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## the answers are at the last page## 1) Deficiency complement component c5-c8 lead to a) Neisseria infection

2) Tumor correct except a) tyrosinase melanoma b) CEA & GI cancer c) Viral EBV Lymphoma d) BCR-Abl fusion protein multiple myeloma e) Alpha- feto protein hepatoma

3) all participate in PTK cascade, except a) Terminal TdT b) Ca+2

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c) Phospholipase C gamma d) DAG e) Protein kinase C1

4) diagnostic of IgA pepsin , except a) (VH, CH1) X 2 b) (VH, CH1, VL, CL) X 2 c) (VH, CH1, CH2, CH3) X 2 d) (VL, CL) X 2

5) mostly affected by INF type I (INF alpha and beta) a) Aspergellus b) Plasmodium c) Listeria bacteria d) Staphylococcus bacteria e) Influenza virus 6) immune system evasion except a) direct killing immuno competent cell b) MHC I inhibition c) Point mutation d) HLA-G Product e) Viral product inhibitory cytokines 7) The enzyme needed in liberation of HIV from infected cell a) Gp120
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b) Protease c) Reverse transcriptase d) Integrase e) Collagenase 8) Blood group receptor for plasmodium vivax protozoa a) P system b) Lewis-secretor c) MNS system d) Kidd e) Duffy Fya- Fyb 9) Active immunity cancer except a) Vaccination by tumor antigen b) BCG local injections c) Anti-CD20 infusion d) Vaccination by whole cell e) IL-2 infusion 10)ABOUT serum sickness what is wrong: a) C-factor b) Monovalent antigen c) Persistence immune complex d) Nutrophils e) Equivalence of antigen and antibody 11) viruses and malignancy except a) Human papilloma virus- cervical cancer b) EBV lymphoma c) Human herpes virus 8 and lymphoma d) HTLV-1 acute T lymph-leukemia
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e) EBV nasopharyngeal

12) factor other than CD4 T cell count vest to give prognosis of HIV infected patient a) CD8 T cell b) Anti HIV IgM level c) IgG level d) PPD skin test e) Viral protein count 13) Successful active immunotherapy by general immune system active locally except a) IL-2 in cancer b) Lymphokine activated killer cell for hypernephroma c) Cancer vaccine for lung cancer d) BCG for urinary bladder cancer e) Anti CD20 for B cell lymphoma 14) best bronchial asthma allergic rhinitis as allergic a) food allergy b) atopic dermatitis c) drug allergy d) urticaria e) Conjunctivitis???

15) Injecting Complement C killing antigen-Ab in patient lacks C3 a) Depress level of serum factor B
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b) Increased chemotactic C5a serum level c) Increased serum level of C8 d) Decreased level of C2

16) How does entamoeba evades the immune system a) By shedding 17) Trophoblast . Immunological phenomenon except a) antibody against paternal antigens b) Increased HLA- G antigens c) Decreased MHC I d) Blocking antibody e) Increased CD8- T recognition 18) Toll-like a) Recognizes gram bacteria cell 19) Anaphylacoid non IgE mediated a) Bee sting allergy b) Penicillin allergy c) Radio contrast allergy d) Food allergy e) House dust mite allergy 20) Regarding pregnancy, which is wrong? a) Androgen suppress T/B cells b) Estrogen suppress T cells c) Placenta TH1 suppress T cell d) NK cell suppressed by increased HLA-G

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21) A 10 years old boy has recurrent skin and lung infections by staphylococcus aureus, what can be found at his diagnosis a) Low IgM, absence of B cell b) Low Ig low B cell c) Low terminal complement d) Abnormal NBT test 22) Which type of Ab is involved in SLE with recurrent mid trimester abortion and DVT and abnormal PTT test a) Anti Sm antibodies b) Anti Ds DNA antibodies c) Anti nuclear Ab d) Anti phospholipid Ab 23) Recognition receptor functions as secreted receptor a) Mannan binding lectin b) CD 14 c) Toll like receptor 24) Pulmonary edema that follows incompatible transfusion results in a) Donor WBC antibodies against recipient granulocytes 25) The BM transplantation is the most difficult .. a) Hyperacute b) Acute rejections c) GVHD d) Tolerance 26) Tumor, except a) Dysregulation of metabolism
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b) Dysregulation of respiration 27) Remission state in pregnancy happens in, except a) SLE b) Type I diabetes c) Contact dermatitis d) Arteritis 28) Causes tolerance rather the immunity a) Insoluble antigen b) Heterologous antigen c) Particulate antigen d) Antigen injected subcutaneously e) Injecting antigen to fetus in development 29) Autoimmune disease a) Shows HLA association b) Run a steady clinical course c) Affect both sexes equally d) are triggered by different antigen in different individuals 30) Candidate Immuno suppression by malnutrition of a) Thyroxin b) Insulin c) Leptin d) Glucagon 31) Regarding Parasitic infection, which one is false a) Complement is usually effective?? 32) Antibodies against sperms results in a) Idiopathic infertility
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33) Pooled from normal human except a) Antivenom 34) Which one in the HIV genome is associated with Low Virulence? a) NEF gene b) POL gene c) GAG gene d) ENV gene 35) Involved in stopping lymphocyte in HEV a) L-selectin b) LFA-1 36) Complement activation a) Activate hapten b) Active C1q binds antigen-antibody complex c) C3 convertase C4bc2b d) C3 convertase C3bBb e) Regulate factor H .37) Which isotype is primarily responsible for the tissue damage associated with Type III Hypersentivity? a. IgA b. IgD c. IgE d. IgG e. IgM 38) A reaction to poison ivy is an example of which type of Hypersentivity ? a. Type I b. Type II
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c. Type III d. Type IV e. Type V

39) Hemolytic disease of the newborn (Rh incompatibility) dose not occur when: a. An Rh positive mother conceives an Rh positive child. b. An Rh negative mother conceives an Rh negative child. c. An Rh positive mother conceives an Rh negative child. d. All of the above. e. None of the above. 40) Contact dermatitis generally occurs against substances that are too small to induce an immune response. How do these substances induce an immune response? a. These substance form depots and are then slowly released into the blo od. b. These low molecular weight substances react with liver enzymes and a re difficult to eliminate. c. These substances bind to tissue and cells resulting in a larger total antigenic size which can then stimulate an immune response. d. The substance triggers the complement cascade and cause neutrophils to accumulate and the serve as antigen presenting cells. e. A and c. 41) Erythrocytes from a patient with hemolytic anemia show a positive indirect Coombs test. The patients plasma

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dose not produces observable direct agglutination of his own erythrocytes , at either body temperature or room temperature. Which of the following is most likely to be correct? a. Antierythrocyte antibodies are abundant in plasma but little antibody is bound to red cells. b. The antierythrocyte antibodies are IgG isotype. c. The patient is of blood type O. d. The antierythrocyte antibodies are incapable of complement activatio n of opsonization. 42)A 23yearold woman becomes dizzy and sweaty while dining at a seafood restaurant. She ultimately faints and is taken to the Emergency Room of a local hospital where epinephrine is administered. She responds quickly, which of the following best describes the immunological mechanisms underlying her illness? a. Crosslinking of IgE antibodies on mast cells/basophils by seafood antigen. b. Formation of soluble immune complexes in plasma and activation of complement. c. Binding of seafood antigen to erythrocytes where they induce hemolysi s by antibodies and complement. d. Release of inflammatory cytokines by seafoodantigenspecific T cell s in the intestinal mucosa. e. Ingestion of bacterial endotoxin along with her seafood.

43) A patient is diagnosed with Brutons Agammaglobulinemia. Which aspect of immune-system histology

would you except to be normal?

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A. Concentration of surface-Ig positive lymphocyte in peripheral blood. B. Primary follicles in lymph nodes. C. Germinal centers in lymph nodes. D. Number of plasma cells in bone marrow. E. Cellularity of paracortical areas of lymph nodes 44) A professional handler of poisonous snakes is bitten by a cobra and receives anti-venom equine antiserum. Four days later he develops malaise, fever, chills, muscle and joint pain, and proteinuria. Laboratory tests reveal decreased concentration of Complement components C3 and C4. Which of the following is the most likely cause of his illness? A. A delayed Hypersentivity reaction (Type IV) to equine serum proteins. B. An immediate-hypersensitivity reaction (Type I) to snake venom components. C. Formation of immune complexes which contain human antibodies and equine serum proteins. D. Formation of immune complexes which contain equine antibodies and snake venom proteins. E. Direct lysis of patients erythrocytes by equine antibodies. 45)In the previous question, which of the following is most likely to have predisposed the patient to this illness? A. A genetic defect in complement system. B. A genetic defect in antibody production. C. A prior immune response to snake-venom proteins. D. A prior episode of immunization with equine antiserum.

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46) Uninfected, normal, nucleated human cells are not attacked by Natur al Killer (NK) cells of the immune system. What feature of their plasma membrane protectes cells form NK attack? A. Absence of class I MHC. B. Presence of class I MHC which lack bound peptides. C. Presence of class I MHC/self peptide complexes. D. Absence of class II MHC. E. Presence of class II MHC which lacks bound peptides. F. Presence of classII MHC/self peptide complexes 47)Some human plasma cell malignancies produce antibodies which bind to antigens on human erythrocytes. In one such case erythrocytes coated with myeloma antibod y were lysed by complement and myeloma antibody also facilitated phagocytosis of erythrocytes by neutrophils. Of what isotype was this myeloma antibody? A. IgA B. IgG C. IgM D. IgD E. IgE 48) During the primary phase of HIV infection, manifestation include: a. Opportunistic infection. b. Lymphoadenopahty. c. Encephalopathy. d. Wasting syndrome

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49) The lag phase of the primary response is longer that n the secondary response because: a. The assays for detecting a primary response are not as sensitive. b. The primary response requires considerable cell proliferation and differentiation to achieve a critical mass of cells to produce immunity. c. Of the lack of cytokines produced during the primary response. d. A & d. e. None of the above. 50) Complement damage may be directed against host tissues, as well as pathogens because: a. Long half-lives of the activated complement components. b. Very low concentrations of the inactivated complement components in serum. c. The inability to activate the system in the presence of IgG antibodies. d. Once activated, the destructive activities of complement are nonspecific. e. None of the above 51) Many pathogenic bacteria are killed outright by contact with normal cell-free human serum, even if the donor had never previously been exposed to the particular bacterium used in th e experiment. In this situation, which component of serum is most likely to be responsible for killing bacteria? a. Complement. b. IgG antibodies. c. IgA antibodies. d. Acute-phase proteins. e. Interleukin-2 and -interferon. f. Tumor necrosis factor. g. Chemokines
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52) Many isolates of the bacterium Neisseria meningitides can produce mucosal infections but cannot survive in the bloodstream. Cells of such bacteria are killed by contact with cell-free plasma or serum, even from persons who have never previously been exposed to Neisseria. Which mechanism is most likely to be responsible for the killing? a. Activation of complement by the alternate pathway. b. Activation of complement by the classical pathway. c. Binding of IgG. d. Binding of IgM. e. Binding of IgA.

53) One of the indicator of systemic inflammatory response is the presenc e of acute phase proteins, produced by the liver. A good example of these would be: a. IgM b. C-reactive protein c. Serum-albumin. d. IL-4 e. None-of the above 54) A child has a history of recurrent infections with organisms having polysaccharide antigens (i.e., Streptococcus pneumoniae & Hemophilus influenzae). This susceptibility can be explained by a deficiency of: a. C3
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b. C5 c. IgG subclass 2 d. Myeloperoxidase in phagocytic cells e. Secretory IgA 55) A 28-year-old mother gives birth to her first child. The father is homozygous Rh D positive & the mother is homozygous Rh D negative. The baby is born without any complications, but the mother is not given RhoGAM (anti-Rh IgG) following the delivery. Eighteen months later she delivers another child, who is anemic, slightly jaundiced, & has an enlarged spleen & liver. Which type of hypersensitivit y best describes this condition? a. Atopic disease b. Cytotoxic disease c. Delayed hypersensitivity d. Immediate hypersensitivity e. Immune complex disease 56) Five minutes after the initiation of an allergic skin reaction, you would expect to see which of the following at that site? 1. Complement fixation. 2. Plasma cells secreting IgE 3. Accumulation of eosinophils 4. Vasodilation 5. None-of the above 57) Your patient is a pregnant woman in the middle of her third trimester, & you have determined that her fetus

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shows serious consequence of Rh incompatibility. Which of the following treatments would be most beneficial? a. Parenatal transfusion of Rh+ RBCs b. Postnatal transfusion of RH+ RBCs c. Parental transfusion of Rh- RBCs d. Immediate administration of RhoGam e. None of the above is likely to be helpful. . 58) CD4 T cell depletion is the hallmark of HIV disease, it occurs as a resu lt of: a. CD4 cell apoptosis. b. Destruction of HIV infected CD4 T cells by HIV specific cytotoxic lymphocytes. c. Lysis of HIV infected CD4 T cell, as a direct result of intracellular HIV replication. d. The destruction of CD4+ T cell precursors. e. All of the above. 59) HIV causes: a. Hypogammaglobulinemia b. Thymic inflammation, involution & fibrosis c. B cell depletion d. Loss of memory B cells. e. All of the above 60) Progressive tumor growth in cancer patients may be enhanced by: a. The presence of tumor specific serum "blocking" antibodies & antigen: antibody immune complexes. b. The infiltration of the tumor with activated natural killer cells.
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c. The activation of tumor-associated Th2 lymphocyte that produce IL-10 d. The activation of tumor-associated Th1 lymphocyte that produce IL-2 & IFN e. All of the above. f. A + C 61) Antibody dependent cellular cytotoxicity (ADCC): a. Is mediated by B-lymphocyte b. Is mediated by T-lymphocyte c. Is mediated by IgM antibodies & complement d. Is mediated by natural killer lymphocytes e. All or none of the above f. A + b 62) The initiation of a graft versus Host (GVH) disase: a. Requires a lack of responsiveness on the part of the recipient to the histocompatibilty antigens of the donor. b. Requires a graft of immunocompetent donor cells. c. May result from the infusion of blood or blood products that contain viable lymphocytes into an immunologically incompetent or compromised recipient. d. Requires the activation of B-cells for pathology to be evident. e. All or none of the above. f. A + B + C 63)The rejection of an allograft can be slowed or prevented by: a. Careful matching of the MHC-class I histocompatibility antigens using antibodies to the cell surface molecules. b. By grafting to a privileged site. c. By treating the recipient with immunosuppressive drugs.
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d. By passive immunization of the recipient with antibodies against the MHC class II antigens of the donor e. All or none of the above. f. A + B but not C + D 64) In the generation of human cytolytic T-cells against allogeneic cellular tissue antigens (grafts), the vast majority of CD8+ cytotoxic T-cell receptors in the recipient recognize & bind: a. Endogenous cellular peptides presented by the major histocompatibilit y antigens of the allogeneic graft cells. b. The foreign HLA-D alloantigens of the cells of the graft. c. Antigen specific helper T-cell factors & cytokines of the recipient d. The foreign HLA-A, B & C molecules o the cells of the graft. e. All or none of the above 65)The graft versus host reaction is most easily induced: a. In immunocompetent adult animals b. With thymic epithelial cells. c. In immunodeficient recipients (adult or infant) d. With the help of an adjuvant e. When lymphocytes from a hybrid donor (a/b) are transfused into a parental recipient (a/a). 66) Rheumatoid arthritis is an example of: a. Type I hypersensitivity b. Type II hypersensitivity c. Type III hypersensitivity d. Type IV hypersensitivity e. Arthus reaction

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THANK YOU ** these Qs may include some information from chs. 33/34/35** ** we want to thank everyone who share us with his/her ideas & suggestions** GOOD LUCK 4 ALL DONE BY: FATIMAH T. ALADIM & WEJDAN Y ALQURAN>> . ATYAF FAMILY .

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A D A B E D B E

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C B C E D E D A

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E A C C D D A A

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C B A E A C A A

33 34 35 36 37 38 39 40

A A A B D D D C

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49

57

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D A A C B

58 59 60 61 62 63 64 F D F E D

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