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Immunology - Medical Physic Qestion
Immunology - Medical Physic Qestion
Immunology - Medical Physic Qestion
Question: Polymorphonuclear neutrophils
Stain with acid dyes
Stain with basic dyes
Divide by mitosis within the circulation
Are multinucleated
Explanation
Question: Polymorphonuclear neutrophils
Contain lactoferrin
Are phagocytic cells
Make up 20% of total leukocyte count
Count is decreased by corticosteroid administration
Explanation
Question: Polymorphonuclear neutrophils
Count is increased in viral infections
Count is increased in tuberculosis
Count is increased in hypersplenism
Count is decreased in brucellosis
Nitric oxide
Peroxynitrite
Lysozyme
Lactoferrin
Explanation
Question: Natural killer cells
Secrete perforin
Secrete interferongamma
Can be activated by uninfected normal host cells
Are activated by MHCnegative virally infected cells
Explanation
Question: With respect to the complement system
By convention, on cleavage of any component, the larger product is given the suffix ?a?
The alternative pathway is a component of the innate immune system
The alternative pathway is activated following antibody binding to microbes
The alternative pathway can be controlled by complement regulatory proteins
True False No answer Correct answer: False
Explanation
Question: The following are acute phase proteins
Albumin
CReactive protein
Mannosebinding protein
Alpha1 acid glycoprotein
Explanation
Question: Creactive protein
Is an acute phase protein
Is a dimer
Binding to microbes is calciumindependent
Binding to microbes activates complement via the alternative pathway
Explanation
Question: Cytokines
Are high molecular weight proteins
Have a short half life
Act via receptors located within the cell nucleus
No answer Correct answer: False
True False
Have multiple effects on a variety of cell types
Explanation
Question: Interferongamma
Is secreted by macrophages
Is secreted by NK cells
Activates macrophages
Inhibits viral replication
Serve as Bcell antigen receptors
May be membranebound
Are present in breast milk
Do not cross the placenta
Explanation
Question: With respect to the structure of antibodies
There are five different types of light chains
There are two different types of heavy chains
Antibodies of identical specificity but containing different heavy chains are said to belong to different isotypes or
classes
IgA has five subtypes
Explanation
Question: With respect to the structure of antibodies
IgG has four subtypes
IgA has a halflife of 6 days in serum
IgG has a half life of 7 days in serum
Secreted IgA forms dimers
No answer Correct answer: True
True False
Explanation
Question: IgA
Is produced by mucosal epithelial cells
Is secreted as monomers which form dimers within the GI tract
Is not present in cervical secretions
Activates complement through the classical pathway
Explanation
Question: The following antigens induce Tcell dependent Bcell antibody production
Peptide antigens
Polysaccharide antigens
Lipid antigens
Nucleic acid antigens
Explanation
Question: With respect to Bcell activation and antibody production
The primary antibody response is characterised by the production of IgD
The primary antibody response is characterised by the production of large amounts of antibody
The secondary antibody response to protein antigens shows immunoglobulin heavy chain class switching
Explanation
Question: Primary antigen stimulation of Bcells results in
Activation of cell division
Increased expression of cytokine receptors
Migration out of lymphoid follicles
Secretion of large quantities of IgG
Explanation
Question: Concerning antibodies in pregnancy
Maternal IgM is responsible for Rhesus disease
The IgA concentration in cord blood is higher than in maternal blood
IgE readily crosses the placenta
Fetal IgM is monomeric
Explanation
Question: IgM
Fixes complement by the alternative pathway
Binds to mast cells
Is smaller than IgE
Explanation
Question: Antibodies play an important role in
Phagocytosis
The Mantoux reaction
Erythroblastosis fetalis
Anaphylaxis
Are the only immune cells with specific receptors for antigens
Make up 5% of the total leukocyte count
Count is increased in viral infections
Count is increased following corticosteroid therapy
Explanation
Question: With respect to Lymphocytes
Count is increased in HIV infection
Blymphocytes are the only cells capable of producing antibodies
Tlymphocytes express membranebound antibodies that serve to recognise antigens
Blymphocytes only recognise peptide antigens bound to MHC molecules on antigen presenting cells
Explanation
Question: With respect to the structure of the spleen
Tcells are located in the periarteriolar lymphoid sheaths
Bcells are located in the red pulp
The capillaries are lined by endothelial cells with tight junctions
The trabeculae of the red pulp contain macrophages
Class I & II MHC molecules are membranebound proteins
Class I & II MHC molecules contain a peptidebinding domain at the aminoterminal end
MHC antigens are inherited in an autosomal dominant fashion
Class I MHC antigens are expressed by professional antigenpresenting cells only
Explanation
Question: With respect to the major histocompatibility (MHC) antigens
CD4 positive Tcells can only respond to antigens presented by class II MHC molecules
There are three polymorphic MHC class I genes in humans
Each human cell expresses three different MHC class I molecules
Humans have four polymorphic MHC class II genes
Explanation
Question: With respect to lymphocyte maturation and the generation of diversity
The immunoglobulin heavy and light chain gene loci contain several hundred variable region (V) genes
The immunoglobulin heavy and light chain gene loci contain several hundred constant region (C ) genes
The Tcell receptor alpha and beta chain gene loci contain several hundred variable region (V) genes
Explanation
Question: With respect to the binding of Tcells to antigen presenting cells
Antigen presenting cells express lymphocyte functionassociated antigen1
Lymphocyte functionassociated antigen1 is an integrin
Lymphocyte functionassociated antigen1 binds to intercellular adhesion molecule 1
The affinity of lymphocyte functionassociated antigen1 for its ligand is decreased following antigen
recognition by Tcells
Explanation
Question: With respect to TH1 and TH2 lymphocytes
TH1 cells are CD4 positive
TH2 cells are CD8 positive
TH1 cells produce interferongamma
TH2 cells produce mainly interleukin12
Explanation
Question: With respect to TH1 and TH2 lymphocytes
TH1 cells stimulate phagocytemediated killing of microbes
TH1 cells stimulate the production of IgE antibodies
TH1 cells stimulate phagocytemediated killing of microbes
Explanation
Question: With respect to TH1 and TH2 lymphocytes
TH2 cells stimulate immune responses against helminthic parasites
Cytokines secreted by TH2 cells activate macrophages
Interleukin12 stimulates the differentiation of helper Tcells into TH2 cells
TH2 cells secrete interleukin4
Hepatitis A
Rubella
Rhesus disease
Immune thrombocytopaenia purpura
Explanation
Question: Passive immunisation
Is associated with serum sickness
Confers longterm immunity
Uses recombinant microbial proteins
Is used to prevent the development of chickenpox in a susceptible contact
Explanation
Question: The following are live attenuated vaccines
BCG
Pertussis vaccine
Measles vaccine
Tetanus vaccine
BCG vaccine
Sabin polio vaccine
Adenovirus vaccine
Cholera vaccine
Explanation
Question: The following vaccines are administered via the oral route
Typhoid vaccine
Hepatitis A vaccine
Diphtheria vaccine
Rubella vaccine
Explanation
Question: Delayed cell mediated (Type IV) hypersensitivity
Results in the Mantoux reaction
Reaches its peak 56 hours after contact with the antigen
In the early stages is characterised histologically by perivascular cuffing with mononuclear cells
The late phase is characterised histologically by a neutrophilic infiltration
True False No answer Correct answer: False
Explanation
Question: The following are characteristic of graftversushost disease
Rash
Diarrhoea
Weight loss
An immunocompetent transplant recipient
Explanation
Question: Hyperacute transplant rejection
Is mediated by Tlymphocytes
Is a TH1 response
Is more likely to occur in patients who have never had a previous blood transfusion
Is the commonest type of transplant rejection
Explanation
Question: HLA B27 is associated with the following disorders
Postsalmonella arthritis
Juvenile rheumatoid arthritis
Celiac disease
No answer Correct answer: False
True False
Insulindependent diabetes
Explanation
Question: The following diseases are more common in females
Polymyositis
Myasthenia gravis
Rheumatoid arthritis
Sjogren syndrome
Is a high frequency magnetic field above the audible range
Medical ultrasound utilises frequencies in the 120MHz range
Medical ultrasound utilises frequencies of ~3MHz
Piezoelectric crystals are used in ultrasound scanning probes to generate a focused beam of ultrasound
Explanation
Question: In Doppler ultrasound imaging
Blood flow velocity can be measured using continuous wave Doppler
Blood flow velocity can be measured using pulsed wave Doppler
Volume flow rates can be measured using continuous wave Doppler
Volume flow rates can be estimated using pulsed wave Doppler
Explanation
Question: The following are examples of stable isotopes
35S
32P
2H (D2)
125I
The gamma camera should not contain lead
The ideal radionuclide should have a very low specific activity
The radiation dose delivered to the patient increases with the number of images taken
Tha radiation dose to the patient is confined to the organ or tissue of diagnostic interest
Explanation
Question: Radiation causes tissue damage by
Free radical production
Ionisation
Damage to DNA but not RNA
Cavitation
Explanation
Question: Technetium99m
Is a stable nuclear isomer of Technetium
Has a half life of ~6 hours
Emits gamma rays
Is the commonest radioisotope used for medical imaging
True False No answer Correct answer: True
Explanation
Question: Gallium67
Has a half life of 67,000 years
Emits gamma rays
Is typically used to image abscesses
Is often used to image the thyroid gland
Explanation
Question: Positron emission tomography
Does not expose the patient to radiation
Uses Xrays
Is used to image functional processes
Can be combined with CT scanning
Explanation
Question: The following are used for positron emission tomography
Carbon11
Technetium99m
Iodine131
No answer Correct answer: False
True False
Oxygen15
Explanation
Question: With respect to the tissue effects of lasers
Scattering increases the depth of penetration of a laser
No tissue effects will occur if the laser is completely reflected by the tissue
No tissue effects will occur if the laser is completely transmitted by the tissue
The amount of laser energy absorbed by a tissue is dependent on the density of the tissue
Fixes complement by the alternative pathway
Binds to mast cells
Is synthesised by plasma cells
Is smaller than IgE
Explanation
Question: IgM
Has a molecular weight of 150kDa
Contains J chains
Is a dimmer in external secretions
Contains an additional peptide produced by epithelial cells
Explanation
Question: Antibodies play an important role in
Phagocytosis
The Mantoux reaction
Erythroblastosis fetalis
Anaphylaxis
Form about 2% of the total white cell count
Have a lifespan of about 30 days
Do not participate in cell mediated immunity
Can differentiate into plasma cells
Explanation
Question: Blymphocytes
Produce tumour necrosis factor
Do not produce antibodies
Play a role in delayed hypersensitivity
Produce IgE
Explanation
Question: Natural killer cells
Have large granular lymphocyte morphology
Have receptors for class I HLA molecules
Are present in large numbers in the decidua during the first trimester
Express CD3 on their surface
True False No answer Correct answer: False
Explanation
Question: Natural killer cells
Are related to Blymphocytes
Express the Tcell receptor on their surface
Express immunoglobulins on their surface
Are CD 56 positive
Explanation
Question: In anaphylactic shock in humans
IgE is the mediator
There is degranulation of mast cells
Complement is required
Histamine release occurs
Explanation
Question: The biological effects of complement in the human include
Opsonisation
Cell membrane lysis
Participation in the blood coagulation system
No answer Correct answer: False
True False
Promotion of sperm motility
Explanation
Question: Tlymphocytes
Differentiate in the thymus
Are involved in both cell mediated and humoral immune responses
Are phagocytic
Produce antibodies
Each subject will take either the drug or placebo but not both
The subjects can choose whether they take the drug or placebo
The investigator decides which subject takes the drug or the placebo
The likelihood of the trial giving statistically significant results is independent of the number of subjects
Explanation
Question: In a randomised doubleblind trial of two cholesterol lowering drugs, 400 patients received
drug A and 398 received drug B. Drug A was found to cause a greater reduction in serum cholesterol
(p = 0.001).
Randomisation is best achieved by alternate allocation of subjects to treatment groups
Randomisation controls for unknown confounding variables
Randomisation controls for known confounding variables
It is likely that the patients receiving drug A had different characteristics from those receiving drug B
Explanation
Question: With respect to the epidemiology of cervical cancer
The overall lifetime risk of cervical cancer is 1 in 300
The peak incidence of carcinoma insitu is in women aged 4550 year
The maximum number of cases of carcinoma insitu occur in women aged 2529 years
The highest number of cases of invasive cancer occur in women aged 5560 years
True False No answer Correct answer: False
Explanation
Question: with respect to the epidemiology of cervical cancer
The agespecific incidence of cervical cancer in the UK has risen steadily over the last 30 years
Adenocarcinoma accounts for 11.5% of all invasive cervical cancers
The incidence of cervical cancer has a peak in the 2025 years age group and another peak in the 5560 years
age group
The overall 5 year survival rate is 92%
Explanation
Question: ovarian cancer
Is more common in women of Asian origin than in White women in the UK
Is more common in women of higher socioeconomic class
Occurs in 1 in 100 women in the UK
5 year survival rates have remained unchanged over the last 20 years
Explanation
Question: With respect to the risk of miscarriage
The risk is about 5% in women in their first pregnancy
The risk is about 5% in women whose last pregnancy ended in a live birth
The risk is about 75% in women in whom all previous pregnancies have ended in miscarriage
No answer Correct answer: False
True False
The risk is 1% in multiparous women in whom all previous pregnancies have ended in live birth
Explanation
Question: With respect to perinatal mortality statistics
There has been a statistically significant fall in perinatal mortality rate in the UK between 2000 and 2008
There has been a statistically significant fall in neonatal mortality rate in the UK between 2000 and 2008
There has been a statistically significant increase in stillbirth rate in the UK between 2000 and 2008
There has been a statistically significant increase in stillbirth rate for twin births the UK between 2000 and 2008
Explanation
Question: With respect to factors that affect fertility
Male fertility declines with age
Fecundability increases with increased frequency of sexual intercourse
Alcohol intake reduces female fertility
Alcohol intake can adversely affect semen parameters
Explanation
Question: With respect to the uptake of contraception in women aged 1649 years in the UK
Sterilization is used by 15% of women
Partner sterilization is used by about 10% of women
The contraceptive implant is used by 10% of women
Explanation
Question: With respect to sexually transmitted infections in the UK
The total number of cases of sexually transmitted infection has fallen over the last 10 years
The rate of new diagnoses of genital herpes is increasing in the over 45 years age group
There has been a 60% decrease in the number of new cases of siphylis diagnosed over the last 10 years
Men account for the majority of new cases of siphylis diagnosed in the UK