No Question

1 What is included in MALT?

A. thymus
B. Peyer’s patches
C. spleen
D. bone marrow
E. none of the above
2 A patient with periodontitis of the lower molar came to the doctor. It
was determined that the inflammatory process spread to the lymph
nodes. What lymph nodes were the first to be affected by the
inflammatory process?
A. Lateral cervical
B. Submandibular
C. Anterior cervical
D. Submental
E. Facial
3 A specimen shows an organ covered with connective tissue capsule
with trabeculae radiating inward the organ. The organ’s cortex
contains lymph nodules; there are medullary cords made of lymphoid
cells. What organ is under study?
A. Tonsils
B. Thymus
C. Spleen
D. Red bone marrow
E. Lymph node
4 The internal immune system is mainly enforced by leukocytes, the
leukocytes have different half-lives and are constantly generated, about
1011 each day in a human adult. Where are they generated?
A. Innate immune cells originate from the bone marrow, lymphocytes from
lymphoid tissue
B. All leukocytes except T cells originate from the bone marrow
C. B cells originates from the bone marrow, T cells from the thymus and
innate immune cells are formed throughout the body
D. Leukocytes originate from most tissues in the adult body
E. All leukocytes originate from the bone marrow
5 A child falls and suffers a deep cut on her leg. The cut went through
her skin and she is bleeding. Which of the following defense
mechanisms will participate in eliminating contaminating microbes?
A. mucociliary escalator
B. normal skin flora
C. phagocytosis in the inflammatory response
D. acidic skin secretions
E. lysozyme
6 Margination refers to
A. the adherence of phagocytes to microorganisms
B. the chemotactic response of phagocytes
C. adherence of phagocytes to the lining of blood vessels
D. dilation of blood vessels
E. the movement of phagocytes through walls of blood vessels
7 Thymus is a central lymphoid organ for cellular maturation and
selection. Which of the following cells are negatively selected in the
thymus?
 A. Autoreactive B-cells
B. Autoreactive NK-cells
C. T-cells recognizing allogeneic MHC
D. T-cells with strong affinity to autologous MHC
E. T-cells with low affinity to autologous MHC
8 Which of the following is mismatched?
A. diapedesis — movement of leukocytes between capillary walls cells out
of blood and into tissue
B. chemotaxis — chemical degradation inside a phagolysosome
C. abcess — a cavity created by tissue damage and filled with pus
D. pus — tissue debris and dead phagocytes in a white or yellow fluid
E. scab — dried blood clot over injured tissue
9 Innate immunity includes all of the following EXCEPT
A. phagocytosis
B. inflammation
C. production of antibody
D. production of interferon
E. activation of complement
10 Which of the following defense systems would be involved in
eliminating virally-infected cells?
A. Humoral immunity
B. Phagocytosis
C. Complement system
D. T lymphocytes
E. AMPs
11 Which of the following statements is true?
A. Memory B cells are typically established when the B cell binds to an
antigen
B. Adaptive defenses include both humoral and cellular immunity
C. Adaptive defenses include humoral immunity only
D. Innate defenses are enough to keep a person healthy
E. Innate defenses include only cell immune responses
12 Which statement regarding the lymphatic system is true?
A. Lymph nodes are sites of activation of neutrophils, which destroy
microbes
B. Lymphatic capillaries possess one-way valves. These valves permit the
uptake of fluid from the body but do not allow the fluid to flow back out of
the capillaries into the intracellular spaces
C. The pancreas contains T-lymphocytes and macrophages that monitor the
blood for microbes
D. The thymus serves as the site for differentiation of B cells
E. Peyer’s patches contain connective tissue capsule
13 Which defense mechanism is considered a specific category of
immunity?
A. Epithelial membranes that cover the body surfaces
B. Strong acidity the gastric juice
C. Phagocytosis of unwanted substances
D. Activation of lectin pathway of complement cascade
E. Activation of B-lymphocytes
14 Haptens are
A. small antigentic organic molecules
B. antigenic when bound to carbohydrates
 C. antigenic when bound to proteins
D. cells that release chemotaxtic agents
E. only short peptides
15 The thymus gland is most active during
A. middle age
B. infancy
C. old age
D. adolescence
E. A and D
16 Where are the tonsils located?
A. beneath sternum overlying heart
B. throat
C. armpits, groin, neck
D. small intestine
E. abdomen
17 The organ responsible for positive selection of B-lymphocyte, is the
A. thymus
B. spleen
C. bone marrow
D. Peyer’s pathce
E. liver
18 During an infection, lymph nodes enlarge and become tender because
A. macrophages are rapidly dividing
B. edema accumulates within the fibrous capsules
C. the nodes are not function properly
D. B and C
E. microorganisms are accumulating
19 Chronic inflammation is characterized by:
A. neutrophilic infiltration
B. lymphocytic and macrophagic infiltration
C. metaplasia
D. hypertrophy
E. All of the above are correct
20 Which of the following is NOT a function of the lymphatic and immune
system?
A.Draining excess interstitial fluid
B.Maintaining water homeostasis in the body
C.Transporting dietary lipids
D.Carrying out immune response
A and B
21 Which of the following is NOT considered an organ of the immune
system?
A.Spleen
B.Lymph node
C.Red bone marrow
D.Thymus
E.Pancreas
22 Which of the following is considered a primary lymphoid organ?
A.Spleen
B.Lymph node
C.Red bone marrow
D.Tonsils
 E.Peyer’s patches
23 Which lymphoid organ is not responsible for the antigen presentation
to the naive T-cells?
A. Spleen
B. Lymph node
C. Red bone marrow
D. Tonsils
E. Peyer’s patches
24 Organized mucosa-associated lymphoid tissue is
A. found in the lymph nodes
B. associated with initial immune response to antigen
C. filled with plasma cells that are producing antibodies
D. composed primarily of M-cells and L-cells
E. all of the above
25 The lymphoid organs are organized tissue where lymphocytes (B- and
T-cells) interact with non-lymphoid cells (APC) and trapped antigen.
They are divided into primary central and secondary peripheral
organs and have different roles in immunity. What is the major
function of the peripheral organs?
A. Provide the microenvironment for maturation of T and B cells
B. Maximize contact between antigen and lymphocytes
C. Produce antigen-specific lymphocytes from stem cells in response to
antigen
D. Provide a site where memory T-cells reside to ensure a rapid response to
antigen
E. Sequester antigen to minimize its damage to the body
26 An example/examples of a non-specific chemical barrier to infection
is/are
A. unbroken skin
B. blood-brain barrier
C. lysozyme in saliva
D. mucociliary escalator
E. all of the above
27 Which non-specific host defense is associated with the trachea?
A. lacrimation
B. ciliary lining
C. desquamation
D. lactic acid
E. all of the above
28 All of the following protect the skin and mucous membranes from
infection EXCEPT
A. multiple layers of cells
B. tears
C. saliva
D. HCl
E. the “ciliary escalator”
29 The function of the "ciliary escalator" is to
A. propel inhaled dust and microorganisms toward the throat
B. remove microorganisms from the gastrointestinal tract
C. remove microorganisms from the lower respiratory tract
D. remove microorganisms from the upper respiratory tract
E. trap inhaled dust and microorganisms in mucous and propel it away from
 the lower respiratory tract
30 Symbiotic microbiota provide protection from infection in each of the
following ways EXCEPT
A. they produce antibacterial chemicals
B. they compete with pathogens for nutrients
C. they make the chemical environment unsuitable for nonresident bacteria
D. they produce lysozyme
E. they change the pH of the environment
31 All of the following occur during inflammation. What is the first step?
A. diapedesis
B. margination
C. phagocyte migration
D. repair
E. vasodilation
32 All of the following are components of the inflammatory process
EXCEPT
A. dilation of blood vessels
B. release of histamines and prostaglandins
C. chemotaxis
D. diapedesis
E. antibody synthesis
33 Which non-specific defense mechanism is mismatched with its
associated body structure or body fluid?
A. lysozyme — tears and saliva
B. mucociliary escalator — intestine
C. very acidic pH— stomach
D. keratin and tightly packed cells — skin
E. cerumen and sebum — ear
34 Mucous membranes are a part of
A. cell-mediated immunity
B. innate defense
C. humoral immunity
D. adaptive defense
E. the complement system
35 First line defenses have what aspect in common with each other?
A. They involve the production of antibodies
B. They create physical barriers against invading pathogens
C. They involve unique cells that attack invading pathogens
D. They recognize specific pathogens
E. All of the above
36 Inflammation :
A. destroys injurious agents.
B. confines injurious agents.
C. stimulated and enhances immunity.
D. promotes healing.
E. All of the above are correct
37 Inflammatory microcirculation changes involve all of the following
EXCEPT:
A. vasodilation
B. days to develop
C. increased vascular permeability
D. exudation
 E. leukocyte extravasation
38 Which is NOT a systemic manifestation of inflammation?
A. fever
B. exudation
C. leukocytosis
D. increased acute-phase reactants
E. A and B
39 The inflammatory response:
A. prevents formation of abscesses
B. minimizes injury and promotes healing
C. prevents blood from entering the injured tissue
D. elevates body temperature to prevent spread of infection
E. A and B
40 Swelling during acute inflammation is caused by:
A. neutrophilic margination
B. collagenase
C. fluid exudation and cell extravasation
D. lymphocytic margination
E. anaerobic glycolysis
41 Which of the below do NOT induce vasodilation and permeability
(increased fluid flow) to an infection site?
A.Histamines
B.Kinins
C.Perforin
D.Leukotrienes
E.Complement
42 Mechanical barriers in the innate immune system's first line of defense
include:
A. Sebum (pathogen-inhibiting agents)
B. A continuous barrier formed by skin and mucous membranes - several
layers of densely packed cells and other materials protecting against
invasion by foreign cells
C. Mucus (pathogens stick and are swept away)
D. Enzymes (hydrolyse pathogens)
E. B and C
43 Chemical barriers in the innate immune system's first line of defence
include:
A. Sebum (pathogen-inhibiting agents)
B. HCl in gastric mucosa to destroy pathogens; saliva, bile acids, tears,
urine
C. Mucus (pathogens stick and are swept away)
D. Enzymes (hydrolyse pathogens)
E. All of the above
44 Inflammatory response does not do the following:
A. Prevent spread of damaging agent
B. Stimulates & enhances immune response
C. Repair process
D. Disposal of cell debris & pathogens
E. Attack specific abnormal or non-self agents
45 Transepithelial transport of antigen is important because without it
A. antigen would only be detected by the lymphoid cells in O-MALT
B. antigen would not be detected by the lymphoid cells in the alternative
 complement pathway
C. polymeric antibody would be pumped through the epithelial cells
D. vascular addressins would target the wrong cell types
E. none of the above
46 Septic shock is a serious medical condition caused by decreased tissue
perfusion and oxygen delivery as a result of infection. It can cause
multiple organ dysfunction syndrome and death. What is causing the
fatal organ failure?
A. Bacteria in the bloodstream
B. Defective innate immune response
C. Overwhelming immune response
D. Fungi in the bloodstream
E. Defective adaptive immune response
47 This is the ability of an antigen to react specifically with the antibodies
or cells it has provoked.
A.Specificity
B.Immunogenicity
C.Reactivity
D.Valence
E.A and B
48 Which of the following inflammatory signs specifies pain?
A. tumor
B. calor
C. dolor
D. rubor
E. tremor
49 An example of an inflammatory mediator that stimulates vasodilation
is
A. anaphylotoxin
B. histamin
C. C3b
D. collagen
E. interferon
50 The swelling associated with inflammation decreases when the fluid
A. returns to the blood
B. goes into lymph capillaries
C. is excreted in urine
D. is lost as perspiration
E. is transported into macrophages
51 Neutrophil defensins are
A. anti-toxins
B. oxygen-dependent
C. enzymes
D. glycolipids
E. antimicrobial peptides
52 Lysozyme:
A. is a cytoplasmic organelle
B. splits peptidoglycan
C. binds bacterial lipopolysacharide
D. is a proteilytic enzyme
E. is released by natural killer cells
53 Protective function of saliva is based on several mechanisms, including
 the presence of enzyme that has bactericidal action and causes lysis of
complex capsular polysaccharides of staphylococci and streptococci.
Name this enzyme:
A. Alpha-amylase
B. Lysozyme
C. Oligo-1,6-glucosidase
D. Collagenase
E. Beta-glucuronidase
54 Lymphocytes and other cells of our body synthesize universal antiviral
agents as a response to viral invasion. Name these protein factors:
A. Interleukin-2
B. Interferon
C. Cytokines
D. Interleukin-4
E. Tumor necrosis factor
55 Which of the following is not an acute phase protein?
A. Fibrinogen
B. C-reactive protein
C. Chondroitin sulfate
D. Mannose binding lectin
E. Serum amyloid P component
56 Interferons:
A. Are divided into 5 main families
B. Are found only in mammalian species
C. Are specific for individual viruses
D. Induce enzyme synthesis in the target cell
E. Only affect infected cells
57 Which of the following is the end product of the complement system?
A. properdin
B. citrulline
C. MAC
D. PAMP
E. anaphylotoxin
58 The complement protein cascade is the same for the classical pathway,
alternative pathway, and lectin pathway beginning with the activation
of
A. C1
B. C2
C. C3
D. C5
E. C6
59 Which of the following statements is TRUE?
A. All three types of interferons have the same effect on the body
B. Alpha interferon promotes phagocytosis
C. Gamma interferon augments macrophage bactericidal activity
D. Alpha interferon acts against specific viruses
E. Beta interferon attacks invading viruses
60 Each of the following is an effect of complement activation EXCEPT
A. increased phagocytic activity
B. bacterial cell lysis
C. opsonization
D. interference with viral replication
 E. increased blood vessel permeability
61 The antimicrobial effects of AMPs include all of the following
EXCEPT
A destruction of cell wall
B. lysis of bacterial cells
C. destruction of nucleic acids
D. pore formation in bacterial membranes
E. inhibition of phagocytosis
62 All of the following are effects of histamine EXCEPT
A. vasodilation
B. fever
C. swelling
D. redness
E. pain
63 Which of the following statements is TRUE?
A. Complement increases after immunization
B. All of the complement proteins are constantly active in serum
C. Factors B, D, and P cause cytolysis
D. Complement activity is antigen-specific
E. There are at least thirty complement proteins
64 All of the following are part of the mechanism of action of alpha and
beta interferons EXCEPT
A. they bind to the surface of uninfected cells
B. they are effective for long periods
C. they initiate synthesis of antiviral proteins
D. they disrupt stages of viral multiplication
E. they initiate transcription
65 The alternative pathway for complement activation is initiated by
A. antigen:antibody complex
B. C5C9
C. lipid-carbohydrate complexes and C3
D. factors released from phagocytes
E. factors released from damaged tissues
66 The classical pathway for complement activation is initiated by
A. lipid-carbohydrate complexes and C3
B. C5C9
C. antigen:antibody complex
D. factors released from phagocytes
E. factors released from damaged tissues
67 C3a is
A. opsonin
B. anaphylotoxin
C. prostaglandin
D. pentraxin
E. resistin
68 Activation of C5C9 results in
A. activation of C3
B. fixation of complement
C. lysis of microbial cells
D. phagocytosis
E. inflammation
69 The lectin pathway for complement action is initiated by
 A. mannose on host membranes
B. mannose on the surface of microbes
C. lectins of the microbe
D. gram-negative cell walls
E. gram-positive cell walls
70 Which of the following statements about the classical pathway of
complement activation is FALSE?
A. C1 is the first protein activated in the classical pathway
B. The C1 protein complex is initiated by antigen:antibody complexes
C. C3 is not involved in the classical pathway
D. Cleaved fragments of some of the proteins act to increase inflammation
E. C3b causes opsonization
71 Lysozyme and the antibiotic penicillin have similar mechanisms of
action in that they both cause damage to the bacterial
A. cell membrane
B. capsule
C. cell wall
D. DNA
E. ribosomes
72 What direct effect do histamines and leukotrienes have on capillaries?
A. They prevent phagocytes from sticking to the walls of capillaries
B. They allow capillary walls to open and become leaky
C. They decrease the diameter of capillaries
D. All of the above
E. None of the above
73 Which of the complement pathways employs properdin?
A. Classical pathway
B. Alternative pathway
C. Lectin pathway
D. Alternative and lectin pathways all employ properdin
E. Classical, alternative, and lectin pathways all employ properdin
74 Antibodies from adaptive immune responses are used in
A. the lectin complement pathway
B. the alternative complement pathway
C. the classical complement pathway
D. both the classical and alternative pathways
E. both the classical and lectin pathways
75 Which of the following is responsible for cleaving C3?
A. C1
B. C4aC2b
C. C5bC6C7
D. C4bC2a
E. C9
76 Which of the following blood cells function primarily as phagocytes?
A. eosinophils
B. basophils
C. neutriphils
D. lymphocytes
E. platelets
77 A patient with pneumonia has body temperature of 39,2oC. What cells
are the main producers of endogenous pyrogen that had caused such
temperature rise?
 A. Neutrophils
B. Eosinophils
C. Monocytes
D. Endotheliocytes
E. Fibroblasts
78 Work in a mine is known to cause inhalation of large amounts of coal
dust. Inhaled coal dust can be detected in the following pulmonary
cells:
A. Capillary endothelial cells
B. Respiratory epithelial cells
C. Secretory epithelial cells
D. Alveolar macrophages
E. Pericapillary cells
79 Cellular composition of exudate largely depends on the etiological
factor of inflammation. What leukocytes are the first to be involved in
the focus of inflammation caused by pyogenic bacteria?
A. Monocytes
B. Neutrophil granulocytes
C. Myelocytes
D. Eosinophilic granulocytes
E. Basophils
80 Alveolar space of acinus was invaded by bacteria that interacted with
the surfactant. This led to the activation of the cells that are localized
in the alveolar walls and on the surface. Name these cells:
A. Alveolocytes type II
B. Alveolocytes type I
C. Endothelial cells
D. Clara cells
E. Alveolar macrophages
81 Natural killer (NK) cells do not:
A. Contain perforins
B. Contain serine proteases
C. Contain tumor necrosis factor (TNF)
D. Kill only by damaging the target cell outer membrane
E. Respond to interferon
82 A signaling molecule from microbes recognized by phagocytes is
A. pyrogen
B. apoptogen
C. PAMP
D. MALT
E. MAC
83 TLRs attach to all of the following EXCEPT
A. flagellin
B. AMPs
C. LPS
D. PAMPs
E. peptidoglycan
84 Which of the following statements about fixed macrophages is FALSE?
A. They are found in certain tissues and organs
B. They develop from neutrophils
C. They are cells of the mononuclear phagocytic system
D. They are mature monocytes
 E. They gather at sites of infection
85 Phagocytes utilize all of the following to optimize interaction with
microorganisms EXCEPT
A. trapping a bacterium against a rough surface
B. opsonization
C. chemotaxis
D. lysozyme
E. complement
86 All of the following are true regarding NK cells EXCEPT
A. they are a type of lymphocyte
B. they are found in tissues of the lymphatic system
C. they have the ability to kill infected body cells and some tumor cells
D. they destroy infected body cells by phagocytosis
E. they release toxic substances that cause cell lysis or apoptosis
87 Which of the following cells are innate immunity cells which
participate in immune responses against parasitic helminths?
A. dendritic cells
B. eosinophils
C. lymphocytes
D. monocytes
E. neutrophils
88 What is the role of opsonins?
A. They attract phagocytes to the location of infection
B. They create "handles" that make it easier for the pseudopods of
phagocytes to attach to the microbe invader
C. They are present on the surface of phagocytes
D. They aid in the formation of the phagolysosome
E. All of the above
89 What is a phagolysosome?
A. A vesicle containing only an engulfed invading microorganism
B. A vesicle containing only digestive enzymes and other antimicrobial
compounds
C. The structure that results from the fusion of a phagosome and a
lysosome
D. A protein that covers the surface of an invading microbe, making it
easier for the phagocyte to ingest
E. Immature phagocyte
90 In macrophages and dendritic cells (so-called antigen-presenting cells)
some small parts of the phagocytosed particle are presented to other
cells of the immune system. If you were to draw an arrow leading to
"antigen presentation" as described above, from which word would it
extend?
A. exocytosis
B. digestion
C. ingestion
D. adherence
E. migration
91 Pus is comprised of
A. unused histamines and leukotrienes
B. excess fluid from leaky blood vessels
C. collected cells from damaged tissue
D. dead phagocytes
 E. none of the above
92 Neutrophils with defective lysosomes are unable to:
A. engulf microorganisms and other foreign material
B. undergo chemotaxis (migrate)
C. attach to microorganisms and other foreign material
D. produce toxic oxygen products
E. undergo NETosis
93 Which of the following statements concerning phagocytosis is TRUE?
A. Phagocytes cannot ingest microorganisms unless they are coated with
antibodies
B. Engulfment always requires opsonization
C. Phagocytes ingest microorganisms by using protein transporters that are
specific for the bacteria
D. Bacteria are digested when the phagosome fuses with a lysosome
E. Phagocytes are only lymphoid cells
94 Natural killer cells
A. mature in thymus gland
B. recognize and destroy tumors in a specific manner
C. require prior exposure to tumor cells to be effective against the tumor
cells
D. do not need to be activated by macrophages that present foreign tumor
antigens
E. derive from myeloid progenitors
95 Monocytes and macrophages are both which type of leukocytes?
A. polymorphonuclear phagocytes
B. mononuclear phagocyte system
C. organ-specific phagocytes
D. fixed phagocytes
E. circulating phagocytes
96 Which of the following types of white blood cells contain preformed
granules of vasoactive amines?
A. monocytes
B. neutrophils
C. macrophages
D. mastocytes
E. B-lymphocytes
97 Primary cells of innate immunity do not include:
A. Epithelial barrier cells
B. Phagocytic cells (neutrophils, macrophages)
C. Natural killer cells
D. Myocytes
E. A and D
98 ________ undergo chemotaxis. They are the predominant phagocytic
cell, which removes debris via phagocytosis
A. Eosinophils
B. Neutrophils
C. Natural killer cells
D. Platelets
E. Monocyte/macrophage
99 Dendritic cells are characterized by
A. The presence of TCR
B. Expression of CD3
 C. Expression of IgM molecules
D. Their ability to release histamine
E. Their interface between the innate and adaptive immune systems
100 An essential part of the innate immune system is phagocytosis followed
by destruction of the phagocytosed particle/microbe followed by
antigen- presentation. What cells are considered professional
phagocytes?
A. Granulocytes, monocytes, macrophages, dendritic cells, B cells
B. Granulocytes, monocytes, macrophages, dendritic cells
C. Granulocytes, monocytes, macrophages, B cells
D. Antigen presenting cells
E. All innate immunity cells
101 Which of the following is NOT TRUE concerning the secondary
immune response?
A. Low IgM titre
B. High IgG
C. Low affinity Ab
D. Lag-phase lasts 5-7 hours
E. High Ab affinity
102 Clonal selection occurs when antigen is encountered by:
A. Basophils
B. Eosinophils
C. Mast cells
D. Neutrophils
E. B-cells
103 The major function of plasma cells is to secrete large amounts of
antibody. Which of the following statements regarding plasma cells is
correct?
A. Are derived from T-cells
B. Develop into B-cells
C. Have a highly developed rough endoplasmic reticulum
D. Have a thin layer of cytoplasm
E. Secrete large amounts of gamma interferon
104 After the contact with foreign antigens, body produces specific
antibody. These specific antibodies are readily detectable in serum
following primary contact with antigen after:
A. 10-15 min
B. 1-2 h
C. 5–7 days
D. 3–5 weeks
E. Only following a second contact with antigen
105 Which immunoglobulin is found secreted in the secondary response?
A. IgM
B. IgG and IgM
C. IgE
D. IgG
E. IgD
106 This isotype of antibodies is mainly found in sweat, tears, breast milk
and GI secretions.
A.IgG
B.IgA
C.IgM
 D.IgD
E.IgE
107 IgG binding to neutrophils cells is mediated by
A. Fc-dependent cellular homing mechanisms
B. sensitization of Mast cells and basophils
C. Fc receptors specific for IgG
D. ICAM’s
E. None of the above
108 IgD participates in antigen recognition by
A. immature T cells
B. NK-cells
C. macrophages
D. B-cells
E. A and D
109 Antibody affinity is determined by the amino acid sequence in
A. the constant regions of the immunoglobulin molecule
B. the variable regions of the immunoglobulin molecule
C. the Fc of the immunoglobulin molecule
D. the J-chain
E. A, C and D
110 Avidity is important because
A. Fc receptor binding depends on it
B. it amplifies the binding strength of low affinity Fab’s
C. G-protein-mediated signal transduction will not occur without it
D. it result in the activation of high affinity antibody-producing clones
E. none of the above
111 The lag phase of the secondary response is shorter than the primary
response because
A. the assays for detecting a primary response are not as sensitive
B. the primary response requires considerable cell proliferation and
differentiation to
achieve a critical mass of cells to produce immunity
C. of the lack of cytokines produced during the primary response
D. A and B
E. all of the above
112 The lag phase of the booster response is
A. very short due to the lack of antigen presenting cells
B. very short, due to memory cells
C. very short when dendritic cells are absent
D. very short, due to the presence of accessory cells
E. prolonged
113 Which of the following gene clusters do NOT contribute to antigen
binding
A. VL
B. VH
C. DH
D. CH
E. JH
114 B cell DO NOT express
A. CD19
B. MHC II
C. MHC I
 D. CD8
E. CD20
115 A given Ig isotype is
A. A light chain constant region encoded by allelic genes
B. A heavy chain variant encoded by allelic genes
C. Present in all normal individuals
D. A collection of hypervariable region epitopes recognized by an anti-
idiotype
E. Monoclonal
116 IgG
A. Appears early in the immune response
B. Kills bacteria directly
C. Is important in mucosal immunity
D. Usually exists as a pentamer
E. Opsonizes bacteria
117 IgA in seromucus secretions
A. Has no J-chain
B. Has no secretory piece
C. Is dimeric
D. Cannot bind to virus
E. Activates the classical complement pathway
118 The cytokine which is most involved in the class switch to IgE
production is
A. IL-2
B. IL-4
C. IL-8
D. IL-10
E. none of the above
119 The molecules mediating signal transduction following antigen binding
to cell surface immunoglobulin on a B-cell are called:
A. Ig Fc
B. Ig-alpha and Ig-beta
C. MHC
D. CD4
E. CD3
120 Carbohydrate is always present on normal immunoglobulin:
A. H-chains
B. L-chains
C. Fab-fragments
D. H and L chains
E. none of the above
121 Which of the following cells may eventually differentiate into an
immunoglobulin-bearing memory cell?
A. naïve B-cell
B. naïve T-cell
C. hematopoietic stem cell
D. A and B
E. activated B-cell
122 All of the following are true with respect to IgM antibodies EXCEPT
which one
A. they fix complement
B. they occur on the surface of lymphocytes
C. they predominate in the primary response to antigen
 D. they are glycoproteins
E. they mediate allergic reaction
123 All of the following are true with respect to IgE molecules, EXCEPT
which one?
A. They are the principal immunoglobulin class involved in allergic
reactions
B. They are involved in mediating anti-parasitic immune responses
C. They will cross the placenta and fix complement
D. They can effect the release of histamine and other chemical mediators
E. They are the least abundant immunoglobulin in the serum
124 All of the following are true about antibodies, EXCEPT which one?
A. They fix complement
B. They occur on the surface of B-lymphocyte
C. They predominate the primary immune response to antigen
D. They are glycoproteins
E. They are molecule with a single, defined amino acid sequence
125 The immunoglobulin Joining chain (J-chain) is
A. only produced by T-Cells
B. only produced by neutrophils
C. associated with only multimeric forms of IgM and IgA
D. associated with IgE for histamine release
E. only produced by mast cells
126 Each of the following is the property of T cell epitopes EXCEPT:
A. protein
B. MHC 1: 9 amino acids long
C. MHCII: 12 amino acids long
D. part of native unprocessed antigen
E. MHCII: 15 amino acids long
127 What is the role of helper T cells in the adaptive immune response?
A. Helper T cells directly kill infected host cells
B. Helper T cells activate B cells and cytotoxic T lymphocytes to kill
infected host cells
C. Helper T cells produce and secrete antibodies
D. Helper T cells phagocytize bacteria and viruses
E. None of the above
128 Which of the following is NOT a step used by cytotoxic T cells to kill
infected host cells?
A. Recognition of infected host cell using its TCR
B. Secretion of perforin
C. Secretion of granzyme
D. Recognition of infected host cell using its CD4 glycoprotein
E. All statements are correct
129 Which pair of molecules do NOT directly interact with one another?
A. CD4 and MHC-II
B. BCR and TCR
C. CD8 and MHC-I
D. BCR and epitope
E. PAMP and PRR
130 A person who has AIDS contracts rare and often life-threatening
infections because their helper T cell count is so low. Which of the
 following components of the immune response still respond to antigen
despite the low helper T cell count?
A. Clonal expansion and antibody production
B. Clonal selection of B cells
C. Activation of cytotoxic T cells
D. Apoptosis of infected host cells
E. All of the above
131 ___ express CD3 and CD4 molecules
A. All T cells
B. Th1 and Th2 cells
C. NK and B cells
D. TH1 and Tc cells
E. Ts and Tc cells
132 Elevated levels of interleukin-1β would result in which of the following
responses?
A. increased activity of cytotoxic (killer) T cells
B. increased production of antibodies by plasma cells
C. increased activity of helper T cells
D. increased body temperature
E. increased activity of NK cells
133 Class-2 MHC molecules are produced by all of the following cells
EXCEPT
A. peritoneal macrophages
B. dendritic cells
C. helper T cells
D. B-lymphocytes
E. alveolar macrophages
134 These cells display CD4 in their membrane and are associated with
MHC class II molecules.
A.Cytotoxic T cells
B.Helper T Cells
C.Supressor T Cells
D.Cortical thymocytes
E.B cells
135 T Cells secrete this substance that is used to fragment DNA.
A.Perforin
B.Tumor antigen
C.Interferons
D.granzyme
E.Toxin T
136 This is a self-responsive cell that is inactive.
A.Immunocompetent cell
B.Hybridoma cell
C.Naive T-cell
D.Anergy cell
E.Natural killer cell
137 Follicular dendritic cells
A. are presents in the skin
B. engulf extracellular pathogens
C. participate in antigen-presentation to T-cells
D. participate in affinity maturation
E. All of the above
138 Protection against microorganisms inside cells is provided by
A. macrophages
B. antibodies
C. complement
D. T-cells
E. all of the above
139 T cell antigen receptor
A. Recognizes conformational epitopes on the native antigen
B. Has Ig light chains
C. Is made up of a heavy chain and beta-2 microglobulin
D. Are associated with Igαand Igβto form a complex
E. Recognize epitopes on linear peptides associated with MHC molecules
140 The class I MHC processing pathway primarily
A. Processes antigen from the extracellular environment
B. Processes antigens that are present in the cytosol
C. Generates peptides, complexes them with class I MHC molecules for
presentation to helper T cells
D. Generates peptides, complexes them with class I MHC molecules for
presentation to NK cells
E. Is involved in the process of the antibody response
141 ___ express CD3 and CD8 molecules
A. All T cells
B. Th1 and Th2 cells
C. NK and B cells
D. TH1 and Tc cells
E. Ts and Tc cells
142 Cell with specific killing effects is
A. LAK
B. CTL
C. NK
D. A and C
E. all of the above
143 During the cell interactions involved in generating a cytotoxic T-cell
response, the Thelper cell receives the necessary “Signal 2” from an
antigen-presenting cell through which of the following interactions?
A. TCR with MHC Class I
B. IgD with antigen
C. A and B
D. B7 with CD28
E. IL-2 with IL-2R
144 The CD3 complex of the T-cell receptor
A. binds complement
B. functions to transduce a signal to the cell's interior following binding of
complexed antigen
C. causes the histamine
D. mediates Immunoglobulin class switching
E. results in the glycosylation of jmmunoglobuiins
145 Cytokines are produced by cells of the immune system in response to
various physiological stimuli
A. modulate cell function through subsequent cell differentiation or cell
proliferation
B. facilitate cell lysis
 C. cause glycosylation of Immunoglobins
D. facilitate Ab generation
E. all of the above
146 Which of the following is NOT true of CD4 and CD8 cell markers?
A. These are both surface glycoproteins expressed on T-cells
B. These serve to distinguish different types of T-cells, e.g., helper,
suppressor and cytotoxic, from each other
C. These are not found associated with immunoglobulins
D. The CD4 proteins serve both to mediate T-cell helper function as well as
the receptor for the AIDS virus.
E. Both of the markers are present on ALL T-cells
147 Which of the following is NOT true of the ability of the T-cell receptor
(TCR) to specifically recognize antigen?
A. The antigen must be "processed" first by an accessory cell of immune
system in order for it to bind to the TCR
B. The recognition of the antigen by the TCR can mediate helper,
suppressor or cytotoxic function
C. The recognition of antigen by the TCR can result in cytokine secretion
and/or an increase in cell proliferation within the immune system
D. The antigen is recognized by the T3-TCR complex only when it is
associated with a protein of the major histocompatibility complex
E. Only the alpha chain of the TCR is necessary for antigen
148 The major histocompatibility complex proteins function to
A. degrade CD4 and CD8 polypeptides
B. bind antibody for lymphokine production
C. bind complement for cell lysis
D. bind antigen fragments for presentation to T-cells
E. none of the above
149 The domain unit of an immunoglobulin or T-cell antigen receptor
A. only include the variable regions
B. only recognizes the paratope
C. only fixes complement
D. is typically about 110 amino acids long
E. A and D
150 The T-cell receptor
A. Is composed of four polypeptide chains
B. is secreted into the plasma by the T-cell
C. Is the recognition element of the humoral arm of the immune system
D. recognizes antigen fragments via the alpha and beta chains
E. None of the above
151 A 13-year-old boy presents with eczematous rashes on his shins and
torso. Anamnesis states cases of otitis, pneumonia, and furuncles in the
patient. Blood test: platelets - 70 · 109/l, low activity of T helper and T
suppressor cells, low IgM, with normal IgA and IgG. What
immunodeficient disease does this boy have?
A. DiGeorge syndrome
B. Louis-Bar syndrome (Ataxiatelangiectasia)
C. Severe combined immunodeficiency (Swiss type)
D. Wiskott-Aldrich syndrome
E. Chediak-Higashi syndrome
152 Parents of a 5-year-old child report him to have frequent colds that
 develop into pneumonias, presence of purulent rashes on the skin.
Laboratory tests have revealed the following: absence of
immunoglobulins of any type; naked cells are absent from the lymph
nodes punctate. What kind of immune disorder is it?
A. Autosomal recessive agammaglobulinaemia (Swiss type)
B. X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
C. Hypoplastic anemia
D. Agranulocytosis
E. Louis-Barr syndrome
153 Several inherited deficiencies in the complement system occur in
humans. Which of the following would be the MOST severe?
A. deficiency of C8
B. deficiency of C7
C. deficiency of C6
D. deficiency of C5
E. deficiency of C3
154 This is characterized by the inability of the immune system to protect
the body from a pathogen.
A. Graft versus host disease
B. Allergy
C. Autoimmune disease
D. Immunodeficiency diseases
E. Acute graft rejection
155 A deficiency of complement component C6 will affect the:
A. classical pathway
B. MBL-pathway
C. alternative pathway
D. only A and B
E. all complement pathways
156 Human RAG-1 Deficiency is caused by an autosomal recessive
mutation which destroys the Recombinase Activating Genes. This
results in a lack of ability to produce:
A. immunoglobulin
B. cytokines
C. T-cell receptor
D. A and C
E. none of the above
157 Individuals unable to make the J protein found in certain
immunoglobulins would be expected to have frequent infections of the
A. brain
B. blood
C. liver
D. pancreas
E. intestinal tract
158 HIV causes AIDS by attacking and destroying
A. CD20+ cells
B. CD16+ cells
C. CD1d+ cells
D. CD4+ cells
E. A and D
159 People who have a primary immunodeficiency disease are most
 at risk for which of the following?
A. heart diseases
B. cancer
C. diabetes
D. infections
E. C and D
160 Which of the following diseases does NOT associated with phagocytosis
and opsonization defect?
A. Chronic granulomatous disease
B. Chedial-Higashi syndrome
C. Leukocyte adhesion deficiency
D. SCID
E. A and C
161 Which of the following diseases does NOT associated with B-cell
defect?
A. Selective IgA deficiency
B. DiGeorge’s syndrome
C. X-linked Bruton’s agammaglobulinemia
D. Х-linked hyper-IgM-syndrom
E. A and B
162 Defects in neutrophil NADPH oxidase system produce:
A. Streptococcal infection
B. Chediak-Higashi disease
C. Hashimoto's disease
D. Chronic granulomatous disease
E. Leukocyte adhesion deficiency
163 Paroxysmal nocturnal hemoglobulinuria results from deficiency in:
A. Myeloperoxidase
B. Decay accelerating factor (DAF)
C. Classical pathway C components
D. C1 inhibitor
E. C8
164 X-linked agammaglobulinemia results from a mutation in:
A. IFNγ receptor
B. The CIITA promoter protein
C. An HLA gene
D. CD40L (CD154)
E. Bruton's tyrosine kinase gene
165 Di George syndrome results from a defect in:
A. Purine nucleoside phosphorylase
B. WASP
C. Thymus development
D. DNA repair
E. CD3
166 Poor skin tests to a range of microbial antigens such as tuberculin and
mumps indicate a deficiency of:
A. NK cells
B. T-cells
C. B-cells
D. phagocytes
E. opsonization
167 HIV binds to:
 A. TNF-receptor
B. IL-2 receptor
C. NF kappa B
D. Reverse transcriptase
E. CD4
168 Primary immunodeficiency producing susceptibility to infection by
viruses and molds is due to:
A. B-cell deficiency
B. T-cell deficiency
C. Phagocyte deficiency
D. complement deficiency
E. eosinophil deficiency
169 Deletions in the T-cell CD154 (CD40L) gene produce:
A. Congenital X-linked agammaglobulinemia
B. IgA deficiency
C. Wiskott–Aldrich Syndrome
D. Deficiency in cytotoxic T-cell activity
E. The hyper–IgM syndrome
170 Which of the following does NOT associated with the development of
secondary immunodeficiency?
A. Viral infection
B. Lymphoproliferative disorders
C. Cytotoxic drugs
D. Mutation in RAG-genes
E. Low iron diet
171 What of the following is NOT TRUE about primary
immunodeficiencies?
A. it is a group of disorders characterized by an impaired ability to produce
normal immune response
B. they are caused by the mutations in genes involved in the development
and functions of the organs, cells and humoral factors (soluble molecules)
of immune system
C. Usually diseases of infancy and childhood
D. Malnutrition is the most common cause of the primary
immunodeficiencies
E. A and B
172 What of the following is NOT TRUE about secondary
immunodeficiency?
A. can be a consequence of prolonged use of cytotoxic agents
B. can be associated with physiologic immunosuppression in elderly
persons
C. usually diseases of infancy and childhood
D. can be caused by the malnutrition
E. B and C
173 Which primary immunodeficiency is the most common in the world?
A. T-cell defects
B. B-cell defects
C. complement defects
D. phagocytosis system defects
E. C and D
174 Examples of primary immunodeficiency disorders do not include
A. SCID
 B. CVID
C. AID
D. “boy in a bubble” disease
E. A and C
175 Which of the following diseases does NOT associated with T-cell
defect?
A. DiGeorge’s syndrome
B. Ataxia-teleangiectasia
C. Chronic mucocutaneous candidiasis
D. Х-linked hyper-IgM-syndrom
E. A and B
176 A 38-year-old man, who has been suffering from systemic lupus
erythematosus for 3 years, developed diffuse renal lesions accompanied
by massive edemas, marked proteinuria, hyperlipidemia, and
dysproteinemia. What is the most likely mechanism of proteinuria
develoment in this case?
A. Increased blood proteins
B. Inflammatory damage to the nephrons
C. Ischemic damage to the tubules
D. Autoimmune damage to the nephrons
E. Morbid affection of the urinary tracts
177 In Graves' autoimmune disease of the thyroid,
A. normally "hidden" antigens of the thyroid escape surveillance to
stimulate the autoimmune response
B. self-antigens of the thyroid cells became the target of the autoimmune
response
C. thyroid cells produce class-2 MHC molecules that stimulate
autoantibodies that bind to the TSH receptor
D. thyroid soluble self-antigens stimulate autoimmune response
E. all of the above
178 Which statement about systemic lupus erythematosus (SLE) is false?
A. SLE results from the abnormal combination of self-antigens and
autoantibodies
B. SLE victims produce antibodies against their own DNA and nuclear
protein
C. SLE is an autoimmune disease that results in the formation of immune
complexes throughout the body
D. SLE is characterized by unexpected immediate hypersensitivity
reactions
E. SLE is an systemic autoimmune disease
179 An isograft is a tissue graft donated by
A. parent
B. the same person
C. an identical twin
D. an unrelated person
E. an organism of different specie
180 This type of graft is taken from a different animal species and is never
successful:
A. autograft
B. isograft
C. xenograft
D. allograft
 E. A and D
181 Which of the following is NOT an autoimmune disease:
A. type I diabetes
B. multiple sclerosis
C. rheumatoid arthritis
D. AIDS
E. SLE
182 In Graves' disease, an antibody causing hypersensitivity may be
present and is directed against:
A. Thyroglobulin
B. Thyroglobulin
C. Thyroid stimulating hormone (TSH) receptor
D. Acetylcholine receptor
E. Thyroxine
183 A graft between members of the same species is termed an
A. isograft
B. allograft
C. autograft
D. xenograft
E. none of the above
184 Graft vs host disease often accompanies transplantation of:
A. cartilage
B. kidney
C. bone marrow
D. heart
E. pancreas
185 The very rapid response to a second allogeneic graft is:
A. Transferred by IgA
B. Dependent on minor histocompatibility antigens
C. Transferred by macrophages to a naive recipient
D. Transferred by platelets
E. Specific for antigens of the major histocompatibility complex (MHC)
186 Hyperacute graft rejection is caused by:
A. Circulating immune complexes
B. CD4 positive lymphocytes
C. CD8 positive lymphocytes
D. Platelets
E. Preformed antibodies
187 Which of the following allogeneic grafts does NOT require
immunosuppression?
A. kidney
B. heart
C. liver
D. bone marrow
E. cartilage
188 Which of the following is a non-organ-specific (systemic) autoimmune
disease?
A. Myasthenia gravis
B. Systemic lupus erythematosus (SLE)
C. Hashimoto's thyroiditis
D. Pernicious anemia
E. Insulin-dependent diabetes mellitus
189 Which of the following antibodies are of most use for the diagnosis of
pernicious anemia?
A. Anti-thyroid peroxidase
B. Anti-parietal cell
C. Anti-nuclear
D. Anti-IgG Fc
E. Anti-TSH receptor
190 The antiphospholipid syndrome is associated with:
A. Infertility
B. Severe anemia
C. Wegener's granulomatosis
D. Raised platelet levels
E. Recurrent fetal loss
191 Neonatal myasthenia gravis is thought to be caused by:
A. An inherited genetic defect
B. Transplacental transfer of maternal IgG against the TSH receptor
C. Anti-idiotype to maternal IgG
D. Transplacental transfer of maternal IgG against the acetylcholine
receptor
E. Maternal T-cells transferred across the placenta
192 In celiac disease there is T-cell sensitivity to:
A. Vitamin B12
B. Gluten
C. β-adrenergic receptors
D. Gastric H+-K+ dependent ATPase
E. Myelin basic protein
193 In type 1 diabetes (insulin-dependent diabetes mellitus), the target of
the autoimmune attack is:
A. All of the cells in the islets of Langerhans
B. The β-cells in the islets of Langerhans
C. The somatostatin-producing cells in the islets of Langerhans
D. The glucagon-producing cells in the islets of Langerhans
E. Cells throughout the body which have an insulin receptor
194 In direct allorecognition,
A. donor alloantigen is internalized, processed, and presented as peptides in
the context of recipient MHC class II by recipient APCs to recipient CD4 T
cells
B. recipient CD4 T cells recognize intact MHC class II alloantigen. This is
present on donor APCs migrating from the graft and on MHC class II–
expressing donor parenchymal cells
C. recipient B-cells recognize CD1c present on donor APCs
D. All of the above
E. None of the above
195 Genes encoding cell surface glycoproteins that are required for antigen
presentation to T-cells and also responsible for rapid graft rejection is
called as
A. B-cell complex
B. T-cell complex
C. receptor complex
D. MHC complex
E. none of the above
196 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
E. All of the above
197 Chronic graft rejection is mediated by
A. Type I and type II hypersensitvity reaction
B. Type II hypersensitvity reaction
C. Type II and type III hypersensitvity reaction
D. Type III and type IV hypersensitvity reaction
E. Type I and III hypersensitvity reactions
198 Acute graft rejection is mediated by
A. Type I hypersensitvity reaction
B. Type II hypersensitvity reaction
C. Type III hypersensitvity reaction
D. Type IV hypersensitvity reaction
E. Type I and III hypersensitvity reactions
199 Reiter's syndrome (arthritis) is an example of
A. Autoimmune complications of immunodeficiencies
B. Paraneoplastic syndromes
C. Neonatal autoimmune pathology
D. Drug-induced autoimmune disorders
E. Autoimmune complications of infectious diseases (cross-reactivity)
200 Immunopathogenic mechanism of autoimune hemolytic anemia is
A. Type I hypersensitvity reaction
B. Type II hypersensitvity reaction
C. Type III hypersensitvity reaction
D. Type IV hypersensitvity reaction
E. A and C
201 A 3-year-old child has eaten some strawberries. Soon he developed a
rash and itching. What was found in the child’s leukogram?
A. Monocytosis
B. Hypolymphemia
C. Neutrophilic leukocytosis
D. Eosinophilia
E. Lymphocytosis
202 After sensitization a test animal received subcutaneously a dose of
antigen. At the site of injection a fibrinous inflammation developed
with alteration of vessel walls, basal substance, and fibrous structures
of connective tissue. The inflammation took form of mucoid and
fibrinoid degeneration, fibrinoid necrosis. What immune response
occurred in the test animal?
A. Delayed hypersensitivity
B. Immediate hypersensitivity
C. Transplantation immune reaction
D. Normergic reaction
E. Granulomatosis
203 A 12-year-old child developed nephritic syndrome (proteinuria,
hematuria, cylindruria) 2 weeks after a case of tonsillitis, which is a
 sign of affected glomerular basement membrane in the kidneys. What
immune mechanism is the most likely to cause the basement membrane
damage?
A. Reaginic
B. Granulomatous
C. Antibody-mediated
D. Immune complex
E. Cytotoxic
204 A 22-year-old woman ate some seafood. 5 hours later her torso and
distal parts of her limbs developed small itchy papules which were
partially fused together. One day later the rash disappeared
spontaneously. Specify the hypersensitivity mechanism underlying
these changes:
A. Systemic anaphylaxis
B. Atopy (local anaphylaxis)
C. Cellular cytotoxicity
D. Immune complex hypersensitivity
E. Antibody-dependent cell-mediated cytolysis
205 On examination of a patient with disease onset 5 days ago the doctor
suspected tularemia and prescribed the patient tularin
intracutaneously. What is the purpose of this drug administration in
the patient?
A. Treatment
B. Prevention
C. Allergy diagnostics
D. Treatment evaluation
E. Prognosis for the disease
206 What condition may develop 15-30 minutes after re-administration of
an antigen as a result of the increased level of antibodies, mainly IgE,
that are adsorbed on the surface of target cells, namely tissue basophils
(mast cells) and blood basophils?
A. Serum sickness
B. Antibody-dependent cytotoxicity
C. Delayed-type hypersensitivity
D. Immune complex hyper responsiveness
E. Anaphylaxis
207 30 minutes after drinking mango juice a child suddenly developed a
local swelling in the area of the soft palate, which impeded swallowing
and, eventually, respiration. Mucosa of the swollen area was hyperemic
and painless. Blood test revealed moderate eosinophilia. Body
temperature was normal. Anamnesis states that the elder sister of the
child has been suffering from bronchial asthma attacks. What kind of
edema has developed in the child?
A. Cardiac
B. Inflammatory
C. Allergic
D. Alimentary
E. Hepatic
208 Several minutes after a dentist administered novocaine for local
anaesthesia of a patient’s tooth, the following symptoms sharply
developed in the patient: fatigue, skin itching. What kind of allergic
reaction is this pathology?
 A. Stimulating
B. Cytotoxic
C. Anaphylactic
D. Cell-mediated immune reaction
E. Immune complex
209 A 10-year-old child had cut his leg with a glass shard, when playing,
and was delivered to the outpatient department to receive anti-tetanus
serum. To prevent development of anaphylactic shock the serum was
introduced by Bezredka method. This method of organism
hyposensitization is based on the following mechanism:
A. Stimulation of antigen-specific IgG2
B. Blocking of mast cell mediators synthesis
C. Stimulation of immune tolerance to antigen
D. Binding of mast cell-fixed IgE
E. Stabilization of mast cell membranes

210 During blood transfusion a patient has developed intravascular

erythrocyte hemolysis. What kind of hypersensitivity does the patient
have?
A. I type (anaphylactic)
B. II type (antibody-dependent)
C. III type (immune complex)
D. IV type (cellular cytotoxicity)
E. IV type (granulomatous)

211 Which of the following conditions belongs to that form of allergy

known as delayed hypersensitivity?
A. allergic rhinitis (runny or stuffy nose)
B. conjunctivitis (red eyes)
C. allergic asthma (difficulty breathing)
D. contact dermatitis (poison ivy)
E. food allergy (eggs, milk etc.)
212 Sensitization to foods is minimized by secretory IgA antibodies by
A. the inflammatory response that occurs in the presence of food, these
antibodies and complement
B. destroying the antigen presenting cells that would normally present the
food antigens to T cells in the gut
C. blocking the penetration of intact food products into the gut
D. All of the above
E. None of the above

213 Contact dermatitis generally occurs against substances that are too
small to induce an immune response. How do these substances induce
an immune response?
A. These substances form depots and are then slowly released into the
blood
B. These low molecular weight substances react with liver enzymes and are
difficult to eliminate
C. These substances bind to tissues and cells, resulting in a larger total
antigenic size which can then stimulate an immune response
D. The substances trigger the complement cascade and cause neutrophils to
accumulate and to serve as antigen presenting cells
 E. A and B

214 Your patient tests positive for the tuberculin antigen. You send him for
a chest x-ray because
A. he may have other lung infections
B. the tuberculin test is only presumptive, indicating that he has been
exposed to a tuberculosis antigen
C. you are looking for fluid in his lungs due to inflammation caused by the
bacillus
D. A and C
E. all of the above

215 Rhesus hemolytic disease of the newborn involves

A. IgE
B. Cytokine release from T-cells
C. A and B
D. Soluble immune complexes
E. Antibody to cell surfaces
216 Immediate hypersensitivity reactions
A. are experienced if the antigen is an allergen
B. result from histamine and other chemical mediator release
C. mediated through antigen specific IgE and mast cells
D. are a consequence of antigen-antibody reactions
E. All of the above

217 Allergic contact dermatitis following skin contact with poison ivy
would normally lead to:
A. acute hypersensitivity
B. anaphylactic shock
C. immediate hypersensitivity
D. IgG-dependent hypersensitivity
E. systemic autoimmune disorder

218 Type I hypersensitivity can be blocked using:

A. an IgA myeloma
B. a myeloma protein of mixed antibody class
C. antiserum
D. sodium cromoglycate
E. histamine
219 Which type of hypersensitivity cannot be transferred with serum
antibody?
A. Type I
B. Type II
C. Type III
D. Type IV
E. A and B
220 Anaphylaxis can be triggered by cross-linking of IgE receptors on:
A. monocytes
B. mast cells
C. B-cells
D. neutrophils
E. eosinophils
221 Rhesus hemolytic disease of the newborn involves:
A. IgE
B. antibodies to cell surface
C. soluble immune complexes
D. Cytokine release from T-cells
E. Stimulatory antibodies
222 The Arthus reaction is characterized by an intense infiltration by
A. mast cells
B. eosinophils
C. neutrophils
D. macrophages
E. Langerhans cells
223 Type IV hypersentivity is often referred to as:
A. immediate
B. delayed
C. anaphylactic
D. anergic
E. allotypic
224 The injection of tuberculin into the skin of a sensitized individual
elicits:
A. Immune complex glomerulonephritis
B. Jarisch-Herxheimer reaction
C. Isohemagglutinins
D. Jones-Mote sensitivity
E. Mantoux reaction
225 The major effector molecules involved in type IV hypersensitivity
reactions are:
A. antibodies
B. complement
C. cytokines
D. prostaglandins
E. 5-hydroxytryptamine (5-HT)

226 In a village a case of anthrax has been registered. Medical services

began epidemiologically indicated specific prophylaxis of population
against anthrax. What preparation was used for this purpose?
A. Anatoxin
B. Inactivated vaccine
C. Chemical vaccine
D. Genetically engineered vaccine
E. Live vaccine

227 Which of the following is not a characteristic of passive immunity?

A. Duration of resistance is days to weeks
B. It can be initiated by injection of antibodies
C. Source of antibodies is the person inoculated
D. Time to develop resistance is immediately after an injection
E. All statements are characteristic of passive immunity

228 Which of these is not associated with adjuvants?

A. forms an antigen depot
B. provides non-specific T cell stimulation
 C. activates antigen-presenting cells
D. activates the complement cascade
E. none of the above
229 Factors may influence the induction of an artificial immunity include
A. The nature of an antigen
B. The route of administration
C. The dose of antigen
D. Maturity of the immune system
E. All of the above
230 During the intracellular phase viruses are detected by cytosolic
immune proteins as well as by cytotoxic T cells recognizing viral
peptides presented on MHC class I. Why are live viruses better than
killed viruses as vaccines?
A. Killed viruses are degraded in lysosomes and are therefore inefficiently
presented by the MHC class I pathway
B. Killed viruses are recognized and destroyed faster since they can’t evade
immunity
C. Killed viruses do not activate complement
D. Only replicating viruses contain ligands that activate the Toll-like
receptors in antigen presenting cells
E. Live viruses infect non-immune cells, whereas killed viruses only enter
phagocytes

231 After the initial immune response subsides, B cells that patrol body
tissues for long periods of time
A. are called helper T cells
B. are called memory cells
C. develop into phagocytes
D. can’t react to the original antigen
E. A and B
232 Vaccines are
A. given to establish B-cell and T-cell memory
B. can consist of dead or weakened pathogens
C. effective in preventing a dangerous infection caused by a pathogen
D. all of the above
E. A and C
233 The specific type of acquired immunity that a fetus obtains from
maternal antibodies that cross the placenta is called
A. artificially acquired passive immunity
B. artificially acquired active immunity
C. naturally acquired passive immunity
D. naturally acquired active immunity
E. naturally acquired innate immunity

234 Which of the following descriptions is a characteristic part of the

secondary response?
A. It represents the response to an initial exposure of that pathogen
B. The latent period between the secondary exposure and the appearance of
antibodies is about 5-10 days
C. Antibody concentrations during this response reach a plateau in a few
days and decline after a few weeks
D. The production of antibody can reach a maximum in less than two hours
 and is maintained for a long time
E. All of the above
235 Vaccines are NOT for:
A. measles
B. tetanus
C. snake bites
D. diphtheria
E. pertussis
236 The process of weakening a pathogen is called
A. vaccination
B. attenuation
C. immunization
D. virulence reduction
E. none of the above
237 The process of introduction of weakened pathogen into human body is
called
A. opsonization
B. attenuation
C. immunization
D. vaccination
E. none of the above
238 A vaccine can be
A. an antigenic protein
B. weakened pathogen
C. live attenuated pathogen
D. all of the above
E. none of the above
239 Which of the following statement is TRUE regarding vaccination?
A. it is a method of passive immunization
B. it is a method of active immunization
C. it is a method of active artificial immunization
D. it is a method of passive artificial immunization
E. none of the above
240 Active immunity may be gained by
A. natural infection
B. vaccines
C. toxoids
D. all of the above
E. A and B
241 Conjugate vaccine consists of
A. protein component of the microorganism
B. whole microorganism destroyed by heat, chemicals, radiation or
antibiotics
C. live microorganism modified to be less deadly
D. poorly immunogenic component of the microorganism paired with
highly immunogenic protein
E. pathogens that infect other animals but do not cause disease or cause
mild disease in human
242 Heterotypic vaccine consists of
A. protein component of the microorganism
B. inactivated toxic compounds
C. poorly immunogenic component of the microorganism paired with
 highly immunogenic protein
D. live microorganism modified to be less deadly
E. pathogens that infect other animals but do not cause disease or cause
mild disease in human
243 Subunit vaccine consists of
A. pathogens that infect other animals but do not cause disease or cause
mild disease in human
B. live microorganism modified to be less deadly
C. poorly immunogenic component of the microorganism paired with
highly immunogenic protein
D. protein component of the microorganism
E. inactivated toxic compounds
244 Multivalent vaccine consists of
A. pathogens that infect other animals but do not cause disease or cause
mild disease in human
B. multiple antigens, strains of microorganisms
C. poorly immunogenic component of the microorganism paired with
highly immunogenic protein
D. inactivated toxic compounds
E. protein component of the microorganism

245 Route of the administration for polio vaccine is

A. subcutaneous
B. intravenous
C. intramuscular
D. intradermal
E. oral
246 Route of the administration for DTaP (Diphtheria, Tetanus, Pertussis)
vaccine is
A. oral
B. intravenous
C. intradermal
D. intramuscular
E. subcutaneous
247 Route of the administration for BCG vaccine is
A. intravenous
B. oral
C. intradermal
D. subcutaneous
E. intramuscular
248 Which of the following route of the vaccine administration is non-
invasive?
A. intravenous
B. oral
C. intranasal
D. rectal
E. B, C, D
249 The concept of vaccination was first developed by
A. Louis Pasteur
B. Carl Landsteiner
C. Joseph Meister
D. Macfarlane Burnet
 E. Edward Jenner
250 Which statement regarding the active immunization is TRUE?
A. it is used for prophylaxis and therapy
B. it only provides humoral immunity
C. it can induce neutralizing antibodies
D. it provides immediate effect
E. none of the above
251 Adoptive-acquired immunity may be the result of:
A. immunization with a vaccine
B. transfer of bone marrow from one individual to another
C. exposure to an individual who has an infectious disease
D. a physician administering a gamma globulin shot to someone who has
had a needle stick (immunoglobulins)
E. A and D
252 Rituximab is a monoclonal anti-CD20 antibody used in the treatment
of CD20+ B-cell non-Hodkin’s lymphoma. How can this antibody
prevent tumor progression?
A. By tagging the tumor cells for destruction by activated cytotoxic T-cells
and/or NKT cells
B. By tagging suppressor T-cells for elimination by NK cells
C. By tagging the tumor cells for destruction mediated by the complement
system and/or by inducing antibody-dependent cell-mediated cytotoxicity
D. By targeting toxins to the malignant cells
E. All of the above

253 The immunosuppressive drug which probably attacks DNA by

alkylation and cross-linking is:
A. Azathioprine
B. Cyclophosphamide
C. Cyclosporine
D. Rapamycin
E. Prednisone

254 Which of the following is NOT a glucocorticoid?

A. Cortisone
B. Prednisolone
C. Dexamethasone
D. Ibuprofen
E. Hydrocortisone

255 Which of the following is NOT a non-steroidal anti-inflammatory agent

(NSAID)?
A. Aspirin
B. Naproxen
C. Dexamethasone
D. Ibuprofen
E. A and B
256 Which of the following is antihistaminic?
A. Aspirin
B. Naproxen
C. Dexamethasone
D. Ibuprofen
 E. Loratadin
257 Which of the following medications can block mast cell vasoactive
mediator that participate in type I hypersensitivity?
A. Aspirin
B. Loratadine
C. Dexamethasone
D. Ibuprofen
E. Prednisolone
258 Which of the following medications can inhibit leukotriene
production?
A. Aspirin
B. Loratadin
C. Montelukast
D. Ibuprofen
E. Prednisolone
259 Which of the following medications does NOT inhibit cyclooxygenase
II?
A. Aspirin
B. monoclonal antibodies against CD52
C. Dexamethasone
D. Ibuprofen
E. Prednisolone
260 Which of the following medications is NOT immunosupressive agent?
A. Aspirin
B. monoclonal antibodies against CD52
C. Dexamethasone
D. Ibuprofen
E. Ribomunyl
261 Which of the following medications is NOT immunostimulatory agent?
A. Bronchovaxom
B. Dexamethasone
C. Luivac
D. A and B
E. Ribomunyl
262 What is the mechanism of Intravenous Immunoglobulin (IVIG) action
in replacement therapy?
A. inhibition of T-cell signaling
B. antiproliferative effect
C. inhibition of cyclooxygenase II
D. opsonization
E. B and C
263 Which of the following is an example of allergy-specific therapy?
A. the use of glucocorticoids
B. the use of antileukotriens
C. inhibition of cyclooxygenase II
D. replacement therapy with IVIG
E. desensitization
264 Which of the following is NOT used in cancer immunotherapy?
A. cytokines
B. monoclonal antibodies
C. checkpoint inhibitors
D. replacement therapy with IVIG
 E. vaccines
265 What therapeutic agent is produced by isolating tumor cells from an
individual and processing those tumor cells into a vaccine formulation
in vitro?
A. allogenic cancer vaccine
B. autologous cancer vaccine
C. dendritic cell cancer vaccine
D. xenogenic cancer vaccine
E. none of the above
266 Which of the following cancer vaccines provides personalized
immunotherapy?
A. allogenic cancer vaccine
B. viral vector-based vaccine
C. autologous cancer vaccine
D. xenogenic cancer vaccine
E. none of the above
267 Which vaccination is marketed and recommended in the prevention of
a virus that is known to cause cervical cancer?
A. Herpes zoster vaccine (Zostavax)
B. Papillomavirus vaccine (Gardasil)
C. Pneumococcal vaccine (Prevnar 13)
D. Hepatitis B virus vaccine (Recombivax HB)
E. None of the above
268 Which of the following is incorrect?
A. monoclonal antibodies can be used to diagnose or treat diseases
B. monoclonal antibodies are polyspecific
C. monoclonal antibodies are used in cancer treatment
D. monoclonal antibodies are monospecific
E. monoclonal antibodies are used for the treatment inflammatory diseases

269 What type of antibody is made in the laboratory by combining a

human antibody with a small part of a mouse or rat monoclonal
antibody?
A. chimeric monoclonal antibody
B. humanized monoclonal antibody
C. xenogenic monoclonal antibody
D. conjugated monoclonal antibody
E. all of the above
270 Cancer vaccine that is composed of a plasmid DNA that contains the
genetic code for a tumor-specific or tumor-associated antigens is called
as
A. carrier vaccine
B. vector-based vaccine
C. peptide vaccine
D. DNA-vaccine
E. none of the above
271 What is the name of a monoclonal antibody that is produced from the
cells of a nonhuman organism, usually a mouse, in which a portion of
the antibody (two thirds) has been replaced with a human sequence of
amino acids?
A. conjugated monoclonal antibody
B. humanized monoclonal antibody
 C. xenogenic monoclonal antibody
D. chimeric monoclonal antibody
E. antiidiotypic monoclonal antibody

272 Which of the following therapeutic monoclonal antibodies prevents

tumor growth by blocking receptors for growth factor?
A. Infliximab
B. Adalizumab
C. Herceptin
D. Rituximab
E. Alemtuzumab

273 Which of the following vaccine types is commonly given with an

adjuvant?
A. an attenuated vaccine
B. a modified live vaccine
C. a chemically killed vaccine
D. an immunoglobulin
E. an agglutinating antigen

274 What is the name of compounds designed to improve the

immunogenicity of vaccines by triggering early innate responses?
A. opsonins
B. stabilizers
C. preservatives
D. antibiotics
E. adjuvants

275 Dendritic cells used in cancer vaccine are generated in vitro from
A. peripheral blood neutrophils
B. peripheral blood lymphocytes
C. tumor-associated macrophages
D. peripheral blood monocytes
E. none of the above

276 Determining a patient’s blood group with monoclonal test-reagents

revealed positive agglutination reaction to anti-A and anti-B reagents,
and negative reaction to anti-D. What blood group does this patient
have?
A. III (В) Rh (-)
B. II (А) Rh (+)
C. IV (АВ) Rh (-)
D. IV (АВ) Rh (+)
E. I (0)Rh (+)

277 Blood group of a 30-year-old man has been determined before a

surgery. The blood was Rhesus-positive. Agglutination did not occur
with standard А (II) and В (III) serums. The blood belongs to the
following group:
 A. А (II)
B. 0 (I)
C. В (III)
D. АВ (IV)
E. the result is false positive

278 Serological diagnostics of infectious diseases is based on specific

Ag:Ab interaction. Specify the serological reaction that underlies
adhesion of microorganisms when they are affected by specific
antibodies in presence of an electrolyte:
A. Neutralization reaction
B. Precipitation reaction
C. Complement-binding reaction
D. Hem adsorption reaction
E. Agglutination reaction

279 A pregnant woman was detected to have IgM to rubella virus. An

obstetrician gynaecologist recommended therapeutic abortion due to
the high risk of teratogenic affection of the fetus. Detection of IgM was
of great importance as it is this specific immunoglobulin that:
A. Are associated with anaphylactic reactions
B. Penetrate placental barrier
C. Have the largest molecular weight
D. Indicate recent infection
E. Are the main factor of antiviral protection

280 A patient has been diagnosed with upper respiratory tract infection
(URTI). Blood serum contains immunoglobulin M. What stage of
infection is it?
A. Prodromal
B. Acute
C. Incubation
D. Reconvalescence
E. Carriage

281 A 6-year-old child with suspected active tuberculosis process has

undergone diagnostic Mantoux test. What immune-biological
preparation was injected?
A. Tularin
B. BCG vaccine
C. DTP vaccine
D. Tuberculin
E. Td vaccine
282 The clumping of antigen-to-antibody particles during an immunoassay
such as the modern pregnancy test, is known as
A. Clustering
B. Agglutination
C. Chemotaxis
D. Diapedesis
E. Precipitation
283 Which statement about the preparation and properties of monoclonal
antibodies is FALSE?
A. These antibodies are raised when an antigen is injected into animals to
activate B lymphocyte production, which are then isolated from the
spleen
B. The selected B lymphocytes are hybridized (fused) with multiple
myeloma (cancer) cells so that they will survive and reproduce in large
numbers
C. Isolated lymphocyte-myeloma fusions (hybridomas) secrete large
amounts of the desired antibodies
D. Monoclonal antibodies are clinically very specific in their action,
serving as vaccines against very virulent viruses and bacteria
E. Monoclonal antibodies are homogenous by isotype, antigenic specificity
and affinity
284 In the production of monoclonal antibodies, B cells are fused with
.....cell to form a ....... cell. What are the two missing words?
A. T cells, hybridoma
B. tumour, hybridoma
C. tumour, monoclonal
D. T cells, monoclonal
E. None of the above
285 A mother has blood type A, Rh+, her newborn child is 0, Rh–. The
newborn’s blood is likely to contain substantial levels of antibodies to
A. anti-A
B. anti-B
C. anti-A and anti-B
D. anti-Rh
E. none of the above
286 In studying a case of Rh incompatibility, you would carry out an
Indirect Coombs’ Test on:
A. father’s serum
B. child’s RBCs
C. mother’s RBCs
D. mother’s serum
E. child’s serum

287 F(ab’)2 fragments prepared from an IgG antibody to sheep red blood
cells should still be able to carry out:
A. hemolysis
B. agglutination
C. both
D. neither
E. complement fixation

288 In immunology a "clone" is a large population of

A. antibody or immunoglobulin molecules belonging to the same subtype
B. cancer cells growing within a tumor
C. specific antigen molecules found on the membrane surface of
lymphocytes
D. genetically identical cells
E. cells of the same origin
289 The competitive immunoassay can be used
A. to detect very small amounts of antigen
B. to detect antibody associated with allergies (IgE)
C. both (A) and (B)
D. commonly to detect trace amounts of drugs
E. none of the above
290 Which of the following is an immunodiffusion test?
A. direct Coombs’ technique
B. Bezredka technique
C. Ouchterloney technique
D. ELISA
E. All of the above
291 ELISA techniques is widely used for quantitative estimation of
A. hormones
B. growth factors
C. tumor markers
D. different analytes which are present in very small concentration in
biological fluid
E. none of the above
292 Polyclonal antibodies are antibodies that are:
A. derived from multiple cell lines that are directed towards a specific
single epitope on an antigen
B. derived from single line of cells that are directed towards a specific
single epitope on an antigen
C. derived from single line of cells that are directed towards multiple
epitopes on an antigen
D. derived from multiple cell lines that are directed towards multiple
epitopes on an antigen
E. all of the above
293 Suppose your laboratory uses a competitive binding assay with a
labeled antigen that incorporates spectrophotometry for the
measurement of a particular antigen. As the amount of measured
antigen ________ in the patient sample, the absorbance of the test
solution will ________.
A. increases, increase
B. decreases, decrease
C. increases, decrease
D. decrease, increase
E. both C and D are correct

294 What is the sensitivity range typically seen with indicator-labeled

immunoassays?
A. mg/ml
B. mg/L
C. μ g/ml
D. mg/dl
E. ng/ml
295 In a noncompetitive immunoassay reaction format...
A. an unlabeled antigen is first mixed with excess antibody and binding
reaches equilibrium. Labeled antigen is then added
B. antigen from an unknown sample is allowed to react with a solid-phase
antibody, and a second labeled antibody is added that reacts with bound
 antigen
C. all reactants are mixed together with both the labeled and unlabeled
antigens binding to the antibody
D. bound label is inversely proportional to unlabeled antigen concentration
E. A and D
296 Substances that have a single known concentration of the analyte being
studied and that are used to set up standard curves to determine
unknown analyte concentration are referred to as
A. absorbers
B. unknowns
C. positive control
D. negative control
E. calibrators
297 In competitive labeled immunoassays, the label is typically placed on
the ________ in the reagent and is used to measure ________ in the
patient sample.
A. antibody, antibody
B. antigen, antigen
C. antibody, antigen
D. antigen, antibody
E. A and B
298 Direct Coombs test detects autoantibodies already bound (in vivo) to
the surface of red blood cells, which is seen in
A. Autoimmune hemolytic anemia (IgG causes premature destruction of
RBCs)
B. HDN/erythroblastosis fetalis (newborn's RBCs have maternal anti-D)
C. Drug induced hemolytic anemia
D. Some patients with Chronic Lymphocytic Leukemia
E. All of the above
299 What is the indication of a positive result in a complement fixation test
(the presence of the antibodies of interest in the examined serum)?
A. Pink serum/non-lysed sheep RBCs
B. Pink serum/lysed sheep RBCs
C. Transparent serum/lysed sheep RBCs
D. Transparent serum/non-lysed sheep RBCs
E. sheep RBC agglutination
300 What is the indication of a negative result in a complement fixation test
(antibodies of interest are absent in the examined serum)?
A. Pink serum/non-lysed sheep RBCs
B. Pink serum/lysed sheep RBCs
C. Transparent serum/lysed sheep RBCs
D. Transparent serum/non-lysed sheep RBCs
E. sheep RBC agglutination