The Final Examination of Immunology (A)

------For 89 K Seven-Year Program (2005. 5)

. Concepts ( 2.5 marks / concept, totally 20 marks )

1. Epitope 2. Superantigen 3. Positive selection 4. Idiotype
5. APC 6. Hypersensitivity 7.Fab 8. McAb

. Fill each of the blank spaces with suitable words. (0.5 mark/blank
space, totally10 marks)

1. Macrophage-derived cytokines include , , ,
and .
2. Cells with the capacity to induce cytotoxicity of the target cell are
, and .
3. Complement can be activated directly by microbes through
pathway and pathway at the early stage of infection. MASP1 and
MASP2 are involved in the pathway. D factor is involved in
the pathway.
4. FcR is usually found on the surface of , , and
cells
5Cytokines like and induce Th1 and inhibit Th2 responses,
while and induce Th2 and inhibit Th1 responses.

. For each of the following questions, choose the ONE BEST answer
or completion. (0.5 mark / question, totally 20 marks)

1. Phagocytosis
A. Is carried by cells of the adaptive immune system
B. Is restricted to macrophages
C. Is important in bacterial infections
D. Is a process that dose not involve energy
E. Results in division of the cell
2. Molecules directly involved in NK cell mediated killing include
A. Muramyl dipeptide B. Granzyme
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C. Complement D. IFN-gamma
E. Superoxide
3. Dendritic cells are characterized by
A. The presence of TCR B. Expression of CD3
C. Expression of IgM molecules D. Their ability to release histamine
E. Their interface between the innate and adaptive immune systems
4. C3b
A. Is chemotactic B. Is an anaphylatoxin
C. Opsonizes bacteria D. Directly injures bacteria
E. Is the inactive form of C3
5. B cell are distinguished from T cells by the presence of
A. CD4 B. Surface Ig
C. CD8 D. CD3
E. Class I MHC antigen
6. Specific antibodies are readily detectable in serum following primary
contact with antigen after:
A. 10 min B. 1 h
C. 57 days D. 35 weeks
E. Only following a second contact with antigen
7. Protection against microorganisms inside cells is provided by:
A. T-cells B. Antibody
C. C3b D. C1q
E. The membrane attack complex
8. Activation of the alternative pathway involves
A. C1q B. C1s C. C2 D. C3 E. C4
9. The infection in the uterus can be diagnosed based on the elevated level
of antigen specific ___ .
A. IgG B. IgM C. IgA D. IgD E. IgE
10. Viral replication within cells is inhibited directly by
A. IFN- B.TNF- C. IL-1 D. IL-4 E. IL -13
11. Which of the following gene clusters do not contribute to antigen
binding
A. VL B. CL C. VH D. D E. J
12. T cell antigen receptor
A. Recognizes conformational epitopes on the native antigen
B. Has Ig light chains
C. Is made up of a heavy chain and beta-2 microglobulin
2
D. Are associated with Igand Igto form a complex
E. Recognize epitopes on linear peptides associated with MHC
molecules
13. The class I MHC processing pathway primarily
A. Processes antigens that are present in the cytosol.
B. Processes antigen from the extracellular environment
C. Generates peptides, complexes them with class I MHC molecules for
presentation to helper T cells
D. Generates peptides, complexes them with class I MHC molecules for
presentation to NK cells
E. Is involved in the process of the antibody response
14. Cytokines responsible for immunosuppression include
A. IL-1 B. IL-2 C. IFN- D. TGF- E. TNF-
15. ___ express CD3 and CD4 molecules
A. Ts and Tc cells B. Th1 and Th2 cells
C. NK and B cells D. TH1 and Tc cells
E. All T cells
16. Cell with specific killing effects is
A. LAK B. NK C. Neutrophils D. CTL E. M
17. CD8
+
T

cells
A. Can be classified into Th1 and Th2 subgroups based on biological
functions
B. Do not produce IFN
C. Can recognize and kill virus infected cells
D. Can bind free virus
E. Do not require direct cell to cell contact with their targets for killing
18. B cell dont express
A. CD2 B. MHC-molecule
C. MHC-molecule D. CR2
E. LFA-3
19. Factors may influence the induction of an immune response include
A. The nature of an antigen B. The route of administration
C. The dose of antigen D. Maturity of the immune system
E. All of the above
20. A given Ig isotype is
A. A heavy chain variant encoded by allelic genes.
B. A light chain constant region encoded by allelic genes.
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C. Present in all normal individuals.
D. A collection of hypervariable region epitopes recognized by an
anti-idiotype.
E. Monoclonal.
21. IgG:
A. Appears early in the immune response.
B. Kills bacteria directly.
C. Is important in mucosal immunity.
D. Usually exists as a pentamer.
E .Opsonizes bacteria.
22. IgA in seromucus secretions:
A. Has no J-chain. B. Has no secretory piece.
C. Is dimeric. D. Cannot bind to virus.
E. Activates the classical complement pathway.
23. Which CD molecule can bind with HIV specifically?
A.CD2 B.CD4
C.CD8 D.CD21
E.CD28
24. The secondary, but not the primary, immune response is based on
A. Memory
B. The bonus effect of multivalency
C. Complement activation
D. Mast cell degranulation
E. Clonal selection
25. Which of the following is true?
A. CD4 MHC- B. CD8 MHC-
C. CTLA-4 B7 D. CD40 CD58
E. CD2 ICAM-1
26. The cytokine which is most involved in the class switch to IgE
production is
A. IL-1 B. IL-2 C. IL-3 D. IL-4 E. IL-5
27. The C3 convertase in classical pathway of complement activation is
A. C3bBb B.C4b2b C.C4a2b D.C4b2b3b E.C3bnBb
28. The molecules mediating signal transduction following antigen
binding to cell surface immunoglobulin on a B-cell are called:
A. Ig Fc B. Ig-alpha and Ig-beta
C. MHC D. CD4
4
E. CD3
29. A severe depression of CD4
+
T cell subset in man is likely to result in
A. Severe depression of humoral immune response
B. Lack of development of skin delayed hypersensitivity reactions
C. Both A and B
D. Neither A nor B
E. Lack of complement
30. Cytokines always act
A. By binding to specific receptors.
B. In an autocrine fashion.
C. At long range.
D. Antagonistically with other cytokines.
E. Synergistically with other cytokines.
31. T cell-derived cytokines
A. Are antigen-specific products of T cell activation
B. Are stored in the resting T cell and released on activation
C. Are MHC-restricted in their effects
D. Influence the class of antibodies produced by B cell
E. All of the above
32. In the complement system
A. Alternative pathway relys on antibody
B. Classical pathway is best activated by bacterial endotoxin
C. C1 is the first enzyme complex in the classical pathway
D. Both the alternative and classical pathway converge at C2
E. The membrane attack complex is made up of C3a and C5a
33. Ig with binding site for C1q are
A. IgE and IgD B. IgG and IgM
C. IgM and IgA D. IgA and Ig G
E. IgM and IgE
34. Prior to class switching, B-cells express
A. IgA alone B. IgA and IgG
C. IgM and IgD D. IgD alone
E. No surface Ig
35. Interactions between _____ are not restricted by MHC molecules
A. Th cell & dendritic cell B. NK cell & target cell
C. Tc cell & target cell D. Macrophage & Th cell
E. Th cell & B cell
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36. A major factor regulating the adaptive immune response is
A. The granulocyte
B. Complement membrane attack complex
C. C-reactive protein
D. Antigen concentration
E. Platelet
37. Penicillin can cause
A. Typehypersensitivity
B. Type& hypersensitivity
C. Type, &hypersensitivity
D. Type, , & hypersensitivity
E. Type & hypersensitivity
38. Which of the following is produced by CD4
+
Th1 Cells?
A. IL-2 receptor B. IL-8 C. C3 D. IL-4 E. IL-12
39. Rhesus hemolytic disease of the newborn involves
A. IgE. B. Antibody to cell surfaces.
C. Soluble immune complexes. D. Cytokine release from T-cells.
E. Stimulatory antibodies.
40. Interferons
A. Are found only in mammalian species
B. Are divided into 5 main families
C. Inhibit virus replication in the target cell
D. Only affect infected cells
E. Are specific for individual viruses

. Answer questions (30 marks)

1. Please simply describe the biological functions of antibodies. (3 marks)
2. Please simply describe the functions of the important surface molecules
of macrophages. (5 marks)
3. Please simply describe the general process of CD4
+
T cell mediate
immune response. (6 marks)
4. Please describe the structure, distribution and functions of HLA-
molecules. (6 marks)
5. Please compare the components and mechanisms of type and
hypersensitivity. (10 marks)
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The Answers for the Final Examination of Immunology
(A)
------For 89K Seven-year Program (2005. 5)

. Concepts (2.5 marks / concept, totally 20 marks)
1. Epitope: the smallest unit of an antigen to which an antibody or cell can
bind.
2. Superantigen: molecules that polyclonally activate a large fraction of the
T cells by binding to MHC class II molecules and T-cell receptors.
3. Positive selection: thymocytes in the cortex of thymus with TCRs with a
moderate affinity for self-MHC molecules on epithelial cells are allowed to
develop further. Others undergo apoptosis and die. MHC restriction.
4. Idiotype: are unique antigenic determinants associated with antigen
binding sites of antibodies and are the results of the different amino acid
sequences which determine their specificities.
5. APC: is a cell that displays peptide fragment of protein antigens, in
association with MHC molecules, on its surface and activates
antigen-specific T cells.
6. Hypersensitivity: refer to the tissue damage or functional disturbance that
occurs as an overreaction by the immune system to a variety of antigens
encountered on a second occasion.
7. Fab: fragment antigen binding. Complete L chain paired with the VH and
CH1 domains of the H chain
8. McAb: monoclonal antibodies which are produced by a single clone of B
cell hybridoma and are homogenous in structure and specificity.




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. Fill each of the blank spaces with suitable words. (0.5 mark/blank
space, totally 10 marks)

1. TNF, IL-1, IL-6, IL-8, IL-12 ()
2. Tc, NK, Macrophage, neurophileeosinophile(,
)
3. Alternative, MBL, MBL, Alternative
4. NK, Macrophage, neurophileB cell, eosinophilepletellete (
, )
5. IFNIL-12, IL-4, IL-10



. For each of the following questions, choose the ONE BEST answer
or completion. (0.5 mark / question, totally 20 marks)

1. C 2. B 3. E 4. C 5. B
6. C 7. A 8. D 9 .B 10. A
11. B 12. E 13. A 14. D 15. B
16. D 17. C 18. A 19. E 20. C
21. E 22. C 23. B 24. A 25.C
26. D 27. B 28. B 29. C 30. A
31. D 32. C 33. B 34. C 35. B
36. D 37. D 38. A 39. B 40. C
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. Answer questions (30 marks)

1. Please simply describe the biological functions of antibodies. (3 marks)

Biological functions of Ab
1)
.5
Bind specific with antigens.
2)
.5
complement activation
3)
.5
Opsonization
4)
.5
ADCC
5)
.5
Mediating type hypersensitivities:
6)
.5
Placental transfer and mucosal transfer

2. Please simply describe the functions of the important surface molecules
of macrophages. (5 marks)

(1).
1
Molecules involved in phagocytosis:
1
Scavenger receptors,
mannose receptors, LPS receptor (CD14), complement receptors, Fc
receptors (FcR / CD16, et al) 1
(2).
1
Molecules involved in signaling of activaton:
.5
TLR-4 (toll-like
eceptor-4), TLR-2
(3).
1
Molecules involved in antigen presentation:
.5
MHC class
molecules and B7 (after activation), MHC class molecules

3. Please simply describe the general process of CD4
+
T cell mediate
immune response. (6 marks)

Antigen recognition of T cell: Class molecules are load with
exogenous peptides in an endosomal compartment and are recognized by
CD4 helper Tcell
2

The activation of T cell: signal 1: the engagement of the TCR; signal 2:
B7 on APC bind to CD28 on the T cell
2

Effects: Act on Mand cause their activation; Mediate type
hypersensitivity; Help B cell growth and Ab production.(
)
2


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4. Please discribe the structure, distribution and functions of HLA-
molecules. (6 marks)

Structure:
.5
heterodimers of andglycoprotein chains,
.5
1 and 1
form the binding groove.
Distribution:
1
expressed on APC
Function: 1.
1
Antigen processing and presenting (exogeneous pathway):
2.
1
Involve in transplant rejection
3.
1
Regulation of immune response
4.
1
Involve in T cell development in the thymus

5. Please compare the components and mechanisms of type and
hypersensitivity. (10 marks)


Type hypersensitivity Typehypersensitivity
Ag
1
cellular antigen
1
mostly are soluble Ag
Ab
1
IgG, IgM
1
IgG, IgM
Mechanism 1.
1
Cell lysis by
complement activation
via classical pathway
2.
1
ADCC by NK cell,
M and neutrophiles
via FcR on these cells
3.
1
Opsonization via
CR and FcR on
phagocytes
1.
1
Complement activation
leads to production of C3aC5a
activation of basophiles
Tissue edema
2
1
Neutrophile infiltration
tissue damage
3
1
Platelet activation
Microthrombi formation


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