Student’s Name: _______________ Roll No: ___________Date:___________

Subject: disorders of immune system Class: 2nd Professional BS Nursing

01. Pollen would most likely evoke which type of hypersensitivity response:
a. Cytotoxic (Type II)
b. Immune complex (Type III)
c. Cell Mediated (Type IV)
d. Immediate type (Type I)
e. latent (Type V) 

02. Which hypersensitivity reactions are T cell mediated?

a. Type I
b. Type II
c. Type III  
d. Type IV
e. None of these
03. Which of the following bind to mast cells and cross-link, resulting in de-granulation and release
of histamine?
a. IgM
b. IgA
c. IgG
d. Interleukins
e. IgE
04. Theoretically, type………… blood can be donated to all persons because it lacks…………
a. O/antigens
b. AB/ antibodies
c. A/ antibodies
d. O/antibodies
e. A/IgE
05. Type II hypersensitivity is due to:
a. IgE
b. Activation of cytotoxic T cells
c. Pollen
d. IgM
e. Mismatched blood types in transfusion
06. Production of auto-antibodies may be due to:
a. Emergence of mutant clones of B cells
b. Production of antibodies against sequestered (hidden) tissues
c. genetic factors
d. all are possible
e. None of these
07.A positive tuberculin test is an example of
a. Type I hypersensitivity
b. Delayed type hypersensitivity
c. acute contact dermatitis
d. Eczema
e. Pollen allergic response
08. Rheumatoid arthritis is an ……….disease that affects the……….
a. Allergic/ cartilage
b. Autoimmune/nerves
c. Autoimmune/ joints
d. Immunodeficiency/ muscles
e. Allergic/ muscles
09. Contact with poison ivy would elicit which type of hypersensitivity reaction?
a. type III
b. type I
c. type II
d. type IV
e. type V
10. A tissue graft between two people who are not genetically identical is termed a:
a.Isograft
b. Heterograft
c. Xenograft
d. Autograft
e. Allograft
11. An example of a type III immune complex disease is:
a. Contact dermatitis
b. Graft rejection
c. Serum sickness
d. Atopy
e. Allergies
12. Graft versus host disease results when the recipient lacks or has a poor immune system, and the
donor organ and recipient express different:
a. HLA
b. T cells
c. Antibodies
d. Autoantibodies
e. Interleukins
13. Agammaglobulinemia is an immunodeficiency disease due to a deficiency in:
a. T cells
b. MHC
c. IgE
d. Cytokines
e. B cells
14. Which disease would be most similar to AIDS in its pathology?
a. SCID  
b. DiGeorge Syndrome
c. Agammaglobulinemia
d. ADA deficiency
e. Kuru
15. Human immunodeficiency virus (HIV) binds specifically to which immune cell marker?
a. CD8
b. MHC
c. CDC
d. CD4
e. GP120
16. HIV has a high mutation rate due to the imprecise operation of its:
a. Viral membrane
b. CD4 receptor
c. Reverse transcriptase
d. protease
e. dismutase
17. Pregnancy test detects the presence of which of the following?
a. Rh
b. Human Chorionic Gonadotropoin (HCG)
c. Fetal proteins
d. Agglutination
e. Depuration factor
18. Which of the following is considered an autoimmune disease?
a. rheumatoid arthritis
b. AIDS
c. SCID
d. agammaglobulinemia
e. CJD
19. A transplant between individuals of different animal species is termed as:
a. allograft
b. isograft
c. enterograft
d. endograft
e. xenograft
20. Immune disorders include
a) hypersensitivity
b) auto-immune diseases
c) immunodeficiency
d) all of these
22. The inappropriate response of immune system towards a relatively harmless antigen causing
harm to the host is referred as
a) hypersensitivity
b) auto-immune diseases
c) immunodeficiency
d) tolerance
23. Which of the following Ig is involved in mediating allergic reactions
a) IgG
b) IgM
c) IgE
d) IgA
24. The major chemical messenger involved in hypersensitivity is
a) interleukins
b) lymphokines
c) hiatamines
d) interferons
25. Which of the following types of hypersensitive reactions is antibody mediated
a) Type I
b) Type II
c) Type III
d) all of these
26. Which one of the following is a cell mediated hypersensitive reaction a) Type I
b) Type II
c) Type III
d) Type IV
27. The inability to distinguish between self-cells and non-self-cells may lead to
a) hypersensitivity
b) auto-immune diseases
c) immunodeficiency
d) tolerance
28. Majority of auto immune diseases are
a) cell mediated
b) antibody mediated
c) macrophage mediated
d)mast cells mediated
29. All of the following are autoimmune disorders except
a) Graves disease
b) SCID
c) Rheumatoid arthritis
d) Addison’s disease
30.HIV attacks
a) T helper cells
b) T cytotoxic cells
c) B cells
d) macrophages
31. All of the following are immunodeficiency diseases except
a) Graves disease
b) SCID
c) DiGeorge’s syndrome
d) Hyper IgM syndrome
32. Phagocytic white cells (leukocytes, e.g. macrophages) congregate within ____ when foreign
organisms get through a cut in the skin.
a) Microseconds
b) Seconds
c) Minutes
d) Hours
e) Days
33. Which of the following mediates an early response to viral infections by the innate immune
system? a) Complement components
b) Vaccines
c) T and B lymphocytes
d) Cytokines
e) Interferons
34. Which of the following is a messenger that mediates the connection between the innate and
adaptive immune systems?
a) Complement components
b) Vaccines
c) T and B lymphocytes
d) Cytokines
e) Interferons
35. Which of the following is NOT true when comparing innate to adaptive immunity?
a) Innate responds quickly and adaptive responds slowly
b) Innate has few pathogen (non-self) recognition mechanisms and adaptive has many
c) Innate has immunologic memory and adaptive does not
d) Innate does not show response improvements over time and adaptive does
e) Innate response is non-specific and adaptive is very specific
36. Phagocytes ingest particular matter into cells for degradation. Which of the following is NOT
considered a phagocyte?
a) Macrophage
b) Neutrophil
c) Eosinophil
d) Basophil
e) Lymphocyte
37.Which of the following components of the innate immune system involves cytokines produced by
macrophages, which are produced during infection?
a) Natural killer (NK) cells
b) Complement system
c) Oxygen dependent and independent killing
d) Interferons
e) Acute phase proteins
Match the following innate immune system cell types with their function:
38.Eosinophils a) Phagocytosis and bacteriocidal mechanisms, antigen presentation
39. Macrophages b) Lysis of some virally infected cells
40. Tissue mast cells c) Killing parasites
41. Natural killer cells d) Release of histamine and other mediators
42. Neutrophils e) Phagocytosis and bacteriocidal mechanisms
43.T cells are made in the ____ and complete their differentiation in the ____.
a) Spleen; Thyroid
b) Spleen; Thymus
c) Bone marrow; Thyroid
d) Bone marrow; Thymus
e) Bone marrow; Thalamus
44.An individual is bitten by a dog with rabies and begins to develop antibodies against the rabies.
These antibodies are harvested and transferred to unimmunized individuals to confer protection
more rapidly for these individuals. This is an example of:
a) Active immunity
b) Passive immunity
45.What types of cell is class II MHC found on?
a) B cells
b) Macrophages
c) Dendritic cells
d) Essentially all cells
e) Mainly on A, B, & C
46.What is the function of major histocompatibility complex (MHC) molecules?
a) Present sugars to T cells
b) Present peptides to T cells
c) Create holes in the membranes of bacteria
d) Lyse foreign antigens
e) Phagocytize foreign antigens
47.Which of the following binds to an Fc receptor on mast cells and basophils?
a) IgA
b) IgD
c) IgE
d) IgG
e) IgM
48. Which of the following is chiefly found on the surface of B cells as a receptor molecule and is
involved in cell activation?
a) IgA
b) IgD
c) IgE
d) IgG
e) IgM
49.In the embryonic human, the primary lymphoid organs are initially in the yolk sac, then in the
fetal ____, and finally in the ____.
a) Spleen and kidneys; Bone marrow and thymus
b) Spleen and thymus; Bone marrow and kidneys
c) Kidneys and thymus; Bone marrow and spleen
d) Kidneys and bone marrow; Spleen and thymus
e) Spleen and liver; Bone marrow and thymus
50.Antibody-dependent cellular cytotoxicity (ADCC) is the process by which natural killer cells
destroy infected cells, identified by what immunoglobulin on the surface?
a) IgA
b) IgD
c) IgE
d) IgG
e) IgM
51.Regarding anaphylactic (type I) and immune complex (type III) hypersensitivities, which of the
following is the MOST accurate?
A. IgE is involved in both anaphylactic and immune complex hypersensitivibes
B. Complement is involved in both anaphylactic and immune complex hypersensitivities
C. Less antigen is typically needed to trigger and anaphylactic reaction than an immune complex reaction
D. Neutrophils play more important role in anaphylactic reactions than in immune complex reactions
52. A patient was undergoing a series of surgical procedures requiring general anesthetic. At the
third procedure he suddenly became hypotensive with marked cardiac arrhythmia. In addition his
breathing became difficuft due to extensive bronchocorstriction and obstructive laryngeal edema.
Despite the efforts of the surgical team the patient developed severe and permanent brain damage
due to hypoxernia. It was subsequently discovered that the patient had developed IgG antibodies to
the anesthetic gas and this had resulted in an anaphylactoid response to the anesthetic. What type
of reaction caused this condition?
A. Type I Hypersensitivity
B. Type II Hypersensitivity
C. Type III Hypersensitivity
D. Type IV Hypersensitivity
E. Direct activation of mast cells by the anesthetic gas
53. Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The ability of this
organism to cause disease is related to it’s ability to infect, persist  in, and replicate within
macrophages. The lepromin skin test is used to determine what type of leprosy a person has. In this
test, inactivated Mycobacterium leprae organisms are injected just beneath the skin. At the site of
injection, a person with a positive test will develop an area of induration with erythema peaking
around 48 hours after the injection. If this test measures a hypersensitivity reaction against the
organism, what type of hypersensitivity reaction is it intended to detect?
A.Type I
B. Type IV
C. Type II
D. Type II or III
E. Type III
54. The principle difference between type II and type III hypersensitivity is:
A. The class (isotype of antibody)
B. Whether the antibody reacts with the antigen on the cell or reacts with antigen before it interacts with
the cell
C. The participation of complement
D. The participation of T cells
55. A child stung by a bee experiences respiratory distress within minutes and lapses into
unconsciousness. This reaction is probably mediated by:
A. IgE antibody
B. IgG antibody
C. Sensitized T cells
D. Complement
E. IgM antibody
56. A patient with severe asthma gets no relief from antihistamines. The symptoms are MOST
likely to be caused by:
A. IL-2
B. Leukotrienes
C. Serotonin
D. Bradykinin
57. Hypersensitivity to penicillin and hypersensitivity to poison oak are both:
A. Mediated by IgE antibody
B. Mediated by IgG and IgM antibody
C. Intiated by haptens
D. Initiated by Th2 cells
58. Your patient has been treated for endocarditis with Penicillin G for the past 2 weeks. She now
has fever and maculopapular erythematous rash over her chest and abdomen. A urinalysis shows
significant protein in the urine. If the fever, rash and proteinuria are immunologic in origin, which
one of the following is MOST likely to be involved?
A. IgG and complement
B. IgE and histamine
C. IL-2 and cytotoxic T cells
D. Gamma interferon and macrophages
59. A child disturbs a wasp nest, is stung repeatedly, and goes into shock within minutes,
manifesting respiratory failure and vascular collapse. This is MOST likely due to;
A. Systemic anaphylaxis
B. Serum sickness
C. An Arthus reaction
D. Cytotoxic hypersensitivity
60. A delayed hypersensitivity reaction is characterized by:
A. Edema without a cellular infiltrate
B. An infiltrate composed of neutrophiis
C. An infiltrate composed of helper T cells and macrophages
D.  An infiltrate composed of eosinophils
61. In Henoch-Schonlein purpura, what is the reason for the purpuric rash?
A. Bacteria that adhere to vascular walls inducing necrosis
B. IgM immune complexes that induce vasculitis
C. Immune-mediated destruction of bacteria, releasing endotoxin
D. The disease is a the result of superantigen activity by the infectious agent
E. IgA immune complexes that induce vasculitis
62. A 44-year-old man is given an intramuscular high dose of penicillin. About 8 days later, he
develops chills, fever and a rash, If his symptoms are due to an immune reaction to the drug, what
type of reaction is this considered?
A. Type I Hypersensitivity reaction
B. Type II Hypersensitivity reaction
C. Type IV Hypersensitivity reaction
D. Anaphylactoid reaction
E. Type III Hypersensitivity reaction
Before continuing, try to answer the following questions. The answers can be found at the end of the
article, together with an explanation. Please answer True or False:
63. Regarding type 1 hypersensitivity reactions:
a. ‘Atopic individuals’ are at higher risk of developing type I hypersensitivity reactions
b. Require prior sensitisation to an antigen
c. Include anaphylactic reactions
d. Are mediated by IgG
e. Have one phase to the reaction
64. Anaphylactoid reactions:
a. Occur due to mast cell degranulation
b. Are the result of IgE cross-linking on mast cells
c. Are induced in all individuals exposed to anaphylactoid substances
d. Are differentiated from anaphylactic reactions by the absence of mast cell tryptase
e. May cause hypotension on induction of anaesthesia
65. Delayed hypersensitivity reactions are:
a. Also known as type IV hypersensitivity reactions
b. Occur within 2 hours of exposure to antigen
c. Comprise an infiltrate of T-helper cells and macrophages
d. May result in granuloma formation
e. Are most commonly seen in cutaneous reactions