REVIEW QUESTIONS (Chapter 7: Complement System)
1. The classical complement pathway is activated by
a. mos viruses
b. antigen-antibody complexes.
c. fungal cell walls.
d. mannose in bacterial cell walls.
2. Which of the following is characteristic of
complement components?
a. Normally present in serum
b. Mainly synthesized by B cells
c. Present as active enzvmes
d. Feat stable
3. All of the following are true of the recognition unit
except
a. it consists of CIg, CIr, and CIs.
b. the subunits require calcium for binding together.
c. binding occurs at the FC region of antibody
molecules.
d. Clq becomes an active esterase
4. Which of the following is referred to as C3
convertase?
a. Clqrs
b. C3Bd
с. C3bBb
d. C4b5a
5. Mannose-binding protein in the lectin pathway is
most similar to which classical pathway component?
a. C3
b. CIrs
c. Clq
d. C4
6. Which of the following describes the role of
properdin in the alternative pathway?
a. Stabilization of C3/C5 convertase
b. Conversion of B to Bb
c. Inhibition of C3 convertase formation
d. Binding and cleavage of Factor B
7. Which best characterizes the membrane attack
complex (MAC)?
a. Each pathway uses different factors to form it.
b. C5 through C9 are not added in any particular order.
c. One MAC unit is sufficient to lyse any type of cell.
d. C9 polymerizes to form the transmembrane channel
8. All of the following represent functions of the
complement system except
a. decreased clearance of antigen-antibody
b. lysis of foreign cells.
c. increase in vascular permeability.
d. migration of neutrophils to the tissues.
9. Which of the following is true of the amplification
loop in complement activation?
a. It is only found in the alternative pathway.
b. The membrane attack unit is amplified.
c. C3b is the product that is increased.
d. Increasing amounts of Clqrs are produced.
10. Factor H acts by competing with which of the
following for the same binding site?
a. Factor B
b. Factor D
c. СЗВ
d. Factor I
11. A lack of CRI receptors on RBCs would result in
which of the following?
a. Decreased binding of C3b to RBCs
b. Decreased clearance of immune complexes by the
spleen
c. Decreased breakdown of Clqrs
d. Decreased binding of Factor H
12. Which best describes the role of CR2 on cell
membranes?
a. Binds CIgrs to inactivate it
b. Acts as co-receptor on B cells lor antigen
c. Increases clearance o immune complexes
d. Binds particles opsonized with C3b
13. Which of the following best characterizes hemolytic
uremic syndrome?
a. It is a rare cause of renal tailure in children.
b. It can be associated with deficiencies in Factor H.
c. The major cause is lack of DAF on RBCs.
d. It is associated with antibody-to-C3 convertase
14. The CH50 test measures which of the following?
a. Patient serum required to lyse 50% of sensitized
sheep RBCs
b. Functioning of both the classical and alternative
pathways
c. Genetic deliciencies o any of the complement
components
d. Functioning of the lectin pathway only
15. Which of the following would be most effective in
preventing bystander lysis of RBCs?
a. CI-INH
b. Factor B
c. DAF
d. Factor H
16. A decreased CH50 level and a normal AH50 level
indicate which deticiency?
a. Decrease in components in the lectin pathway only
b. Decrease in components in the alternative pathway
only
c. Decrease in components of both classical and
alternative pathways
d. Decrease in components of the classical pathway only
17. Which best describes the role of an anaphylatoxin?
a. Coats cells to increase phagocytosis
b. Attracts WBCs to the area of antigen concentration
c. Increases production of interleukin-1
d. Increases permeability of blood vessels
18. Which best describes the role of Factor H?
a. Acts with DAF to break down C3b
b. Prevents binding of Factor B to C3b
c. Binds to the C5C6C7 complex
d. Binds to C1q to shut down the classical pathway
19. A lack of CI-INH might result in which of the
following conditions?
a. Paroxysmal nocturnal hemoglobinuria
b. Hemolytic uremic syndrome
c. Hereditary angioedema
d. Increased bacterial infections
20. Which would be most effective in measuring an
individual complement component?
a. CH50 assay
b. Radial immunodiffusion
c. AH50 assay
d. Lytic assay with liposome
CHAPTER 17: HYPERSENSITIVYT
1. Which of the following is a general characteristic of
hypersensitivity reactions?
a. The immune responsiveness is depressed.
b. Antibodies are involved in all reactions.
c. An exaggerated immune response to an antigen
occurs.
d. The antigen triggering the reaction is a harmful one.
2. Which of the following is associated with an increase
in IgE production?
a. Transfusion reaction b. Activation of Th2 cells c.
Reaction to poison ivy d. HDN
3. Which of the following would cause a positive DAT
test?
a. Presence of IgG on RBCs
b. Presence of C3b or C3d on RBCs
c. Atransfusionreactioncausedbypreformedantibody
d. Any of the above
4. All of the following are associated with type I hyper-
sensitivity except
a. release of preformed mediators from mast cells. b.
activation of complement.
c. cell-bound antibody bridged by antigen.
d. an inherited tendency to respond to allergens.
5. Which of the following is associated with
anaphylaxis?
a. Buildup of IgE on mast cells
b. Activation of complement
c. Increase in cytotoxic T cells
d. Large amount of circulating IgG
6. To determine if a patient is allergic to rye grass, the
best test to perform is the
a. total IgE test.
b. skin prick test.
c. DAT.
d. complement fixation.
7. Which condition would result in HDN?
a. Buildup of IgE on mother’s cells
b. Sensitization of cytotoxic T cells
c. Exposure to antigen found on both mother and
baby RBCs
d. Prior exposure to foreign RBC antigen
8. What is the immune mechanism involved in type III
hypersensitivity reactions?
a. Cellular antigens are involved.
b. Deposition of immune complexes occurs in anti-
body excess.
c. Only heterologous antigens are involved.
d. Tissue damage results from exocytosis
9. What is the immune phenomenon associated with
the Arthus reaction?
a. Tissue destruction by cytotoxic T cells
b. Removal of antibody-coated RBCs
c. Deposition of immune complexes in blood vessels
d. Release of histamine from mast cells
10. Which of the following conclusions can be drawn
about a patient whose total IgE level was determined to
be 150 IU/mL?
a. The patient definitely has allergic tendencies.
b. The patient may be subject to anaphylactic shock. c.
Antigen-specific testing should be done.
d. The patient will never have an allergic reaction
.
11. Which of the following explains the difference
between type II and type III hypersensitivity reactions?
a. Type II involves cellular antigens.
b. Type III involves IgE.
c. IgG is involved only in type III reactions.
d. Type II reactions involve no antibody.

12. Two days after administration of the PPD test, a

female health-care worker developed an area of
redness and induration 12 mm in size at the injection
site. This result means that she has
a. an active case of tuberculosis.
b. been exposed to M tuberculosis.
c. developed protective immunity against tuberculosis.
d. a result in the normal range for her risk group.

13. A young woman developed red, itchy papules on her

wrist 2 days after wearing a new bracelet. This reaction
was caused by
a. IgE-sensitized mast cells in the skin.
b. antigen-antibody complexes in the skin.
c. damage to the skin cells by antibodies and
complement.
d. an inflammatory response induced by cytokines
released from Th1 cells.

14. Reactions to latex are caused by

a) type I hypersensitivity.
b) type IV hypersensitivity.
c) skin irritation.
d) all of the above.

15. To determine a cold agglutinin titer

a) patient serum should be separated from whole blood
at 4°C and tested at 4°C.
b) patient serum should be separated from whole blood
at 4°C and tested at 37°C.
c) patient serum should be separated from whole blood
at 37°C and tested at 4°C.
d) patient serum should be separated from whole blood
at 37°C and tested at 37°C.