IS LECTURE P1 QUIZZES COMPILATION The structure formed by the fusion of engulfed

material and enzymatic granules within the

MINI QUIZ: LESSON 1 & 2 phagocytic cell is called a *
phagosome
Enhancement of phagocytosis by coating of lysosome
foreign particles with serum proteins is called * vacuole
opsonization phagolysosome
agglutination
solubilization Which of the following white blood cells is
chemotaxis capable of further differentiation in the
tissues? *
Jenner’s work with cowpox, which provided Neutrophil
immunity against smallpox, demonstrates Eosinophil
which phenomenon? * Basophil
Natural immunity Monocyte
Attenuation of vaccines
Phagocytosis The presence of normal flora acts as a defense
Cross-immunity mechanism by which of the following means? *
Maintaining an acid environment
Which of the following can be attributed to Competing with pathogens for nutrients
Pasteur? * Keeping phagocytes in the area
Discovery of opsonins Coating mucosal surfaces
Research on haptens
First attenuated vaccines Measurement of CRP levels can be used for all
Discovery of the ABO blood groups of the following except *
monitoring drug therapy with anti-inflammatory
Which of the following peripheral blood cells agents.
plays a key role in killing of parasites? * tracking the normal progress of surgery.
Neutrophils diagnosis of a specific bacterial infection.
Monocytes determining active phases of rheumatoid arthritis.
Lymphocytes
Eosinophils Which of the following are characteristics of
acute-phase reactants? *
Which of the following plays an important role Rapid increase following infection
as an external defense mechanism? * Enhancement of phagocytosis
Phagocytosis Nonspecific indicators of inflammation
C-reactive protein All of the above
Lysozyme
Complement A latex agglutination test for CRP is run on a 12-
yearold girl who has been ill for the past 5 days
The process of inflammation is characterized by all with an undiagnosed disease. The results
of the following except * obtained are as follows: weakly reactive with
increased blood supply to the area. the undiluted serum and negative for both the
migration of white blood cells. positive and negative controls. What should the
decreased capillary permeability. technologist do next? *
appearance of acute-phase reactants. Repeat the entire test
Report the results as indeterminate
Skin, lactic acid secretions, stomach acidity, and Report the result as positive
the motion of cilia represent which type of Obtain a new sample
immunity? *
Natural Which is the most significant agent formed in
Acquired the phagolysosome for the killing of
Adaptive microorganisms? *
Auto Proteolytic enzymes
Hydroxyl radicals
Hydrogen peroxide
Superoxides CD4
CD8
The action of CRP can be distinguished from
that of an antibody in which of the following Which of the following can be attributed to
ways? * antigen stimulated T cells? *
CRP acts before the antibody appears. Humoral response
Only the antibody triggers the complement Plasma cells
cascade. Cytokines
Binding of the antibody is calcium-dependent. Antibody
Only CRP acts as an opsonin.
14 of 15 points Which is a distinguishing feature of a pre-B
Which of the following is a primary lymphoid cell? *
organ? * μ chains in the cytoplasm
Lymph node Complete IgM on the surface
Spleen Presence of CD21 antigen
Thymus Presence of CD25 antigen
MALT
When does genetic rearrangement for coding of
What type of cells would be found in a primary light chains take place? *
follicle? * Before the pre-B cell stage
Unstimulated B cells As the cell becomes an immature B cell
Germinal centers Not until the cell becomes a mature B cell
Plasma cells When the B cell becomes a plasma cell
Memory cells
Which of the following antigens are found on
Which of the following is true of NK cells? * the T cell subset known as helper/inducers? *
They rely on memory for antigen recognition. CD3
They share antigens with B cells. CD4
They are found mainly in lymph nodes. CD8
They recognize a lack of MHC proteins. CD11
Where does the major portion of antibody
Where are all undifferentiated lymphocytes production occur? *
made? * Peripheral blood
Bone marrow Bone marrow
Thymus Thymus
Spleen Lymph nodes
Lymph nodes
Which of the following would represent a
In the thymus, positive selection of immature T double negative thymocyte? *
cells is based upon recognition of which of the CD2–CD3CD4–CD8+
following? * CD2+CD3–CD4–CD8-
Self-antigens CD2–CD3+CD4+CD8-
Stress proteins CD2+CD3+CD4+CD8-
MHC antigens
μ chains Which of the following best describes the T-cell
receptor for antigen? *
Which of these are found on a mature B cell? * It consists of IgM and IgD molecules.
IgG and IgD It is the same for all T cells.
IgM and IgD It is present in the double-negative stage.
Alpha and beta chains Alpha and beta chains are unique for each antigen.
CD3
What is the largest secondary lymphoid organ? *
Which receptor on T cells is responsible for Lymph Node
rosetting with sheep red blood cells? * Spleen
CD2 Bone Marrow
CD3 Liver
ASSIGNMENT-RELATED QUIZ 1
refers to the injection of immunogenic material
to induce immunity * vaccination
are proteins that ↑ due to infection, injury,
trauma (e.g., C-reactive protein, alpha-1
antitrypsin, haptoglobin,fibrinogen,
ceruloplasmin, alpha-1 acid glycoprotein,
complement) * acute-phase reactants
a foreign substance that stimulates antibody
production. Large, complex molecules (MW
>10,000), usually protein or polysaccharide. *
antigen
Migration of cells toward chemokine/s *
chemotaxis
is a small, flat bilobed organ found in thorax;
site of T-lymph development. One of the primary
lymphoid organs * thymus
an enzyme found in tears & saliva that attacks
cell walls of microorganisms. * lysozyme
Serum proteins that attach to foreign substance
& enhance phagocytosis. * opsonins
Ab derived from a single B-cell clone *
monoclonal antibody
Transformed B cells that secrete Abs * plasma
cells
a vasoactive amine released from mast cells &
basophils during allergic reaction * histamine
Any substance capable of inducing immune
response. * immunogen
are cytokines with antiviral properties. Also
active against certain tumors & inflammatory
processes. * interferons
Low molecular weight substance that can bind
to ab once it’s formed, but is incapable of
stimulating Ab production unless bound to
larger carrier molecule. * hapten
Determinant site on an antigen. * epitope
Antigenic features of leukocytes. *
clusters of differentiation
neutrophils show multilobed nuclei, because of
which these cells are also called
___________leukocytes * polymorphonuclear
are cell populations that are specialized to
capture microbial and other antigens,display
them to lymphocytes, and provide signals that
stimulate the proliferation and differentiation of
the lymphocytes * antigen-presenting cells
are the most important APCs for activating
naive T cells, and they play major roles in innate
responses to infections and in linking innate
and adaptive immune responses. * dendritic
cells
are the only cells in the body that express
clonally distributed antigen receptors, each
with a fine specificity for a different antigenic
determinant. * lymphocytes
are encapsulated, vascularized secondary
lymphoid organs with anatomic features that
favor the initiation of adaptive immune
responses to antigens carried from tissues by
lymphatics * lymph nodes
is a highly vascularized organ whose major
functions are to remove aging and damaged
blood cells and particles (such as immune
complexes and opsonized microbes) from the
circulation and to initiate adaptive immune
responses to blood-borne antigens * spleen
are the circulating precursors of tissue
macrophages * monocytes
The condition of being resistant to infection. *
immunity
The process by which cells are capable of
moving from the circulating blood to the tissues
by squeezing through the wall of a blood
vessel. * diapedesis
is the most abundant of the coagulation factors
in plasma, and it forms the fibrin clot *
fibrinogen
are the smallest of the granulocytes * basophils
are the major type of cell present in acute
inflammation * neutrophils
is the most widely monitored of the acute-phase
reactants and is the best indicator of acute
inflammation * c-reactive protein
the key cell involved in the immune response *
lymphocyte
A series of proteins that are normally present in
serum and whose overall function is mediation
of inflammation * complement
the Chinese people developed a practice of
inhaling powder made from smallpox scabs in
order to produce protection against this
dreaded disease. This practice of deliberately
exposing an individual to material from
smallpox lesions was known as? * variolation
Elie Metchnikoff, a Russian scientist, observed
that foreign objects introduced into transparent
starfish larvae became surrounded by motile
cells that attempted to destroy these invaders.
He called this process ______________,
meaning cells that eat cells. * phagocytosis
are chemical messengers that cause cells to
migrate in a particular direction * chemotaxins
are neutrophilic granules and are also called
azurophilic granules, they contain enzymes
such as myeloperoxidase; elastase; proteinase
3; lysozyme; cathepsin G; and defensins, small
proteins that have antibacterial activity * primary
granules
the most abundant phagocytes in the
bloodstream * neutrophils
also known as mononuclear cells, they are the
largest cells in the peripheral blood, with a
diameter that can vary from 12 to 22 μm; they
have an average size of 18 μm * monocytes
The macrophages in the liver are known as? *
Kupffer cells
The overall reaction of the body to injury or
invasion by an infectious agent is known as? *
inflammation
are produced by plasma cells * antibodies
acquired, adaptive, active artificial immunity is
best exemplified when Ags are deliberately
introduced through a ________. * vaccine
__________ immunity results when an
individual is exposed to an antigen (either
naturally or artificially) and the response of the
individual's own immune system is the cause of
the immunity * active
specificity and ___________ both best define
acquired adaptive immunity * memory
are the primary secretory products of the cell-
mediated immunity (T cells) * cytokines
yes or no, is there allergic reaction involvement
in innate immunity? * no
yes or no, can we say that the acquired
adaptive, passive natural immunity acts on a
long-term basis? * no
MINI QUIZ: LESSON 3-4
Macrophages produce which of the following
proteins during antigen processing? *
A. IL-1 and IL-6
B. γ-Interferon
C. IL-4, IL-5, and IL-10
D. Complement components C1 and C3
Feedback
A. IL-1 and IL-6 A Interleukin-1 (IL-1) and IL-6 are
proinflammatory macrophage-produced cytokines.
In addition to their inflammatory properties, they
activate T-helper cells during antigen presentation.
γ-Interferon, IL-4, 5, and 10 are all produced by T
cells. Complement components are produced by a
variety of cells but are not part of the macrophage
antigen presentation process.
Which MHC class of molecule is necessary for
antigen recognition by CD4-positive T cells? *
A. Class I
B. Class II
C. Class III
D. No MHC molecule is necessary for antigen
recognition
Feedback
B. Class II B Helper T lymphocytes (CD4-positive T
cells) recognize antigens only in the context of a
class II molecule. Because class II antigens are
expressed on macrophages, monocytes, and B
cells, the helper T-cell response is mediated by
interaction with processed antigen on the surface of
these cells.
Which of the following are products of HLA
class III genes? *
A. T-cell immune receptors
B. HLA-D antigens on immune cells
C. Complement proteins C2, C4, and Factor B
D. Immunoglobulin VL regions
Feedback
C. Complement proteins C2, C4, and Factor B
C. Complement components C2 and C4 of the
classic pathway and Factor B of the alternative
pathway are class III molecules. HLA-A, HLA-B,
and HLA-C antigens are classified as class I
antigens, and HLA-D, HLA-DR, HLA-DQ, and HLA-
DP antigens as class II antigens.
Which immunoglobulin appears first in the
primary immune response? *
A. IgG
B. IgM
C. IgA
D. IgE
Feedback
B. IgM - The first antibody to appear in the primary
immune response to an antigen is IgM. The titer of
antiviral IgM (e.g., IgM antibody to cytomegalovirus
[anti-CMV]) is more specific for acute or active viral
infection than IgG and may be measured to help
differentiate active from prior infection.
Which immunoglobulin appears in highest titer
in the secondary response? *
A. IgG
B. IgM
C. IgA
D. IgE
Feedback
A. IgG A high titer of IgG characterizes the
secondary immune response. Consequently, IgG
antibodies comprise about 80% of the total
immunoglobulin concentration in normal serum.
Which immunoglobulin can cross the
placenta? *
A. IgG
B. IgM
C. IgA
D. IgE
Feedback
IgG is the only immunoglobulin class that can cross
the placenta. All subclasses of IgG can cross the
placenta, but IgG2 crosses more slowly. This
process requires recognition of the Fc region of the
IgG by placental cells. These cells take up the IgG
from the maternal blood and secrete it into the fetal
blood, providing humoral immunity to the neonate
for the first few months after delivery.
Which immunoglobulin cross links mast cells to
release histamine? *
A. IgG
B. IgM
C. IgA
D. IgE
Feedback
IgE is the immunoglobulin that cross links with
basophils and mast cells. IgE causes the release of
such immune response modifiers as histamine and
mediates an allergic immune response.
All of the following are functions of
immunoglobulins except: *
A. Neutralizing toxic substances
B. Facilitating phagocytosis through opsonization
C. Interacting with TC cells to lyse viruses
D. Combining with complement to destroy cellular
Ags
Feedback
C Cytotoxic T cells lyse virally infected cells
directly, without requirement for specific antibody.
The TC cell is activated by viral antigen that is
associated with MHC class I molecules on the
surface of the infected cell. The activated TC cell
secretes several toxins, such as tumor necrosis
factor, which destroy the infected cell and virions.
Which of the following cell surface molecules is
classified as an MHC class II antigen? *
A. HLA-A
B. HLA-B
C. HLA-C
D. HLA-DR
Feedback
HLA-DR - The MHC region is located on the short
arm of chromosome 6 and codes for antigens
expressed on the surface of leukocytes and
tissues. The MHC region genes control immune
recognition; their products include the antigens that
determine transplantation rejection. HLA-DR
antigens are expressed on B cells. HLA-DR2, DR3,
DR4, and DR5 antigens show linkage with a wide
range of autoimmune diseases.
Which immunoglobulin(s) help(s) initiate the
classical complement pathway? *
A. IgA and IgD
B. IgM only
C. IgG and IgM
D. IgG only
Feedback
Both IgG and IgM are the immunoglobulins that
help to initiate the activation of the classic
complement pathway. IgM is a more potent
complement activator, however.
What is the purpose of C3a, C4a, and C5a, the
split products of the complement cascade? *
A. To bind with specific membrane receptors of
lymphocytes and cause release of cytotoxic
substances
B. To cause increased vascular permeability,
contraction of smooth muscle, and release of
histamine from basophils
C. To bind with membrane receptors of
macrophages to facilitate phagocytosis and the
removal of debris and foreign substances
D. To regulate and degrade membrane cofactor
protein after activation by C3 convertase
Which region of the immunoglobulin molecule
can bind antigen? *
A. Fab
B. Fc
C. CL
D. CH
The Fab (fragment antigen binding) is the region of
the immunoglobulin molecule that can bind antigen.
Two Fab fragments are formed from hydrolysis of
the immunoglobulin molecule by papain. Each
consists of a light chain and the VH and CH1
regions of the heavy chain. The variable regions of
the light and heavy chains interact, forming a
specific antigen-combining site.
Which region determines whether an
immunoglobulin molecule can fix
complement? *
A. VH
B. CH
C. VL
D. CL
The composition and structure of the constant
region of the heavy chain determine whether that
immunoglobulin will fix complement. The Fc
fragment (fragment crystallizable) is formed by
partial immunoglobulin digestion with papain and
includes the CH2 and CH3 domains of both heavy
chains. The complement component C1q molecule
will bind to the CH2 region of an IgG or IgM
molecule.
Which immunoglobulin class(es) has (have) a J
chain? *
A. IgM
B. IgE and IgD
C. IgM and sIgA
D. IgG3 and IgA
Both IgM and secretory IgA have a J chain joining
individual molecules together; the J chain in IgM
joins five molecules and the J chain in sIgA joins
two molecules.
From the following, identify a specific
component of the adaptive immune system that
is formed in response to antigenic stimulation: *
A. Lysozyme
B. Complement
C. Commensal organisms
D. Immunoglobulin
Immunoglobulin is a specific part of the adaptive
immune system and is formed only in response to a
specific antigenic stimulation. Complement,
lysozyme, and commensal organisms all act
nonspecifically as a part of the adaptive immune
system. These three components do not require
any type of specific antigenic stimulation.
Which two organs are considered the primary
lymphoid organs in which immuno- competent
cells originate and mature? *
A. Thyroid and Peyer’s patches
B. Thymus and bone marrow
C. Spleen and mucosal-associated lymphoid tissue
D. Lymph nodes and thoracic duct
The bone marrow and thymus are considered
primary lymphoid organs because
immunocompetent cells either originate or mature
in them. Some immunocompetent cells mature or
reside in the bone marrow (the source of all
hematopoietic cells) until transported to the thymus,
spleen, or Peyer’s patches, where they process
antigen or manufacture antibody. T lymphocytes,
after originating in the bone marrow, travel to the
thymus to mature and differentiate.
What type of B cells are formed after antigen
stimulation? *
A. Plasma cells and memory B cells
B. Mature B cells
C. Antigen-dependent B cells
D. Receptor-activated B cell
Mature B cells exhibit surface immunoglobulin
that may cross link a foreign antigen, thus forming
the activated B cell and leading to capping and
internalization of antigen. The activated B cell
gives rise to plasma cells that produce and secrete
immunoglobulins and memory cells that reside in
lymphoid organs.
T cells travel from the bone marrow to the
thymus for maturation. What is the correct
order of the maturation sequence for T cells in
the thymus? *
A. Bone marrow to the cortex; after thymic
education, released back to peripheral circulation
B. Maturation and selection occur in the cortex;
migration to the medulla; release of mature T cells
to secondary lymphoid organs
C. Storage in either the cortex or medulla; release
of T cells into the peripheral circulation
D. Activation and selection occur in the medulla;
mature T cells are stored in the cortex until
activated by antigen
B Immature T cells travel from the bone marrow to
the thymus to mature into functional T cells. Once
in the thymus, T cells undergo a selection and
maturation sequence that begins in the cortex and
moves to the medulla of the thymus. Thymic factors
such as thymosin and thymopoietin and cells within
the thymus such as macrophages and dendritic
cells assist in this sequence. After completion of the
maturation cycle, T cells are released to secondary
lymphoid organs to await antigen recognition and
activation.
Crohn’s disease is a major form of chronic
inflammatory bowel disease. Evidence
indicates a strong genetic component to this
disease. For instance, the concordance rate of
this disease for identical twins is 44%,
compared with 4% for nonidentical twins. To
assess the possible role of CD4 T cells in this
disease, follow-up genetic studies could: *
examine the frequencies of CD4 T cells in the
blood of patients versus controls.
examine the levels of autoantibodies in the blood
of patients versus controls.
examine the levels of cytokines in the blood of
patients versus controls.
examine whether specific MHC class II alleles are
more frequent in patients versus controls.
test whether type I interferons induce higher MHC
class II protein expression on B cells of patients
versus controls.
The MHC is highly polymorphic; that is, there are
multiple variants, or alleles, of each gene within the
population as a whole. Epidemiological studies of
MHC allele frequencies in specific patient
populations compared with controls has provided
evidence for an immune component in many
chronic diseases. When these linkages between a
particular disease and certain MHC alleles are in
MHC class II genes, the findings indicate a role for
CD4 T cells in the disease.
The murine MHC class II genes were initially
called ‘immune response’ genes, based on the
findings that certain inbred strains of mice
would fail to respond to a given protein antigen
following immunization. The inbred mouse
strains used in the laboratory have only two
functional MHC class II genes, or sometimes
only one. It is unlikely that such ‘immune
response’ defects would be seen in humans,
because: *
human MHC class II genes, but not mouse class II
genes, are upregulated by stimulation with
interferon-γ.
human MHC class II proteins bind a wider array of
peptides than mouse class II proteins.
humans are not generally immunized with single-
protein antigens.
humans generally express at least six different
MHC class II proteins on all of their antigen-
presenting cells.
humans have a much larger repertoire of CD4 T
cells and so are likely more capable of recognizing
any given protein antigen.
There are three pairs of MHC class II α- and β-
chain genes, called HLA-DR, -DP, and -DQ. In
many people, however, the HLA-DR cluster
contains an extra β-chain gene whose product can
pair with the DRα chain. This means that the three
sets of genes can give rise to four types of MHC
class II molecules. Furthermore, human
populations are outbred, meaning that most
individuals inherit different HLA genes from their
mother and their father. Thus, in total, most people
express a minimum of six different MHC class II
proteins on all of their antigen-presenting cells. All
the MHC class I and class II molecules can present
peptides to T cells, but each protein binds a
different range of peptides. Thus, the presence of
several different genes for each MHC class means
that any one individual is equipped to present a
much broader range of peptides than if only one
MHC molecule of each class were expressed at the
cell surface
For individuals with kidney failure who require
a kidney transplant, the preferred option is to
receive a healthy kidney from a living donor,
such as a close relative. To determine which
relative might be the best option, patients and
their relatives are tested for their MHC class I
and class II genotypes, a process referred to as
HLA typing. For historical reasons, HLA typing
determines the MHC class I HLA-A and HLA-B
as well as the MHC class II DR alleles in each
individual’s genome. Normally, HLA-C, -DP, and
-DQ alleles are not examined. While the goal is
to find a perfectly matched donor, this is
generally not an achievable option; instead 3
out of 6 matched HLA alleles are considered
sufficient. Given the information in the table
shown in the figure, the patient’s clinician
would recommend that: *
 nearly all proteins encoded by the human genome
are polymorphic, and therefore generate different
peptide sequences in each individual.
T-cell receptors are indiscriminate in their
recognition, and, much like antibodies, bind to a
broad range of proteins and other antigens.
the immune system has evolved a response to
prevent transplantation of tissues between
individuals.

Monocytes and macrophages play a major role

in the mononuclear phagocytic system. For an
any family member, except sibling 2, would be a
antibody-coated antigen to be phagocytized,
good donor.
what part of the antibody molecule fits into a
any of the family members could be a good kidney
receptor on the phagocytic cell? *
donor.
A. Fc region
any of the siblings could be a good kidney donor.
B. Fab region
neither of the parents would be a good kidney
C. Hinge region
donor.
D. Variable region
the family consider a nonrelated kidney donor.
Cell-mediated immunity is primarily mediated
Based on the data in the table, the patient shares 3
by *
out of 6 HLA alleles with each of the family
A. B cells
members, except sibling 2. In principle, there is a
B. T helper cells
25% chance that one of the siblings would be a 6
C. Plasma cells
out of 6 matches with the patient, but in this family
D. Dendritic cells
that turned out to not be the case. Therefore, any of
the family members other than sibling 2 would be
The HLA complex is located primarily on *
an acceptable donor. Since the family members
A. Chromosomes
who share HLA alleles with the patient all have the
B. Chromosome 6
same entire chromosome 6, this means that they
C. Chromosome 9
are also 50% matched for the untyped genes, HLA-
D. Chromosome 17
C, -DP, and -DQ. This makes the family members
preferred donors over unrelated individuals who
HLA antigens are found on *
might also have 50% matching for HLA-A, -B, and -
A. All nucleated cells
DR.
B. Red blood cells only
C. Solid tissue only
The phenomenon of alloreactivity was initially
D. White blood cells only
difficult to understand, as it was unclear why
such a high frequency of T cells from one
A young woman shows increased susceptibility
individual (1–10%) would recognize any given
to pyogenic infections. Upon assay, she shows
foreign MHC molecule. This is in direct contrast
a low level of C3. Which of the following
to the frequencies of T cells specific for any
statements is probably true? *
given pathogen-derived peptide bound to self
A. She has an autoimmune disease with continual
MHC, which are generally >103-fold less
antigen-antibody activity causing consumption of
abundant. A major contribution to the high
C3.
frequency of alloreactive T cells is the fact
B. She has DiGeorge syndrome.
that: *
C. She has decreased production of C3.
a foreign MHC allele generally binds a completely
D. She may produce an inactive form of C2, a
distinct array of peptides from self MHC, thereby
precursor of C3.
generating thousands of potential foreign antigens
for T-cell recognition.
What is the predominant type of antibody found
MHC alleles that differ between individuals nearly
in the serum of neonates born after full-term
always involve the amino acid residues that bind to
gestation? *
conserved CDR1 and CDR2 sequences in T-cell
A. Infant IgA
receptor Vβ sequences.
B. Infant IgG
C. Infant IgM C. Epitope
D. Maternal IgG D. Valence

An important part of the nonspecific immune A human cell with CD8 on its surface is most
response is(are) * likely a *
A. B cells A. Bcell
B. Basophils B. Monocyte
C. Complement cascade C. T helper cell
D. Cytotoxic T lymphocytes D. Cytotoxic T cell

The major class of immunoglobulin found in Monoclonal antibodies are produced by *

adult human serum is * A. Cultured T cells
A. IgA B. Human plasma cells
B. IgE C. Mouse plasma cells
C. IgG D. Hybridomas
D. IgM
Antibodies that bind to the same epitope are of
Which class of immunoglobulin possesses the same *
delta heavy chains? * A. Allotype
A. IgA B. Autotype
B. IgD C. Idiotype
C. IgE D. Isotype
D. IgG
Interaction between B and T helper cells
Which class of immunoglobulin possesses 10 involves *
antigenic binding sites? * A. MHC II molecule on B cell binding to MHCI
A. IgA molecule on the T cell
B. IgD B. MHC II molecule on B cell binding to CD8 on the
C. IgG T cell
D. IgM C. Foreign antigen on B cell binding to T cell
receptor
Which class of immunoglobulin binds to D. CDS molecule on B cell binding to
basophils and mast cells to mediate immediate
hypersensitivity reactions? *
A. IgA
B. IgD
C. IgE LONG QUIZ 1
D. IgG
they recognize foreign antigens combined with
After exposure to antigen, the first antibodies MHC-1 molecules on the surface of body cells
that can be detected belong to the class * infected by microbes, some tumor cells, and
A. IgA cells of a tissue transplant; display CD8
B. IgE proteins *
C. IgG active helper T cells
D. IgM cytotoxic T cells
memory T cells
The Fab portion of an antibody * B cells
A. Binds T cell receptor NK cells
B. Consists of two light chains only phagocytes
C. Consists of two heavy chains only antigen presenting cells (APCs)
D. Contains the hypervariable region
The major histocompatibility complex *
The portion of an antigen that binds to an are glycoproteins.
antibody or T cell receptor is called a(n) * attach to the plasma membrane.
A. Allergin have a variable region that can bind to foreign and
B. Avidin self-antigens.
may form an MHC/antigen complex that activates What molecule on the surface of most T cells
T cells. recognizes antigen? *
all of the above. IgT, a four-chain molecule that includes the tau
heavy chain
Antigen-presenting cells can * MHC protein, a two-chain molecule encoded by the
take in foreign antigens. HLA region
process antigens. CD3, consisting of six different chains
use MHC class II molecules to display the TcR, consisting of two chains, alpha and beta
antigens.
stimulate other immune system cells. The T-cell antigen receptor is similar to
all of the above. immunoglobulin molecules in that it: *
Remains bound to the cell surface and is never
Your T cells must be able to recognize your own secreted
MHC molecules, a process known as self- Contains V and C regions on each of its chains
recognition, and lack reactivity to peptide Binds complement
fragments from your own proteins, a condition Can cross the placenta and provide protection to a
known as __________. * fetus
anergy
susceptibility An individual is recovering from a bacterial
self-tolerance infection and tests positive for antibodies to a
autoimmunity protein normally found in the cytoplasm of this
none of the choices bacterium. Which of the following statements is
true of this situation? *
Which T cell expresses the CD8 marker and acts Class I molecules have presented bacterial antigen
specifically to kill tumors or virally infected to CD8+ T cells.
cells? * Class I molecules have presented bacterial antigen
T inducer/suppressor to CD4+ T cells.
Helper T Class II molecules have presented bacterial
T suppressor antigen
T cytotoxic B cells have recognized bacterial antigen without
help from T cells.
Which of the following cell surface molecules is
classified as an MHC class II antigen? * MHC molecules are associated with which of
1 point the following? *
HLA-A Graft rejection
HLA-B Autoimmune diseases
HLA-C Determining to which antigens an individual
HLA-DR responds
All of the above
Which MHC class of molecule is necessary for none of the above
antigen recognition by CD4-positive T cells? *
1 point Which of the following is true of MHC (HLA)
Class I class II antigens? *
Class II They are found on all nucleated cells.
Class III They are found on B cells and macrophages.
No MHC molecule is necessary for antigen They all originate at one locus.
recognition They are coded for on chromosome 9.

Which of the following are products of HLA
class III genes? *
T-cell immune receptors
HLA-D antigens on immune cells
Complement proteins C2, C4, and Factor B
Immunoglobulin VL regions
Which of the following best describes the role
of TAP? *
They bind to class II molecules to help block the
antigen-binding site.
They bind to class I proteins in proteosomes.
They transport peptides into the lumen of the
endoplasmic reticulum.
They help cleave peptides for transport to Class I includes HLA-________ antigens. *
endosomes. DR, DC(DQ), and A
A, B, and C
All of the following are characteristic of a good DR, DC(DQ), and SB
immunogen except * B, C, and D
internal complexity.
large molecular weight. Class I molecules: *
the presence of numerous epitopes. Restrict activity of regulatory T cells and target
found on host cells. cells.
none of the choices Represent components of the complement
pathways.
Which of the following best describes a Regulate interaction between helper T cells and
hapten? * antigen-presenting cells.
Not able to react with antibody Regulate interaction between cytolytic T cells and
Antigenic only when coupled to a carrier target cells.
Has multiple determinant sites
A large chemically complex molecule Match the following to show the relationship
none of the choices between certain HLA antigens and diseases. *
B8
Which would be the best immunogen? * B27
Protein with a molecular weight of 200,000 DR2
Nylon DR3
Polysaccharide with a molecular weight of 250,000 Ankylosing spondylitis
Protein with a molecular weight of 175,000 Type I diabetes
none of the choices Myasthenia gravis
all of the choices Multiple sclerosis

All of the following describe an epitope except * All of the following are true of IgM except that
same as an antigenic determinant site. it *
area of an immunogen recognized by T cells. fixes complement.
consists of sequential amino acids only. has a J chain.
key portion of the immunogen. can cross the placenta.
is a primary response antibody.
Adjuvants act by which of the following
methods? * An Fab fragment consists of *
Complex to antigen to increase its size two H chains.
Prevent rapid escape from the tissues two L chains.
Increase processing of antigen one L chain and one-half of an H chain.
All of the above one L chain and an entire H chain.

A heterophile antigen is one that * Which of the following are L chains of antibody
is a self-antigen. molecules? *
exists in unrelated plants or animals. kappa
has been used previously to stimulate antibody gamma
response. mu
is from the same species but is different from the alpha
host. epsilon
delta
The D region of the major histocompatibility
complex (MHC) codes for class ________ If the results of serum protein electrophoresis
molecules. * show a significant decrease in the gamma band,
I which of the following is a likely possibility? *
II Normal response to active infection
III Multiple myeloma
IV Immunodeficiency disorder
none of the choices Monoclonal gammopathy
Monoclonal gammopathy (MG)is the name Which best describes coding for
given to a “band” in serum protein immunoglobulin molecules? *
electrophoresis, caused by the overproduction All genes are located on the same chromosome.
of a population of plasma cells, which in turn L chain rearrangement occurs before H chain
produce a single immunoglobulin (the so-called rearrangement.
“plasma cell dyscrasias”). What condition is Four different regions are involved in coding of H
associated with an MG that is reflected in the chains.
electrophoretogram of plasma proteins lambda rearrangement occurs before kappa
below? * rearrangement

Which of the following can be attributed to the

clonal selection theory of antibody formation? *
Plasma cells make generalized antibody.
B cells are preprogrammed for specific antibody
synthesis.
Proteins can alter their shape to conform to
antigen.
Cell receptors break off and become circulating
antibody.

they differentiate into plasma cells that secrete

specific antibodies *
active helper T cells
latent viral infection cytotoxic T cells
multiple myeloma memory T cells
severe immunodeficiency disorder B cells
normal Ig production Natural killer (NK) cells
none of the choices phagocytes
antigen presenting cells APCs
Which represents the main function of IgD? *
Protection of the mucous membranes Ab: Characteristics and Functions *
Removal of antigens by complement fixation IgM
Enhancing proliferation of B cells IgG
Destruction of parasitic worms IgA
IgE
Which antibody is best at agglutination and IgD
complement-fixation? * Accounts for 10% of Ig pool, largely confined to the
IgA intravascular space
IgG Mediates some types of hypersensitivity
IgD Found in tears, saliva, colostrum, milk, and
IgM intestinal secretions
Makes up less than 1% of total immunoglobulins
All of the following are true of IgE except that Diffuses more readily into extravascular spaces,
it * neutralizes toxins, and binds to microorganisms
fails to fix complement.
is heat stable. Comparison of the Types of Adaptive Immunity
attaches to tissue mast cells. (question: are Abs produced by the host in the
is found in the serum of allergic persons. following scenarios?) *
yes
What is the purpose of the HAT medium in the no
preparation of the monoclonal antibody? * Active natural
Fusion of the two cell types Artificial active
Restricting the growth of unfused spleen cells Passive natural
Restricting antibody production to the IgM class Artificial passive
Restricting the growth of unfused myeloma cells
The largest percentage of antibodies in the Which immunoglobulin can cross the
blood are * placenta? *
IgA IgG
IgE IgM
IgG IgA
IgM IgE
IgD
Which immunoglobulin cross-links mast cells
Which of the following are functions of to release histamine? *
antibodies? (1) neutralization of antigens, (2) IgG
immobilization of bacteria, (3) agglutination and IgM
precipitation of antigens, (4) activation of IgA
complement, (5) enhancement * IgE
1, 3, and 4
1, 2, 3, and 4 All of the following are functions of
2, 4, and 5 immunoglobulins except: *
1, 2, 3, and 5 Neutralizing toxic substances
1, 2, 3, 4, and 5 Interacting with TC cells to lyse viruses
Facilitating phagocytosis through opsonization
Which immunoglobulin(s) help(s) initiate the Combining with complement to destroy cellular
classic complement pathway? * antigens
IgA and IgD
IgM only The interaction between an individual antigen
IgG and IgM and antibody molecule depends upon several
IgG only types of bonds such as ionic bonds, hydrogen
bonds, hydrophobic bonds, and van der Waals
Which region of the immunoglobulin molecule forces. How is the strength of this attraction
can bind antigen? * characterized? *
Fab Avidity
Fc Affinity
constant light Reactivity
constant heavy Valency

Which region determines whether an The chemical composition of an antibody is: *

immunoglobulin molecule can fix Lipid
complement? * Protein
VH Carbohydrate
CH Any of the above
VL
CL Highest in plasma or serum concentration in
normal individuals *
Which immunoglobulin appears first in the IgM
primary immune response? * IgA
IgG IgE
IgM IgG
IgA IgD
IgE
Shortest half-life *
Which immunoglobulin appears in the highest IgM
titer in the secondary response? * IgG
IgG IgA
IgM IgE
IgA IgD
IgE
Increased in infectious diseases, collagen
disorders, and hematologic disorders *
IgG Immunodeficiency disorders may involve
IgM deficiencies in production and/or function of
IgA lymphocytes and phagocytic cells or a deficiency in
IgD production of a complement factor. Choice of
IgE laboratory tests is based upon the patient’s clinical
presentation, age, and history.
Produced early in an immune response *
IgG What screening test should be performed first in
IgM a young patient suspected of having an immune
IgA dysfunction disorder? *
IgD A. Complete blood count (CBC) and white cell
IgE differential
B. Chemotaxis assay
Primarily a cell membrane immunoglobulin * C. Complement levels
IgG D. Bone marrow biopsy
IgM The first screening tests performed in the
IgA initial evaluation of a young patient who is suspected
IgD of having an immune dysfunction are the CBC and
IgE differential. White blood cells that are decreased in
number or abnormal in appearance may indicate
Which type of antibody is capable of placental further testing.
transfer? *
IgG What is measured in the CH50 assay? *
IgM A. RBC quantity needed to agglutinate 50% of
IgA antibody
IgD B. Complement needed to lyse 50% of RBCs
IgE C. Complement needed to lyse 50% of antibody
sensitized RBCs
The subclasses of IgG differ mainly in * D. Antibody and complement needed to sensitize
the type of L chain. 50% of RBCs
the arrangement of disulfide bonds. The CH50 is the amount of complement
the ability to act as opsonins. needed to lyse 50% of standardized hemolysin-
molecular weight. sensitized sheep RBCs. It is expressed as the
reciprocal of the serum dilution resulting in 50%
Which is characteristic of variable domains of hemolysis. Low levels are associated with deficiency
immunoglobulins? * of some complement components and active
They represent the complement binding site. systemic autoimmune diseases in which
They are at the carboxy-terminal ends of the complement is being consumed.
molecules.
They occur on both the H and L chains. What type of disorders would show a decrease
All of the above in C3, C4, and CH50? *
A. Autoimmune disorders such as SLE and RA
B. Immunodeficiency disorders such as common
MINI QUIZ: LESSON 5-6 variable immunodeficiency
C. Tumors
D. Bacterial, viral, fungal, or parasitic infections
Which of the following symptoms in a young The pattern of decreased C3, C4, and CH50
child may indicate an immunodeficiency indicates classic pathway activation. This results in
syndrome? * consumption of complement and is associated
A. Anaphylactic reactions with SLE, serum sickness, subacute bacterial
B. Severe rashes and myalgia endocarditis, and other immune complex diseases.
C. Recurrent bacterial, fungal, and viral infections The inflammatory response seen in malignancy
D. Weight loss, rapid heartbeat, breathlessness and acute infections gives rise to an increase in
An immunodeficiency syndrome should be complement components. Immunodeficiency
considered in a young child who has a history of caused by an inherited deficiency in complement
recurrent bacterial, fungal, and viral infections constitutes only about 1% of immunodeficiency
manifested after the disappearance of maternal IgG.
diseases. Such disorders reduce the CH50 but
involve a deficient serum level of only one
complement factor.
The alternative complement pathway is initiated
by: *
A. cell-surface constituents that are recognized as
foreign to the host.
B. mannose-containing residues of glycoproteins
on certain microbes.
C. stimulation of killer activation receptors on N K
cells.
D. the formation of antibody-antigen complexes.
E. toll-like receptor binding to pathogen-associated
molecular patterns.
A 76-year-old man is diagnosed with Escherichia
coli septicemia. The initial immune response to
E. coli(Gram-negative bacteria) will include *
A. binding by LPS-binding proteins and delivery to
receptors on macrophages.
B. formation of specific somatically generated
receptors to bind E. coli.
C. generation and secretion of specific antibodies
to recognize E. coli.
D. production of E. coli-specific cytokines by
recognize E. coli.
E. stimulation of killer activation receptors on NK
cells.
Other:-----
LPS of gram-negative bacteria
is recognized by LPS-binding protein in the
bloodstream and tissue fluids. The LPS-LPS-binding
protein complex is then delivered to the cell
membrane of a macrophage, where resident LPS
receptors, composed of a complex of proteins
(TLR-CD 1 4-MD-2) bind the bacterial LPS. As a
result of receptor engagement, the microbes are
ingested and degraded, the macrophage is
activated, and cytokine production and inflammation
result. Actions of somatically generated receptors
of B and T cells and of antibodies are part of the
adaptive immune response as opposed to the
innate response. Cytokines do not have antigen
specific activities, and killer activation receptors
on NK cells recognize stress-related molecules
on the surfaces of abnormal host cells.
DiGeorge syndrome is an immune deficiency
disease resulting from impaired thymic
development. Which of the following is/are
affected in patients with DiGeorge syndrome? *
A. B cell development only
B. complement only
C. NK cell function
D. T cell development only
E. T cell and B cell functions
The defective thymic environment inhibits T
cell development and function. Because so much B
cell activity depends on interaction with T cells, B cell
responses will also be impaired. Complement
would not be impaired while sparing T and
B cell activity. N K cell function should not be
affected.
Negative selection of T cells occurs in the *
A. blood vessels.
B. bone marrow.
C. lymph node.
D. spleen.
E . thymus
Negative selection of T cells occurs as they
move from the thymic cortex into the thymic medulla.
It does not occur at sites outside of the thymus.
NKT cells *
A. are usually CDS single positive cells.
B. bind epitopes presented by MHC class II
molecules.
C. express TCRs generated by DNA
rearrangement and junctional diversity.
D. recognize carbohydrates and complex proteins.
E. synthesize immunoglobulin and display it on
their cell surfaces.
N KT cells do express TCRs generated (like
those of other T cells) by DNA rearrangement and
junctional diversity. They are either CD4+ or
CD4+CDa+. Despite this, their TCRs recognize lipid-
related molecular fragments presented by the
nonclassical class I molecule CD1 d. They do not
synthesize or express immunoglobulins.
T cells recognize epitopes they have never
before encountered by *
A. randomly generating enormous numbers of
TCRs prior to antigenic encounter.
B. sampling the environment using phagocytosis
and pinocytosis.
C. synthesizing immunoglobulins specific for a
wide variety of epitopes.
D. selecting widely expressed molecules as TCR
ligands.
E. using genomically encoded pattern recognition
receptors.
T-cell receptors are randomly generated prior to any
engagement with antigens. Phagocytic cells use
phagocytosis and pinocytosis to internalize antigens
without regard to the specificity of the ingested
material. T cells do not synthesize immunoglobulins.
The selection for receptors recognizing
a widely expressed set of microbial molecules
is a property of toll-like receptors, not of T-cell
receptors. The genomically encoded pattern
recognition receptors are toll-like receptors.
Which of the following na'ive cells load peptide
fragments into MHC class II molecules? *
A. CD4+ T cells
B. CDS+ T cells
C. dendritic cells
D. -yo T cells
E. neutrophils
Of those cell types listed, only dend ritic cells can
process peptide fragments and load them on MHC II
molecules for presentation. Lymphocytes, whether
of the C04+, Cos+, or -y8 type, cannot do this.
Neutrophils can ingest peptides and degrade them
but do not synthesize MHC II molecules.
Fragments of a cytoplasmic pathogen are
presented to T cells by *
A. direct engagement of cell su rface pattern
recognition receptors.
B. macropinocytosis into gamma delta T cells.
C. MHC class I molecules to CD8+ T cells.
D. phagocytosis and presentation to CD4 + T cells.
E. placement into endocytic vesicles and
complexing with MHC class II molecules
Cytoplasmatically derived peptides are presented by
MHC I molecules. Pattern recognition receptors do
not present peptides to T cells nor do gamma delta
T cells. CD8+ T cells recognize peptide fragments
presented by class I MHC molecules. They are not
processed in endocytic vesicles for presentation
by MHC II molecules to CD4+ T cells.
The term immunologic synapse refers to *
A. PAMP recognition by pattern recognition
receptors.
B. restriction of CD4 + T cells to MHC class I .
C. selective unresponsiveness of T cells.
D. T cell recognition of soluble molecules.
E. the interface between antigen-presenting cells
and T cells.
The immunologic synapse is the interface between
T cells and antigen-presenting cells. It does not refer
to the recognition and binding by pattern recognition
receptors. CD4 + T cells are restricted to the
recognition of peptide presented by MHC I I
molecules. The selective un responsiveness of T
cells is called tolerance or anergy. T-cell receptors
do not recognize soluble molecules.
CD4 + T cells that respond to intracellular
pathogens by recruiting and activating
phagocytic cells are termed *
A. antigen-presenting cells.
B. cytotoxic T lymphocytes.
C. ThO cells.
D. Th1 cells.
E. Th2 cells.
CD4+ Th1 cells recruit and activate macrophages to
destroy intracellular pathogens. Antigen-presenting
cells are not T cells. Cytotoxic T lymphocytes are
CD8+. ThO and Th2 cells, although also being
CD4+, do not engage in this activity.
In the presence of microbe-derived
lipopolysaccharide *
A. antigen-presenting cells may secrete I L- 1 2 .
B. release o f cytokines results in leukocyte
activation.
C. stimulation of I FN--y secretion activates
leukocytes.
D. ThO cells further differentiate into Th1 cells.
E. all of the above
The correct answer is E. All of these activities
can follow activation of phagocytic cells
by the recogn ition and binding of lipopolysaccharide
via their toll-like receptors. Activated
phagocytes can secrete various cytokines that
can be involved in chemotaxis and activation
of other leukocytes. Among these cytokinesis
I L-1 2, which stimulates natu ral killer cells to
increase their production of I FN--y, which, in
turn, promotes the differentiation of CD4+ ThO
cells into Th 1 cells.
Upon encountering an appropriate pMHC I on an
infected cell, *
A. B-cell receptors become cross-linked and
signaling ensues.
B. CD4+ cells release I L-4.
C. CD8 + cytotoxic T cells destroy the infected cell
D . na"ive Th1 cells secrete cytokines.
E. ThO cells differentiate into Th2 cells.
Once activated, cytotoxic T lymphocytes can bind
and destroy infected cells expressing pMHC I
complexes recognized by their T-cell receptors.
Neither B cells nor CD4+ T cells recognize pMHC I.
T helper cells-whether ThO, Th1 , or Th2-are
CD4+ and do not recognize pMHC I .
Activation of an individual na"ive B cell involves
binding of membrane-associated epitopes
leading to *
A. dendritic cell presentation of MHC class I.
B. recognition of different epitopes by su rface lgD
and lgM.
C. signaling from both the B-cell receptor and a
CD4 + Th2 cell .
D . the isotype switch.
E. ubiquitination and destruction of antigen by lytic pathway
proteasomes classical pathway
Activation of a naive B cell requires both the alternative pathway
engagement of its B cell receptor (immunoglobulin) lectin pathway
and the receipt of secondary signals from CD4+ Th2 none of the choices
cells. The B cell does not require interaction with
antigen presenting cells such as dendritic cells. The CD59 glycoprotein, also known as MAC-
lgD and lgM on its surface have the same epitope inhibitory protein (MAC-IP), membrane inhibitor
specificity. Turn over of cytoplasmic molecules of reactive lysis (MIRL), or protectin and DAF
by proteasomes is a normal ongoing activity deficiencies lead to the development of what
but is not involved in the naive B cell's activation. The disease? *
isotype switch occurs only during the Hemolytic uremic syndrome
reactivation of memory B cells, not during the hereditary angioedema
initial activation of naive B cells. Systemic lupus erythematosus
Wiskott-Aldrich syndrome
are the ways in which the complement system Paroxysmal nocturnal hemoglobinuria
destroys foreign cells and organisms, except; *
direct lysis aside from macrophages what other cell type is
opsonization responsible of most cytokine production? *
attracting phagocytic cells basophils
none of the choices T lymphocytes
neutrophils
which components of the membrane attack B lymphocytes
complex (MAC) initially insert into the lipid none of the choices
bilayer of cell membranes *
C3bBb interferon gamma chiefly stimulates what
C1q cells? *
DAF gamma delta T cells
C5b-7 NKT cells
none of the choices macrophages
neutrophils
which of the following complement components DCs
are anaphylatoxins? *
C3a the 3 main stages of complement activation
C4a include the following, except *
C5a recognition
none of the choices activation
all of the first three choices MAC
opsonization
What is the major physiologic role of
complement receptor 1 (CR1) ? * the most efficient immunoglobulin in activating
enhances chemotaxis the classical pathway *
accentuates cell activation IgE
facilitates opsonization IgM
aborts neutralization IgG3
IgD
Deficiencies of the components of the none of the choices
membrane attack complex are associated with
increased infections with what organisms? * Most of the complement proteins are
Streptococcus pneumoniae synthesized in what organ? *
Neisseria meningitidis pancreas
Staphylococcus aureus liver
Vibrio parahaemolyticus spleen
red bone marrow
Deficiencies in what pathway are well associated kidneys
with SLE? *
An anaphylatoxin is a small peptide that causes
the following, except; *
decreased vascular permeability
smooth muscle contraction
histamine release from basophils
are formed as cleavage products from larger
complement components
Complement is central to the development of
inflammatory reactions and forms one of the
major immune defense systems of the body. *
True
False
The alternative and lectin pathways provide
antibody-independent ‘innate’ immunity,and the
alternative pathway is linked to and amplifies the
classical pathway. *
True
False
C1 which is the most abundant and most
important of the complement proteins *
true
False
C3a and C3b are chemotactic fragments *
true
false
because the small chemotactic and
proinflammatory fragments are C3a and C5a
in the classical pathway, IgM is the most efficient
activator, but unbound IgM in plasma does not
activate complement *
True
False
Assembly of the C1 complex is Ca2+ -dependent,
and the classical pathway is therefore active if
Ca2+ ions are absent. *
True
False
because, assembly of the C1 complex is Ca2+
-dependent, and the classical pathway is therefore
inactive if Ca2+ ions are absent.
the complement components were named
chronologically, according to the order of their
discovery, rather than according to their position
in the reaction *
True
False
The lectin pathway differs from the classical
pathway only in the initial recognition and
activation steps. *
True
False
The lectin pathway is not the only means of
activating the classical pathway in the absence
of antibody. Apoptotic cells, released DNA,
mitochondria and other products of cell damage
can directly bind C1q, triggering complement
activation and aiding the clearance of the dead
and dying tissue. *
True
False
The lectin pathway is in a constant state of low-
level activation (termed ‘tickover’). *
true
false
The alternative pathway of complement
activation also provides antibody-independent
activation of complement on pathogen surfaces.
This pathway is in a constant state of
low-level activation (termed ‘tickover’).
The fully formed MAC creates a rigid pore in the
membrane, the walls of which are formed from
multiple copies of C19 (up to 12), arranged like
barrel staves around a central cavity. *
true
false
there is no C19 component only C9
Complement activation and amplification cause
complement fragments to efficiently coat
activator surfaces of targets such as bacteria or
immune complexes, enhancing their recognition
by phagocytes *
True
False
Bystander lysis is the deposition of MACs on
cells near to but not directly the cause of
complement activation, *
true
false
complement-opsonized particles may be 1000-
fold as active as the un opsonized particle in
triggering antibody production *
true
false
Classical pathway activation and opsonization of
immune complexes helps prevent precipitation
in tissues and aids the carriage of immune /At which stage does the complement system
complexes on erythrocytes. * reach its full amplitude? *1 point
True C1q, C1r, C1s complex
False C2
C3
C4
LONG QUIZ: LESSON 5-6
/Which of the following is not a component of the
membrane attack complex? *1 point
/The complement system is: *
C3b
A heat-labile series of plasma proteins
C6
Composed of many proteinases
C7
Composed of three interrelated pathways
C8
All of the above
/The final steps (C8 and C9) in complement
/All the following are complement-controlling
activation lead to: * 1 point
proteins except: * 1 point
Cell lysis
C1 (INH)
Phagocytosis
Factor I
Immune opsonin adherence
Factor H
Virus neutralization
C3
/Select the appropriate pathway response. * 3
/The three complement activation pathways
points
converge at the point of cleavage of complement
Classic pathway
component _____. * 1 point
Alternative pathway
C3
Both pathway
C5
Activated by antigen-antibody complexes
C7
Generates an active (C3b, Bb) C3 convertase
C8
Terminates in a membrane attack complex
/All the following result from complement
/The alternate complement pathway is(can be): *
activation except: * 1 point
1 point
Decreased cell susceptibility to phagocytosis
Initiated by the formation of antigen-antibody
Blood vessel dilation and increased vascular
reactions
permeability
Predominantly a non–antibody-initiated pathway
Production of inflammatory mediators
Activated by factors such as endotoxins
Cytolysis or hemolysis
Both b and c
/Which complement component is present in the
/Which of the following conditions can be
greatest quantity in plasma? *1 point
associated with hypercomplementemia? * 1 point
2
Myocardial infarction
3
Systemic lupus erythematosus
4
Glomerulonephritis
8
Subacute bacterial endocarditis
/Fixation of the C1 complement component is
/Match the following complement deficiency
related to each of the following factors except: *
states in humans with their respective deficient
1 point
components. (Use an answer only once.) * 4
Molecular weight of the antibody
points
The presence of IgM antibody
Xeroderma pigmentosa
The presence of most IgG subclasses
Leiner’s disease
Spatial constraints
Raynaud’s phenomenon
Recurrent pyogenic infections
C2 Interleukin-7 (IL-7)
C5 dysfunction Interleukin-8 (IL-8)
C6 and C7
C8 /Match the following: * 4 points
Inhibits cytokine synthesis
/A (the) nonspecific component(s) of the immune Increases the number of IgG-secreting B
system is (are): * 1 point lymphocytes
Complement Stimulates proliferation of T cells and
T cells mast cells
B cells Enhances the activity of cytotoxic
Both a and b effector T cells
Interleukin-9 (IL-9)
/Match the following: * 4 points Interleukin-10 (IL-10)
T cell growth factor Interleukin-11 (IL-11)
Lymphocyte-activating factor Interleukin-12 (IL-12)
B cell growth factor 2
Multicolony colony-stimulating factor /Match the following: * 4 points
Interleukin-1 (IL-1) Inhibits activation of macrophages
Interleukin-2 (IL-2) Produced in response to viral infection
Interleukin-3 (IL-3) Acts as a T cell chemoattractant
Interleukin-5 (IL-5) Acts as a B cell growth factor
Interleukin-13 (IL-13)
/Match the following: * 4 points Interleukin-14 (IL-14)
NK cell stimulatory factor Interleukin-15 (IL-15)
Stimulates neutrophils in chemotaxis Interleukin-16 (IL-16}
Induce acute phase response
Stimulates expansion of immune T and B /Match the following: * 4 points
cells Acts as a synergist with IL-12
Interleukin-6 (IL-6) Suppresses activities of Th1 and Th2
Interleukin-7 (IL-7) Associated with skin inflammations
Interleukin-8 (IL-8) Induces granulopoiesis
Interleukin-12 (IL-12) Interleukin-17 (IL-17)
Interleukin-18 (IL-18)
/Match the following: * 4 points Interleukin-19 (IL-19)
Enhances cytolytic activity of Interleukin-20 (IL-20)
lymphokine-activated killer cells (LAK)
Potent mediator in acute-phase response /Match the following: * 4 points
Stimulates hematopoietic cells Promotes increased production of T cells
Enhances production of IgG and inhibits Somewhat similar to IFN-α, IFN-β, and
production of IgE by activated B cells IFN-γ
Interleukin-1 (IL-1) A member of the IL-17 cytokine family
Interleukin-2 (IL-2) Shares some in vivo functions with IL-12
Interleukin-3 (IL-3) Interleukin-21 (IL-21)
Interleukin-4 (IL-4) Interleukin-22 (IL_22)
Interleukin-23 (IL-23)
/Match the following: *4 points Interleukin-25 (IL-25)
Induction of secretion of Ig
Activates the respiratory burst /Cytokines secreted by lymphocytes are also
Stimulates early B cell progenitor cells called lymphokines. * 1 point
Activates eosinophils True
Interleukin-5 (IL-5) False
Interleukin-6 (IL-6)
/Cytokines are polypeptide products of activated
cells. * 1 point
True
False
/Cytokines are released only in response to
specific antigens. * 1 point
True
False
/Most cytokines have multiple activities and act
on numerous cell types. * 1 point
True
False
/Match each term to its appropriate description.
(Use each answer only once.) * 4 points
Unable to stimulate T cell proliferation
Act(s) between leukocytes
Discovered in virally infected cells
Provide(s) a link between the lymphoid
hematopoietic system
Interleukins
Interferons
Tumor necrosis factor
Colony-stimulating factors
/Transforming growth factors: * 1 point
Are products of virally transformed cells
Can be a potent inhibitor of IL-1–induced T cell
proliferation in their beta form
Are important in inflammation, tumor defense, and
cell growth
All of the above
/Which activity is associated with interferon? * 1
Enhances phagocytosis
Retards expression of specific genes
Promotes complement-mediated cytolysis
Interferes with viral replication
/Tumor necrosis factor (TNF) differs from IL-1 in
that TNF is not able to: * 1 point
Mediate an acute inflammatory reaction
Increase the expression of IL-2 receptors
Enhance the proliferation and differentiation of B
lymphocytes
Stimulate T cell proliferation
/The classical complement pathway is activated
by * 1 point
most viruses.
antigen–antibody complexes.
fungal cell walls.
All of the above
/All of the following are characteristic of
complement components except * 1 point
normally present in serum.
mainly synthesized in the liver.
present as active enzymes.
heat-labile.
/All of the following are true of the recognition
unit except * 1 point
it consists of C1q, C1r, and C1s.
the subunits require calcium for binding together.
binding occurs at the FC region of antibody
molecules.
C1q becomes an active esterase.
/Which is referred to as C3 convertase? * 1 point
C4b2a
C3bBb
iC3Bb
All of the above
/Mannose-binding protein in the lectin pathway
is most similar to which classical pathway
component? * 1 point
C3
C1rs
C1q
C4
/Which of the following describes the role of
properdin in the alternative pathway? * 1 point
Stabilization of C3/C5 convertase
Conversion of B to Bb
Inhibition of C3 convertase formation
Binding to the initiating antigen
/Which best characterizes the membrane attack
complex? * 1 point
Each pathway utilizes different factors to form it.
C5 through C9 are not added in any particular order.
One MAC unit is sufficient to lyse any type of cell.
C9 polymerizes to form the transmembrane channel.
/All of the following represent functions of the
complement system except * 1 point
decreased clearance of antigen–antibody
complexes.
lysis of foreign cells.
increase in vascular permeability.
migration of neutrophils to the tissues. Which of the following would be most effective
in preventing bystander lysis of red blood
/Which of the following is true of the cells? * 1 point
amplification loop in complement activation? * 1 C1INH
point Factor B
It is found in the alternative pathway. DAF
iC3 binds factor B to generate amplification. Factor H
C3b is the product that is increased.
All of the above /Decreased CH50 levels may be caused by * 1
point
/Factor H acts by competing with which of the inadequate refrigeration of specimen.
following for the same binding site? * 1 point coagulation-associated complement consumption.
Factor B autoimmune disease process.
Factor D All of the above
C3B
Factor I

/A lack of CR1 receptors on red blood cells would

result in which of the following? * 1 point
Decreased binding of C3b to red blood cells
Lack of clearance of immune complexes by the
spleen
Increased breakdown of C3b to C3d and C3dg
All of the above

/A lack of CR2 on cell membranes would result

in which of the following? * 1 point
Decrease in hemolysis
Increased susceptibility to infection
Decreased antibody production
Increase in antibody of the IgG class

/Why is complement not activated with anti-Rh

(D) antibodies? * 1 point
Rh antigens stimulate little antibody production.
Rh antigens are too far apart on red blood cells.
Rh antibodies are not capable of fixing complement.
DAF protects red blood cells from buildup of
antibody.

/The CH50 test measures which of the

following? * 1 point
The dilution of patient serum required to lyse 50
percent of a standard concentration of sensitized
sheep red blood cells
Functioning of both the classical and alternative
pathways
Genetic deficiencies of any of the complement
components
All of the above
LONG QUIZ: LESSON 7 Loss of self-tolerance results in *
Graft-versus-host disease
A 38-year-old woman visited her physician Autoimmune disease
because of fatigue, fever, and joint pain Immunodeficiency
(proximal interphalangeal, wrist, and knee Tumors
joints). She also notices sensitivity to the sun
and reported having a rash following recent Which of the following serologic tests is
exposure. The physician noted a rash over her commonly performed by an
nose and cheeks. Laboratory results included immunofluorescence method? *
white blood cell count 5.5 X 109/L (reference Anti-HBs
range 4.8-10.8 X 109/L) and red blood cell count Antistreptolysin O (ASO)
4.5 X 1012/L (reference range4.0-5.4 X 1012/L). C-reactive protein (CRP)
Urinalysis results were within reference ranges, Antinuclear antibody (ANA)
except for4+ protein and 1+ RBCs, 0-3 hyaline
casts/lpf, and 0-1 RBC cast/lpf on microscopic The antibody most frequently present in
examination. Which of the following tests would systemic lupus erythematosus is directed
be most helpful in diagnosing this patient's against *
condition? * Surface antigens of bone marrow
Anti-nuclear antibody Nuclear antigen
a-Fetoprotein stem cells
Anti-streptolysin O Surface antigens of renal cells
Hepatitis profile Myelin

Hashimoto disease is an autoimmune disease The serologically detectable antibody produced

primarily involving the * in rheumatoid arthritis (RA) is primarily of the
Kidneys class *
Liver IgA
Lungs IgE
Thyroid gland IgG
IgM
Rheumatic fever sometimes occurs after group
A streptococcal infections. In this condition, an What is a general definition of autoimmunity? *
autoimmune response attacks the tissue of the Increase of tolerance to self-antigens
heart valves. This phenomenon is an example Loss of tolerance to self-antigens
of * Increase in clonal deletion of mutant cells
Epitope spreading Manifestation of immunosuppression
Molecular mimicry
Polyclonal B cell activation Which disease is likely to show a rim (peripheral)
Preferential activation of T helper cells pattern in an immunofluorescence (IF)
microscopy test for ANA? *
An autoimmune disease-causing destruction of Mixed connective tissue disease (MCTD)
pancreatic cells can result in * Rheumatoid arthritis
Hashimoto disease Systemic lupus erythematosus
Multiple sclerosis Scleroderma
Myasthenia gravis
Type 1 diabetes What type of antibodies is represented by the
Type 2 diabetes solid or homogeneous pattern in the
immunofluorescence test for antinuclear
The primary mechanism responsible for antibodies? *
pathology in systemic lupus erythematosus is * Antihistone antibodies
Allergic reaction to foreign molecules Anticentromere antibodies
Polyclonal activation of cytotoxic T cells Anti-ENA (anti-Sm and anti-RNP) antibodies
Antibodies directed against self Ags Anti-RNA antibodies
Lack of intracellular killing after neutrophil
phagocytosis of bacteria What disease is indicated by a high titer of anti-
none of the choices Sm (anti-Smith) antibody? *
Mixed connective tissue disease (MCTD) Match the environmental factors and associated
RA cancers *
SLE endometrial CA
Scleroderma hepatocellular carcinoma
Burkitt's lymphoma
Which disease is least likely when a nucleolar leukemia
pattern occurs in an immunofluorescence test mesothelioma
for antinuclear antibodies? * Benzene
MCTD Estrogen
Sjögren’s syndrome Epstein-Barr virus
SLE Hepatitis B
Scleroderma Asbestos
none of the choices
Active host immunotherapy responses may be
What antibodies are represented by the achieved by: *
nucleolar pattern in the immunofluorescence Transferring immune cells into host.
test for antinuclear antibodies? * Vaccination with killed tumor cells.
Antihistone antibodies Administration of tumor-specific MAbs.
Anti-dsDNA antibodies Administration of IFN-α.
Anti-ENA (anti-Sm and anti-RNP) antibodies
Anti-RNA antibodies Benign tumors are characterized as: *
none of the choices a. Growing slowly
b. Resembling the parent tissue
Which immunofluorescence pattern indicates c. Usually invading tissues (metastasizing)
the need for ENA testing by Ouchterlony d. Both a and b
immunodiffusion, Multiplex, or ELISA assays? *
Homogeneous or solid Match the following: *
Peripheral or rim Sarcoma
Speckled Adenoma
Nucleolar Adenocarcinoma
Papillomas
Which of the following is used in rapid slide tests Benign tumor arising from glands
for the detection of rheumatoid factors? * Benign tumor arising from epithelial surfaces
Whole IgM molecules Malignant tumor of connective tissue
Fc portion of the IgG molecule Malignant tumor of glandular epithelium
Fab portion of the IgG molecule
Fc portion of the IgM molecule Tumor cells typically carry _______ genetic
change(s). *
Antibodies to thyroid peroxidase can be One
detected by using agglutination assays. Which Two
of the following diseases may show positive Three to six
results with this type of assay? * Multiple
Graves’ disease and Hashimoto’s thyroiditis
Myasthenia gravis Oncogenes are: *
Granulomatous thyroid disease Genetic targets of carcinogens
Addison’s disease Altered versions of normal genes
Detectable in 15% to 20% of a variety of human
What is the main use of laboratory tests to detect tumors
antibodies to islet cells and insulin in cases of All of the above
insulin-dependent diabetes mellitus (IDDM)? *
To regulate levels of injected insulin Which of the following is used to determine the
To diagnose IDDM risk of developing cancer? *
To rule out the presence of other autoimmune p53 gene
diseases c-erbB-2 gene
To screen susceptible individuals prior to Squamous cell carcinoma antigen
destruction of β cells Epidermal growth factor receptor (EGFR)
A tumor marker assay is most useful: * Tumor-specific antigens
To screen patients for malignancies Tumor-associated antigens
To monitor a cancer patient for disease recurrence Carcinofetal antigens
To determine the degree of tumor burden
All of the above Carcinoembryonic antigen is: *
An oncofetal protein, elevated in some types of
The cells involved in the immune response to cancer, that is found on normal fetal endocrine
tumors are: * tissue in the second trimester of gestation
T lymphocytes, B lymphocytes, and macrophages b. An elevated oncofetal protein, strongly
Cytotoxic T lymphocytes, NK cells, and correlated with various malignancies, that is found
macrophages on normal fetal endocrine tissue in the second
Neutrophils, lymphocytes, and monocytes trimester of gestation
CD8+ lymphocytes, monocytes, and basophils c. Used clinically to monitor tumor progress in
some types of patients, persistently elevated even
Match the following. * in residual disease
a. TRUE d. Both b & c
b. FALSE
Antibodies dominate body defenses against β-hCG is not: *
cancer. Elevated in normal pregnancy
Tumors express antigens that can be recognized A sensitive tumor marker
as foreign by the immune system of the tumor- Elevated in squamous cell carcinoma of the lung
bearing host Elevated in teratocarcinoma and choriocarcinoma
The normal immune response frequently fails to
prevent the growth of tumors. Prostate-specific antigen is: *
Prostate tissue–specific
Which of the following factors is not a risk factor Prostate cancer–specific
in the development of cancer? * Not useful for monitoring response to therapy in
Smoking patients with prostate cancer
Low-fat diet Not directly proportional to tumor volume in
Obesity prostate malignancies
Sedentary lifestyle
Match the following tumor markers and
The risk factor associated with the development applications. *
of basal cell carcinoma or malignant melanoma a. Frequently elevated in endometrially derived
is: * gastrointestinal neoplasms gastrointestinal
Infrared light neoplasms
Sunless tanning lotions b. Most useful in ovarian and endometrial
Ultraviolet light carcinomas
Strobe lights c. Increased levels may indicate recurrent breast
visible light d. May be elevated in patients with gastrointestinal
malignancies
Match the following definitions. * e. Should be quantitated with β-hCG initially in all
a. Results in the production of nonfunctional patients with teratocarcinoma
proteins that can no longer control cell proliferation CEA
b. Produces proteins that can stimulate AFP
uncontrolled cell growth CA 125
Mutation or overexpression of oncogenes CA 19-9
Mutation or overexpression of tumor suppress 27-29 1
genes or
Which tumor marker is used to monitor patients
Match the following. * with breast cancer for recurrence of disease? *
a. Cell surface molecules coded for by tumorigenic CA 15-3
viruses Estrogen receptor (ER)
b. Gene products resulting from gene derepression Cathepsin-D
c. Antigens uniquely related to each tumor CA 50
d. Probably do not produce unique antigens
Tamoxifen acts as a(an) _______ pharmaceutical
agent. *
a. Cell cycle active, phase-specific
b. Non–cell cycle active
c. Estrogen receptor–blocking
d. Both b and c