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Imm 100 Immunology Question Paper

Imm 100 Immunology

Course:Bachelor Of Medicine And Bachelor Of Surgery

Institution: Moi University question papers

Exam Year:2006

M O I U N I V E R S I T Y

SCHOOL OF MEDICINE
END OF YEAR EXAMINATION (EYE) 2005/2006
COURSE: IMMUNOLOGY -IMM 100
PROGRAMME: M.B.Ch.B. YEAR OF STUDY: 1(ONE)
DATE: 13TH OCTOBER 2006 TIME: 9.00 A.M. -12.00 NOON.

GENERAL INSTRUCTIONS:-

(I) WRITE YOUR UNIVERSITY REGISTRATION NUMBER ON EVERY PIECE OF PAPER YOU USE.

(II) DO NOT WRITE YOUR NAMES ON ANY PIECE OF PAPER YOU USE.

(III) THIS PAPER IS MADE UP OF TWO (2) SECTIONS: I AND II. SECTION I CONSISTS OF SIXTY (60) MULTIPLE CHOICE QUESTIONS (MCQS) TO BE ANSWERED IN SIXTY (60) MINUTES. SECTION II CONSISTS OF TEN (10) SHORT ANSWER QUESTIONS (SAQS) TO BE ANSWERED IN ONE HUNDRED AND TWENTY (120) MINUTES.

(IV) FOR THE MCQS, EACH QUESTION CONSISTS OF A STATEMENT/STEM WHOSE MOST CORRECT COMPLETION OR ANSWER IS PROVIDED AMONG THE FIVE OPTIONS NUMBER A TO E.

(V) FOR EACH MCQ, SELECT ONLY ONE APPROPRIATE OPTION AND INDICATE BY CIRCLING IT.

EXAMPLE:

Major features of innate immunity include
(a) Recognition
(b) Specificity
(c) Memory
(d) First line of defense
(e) Adaptability
The appropriate response is (d)

(VI) ATTEMP ALL QUESTIONS IN BOTH SECTIONS.

SECTION I: MULTIPLE CHOICE QUESTIONS (MCQs)
(30 MINUTES)

1. CD40 ligand (CD 154) is expressed by the following cells

(a) B cells
(b) Dendritic cells
(c) Resting T cells
(d) Activated T cells *
(e) All leukocytes

2. Immunoglobulin heavy chain genes are located on

(a) Chromosome 6
(b) Chromosome 2
(c) Chromosome 22
(d) Chromosome 14*
(e) Chromosome 12

3. Th2 response is associated with the following cytokines

(a) IL – 4, IL – 5, IL – 10 and IL – 13*
(b) IL – 8, IL – 10 and IL – 13
(c) ? - IFN and TNF - ?
(d) IL – 4, IL – 5, IL – 10 and IL – 12
(e) ? - IFN and IL – 13

4. In tuberculin test

(a) Positivity indicates past CD8 T cell exposure to gram-negative bacteria
(b) False positive reaction may occur due to immunodeficiency
(c) Screening for anergy is ineffective
(d) Positivity indicates past CD4 T cell exposure to mycobacterial infection *
(e) Contact sensitivity is always negative

5. Investigation of T cell function involves

(a) Enumeration of SmIg+ lymphocytes
(b) Detection of CD3 T cells only
(c) Detection and measurement of cytokine inhibition
(d) Phenotype characterization of CD4 and CD8 T cells*
(e) Antigen-specific B cell proliferative response

6. Bursa of Fabricius in birds is the human equivalent of

(a) Tonsils
(b) Thymus
(c) Spleen
(d) Liver
(e) Bone marrow*

7. Functional specific immunity is divided into

(a) T cells and macrophages
(b) Antibodies and complement proteins
(c) Innate and adaptive immune mechanisms
(d) Cellular and humoral immune responses*
(e) Antibodies and immunoglobulins

8. Supergene family molecules exclude

(a) Class III MHC products*
(b) T cell antigenic receptor
(c) B cell antigenic receptor
(d) Class I and II MHC products
(e) CD2 and CD4 molecules

9. Gut associated lymphoid tissue (GALT) is

(a) The largest lymphoid tissue in the body
(b) Encapsulated
(c) Designated Waldeyer ring*
(d) A primary lymphoid organ
(e) Both a primary and secondary lymphoid organ

10. B cells predominantly express the following cell markers

(a) CD19 and CD20*
(b) CD16 and CD56
(c) CD18 and CD35
(d) CD46 and CD55
(e) CD28 and CD23

11. The successful protection of humans against smallpox infection by vaccination with cowpox marked the foundation of Immunology as described by

(a) Emil von Behring
(b) Elie Metchnikoff
(c) Peter Medawar
(d) Edward Jenner*
(e) Rolf Zinkernagal

12. Class II MHC molecules include

(a) Gene products of HLA-D, HLA-DP and HLA-B
(b) Gene products of HLA-A, B and C
(c) Gene products of HLA – DP, DQ and DR*
(d) Complement components C2, Factor B, C4b and C4a
(e) Gene products of HLA-B, C and DP

13. Most of the intrathymic death of potential T cell subsets is due to

(a) Apoptosis*
(b) Necrosis
(c) Phagocytosis
(d) Pinocytosis
(e) MHC-restriction

14. Which of the following does not describe cytokines?

(a) They are produced by antigen – stimulated T cells
(b) They are only produced by antigen – stimulated B cells*
(c) They are pleiotropic
(d) They are glucoproteins of low molecular weight
(e) They interact with specific receptors on surface of target cells

15. Th2 CD4+ T cells are closely associated with

(a) Strong delayed type hypersensitivity reactions
(b) Strong antibody response*
(c) Increased inflammatory reactions
(d) Increased production of IL-2
(e) Increased production of Interferon – gamma (IFN-?)

16. The following marker on T cells mediates the phenomenon of E-rosetting

(a) CD1
(b) CD2*
(c) CD3
(d) CD20
(e) CD21

17. Natural killer (NK) cells

(a) Express CD3+ TCR+ cell markers
(b) Are non-phagocytic and non adherent cells*
(c) Do not express CD16 and CD56 differentiation antigens
(d) Eliminate target tumour cells under MHC-restriction
(e) Do not regulate CD8 cytotoxic T cells

18. Gamma –interferon (?-IFN)

(a) Enhances MHC II expression on accessory cells*
(b) Enhances MHC I expression on macrophages
(c) Is a colony stimulatory factor
(d) Is a Th2 cytokine
(e) Promotes differentiation of eosinophils

19. Cell-mediated immunity

(a) Can be transferred passively using sera
(b) Is mediated by B and T cells
(c) Is mediated by T cells, macrophages and interleukins*
(d) Forms the major part of innate immunity
(e) Is mediated by antibodies and interleukins

20. MHC genes are specifically located on the

(a) Long arm chromosome 6
(b) Short arm of chromosome 6
(c) Shorter arm of chromosome 6 at position 6p 21.1 to 6p 21.3*
(d) Longer arm of the chromosome 6 at position 6p 21.1 to 6p 21.3
(e) On the short arm of chromosome 2

21. Polymorphism exhibited by MHC class I molecules is due to

(a) Heavy chain*
(b) Light chain
(c) ?2-microglobulin
(d) Kappa chain
(e) ?2-macroglobulin

22. Th1 cytokines includes

(a) IL – 2 and IFN - ?*
(b) IL – 2 and IL – 6
(c) IL – 4 and IL – 5
(d) IL – 10 and IL – 13
(e) IL - ? and TNF - ?

23. The theory of adaptive immune response is based on

(a) Jerne’s postulation
(b) Jule Bordet’s theory
(c) Burnet’s clonal selection theory*
(d) Edward Jenner’s theory
(e) Paul Ehrlich’s theory

24. IIya Metchnikoff is credited for

(a) Description of phagocytes*
(b) Production of attenuated cholera vaccine
(c) Discovery of ABO blood groups
(d) Delayed type hypersensitivity reaction
(e) Development of a virulent BCG vaccine

25. Eosinophils play major role in

(a) Clearance of debris and dead cells
(b) Intracellular killing of pathogens
(c) Phagocytosis of bacteria
(d) Killing of helminthes and nematodes*
(e) Killing of viruses

26. Three primary lymphoid organs include

(a) Peyer’s patches, thymus and spleen
(b) Thymus, peyer’s patches and bone marrow*
(c) Bone marrow. Lymph node and thymus
(d) Spleen, tonsils and Peyer’s paches
(e) Appendix, tonsils and Peyer’s patches

27. Commensal bacteria are beneficial through

(a) Synthesis of glycolipids
(b) Synthesis of vitamins*
(c) Digestion of fatty acids
(d) Inhibition of Th1 type response
(e) Digesting polysaccharides with body enzymes

28. Physical barriers to infection exclude

(a) Secretory immunoglobulins
(b) Mucous and saliva
(c) Lung tracheal cilia
(d) Gastrointestinal 1 tract natural flora
(e) Encystment*

29. Lipopolysaccharide (LPS) activated macrophages lead to

(a) Decreased phagocytosis and intracellular killing
(b) Increased phagocytosis and intracellular killing*
(c) Decrease of proinflammatory cytokines
(d) Decrease in nitric oxide release
(e) Decrease in reactive nitrogen intermediates

30. Innate immunity trigger adaptive immunity through

(a) Induction of coactivation molecules
(b) Induction of costimulatory molecules*
(c) Synthesis of MHC molecules
(d) Activation of suppressor mechanisms
(e) Increased expression of MHC molecules

31. Mature and differentiated double positive CD4+ CD8+ T cells express the following molecules

(a) TCR, CD3 and CD4/CD8*
(b) MHC, CD3 and CD4/CD8
(c) CD2, CD7 and CD3
(d) TCR, CD7 and CD3
(e) CD4, CD7 and CD8

32. A majority of T cell express

(a) ?? TCR
(b) ?? TCR
(c) ?? TCR*
(d) ?? TCR
(e) ?? TCR

33. Memory T cells express the following markers

(a) CD45RA
(b) CD56
(c) CD45RO*
(d) CD45RE
(e) CD3 and CD1

34. Accessory antigen presenting cells include

(a) Dendritic cells and macrophages*
(b) Activated T cells and neutrophils
(c) B cells and eosinophils
(d) Macrophages and basophils
(e) Mast cells and basophils

35. Cytotoxic T cell is

(a) MHC class II restricted
(b) MHC class I restricted*
(c) MHC class III restricted
(d) HLA DP restricted
(e) HLA DQ restricted

36. In order to achieve full T cell activation the following signals are not required

(a) MHC – TCR/CD3 – MHC-Peptide – CD4/CD8
(b) CD28 – CD80/86 constimulatory molecules
(c) CD40 – CD 154 coactivation molecules
(d) BCR – TCR/CD3-MHC-Peptide-CD4/CD8*
(e) Antigen specific, coactivation and costimulatory molecules

37. Cytotoxic T cells (CTL) are not associated with

(a) Killing of virus infected cells expressing class II MHC molecules*
(b) Synthesis of perforins
(c) Apoptosis triggered by granzymes
(d) Release of Th1 cytokines
(e) Killing of tumour cells expressing class I MHC molecules

38. The following represent macrophage associated functions except

(a) Antigen processing and presentation
(b) Phagocytosis
(c) Oxidative respiratory burst
(d) Production of immunoglobulins and cytokines*
(e) Microbicidal and tumouricidal activity

39. Delayed type hypersensitivity reaction is not mediated by

(a) Cytotoxic T lymphocyte (CTL)
(b) Th1 cytokine activated macrophages
(c) Th2 cytokine activated macrophages*
(d) Granuloma formation
(e) Recruitment and activation of inflammatory cells

40. During intrathymic education of T cells the mechanism involved is

(a) Maturation of self-reactive B cells
(b) Differentiation of self reactive T cells
(c) Apoptosis of T cells*
(d) Positive selection of plasma cells
(e) Negative selection of B cells

41. Regulatory T cells include

(a) CD8+T cells and CD4+ T cells
(b) CD8+ T cells and CD3+ T cells
(c) CD4+ T cells and CD+ T cells
(d) CD8+ cytotoxic T cells and macrophages
(e) CD4+ T cells and NK cells

42. Neuroendocrine system in the immuneregulation mechanisms regulates

(a) Cytokines
(b) Corticosteroids
(c) Defensins
(d) Lactoferrin
(e) Complement proteins

43. Classical pathway activation is regulated by the following except

(a) DAF
(b) CRI
(c) CD35
(d) C4Bp
(e) Factor H

44. Lectin pathway complement is activated by

(a) Bacterial carbohydrates
(b) Viral carbohydrates
(c) Immune complexes of IgG and IgM
(d) Immunes complexes aggregates of IgA
(e) Membrane attack complex

45. Pro-inflammatory lymphocytes are controlled by the following mechanisms except

(a) Apoptosis
(b) Fas-ligand expression
(c) Transforming growth factor-?
(d) IL – 10
(e) Interferon-?

46. Administration of an antigen below immunization level is designated

(a) Low zone tolerance
(b) High zone tolerance
(c) Optimal antigen loading
(d) Polyclonal B cell activation
(e) Immune paralysis

47. C3b receptor (CD35) is expressed by

(a) Macrophages and neutrophils
(b) Neutrophils and mast cells
(c) Eosinophils
(d) Erythrocytes and macrophages
(e) Basophils and mast cells

48. The following statement is not true about apoptosis

(a) Intrathymic death of thymocytes
(b) Necrosis
(c) Cytotoxic lymphocytes killing
(d) Antibody dependent cell mediated cytotoxicity
(e) Regulation of autoreactive T cells

49. Examples of immune priveledged sites exclude

(a) Anterior chamber of the eye
(b) Testes
(c) Brain
(d) Placenta
(e) Breast

50. Idiotypes are present on the following except

(a) CD4+ T lymphocytes
(b) CD8+ T lymphocytes
(c) Plasma cells
(d) Immunoglobulins
(e) B lymphocytes

51. The stage of immunoglobulin synthesis first detectable in immature B cells is

(a) Synthesis of ?-chains
(b) Synthesis of kappa chains
(c) Synthesis of kappa chains
(d) Synthesis of ? chains
(e) Synthesis of complement proteins

52. The largest immunoglobulin molecule is

(a) Serum IgA
(b) Secretory IgA
(c) Serum IgM
(d) Serum IgE
(e) Serum IgG

53. Isotype refers to the following

(a) Characteristics of immunoglobulin H chains
(b) Presence or absence of secretory component
(c) Presence or absence of J-chain
(d) V region uniqueness
(e) Genetic variations in H chains of immunoglobulins

54. Specific regions in antibody molecule that form antigen combining site are

(a) Domains
(b) Hypervariable regions
(c) Hinge regions
(d) Fc regions
(e) Epitopes

55. A receptor present on certain cells of the immune system that facilitate ADCC mechanisms is

(a) CIq receptor
(b) Fc receptor
(c) CD4 receptor
(d) MHC receptor
(e) T cell antigenic receptor

56. Cells that actively synthesise and secrete IgM include the following

(a) Antigen presenting cells
(b) Monocytes
(c) Plasma cells
(d) CD4+ T cells
(e) Basophils

57. Laboratory determination of serum immunoglobulin concentration is performed using the following technique

(a) Simple electrophoresis
(b) Haemagglutination
(c) Latex agglutination
(d) Double immunodiffusion
(e) Single radial immunodiffusion test

58. Immature B lymphocytes

(a) Mature in the thymus
(b) Mature in the spleen
(c) Synthesize ? chains
(d) Express surface IgD
(e) Express surface IgM and IgG

59. Trivalent oral polio vaccine predominantly induces synthesis and secretion of the following immunoglobulin

(a) Serum IgA
(b) Secretory IgA
(c) Secretory IgE
(d) Serum IgG
(e) Serum IgM

60. In the lymph node, antibody secreting cells are located in

(a) Primary follicles
(b) Secondary follicles
(c) Medullary cords
(d) Cortex
(e) Paracortex

SECTION II: SHORT ANSWER QUESTIONS (SAQs)
(120 minutes)

INSTRUCTIONS

(I) THERE ARE TEN (10) QUESTIONS IN THIS SECTION

(II) ANSWER ALL THE TEN (10) QUESTIONS

(III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET.

SAQ 1. With aid of an annotated diagram describe:

(a) The structure of T cell antigenic receptor (TCR)
(10 minutes)
(b) Schematic map of HLA region.
(10 minutes)

SAQ 2. (a) Describe five (5) cytotoxicity mechanisms.
(10 minutes)
(b) Describe three mechanisms involved in T cell activition.
(10 minutes)

SAQ 3. Describe five (5) possible way in which self-reactive lymphocytes may be prevented from responding to self antigens.
(10 minutes)

SAQ 4. Describe how central tolerance is induced in T and B lymphocytes.
(10 minutes)

SAQ 5. Describe and explain how cytokines regulate immune responses.
(10 minutes)

SAQ 6. Describe and explain how antibody exert feedback control on the immune responses.
(10 minutes)

SAQ 7. Describe and explain the activation and sequence of alternative pathway complement system.
(10 minutes)

SAQ 8. Describe and explain the biological functions of activated complement system.
(10 minutes)

SAQ 9. Describe and explain five (5) mechanisms which regulate complement activation.
(10 minutes)

SAQ 10. Describe and explain five (5) functions of immunoglobulins in the body, giving examples.
(10 minutes)

Imm 100 Immunology Question Paper

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