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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:2008
M O I U N I V E R S I T Y
SCHOOL OF MEDICINE
END OF YEAR EXAMINATION (EYE) 2007/2008
COURSE: IMMUNOLOGY
COURSE CODE: IMM 100
PROGRAMME: M.B.Ch.B. I . YEAR OF STUDY: 1(ONE)
DATE: 31ST OCTOBER, 2008 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 NAMELY: SECTION I CONSISTS OF THIRTY ONE (31) MULTIPLE CHOICE QUESTIONS (MCQS) TO BE ANSWERED IN THIRTY (30) MINUTES AND SECTION II: CONSISTS OF FOUR (4) SHORT ANSWER QUESTIONS (SAQS) TO BE ANSWERED IN SIXTY (60) MINUTES.
(IV) ATTEMPT ALL QUESTIONS.
SECTION I: MULTIPLE CHOICE QUESTIONS (MCQs) (30 MINUTES)
INSTRUCTIONS:
(I) THERE ARE THIRTY (30) QUESTIONS IN THIS SECTION.
(II) FOR THE MCQS, EACH QUESTION CONSISTS OF A STATEMENT/STEM WHOSE MOST CORRECT COMPLETION OR ANSWER IS PROVIDED FOR AMONG THE FIVE OPTIONS NUMBER A TO E.
(III) 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)
(IV) ATTEMPT ALL QUESTIONS IN SECTION.
1. Which of the following is NOT true?
a) TLR – 2 binds to peptidoglycan.
b) TLR – 3 binds to ds RNA of viruses.
c) TLR – 4 binds to gram-positive bacterial walls. *
d) TLR – 5 binds to flagellin of motile bacteria.
e) TLR – 8 binds to ass RNA of influenza virus.
2. Which of the following is NOT involved in the process of phagocytosis?
a) Release of acid hydrolases.
b) Phagosome – lysosome fusion.
c) Membrane evagination and engulfing.
d) Release of debris and pathogen products from the cell.
e) Inhibition of proteolytic enzymes. *
3. In secondary lymphoid organs, paracortex contains:
a) Germinar centres.
b) B cells and dendritic cells.
c) Plasma cells.
d) T cells and dendritic cells. *
e) B cells and T cells.
4. During haemopoetic cell differentiation:
a) Lymphoid progenitors produce basophils.
b) Megakaryocytes differentiate into monocytes.
c) Granulocytes are derived from lymphoid cells.
d) Myeloid progenitors give rise to granulocytes and platelets. *
e) Red blood cells and platelets are derived from lymphoid progenitors.
5. If a self-specific B-lymphocyte is still in the bone marrow and it forms high affinity bonds with an epitope on a soluble self molecule, the result of that interaction will be which of the following?
a) Expression of CTLA-4 surface molecules.
b) Apoptosis.
c) Anergy. *
d) A very large number of cell replications which drains the energy.
e) Expression of CD4+ surface makers.
6. In a complement fixation essay designed to measure the level of a viral antigen, the indicator cells will be sheep blood cells (SRBC) coated with:
a) Nothing.
b) Viral antigen.
c) Anti-viral antibody.
d) Anti-SRBC antibody.
e) Complement.
7. TCR is normally co-expressed with the following molecule.
a) CD1.
b) CD2.
c) CD3.
d) CD4.
e) CD5.
8. 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.
9. The following statements are true of complement proteins EXCEPT:
a) Are activated very potently by IgD.
b) C2 and C4 synthesized by macrophages.
c) Are glycoproteins of plasma and cell membranes.
d) Confer body defense.
e) Are involved in opsonization and antigen clearance.
10. Components of alternative pathway include:
a) C1, C4 and C2.
b) Factor B, D and porperdin.
c) C3, C4 and C5.
d) C1q, C3b and C4b.
e) Properdin, C1q and factor B.
11. Members of supergene family molecules EXCLUDE:
a) BCR and TCR.
b) CD3 thymocyte.
c) ?2 microglobulin.
d) MHC molecules I and II.
e) CD2 and C-reactive protein.
12. The following are true of structure of class I MHC molecules EXCEPT:
a) Transmembrane region hydrophilic.
b) Transmembrane region hydrophobic.
c) Cytoplasmic tail hydrophilic.
d) Beta (?)-2 microglobulin stabilizes the complex.
e) Consists of alpha chain with three (3) domains.
13. Class II MHC molecules are NOT expressed by:
a) Macrophage lineage cells.
b) Dendritic cells.
c) Langerhans cells.
d) All nucleated cell.
e) Activated T cells.
14. Major opsonins derived from complement proteins include:
a) C5b – 9.
b) C5a, C3 and C4b.
c) C1q, C3b and C4b.
d) C3 convertase and C3b BbP.
e) iC2b, C6 and C5b.
15. Epidermis of the skin is not equipped with the following cell types:
a) Kuppfers cells.
b) Langerhans cells.
c) Keratinocytes.
d) Epithelial cells.
e) Dendritic cells.
16. Eosinophils are not:
a) Induced to differentiate by IL-5,
b) Identical to basophils.
c) About 2 - 5% of PMNL.
d) Involved in killing of haemoflagellas and schistomes.
e) Associated with major basic proteins when activated.
17. Genetic factors that confer resistance against malaria EXCLUDE:
a) Sickle cell trait A/S.
b) Positive Duffy (a-b) blood groups.
c) G – 6 – PO4 dehydrogenase deficiency.
d) Negative Dufty (a-b) blood group.
e) Sickle cell susceptibility to reactive oxygen species.
18. T cell interaction with antigen presenting cells (APC) involve the following membrane molecules EXCEPT:
a) CD2 ---------- LFA 3.
b) LFA-1 -------- ICAM-1.
c) CD1 ---------- ICAM-1.
d) CD45R ------- CD22.
e) CD28 --------- CD80/86.
19. The following cluster of differentiation (CD) antigens define the cell subpopulation indicated:
a) CD2 for macrophages.
b) CD23 for normal B cells.
c) CD8 for pan T cells.
d) CD2 for thymocytes.
e) CD8 for cytotoxic T cells.
20. 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.
21. 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.
22. Which of the following does not describe cytokines?
a) Are produced by antigen – stimulated T cells.
b) Are only produced by antigen – stimulated B cells.
c) Are pleiotropic.
d) Are glycoproteins of low molecular weight.
e) Interact with specific receptors on surface of target cell.
23. The following cell membrane marker mediates E-rosetting of T cells:
a) CD1.
b) CD2.
c) CD3.
d) CD20.
e) CD21.
24. Laboratory determination of body fluid immunoglobulins is performed using the following technique:
a) Simple electrophoresis.
b) Haemagglutination.
c) Latex agglutination.
d) Double immunodiffusion.
e) Single radial immunodiffusion test.
25. Commensal bacateria 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.
26. 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.
27. 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.
28. 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 costimulatory molecules.
c) Cd40 – CD 154 coactivation molecules.
d) BCR – TCR/CD3-MHC-Peptide-CD4/CD8.
e) Antigen specific, coactivation and costimulatory molecules.
29. Detrimental consequences of complement activation is all the below EXCEPT:
a) Endotoxic shock.
b) Embolus of the lung.
c) Pernicious anemia.
d) Hypocomplementaemia.
e) Connective tissue damage.
30. Importance of HLA molecule is not associated with:
a) Skin transplantation.
b) Paternity identification.
c) Disease susceptibility.
d) In vitro fertilization.
e) Criminal apprehending.
31. Regulators of complement system are as follows EXCEPT:
a) Properdin stabilizes C3b BbP.
b) C1 – esterase inhibitor dissociates active C1r and C15 an active enzyme sites.
c) Factor I dissociates alternative C3 convertase.
d) Decay accelerating factor (DAF) dissociates C3 and C5.
e) S-protein inhibits C5, 6, 7 and 8 polymerization with C9.
SECTION II: SHORT ANSWER QUESTIONS (SAQs)
(60 Minutes)
INSTRUCTIONS
(I) THERE ARE FOUR (4) QUESTIONS IN THIS SECTION.
(II) ANSWER ALL THE FOUR (4) QUESTIONS.
(III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET.
SAQ 1. With the aid of annotated diagrams describe the structures of:
a) Structure of a T cell receptor (TCR).
(5 minutes)
b) Map of HLA region on chromosome 6.
(5 minutes)
c) Structure of class I molecule.
(5 minutes)
SAQ 2. Briefly describe five (5) of the following:
a) Functions of IgG molecule.
(5 minutes)
b) Functions of complement system.
(5 minutes)
c) Functions of T cells.
(5 minutes)
SAQ 3. With aid of annotated diagrams describe structures of:
a) Secretory IgA (sIgA) molecule.
(5 minutes)
b) Secondary lymphoid organ.
(5 minutes)
c) IgG molecule.
(5 minutes)
SAQ 4. Explain the following:
a) Morphological features of three (3) cells of immune system.
(5 minutes)
b) Activation of complement system by manna-binding lectin pathway.
(5 minutes)
c) Delayed type hypersensitivity reaction.
(5 minutes)
SAQ 5. Outline five (5) of the following:
a) Importance of immunology.
(5 minutes)
b) Factors that enhance immunogenicity of a substance.
5 minutes)
c) Cytokines and their biological activities.
(5 minutes)
SAQ 6. With aid of a diagram, describe and explain:
a) Burnet clonal selection theory.
(5 minutes)
b) Kinetics of primary and secondary immune responses.
(10 minutes)
SAQ 7. Describe and explain five (5) cell mediated cytotoxicity mechanisms.
(15 minute)
SAQ 8. Describe and explain five (5) immunoregulatory mechanisms.
(15 minutes)
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