***THE ANSWERS ARE IN THE LAST PAGE***

1) used by HIV for cell penetration beside CD4 a) CR2 b) Chemokine receptor c) Fc d) CD3

2) NADPH oxidase lack which of the macrophages bactericidal mechanism a) H2O2 b) Acidification c) Defensin d) Lactoferrin

3) M. tuberculosis is best eliminated by a) TNF alpha b) IL-4 c) IL-5 d) IL-8 4) Which on is not involved in respiratory burst pathway of neutrophils killing a) Phospholipase C gamma

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5) Granulomas form in the lung of patients with tuberculosis. This an example of: a. An autoimmune disease. b. A primary immune response. c. DTH. d. Transformed cells forming a metastatic tumor. e. Type I Hypersentivity. 6)The alternative pathway of complement activation: a. Causes tissue damage in the absence of C1INH. b. Occurs after the classic pathway is activated. c. Occurs only if the classical pathway is ineffective in pathogen clearance. d. Requires C3. e. Requires C4. 7) If a person is born without C2 and C4, a. C5 can still be cleaved by the classical pathway. b. C3b will not be able to bind to bacteria. c. C9 will polymerize inappropriately and lyse host cells. d. The classical pathway will be changed into the alternative pathway. e. The amount of C3b produced during bacterial infections will be reduced 8) A cytokine can do all of the following EXCEPT: a. Bind to receptors which do not share cytokine-binding subunits. b. Bind to its specific receptor on the same cell that produced it. c. Bind to receptor antagonists produced by pathogenic viruses. d. compete with other cytokines whose receptors share signal-transducing subunits e. Upregulate (increase) synthesis of high affinity subunits for its receptor
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9) Cytokines are NOT: a. Able to inhibit the function of other cytokines. b. Able to stimulate the synthesis of other cytokines. c. Produced by more than one cell type. d. Small protein molecules. e. Stored in the cell for quick release ch23 10) The IL-2R subfamily consists of receptors for IL-2, IL-4, IL-7, IL-9, and IL-15. This group of cytokine receptors: a. Bind all five cytokines to promote synergistic action on target cells. b. Bind cytokines which are produced by the same cell. c. each has a unique high affinity cytokine-specific chain d. Shift the immune response towards cellular immunity. e. Each has a unique signal-transducing chain 11) Alternative pathway is inhibited by: a. Factor B b. Factor D c. Factor H d. Factor P

12) Two or more cytokines that exhibit the similar function are said to be: a. Pleiotropic. b. Redundant. c. Synergistic d. Antagonistic 13) Each C1 molecule must bind by its globular head to:
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a. Antigens on the bacterial cell surface for stable interaction. b. Two molecules of C1s for stable interaction. c. At least two Fc sites for a stable interaction. d. At least two Fab sites for a stable interaction 14)A component that facilitates phagocytosis when bound to a microorganism: a. Antigen. b. KDO c. Capsule d. Opsonins e. bactoprenol 15)Neutrophils accumulate in tissue at the site of bacterial infection. For which of the following is the major role chemoattraction of neutrophils? a. IL1 b. IL2 c. IL8 d. IL12 e. TNF 16) A cytokine is an example of a lymphokine: a. True. b. False. 17) In an immune response large amounts of IL-4 are produced by stimulated lymphocytes. Which aspect of immunity will be most strongly stimulated by the IL-4? A. Antibody production by b cells. B. Killing by cytolytic t cells.
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C. Activation of macrophages. D. Infiltration of tissue by neutrophils. E. Activation of complement 18) A patient shows sign and symptoms of chronic systemic inflammation. Which of the following cytokines is classically associated with such situations? A. IL-1 B. IL-2 C. IL-4 D. IL-8 19) A three-year-old girl has persistent oral Candida infection and chronic diarrhea; she is in the lowest 5% of the normal weight range for her age. She has received all usual childhood immunizations. She is given a panel of tuberculin-type skin tests. Reaction to tetanus Toxoid, Mumps virus antigen, PPD, and Candida antigen were all negative. Which component of this patients immune system is most likely to be defective? a. Antibody production. b. Cell-mediated immunity. c. Complement. d. Neutrophils

20) in order for a cell to respond to cytokine, that cell must possess a: a. PRP receptor. b. PAMP receptor. c. Fc receptor.
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d. Complement receptor. e. None of the above 21) Surveillance by the immune system is thought to be important in defense against tumor formation, yet many tumors escape. One means of escape is by mutations which prevent expression of class I mhc on the plasma membrane. Which of the following cell types would be most efficient at killing tumor cells that contain such mutation? a. CTL. b. TH c. NK cell. d. Mast cell. e. Neutrophil 22)Pathogen engulfed by macrophages: a. Are completely degraded by hydrolytic enzymes. b. Are degraded to small peptides & carbohydrates presented on class I. c. May survive & replicate in the macrophage phagocytic vesicles. d. Stimulate macrophages to adhere to B cells. e. Stimulate vascular endothelium to upregulate selection expression 23) Phagocytosis must be preceded by: a. Antigen binding. b. Chemotaxis. c. Extravasation d. Integrins binding to Ig superfamily CAMs e. Oxidative burst
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24) The components of the complement system that are involved in the alternate response but NOT the classical response are: a. C1, C4, C2 b. C2 & C3 c. C2 & C5 & C11 d. Factors D & B e. None of the above 25) The component of the complement that acts as an opsonin is: a. C5b b. C3a c. C3b d. C2A e. None-of the above 26) C3a & C5a & IgE can all cause: a. Class switching of B cells b. Activation of T cells c. Activation of macrophages. d. Degranulation of mast cells. e. All of the above

27) Which of the following enzymes dose the neutrophil use to initiate the production of toxic oxygen compounds that kill bacteria? a. Hydrogen peroxide b. Myeloperoxidase c. NADPH oxidase
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d. Superoxide e. Superoxide dismutase

28) A 42-year-old Nigerian in the United States visiting his brother comes to the clinic with complaints of several months of weight loss, night sweats, sputum production, & occasional spitting up blood. His physician places a tuberculin skin test & the result are positive. This positive tuberculin test indicates which of the following? a. a cell-mediated immune response has occurred b. a humoral immune response to TB is positive c. The T & B cell systems are functional d.Te b cell system is functional e. The phagocytic neutrophilic system is functional 29) Complement component (s) which recruit (s) PMNs to a site of inflammation: a. C3a & C5a b. C1q, r & s c. C5, 6,7,8 & 9 d. C3B &C4B e. Mannan-binding lectin (MBL)

30) Which of the following molecules stimulate macrophages via TLR-4 (toll-like receptor 4) to produce TNF-alpha?
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a. C3a b. Bradykinin c. IL-8 d. LPS (lipopolysacchardie) e. IL-1 31)Which of the following is/are true of the complement protein fragment C5a? a. It cause smooth muscle contraction & increased vascular permeability. b. It stimulate phagocytosis via CR1 (CD35) by macrophages. c. It acts through G-protein-coupled receptors. d. It can stimulate Mast cells to release mediators such as histamine. e. All of the above are correct. 32) Factor B a) Is the enzymatic part of the C3 convertase in the alternative pathway b) Only component of complement pathway that circulate active enzyme c) Bind covalently to pathogen through thioster bond d) Has no potential enzymatic activity e) Cleavage factor D 33) Not used as an evading mechanism by viruses a) Mutation b) Production of cytotoxic Abs c) Downregulatin of MHC class I molecules d) Destroying the immune system

34) Regarding HIV vaccine candidates which one is wrong? a) Mucous and gp120
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b) IM gp120 c) Recombinational vaccine was tried d) IM peptide e) DNA vaccine is practical

THE ANSWERS: 1) B 2) 3) 4) 5) 6) 7) 8) 9) 10) B 11) 12) 13)

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14) D 15) C 16) B 17) A 18) A 19) 20) E 21) C 22) C 23) A 24) B 25) C 26)

27) C 28) A 29) 30) D 31) 32) A 33) B 34) E

A A A C

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