IMMUNOLOGY & SEROLOGY
Session 1
1. Miggy was doing experimental research
that involved laboratory animals; in his
case, he was using AG129 mice for his
dengue antiviral study. In his study design,
he was planning to remove the thymus of
each mouse pup right after delivery from
their mothers. The following features can
be manifested by the mice pups:
a. they will have an increase in leukocyte
numbers
b. susceptibility to infection is greater
c. increased ability to reject grafts is
possible
d. an uncompromised immune system can
be observed
2. Which of the following is a normal
immune reaction that can become a source
of inconvenience in the context of modern
medicine?
a. inflammation
b. phagocytosis
c. blood transfusion reaction
d. the cytotoxic cell-mediated killing of
target cells
3. The following belong to the second line
of defense/internal defense, except:
a. fever b. natural killer (NK) cells
c. complement system d. lysozyme
4. Which of the following is not classified as
a peripheral/secondary lymphoid organ?
a. spleen b. lymph nodes
c. red bone marrow d. appendix
5. An in vivo human study employed an
experimental strategy of knocking-out the
genes responsible for MHC class I
expression. What possible consequence can
happen from thus scenario?
a. helper T cells can no longer recognize
antigens
b. CD4+ T cells possibly can increase their
effector functions
c. cytotoxic lymphocytes will no longer be
able to perform antigen recognition
d. CD8+ T cells still will be able to recognize
fully the antigenic peptides displayed
6. The following can happen during an
inflammatory response, Except:
a. endothelial cells retract, causing an
increased capillary permeability
b. the infected area receives an increase of
blood supply
c. leukocytes migrate out of the venules
into the surrounding tissues
d. the primary cells to arrive at the site of
inflammation are the monocytes
7. Which of the following given sentences is
true with regards to vaccination?
a. the toxins and or pathogens are made
innocuous without losing pathogenicity
b. the antigenic material is designed to be
harmless and no longer antigenic
c. the toxin or the whole organism involved
is recognized by the T cells once it is
injected into the human body
d. it is based on the principles of specificity
and memory
IMMUNOLOGY & SEROLOGY

8. Which of the following situations best much sugar to keep his immune system
exemplifies a setting wherein there is a healthy
failure of the immune system to properly
Session 2
function primarily in the case when the
helper T cell function is severely impaired? 1. A cut on a person’s finger becomes
contaminated with the bacterium
a. a patient experiencing an asthmatic
Staphylococcus aureus. The first response
attack
by the immune system consists of activity of
b. a teen was suffering the flares of SLE
a. B cells b. Monocytes
C. a 1-month-old baby with hemolytic
c. Neutrophils d. T cells
disease of the new born
2. Which cell is the principal source of
d. a 20-year-old male diagnosed with AIDS
interleukin 2?
9. A male student contracted a bacterial
a. B cell b. T cell
infection, from his Microbiology laboratory
class his wound got in contact with the c. Monocyte d. Plasma cell
bacterial sample he was using, a few days
after local inflammation was noted on his 3. After exposure to antigen, the first
wounded right thumb which is swollen, and antibodies that can be detected belong to
red. He complained of pain. Granting that the class
the bacterium implicated is extracellular, a. IgA B. IgE
what possible effector cells can we exclude
as the primary responders of this c. IgG d. IgM
inflammatory state? 4. Which of the following is characteristic of
a. neutrophils b. monocytes B cells?

c. B lymphocytes d. T cells a. Phagocytic

10. Pick the choice that best illustrates the b. Participate in antibody-dependent
wiping out of the effects of the normal flora cellular cytotoxic (ADCC) reactions
of the body. c. Contain surface immunoglobulins
a. gram (+) microorganisms are killed by the d. Secrete the C5 component of
lysozymes present in tears and saliva complement
b. because of the production of lactic acid in 5. Cell-mediated immunity is primarily
the female genital tract, the vaginal pH is mediated by
kept at -5
a. B cells b. T helper cells
c. sebaceous glands synthesize fatty acids
that maintain the skin at a pH of c. Plasma cells d. Dendritic Cells
approximately 5.6 6. Which of the following best characterize
d. a diabetic patient taking more than the the adaptive immune system?
regular dose of antibiotics and consuming i. the first line of defense
IMMUNOLOGY & SEROLOGY

ii. has a high level of specificity vaccine. According to the CDC, one dose of
MMR vaccine is 93% effective against
iii. has a long-lasting memory
measles, 78% effective against mumps, and
iv. is also known as natural immunity 97% effective against rubella. What type of
acquired immunity could be involved in this
a. I,II,III,IV b. I,II scenario?
c. I,II,III d. I,II,IV a. Active Natural Immunity
e. II,III b. Active Artificial Immunity
7. One of the following is not correctly c. Passive Natural Immunity
matched;
d. Passive Artificial Immunity
a. regulatory T lymphocyte-the activation
(proliferation and differentiation) of T and B 10. Cell-Mediated immunity can be
lymphocytes associated with the following sentences,
except;
b. natural killer (NK) cell - the killing of
infected cells a. this type of immunity functions in the
elimination of extracellular microbes
c. B lymphocyte- the neutralization of
microbe, phagocytosis, complement b. to kill phagocytosed microbes,
activation macrophages are activated.

d. Cytotoxic T lymphocyte (CTL) – the killing c. eliminates the reservoir of infection and
of infected cells kills infected cells.

8. Waking up late, Shaun was late for the d. responding lymphocytes include the
class. He was running as fast as he could helper and cytotoxic T cells.
when suddenly a stray dog bit his knee on
11. When the immune system recovers
his way to school. In the emergency clinic, a
from one response so that it can effectively
full dose of rabies immunoglobulin was
respond to newly encountered antigens,
administered into and around the wound
this is known as?
site. This post exposure prophylaxis done to
the patient demonstrates what type of a. Diversity b. memory
adaptive immunity?
c. clonal expansion d. specificity
a. Active Natural Immunity
d. contraction and hemostasis
b. Active Artificial Immunity
12. Biologic actions of type I interferons are
c. Passive Natural Immunity represented by the following except;
d. Passive Artificial Immunity a. viral RNA degradation
9. Murphy is turning 12 months next month, b. inhibition of viral protein synthesis
his mon is thinking of bringing him to the
c. inhibition of viral expression and virion
pediatrician for him to receive his first dose
assembly
of the MMR (measles-mumps-rubella)
IMMUNOLOGY & SEROLOGY
d. suppression of other lymphocytes
13. Dengue virus genomic viral RNA
translation and particle assembly takes
place in the cytosol. The evolution of the
immune system equipped it with pattern
recognition receptors that can detect cell
damage and infection in the cytoplasm. Of
the PRRs given below, which one cannot
detect PAMPs and DAMPs on the cytosol?
a. Toll-like receptors
b. RIG-like receptors
c. NOD-like receptors
d. Cytosolic DNA sensors
14. As macrophages and neutrophils are
activated, they kill phagocytosed microbes
by the action of microbicidal molecules like
ROS, nitric oxide, and lysosomal enzymes in
the structure known as _______.
a. endosome b. phagolysosome
c. phagosome d. inflammasome
15. Which one of the following sentences is
untrue regarding the complement system.
a. the endpoint is the lysis of the microbe
b. activation happens in the cell surface
c. the classical pathway is phylogenetically
older than the alternative
d. the three pathways lead to the formation
of C3b
Session 3
1. A major advantage of passive
immunization compared to active
immunization is that
a. antibody is available more quickly
b. antibody persists for the life of the
recipient
c. IgM is the predominant antibody class
provided
d. Oral administration can be used
2. the type of immunity that follows the
injection of an immunogen is termed
a. Artificial active b. Natural Active
c. Artificial passive d. Innate
3. The type of immunity that follows the
injection of antibodies synthesized by
another individual or animal is termed
a. Artificial active b. Natural Active
c. Artificial Passive d. Natural Passive
4. Innate immunity includes
a. Anamnestic response
b. Antibody production
c. cytotoxic T cell activity
d. Phagocytosis by polymorphonuclear cells
5. The activity of natural killer (NK) cells
a. Does not require previous exposure to an
antigen
b. Involves phagocytosis and killing of
bacteria
c. Requires interaction with cytotoxic T cells
d. Requires interaction with B cells
6. Of the factors that influence the immune
response, which one of the following
sentences is false?
a. A sexually active HIV patient with CD4
count of 97 is very less likely to mount a
productive immune response.
IMMUNOLOGY & SEROLOGY
b. upon HLA testing, it was found out that
Podrick bears the HLA B27 Ag thus his chance
of developing Relter’s syndrome or
Ankylosing spondylitis is high
c. a 13-day old infant has a robust well-
developed immune system to fight infantile
diseases
d. because of reduced production of B and T
cells in the bone marrow and thymus and
diminished function of mature lymphocytes
in secondary lymphoid tissues; as a result,
elderly individuals do not respond to the
immune challenge as robustly as the young
e. none of the choices is false
7. forms of the class II molecules comprise
the following except;
a. HLA-DP b. HLA-DQ
c. HLA-DR d.None of the above
8. A 37-year-old male was suffering from a
chronic infection with the hepatitis C virus.
His liver functions showed that his liver is
severely damaged beyond the body’s
capacity to regenerate it. Thus he was
advised to undergo a liver transplant. With
regards to the roles of MHC molecules in
transplantation, which of the following is
false?
a. Liver transplantation can be performed
with reasonable safety across major HLA
incompatibilities.
b. HLA-DP, HLA-DQ, and HLA-DR molecules
are low or undetectable on liver hepatocytes
c. Class I MHC molecules are found on all
nucleated cells in the body.
d. The hepatocytes do not express class I
MHC molecules.
9. An-antigenic fragment presented in
association with class I MHC is recognized
by what T lymphocyte population?
a. CD4+ cytotoxic T cells
b. CD8- cytototoxic T lymphocytes
c. CD8+ helper T cells
d. Cytotoxic T lymphocytes
10. If one is pertaining to the structures of
the MHC molecules, which of the given
choices is incorrect?
a. Both MHC class, I, and II molecules possess
a peptide binding cleft
b. B2- macroglobulin is associated with the
MHC class I structure
c. The class II MHC peptide-binding cleft can
accommodate antigenic peptides of 8-11
residues.
d. The binding site of the T cell coreceptor in
class II MHC is the B2 region.
11. If the site of peptide loading of MHC
takes place in the endoplasmic reticulum,
then the pathway of antigen processing and
presentation involved here is?
a. class I MHC pathway
b. classical pathway
c. alternative pathway
d. class II MHC pathway
12. If a given HLA nomenclature appears
like this, HLA-DRB1*1301N; then it can
signify that
a. This allele contains a mutation outside the
coding region
b. this allele has a mutation, previously
shown to have a significant effect on cell
IMMUNOLOGY & SEROLOGY
surface expression, but where this has not
been confirmed, and its expression remains
questionable
c. this allele encodes a protein with a
significantly reduced or low cell surface
expression
d. this allele is an example of a null allele
13. The T cell effector functions implicated
in class I MHC-associated presentation of
cytosolic antigen to helper T lymphocytes
is?
a. the macrophage activation:
destruction of phagocytosed antigen
b. the killing of the antigen-expressing target
cell
c. the B cell antibody-mediated secretion:
antibody binding to antigen
d. None of the above
14. The best immunogen among the choices
would be?
a. Tropomyosin: molecular weight around
65-70 kilodalton
b. glycogen: molecular weight between 106
and 107 daltons
c. Teflon synthetic polymer
d. C12H25NO11: molecular weight; 359.33
g/mol
15. A hapten can be best described as?
a. a molecular with a molecular weight
greater than 100,000 daltons
b. already retains antigenicity even without
the presence of a carrier
c. has the inert ability in joining antibody-
mediated reactions
d. multiple antigenic determinants are
present on its surface
e. none of the above
Session 4
1. A 65-year-old woman presented with
painful swelling is his feet, and right wrist
13 days after a throat infection. Then the
patient developed angina pectoris,
followed by a febrile episode (38.9*C).
Antistreptolysin O tilters were raised at
>800 units/ml (<200), anti-DNAse B 3840
units/ml (<240), and these subsequently fell
the
indicating evidence of recent group A
streptococcus infection. So in his case of
rheumatic fever, the group A streptococcal
cell wall Abs cross-react with human
cardiolipin antigens and thus damage the
patient’s myocardial tissues. Here we can
classify the group A beta-hemolytic
streptococci (Streptococcus pyogenes) Ags
and the human myocardium Ags as?
a. autoantigens
b. heterophile antigens
c. alloantigens
d. none of the choices
2. Interaction between B and T helper cells
involves
a. MHC II molecule on B cell binding to MHCI
molecule on the T cell
b. MHC II molecule on B cell binding to CDS
on the T cell
c. Foreign antigen on B cell binding to T cell
receptor
d. CDS molecule on B cell binding to T cell
receptor
IMMUNOLOGY & SEROLOGY
3. HLA antigens are found on
a. All nucleated cells
b. Red blood cells only
c. solid tissue only
d. white blood cells only
4. A hatpen is
a. Half of an immunoglobulin molecule
b. A earner molecule for an antigen that is
not antigenic alone
c. An immunoglobulin functional only in the
presence of complement
d. A determinant capable of stimulating an
immune response only when bound to a
carrier
5. The HLA complex is located primarily on
a. Chromosomes
b. Chromosome 6
c. Chromosome 9
d. Chromosome 17
6. All of the following sentences are true
regarding IgG, except
a. is known as the primary response antibody
(because it is the first to appear after
antigenic stimulation)
b. can neutralizing toxins and viruses
c. has the most prolonged half-life of any Ig
class (- 23 to 25 days)
d. Activates the classical pathway
7. The purpose of the HAT medium in the
generation of monoclonal antibodies is;
a. it allows fusion of the murine spleen cells
that have been immunized with a known Ag
or a mixture of Ags with an enzyme deficient
partner myeloma cell line
b. provides preservation of the morphology
of the splenic cells that will be used
c. permits the survival of the immortalized
hybrids
d. enables the growth of the mutant
myeloma cell line even they do not produce
Abs
8. Which does not best define the coding
process for immunoglobulin molecules?
a. a rearrangement process employing
special recombinase enzymes is required so
that the genes coding for Abs can be
transcribed and translated into functional Ab
molecules
b. permanent changes happen to the DNA of
the particular lymphocyte one gene
rearrangement occurs
c. human Ig genes are found in three
unlinked clusters on chromosomes 14, 2,
and 22
d. the three groups of genes that code for
the variable region include: VH, D, and J
e. none of the above
9. While hiking on a rain forest trail, a 32-
year-old male was severely stung with fire
ants on his ankles. He developed intense
pruritus on the bitten sires and immediately
progressed to manifest diaphoresis,
shortness of breath, tightness of the chest,
and hive. Upon arrival at the nearest ER, the
patient was found to be unresponsive and
cyanotic. What putative immunoglobulin is
at play in this scenario?
a. IgA b. IgG
c. IgE d. IgM
IMMUNOLOGY & SEROLOGY

e. IgD 13. Papain digestion allows separation of

these two fragments except
10. A primigravida patient was in her OB-
GYN clinic for a pre-natal check-up. She will a. Fab fragments b. F(ab’)2
be due for the next month. She was
c. Fc Fragments d. none of the choices
discussing breastfeeding with the
physician. The patient wondered why 14. Antibodies can be described by the
breastfeeding is essential and what is the following, except
link it has in the immunity for her baby.
Which of the given sentences must not be a. Show the most exceptional ability to
advised/said by her OB-GYN? discriminate between different Ags, and
bind Ags with the greatest strength as
a. Breast milk delivers the first source of compared to MHC molecules and T cell Ag
antibody-mediated immune protection in receptors
the intestinal tract of sucking infants
b. are the products generated when B
b. IgE is the predominant immunoglobulin in lymphocytes differentiate into plasma cells
human milk
c. have the ability to recognize foreign
c. long-term benefits of early exposure to molecular structures in a specific manner
secretory IgA included maintenance of
healthy gut microbiota and regulation of d. can be separated by serum
gene expression in intestinal epithelial cells electrophoreses

d. an essential immunoglobulin e. are the primary mediators of cellular

11. one of the following is improperly
matched
a. is the most heat-labile of all Igs;IgE
b. is principally seen in secretions at mucosal
surfaces: IgA
c. the most efficient complement activator:
IgG
immunity against all classes of microbes
15. Of the Ag-Ab interactions, which of the
following choices can we consider as
secondary interactions?
a. ionic bond reactions
b. hydrogen bond reactions
c. interactions with Van der Waals forces

d. It is incapable of crossing the placenta: IgD d. None of the choices

12. it is the terminology used to designate Session 5

the unique variations within the constant 1. What is the predominant type of antibody
regions of the y and a heavy chains and found in the serum of neonates born after full-
kappa light chains in different individuals term gestation?

a. isotype b. Allotype a. Infant IgA b. Infant IgG

c. haplotype d. idiotype c. Infant IgM d. Maternal IgG

IMMUNOLOGY & SEROLOGY

2. The major class of immunoglobulin found in 8. The complement activation pathway that is
adult human serum is referred to as the main effector mechanism of
adaptive humoral immunity.
a. IgA b. IgE
c. IgG d.IgM a. Lectin Pathway
b. Alternative Pathway
3. Which class of immunoglobulin possesses c. Classical Pathway
delta heavy chains? d. All of the choices
a. IgA b.IgD 9. The mode of alternative pathway of
c. IgE d.IgG activation occurs only on the surface of
microbial and NOT on mammalian cells.
4. Which class of immunoglobulin possesses
antigenic binding sites? a. False
a. IgA b. IgD b. True
c. IgG d. IgM c. Either
5. Monocytes and macrophages play a major d. Neither
role in the mononuclear system. For an
antibody-coated antigen to be phagocytized, 10. A case of salmonellosis was suspected of a
what part of the antibody molecule fits into a 12-year old boy who presented a high-grade
receptor on the phagocytic cell? fever, diarrhea, and abnormal cramps upon ER
admission. The good thing he did not progress
a. Fc region b. Fab region
to develop septic shock. These signs and
c. Hinge region d. Variable region symptoms we have observed can be attribute
6. Which of the following is considered as the to what cytokine of the innate immune
most serious of all the component deficiencies? response?

a. C1INH deficiency b. DAF deficiency a. TNF-alpha

c.C2 deficiency d. C3 Deficiency b. IL-6

7. The following are biological functions except c. IL-1

a. The proteolytic complement fragments C2, C1, d. TGF-beta

and C3 induce acute inflammation by activating
mast cells and neutrophils.
b. MAC mediates the complement-mediated
lysis of foreign microbes.
c. Promotes the solubilization of Ag-Ab
complexes and their clearance by phagocytes.
d. Binding of C3b (or C4b) to microbe
(opsonization).
11. A medical technologist cancer researcher
wanted to investigate the role of inflammation
in malignancies he was planning to perform an
assay on anti-inflammatory cytokines, granting
he wanted to detect about 100 cytokines in
one reaction then it is nest for him to use
which of the following?
a. Multiplexed ELISA

b. New Microbead assays

c. EliSpot ELISA
IMMUNOLOGY & SEROLOGY
d. CH50 Test
12. The complement can induce harm in the
following situation except
a. A patient who tested positive for the
presence of autoantibodies directed against
antigens on the surface of the patient’s own
erythrocytes cold autoimmune hemolytic
anemia.
b. A hypertensive 76-year old man who sought
medical care at the hospital due to severe chest
pain. Without prior symptoms, he started to
have severe chest pain and sought emergency
medical care after about 24 hours due to pain
persistence. After a battery of test, the patient
was diagnosed with acute myocardial infarction.
c. A 58-year old woman undergoing
immunosuppressive treatment (cancer
chemotherapy) presented with an acute
alteration in mental status, organ dysfunction,
hypotension, Lactic acidosis, and oliguria.
Bacterial culture of the Patient’s stool
confirmed the presence of E coli bacteria.
d. None of the above
13. MM, a 30-year old was admitted for the
second time in the SWU medical Center with a
Chief complain of dysuria and purulent
urethral discharge. One week prior to his
admission, he experienced itching in his
private area. Cultures are taken, and gram-
negative diplococci were seen on gram
staining. During his previous admission, he was
diagnosed with Neisserial infection. A genetic
workup revealed a deficiency in one of the
components of MAC. Which of the following
components of complement proteins would
most likely be defective?
A. C2 b. C3
c. C6 d. C7
14. C3b, C4b, and C 1q are complement
components that are vital in bacterial
recognition. The following statements are true,
except
a. The above-mentioned complement
components can act as opsonin.
b. C3 deficiency, in particular, is always
associated with repeated severe bacterial
infections.
c. The deficiency of this complement
components will most likely affect the
phagocytic response of the immune cells.
d. These complement components can sensitize
a bacterium by covalent binding.
15. As a complement regular, C1 Inhibitor
(C1INH) can be described as?
a. The primary soluble regulator of the
alternative pathway
b. A soluble control protein that acts at a
deeper level of the activation of complement
c. A receptor that responds to inhibit MAC
formation.
d. A glycoprotein that blocks the activation at
the initial stages of the lectin pathway the only
None of the above
Session 6
1. Which complement protein is present in the
greatest concentration in human serum?
a. C1 b. C2
c. C3 d. C4
2. After activation of the complement system,
leukocytes and macrophages are attracted to
the site of complement activation by
a. CI
b. C5a
IMMUNOLOGY & SEROLOGY
c. C8
d. IgM
3. A young woman shows increased
susceptibility to pyogenic infections. Upon
assay, she shows a low level of C3. Which of
the following statements is probably true?
a. She has an autoimmune disease with
continual antigen-antibody activity causing
consumption of C3.
b. She has DiGeorge syndrome.
c. She has decreased production of C3.
d. She may produce an inactive form of C2, a
precursor of C3
4. An important part of the nonspecific
immune response is(are)
a. B cells
b. Basophils
c. Complement Cascade
d. Cytotoxic T lymphocytes
5. The classical complement pathway is
activated by
a. Most viruses
b. Antigen-antibody complexes
c. Fungal cell walls
d. Mannose in bacterial cell walls
6. Is the site wherein Ags entering the
circulation that are captured by DCs are
filtered:
a. Thymus
b. Lymph nodes
c. Renal epithelium
d. Neutrophil extracellular traps (NET s)
7. Splenic and lymph node marginal zone B
cells and B1 B cells are distinct B cell subsets
that mediate a common type of antibody
response as demonstrated by which one of the
following:
a. T-dependent, isotyped-switched, highly-
affinity antibodies; long-lived plasma cells
b. T-dependent, mainly Igm; short-lived plasma
cells
c. T-dependent, isotyped-switched, low-affinity
antibodies; short-lived plasma cells
d. T-dependent, mainly IgG; Long-lived plasma
cells
8. Secondary humoral immune responses are
characterized by the following, except
a. Induced by only protein antigens
b. ab isotype: Relative increase in IgG and,
under certain situations, in IgA or IgE
c. has a larger peak response
d. Ab isotype: usually IgM > IgG
9. Ig heavy chain isotype switching results to
different Ig Isotypes, which mediate distinct
principal effector functions.
a. IgM: complement activation
b. IgE: immunity against helminths Mast cell
degranulation (immediate hypersensitivity)
c. IgD: musical immunity (transport through
epithelia)
d. IgG subclasses (IgG1, IgG3): Fc receptor-
dependent phagocyte responses; complement
activation; neonatal immunity (placental
transfer)
IMMUNOLOGY & SEROLOGY

10. T-Independent antigens are indicated by b. the APCs are resting and express
the following except; costimulators

a. majority of them are multivalent, comprised
of repeated identical antigenic epitopes
b. cannot be recognized by CD4+ helper T cells
because they cannot be processed and
presented in associated with MHC molecules
c. the activated APCs have an increased
expression of costimulators and cytokine
secretion
d. the APCs are activated by microbes and do
not express costimulators

c. the most prominent examples are glycolipids, 14. is the most important cytokine produced
polysaccharides, and nucleic acids by T cells early after activation, other within 2
to 4 hours after Ag recognition and
d. cellular immunity is the primary mechanism
costimulation
of host defense against these Ags (e.g.,
encapsulated bacteria) a. IL6 b. IL2

e. none of the above C. IL1 d IL8

11. Host defense against helminthic parasites e. IL17

is offered by what CD4+ helper T cells subset?
15. The participation of these cells is needed
a. TH2 cell b. TH17 cell for the full activation of naïve CD8+ T cells and
their differentiation into functional CTLs and
c. TH1 cell d. TH34 cell
memory cells
12. The proper sequence of the phase of T cell
a. B lymphocytes
response is:
b. Dendritic Cells
a. lymphocyte activation, differentiation, clonal
expansion, antigen, recognition, effector C. NK T cells
functions
d. d. CD4+ helper T cells
b. antigen recognition, lymphocyte activation,
Session 7
clonal expansion, differentiation, effector
functions 1. A human cell with CDS on its surface is most
likely a
c. lymphocyte activation, clonal expansion,
antigen recognition, effector functions, a. B cell b. Monocyte
differentiation
c. T helper cell d. Cytotoxic T cell
d. effector functions, antigen recognition,
lymphocyte recognition, differentiation, clonal 2. which of the following is a characteristic of T
expansion cells?

13. T cell survival, proliferation, and a. Synthesize antibody

differentiation occur when: b. Mature in the thymus
a. the APCs are deficient with costimulators c. Able to bind unprocessed antigen
IMMUNOLOGY & SEROLOGY
d. Primarily protects against extracellular
parasites
3. How do cytotoxic T cells kill target cells?
a. They produce antibodies that bind to the cell
b. They engulf the cell by phagocytes
c. They stop protein synthesis in the target cell
d. They produce granzymes that stimulate
apoptosis
4. Which of the following can be attributed to
antigen-stimulated T cells?
a. humoral response
b. plasma cells
c. cytokines
d. antibody
5. Where do germinal centers occur?
a. In the thymus b. In the bone marrow
c. In peripheral blood d. In Lymph nodes
6. The phenomenon of clonal exhaustion, is
associated with the following
a. Is observed in viral systemic infections in
which the immune response is initiated, but the
response is impaired before viral clearance
b. results to a persistent state of infection
c. Virus-specific T cell clones are present but do
not respond normally and are unable to
eradicate the infection
d. favors viral persistence because it is a viral
mechanism for immune evasion
e. all of the above
7. Molecular mimicry could induce
autoimmunity, which of the following is
molecular mimicry exemplified?
a. Patients with rheumatic fever can develop an
autoimmune disease due to infection with
group A beta hemolytic streptococci
b. raised titers of both IgM and IgG antibodies
to coxsackievirus and later to coxsackie B4 in
newly diagnosed type 1 diabetics
c. HIV-1 virus has been shown to cause diseases
of the central nervous system (CNS)
d. Association between the development of SLE
and viruses such as Epstein-Barr virus (EBV),
Coxsackie virus, and retrovirus
e. All of the choices
8. The clinical signs and symptoms of SLE are
non-specific and extremely diverse and include
the following except for one
a. Polyarthralgia or arthritis
b. positive for the presence of atypical
lymphocytes
c. diffuse proliferative glomerulonephritis
(DPGN)
d. classic butterfly rash
9. A 29-year-old female after a check-up from
her physician was found to have a slowly-
enlarging painless mass in her front neck. This
mass had grown over a 4-year period. She
manifests fine tremor of the hands or fingers,
lack of concentration and is irritable, and easily
feelings fatigue. ECG was normal. Thyroid
Ultrasound results were not yet released.
Admission thyroid function tests showed TSH
0.021 mIU/mL (normal 0.35-4.94 mIU/ml), T3
2.97 pg/ml (2.97-4.47 pg/ml), Free T4 1.94 ng/dl
(normal 0.79-1.34 ng/dL), Thyroid Peroxidase
Antibody (TPOAb) was positive 554.7 IU/ml
(normal Negative IU/ml). Thyroglobulin
Antibody (TgAb) 507 IU/ml (normal 0-40 IU/ml.
The disease that inflicted this lady can be
defined by which of the following choices
below?
IMMUNOLOGY & SEROLOGY

a. is a syndrome that may consist of 12. A mutation of this gene gives rises to a
hyperthyroidism, goiter, thyroid eye disease stable mutant protein whose accumulation is
(orbitopathy), and occasionally a dermopathy regarded as a hallmark of cancer cells
referred to as pretibial or localized myxedema
a. p53 b. c-myc
(PTM)
c. Rb d. src
b. is a form of anti-glomerular basement
membrane (GBM) disease, in which e. sis
autoantibodies bind to a3(IV) collagen in GBM
causing rapidly progressive glomerulonephritis 13. B cells that encounter self-antigens in
and pulmonary hemorrhage peripheral tissues become:

c. is an autoimmune disease of the I. Anergic II. Transform into Plasma cells

neuromuscular junction (NMJ) caused by III. Apoptotic IV. Secrete massive amounts of
antibodies that attack components of the cytokines
postsynaptic membrane, impair neuromuscular
transmission, and lead to weakness and fatigue a. I, II, III, IV b. II, III
of skeletal muscle c. I, III d. III, IV
d. is an immune-mediated inflammatory disease 14. AN autoimmune disease-causing
that attacks myelinated axons in the central destruction of pancreatic cells can result in
nervous system, destroying the myelin and the
axon. a. Hashimoto disease b. Multiple Sclerosis

10. The 3 distinctive properties of tumors are, c. My asthenia gravis d. Type 1 diabetes
except;
15. Anti-CCP (cyclic citrullinated proteins) is
a. capable of multiple lineage development specially associated with which autoimmune
disease?
b. can manifest self-renewal
a. RA
c. potential for extensive proliferation
b. MG
d. development is based on a single lineage of
cells c. Autoimmune hepatitis

11. True type of I DM, except; d. Goodpasture’s syndrome

a. The body’s immune system attacks and Session 8

destroys the cells that produce insulin
b. is known as autoimmune diabetes mellitus
c. the body does not produce enough insulin, or
the body’s cells do not react to insulin
1. Which of the following is characterized by
hyperplasia and diffuse goiter, exophthalmos
(bulging eyes) and infiltrative dermopathy?
a. Hashimoto disease b. Grave’s disease

d. inheritance of the HLA-DR3 or DR4 gene- c. MG d. Multiple Sclerosis

increases the risk/disease susceptibility
2. Autoimmune hemolytic anemia is classified
under what type of autoimmune disease?
IMMUNOLOGY & SEROLOGY

a. Non-organ specific b. Organ-Specific 7. Which of the following is utilized largely for

c. Both A and B d. Neither
3. Which of the following is an autoimmune
disease affecting the small intestine and other
organs; unique in that it is associated with a
known environmental trigger-dietary gluten
a. Autoimmune Hepatitis
the diagnosis of ovarian cancer
a. CEA b. CA 125
c. AFP d. Prostate acid phosphatase
8. Each of the following markers is correctly
paired with a disease in which it can be used for
patient monitoring, except;

b. Myasthenia Gravis (GV) a. CEA/choriocarcinoma

c. Celiac disease b.CA 15-3/breast adenocarcinoma

d. None of the above c. CA 125/ovarian adenocarcinoma

4. Which of the following would be considered d. CA 19-9/pancreatic adenocarcinoma

a significant finding in Graves’ disease?
9. Which of the following is a marker used in
a. Increased TSH level immunohistochemical staining to identify
tumors of epithelial origin?
b. Antibody to TSHR
a. Cytokeratins b. Vimentin
c. Decreased T3 and T4
c. CD45 d. CD10
d. Antithyroglobulin antibody
10. The best use of serum tumor markers is
5. Destruction of the myelin sheath of axons
considered to be in
caused by the presence of antibody is
characteristic of which disease? a. screening for cancer

a. MS b. MG b. initial diagnosis of cancer

c. Graves’ disease d. Goodpasture’s syndrome c. monitoring patients undergoing cancer

treatment
6. Tumor markers are:
d. determining patient prognosis
a. more often caused to monitor CA recurrence
11. Both AFP and hCG exhibit serum elevations
b. produced by or present in tumors that can be
in
used to detect the presence of cancer based in
their measurement on blood, body fluids, cells, a. pregnancy
or tissue
b. ovarian germ cell carcinoma
c. utilized to differentiate a tumor from normal
c. nonseminomatous testicular cancer
tissue
d. all of the above
d. products of cancerous cell or as a response to
cancer 12. Which of the following markers could be
elevated in nonmalignant liver disease?
e. all of the above
a. AFP b. CEA
IMMUNOLOGY & SEROLOGY

c. CA 15-3 d. All of the above

13. Most tumor markers are not used to screen

the general population because they

a. cannot be inexpensively quantified

b. do not rise to high enough levels in the

presence of cancer

c. can also be elevated in conditions other than

the cancer

d. vary too much between patients belonging to

different ethnic populations

14. Which of the following is an example of a

tumor specific antigen?

a. BCR/ABL fusion protein b. CEA

c. CA 125 d. PSA

15. How can normal cells become malignant?

a. Overexpression of oncogenes

b. Underexpression of tumor suppressor genes

c. Viral infection

d. All of the above