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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:2007

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

SCHOOL OF MEDICINE
END OF YEAR EXAMINATION (EYE) 2006/2007
COURSE: IMMUNOLOGY -IMM 100
PROGRAMME: M.B.Ch.B. YEAR OF STUDY: 1(ONE)
DATE: 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 SEVEN (7) 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. The following Nobel prize winners are NOT credited for

(a) Edward Jenner for vaccination against small pox
(b) Ilya Mectchnikoff for phagocytes
(c) Robert Koch for delayed type hypersensitivity reaction
(d) Landsteiner fro ABO immunoglobulin rearranged genes
(e) Calmette Guerrin for BCG vaccine

2. Adaptive immunity is NOT associated with

(a) Memory of prior exposure exists
(b) Inborn pattern recognition receptors 9PRR) recognize pathogens
(c) Randomly generated receptors recognize pathogens
(d) Response is generally slow
(e) Pathogen associated molecular patterns (PAMPs) display narrow specificity

3. Mechanical control of upper respiratory tract (URT) is mediated by

(a) Lysozyme
(b) Mucociliary elevation
(c) Alveolar lymphocytes
(d) Alveolar macrophages
(e) Lactoferrin

4. Principles of adaptive immunity EXCLUDES

(a) Humoral responses eliminate extracellular pathogens
(b) Cell mediated immunity comprises T lymphocytes, macrophages and NK cells
(c) Recognition, narrow specificity and memory are hallmarks
(d) Both B and T lymphocytes possess antigen specific receptors
(e) T cells do not recognize antigens in association with MHC antigens

5. A substance that induce a detectable immune response is called

(a) Hapten
(b) Immunogen
(c) Alloantigen
(d) Antigen
(e) Superantigen

6. Immunogenicity of a substance is NOT enhanced by

(a) High molecular size
(b) High degree of foreignness
(c) Low molecular size
(d) Subcutaneous antigen administration
(e) Optimal antigen dose

7. Most common inorganic adjuvants do NOT include

(a) Aluminum oxide
(b) Aluminium hydroxide (Alum)
(c) Aluminum phosphate
(d) Potassium ammonium sulphate
(e) Calcium phosphate

8. The following cluster of differentiation (CD) antigens define the cell subpopulation indicated

(a) CD29 for all B cells
(b) CD23 for normal B cells
(c) CD8 for helper/inducer T cells
(d) CD2 for thymocytes
(e) CD8 for cytotoxic T cells

9. On chromosome 6, MHC molecules are coded as follows

(a) Complement proteins coded for by class II genes
(b) HLA-DP, DM, DO, DQ and DR code for class II molecules
(c) HLA-B, C,E,A,G and F code for class II molecules
(d) Tumour necrosis factor (TNF) coded for by class I genes
(e) Lymphotoxin and heatshock proteins coded for by class II genes

10. Antigen presenting cells (APC) selectively express

(a) HLA-class II gene products
(b) HLA-class I gene products
(c) HLA-class III proteins
(d) HLA-A,B and DR molecules
(e) HLA-DP, DR and F molecules

11. The most polymorphic HLA – region is

(a) HLA – DP
(b) HLA – A
(c) HLA – C
(d) HLD – DQ
(e) HLA – B

12. HLA alleles in strong linkage disequilibrium are

(a) A1 and B9
(b) A11 and B8
(c) A29 and B5
(d) A1 and B5
(e) A1 and B8

13. Soluble factors/chemicals that confer innate immunity EXCLUDE

(a) Lactoferrin
(b) Defensins
(c) Alternative complement proteins
(d) Interferons
(e) Immunoglobulins

14. The portion of antigen (antigen determinant) responsible for B cell or T cell activation is

(a) Paratope
(b) Agretope
(c) Avidity
(d) Epitope
(e) Affinity

15. A polyclonal activator of the immune system is called

(a) Adjuvant
(b) Mitogen
(c) Hapten
(d) Carrier
(e) Alloantigen

16. The following are NOT tissue macrophages

(a) Monocytes
(b) Kuppfer cells
(c) Microglial cells
(d) Alveolar cells
(e) Osteoclasts

17. Importance of HLA molecules is NOT associated with

(a) Organ/tissue transplantation
(b) Paternity identity
(c) Disease susceptibility
(d) Human cloning
(e) Criminal apprehending

18. The mechanisms of innate immunity provide

(a) Co-stimulation of T lymphocytes cells
(b) Co-stimulation of B lymphocyte cells
(c) Specific immune responses to pathogens
(d) First line defense against infections
(e) Stimulation of natural killer cells

19. The impact of hydridoma technology on basic sciences, medicine and pharmaceutical industry is credited to the following scientists

(a) Kohler, Milstein and Jerne
(b) Jenner and Metchnikoff
(c) Ehrlich and Burnet
(d) Border and Jenner
(e) Jenner, Bordet and Burnet

20. Antimicrobial factors that are products of secretory glands include the following

(a) Arglsulphate
(b) Lysosomes
(c) Arachadonic acid
(d) Lactoperoxidase
(e) Interferon-gamma (?-IFN)

21. Most regulatory T cells express the following markers except

(a) CD4
(b) CD25
(c) CD8
(d) Th2
(e) CD2

22. A substance that enhances T cell activation by promoting the accumulation of antigen-presenting cells at a site of antigen exposure is called

(a) Adjuvant
(b) Stimulant
(c) Hapten
(d) Carrier
(e) Monoclonal antibody

23. The collection of different antibody specificity expressed in an individual is termed as

(a) Antibody feedback
(b) Antibody repertoire
(c) Immune profile
(d) Antibody-dependent cell-mediated cytotoxicity
(e) Antibody-cellular immune repertoire

24. Typical antibody – secreting cells are

(a) Immature B cells
(b) Mature B cells
(c) Plasma cells
(d) B and T lymphocyte cells
(e) Natural killer cells

25. Immature B cell phase development is associated with

(a) Expression of all isotypes on surface
(b) Surface expression of IgM
(c) Cytoplasmic fc-chain expression
(d) Surface expression of IgD and IgG
(e) Secretion of IgM antibody

26. Delayed type hypersensitivity reaction (DTH) is NOT associated with

(a) CD 45 RA T cells
(b) CD 45 RO T cells
(c) Granulomas
(d) Macrophages CTL
(e) Production of Th1 cytokines

27. Cell surface receptors on phagocytes that act as pattern recognition receptors in innate immune response to lipopolysaccharides and other microbial products are called

(a) T - cell receptors
(b) B – cell receptors
(c) Intergrins
(d) Toll-like receptors
(e) Surrogate T cell receptors

28. Macrophages are activated by CTL through production of

(a) Cytolysins
(b) Lyphotoxins
(c) Gamma-interferon (?-IFN)
(d) Reactive oxygen intermediates
(e) Lysozymes

29. The following are cytotoxic products of activated Natural Killer cells except

(a) Perforins
(b) Serine proteases
(c) Nucleases
(d) FAS Ligand (CD 95)
(e) C-reactive protein

30. Advances in the field of vaccinology, has lead to the eradication of the following disease in the world

(a) Polio virus infection
(b) Hepatitis virus B infection
(c) Tuberculosis
(d) Smallpox
(e) Dengue

31. Naïve (virgin) mature B cells express membrane surface immunoglobulin (SmIg) consisting

(a) IgD and IgA
(b) IgA and IgG
(c) IgM and IgE
(d) IgA and IgE
(e) IgD and IgM

32. Antigen specific T cell activation does NOT involve the following molecule

(a) MHC
(b) TCR
(c) ?2-microglobulin
(d) CD 4
(e) CD 8

33. IgD molecule

(a) Initiates a primary response
(b) Monomer is about 150 kDa in Mw
(c) Ig displays a very short hinge region
(d) Constitute about 90% of circulating Igs
(e) Secreted form is not extremely labile

34. IgE molecule

(a) Is not a monomer of Mw 188kDa
(b) Secreted from shows higest concentration of all Igs
(c) Has a 5th chain in variable region
(d) Production is strongly regulated by T cells
(e) Produced abundantly in primary responses

35. Major charactertistic features of Ig G do NOT include

(a) Produced minaly in lymph nodes and spleen
(b) Constitutes 70 – 75% of total Igs produced
(c) Antibody of both primary and secondary immunity
(d) Molecular weight range from 146-170 (about 150) kDa
(e) Displays selective transfer to infant across maternal placenta

36. Digestion of IgG by pepsin yields

(a) F(ab)2 and one Fc – fragment
(b) 2Fab and one Fc-fragment
(c) 2Fab and two Fc-fragment
(d) F(ab)2 and two Fc-fragment
(e) 2Fab and two Fc-fragment

37. Genetic variants in the variable and constant regions of Igs are

(a) Allotypes
(b) Isotypes
(c) Idiotypes
(d) Mutations
(e) Genotypes

38. Plasma cells

(a) Express IgM and IgD
(b) Express IgM only
(c) Express Ig D only
(d) Express ? chain in cytoplasm
(e) Secrete ? chain

39. Ig class switching is facilitated by

(a) ?-IFN
(b) IL-6
(c) CD 28
(d) IL-12
(e) IL-4 cytokine

40. The most potent opsonins are

(a) C2a and C4a
(b) C3a and C1a
(c) C4b and C5b
(d) C5a and C3a
(e) C3b and C4b

41. Member of immunoglobulin superfamily molecules EXCLUDE

(a) BCR and TCR
(b) CD3 thymocytes
(c) ?-2 microglobulin
(d) MHC molecules (I + II)
(e) CD2 and C-reactive protein

42. The following are NOT characteristic features of natural killer (NK) cells

(a) Provide defence against intracellular pathogens
(b) Express CD 16, CD 56 and C 94 cell markers
(c) Are large granular lymphocytes
(d) Killing mechanism of pathogens is MHC-dependent
(e) Kill viral and tumour cells by apoptosis

43. Terminal sequence complement proteins are

(a) C1, inhibitor, Factor H and S-protein
(b) Factor B, D and properdin
(c) C6 7, 8 and 9
(d) C1q, Cir and CIs
(e) C2, C3 and C4

44. Major opsonin derived from complement proteins include

(a) C5b-9(MAC)
(b) C5a, C3 and C4b
(c) C1q C3b and C4b
(d) C3 convertase and C3bBbP
(e) C3b, C6 and C5b

45. Components of alternative complement pathway include

(a) C1, C4 and C2
(b) Factor D, B and properdin
(c) C3, C4, and C5
(d) C1q, C3b, C4b
(e) Properdin, C11 and factor B(Bf)

46. Activators of alternative pathway proteins EXCLUDE

(a) Gram negative bacteria
(b) Heterologous red cells
(c) Ig A aggregates
(d) IgG aggregates
(e) Cobra venom factor

47. In the activation of complement system

(a) C5a, C3a and C2b are not chemotactic factors
(b) C3b and C4b bind into cell surfaces
(c) C4a and C1q diffuse into fluid phase
(d) C3 convertase cleaves C3 in absence of Mg++
(e) C5b, C3B, 7 and 8 polymerize to generate membrane attack complex

48. The following statements are true of complement proteins EXCEPT

(a) C2 and C4 synthesized by macrophages
(b) Are glycoproteins of plasma and cell membranes
(c) Function in conjunction with antibodies
(d) Confer body defence
(e) Do not regulate the immune system

49. Major macrophage associated functions do NOT include

(a) Antigen processing and presentation
(b) Phagocytosis
(c) Ig secretion
(d) Oxidative respiratory burst
(e) Microbicidal activity

50. Cytotoxic T cells (CTL)

(a) Do not trigger granzymes to destroy viruses
(b) Mediate class I MHC restricted killing of intracellular pathogens
(c) Do not regulate immune responses by producing IL-1
(d) Co-operate with CD3 T cells through production of IL-2 and IFN-?
(e) Mediate protection against extracellular pathogens

51. Class II MHC molecules are NOT expressed by

(a) Monocyte-macrophae lineage cells
(b) Dendritic cells
(c) Langerhans cells
(d) All nucleated cell
(e) Activated T cells

52. TCR is normally co-expressed with the following molecules

(a) CD3
(b) CD4
(c) CD8
(d) DC2
(e) CD7

53. Intrathymic death of thymocytes in thymus is mediated through

(a) Positive T cell selection
(b) T cell cytotoxicity
(c) Apoptosis
(d) Programmed cell survival
(e) Necrosis

54. The basic molecular formula of human immunoglobulin is

(a) ?2 K2
(b) ?2 L2
(c) H2 L2
(d) H4 L4
(e) H4 L2

55. T cell interaction with antigen presenting cells (APC) involve the following adhesion molecules EXCEPT

(a) CD2…………..LFA – 3
(b) LFA-1………..1 CAM-1
(c) CD1………….1 CAM-1
(d) CD45R………CD22
(e) CD28………..CD80/86

56. T cell activation occurs in secondary lymphoid organs as follows

(a) Spleen fro pathogens in peripheral tissues
(b) Peyer’s patches for pathogens in mucosal associated lymphoid tissue (MALT)
(c) Tonsils for pathogens in blood
(d) Draining lymph nodes for pathogens in blood
(e) Peyer’s patches for pathogens in central nervous system (CNS)

57. Signals involved in T cell activation do NOT include

(a) MHC – TCR/CD3 –peptides – CD/CD8
(b) CD40L – CD 40
(c) CD 80/86 – CD28
(d) Interleukin – 1(IL-1)
(e) MHC – TCR/CD3 – CD4/CD8

58. Biochemical events in T cell activation do NOT include

(a) Intracellular Ca++ increase
(b) Activation of phosphatase
(c) IL – 2 gene transcription
(d) IL-2R(Tac) synthesis and IL-2 production
(e) Decrease of intracellular Ca++

59. The following are NOT true of cytotoxic T cells (CTL)

(a) Do not trigger granzymes to destroy viruses
(b) Mediated class I MHC restricted killing of intracellular pathogens
(c) Regulate immune response by producing IFN-?
(d) Co-operate with CD4+ T cells through production of IL-1 and IFN-?
(e) Mediate protection against tumours

60. Major macrophage associated functions do NOT include

(a) Antigen processing and presentation
(b) Phagocytosis
(c) Ig secretion
(d) Oxidative respiratory tract
(e) Microbicidal activity

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

INSTRUCTIONS

(I) THERE ARE EIGHT (8 QUESTIONS IN THIS SECTION

(II) ANSWER ALL THE EIGHT (8) QUESTIONS

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

SAQ 1. (a) Describe five (5) landmarks of Immunology to medicine.
(10 minutes)
(b) Outline five (5) characteristic features of innate immunity.
(5 minutes)

SAQ 2. With aid of annotated diagrams:

(a) Describe a schematic map of Ig locus on chromosome 14
(10 minutes)
(b) Describe the structure of class II MHC molecule.
(5 minutes)

SAQ 3. With aid of annotated diagram describe the kinetics of primary and secondary immune responses.
(10 minutes)

SAQ 4. Describe secretory A:

(a) Structure of secretory IgA (sIgA) molecule
(5 minutes)
(b) Functions of sIgA
(5 minutes)
(c) Structure of IgG molecule
(5 minutes)

SAQ 5. (a) Explain two (2) pathways of complement activation.
(10 minutes)
(b) Outline five (5) functions of complement system.
(5 minutes)

SAQ 6. (a) With aid of annotated diagram describe the structure of T cell
antigenic receptor (TCR).
(5 minutes)

(b) Explain five cytotoxicity effector mechanisms.
(10 minutes)

SAQ 7. (a) Describe the cell source and biological activities of five (5)
cytokines.
(10 minutes)
(b) Outline five (5) characteristic features of cytokines.
(5 minutes)

SAQ 8. Describe and explain five (5) immunoregulatory mechanisms.
(10 minutes)

Imm 100 Immunology Question Paper

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