130 Immunology questions and answers IMMUNOLOGY[dse1] From Medical Microbiology & Immunology Examination & Board Review, 6th

ed., 2000 W. Levinson & E. Jawetz

Directions (Questions 387-474): Select the ONE lettered answer that is BEST in each question.

387. Which category of hypersensitivity BEST describes hemolytic disease of the newborn caused by Rh incompatibility?

A. atopic or anaphylactic B. cytotoxic C. immune complex D. delayed

388. The principal difference between cytotoxic (type II) and immune complex (type III) hypersensitivity is

A. the class (isotype) of antibody. B. the site where antigen-antibody complexes are formed. C. the participation of complement. D. the participation of T cells.

389. 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.

390. A patient with rheumatic fever develops a sore throat from which betahemolytic streptococci are cultured. The patient is started on treatment with penicillin, and the sore throat resolves within several days. However, 7 days after initiation of penicillin therapy the patient develops a fever of 103°F, a generalized rash, and proteinuria. This MOST probably resulted from

A. recurrence of the rheumatic fever. B. a different infectious disease. C. an IgE response to penicillin. D. an IgG-IgM response to penicillin. E. a delayed hypersensitivity reaction to penicillin.

391. A kidney biopsy specimen taken from a patient with acute glomerulonephritis and stained with fluorescein-conjugated anti-human IgG antibody would probably show

A. no fluorescence. B. uniform fluorescence of the glomerular basement membrane. C. patchy, irregular fluorescence of the glomerular basement membrane.

D. fluorescent B cells. E. fluorescent macrophages.

392. A patient with severe asthma gets no relief from antihistamines. The symptoms are MOST likely to be caused by

A. interleukin-2. B. slow-reacting substance A (leukotrienes). C. serotonin. D. bradykinin.

393. Hypersensitivity to penicillin and hypersensitivity to poison oak are both

A. mediated by IgE antibody. B. mediated by IgG and IgM antibody. C. initiated by haptens. D. initiated by Th-2 cells.

394. A recipient of a 2-haplotype MHC-matched kidney from a relative still needs immunosuppression to prevent graft rejection because

A. graft-versus-host disease is a problem. B. minor histocompatibility antigens will not be matched. C. minor histocompatibility antigens will not be matched. D. complement components will not be matched.

395. Bone marrow transplantation in immunocompromised patients presents which major problem?

A. potentially lethal graft-versus-host disease B. high risk of T cell leukemia C. inability to use a live donor D. delayed hypersensitivity

396. What is the role of class II MHC proteins on donor cells in graft rejection?

A. They are the receptors for interleukin-2, which is produced by macrophages when they attack the donor cells. B. They are recognized by helper T cells, which then activate cytotoxic T cells to kill the donor cells. C. They induce the production of blocking antibodies that protect the graft. D. They induce IgE which mediates graft rejection.

397. Grafts between genetically identical individuals (i.e., identical twins)

A. are rejected slowly as a result of minor histocompatibility antigens. B. are subject to hyperacute rejection. C. are not rejected, even without immunosuppression. D. are not rejected if a kidney is grafted, but skin grafts are rejected.

398. Penicillin is a hapten in both humans and mice. To explore the hapten-carrier

B lymphocytes. Of the following. 401. are different for two tumors of different histologic type even if induced by the same carcinogen. Chemically-induced tumors have tumor-associated transplantation antigens that A. bovine serum albumin 399. lymphocyte stem cells. B. penicillin bound to egg albumin C. D. C. are always the same for a given carcinogen. do not induce an immune response. egg albumin D. C. a mouse was injected with penicillin covalently bound to bovine serum albumin and. D. B. CD4-positive T lymphocytes. are very strong antigens. 400. CD8-positive T lymphocytes. AIDS is caused by a human retrovirus that kills A.relationship. Polyomavirus (a DNA virus) causes tumors in "nude mice" (nude mice do not . at the same time. which one will induce a secondary response to penicillin when injected into the mouse 1 month later? A. with egg albumin to which no penicillin was bound. penicillin B.

404. D. Diversity is an important feature of the immune system. Which one of the following statements about it is INCORRECT? . B. After binding to its specific antigen. T lymphocytes play an important role in the rejection of polyomavirus-induced tumors. promoting phagocytosis. B lymphocytes play no role in rejection of polyomavirus-induced tumors. variable region of the immunoglobulin heavy chain. B. C. forming C5 convertase. C. altering vascular permeability. 402. forming alternative-pathway C3 convertase. a B lymphocyte may switch its A.have a thymus. C3b is involved in all of the following EXCEPT A. B. the BEST interpretation is that A. macrophages are required to reject polyomavirus-induced tumors. because of a genetic defect) but not in normal mice. immunoglobulin light-chain isotype. C3 is cleaved to form C3a and C3b by C3 convertase. immunoglobulin heavy-chain class. constant region of the immunoglobulin light chain. 403. natural killer cells can reject polyomavirus-induced tumors without help from T lymphocytes. D. D. C.

A. C. Neutrophils are attracted to an infected area by A. phagocytosis of IgE-coated bacteria. D. The hematopoietic stem cell carries the genetic potential to create more than 104 immunoglobulin genes. B. 405. aggregation of C4 and C2. then switch to IgA antibody. C3a and C5a can cause A. bacterial lysis. the ingestion of C3b-coated bacteria by macrophages. D. vascular permeability. phagocytosis of IgE-coated bacteria. B. Complement fixation refers to A. A single B lymphocyte can produce antibodies of many different specificities. B. C. aggregation of C4 and C2. IgM. but a plasma cell is monospecific. D. 406. . C. A single cell can synthesize IgM antibody. vascular permeability. Humans can make antibodies with about 108 different VH X VL combinations. 407.

C. 410. decreased resistance to Neisseria bacteremia. D. B. C. the interaction of C3b with mast cells. antigen-IgG complexes. B. D. antigen. the binding of complement components by antigen-antibody complexes. C. increased hypersensitivity reactions. Patients with severely reduced C3 levels tend to have A. frequent episodes of hemolytic anemia. increased frequency of cancer. increased numbers of severe bacterial infections. . bacterial lipopolysaccharides. 409. 408. decreased resistance to viral infections. low gamma globulin levels. B. The classic complement pathway is initiated by interaction of C1 with A. factor B. the destruction of complement in serum by heating at 56°C for 30 minutes. increased numbers of severe viral infections.B. Individuals with a genetic deficiency of C6 have A. D. C. D.

This is MOST likely . both the T and B cell systems are functional. D. C.411. cytotoxic T cells. D. Reaction to poison ivy or poison oak is A. 412. C. able to kill virus-infected cells without prior sensitization. B. A positive tuberculin skin test (a delayed hypersensitivity reaction) indicates that A. is stung repeatedly. B. C. an IgE-mediated response. B cells that can kill without complement. Natural killer cells are A. an Arthus reaction. a cell-mediated immune response has occurred. and goes into shock within minutes. A child disturbs a wasp nest. 413. B. a cell-mediated response. an IgG-mediated response. manifesting respiratory failure and vascular collapse. only the B cell system is functional. increased by immunization. 414. D. a humoral immune response has occurred.

V gene for lambda chain and C gene for kappa chain B. . B. C gene for gamma chain and C gene for kappa chain C. simultaneous insertion of VH genes adjacent to each CH gene. cytotoxic hypersensitivity.to be due to A. 415. activation of homologous genes on chromosome 6. "Isotype switching" of immunoglobulin classes by B cells involves A. V gene for lambda chain and V gene for heavy chain D. B. 416. D. an Arthus reaction. systemic anaphylaxis. C. serum sickness. C. switching of light-chain types (kappa and lambda). Idiotypic determinants are located within A. C gene for gamma chain and C gene for alpha chain 417. D. successive insertion of a single VH gene adjacent to different CH genes. hypervariable regions of heavy and light chains. Which one of the following pairs of genes is linked on a single chromosome? A.

C. C. have different VH and VL regions 420. . epsilon chain. gamma chain. D. 3 days C. 418.B. A primary immune response in an adult human requires approximately how much time to produce detectable antibody levels in the blood? A. the hinge region. have identical heavy chains but different light chains B. B. constant regions of heavy chains. 1 week D. 3 weeks 419. Mu chain. During the maturation of a B lymphocyte. the first immunoglobulin heavy chain synthesized is the A. are identical except for their VH regions D. The membrane IgM and IgD on the surface of an individual B cell A. constant regions of light chains. 12 hours B. are identical except for their CH regions C.

) A. In the immune response to a hapten-protein conjugate. isotope-labeled anti-insulin antibody made in goats 423. C. anti-goat gamma globulin made in rabbits D. HIV antigen/patient's serum/enzyme-labeled antibody against human gamma globulin/enzyme substrate C. alpha chain. the protein be recognized by helper T cells. In the determination of serum insulin levels by radioimmunoassay. which one of the following is NOT needed? A. B. 421. Which one of the following sequences is appropriate for testing a patient for antibody against the AIDS virus with the ELISA procedure? (The assay is carried out in a plastic plate with an incubation and a wash step after each addition except the final one. D. isotope-labeled insulin B. in order to get antihapten antibodies it is essential that A. 422.D. the hapten be recognized by helper T cells. anti-insulin antibody made in goats C. the hapten be recognized by suppressor T cells. the protein be recognized by B cells. patient's serum/enzyme substrate/HIV antigen/enzyme-labeled antibody against HIV B. enzyme-labeled antibody against human gamma globulin/patient's serum/HIV .

The toxin activates many CD4-positive T cells. B A. C 430. which one of the following is LEAST accurate? 423. indirect fluorescent-antibody test. complement fixation test. D 432. D 425. D. When all cultures showed no bacterial growth. hypotension. B. and large amounts of interleukins are released. C 429. B 421. D. which resolves shortly after the drug is withdrawn. D 431. D 426. The BEST method to demonstrate IgG on the glomerular basement membrane in a kidney tissue section is the A. The toxin has an A-B subunit structure--the B subunit binds to a receptor. C. and a diffuse macular rash. A patient with a central nervous system disorder is maintained on the drug methyldopa. D 425. enzyme-labeled antibody against HIV/HIV antigen/patient's serum/enzyme substrate 424. B. The toxin binds to both the class II MHC protein and the T cell receptor. a diagnosis of toxic shock syndrome was made. Hemolytic anemia develops. . The toxin is not processed within the macrophage. B 424. Regarding the mechanism by which the toxin causes this disease. B 427. 426. and the A subunit enters the cells and activates them. precipitin test. agglutination test. D 433. C. A woman had a high fever. 422. atopic hypersensitivity.antigen/enzyme substrate D. A 428. This is MOST probably an example of A.

If a large dose of spleen cells from an adult A mouse is injected into an adult AB mouse. immune-complex hypersensitivity. interleukin-2 D. gamma interferon C. B. The spleen cells will be destroyed. an infiltrate composed of helper T cells and macrophages D. interleukin-4 428. B.B. A delayed hypersensitivity reaction is characterized by A. which one of the following is MOST likely to occur? An explanation of the answer to this question is given on p. edema without a cellular infiltrate. Which one of the following substances is NOT released by activated helper T cells? A. interleukin-1 B. cell-mediated hypersensitivity. 429. Two dissimilar inbred strains of mice. A. 24. C. 427. D. . are crossed to yield an F1 hybrid strain. an infiltrate composed of eosinophils. The spleen cells will survive and will have no effect in the recipient. an infiltrate composed of neutrophils. cytotoxic hypersensitivity. C. AB. A and B.

B. 432. C. Which one of the following is NOT true of class I MHC antigens? A. If adult AB spleen cells are injected into a newborn B mouse. which one of the following is MOST likely to occur? An explanation of the answer to this question is given on p. D. 430. They can usually be identified in the laboratory in a few hours. C. are detected by reaction with antibodies and complement.C. The spleen cells will induce a graft-versus-host reaction in the recipient. . A. 431. The spleen cells will survive and induce tolerance of strain A grafts in the recipient. The spleen cells will induce a graft-versus-host reaction in the recipient. They can be assayed by a cytotoxic test that uses antibody and complement. D. The spleen cells will survive and induce tolerance of strain A grafts in the recipient. This question is based on the same strains of mice described in the previous question. are controlled by several genes in the major histocompatibility complex. The spleen cells will survive without any effect on the recipient. The spleen cells will be destroyed. 24. D. induce reactions that can cumulatively lead to a strong rejection response. are unimportant in human transplantation. B. B. The minor histocompatibility antigens on cells A.

D. and activated T cells. D. B. alpha-fetoprotein. macrophages. C. V. B. An antibody directed against the idiotypic determinants of a human IgG antibody would react with A. 435. They are controlled by at least three gene loci in the major histocompatibility complex. all human kappa chains. Several J segments and several D segments are available. carcinoembryonic antigen. An antigen found in relatively high concentration in the plasma of normal fetuses and a high proportion of patients with progressive carcinoma of the colon is A. Many V region segments are available. D. C. Which one of the following is NOT true of the gene segments that combine to make up a heavy-chain gene? A.C. C. heterophil 434. B. the Fc part of the IgG. and J segments combine to encode the antigen-binding site. viral antigen. all human gamma chains. . an IgM antibody produced by the same plasma cell that produced the IgG. 433. D. They are found mainly on B cells.

the hypervariable regions of H chains. A V segment and a J segment are preselected by an antigen to make up the variable-region portion of the gene. IgA D. IgM and IgA 438. D. gamma interferon. the variable regions of H chains.D. damage to the membrane is caused mainly by A. enzymes released by polymorphonuclear cells. When immune complexes from the serum are deposited on glomerular basement membrane. The antibody-binding site is formed primarily by A. B. C. If an individual was genetically unable to make J chains. phagocytosis. 437. D. C. . IgG B. IgG and IgM E. cytotoxic T cells. B. the constant regions of H and L chains. IgM C. the hypervariable regions of H and L chains. which immunoglobulin(s) would be affected? A. 436.

Cytotoxic T cells induced by infection with virus A will kill target cells A. 441. Individuals of blood group type AB A. are Rh(d)-negative. from the same host infected with any virus. IgE. D. infected by virus A and identical at class II MHC loci of the cytotoxic T cells. The class of immunoglobulin present in highest concentration in the blood of a human newborn is A. infected with a different virus and identical at class I MHC loci of the cytotoxic cells. the variable regions of L chains. . have circulating anti-A and anti-B antibodies. have the same haplotype. B. C. IgD. C. are "universal recipients" of transfusions. infected by virus A and identical at class I MHC loci of the cytotoxic T cells. D. B. B. 440. IgA. IgG. D. IgM. 439. C.E. E.

C2. D. classic-pathway C5 convertase B. Which one of the following does NOT contain C3b? A. class II MHC antigens 443. alternative-pathway C3 convertase 444. It does not require C1. It cannot be initiated unless C3b fragments are already present.E. B. Antigen-presenting cells that activate helper T cells must express which one of the following on their surfaces? A. or C4. Which one of the following is NOT true regarding the alternative complement pathway? A. alternative-pathway C5 convertase C. It can be triggered by infectious agents in absence of antibody. C. 442. It has the same terminal sequence of events as the classic pathway. class I MHC antigens D. classic-pathway C3 convertase D. . gamma interferon C. IgE B. infected with a different virus and identical at class II MHC loci of the cytotoxic cells.

Proteins from two samples of animal blood. were tested by the double-diffusion (Ouchterlony) test in agar against antibody to bovine albumin. In setting up a complement fixation test for antibody. C = complement. both samples . 24. C + patient's serum + EA/wait/ + Ag C.445. Ag + patient's serum + C/wait/ + EA 446. sample B C. Ag + patient's serum + EA/wait/ + C D. Which sample(s) contain horse blood? An explanation of the answer to this question is given on p[dse2] .) A. Ag + EA + C/wait/ + patient's serum B. A and B. EA = antibody-coated indicator erythrocytes. A. the reactants should be added in what sequence? (Ag = antigen. Ab = antibody. sample A B.

activation of adenylate cyclase. affinity for antigen . phagocytic cells. insertion of complement proteins into the cell membrane. C. helper T cells.D. isotype (class) C. 449. 448. neither sample 447. Graft and tumor rejection are mediated primarily by A. D. D. ability to cross the placenta B. ability to fix complement D. non-complement-fixing antibodies. inhibition of elongation factor 2. enzymatic digestion of the cell membrane. Complement lyses cells by A. Which one of the following properties of antibodies is NOT dependent on the structure of the heavy-chain constant region? A. B. B. cytotoxic T cells. C.

are irradiated and then cultured with lymphocytes from person Z. the reaction site would MOST probably show A. 452. eosinophils. neutrophils. adult strain A spleen cells injected into an x-irradiated strain AB adult D. D. C. adult strain AB spleen cells injected into a strain A newborn 451. C. AB is an F1 hybrid between strain A and strain B. who is homozygous for the HLA-Dw7 allele. D. person Z is homozygous for HLA-Dw7. In which one of the following situations would a graft-versus-host reaction be MOST likely to occur? (Mouse strains A and B are highly inbred. . person Z is homozygous or heterozygous for HLA-Dw7. B. Histologically. In a mixed-lymphocyte culture. B. x-irradiated adult strain A spleen cells injected into a strain B adult C. B cells. person Z is heterozygous for HLA-Dw7.450. lymphocytes from person X.) A. newborn strain A spleen cells injected into a strain B adult B. It is found that DNA synthesis is NOT stimulated. person Z does not carry the HLA-Dw7 allele. The proper conclusion to be drawn is that A. helper T cells and macrophages. A patient skin-tested with purified protein derivative (PPD) to determine previous exposure to Mycobacterium tuberculosis develops induration at the skin test site 48 hours later.

B. IgG antibody. 455.453. D. Therefore. Streptococci are ingested by neutrophils that release proteases that damage heart tissue. B. zero. C. Which one of the following statements BEST explains the relationship between inflammation of the heart (carditis) and infection with group A beta-hemolytic streptococci? A. Streptococci are polyclonal activators of B cells. IgM antibody. . the mediator of this disease is A. C. 454. Streptococcal antigens induce antibodies cross-reactive with heart tissue. 1:4. IgE antibody. The probability that all three of their children are Rh-positive is A. D. 1:2. D. An Rh-negative woman married to a heterozygous Rh-positive man has three children. C. Hemolytic disease of the newborn caused by Rh blood group incompatibility requires maternal antibody to enter the fetal bloodstream. IgA antibody. Streptococcal antigens bind to IgE on the surface of heart tissue and histamine is released. B. 1:8.

C. What is your conclusion? A. No HLA-B27 cell will be killed. It is unlikely that the patient has encountered this organism previously. You have a patient who makes autoantibodies against his own red blood cells. Any HLA-B27 cell will be killed. Which one of the following mechanisms is MOST likely to explain the hemolysis? A. Complement is activated. C. . leading to hemolysis. B. It is likely that the patient has an autoimmune disease. 458. and membrane attack complexes lyse the red cells. Only virus X-infected cells of HLA-B27 type will be killed. Neutrophils release proteases that lyse the red cells. The information given is irrelevant to previous antigen exposure. D. D. B. 457. The patient is predisposed to IgE-mediated hypersensitivity reactions. Laboratory examination reveals that the patient's antibodies against this virus have a high ratio of IgM to IgG. C. B. D. If you measure the ability of cytotoxic T cells from an HLA-B27 person to kill virus X-infected target cells. Any virus X-infected target cell will be killed. which one of the following statements is CORRECT? A. which results in lysis of the red cells. Perforins from cytotoxic T cells lyse the red cells. Interleukin-2 binds to its receptor on the red cells.456. Your patient became ill 10 days ago with a viral disease.

make antibody.459. B. C. The structural basis of blood group A and B antigen specificity is A. B. D. C. stem cells originating in the bone marrow. multiple differences in the carbohydrate portion. This immunodeficiency is most probably the result of a defect in A. 462. a single terminal amino acid. process antigen and present it. a single terminal sugar residue. 460. T cell-B cell interaction. lyse virus-infected target cells. Complement can enhance phagocytosis because of the presence on macrophages and neutrophils of receptors for . The role of the macrophage during an antibody response is to A. Your patient is a child who has no detectable T or B cells. 461. activate cytotoxic T cells. the bursal equivalent. B. the thymus. C. D. multiple differences in the protein portion. D.

465. C. The main advantage of passive immunization over active immunization is that A. and 320 on February 20. it contains primarily IgM. C. D. known as "allelic exclusion. C6. Which one of the following is the MOST appropriate interpretation? A.A. An individual who is heterozygous for Gm allotypes contains two allelic forms of IgG in serum. B. D. D. properdin. it can be administered orally. but individual lymphocytes produce only one of the two forms." is consistent with . B. B. She had no influenza immunization during this period. The patient was not infected with influenza virus. factor D. On January 15. The patient was ill with influenza A on January 15. antibody persists for a longer period. it provides antibody more rapidly. which lasted 1 week. This phenomenon. On February 20. 463. The patient has an autoimmune disease. C3b. Her hemagglutination inhibition titer to influenza A virus was 10 on January 18. she had a similar illness. a patient developed an illness suggestive of influenza. C. 464. The patient was ill with influenza A on February 20. 40 on January 30.

matching the complement components of donor and recipient B. a rearrangement of a heavy-chain gene on only one chromosome in a lymphocyte. They are important in the skin test response to Mycobacterium tuberculosis. D. Regarding Th-1 and Th-2 cells. Each of the following statements concerning class I MHC proteins is correct EXCEPT: A. Which one of the following is the BEST method of reducing the effect of graftversus-host disease in a bone marrow recipient? A. Th-1 cells produce gamma interferon and promote cell-mediated immunity. . C. rearrangements of light-chain genes on both chromosomes in a lymphocyte. removing mature T cells from the graft D. They are codominantly expressed. 467. 466. They are cell surface proteins on virtually all cells. D. which one of the following is LEAST accurate? A. rearrangements of heavy-chain genes on both chromosomes in a lymphocyte. B. C. They are recognition elements for cytotoxic T cells. B.A. administering alpha interferon C. a rearrangement of a light-chain gene on only one chromosome in a lymphocyte. removing pre-B cells from the graft 468.

They are encoded on different chromosomes. 470. They have the same amino acid sequence. i. D. They have a binding site for CD4 proteins. B. Th-2 cells produce interleukin-4 and -5 and promote antibody-mediated immunity. Which one of the following statements concerning immunoglobulin allotypes is CORRECT? . They are involved in the presentation of antigen by macrophages.. D. Before naïve Th cells differentiate into Th-1 or Th-2 cells. 471. They are found on the surface of both B and T cells.e. D. they are doublepositives. C. They contain the hypervariable regions. 469. C. Each of the following statements concerning the variable regions of heavy chains and the variable regions of light chains in a given antibody molecule is correct EXCEPT: A. They define the specificity for antigen. Both Th-1 and Th-2 cells have both CD3 and CD4 proteins on their outer cell membrane. B. they produce both gamma interferon and interleukin-4. They have a high degree of polymorphism.B. C. Each of the following statements concerning class II MHC proteins is correct EXCEPT: A.

C. paralysis of the immune cells results in a failure to produce a response against many antigens. it is directed against a single epitope. B. D. .A. D. A hapten can combine with (bind to) an antibody. Each of the following statements concerning immunologic tolerance is correct EXCEPT: A. Allotypes are confined to the variable regions. 473. The antibody produced by a hybridoma cell is IgM. Each of the following statements concerning a hybridoma cell is correct EXCEPT: A. because heavy-chain switching does not occur. Allotypes are determined by class I MHC genes.. 472. B. Tolerance is more easily induced in neonates than in adults. The spleen cell component provides the ability to form antibody.. Each of the following statements concerning haptens is correct EXCEPT: A. Tolerance is not antigen-specific. Allotypes are found only on heavy chains. Tolerance is more easily induced by simple molecules than by complex ones. C. C.e. D. The myeloma cell component provides the ability to grow indefinitely. The antibody produced by a hybridoma cell is homogeneous. i. Tolerance is more easily induced in T cells than in B cells. Allotypes are due to genetic polymorphism within a species. B. i. 474.e.

A 396. D 391. the allergens are haptens. C 398. C 394. D. B 393. D 388. A 390. B 389. C 392. C 395. A . rather. it must be bound to a carrier protein to be able to induce antibody. Answers (Questions 387-474): 387. Haptens must be processed by CD8+ cells to become immunogenic. B 397. C 402. C. In both penicillin-induced anaphylaxis and poison ivy. C 400. A hapten cannot induce an antibody by itself.B. B 401. D 399.

B 413. B . C 408. D 425. B 420. D 426. D 423. B 404. B 410. C 419. B 406. D 412. B 422. B 424. B 416. C 407. D 405.403. D 417. D 411. A 415. A 418. A 421. C 414. C 409.

B 447. D 433. B 435. D 446. B 434. C 444. B 442. D 432. C . D 436. D 449. C 445.427. C 429. C 430. D 437. D 450. C 448. A 440. B 441. D 431. D 443. A 428. B 439. E 438.

C 455. A 457. A 471. B 458. B 452.451. B 463. A 473. A 466. A 470. A 456. D 459. B 464. C 453. D . D 472. C 468. D 467. B 454. D 460. A 462. A 465. C 474. D 469. D 461.

Major source of interleukin-2 478. Express class I MHC markers 479. B cells C. Secondary antibody response . Express surface immunoglobulin Questions 481-484 A. Each lettered option may selected once. Express class II MHC markers 480. T cells.Directions (Questions 475-535): Select the ONE lettered option that is MOST closely associated with the numbered items. Questions 475-480 A. and macrophages 475. Primary antibody response B. more than one. Acted on by interleukin-1 477. T cells B. Major source of interleukin-1 476. nor not at all. Macrophages D. B cells. B cells and macrophages E.

481. People with this type are called "universal recipients. People with this type have circulating anti-B antibodies. Variable region of light chain B. People with this type have circulating anti-A antibodies. variable region of heavy chain C." 488. Typically takes 7-10 days for antibody to appear Questions 485-488 A. People with this type are called "universal donors. Constant region of heavy chain . Relatively richer in IgM 484. 486." Questions 489-494 A. Blood groups A and O D. Variable regions of light and heavy chains D. Relatively richer in IgG 483. 487. Blood group AB 485. Blood group A B. Appears more quickly and persists longer 482. Blood group O C.

Antigen-binding site Questions 495-498 The following double-immunodiffusion plate contains antibody prepared against whole human serum in the center well. Constant regions of light and heavy chains 489. Determines idiotypes 492. Determines allotypes 491.E. Determines immunoglobulin class 490. Binding of IgG to macrophages 493. Fixation of complement by IgG 494. 495. Whole human serum . An explanation of the answer to this question is given on p. 24[dse3] . Identify the contents of each peripheral well from the following list (each well to be used once).

496. Baboon IgG 498. IgA D. Involves mast cells and basophils 501. Human transferrin Questions 499-501 A. Can contain a polypeptide chain not synthesized by a B lymphocyte . Cytotoxic hypersensitivity C. Mediated by lymphokines Questions 502-505 A. IgG C. Human IgG 497. Crosses the placenta 503. IgM B. Immune-complex hypersensitivity D. IgE 502. Delayed hypersensitivity 499. Immediate hypersensitivity B. Irregular deposition of IgG along glomerular basement membrane 500.

IgM 510. Surface IgM on cells in a bone marrow smear 508. Concentration of IgG in serum 507. Growth hormone in serum 509. Present in highest concentration in secretions . Precipitin test C.504. IgA B. IgE C. Immunofluorescence D. IgG D. Present in highest concentration in serum 511. Agglutination B. Found in the milk of lactating women 505. Binds firmly to mast cells and triggers anaphylaxis Questions 506-509 A. Enzyme immunoassay 506. Type A blood group antigen on erythrocytes Questions 510-513 A.

Which protein is present in well No. the center well contains antibody against whole human serum.512. Which protein is present in well No. Contains 10 heavy and 10 light chains Questions 514-517 In this double diffusion (Ouchterlony) assay. Sheep serum albumin 514. Human serum albumin at low concentration B. Human serum albumin at high concentration C. Which protein is present in well No. Human serum transferrin D. 3? . 1? 515. Present in lowest concentration in serum 513. 2? 516. The peripheral (numbered) wells contain one of the following proteins[dse4] : A.

Fab fragment of IgG B. Which protein is present in well No. Involved in target cell recognition by cytotoxic T cells Questions 522-525 A. Fc fragment of IgG 522. Class II MHC proteins 518. Involved in the presentation of antigen to CD4-positive cells 519. 24. Contains a complement-binding site 525. Class I MHC proteins B. Contains hypervariable regions 524. Contains an antigen-combining site 523. Questions 518-521 A. Involved in antibody responses to T-dependent antigens 521.517. Is crystallizable . 4? An explanation of the answer to this question is given on p. Involved in the presentation of antigen to CD8-positive cells 520.

Graves' disease E. Caused by a virtual absence of both B and T cells Questions 531-535 A. Associated with antibody to IgG . Caused by a deficiency in an inhibitor of the C1 component of complement 529. Severe combined immunodeficiency disease (SCID) B. X-linked hypogammaglobulinemia C. Rheumatoid arthritis C. Chronic granulomatous disease E. Hereditary angioedema 526. Systemic lupus erythematosus B. Caused by a defect in the ability of neutrophils to kill microorganisms 527. Associated with antibody to the thyroid-stimulating hormone (TSH) receptor 532.Questions 522-525 A. Thymic aplasia D. Caused by a development defect that results in a profound loss of T cells 528. Rheumatic fever D. Myasthenia gravis 531. Caused by a marked deficiency of B cells 530.

C 476. B 481. Associated with antibody to streptococci Answers (Questions 475-535): 475. Associated with antibody to DNA 535. B 482. E 479. D 480. C . E 491. D 489. A 477. Associated with antibody to the acetylcholine receptor 534. A 484. B 488. B 483. A 485. A 478. B 486. C 487. D 490.533.

A . C 497. C 500. D 507. B 515. D 506. D 514. C 504. C 505. D 493. D 496. A 512. C 495. D 509. B 503. A 501. B 513. A 510.492. C 508. C 511. D 502. B 499. A 498. D 494.

A 523. C Explanation of Question 429: Spleen cells from the adult donor A will recognize the B antigen on the recipient's cell as foreign.516. Spleen cells from the adult donor will contain mature CD4 and CD8 cells that will attack the recipient cells. B 530. E 534. C 518. B 519. A 520. B 526. B 533. C 528. E 529. A 535. B 525. B 521. causing a . D 517. D 527. D 532. A 531. A 524. A 522.

no graft-versus-host reaction will occur. therefore. Answer D is incorrect because the recipient is already tolerant to antigen A.graft-versus-host reaction. therefore. Because the recipient is tolerant to antigen A. The other lines are formed by the interaction of the subset of antibodies in the antibovine serum with the epitopes shared by the two albumins. A spur is formed by the interaction of the subset of antibodies in the anti-bovine serum with the unique epitopes in bovine albumin. This line would not form if well 2 contained the high concentration of HAS because it would be a zone of antigen . answer A is incorrect. therefore. well B contains human transferrin. therefore. they will have an effect on the recipient. also. There is a line of nonidentity between wells B and C. therefore. answer A is incorrect. there are epitopes unique to each protein. Answer D is more correct than answer B because the donor cells will survive and induce tolerance to antigen A in the newborn recipient. Explanation of Questions 495-498: The center well contains antibody against whole human serum. although the donor cells will survive. Note that the line of immunoprecipitate is very close to well 2. The spur indicates partial identity between the two proteins. answer C is correct. answer C is incorrect. Partial identity means that there are epitopes shared between the two albumins but that. B. therefore. This indicates that well C contains human IgG and well A contains baboon IgG. the donor A spleen cells will not be destroyed. Explanation of Question 430: Because the donor AB spleen cells will not see any foreign antigen in the recipient. Explanation of Questions 514-517: There is a line of identity between wells 1 and 2. Note that there is a spur formed between the wells containing sample A and horse albumin and between the wells containing sample B and bovine albumin. a protein immunologically distinct from human IgG. The concept of partial identity is explained above in the discussion of question 446. sample B is horse albumin. There is a line of identity between well C and a protein in whole human serum and a line of partial identity with that same protein and well A. therefore. sample A is bovine albumin. The immune cells of the newborn mouse do not have the capability to kill the donor cells. There is a line of identity between sample B and horse albumin. therefore. well D must contain whole human serum because there are multiple lines representing some of the many proteins in whole human serum. they contain human serum albumin (HAS). Answer B is incorrect because. therefore. Explanation of Question 446: There is a line of identity between sample A and bovine albumin. because they are from different species. The answer to the question is. therefore.

and the line only forms in a zone of equivalence. There is a line of partial identity between well 2 and 3. Therefore. therefore. therefore.excess.edu . ref: idtl. well 4 contains human transferrin which is immunologically distinct from HAS and SSA.wright. well 3 contains sheep serum albumin (SSA). well 2 contains the low concentration and well 1 contains the high concentration of HAS. There is a line of nonidentity between wells 1 and 4 and wells 3 and 4.

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