     

  E. Wiskott-Aldrich syndrome  

Answers 1-5

1. Answer D  Both are found on the two "arms" of the antibody, which makes up the Fab fragment.  The far end of the Fab fragment is the amino terminal, but only the variable light chain reaches that far.  The end of the Fc fragment is the carboxy terminal.

2. Answer A  Since bacterial antigen is exogenous, it is presented via class II MHC, which interacts with CD4+ T cells.  Endogenous antigen is presented via MHC class I, which interacts with CD8+ T cells.

3. Answer C  Hypersensitivity pneumonitis is the only  reaction presented that worked through immune complexes.  Other examples of type III are rheumatoid arthritis and SLE.  Answer A is a type I, and answer B is a type II.  Both answers D and E are type IV, since they are mediated through T cells.

4. Answer A  IgA is the secretory antibody.

5. Answer E  Wiskott-Aldrich is an X linked immunodeficiency disorder of B cells.  It has three characteristic findings: thrombocytopenia, eczema, and recurrent infections.

Questions 6-10

6. A cell that is CD3+ CD4+ CD28+ CD40L+ is most likely a

A. B cell

B. macrophage

C. Th1 cell

D. neutrophil

E. T reg cell

7. Which of the following has a similar mechanism of disease to rheumatic fever?

A. hay fever

B. myasthenia gravis

C. graft-versus host disease

D. Guillain-Barre syndrome

E. SLE

8. Transplantation of a pig valve to replace a stenotic aortic valve is which of the following?

A. syngeneic graft

B. allograft

C. autograft

D. xenograft

9. The type of transplant rejection characterized by antibodies that cause fibrinoid necrosis of vessels is which of the following?

A. subacute

B. acute

C. chronic

D. graft-versus-host

10. A patient with multiple myeloma most likely has deposits of what in his kidney?

A. protein AL

B. protein AA

C. Amyloid precursor protein

D. amylin

E. beta2-microglobulin

Answers 6-10

6.  Answer D

7. Answer B  Both myasthenia gravis and rheumatic fever are type II hypersensitivity reactions, caused by anti-self IgG antibodies.

8. Answer D  Tissue from another species is a xenograft.  Most transplants are allografts from a cadaver.

9. Answer D  Chonic rejection is from the formation of new antibodies to the transplanted tissue, and takes months to happen.  Subacute is from preformed antibodies, and it is an extremely rapid process (within minutes).  Acute rejection is mediated by T cells, at takes weeks to happen.

10. Answer A  The light chains from immunoglobulin produce AL.  This is one of many forms of amyloidosis.

Questions 11-15

11. What MHC predisposes an individual for having celiac sprue?

A. HLA-DR3

B. HLA-DR4

C. HLA-DR5

D. HLA-B8

E. HLA-B27

Answers 11-15

11.  Answer D  You get celiac because of what you 8 (ate).  HLA-B8 also predisposes to Grave's disease.  So if what you '8' gets stuck in your throat, you get Grave's.

Find a mistake? Email dlynch@creighton.edu