Immunology Exam

Name: Score:

1. Choose the best answer and put the corresponding letter in the table below:
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

(11) (12) (13) (14) (15) (16) (17) (18) (19) (20)

(1) In adult humans, multiple hematopoietic stem cells are mainly found in
A. thymus B. bone marrow C. blood D. lymph nodes
(2) High endothelial venules are special because they
A. allow migration of leukocytes into inflamed tissue
B. serve as the site for antibody to enter the circulation
C. allow naive lymphocytes to enter lymph nodes in search of antigen
D. allow activated lymphocytes to re-enter the blood circulation
(3) Antibodies generally bind only a small part of a big molecule. What do we usually call the
small part of the molecule that is bound by a particular antibody?
A. target B. attachment site C. epitope D. adhesion determinant
(4) Which of the following macromolecules usually act as the best immunogens?
A. carbohydrates B. lipids C. proteins D. nucleic acids
(5) A 17-year-old boy suffered an injury to his left eye when, during a car crash, a sharp sliver of
glass penetrated his left eye, damaging his lens and uveal tract. The glass was removed and the
injury repaired with complete recovery. However, 3 weeks later he noticed some redness in the left
eye and photophobia, followed by pain and severe visual impairment. The left eye was removed
and histologic examination showed an extensively infiltrated uveal tract with abundant
lymphocytes. Two weeks later the other eye began to show the same symptoms. The most likely
scenario is that:
A. this is an example of immediate hypersensitivity.
B. sequestered antigen was released and initiated an immune response.
C. some of the glass must have penetrated the right eye as well.
D. the bacteria entered the damaged eye and is causing an infection in both eyes.
(6) In the picture below, which letter best identifies the Fc portion of the Ig molecule?

(7) The effector cells which carry out ADCC (“antibody-dependent cell-mediated
cytotoxicity”) must express membrane-bound:
A. Complement receptors
B. Fc receptors
C. T cell receptors
D. Antigen-specific Ig
(8) Complement proteins mainly exist in:
 A. blood serum B. liver C. spleen D. Macrophages
(9) CD4 is found on the surface of certain cells and it helps those cells bind to
A. MHC class I B. TCR C. bacteria D. MHC class II
(10) A patient walks into your clinic complaining of a chronic cough and general fatigue. Upon
examination you diagnose him to have small cell lung cancer. Since the patient has a very
aggressive form of cancer, that has been unresponsive to medication or radiation., you decide to
enroll him in a new clinical trial that is using gene therapy to treat lung cancer. The theory behind
the trial is to use gene therapy to express a protein on the cell surface that will stimulate T-cell
proliferation upon immune surveillance of the tumor cells. Which of the following would be the
most effective co-stimulatory protein to be expressed on the tumor cell in this clinical trial?
A.CD28 B.ICAM 2 C. CD80/CD86 D. CD40L
(11) Positive selection induces apoptosis in developing T cells with receptors that bind to
_______.
A. both MHC I and II B. neither MHC I nor II
C. self-antigen D. foreign antigen
(12) If a cell is infected with a virus and there is an effective immune response against the virus,
what is the likely outcome for the infected cell?
A. It will be cured of the infection by antibody
B. It will be cured of the infection by T cells
C. It will be killed by T cells
D. Nothing can be done to disrupt replication of the virus
(13) Assume a single B cell has100,000 immunoglobulin molecules (BCR) on it’s surface. How
many different antibody specificities (i.e., different binding sites) can be simultaneously expressed
on this B cell?
A. 100,000 B. 1 C. 2
D. less than 100,000 but no way to make a more reasonable guess
(14) A mother is blood type B,Rh+, her child is A,Rh–. The child’s blood at one year of
age is likely to contain substantial amounts of which of the following antibodies?
A. Anti-A B. Anti-B C. Anti-Rh D. Anti-B and Anti-Rh
(15) Allergists sometimes treat patients by injecting them with the very allergen they are sensitive
to. Why?
A. If the allergen is present in high enough titers, it may be mistaken for a self protein and
ignored.
B. The allergen may trigger the production of IgG, and thus prevent IgE-triggered responses.
C. An injection into muscle will divert the immune response from the upper respiratory tract.
D. This prevents the allergen from denaturing as it crosses an epithelial barrier.
(16) Symptoms associated with delayed type hypersensitivity reactions take days to develop
because these reactions require time for
A. B cell activation and antibody production
B. TH1 cell activation and macrophage recruitment
C. TH1 cell activation and neutrophil recruitment
D. TH2 cell activation and macrophage recruitment
(17) A 21-year-old femal presents with a three week history of symmetrical swelling of the small
joints of the hands and feet and morning stiffness of one and one-half hour duration. Tests indicate
IgM auto-antibodies that have a specificity for Fc portion of IgG. This patient most likely has:
A. Rheumatoid Arthritis B. Goodpasture’s Syndrome
C. Type 1 diabetes D. Graves’ Disease
(18) The immunity to infectious disease provided by the transfer of maternal IgA in breast milk to
newborns is an example of
A. an attenuated vaccine B. a recombinant vaccine
C. active immunization D. passive immunization
(19) Passive and active immunity are similar in that they BOTH ______.
A. result in the production of memory cells that recognize the pathogenic antigen
B. take about two weeks after treatment to become effective
C. involve recognition of a pathogenic antigen by antibodies
D. can result in a patient getting serum sickness
(20) A 3-week-old boy fell to the ground and got a laceration. His mother rushed him to the doctor.
Which of the following would be the preferred treatment?
A. A tetanus immune globulin(human) injection this visit, with an injection of tetanus toxiod
several weeks later.
B. A mixture of tetanus toxoid and tetanus immune globulin (human) as one injection.
C. A tetanus toxiod injection this visit , with an injection of tetanus immune globulin (human)
approximately one week later.
D. Separate injections of tetanus toxiod and tetanus imune globulin in different sitess on this one
visit.

2. Fill in the blanks with proper answers.

(1) The main target cells of HIV include ____________ , _____________ and_____________.
(2) Complement system can be activated by ________ pathway, ___________ pathway or
_________ pathway .
(3) The activation of B cells usually requires two signals. The first signal is provied by _____
when it binds to antigens. The second signal is provided by _____ cells.
(4) The activation of T cells usually requires two signals. The first signal is provied by _____
when it binds to peptide –MHC complex. The second signal is mainly provided by _____
when it binds with CD80/86.
(5) Lymphocytes include ________ cells ,_________ cells and _______ cells.
(6) There’re five classes of immunoglobulins. They are _____, ______, _____ ,_____
and_____.
(7) Professional APCs include ____________, ________________ and ____________ .
(8) Complete antigens have two important characteristics:___________ and __________ .
(9) Immune system is composed of ______________, ______________ and
_______________ .
(10) TNF can be devided into two types:_______ and ________. The former one is mainly
produced by ___________; the latter one is mainly produced by activated _____ cells.

3. Judge the sentences below. If the sentence is correct, put down “T” in the bracket before the
sentence; if the sentence is wrong, put down “F” in the bracket before the sentence.
( ) (1) lymph nodes are central lymphoid organs.
( ) (2) Both T cells and plasma cells can release antibodies.
( ) (3) IgE is the main antibody that mediates type I hypersensitivity.
( ) (4) The main function of membrane attack complex (MAC) is to lyse target cells.
( ) (5) Contact dermatitis is a kind of type III hypersensitivity disease.
( ) (6) Human MHC is localized on chromosome 6.
( ) (7) B cells mature in thymus.
( ) (8) Coating an antigen with antibodies or other compounds so that it can be easily recognized
and phagocytized by macrophages or neutrophils is called opsonization.
.( ) (9) Interferons are noted for their ability to inhibit viral infection/reproduction.
( ) (10) Antibody dependent cell-mediated cytotoxicity is due to the recruitment of effector
cells via antibody interactions with Fc receptors.

4. Mrs Chareston has the blood group O, Rhesus-negative, and her husband Mr Chareston is A,
Rhesus-positive. They have had four children, of which two have been affected by haemolytic
disease of the newborn, as follows:
first child born 1968 unaffected
second child born 1974 mildly affected
third child born 1978 seriously affected
fourth child born 1980 unaffected
In both affected cases (second and third), the cause of the haemolytic disease was identified as
antibodies to Rhesus-D binding to the child’s red cells.
(1) From this information, the blood group of the first child is deduced to be ________
(A/B/O/AB),__________(Rh positive/Rh negative).
(2) The fourth child is unaffected . The best answer is because the blood group of the fourth child
is___________.
When the blood groups of the children are examined it is found that they are:
first child O
second child B
third child A
fourth child A
(3) Which child was definited not fathered by Mr Chareston?_________________.
(4) As Mrs Chareston has antibodies to blood group A, Why was the fourth child not affected by
haemolytic disease of the newborn?
___________________________________________________________________________.