Department of Clinical Pathology Date: 7-11-2021

Master degree Number of pages 20

Immunology Exam. Degrees: 125 degree
First Part

Answer the following questions

The following five questions relate to immunoglobulins, IgG, M, A,

and E.

1.Choose the correct answer from the list : (5 mark each)

A. IgG
B. IgA
C. IgM
D. IgE
E. IgD

1. Immunoglobulin that is initially seen on the primary immune response, It is

present as a monomer on B cell surfaces but as a pentamer in serum. ( C)

2. Immunoglobulin mediates immediate htpersensitivity and is involved in immune

response to parasitic infection. (D)

3. immunoglobulin is the primary antibody in saliva, tears, an intestinal and genital

secretions (B)

4.Immunoglobulin is the predominant antibody in secondary immune response, it is

four subclasses. ( A)
5. immunoglobulin has no known function, but is present on the surface of B
lymphocytes? It may function as an antigen receptor. (E)

2.Give a short answer: (5 mark each)

A. Type I hypersensitivity reactions.

B. Monoclonal antibodies and their uses. .
C. Pathways of complement activation.
1
 D. Similartities and differences between MHC I and MHC II.
E. Mechanism of graft rejection.

3.Choose the best answer: (1mark each)

1.Immunity may be natural or acquired. Which of the following best describes

acquired immunity?
a. Increase in C-reactive protein (CRP)
b. Presence of natural killer (NK) cells
c. Complement cascade
d. Inflammatory response

2.The major role of T cells in the immune response includes which one

of the following?

a. Recognition of epitopes presented with major histocompatibility complex

molecules

on all surfaces

b. Complement fixation

c. Phagocytosis

d. Production of antibodies

3.Antistreptolysin titer of 400 international units (IU) indicates which one of the
following diseases?

a. Chronic infectious mononucleosis

b. Primary syphilis

c. Scarlet fever

d. Primary atypical pneumonia

4.First line of body defence is

2
a. Antibody molecules

b. Unbroken skin

c. Antigen molecules

d. Phagocytic cells

5.Antibodies in our body are produced by

a. B-lymphocytes

b. T-lymphocytes

c. Monocytes

d. RBC’

6.The reaction of soluble antigen with antibody is known by

a. Precipitation

b. Flocculation

c. Agglutination

d. Complement fixation

7.Antigenic variation is most extensive in

a. Influenza virus

b. Small pox virus

c. Measles virus

d. Herpes virus

8.Out of the following which are the examples of autoimmune disease?

a. Acquired Haemolytic anaemia

b. Rheumatoid arthritis

3
c. Hashiomoto disease

d. All of these.

9.Cell mediated immunity can be identified by

a. Sheep bred blood corpuscles roasette

formation

b. Microphase inhibiting factor

c. Skin test for delayed hyper sensitivity

d. All of these

10.In blood transfusion it is essential that

a. Blood of hologous group should always be same

b. Direct matching between patient’s serum and

donor’s corpuscles be performed

c. Both a & b

d. None of these

11.The immunity acquired by inoculation of living organism of attenuated virulence

is

a. Artificial active immunity

b. Passive immunity

c. Natural active immunity

d. Local immunity

12.DPT is given for the prevention of

a. Diphtheria, Tetanus

4
b. Diphtheria, Pertusis

c. Diphtheria, Tetanus & pertusis

d. None of these

13.If more than one kind of immunizing agent is included in the vaccine, it is

a. Cellular vaccine

b. Recombinant vaccine

c. Mixed vaccine

d. Toxoid vaccine

14.Mountax reaction is used for detection of

a. T.B

. b. Diphtheria

c. Cholera

d. None of these

15.Example for cell-mediated immunity are

a. Tuberculin type

b. Contact dermatitis

c. Granulomatous

d. All of these

16.Innate immunity is

a. Specific

b. Non-specific

c. Active

d. Passive

5
17.Serological reactions are useful for

a. Detection of antigens

b. Detection of antibodies

c. Both a and b

d. None of these

18.Antibody present in colostrums is

a. IgG

b. IgA

c. IgM

d. IgE

19.Basophils have receptors for antibodies

a. IgG

b. IgA

c. IgM

d.IgE

20.Immunity is life long following

a. Diphtheria

b. Tetanus

c. Measles

d. Yellow fever

21.The primary cells involved in immune response are

a. NK-cells

6
b. K-cells

c. Lymphocytes

d. None of these

22.Antibody formation depends on

a. Age of the person

b. Amount of antigen

c. Well being of the person

d. All of the above

23.To be antigen, the chemical molecule (protein) needs

a. High molecular weight

b. Chemical complexity

c. Both a and b

d. None of these

24.Delayed type of hypersensitivity is seen

in

a. Penicillin allergy

b. Contact dermatitis

c. Arthus reaction

d. Anaphylaxis

25.Intensity of attraction between antigen and antibody molecule is known as

a. Affiniy

b. Avidity

c. Reaction

7
d. None of these

26.Hybridoma technique is used for

a. Monoclonal antibodies

b. Polyclonal antibodies

c. Both a and b

d. None of these

27.Which of the following can provide naturally acquired passive immunity for

the new born.

a. IgA

b. IgG

c. IgE

d. IgM

28.Antitoxin is used for _____ immunization.

a. Active

b. Passive

c. Both a and b

d. None of these

29.The agglutinin test is used for _______

a. Identification of isolated bacteria

b. Typing of bacterial species

c. Study of antigenic structure of bacteria

d. All of these

8
30.To be anaphylactic, the sensitizing substance should be

a. Protein in nature

b. Should have a large molecular weight

c. Soluble in tissue fluids

d. All of the above

31.The major role of T cells in the immune response includes which one of the
following?

a. Recognition of epitopes presented with major histocompatibility complex

molecules

on all surfaces

b. Complement fixation

c. Phagocytosis

d. Production of antibodies

32.Survival of allografts is increased by choosing donors with few major

histocompatibility complex (MHC) mismatches with recipients and by use

of immunosuppression in recipients. Which one of the following procedures

might be a useful measure of immunosuppression?

a. Administration of corticosteroids to recipient

b. Lymphoid irradiation of donor

c. Administration of immunoglobulin to recipient

d. Destruction of donor B cells

33.An autograft is best described as a

a. Transplant from one region of a person to another

9
b. Transplant from one person to a genetically identical person

c. Transplant from one species to the same species

d. Transplant from one species to another species

34. leukocyte responsible for cellular ( Cell mediated) immunity:

a. T lymphocyte

b. B lymphocyte

c. monocyte

d. basophile

35.leukocyte responsible for parasitic infection and allergic reaction:

a. lymphocyte

b. monocyte

c. neutrophil

d. eosinophil

36.Unidirectional movement of WBCs directly

to its target:

a. sliding

b. phagocytes

c. chemotaxis

d. None of the above

37. Immune response to infection cause all except

a. rheumatic fever

b. TSS (toxic shock syndrome)

c. Glomerulonephritis

10
d.None of the above

38.The label in ELISA tests is?

a. enzyme

b. radioactive substance

c. antibody

d. antigen

39.A 34-year-old male patient visits a physician with complaints of

fatigue, weight loss, night sweats, and “swollen glands.” The physician also

observes that he has an oral yeast infection. Which of the following tests

would most likely reveal the cause of his problems?

a. A test for CD8 lymphocytes

b. A human T-lymphotropic virus type I (HTLV-I) test

c. An HIV ELISA test

d. A test for infectious mononucleosis

40.Vaccination operates to generate a humoral immune response to the

immunogen(s). Which one of the following represents the critical function of the
resultant humoral response in protecting vaccinated patients from future infections
by targeted pathogenic agents?

a. Opsonization

b. Extravasation

c. Neutralization

d. Complement activation

11
41.Which one of the following represents the major role of negative selection in the
thymus?

a. Elimination of self-reactive T cells

b. Expansion of nonself-reactive T cells

c. Maturation of professional antigen presenting cells such as dendritic cells

d. Expression of T-cell receptors on mature T cells

42.Antigens from which one of the following microbes would be presented on MHC
class I molecules by macrophages?

a. Ascaris lumbricoides

b. Candida albicans

c. Influenza virus

d. Streptococcus pneumoniae

43.A 36-year-old woman with severe allergy to yellow jackets was stung multiple
times at a soccer game. Within minutes she developed respiratory distress and
became unconscious. Which mediator is primarily responsible for this reaction?

a. Complement

b. IgG

c. Histamine

d. TNF

44.Vaccination is based on the principle of

a. Agglutination

b. Phagocytosis

12
c. Immunological memory

d. Clonal detection

45.Prozone phenomenon is due to:

a. Excess antigen

b. Excess antibody

c. Hyperimmune reaction

d. Disproportionate antigen – antibody levels

46. Cell type which lacks HLA antigen is: (AIIMS May 2005)

a. Monocyte

b. Thrombocyte

c. Neutrophil

d. Red blood cell

47.The role played by MHC 1 and 2 is to:

a. Stimulate interleukin production

b. Immunoglobulin class switch over

c. Transduce the signal to T cell following antigen binding

d. Presenting the antigen for recognition byT cell antigen binding receptors

48.T helper cell recognizes:

a. MHC class I

b. MHC class II

c. Processed peptides

d. Surface Ig

13
49.Graves disease is an example of which type immunologic response:

a. Type I

b. Type II

c. Type III

d. Type IV

50.A 45-year-old female presents with anorexia and some abdominal pain. Fecal
smears reveal the presence of Taenia eggs, products of a parasitic tapeworm
infection. Which one of the following cells would be most effective in defence against
this parasite?

a.Platelets

b.Neutrophils

c. Eosinophils

d. Monocytes

51.A 45-year-old woman presents to her primary care physician with complaints of
fatigue, malaise, and pain and stiffness in the shoulders, hands, and knees for the
past 6 weeks. Joint stiffness was particularly pronounced in the morning and
improved within an hour. Physical exam reveals tenderness and warmth of affected
joints with no deformations. Laboratory tests reveal a normocytic and normochromic
anemia, and analysis of synovial fluid from the knee revealed a white blood cell
count of 10,000 with a predominance of neutrophils. Which test would be most
useful in establishing a diagnosis of her condition?

a. Coombs test

b. Erythrocyte sedimentation rate

c. Radiographs

d. Rheumatoid factor test

14
52. A 14-year-old male child with extensive third-degree burns from a house fi re
receives a skin graft. Skin grafted from which donor has the lowest risk of

immunologic rejection?

a. The patient

b. The patient’s father

c. The patient’s fraternal twin sister

d. The patient’s mother

53. True about passive immunity

a. Cannot be given with active immunity

b. Last for 4-5 days only

c. Can be transferred by antibodies from another Host

d.Takes longer time to develop

54.Action of papain on an IgG molecule produces

a. 2 Fc fragments and 1 Fab fragment

b. 1 Fc fragment and 2 fab fragments

c. 2 Fc fragments and 2 fab fragments

d. 1 Fc fragment and 1 fab fragment

55. Activator of classical pathway of complement?

a. IgA

b. IgG

c. IgM

d. IgE

15
56.True about an immunoglobulin

a. IgG has max conc. in serum

b. IgM has max conc. in serum

c. IgA has max conc. in serum

d. IgE has max conc. in serum

57.Which of the following best denotes classical complement pathway activation in

immuno inflammatory condition

a. C2, C4, C3 decreased

b. C2 and C4 normal, C3 is decreased

c. C3 normal and C2 C4 decreased

d. C2, C4, C3 all are elevated

58.Prozone phenomenon is a feature is

a. Tularemia

b. Legionnaire’s disease

c. Plague

d. Brucellosis

59.The following features are common to T and B-lymphocytes except

a. Site of origin

b. Site of differentiation

c. Stimulated by Cytokines

d. Memory

60. Interferon gamma secreted by

16
a. Activated T-cell

b. CD 8 cells

c. RBC

d. Neutrophils

61.Allergic rhinitis is an example of

a. Type I hypersensitivity reaction

b. Type II hypersensitivity reaction

c. Type III hypersensitivity reaction

d. Type IV hypersensitivity reaction

62.Which complement component is found in both the classic and alternative

pathways?

a. C1

b. C4

c. Factor D

d. C3

63. Which T cell expresses the CD8 marker and acts specifically to kill tumors or
virally infected cells?

a. Helper T

b. T suppressor

c. T cytotoxic

d. T inducer/suppressor

64.What is the name of the process by which phagocytic cells are attracted to a
substance such as a bacterial peptide?

a. Diapedesis

17
b. Degranulation

c. Chemotaxis

d. Phagotaxis

65.Which region of the immunoglobulin molecule can bind antigen?

a. Fab

b. Fc

c. CL

d. CH

66.What molecule on the surface of most T cells recognizes antigen?

a. IgT, a four-chain molecule that includes the tau heavy chain

b. MHC protein, a two-chain molecule encoded by the HLA region

c. CD3, consisting of six different chains

d. TcR, consisting of two chains, alpha and beta

67.What outcome results from improper washing of a tube or well after adding the
enzyme–antibody conjugate in an ELISA system?

a. Result will be falsely decreased

b. Result will be falsely increased

c. Result will be unaffected

d. Result is impossible to determine

68. 12-year old girl has symptoms of fatigue and a localized lymphadenopathy.
Laboratory tests reveal a peripheral blood lymphocytosis, a positive RPR, and a
positive spot test for IM. What test should be performed next?

a. HIV test by ELISA

18
b. VDRL

c. Epstein–Barr virus (EBV) specific antigen test

d. Treponema pallidum particle agglutination(TP-PA) test

69.Which tests are considered screening tests for HIV?

a. ELISA, 4th generation, and rapid antibody tests

b. Immunofluorescence, Western blot, radioimmuno-precipitation assay

c. Culture, antigen capture assay, DNA amplification

d. Reverse transcriptase and messenger RNA (mRNA) assay

70.Which is the first antibody detected in serum after infection with hepatitis B virus
(HBV)?

a. Anti-HBs

b. Anti-HBc IgM

c. Anti-HBe

d. All are detectable at the same time

71.What is the most likely explanation when a patient has clinical signs of viral
hepatitis but tests negative for hepatitis A IgM, hepatitis B surface antigen, and
hepatitis C Ab?

a. Tests were performed improperly

b. The patient does not have hepatitis

c. The patient may be in the “core window”

d. Clinical evaluation was performed improperly

72.What is the endpoint for the antistreptolysin O (ASO) latex agglutination assay?

19
a. Highest serum dilution that shows no agglutination

b. Highest serum dilution that shows agglutination

c. Lowest serum dilution that shows agglutination

d. Lowest serum dilution that shows no agglutination

73.Which of the following positive antibody tests may be an indication of recent

vaccination or early primary infection for rubella in a patient with no clinical
symptoms?

a. Only IgG antibodies positive

b. Only IgM antibodies positive

c. Both IgG and IgM antibodies positive

d. Fourfold rise in titer for IgG antibodie

74.What is a general definition for autoimmunity?

a. Increase of tolerance to self-antigens

b. Loss of tolerance to self-antigens

c. Increase in clonal deletion of mutant cells

d. Manifestation of immunosuppression

75.Which of the following symptoms in a young child may indicate an

immunodeficiency syndrome?

a. Anaphylactic reactions

b. Severe rashes and myalgia

c. Recurrent bacterial, fungal, and viral infections

d. Weight loss, rapid heartbeat, breathlessness

20