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b. WRONG
Antigen & antibody complex are? a. is the correct answer
a. Weakly bound Antigens are bound to antibodies through weak and
2 b. strongly bound noncovalent bonds such as electrostatic interactions,
c. no bound at all. hydrogen bonds, Van der Waals forces, and
d. none of the above hydrophobic interactions.
http://www.ncbi.nlm.nih.gov/books/NBK27160/
Prozone phenomenon:
4 a. Excess Ag b.
b. Excess Ab
B cells (x)
Impaired cellular immunity mycobacteria,
nocardia, fungi (e.g. pneumocystis carinii & candida),
viruses, parasites. The majority of conditions
predisposing to Pneumocystis pneumonia are
Responsible for immunity for
17 associated with profound defects in cellular
pneumocystis carinii:
immunity. Also, risk of P. carinii infection increases
when CD4+ T lymphocytes levels are < 200 cells/L
Impaired granulocytes staph. abscesses.
Impaired antibody formation pneumonia by
pyogenic organisms.
e.
http://www.dartmouth.edu/~nlevy/pln3.html
All are false except:
c.
a. T cells are predominantly located at
White pulp contains lymphoid aggregations, mostly
the medullery area of LN
lymphocytes, and macrophages which are arranged
b. T cells are predominantly located at
around the arteries. T lymphocytes (mainly T-helper)
the germinal centre of LN
19 are present in Periarteriolar lymphoid sheaths (PALS),
c. T cells are predominantly located in
while B-cells are present in the follicles.
the periarteriolar region of the white
Red pulp is vascular, and has parencyhma and lots of
pulp of spleen
vascular sinuses. These are sinuosoids - a specialised
d. T cells are predominantly located in
type of capillary, which is very leaky
the red pulp of spleen
c.
Perforin is a cytolytic protein found in the granules
of Cytotoxic T lymphocytes (CTLs) and NK cells.
Cytokines
b.
Which is wrong: IL-1 is a pro-inflammatory cytokine released from
a. IL-1 is produced early in immune macrophages & dendritic cells to enhance the
29 response inflammatory process.
b. T cells do not respond to IL2 early in IL-2 promotes the differentiation of effector T cells
immune response and memory T cells when the initial T cells is
stimulated by an antigen.
Transplantation
a.
Presence of C4d in graft tissue capillaries
C4d is an inactive split product of C4 cleavage that
a. C4d is stable from classic pathway
occurs in classic or lectin pathways (not alternative). It
b. C4d is unstable from alternative
has no biological function, but it binds to endothelial
32 pathway
cells firmly, with long half life, so it is considered the
c. C4d is unstable from classic pathway
'footprint' of antibody-mediated tissue injury that
d. C4d is of little value as it remain bound
occurs in acute graft rejection.
to endothelium for more than a month.
http://www.medscape.com/viewarticle/761036
Hypersensitivity
b.
It is a local type III hypersensitivity reaction, in the
Arthus phenomenon results from: form of dermal inflammatory reaction produced
a. Antigen excess. under conditions of antibody excess, when a second
36 b. Antibody excess. injection of antigen produces intravascular antigen-
c. Antigen and antibody in equal antibody complexes which bind complement, causing
proportions. cell clumping, endothelial damage & vascular necrosis.
http://www.ncbi.nlm.nih.gov/
mesh?term=Arthus%20reaction
Immunoglobulins
Immunoglobulin is:
a. Synthesized in liver.
40 b. beta globulin d.
c. alfa globulin
d. gamma globulin
Heaviest Ig:
a. IgG
b. IgM
46 b.
c. IgA
d. IgE
a. IgD
IgM is:
a. Acute immunoglobulin
48 b. Immunoglobulin in allergic condition a.
c. Chronic immunoglobulin
d. -globulin
Immunodeficiency
e. CD40/CD40L
Normally, binding between CD40 on B cells & CD40L
(CD158) on T cells is necessary for B cells to switch
from IgM synthesis to IgG, IgA or IgE.
In hyper IgM syndrome, the switching process is
Hereditary IgM increase is due to disease
blocked, leading to normal or high levels of IgM, with
with marker:
low IgA & IgG levels. The patient is susceptible to
a. CD 1a
bacterial infections (also viral, fungl & parasitic). This
49 b. CD 10
is due to:
c. CD 20
X-linked recessive gene mutation of T cells' CD40L:
d. CD 30
the most common.
e. CD 40
Autosomal recessive gene mutation of B cells'
CD40.
Mutations of genes involved in the CD40 signaling
pathway: either autosomal recessive (AID & UNG
genes) or X-linked recessive (NEMO gene).
b.
* Decrease oxidative burst:
Chronic granulomatous disease (chronic
* Child with long history of repeated
granulomatosis) is a diverse group of hereditary
infection. Investigations show decrease
diseases in which certain cells of the immune system
52 superoxide activity:
have difficulty forming the reactive oxygen
a. Defective phagocytosis
compounds (most importantly, superoxide) used to
b. Granulomatous disease
kill certain ingested pathogens. This leads to
c. Chediak Higashi syndrome
formation of granulomas in many organs.
Complement deficiency:
53 a. Chronic granulomatosis Neither a. nor b.
b. HIV
b.
C1 esterase inhibitor deficiency:
C1 esterase inhibitor is an acute phase reactant that
54 a. Digeorge syndrome
inhibits the complement classical pathway by binding
b. Hereditary Angioedema
to C1r & C1s proteases.
Autoimmune diseases
40 yrs old male with pain in the knee b. case of rheumatoid arthritis
increase with rest, decrease with walk: c. for ankylosing spondylitis. It is a seronegative (RF -
**Patient with pain increase by rest ve) spondyloarthropathy causing kyphosis, loss of
decrease with exercise. X ray show lesion spinal mobility, arthritis, systemic manifestations (e.g.
57
in pelvic joints. Recommended test is: uveitis, lung fibrosis, aortitis) & Pain.
a. ANA Pain is the initial symptom. It is characteristically
b. RF chronic, dull, insidious onset, low back & gluteal pain.
c. HLA-B27 It is severe at rest, but improves with physical activity.
a.
ANCA is not specific, associated with several AIDs such
Case. patient is P-ANCA +ve
as ulcerative colitis (97% of cases, mostly with ASCA),
59 a. Ulcerative colitis
Crohn's disease (30%), Churg-Strauss syndrome (50%),
b. Chron's disease
PAN, rheumatoid arthritis, glomerulonephritis, AIH
type 1, primary sclerosing cholangitis (PSC).
Immuno-assay
b.
In ELISA, the first washing is used to remove the
Washing must be done in all unbound (free) sample antigen. The second washing
heterogeneous ELISA technique because? removes unreacted free label (not excess binding in
a. increase the specificity either of the 2 washings)
66
b. increase the sensitivity If washing is not complete, this will false high
c. it removes the excess binding specificity.
d. none of the above If the question comes as It avoids excess binding,
then this will be the choice.
c.
co efficient ELISA we use :
a. one negative and 3 positive control
67 a.
b. 3 negative and one positive control
c. 3 negative and 3 positive control
Pyrimidine base:
a. Adenine
b. Guanine c.
71
c. Thymine Pyrimidines = cytosine & thymine
d. Uric acid
e. Urea