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Do these come with answers?
1. Which category of hypersensitivity BEST describes hemolytic phenomenon caused by ABO blood group incompatibility?
(A) Atopic or anaphylactic
(B) Cytotoxic
(C) Immune complex
(D) Delayed
2. The principal difference between type II and type III hypersensitivity is
(A) the class (isotype) of antibody
(B) the site where antigen-antibody complexes
are formed
(C) the participation of complement
(D) the participation of T cells
3. A patient with rheumatic fever develops a sore throat from which beta-hemolytic streptococci
are cultured. The patient is started on treatment with penicillin, and the sore throat resolves within several days. However, 7 days after initiation of penicillin therapy the patient develops
a fever of 39?C, a generalized rash, and proteinuria. This MOST probably resulted from (A) recurrence of the rheumatic fever
(B) a delayed hypersensitivity reaction to penicillin
(C) an IgE response to penicillin
(D) an IgG-IgM response to penicillin
4. A kidney biopsy specimen taken from a patient with acute glomerulonephritis and stained with
fluorescein-conjugated anti-human IgG antibody would probably show
(A) no fluorescence
(B) uniform fluorescence of the glomerular basement membrane
(C) patchy, irregular fluorescence of the glomerular basement membrane
(D) fluorescent B cells
5. A patient with severe asthma gets no relief from antihistamines. The symptoms are MOST
likely to be caused by
(A) interleukin-2
(B) slow-reacting substance A (leukotrienes)
((2) serotonin
(D) bradykinin
6. Hypersensitivity to penicillin and hypersensitivity to poison oak are both
(A) mediated by IgE antibody
(B) mediated by IgG and IgM antibody
(C) initiated by haptens
(D) initiated by Th-2 cells
7. A recipient of a 2-haplotype MHC-matched kidney from a relative still needs immunosup-
pression to prevent graft rejection because
(A) graft-versus-host disease is a problem
(B) class II MHC antigens will not be matched
(C) minor histocompatibility antigens will not be matched
(D) complement components will not be matched
8. Bone marrow transplantation in immunocompromised patients presents which major problem?
(A) Potentially lethal graft-versus-host disease
(B) High risk of T cell leukemia
(C) Inability to use a live donor
(D) Delayed hypersensitivity
9. What is the role of class II MHC proteins on donor cells in graft rejection?
(A) They are the receptors for interleukin-2, which is produced by macrophages when
they attack the donor cells
(B) They are recognized by helper T cells, which then activate cytotoxic T cells to kill the donor cells
(C) They induce the production of blocking antibodies that protect the graft
(D) They induce IgE which mediates graft rejection
10. Grafts between genetically identical individuals (ie, identical twins)
(A) are rejected slowly as a result of minor his-tocompatibility antigens
(B) are subject to hyperacute rejection
(C) are not rejected, even without immunosuppression
(D) are not rejected if a kidney is grafted, but skin grafts are rejected
11. AIDS is caused by a human retrovirus that kills
(A) B lymphocytes
(B) lymphocyte stem cells
(C) CD4-positive T lymphocytes
(D) CD8-positive T lymphocytes
12. Polyomavirus (a DNA virus) causes tumors in "nude mice" (nude mice do not have a thymus,
because of a genetic defect) but not in normal mice. The BEST interpretation is that
(A) macrophages are required to reject polyomavirus-induced tumors
(B) natural killer cells can reject polyomavirus-induced tumors without help from T lymphocytes
(C) T lymphocytes play an important role in the rejection of polyomavirus-induced tumors
(D) B lymphocytes play no role in rejection of polyomavirus-induced tumors
13. C3 is cleaved to form C3a and C3b by C3 convertase. C3b is involved in all of the following
EXCEPT:
(A) altering vascular permeability
(B) promoting phagocytosis
(C) forming alternative-pathway C3 convertase
(D) forming C5 convertase
14. C3a and C5a can cause
(A) bacterial lysis
(B) vascular permeability
(C) phagocytosis of IgE-coated bacteria
(D) aggregation of C4 and C2
15. Neutrophils are attracted to an infected area by
(A) IgM
(B) G1
(C) C567
(D) C8
16. Complement fixation refers to
(A) the ingestion of C3b-coated bacteria by macrophages
(B) the destruction of complement in serum by heating at 56 ^C for 30 minutes
(C) the binding of complement components by antigen-antibody complexes
(D) the interaction of C3b with mast cells
17. The classic complement pathway is initiated by interaction of CI with
(A) antigen
(B) factor B
(C) antigen-IgG complexes
(D) bacterial lipopolysaccharides
18. Patients with severely reduced C3 levels tend to have
(A) increased numbers of severe viral infections
(B) increased numbers of severe bacterial infections
(C) low gamma globulin levels
(D) frequent episodes of hemolytic anemia
19. Natural killer cells are
(A) B cells that can kill without complement
(B) cytotoxic T cells
(C) increased by immunization
(D) able to kill virus-infected cells without prior sensitization
20. A positive tuberculin skin test (a delayed hypersensitivity reaction) indicates that
(A) a humoral immune response has occurred
(B) a cell-mediated immune response has occurred
(C) both the T and B cell systems are functional
(D) only the B cell system is functional
21. Reaction to poison ivy or poison oak is
(A) an IgG-mediated response
(B) an IgE-mediated response
(C) a cell-mediated response
(D) an Arthus reaction
22. Idiotypic determinants are located within
(A) hypervariable regions of heavy and light chains
(B) constant regions of light chains
(C) constant regions of heavy chains
(D) the hinge region
23. A primary immune response in an adult human requires approximately how much time to produce detectable antibody levels in the blood?
(A) 12 hours
(B) 3 days
(C) 1 week
(D) 3 weeks
24. During the maturation of a B lymphocyte, the first immunoglobulin heavy chain synthesized
is the
(A) mu chain
(B) gamma chain
(C) epsilon chain
(D) alpha chain
25. Which one of the following sequences is appropriate for testing a patient for antibody against
the AIDS virus with the ELISA procedure? (The assay is carried out in a plastic plate with an incubation and a wash step after each addition except the final one.)
(A) Patient's serum/enzyme substrate/HIV antigen/enzyme-labeled antibody against
HIV
(B) HIV antigen/patient' s serum/enzyme-labeled antibody against human gamma
globulin/enzyme substrate
(C) enzyme-labeled antibody against human gamma globulin/patient's serum/HIV
antigen/enzyme substrate
(D) enzyme-labeled antibody against HIV/HIV antigen/patient's serum/enzyme substrate
26. The BEST method to demonstrate IgG on the glomerular basement membrane in a kidney tissue section is the
(A) precipitin test
(B) complement fixation test
(C) agglutination test
(D) indirect fluorescent-antibody test
27. A patient with a central nervous system disorder is maintained on the drug methyldopa. Hemolytic anemia develops, which resolves shortly after the drug is withdrawn. This is MOST probably an example of
(A) atopic hypersensitivity
(B) cytotoxic hypersensitivity
(C) immune-complex hypersensitivity
(D) cell-mediated hypersensitivity
28. Which one of the following substances is NOT released by activated helper T cells?
(A) Alpha interferon
(B) Gamma interferon
(C) Interleukin-2
(D) Interleukin-4
29. A delayed hypersensitivity reaction is characterized by
(A) edema without a cellular infiltrate
(B) an infiltrate composed of neutrophils
(C) an infiltrate composed of helper T cells and macrophages
(D) an infiltrate composed of eosinophils
30. Which one of the following is NOT true of class I MHC antigens?
(A) They can be assayed by a cytotoxic test that uses antibody and complement
(B) They can usually be identified in the laboratory in a few hours
(C) They are controlled by at least three gene loci in the major histocompatibility
complex
(D) They are found mainly on B cells, macrophages, and activated T cells
31. An antigen found in relatively high concentration in the plasma of normal fetuses and a high
proportion of patients with progressive carcinoma of the colon is
(A) viral antigen
(B) carcinoembryonic antigen
(C) alpha-fetoprotein
(D) heterophil antigen
32. When immune complexes from the serum are deposited on glomerular basement membrane,
damage to the membrane is caused mainly by
(A) gamma interferon
(B) phagocytosis
(C) cytotoxic T cells
(D) enzymes released by polymorphonuclear
cells
33. If an individual was genetically unable to make J chains, which immunoglobulin (s) would be
affected?
(A) IgG
(B) IgM
(C) IgA
(D) IgG and IgM
(E) IgM and IgA
34. The antibody-binding site is formed primarily by
(A) the constant regions of H and L chains
(B) the hypervariable regions of H and L chains
(C) the hypervariable regions of H chains
(D) the variable regions of H and L chains
35. The class of immunoglobulin present in highest concentration in the blood of a human newborn is
(A) IgG
(B) lgM
(C) lgA
(D) lgD
36. Cytotoxic T cells induced by infection with virus A will kill target cells
(A) from the same host infected with any virus
(B) infected by virus A and identical at class I MHC loci of the cytotoxic T cells
(C) infected by virus A and identical at class II MHC loci of the cytotoxic T cells
(D) infected with a different vires and identical at class I MHC loci of the cytotoxic cells
37. Antigen-presenting cells that activate helper T cells must express which one of the following
on their surfaces?
(A) IgE
(B) Gamma interferon
(C) Class I MHC antigens
(D) Class II MHC antigens
38. Which one of the following does NOT contain C3b?
(A) Classic-pathway C5 convertase
(B) Alternative-pathway C5 convertase
(C) Classic-pathway C3 convertase
(D) Alternative-pathway C3 convertase
39. In setting up a complement fixation test for antibody, the reactants should be added in what
sequence? (Ag = antigen; Ab = antibody; C =complement; EA = antibody-coated indicator
erythrocytes.)
(A) Ag + EA + C/wait/+ patient's serum
(B) C + patient's serum + Egdwait/+ Ag
(C) Ag + patient's serum + EA/wait/+ C
(D) Ag + patient's serum + C/wait/+ EA
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