IMMUNITY TO MICROBES##BY : RAJA PARDOMUAN HARAHAP

Many pathogenic microbes have evolved to resist innate immunity, and protection
against such infections is critically dependent on which immune response?
1
Adaptive immune response

2
What type of cell that protects individual from repeated infections?
Memory cells

3
The viral DNA may be integrated into the DNA of infected cells, but no infectious
virus is produced. Which form of infection has this feature?
Latency

In persistent bacterial infections, such as tuberculosis, the bacteria may survive

within what structure/organelle?
4
Phagocytic vesicles of infected cells

Some infections in which the microbe cannot be cultured or is present in tissues

that are not readily accesible must be analyzed with measurement of what component
of humoral immunity?
5
Serum antibodies specific for particular microbes

The presence of which antibodies is indicative of recent infection?

6
IgM

The presence of which only antibodies suggests past infection?

7
IgG

8
Name the bacterial species on which infections can be detected by skin test and
cytokine release by T cell responses.
Mycobacterium tuberculosis

Which fungi that can cause invasion and thrombosis of blood vessels lead to
ischemic necrosis and cell injury?
9
Aspergillus fumigatus an EXTRACELLULAR FUNGI – with Candida albicans

Name three species of obligate intracellular bacteria.

10
Mycobacterium leprae, Rickettsia spp., Chlamydia spp.

Name the systemic disease caused by Staphylococcus aureus by producing

superantigen.
11
Toxic shock syndrome

Name three forms of disease caused by streptolysin O-producing organism.

12
Pharyngitis
Skin infections : impetigo, erysipelas, cellulitis
Systemic infections : scarlet fever
Name two diseases caused by pneumolysin-producing organism.
13
Lobar pneumonia, septic meningitis, otitis media

Which bacterial species producing toxin that binds to the motor endplate at
neuromuscular junctions and causes irreversible muscle contraction?
14
Clostridium tetani

15
Name five facultative intracellular bacteria.
Mycobacterium tuberculosis
Salmonella typhi
Neisseria meningitidis (meningococcus)
Listeria monocytogenes
Legionella pneumophila

16
As the name of the species, what disease caused by Legionella pneumophila?
Legionnaire’s disease

17
Listeriosis is caused by what species?
Listeria monocytogenes

Which fungal species can cause acute inflammation and binds complement protein?
18
Candida albicans

Which bacterial species can cause urogenital, eye, and pulmonary infection?
19
Chlamydia trachomatis

20
Name three intracellular fungi.
Cryptococcus neoformans
Histoplasma capsulatum
Pneumocystis jirovecii

21
Which is not how the microbes produce disease?##1. Functional derangements in
neighboring or distant cells#2. Liberating toxins that can cause tissue damage#3.
Creating membrane attack complex that is poisonous to infected cells#4. Functional
derangements in tissues that are not infected#5. Stimulating immune response that
injure both infected tissues and normal tissue
3

22
Which microbes do not show latency feature?##1. Herpesviruses#2. Intracellular
bacteria#3. Facultative intracellular fungi#4. Poxviruses
3

23
Which is not common acquired causes of immunodeficiency?##1. HIV infection#2.
Extensively active inflammation#3. Intentional immunosuppression by drugs to treat
inflammatory#4. Treating autoimmune disease#5. Preventing transplant rejection
2
24
Which organism has toxins inducing intestinal epithelial chloride and water
secretion and endotoxin stimulating cytokine secretion by macrophages?##1.
Escherichia coli#2. Vibrio cholerae#3. Salmonella typhi#4. Corynebacterium
diphtheriae
1, gastroenteritis, UTI, septic shock

Vibrio cholerae : Cholera toxin ADP-ribosylates G protein subunit, leading to

increased cyclic AMP (cAMP) in intestinal cells resulting in chloride secretion and
water loss

Salmonella typhi : enterocolitis

Corynebacterium diphtheriae : diphtheria toxin ADP-ribosylates elongation factor 2

and inhibits protein synthesis, similar with Pseudomonas aeruginosa

25
Which virus creates infection by killing CD4+ T cells lead to functional impairment
of immune cells?##1. Poliovirus#2. Herpes simplex virus#3. Hepatitis B virus#4.
Epstein-Barr virus#5. HIV
5

26
Which fungi causes alveolar inflammation due to impaired macrophage clearance in
setting of impaired T cell immunity caused by HIV?##1. Pneumocystis jirovecii#2.
Aspergillus fumigatus#3. Cryptococcus neoformans#4. Histoplasma capsulatum#5.
Candida albicans
1
Innate immunity with collectins as soluble PRR
Collectins also recognize terminal mannose residues and fructose
Receptor mannose-binding lectin in mannose-binding lectin complement pathway

27
Which fungi causes lung infection due to granulomatous inflammation?##1.
Histoplasma capsulatum#2. Cryptococcus neoformans#3. Pneumocystis jiroveci#4.
Candida albicans#5. Aspergillus fumigatus
1
Review group of fungal infection
Review the reservoir
Review the mycotoxin

28
Which virus that inhibits host cell protein synthesis and has tropism for motor
neurons in the anterior horn of the spinal cord?##1. Polio virus#2. Rabies virus#3.
Hepatitis B virus#4. Herpes simplex virus#5. Epstein-Barr virus
1

Inhibits host cell protein synthesis – poliovirus, influenza virus, rabies virus,
herpes simplex virus
Tropism for:
POLIO VIRUS Motor neuron in the anterior horn of the spinal cord
INFLUENZA VIRUS Ciliated epithelium of respiratory tract
RABIES VIRUS Peripheral nerves
HERPES SIMPLEX VIRUS Functional impairment of immune cells

29
Which virus that causes acute infection lead to B cell lysis and latent infection
lead to overstimulation of B cell proliferation?##1. Polio virus#2. Rabies virus#3.
Hepatitis B virus#4. Herpes simplex virus#5. Epstein-Barr virus
5

30
Which virus that causes encephalitis especially in temporal lobe of the brain?##1.
Polio virus#2. Rabies virus#3. Hepatitis B virus#4. Herpes simplex virus#5.
Epstein-Barr virus
4

Which is not the criteria of infectious agent for most effective vaccine?##1. Does
not establish latency#2. Does not interfere with the host immune response#3. Does
not undergo antigenic variation#4. Does not elicit an immune response#5. Does not
have animal reservoir
31
4

HIV = establishes latent infection and highly variable

32
Which is not the principal mediators of innate immunity against fungi?##1.
Neutrophils#2. Macrophages#3. CD8+ T cells#4. Innate lymphoid cells
3

CD8+ T cell is CTL in adaptive immune system

33
Which condition is extremely make patients susceptible to opportunistic fungal
infections?##1. Neutropenia#2. AIDS#3. Transplantation#4. Underlying diabetes
mellitus
1

34
Which PRR recognizes beta-glucans on fungal cell wall through C-type lectin-like
receptor (CLR)?##1. Dectin-1, dectin-2#2. DC-sign#3. Mannose receptor#4. Mannose-
binding lectin
1

35
Which fungal species inhibits the production of cytokines, such as TNF and IL-12 by
macrophages and stimulates production of IL-10, thus inhibiting macrophage
activation?##1. Pneumocystis jiroveci#2. Cryptococcus neoformans#3. Histoplasma
capsulatum#4. Aspergillus fumigatus#5. Candida albicans
2

36
Which is the transcription factor important for regulation ILC1 cells for
intracellular fungi?##1. T-bet#2. GATA-3#3. RORgamma - t#4. Lymphoid tissue inducer
(LTi)
1

37
Defective of which T-helper responses are susceptible to chronic mucocutaneous
Candida infections?##1. Th1#2. Th2#3. Th17#4. ILC1-mediated cells#5. ILC2-mediated
cells
3

38
Defective of which T-helper responses are susceptible to histoplasmosis, but may
elicit granulomatous inflammation?##1. Th1#2. Th2#3. Th17#4. ILC2-mediated cells
1
39
Which condition is extremely make patients susceptible to intracellular bacterial
infections?##1. Neutropenia#2. AIDS#3. Transplantation#4. Underlying diabetes
mellitus
2

40
Which is not the microbicidal substance produced by activated macrophages for
intracellular bacterial killing?##1. Reactive oxygen species#2. Nitric oxide#3.
Lysosomal enzymes#4. Superoxide dismutase
4

Name parasitic genus that show ability of continuous antigenic variation.

41
Trypanosoma

Review those parasitic species and the diseases.

Continuous antigenic variation in trypanosomes is mainly due to changes in

expression of the genes encoding the major surface antigen.

Name parasitic genus that show ability of stage-specific antigenic variation.

42
Plasmodium

Name parasitic genus whose larvae can travel up the lungs and develop a tegument
that is resistant to damage by complement and by CTLs.
43
Schistosoma

Name parasitic species that shows antigen shedding.

44
Entamoeba histolytica

Parasites may also shed their antigenic coats, either spontaneously or after
binding specific antibodies. Shedding of antigens renders the parasites resistant
to subsequent antibody-mediated attack. Entamoeba histolytica is a protozoan
parasite that sheds antigens and can also convert to a cyst form in a lumen of the
large intestine.

45
Name parasitic genus that make T cell becomes anergy to those genus.
Schistosoma, especially involves the liver and spleen
,and some filarial infection

Name parasitic genus that stimulate the development of regulatory T cells, which
suppress the immune response.
46
Leishmania

47
Most vaccines in use today work by inducing what type of immunity?
Humoral immunity

Name three examples of live, attenuated viral vaccines.

48
Polio vaccine, yellow fever vaccines, measles vaccines
A widely used inactivated vaccine of considerable public health is the influenza
vaccine. How do we administer this vaccine?
49
Inactivated (killed) = Intramuscularly

Influenza virus has two types of vaccine: trivalent inactivated (killed) and
trivalent live attenuated viruses. How do we administer the last?
50
Live attenuated influenza virus = nasal spray

51
The principal mechanisms of innate immunity against viruses are inhibition of
infection by which type of interferon?
Type I interferons

52
The principal mechanisms of innate immunity against viruses are inhibition of
infection by what type of cell?
Natural killer (NK) cell-mediated killing of infected cells

Absence of which class of MHC lead to infected cell-killing mediated by NK cells?

53
CLASS I MHC

54
What type of cell from adaptive immunity eliminates the infection by killing
infected cells?
CTL = Cytotoxic T lymphocytes

55
Where are most effective high-affinity antibodies are produced?
T-dependent germinal center

56
What does the cholera toxin interfere?##1. Protein synthesis in infected cells#2.
Ion and water transport#3. Neuromuscular transmission#4. Disrupts biochemical
signaling
2

57
Which T-helper cells undergo genetic defects lead to increased susceptibility to
bacterial and fungal infections and develop multiple skin abscesses?##1. Th0#2.
Th1#3. Th2#4. Th17
4

58
Which is cytokine produced by T-helper 1 cells?##1. Interferon gamma#2. IL-5, IL-9,
IL-13#3. IL-17, IL-22#4. IL-1, IL-6, TNF
1

59
Which virus show antigenic variation?##1. Influenza virus#2. Cytomegalovirus#3.
Epstein-Barr virus#4. Vaccinia virus
1

60
Which virus produce “decoy” MHC molecules to inhibit NK cells?##1.
Cytomegalovirus#2. Vaccinia virus#3. Epstein-Barr virus#4. HIV#5. Poliovirus
1
61
Which virus has immunosuppresive cytokine (IL-10)?##1. Epstein-Barr virus#2. HIV#3.
Herpes simplex virus#4. Poxviruses#5. Influenza virus
1

62
What term refers to reassortment of viral genes result in major changes in
antigenic structure, such as in avian flu or swine flu viruses?
Antigenic shift

63
What term refers to mutations of viral genomes in the genes that encode the surface
proteins and make variation?
Antigenic drift

64
Which parasite make CD4+ Th1 cells activate macrophages to kill themselves by
phagocytosis?##1. Plasmodium#2. Trypanosoma brucei#3. Schistosoma#4. Leishmania
donovani
4

65
Extracellular bacteria produce toxins, which have diverse pathological effects.
What toxins are traditionally become components of cell wall?
Endotoxins

66
Extracellular bacteria produce toxins, which have diverse pathological effects.
What toxins are secreted by the bacteria?
Exotoxins

67
The only toxin that is commonly called endotoxin is lipopolysaccharide (LPS) in
gram-negative bacteria. LPS is a ligand of which TLR?
TLR-4, potent activator of macrophages, dendritic cells, and endothelial cells

68
What is the mechanism of action of diphtheria toxin?
Interferes with elongation factor -2 lead to protein synthesis inhibiton.

Similar with which exotoxin????

69
Which complement pathway activated by peptidoglycans in the cell walls of gram-
positive bacteria and LPS in gram-negative bacteria?
Alternative pathway

Microbial surface products

70
Which is not the antibodies isotype that mediates the neutralization?##1. IgG#2.
IgA#3. IgM#4. IgE
4

GAM for neutralization

71
Bacteria that express mannose on their surface may bind mannose-binding lectin,
which activates complement by which pathway?
Lectin pathway

72
Name an example of bacterial genus that is lysed by complement system by membrane
attack complex because of their thin cell wall.
Neisseria

73
Name a cytokine produced by innate lymphoid cells (ILCs) 3 to response to microbes
and cell damage.
IL-17, 1L-22, GM-CSF

T-bet, GATA-3, RORgamma-t

74
Which antibodies subclass mediates opsonization of extracellular bacteria?
IgG1, IgG3

75
Which antibodies subclass mediates complement activation?
IgM, IgG1, IgG3