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Exam I: Form A. Immunology 474, Fall 2001. (Chapters 1, 2, 3, and 4, Sept.

13, 2002), Name Social security number _________________________ ________________________

37 questions (57 total points) Read all questions carefully. Only one correct answer exists for each multiple-choice question. Clearly circle correct answer. Where appropriate, fill in correct answers as indicated by question. Keep the short answers short (two to three sentences)! 1. (1 pt). Louis Pasteur cultured the organism responsible for chicken cholera and demonstrated the organism caused disease in chickens. He then discovered that certain cultures of the organism got the chickens sick, but then they recovered. Later, when he challenged these chickens with virulent cholera, they did not get sick. The term that best describes the initial inoculating culture is A. variolated. B. attentuated. C. denatured. D. immune. 2. (1 pt). Of the following, which best describes a major difference between the selective and instructional theories of immune specificity? A. The selective theory included the interaction of a receptor (or antibody) and antigen, while the instructional theory did not. B. The selective theory suggested that receptor (or antibody) specificity was determined before the receptor (or antibody) interacted with the antigen, while the instructional theory did not. C. The instructional theory led other investigators to propose the "clonal selection theory", while the selective theory did not. D. None of the above represents a major difference between the selective and instructional theory of immune specificity. 3. (1 pt). Most pathogens enter the body via the A. skin. B. gastrointestinal tract. C. respiratory tract. D. mucous membranes. E. conjunctiva.

4. (3 pts). Describe below three defined events that lead to the influx of phagocytes into tissue following an inflammatory event and include the appropriate terms. i. ii. iii. 5. (1 pt). Fill in the blank. A number of proteins called acute phase proteins are released in response to tissue damage. One of these proteins can bind to a cell wall component of certain pathogens, which then leads directly to the activation of complement. This protein is referred to as __________________. 6. (1 pt). TRUE or FALSE. There are two major classes of major histocompatibility complex molecules, of which class II MHC molecules are found in conjunction with 2microglobin. 7. (3 pts). Define the three membrane molecules indicated below by the arrows by name.

8. (2 pts). Fill in the blanks. The increased quantities of antibodies produced in a secondary immune response is due to the clonally expanded __________ _______, while an increase in the speed of tissue rejection during a secondary response is due to the clonally expanded ___________ _____________ and ____________ cells.

9. (2 pts). One type of lymphocyte has been described as MHC-I restricted. Define this cell type below and describe why is it considered MHC-I restricted.

10. (1 pt). Which of the following is true for exogenous or endogenous antigens? A. Exogenous antigenic peptides are always presented on MHC I molecules. B. Endogenous antigenic peptides are derived from the endocytic pathway. C. Endogenous antigenic peptides are always presented on MHC II molecules. D. None of the above is true for exogenous or endogenous antigens. 11. (1 pt). The pluripotent hematopoietic stem cell gives rise to the lymphoid- and myeloid-stem cells. The presence of which cytokine pair leads to the formation of the myeloid stem cell from the pluripotent hematopoietic stem cell? A. IL-3 and IL-1 B. Macrophage colony - stimulating factor and IL-3. C. Granulocyte colony - stimulating factor and IL-7. D. Granulocyte-macrophage colony-stimulating factor and IL-3. 12. (1 pt). Apoptosis and necrosis are two mechanisms that lead to cell death. Which of the following changes do not occur to (or within) cells during (or following) the process of apoptosis? A. cell disintegration B. pronounced decrease in cell volume C. condensation of chromatin D. degradation of chromosomal DNA 13. (4 pts) The figure below is related to the enrichment process of pluripotent hematopoietic stem cells from mice. Describe what is meant by i. "fully enriched"; ii. "partly enriched"; iii. "unenriched cells".

iv. What important receptor helps define a pluripotent cell?

14. (1 pt). Which membrane molecule below acts as a receptor for the co-stimulatory B7 receptors on the surface of antigen presenting cells? A. CD8 B. CD40 C. CD4 D. CD28 15. (1 pt). Natural killer cells are a unique group of lymphocytes that do not express precise immunologic specificity or memory. However, these cells do express the CD16 receptor. The CD16 receptor binds to A. class I MHC molecules. B. CD 8 receptors. C. carboxy-termini of two heavy chains. D. amino-termini of the two heavy chains. 16. (1 pt). Which of the following cells do not exhibit phagocytic activity? A. basophils B. neutrophils C. dendritic cells D. eosinophils 17. (1 pt). Fill in the blanks. One type of cell, found exclusively in the lymph nodes that expresses high levels of antibody and complement receptors is thought to facilitate B-cell activation and the development of memory B-cells. This cell is referred to as the ________________ ______________ cell. 18. (1 pt). Which of the following is not considered an inflammatory cytokine? A. IL-1 B. IL-6 C. TNF- D. IFN- 19. (1 pt). Activated phagocytes can express both oxygen-dependent and -independent cyotoxic molecules. Describe below two oxygen-independent cytotoxic molecules produced by activated phagocytes and their respective function. i. ii.

20. (3 pts). Fill in the two boxes below with the appropriate lymphoid organ or tissue.

21. (2 pt). During T-cell maturation, 95-99% of all thymocytes are eliminated. Describe below the major reasons that leads to the destruction of these potential T-cells.

22. (2 pt). Fill in the blanks. The lymph exiting the efferent lymphatic vessel is rich in _____________ that is/are produced from activated lymphocytes within the _____________ region of the lymph node. 23. (1 pt). Which answer below best fills the blank in the following sentence. The initial activation of B and T-cells within the spleen takes place in the _____________ region. A. trabeculae B. marginal zone C. vascular sinusoid D. periarterial lymphatic sheath.

24 (2 pts). Briefly describe the function and location of the M cell.

25. (1 pt). Which of the following is a characteristic of haptens? A. exhibit antigenicity B. activate B-cells by themselves C. Both A and B above are characteristics for haptens. D. Neither A nor B above are characteristics for haptens. 26. (1 pt). Which of the following macromolecules usually act as the best immunogens? A. carbohydrates B. lipids C. proteins D. nucleic acids 27. (1 pt). The mechanisms by which adjuvants augment the immune reaction include all of the following except: A. inducing granuloma formation B. enhancing co-stimulatory signals C. preventing leukocytosis D. stimulating lymphocyte proliferation 28. (1 pt). Which of the following is true for antigen recognition by a B-cell? A. antigenic peptide is generally inaccessible B. recognition involves MHC molecules C. antigen can be recognized without processing D. none of the above is true for antigen recognition by a B-cell. 29. (2 pts). Fill in the boxes below with "+" to indicate secondary immune response and "-" to indicate no secondary response

30. (1 pt). The isotype of an immunoglobulin molecule is determined by the expression of genes that encode for the A. light chains. B. hinge region. C. heavy chains. D. hypervariable regions. 31. (1 pt). One protein monomer covalently attached to secretory IgA is the secretory component. The secretory component is directly derived from A. all dendritic cells. B. one of the light chains of IgA. C. the poly-Ig receptor. D. class II MHC receptors. 32. (4 pts). Sketch a cartoon of a IgM pentamer below. Label the Fab and Fc regions, disulfide bonds linking Fc portions and the J chain.

33. (1 pt). Three hypervariable regions exist within the variable region of the heavy and light chains of antibodies. These areas are referred to as the A. framework regions. B. complementarity-determining regions. C. Both A and B above are correct. D. Neither A nor B above are correct. 34. (1 pt). During the production of hybridomas (plasma/myeloma cell fusion) for the production of monoclonal antibodies, the compound aminopterin is added to the HAT media to inhibit the growth of certain cells. Aminopterin inhibits A. unfused plasma cell growth. B. unfused myeloma cell growth. C. hybridoma cell growth.

35. (1 pt). All of the following are true for the "immunoglobulin fold" except: A. found within the structure of immunoglobulin superfamily members B. R groups of hydrophilic amino acids are orientated to the outside halves of the sandwich structure. C. held together by four conserved disulfide bonds D. composed of extensive -sheet structure 36. (3 pts). Fill in the appropriate property/activity that is missing in the white boxes below (you can also place it on the side).

i. ii. iii.

37. (1 pt). Certain regions of immunoglobins are modified with carbohydrate residues. The region on the IgM molecule that is modified with carbohydrates is the A. CH3/CH3 B. CH2/CH2 C. hinge region D. CH1/CH1

Exam II: Immunology 474, Fall 2001. (Chapters 5, 6, 7, 8, and 9. Oct. 11, 2002), Name Last four numbers of social security number ________________________ ________________________

29 questions (53 total points), 3 extra credit question (3% points towards test one). Read all questions carefully. Only one correct answer exists for each multiple-choice question. Clearly circle correct answer or TRUE or FALSE. Where appropriate, fill in correct answers as indicated by question. Keep the short answers short (two to three sentences)! 1. (1 pt). The first antibody produced by a B-cell during development is A. IgD B. IgG C. IgM D. IgE. 2. (1 pt.). Which multigene family contains the most V gene segments A. -chain B. -chain C. Heavy chain. D. All of the above multigene families contain the same amount of V gene segments. 3. (1 pt.) Of the mouse -chain multigene family (mouse germline) which group of genes encodes for a pseudogene? A. V and J gene segments B. C and V gene segments C. D and C gene segments D. C and J gene segments. 4. (1 pt). Besides the V gene segments, which gene segments for the light and heavy chain, both encode for variable regions of the heavy and light chains? A. C gene segment B. D gene segment C. J gene segment D. B and C above are both correct

5. (1 pt). Which of the following was not used in the classic Tonegawa and Hozumi experiment to prove that the variable and constant regions of antibodies were encoded for by separate genes and that these genes were rearranged during B-cell differentiation? A. Restriction endonucleases B. Myeloma cell C. Hybridization D. Recombinases 6. (1 pt). The major reason that the Dryer and Bennet hypothesis for diverse antibody production was not immediately accepted by the scientific community is because they A. proposed that only one gene encoded the constant regions of antibodies. B. proposed that many genes encoded different variable regions of antibodies. C. contradicted the one-gene/one polypeptide hypothesis. D. contradicted that nucleic acids could contain genes. 7. (1 pt). Alterations in the antibody light chain primary amino acid sequence can be altered by all of the following except A. gene rearrangment B. RNA - processing enzymes C. carbohydrate additions D. post-translational modifications 8. (4 pts). Fill-in the boxes labeled with i., ii., iii., and iv., with the most appropriate description. i .

ii. iii. (2 processes)

iv. 10

9. (2 pts). Breifly Explain the one-turn/two turn joining rule of recombination signal sequences during variable DNA rearrangements.

10. (1 pt.) The peptide segment that is removed during the maturation of immunoglobulins is called the __________ ___________. 11. (1 pts). Which of the following statements concerning diversity generation in T-cell receptors and immunoglobulins is untrue? A. P-nucleotide addition occurs with the diversity generation of both type of molecules. B. Removal, or addition, of S and M sequences only occurs with immunoglobulin development. C. N-nucleotide addition occurs in both chains of the T- cell receptor, but only with the light chain of immunoglobulins D. Gene rearrangement occurs during the generation of diversity with both T-cell receptors and immunoglobulins. 12. (3 pts). Label i., ii., and iii., with the most appropriate description of the organelle or organelle area.

i .

ii.

iii.

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13. (1 pts). Using one of the early pregnancy test kits you observe visible clumping when you add your own or spouse's urine to the appropriate kit reagents. Visible clumping using this test indicates A. That you are pregnant. B. That you do not have human chorionic gonadotropin in your urine C. Neither A, nor B above is correct. 14. ( 1pt). The process of visualizing specific proteins on a membrane support with the use of specific antibodys is referred to as a A. Southern blot B. Western blot C. Northern blot D. Eastern blot. 15. (3 pts). Describe the steps i., ii., and iii., involved with performing an indirect ELISA.

i. Write answers below i. ii. iii.

ii.

iii.

16. (4 pts). Fill in the missing descriptions next to i., ii., iii., and iv.

i. ii.

iii. iv.

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17. (4 pts). Label i., ii., iii., and iv., with the most appropriate description. i. and iii. are supposed to be the name of the MHC

i.

ii.

iii.

iv.

18. (1 pt). The class 1b H-2M nonclassical MHC was unique. The molecule is unique because it binds a specific peptide derived from the mitochrondria. Which of the reasons below best describes why this MHC molecule is unique? A. binds peptide that are 20 amino acids in length B. binds self peptides which contain a formylated methionine C. is controlled by allelic dominance D. it may be uniquely suited to bind eukaryotic pathogen peptides. 19. (1 pt). How many different MHC I molecules can an individual have on the surface of their nucleated cells? _______ 20. (2 pts). Viruses can thwart the immune system by altering MHC production. Briefly describe how Adenovirus (serotype 12) alters MHC production.

21. (3 pts). Describe the "hole in the T-cell repertoire model" and what it attempts to explain.

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22. (1 pt.) TRUE or FALSE. The CD1 MHC molecule that is required for lipid antigen presentation resembles a class I MHC molecule. 23. (1 pt). Proteins that are targeted for degradation by the proteosome are bound by A. ATP B. MHC II C. Invariant chain D. Ubiquitin 24. (6 pts). Fill in the most appropriate descriptions for i., ii., iii., iv., v., and vi.

i. ii. iii.(not MHC)

iv.(not MHC) v. (pathway) vi.(pathway)

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25. (2 pts). Answer the following questions about the figure directly below. Why was the experiment performed? What is the name of the technique deployed in the experiment?

26. (2 pts). The CD3 complex of the T-cell receptor and Ig-/Ig- heterodimer of the Bcell have similar functions. Briefly describe the functions of these protein complexes.

27. (1 pt). TRUE or FALSE. The T-cell receptor structurally resembles that Fab portion of immunoglobulin molecules. 28. (1 pt). Which CDR of the T-cell receptor interacts with the MHC molecule? A. CDR1 B. CDR2 C. CDR3 D. None of the above CDR interacts with the MHC molecule. 29. (1 pt). Which of the following is true for both the CD4 and CD8 coreceptors? A. are heterodimers B. bind to the -2 domain of the MHC molecule C. bind the membrane proximal region of the MHC molecules D. bind to class II MHC molecules

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EXTRA CREDIT 3 % points possible towards EXAM I. 1. (1% pt). Name the protein that the researchers fused to the MHC II molecule so that they could observe its movements in real-time. 2. (1% pt). What is the MHC class II compartment a special form of? 3. (1% pt). What did Chow et al., add to dendritic cells to induce tubule formation that they were observing?

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Exam III: Immunology 474, Fall 2001. (Chapters 10, 11, 12, 13, and 14). Name Last four numbers of social security number ________________________ ________________________

55 questions (80 total points). Read all questions carefully. Only one correct answer exists for each multiple-choice question. Clearly circle correct answer for TRUE or FALSE. Where appropriate, fill in correct answers as indicated by question. Keep the short answers short (two to three sentences)! 1. (1 pt). Of the following, which is a true for double negative thymocytes? A. express a mature T-cell receptor B. do not express CD44 C. can express the pre-TCR receptor D. all become periphery T-cells 2. (1 pt). Of the following, which appears first on the surface of a developing murine (mouse) T-cell? A. CD25 B. CD4 C. c-kit D. -subunit of T-cell receptor 3. (1 pt). TRUE or FALSE. -chain DNA rearrangements of the mature T-cell receptor occur before -chain DNA rearrangements in a developing T-cell. 4. What are the conclusions of the experiments described in table below (3 pts)? Is this experimental evidence for positive or negative selection during T-cell maturation (1 pt)?

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5. (1 pt). Which cell pair below is intimately involved with negative selection during Tcells maturation in the thymus? A. thymic epithelial cells and macrophages B. natural killer cells and dendritic cells C. macrophages and dendritic cells D. Langerhans cells and thymic epithelial cells 6. (1 pt). Of the following enzymes which is not directly involved with the rearrangement of T-cell receptor -chain and -chain genomic DNA? A. RAG-1 B. Lck C. TdT D. RAG-2 7. (1 pt). TRUE or FALSE. Positive and negative selection of thymocytes in the thymus occur within the same thymic region. 8. (3 pts). State and describe three common themes in signal transduction. i. ii. iii. 9. (3 pts). The cartoon below describes the initial steps in T-cell activation. Fill in the boxes with the correct name of the factors that play a role in this process.

10. (1 pt). During superantigen-induced T-cell activation the superantigens bind simultaneously to the A. V domain of the T-cell receptor and chain of class II MHC. B. V domain of the T-cell receptor and chain of class II MHC. C. V domain of the T-cell receptor and chain of class I MHC. D. V domain of the T-cell receptor and chain of class I MHC.

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11. (1 pt). Specifically, describe what leads to the systemic toxicity associated with exposure of humans to superantigens.

12. (1 pt). Of the following cytokines, which is not a member of the TH2 subset? A. IL-4 B. IL-2 C. IL-5 D. IL-10 13. (1 pt). At what stage in B cell development have the VHDHJH rearrangements ceased? A. pro-B cell stage B. mature B cell stage C. pre-B cell stage D. immature B cell stage 14. (1 pt). Which cytokine is secreted by stromal cells, following interaction of pro-B cells and stromal cells, that leads to further maturation of B cells? A. IL-3 B. IL-2 C. IL-5 D. IL-7 15. (1 pt). The major difference between the pre-B cell and immature B cell immunoglobulin receptors is that A. pre-B cell receptors do not contain Ig-, while immature B cell receptors do. B. immature B cells receptors do not contain heavy chain Ig-subunits, while pre-B cell receptors do. C. pre-B cell receptors have a surrogate light chain, while immature B cell receptors do not. D. pre-B cell receptors contain the light chain, while immature B cell receptors do not.

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16. (3 pts). Describe two important findings for the experiment described in the cartoon below (i. and ii.). Do these experiment provide evidence for negative or positive selection during B cell development (iii.)? i.

ii.

iii.

17. (1 pt). Which of the following is not true? A. Thymus-dependent antigens require direct contact with TH cells. B. Lipopolysaccharide is an example of a type 2 thymus-independent antigen. C. Type 1 thymus-independent antigens act as mitogens. D. Soluble proteins make good thymus-dependent antigens. 18. (1 pt). Which of the following is not true for both B-cell and T-cell activation? A. Membrane-associated Src protein tyrosine kinases are involved. B. Activation involves ITAM motifs. C. Other signal-transducing pathways are recruited. D. All of the above are true for both B-cell and T-cell activation 19. (1 pt). Following activation of the TH cell by an antigen presenting B-cell, B-cell activation is enhanced by the interaction between the B7 and CD28 receptor-ligand combination, and the interaction of the B-cell membrane glycoprotein _____________ to the induced __________ on the T-cell surface. 20. (3 pts). Briefly describe the experiment outlined in the cartoon below and its importance.

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21. (1 pt). The cell type that presents antigen to TH cells when the antigen concentration is extremely low is A. B-cells. B. macrophages. C. dendritic cells. D. natural killer cells. 22. (4 pts). Fill in the best descriptive answers for the i. ii. iii. and iv. indicated by the arrows in the cartoon below. Place answers here ii. i. i. ii. iii. iv. iii. iv.

23. (1 pt.). What does the tingible-body macrophage specialize in?

24. (1 pt). The cell type that produces the iccosomes within secondary follicles is referred to as the A. centrocyte. B. plasmablast. C. follicular dendritic cell. D. centroblast. 25. (1 pt). Initial T-cell and B-cell activation occurs within the ___________ region of the peripheral lymph node. A. primary follicle B. paracortex C. cortex D. medulla 26. (1 pt). Activation of a proliferating B-cell (centrocyte) with cytokine IL-4 will lead to a plasma cell that produces A. IgG3 B. IgM C. IgE D. IgA 21

27. (2 pts). Identify the attributes (e.g. synergy) (i. and ii.) being displayed by the cytokine(s) in the cartoon below. Place answers here i. ii. ii. i.

28. (3 pts). Answer the following questions for the figure below: i. What partial receptor is being out-competed?; ii. What cytokine attribute is demonstrated; and iii. What role does the subunit play with regard to activation of a cell by IL-3 or GM-CSF? Place answers here i. ii. iii. 29. (1 pt). Which cytokine below is produced during both the TH1 and TH2 response? A. IL-2 B. IFN- C. IL3 D. IL-10 30. (1 pt). Which of the following responses is not induced by the TH2 cytokine subset? A. high production of opsonizing IgG B. eosinophil activation C. production of IgE D. allergic reaction

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31. (1 pt). Which cytokine below leads to the activation of the TH1 response? A. IL-4 B. IL-10 C. TNF- D. IL-12 32. (1 pt). Some human cytokine inhibitors can be found in bloodstream. Describe where these inhibitors arise from.

33. (1 pt). __________ inhibits both the TH1 and TH2 response in T-cells. A. IL-4 B. IFN- C. TGF- D. IL-10 34. (2 pts). Briefly describe how tuberculoid and lepromatous forms of leprosy differ in presentation and immunologically.

35. (1 pt). Treatment of septic shock patients with _______________ has been shown to reduce mortality in these patients. A. recombinant IL-2 receptor B. recombinant TNF- C. recombinant IL-1 receptor D. human derived anti-IL-6 36. (1 pt). Which of the following is not a function of complement? A. lysis of bacterial cells B. increased T-cell receptor production in TH cells C. triggering inflammation D. clearance of immune complexes.

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37. (1 pt). Deficiencies in the terminal complement components (C5-9) can lead to increased susceptibility to life-threatening infections with bacteria of the Neisseria spp. These terminal complement components are important in A. opsonization of pathogens such as Neisseria. B. binding immunoglobulin molecules in the classical pathway. C. stabilizing the alternative pathway C5 convertase. D. formation of the membrane attack complex and lysis of the bacterial cell. 38. (3 pts). A process is depicted in the cartoon below. During this process the bacterium is coated with two immune components, which in turn increase the phagocytosis of these bacteria. What complement component binds to these bacteria (i.)? What is the name of the two receptors that bind to the immune components bound to the bacteria (ii. and iii.)? Place answers here i. ii. iii.

39. (1 pt). Which of the following is the correct designation of the C3 convertase of the classical complement pathway. A. C4b2a B. C3bBb C. C4b2a3b D. C1qr2s2 E. None of the above is correct. 40. (1 pt) The alternative complement pathway A. is antibody dependent. B. requires factor D for formation of C3 convertase. C. requires the classical complement pathway C3 convertase. D. involves activation of the C2 component. 41. (1 pt). The lectin pathway of complement activation does not A. lead to the formation of the membrane attack complex. B. involve complement component C4. C. utilize the C5 convertase of the alternative complement pathway. D. involve complement component C2.

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42. (1 pt). What is the function of properdin in the alternative complement pathway?

43. (1 pt). Which of the complement components below is an anaphylatoxin and can induce an inflammatory response? A. C2 B. C4b C. C3a D. C2b 44. (2 pts). We produce a protein that regulates anaphylatoxins. What is the name of this protein (i.) and how does it function (ii.)? i. ii. 45. (1 pt). Which of the following is a correct statement? A. Nave T-cells express the CD45RO receptor. B. Effector T-cells require costimulation for activation. C. Nave T-cells express much more cell adhesion molecules than effector T-cells. D. Effector T-cells can home in on inflammatory sites. 46. (1 pt). What phrase is used to characterize the process depicted in the cartoon below?

47. (1 pt). A cytotoxic T cell requires binding of __________ in the target cell membrane to deliver the lethal hit via granzymes to the target cell. A. membrane attack complex B. perforin C. Fas D. CD16

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48. (2 pts). Besides granzymes, cytotoxic T-cells can induce apoptosis in target cells by another mechanism. Describe this mechanism.

49. (1 pt). TRUE or FALSE. Activation of a delayed type hypersensitivity reaction by a pathogen can actually lead to tissue damage in the host. 50. (1 pt). The delayed type hypersensitivity reaction can help protect us from infections with A. extracellular bacteria. B. intracellular fungi. C. Niether A nor B above is correct. D. Both A and B above are correct. 51. (1 pt). Which of the following represents the first step (signal) in the generation of an effector cytotoxic T-cell? A. interaction between CD28 and B7 B. interaction of IL-2 with high-affinity cytotoxic T-cell IL-2 receptor C. interaction of TCR with MHC I-antigenic peptide complex D. None of the above represents the first step (signal) in the generation of effector cytotoxic T-cells. 52. (1 pt). TRUE or FALSE. An effector CTL can induce apoptosis in multiple target cells. 53. (3 pts). What model is depicted in the cartoon below (i)? What are the general terms used to describe the two receptors involved with this model that are found on the surface of the natural killer cell (ii. and iii.) ? Place answers here i. ii. iii.

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54. (1 pt). Which of the following is not true for a natural killer cell? A. do not undergo rearrangement of receptor genes B. develop in the thymus C. stimulated (activated) by IFN- and other cytokines D. lack of NK cells can lead to severe viral infections. 55. (2 pts). What causes the spleen to enlarge during a Graft-vs-host reaction?

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Exam IV: Immunology 474, Fall 2001. (Chapters 15, 16, 17, 18, and 19). Name ________________________

Last four numbers of social security number ________________________ 43 questions (56 total points). Read all questions carefully. Only one correct answer exists for each multiple-choice question. Clearly circle correct answer for TRUE or FALSE. Where appropriate, fill in correct answers as indicated by question. Keep the short answers short (two to three sentences)! 1. (4 pts). Fill in the blanks below to describe the process taking place at each point in neutrophil extravasation.

2. (1 pt). The function of chemokines during leukocyte extravasation is to A. cause clotting. B. home in on inflamed endothelium only expressing GTP-binding proteins. C. induce adherence of cells to endothelium. D. induce the production of the IL-2 receptor only. 3. (1 pt). The kinin, clotting and fibrinolytic pathways would all be affected by a genetic defect in the gene encoding A. plasmin. B. fibrin. C. hageman factor. D. bradykinin. 4. (1 pt). The main function of LFA-1 found on certain leukocytes is in A. leukocyte adhesion B. lymphocyte extravasation via HEVs (high-endothelial venules). C. Both A and B above are correct. D. Neither A nor B above is correct.

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5. (2 pts). What are the two possible inflammatory mediators produced if arachidonic acid enters the cyclooxygenase pathway? _____________________ and _____________________. 6. (1 pt). The induction of the systemic acute inflammatory response is partially due to the production of which of the cytokines below? A. TNF- B. IL-2 C. IL-3 D. IFN- 7. (2 pt). Briefly describe the function of the C-reactive protein (i.) and where in the body is it predominantly produced (ii.)? i. ii. 8. (1 pt). The ability of at least 5 cytokines to induce the production of acute phase proteins from hepatocytes (redundancy) is because they all exert their action via a common A. receptor. B. transcription factor. C. activated macrophage. D. shared protein motif. 9. (2 pts). Briefly describe the genes (one class of genes and one specific gene) that are linked to a propensity for atopy.

10. (1 pt). What "process" at the surface of mast cells leads to the degranulation of these cells?

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11. (1 pt). Mice that lack the receptor FcRI are resistant to what type of allergic hypersensitivity reaction? A. Type I B. Type II C. Type III D. Type IV 12. (2 pts). The figure below demonstrates what occurs during a certain type of treatment for allergies. i. What is the common name for such a treatment? ii. What is the patient being exposed to? i. ii.

13. ( 1 pt). The reaction to the PPD antigen of Mycobacterium tuberculosis is due to what type of hypersensitivity reaction? A. Type I B. Type II C. Type III D. Type IV 14. (2 pts). Below is a cartoon that describes the development of serum sickness. Write in the phrase or descriptive term that best describes the event(s) (i) or compound substance(s) (ii) indicated. i.

ii.

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15. (1 pt). Of the cytokines below, which lowers IgE production? A. IL-4 B. IL-2 C. IFN- D. TNF- 16. (1 pt). The pathology of type III hypersensitivity reactions is mediated by A. IgE B. sensitized TDTH cells C. antibody dependent cell mediated cytotoxicity D. antigen-antibody structures 17. (1 pt). Which of the following is not true for erythroblastosis fetalis (hemolytic disease of the newborn). A. occurs during second pregnancy B. can be treated by removing fetal Rh-negative RBCs following birth of first child. C. Both A and B above are true for erythroblastosis fetalis. D. Niether A nor B above are true for erythroblastosis fetalis 18. (1 pt). Of the following which disease not account for over one million deaths worldwide per year? A. malaria B. AIDs C. rabies D. tuberculosis 19. (3 pts). The figure below describes how interferon induces an antiviral state in cells. Fill in the blanks (i, ii, and iii) with the most appropriate terms.

i.

ii.

iii.

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20. (1 pt). Describe what cytomegalovirus infection cause that protects this virus from the bodies immune response?

21. (2 pts). The cartoon below describes a granuloma formed in the lungs during pulmonary tuberculosis. What are the two major cell types (i. and ii.) indicated by the arrows? i. ii.

22. (1 pt). Following infection with Borrelia burgdorferi and the disease state that follows (lymes disease), the arthritis that occurs is caused by a A. Type I hypersensitivity reaction B. Type II hypersensitivity reaction C. Type III hypersensitivity reaction D. None of the above are correct. 23. (1 pt). If one were to produce a effective vaccine to prevent malaria, the vaccine would have to designed to produce an immune response that targets the A. malarial merozoite. B. malarial gametocyte. C. malarial hepatocyte. D. malarial sporozoite. 24. (1 pt). Which phase of Malaria infection leads to the recurrent fever? A. infection of liver with sporozoites B. formation of merozoites in liver C. release of merozoites D. release of gametocytes from merozoites 25. (1 pt). The causative agent of African sleeping sickness (Trypanosoma) protects itself from our immune system by A. binding host MHC I and blood-group antigens. B. inducing a TH2 response. C. altering a surface glycoprotein. D. inhibiting antibody formation. 32

26. (1 pt). The major damage caused by Schistosoma infection is mediated by the release of eggs, many of which remain in the host. These eggs then cause a cell mediated DTH response which leads to the formation of granulomas, blood flow loss and tissue destruction. The organ that these organisms can infect is the A. stomach. B. colon. C. spleen D. liver 27. (1 pt). Capsular polysaccharide from ____________ is used in the vaccine preparation to protect against infection with this organism. A. Clostridium tetani B. Mycobacterium turberculosis C. Streptococcus pneumoniae D. Leishmania major 28. (1 pt). TRUE or FALSE. Development of an immune response always leads to a state of protective immunity against the immunogen producer. 29. (2 pts). Describe passive immunity and give an example of passive immunity.

30. (1 pt.). Of the following, which is not true for an attenuated vaccine? A. generally requires multiple boosters B. not as stable as an inactivated vaccine C. may revert and causes disease D. selected from virulent pathogens 31. (1 pt). A toxoid preparation formulated from the toxin produced by ____________ is used in the vaccine preparation to protect against infection with this organism. A. Corynebacterium diphtheriae B. Bacillus anthrax C. Salmonella typhi (typhoid) D. Bordetella pertussis (whopping cough, or pertussis)

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32. (1 pt). Which of the following is true in regards to a vaccine produced with a capsular polysaccharide? A. fully activates TH cells B. results in IgM production C. leads to the development of immunologic memory D. induces antibody class switching 33. (1 pt). A DNA vaccine A. cannot induce both humoral and cell mediated immune responses. B. can generate significant immunological memory. C. is not translated within the cells that is resides. D. is not maintained within cells for a long period. 34. (1 pt). TRUE or FALSE. Individuals with B-cell deficiencies are subject to recurrent bacterial infections. 35. (1 pt). One study discussed in class found that genetic defects in the gene encoding ___________________ is the primary cause of severe combined immunodeficiency in children. A. IgM B. the chain of IL-2 receptor C. Janus kinase (involved with T-cell signal transduction) D. adenosine deaminase. 36. (1 pt). Briefly describe how neutropenia can be acquired?

37. (1 pt). X-linked hyper-IgM syndrome A. leads to reduced IgM levels. B. is caused by mutations in L chain genes, that cause them to remain in the germline configuration. C. leads to the formation of high IgG levels. D. is caused by a mutation in the gene encoding the CD40 ligand. 38. (1 pt). Chronic granulomatous disease results from A. a serious infection induced autoimmunity. B. an overexpression of IFN-. C. a defective oxidative pathway in phagocytes. D. None of the above is correct.

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39. (1 pt). The following are all classes of anti-HIV drugs in clinical use except A. nucleoside analogues that inhibit reverse transcriptase. B. compounds that inhibit the HIV specific protease C. non-nucleoside analogues that inhibit reverse transcriptase. D. integrase inhibitors that inhibit provirus formation. 40. (1 pt). Besides the CD4 receptor, the ___________ chemokine receptor on T-cells is also required for infection of a cell with HIV. 41. (1 pt). TRUE or FALSE. Worldwide, the number of HIV cases is equal among men and women. 42. (2 pts). In particular, what interaction leads to the death of cells infected with HIV? Be specific as possible.

43. (1 pt). An effective HIV vaccine has not been developed. Which of the following is not a reason why there is no effective vaccine? A. no suitable animal model for HIV B. majority of HIV infections occur via the genital tract C. HIV mutates at a rapid rate D. All of the above are reasons why an effective HIV vaccine has not been developed

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5% extra credit (happy holidays) on rotavirus handouts at the end of this exam. This will be applied to your lowest lecture test grade, if this brings the grade to 60%, regular syllabus rules apply. No matter what, you will not lose these points, even if you have already dropped a test then the points are applied to your three test average. Thank you for being my first class at NMSU, I truly wish you all, the finest life possible. 1. (1 % pt). TRUE or FALSE. Rotavirus infections in children is blamed for ~500,000 physician visits each year in the United States and therefore contributes substantially to the overall medical costs within this country. 2. (1 % pt). The rotavirus vaccine was approved by the Food and Drug Administration in A. 1961 B. 1980s C. 1977 D. 1998 3. (1 % pt). The rotavius vaccine was withdrawn from use because in some cases it led to _______________ in infants receiving the vaccine A. encephalitis B. pneumonia C. bowel obstruction D. skin infections 4. (1 % pt). TRUE or FALSE. Rotavirus infection cannot be deadly. 5. (1 % pt). TRUE or FALSE. If a child received the rotavirus vaccine last year and has not yet become ill, your child is still at risk of intussusception.

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