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UNIVERSITY OF TORONTO

Faculty of Arts and Science


IMM250H1S
April Examination 2014
Duration - 2 hours
No aids allowed. Please use pencil.
After completing this exam,
you may take the exam paper with you.

This test consists of a total of 54 multiple choice questions, and is


worth 40% of the final course grade

BE SURE TO COMPLETE
YOUR NAME, STUDENT NUMBER, AND BOOKLET CODE
ON THE SCANTRON SHEET


Dr. Philpott (Innate immunity)


1. Which of the following statements is incorrect
A. The intestinal microbiota can provide vitamins that humans are not able to
synthesize
B. The intestinal microbiota can provide lactoferrin that humans are not able to
synthesize
C. There is evidence of a link between obesity and alteration of the microbiota
D. The bacterial cells in our body are in the range of 1014, 10 times more than
our own cells
E. Fungi are part of normal microbiota

Ans. B
2. Identify the incorrect statement concerned with Salmonella

A.
B.
C.
D.
E.

Is Gram negative bacterium


Is a motile bacterium
Is a bacterium that exploits M cells to penetrate the intestinal barrier
Able to replicate inside epithelial cells
Able to survive inside phagosomes

Ans. C
3. Receptors that can recognize peptidoglycan
A. NOD1
B. TLR4
C. TLR3
D. NLRP3
E. None of the above
Ans. A
4. RIG-I is a receptor for
A.
B.
C.
D.
E.

DAMPs
LPS
CpG sequences
Viruses
Fungi


Ans. D

5. Cells important in the defense against multicellular parasites such as worms

A.
B.
C.
D.
E.

Mast cells
Neutrophils
Eosinophils
NK cells
Both A and C

Ans. E
6. C1 inhibitor is

A.
B.
C.
D.
E.

A protein blocking the assembly of MAC


A protein blocking the alternative pathway of complement activation
An inhibitor of the classical pathway of complement activation
A protein activating the lectin pathway of complement activation
A complement protein acting as an opsonin

Ans. C
7. What of the following is true about SARS
A.
B.
C.
D.

The 2003 outbreak had a mortality rate of 10%


This high mortality rate is due to multiple organ failure
No animal reservoir has been identified
The symptoms are thought to be caused by massive release of
proinflammatory cytokines
E. A and D are correct

Ans. E
8. Epidemiological studies support a positive correlation between the incidence of
asthma and

A.
B.
C.
D.
E.

Early exposure to rural settings


Low use of antibiotics
High vaccination rates
Poor sanitation
Living in developing countries

Ans. C
Dr. Watts (Influenza)
9. Which of the following statements about Influenza virus is NOT correct

A. Type A Influenza is responsible for regular outbreaks


B. Is an RNA virus containing a reverse transcriptase necessary for viral
replication
C. Tamiflu interferes with the release of newly formed virus from the infected
cell
D. Viral Hemagglutinin (HA) binds sialic acid residues on surface carbohydrates
and allows entry of the virus into the cell
E. The flu vaccine is a mixture of three or four current flu strains
Ans. B
10. Viral antigenic drift
A. Causes the rapid evolution of viruses and the need for annual vaccination
B. Is caused by mutations introduced in the viral genome by the viral error-
prone RNA polymerase
C. Affects only internal viral proteins not recognized by preexisting antibodies
D. Is responsible for pandemics
E. A and B are correct
Ans. E
11. What is NOT true about the 1918 Spanish Flu
A. It is estimated to have infected up to 1/3 of the world population
B. It is estimated to have killed 50-100 million people worldwide
C. Recent data in mice from infection with the reconstructed virus suggest an
excessive inflammatory response in response to infection
D. A higher than normal number of young adults was killed by the Spanish Flu
E. This high death rate was due to the ability of Spanish Flu to infect
systemically and not only lung cells
Ans. E
12. Avian Influenza has not so far caused a human pandemic because
A. Avian flu causes only mild infection in humans compared to birds
B. Avian flu recognize a variant of sialic acid only found on avian cells
C. Avian flu recognizes a variant of sialic acid only found in deep lung tissues in
humans
D. Because H5N1 is included in the current vaccine
E. Avian flu does not infect pigs, a necessary intermediate host for virus re-
assortment
Ans. C

13. The best animal model for flu transmission studies is considered to be

A.
B.
C.
D.
E.

Swine
Birds
Horses
Ferrets
Mice

Ans. D
14. Which of the following is correct about 2009 H1N1?
A. Considered now a seasonal strain
B. The 2009 epidemic caused the same death rate as SARS of about 10%
C. It represents a re-assortment of 4 different viruses including swine, avian
and human viruses
D. During the epidemic fewer individuals older than 65 years of age were
infected when compared to other flu outbreaks
E. A, C and D are correct

Ans. E
15. Cell-culture based methods of flu vaccine production
A. Are the current common method for producing the current seasonal flu
vaccine
B. Are promising because of the high levels of virus they yield
C. Must be produced by using live embryonated chicken eggs
D. Are based on a plasmid cassette where the desired HA and NA combination
can be rapidly introduced into cells expressing the other 6 segments
E. Both C and D are correct
Ans. D
Dr. Ratcliffe (HIV infection)
16. HIV-1 is

A.
B.
C.
D.
E.

A lentivirus
A retrovirus
Thought to have evolved from the simian immunodeficiency virus (SIV)
Considered more virulent than HIV-2
All of the above

Ans. E

17. gp41 is

A.
B.
C.
D.
E.

A fragment of gp120
Necessary for integration into the cell genome
A protein that can protrude from the viral envelope
A matrix protein
Both A and C


Ans. C
18. Which of the following statements about the course of HIV infection is NOT
correct
A. During the acute phase the levels of circulating virus are high
B. During the acute phase the levels of CD4+ T cells drop considerably
C. During the clinical latency phase CD4+ T cells return to normal levels and
stay unchanged until the symptomatic phase defined as AIDS starts
D. The length of the latency phase is variable and can be influenced by antiviral
therapy
E. Individuals with AIDS suffer of many opportunistic infections

Ans. C
19. Drug-combination treatments are preferred for HIV infection over single-drug
treatments because

A. Single-drug treatments favor the development of drug-resistant viral


variants
B. The several drugs have a synergistic effect
C. It requires multiple mutations to HIV to survive multiple drugs targeting
different viral proteins
D. Drug combinations are able to completely eliminate the virus from HIV
patients
E. Both A and C are true

Ans. E
20. The most important region(s) of an antibody molecule with respect to antigen
binding is/are
A.
B.
C.
D.
E.

FR1
FR2
FR3
FR4
HV 1-3

Ans. E
21. Antibodies often found in dimeric form are
A. IgM
B. IgE
C. IgA
D. IgG
E. All of the above
Ans. C
22. The ideal vaccine for HIV is

A.
B.
C.
D.
E.

A vaccine containing attenuated HIV


A vaccine containing killed HIV
A subunit vaccine inducing neutralizing antibodies
A subunit vaccine targeting the least variable region of gp120
Both C and D

Ans. E
Dr. Gommerman (B cell and T cell section)
23. Cells secreting antibodies are
A.
B.
C.
D.
E.

Nave T cells
Nave B cells
Plasma cells
Pro-B cells
Both B and C


Ans. C
24. Which of the following would be recognized by the B cell receptor (BCR)

A.
B.
C.
D.
E.

Epitopes on self-antigens
Epitopes on tumor antigens
Conformational epitopes
Allergens
All of the above

Ans. E
25. Which of the following would NOT be recognized by the T cell receptor (TCR)
A. Epitopes on self-antigens
B. Epitopes on tumor antigens

C. Conformational epitopes
D. Linear epitopes
E. All of the above

Ans. C
26. VDJ gene rearrangement of the immunoglobulin gene (Ig) loci happens
A.
B.
C.
D.
E.

In developing B cells
In developing T cells
In mature B cells
During the germinal center reaction
In plasma cells


Ans. A
27. The gene segments that are combined to generate the light chain of the BCR does
NOT include

A.
B.
C.
D.
E.

V
J
D
C
Transmembrane region

Ans. C and E
28. Which of the following statements is NOT true
A.
B.
C.
D.
E.

The BCR of an immature B lymphocyte in the bone marrow is always an IgM


The BCR of a B lymphocyte that has encountered antigen is always an IgM
Secreted IgM are pentameric
IgM can activate complement
The gene segment encoding the C region of an IgM is the closest to the
variable gene segments


Ans. B
29. The Ig class that is more efficient at opsonizing pathogens is
A.
B.
C.
D.
E.

IgM
IgD
IgG
IgA
IgE
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Ans. C
30. The TCR is
A.
B.
C.
D.
E.

Composed of 2 chains and 2 chains


Found in complex with CD3
Rearranged in the bone marrow
Secreted
All of the above is correct about the TCR


Ans. B
31. Which of the following statements is NOT true
A.
B.
C.
D.
E.

T helper cells and CTLs recognize epitopes derived from proteins


CD3, CD4 and CD8 bind MHC molecules
CTLs express CD8
CD4+ T cells recognize peptides presented by MHC class II molecules
CD3 is necessary for T cell activation and proliferation


Ans. B
32. An effector T cell
A.
B.
C.
D.
E.

Has encountered antigen


Might secrete cytokines
Might kill virus-infected cells
Is part of a cell clone derived from the activation of a nave T cell
Is all of the above


Ans. E
33. The cells best at activating nave T lymphocytes in the paracortex (T cell region)
are:

A.
B.
C.
D.
E.

Nave B cells
Activated B cells
Dendritic cells
Macrophages
Follicular dendritic cells

Ans. C
34. Dendritic cells enter lymph nodes via

A.
B.
C.
D.
E.

Arteries
High Endothelial venules
Afferent lymphatics
Efferent lymphatics
Any of the above


Ans. C
35. Signal 2 for T cell activation is provided by:
A.
B.
C.
D.
E.

B7/CD28 interaction
TCR/MHC plus peptide interaction
CD4/MHC plus peptide interaction
CD8/MHC plus peptide interaction
Cytokines/Cytokine receptor interaction


Ans. A
36. A cell type producing IL-4 is a:
A.
B.
C.
D.
E.

TH1 cell
TH2 cell
TH17 cell
CTL
All of the above


Ans. B
37. IL-2 is
A.
B.
C.
D.
E.

Produced by dendritic cells


A polarizing cytokine (e.g. induces T subset differentiation)
An effector cytokine (e.g. induces antibody production)
A growth factors for activated T cells
Both A and B


Ans. D


38. Some features of effector T cells are that they:
A. Leave the lymph nodes via the efferent lymphatics
B. Can enter sites of infection via blood

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C. Mostly die by apoptosis after the infection is resolved


D. Perform their effector functions in the lymph node draining the site of
infection
E. A, B and C are correct

Ans. E
39. Based on mouse studies, which of the following molecules is important in the
defense against Leishmania?
A.
B.
C.
D.
E.

TGF-
IL-10
IFN-
IL-4
IL-5


Ans. C
40. Nave lymphocytes enter LN through

A.
B.
C.
D.
E.

Afferent lymphatics
Arterials
HEV
Efferent lymphatics
Thoracic duct

Ans. C
41. Molecules required for entry of nave lymphocytes into lymph nodes are:

A.
B.
C.
D.
E.

Chemokines
L-selectin
PNaD
All of the above
None of the above

Ans. D

42. The B cell area of the lymph node is called the:
A. Cortex
B. Paracortex
C. Medulla

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D. Germinal center
E. A, B and C

Ans. A
43. Nave T cells and dendritic cells interact in which area of the lymph node:

A.
B.
C.
D.
E.

The cortex
The paracortex
The medulla
Germinal Centers
The subcapsular sinus

Ans. B
44. T cells that encounter antigen in a lymph node

A.
B.
C.
D.
E.

Move slower than T cells that are not specific for the same antigens
Are found in stable interactions with dendritic cells
Start to proliferate
Move to B cell areas
All of the above

Ans. E
45. Which of the following sentences is correct
A.
B.
C.
D.

B cells that have encountered antigen move from follicles to germinal centres
Activated B cells can present antigens to T cells
B cells need T cell help to produce most antibodies
Cytokines secreted by helper T cells influence the type of antibody produced
by B cells
E. All of the above

Ans. E
46. What is NOT true about the germinal center (GC)
A.
B.
C.
D.

A GC is divided into a dark zone and a light zone


B cells divide vigorously in the dark zone of the GC
Follicular dendritic cells are found in the light zone of the GC
B cells with a very high affinity for antigen displayed by follicular dendritic
cells die by apoptosis
E. GC are structures that develop in LN follicles during an immune response

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Ans. D
47. With respect to CD4 and CD8 expression, what types of T cells or T cell
precursors are found in the thymus
A. Cells negative for both
B. Cell positive for both
C. CD4+ CD8- cells
D. CD8+ CD4- cells
E. All of the above
Ans. E
48. What is NOT true about negative selection in the thymus

A. Is mediated by medullary thymic epithelial cells


B. Results in the elimination of more than 90% of developing thymocytes
C. Results in the elimination of developing thymocytes that fail to recognize
self-peptide/MHC
D. Takes place in the thymic medulla
E. It involves a signal mediated by FAS expressed on the membrane of
developing thymocytes

Ans. C
49. AIRE is
A. A transcription factor expressed in thymocytes
B. A receptor mediating apoptosis of self-reactive thymocytes
C. A transcription factor that allows the expression of peripheral self-antigens
in the thymus
D. A transcription factor expressed by Tregs
E. An autoimmune disease

Ans. C
50. Mechanisms of peripheral tolerance include
A.
B.
C.
D.
E.

Antigen sequestration
T regulatory cell function
Negative selection in the thymus
All of the above
Only A and B


Ans. E
51. Which of the following sentences is NOT true about multiple sclerosis

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A.
B.
C.
D.
E.

More common in countries far from the equator


There is some evidence of a link with certain HLA alleles
It strikes more women than men
Is a disease of the elderly, the onset peaks at 65 years of age
For most patients the disease goes through phases of remission and
exacerbation

Ans. D
52. T cell subsets involved in initiation and/or progression of MS include

A.
B.
C.
D.
E.

TH2
CTL
TH1
TH17
Both C and D

Ans. E
53. Disease-modifying drugs are preferable over classical immunosuppressive drugs
to treat autoimmune diseases because

A. They target the cell type or immune reactant directly responsible of the
disease
B. They have no side effects
C. They can be used in lower doses
D. They acts on many immune cells at the same time, a feature that increases
their efficacy
E. All of the above

Ans. A
54. Tysabri is
A. A B-cell depleting drug
B. A drug that has been tested in MS
C. A drug that targets cell signaling in T and B cells
D. An anti-TNF drug
E. Both A and C
Ans. B

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