Rapid Fire

A complement component which is strongly chemotactic for neutrophils is:

 A C9
 B C5a
 C C3
 D C3b
 E C5b
The correct answer is B. C5a is a powerful chemotactic agent and also an
anaphylatoxin. C9 is the terminal complement component which forms part
of the membrane attack complex. C3 has no direct biological action but is
split to give C3a and C3b when the complement system is activated. C3b
opsonizes microorganisms for adherence to phagocytic cells. C5b initiates
formation of the membrane attack complex.
The classical and alternative pathways meet at complement component:
 A C4
 B C4b
 C Factor D
 D C5
 E C3
The correct answer is E. Each pathway of complement activation produces a C3
convertase, either C4b2b (classical and lectin pathways) or C3bBb (alternative
pathway), which cleaves C3 into C3a and C3b. C4 is only found in the classical
and lectin pathways. Note that the complement components are numbered in the
order they were first identified rather than the order in which they act. C4b is
produced by cleavage of C4 by C1qrs or MBL/MASP1/2 and forms part of the
classical and the lectin pathways of complement activation. Factor D is found in
the alternative pathway and cleaves factor B in the C3bB complex to produce
C3bBb, the alternative pathway C3 convertase. C5 is one of the later complement
components which upon being split by C5 convertase forms the anaphylatoxin
C5a and may go on to form the membrane attack complex containing complement
components C5b, C6, C7, C8, and C9.
What is the major factor regulating the adaptive immune response?
 A The neutrophil
 B Complement membrane attack complex
 C C-reactive protein
 D Antigen concentration
 E Haptoglobin
The correct answer is D. Lymphocytes are directly driven by antigen. The
concentration of antigen is important because the binding to the surface of
responding B-cells is necessary for continued stimulation. As the antigen
concentration falls through catabolism or neutralization or complex formation with
antibody, so the immune response diminishes. In this way the immune response is
not maintained at a high level when the antigen has been eliminated. Neutrophils
are phagocytic cells that will take up and kill microorganisms coated with antibody
and complement. The membrane attack complex is inserted into cell membranes at
the final stages of complement activation, and leads to death of the cell. C-reactive
protein, like the other acute phase proteins, is a general innate immune response to
infection and is produced through stimulation of the liver by IL-1 or IL-6.
Haptoglobin is a molecule that is present in plasma and binds free hemoglobin.
IgE:
 A Is abundant in saliva.
 B Binds strongly to mast cells.
 C Cannot bind to macrophages.
 D Activates the complement cascade.
 E Has an insignificant role in worm infestations
The correct answer is B. The Fcϵ receptor on mast cells, FcϵRI, binds IgE very
strongly and cross-linking by antigen leads to mast cell activation and initiation of
an inflammatory response. IgE is at a very low concentration in the body fluids.
IgA is predominant in saliva. The FcϵRIIb isoform of the low affinity FcϵRII
(CD23) is present on several different cell types including macrophages. IgE
antibodies have an important role in defense against worm infection.
What do MHC class III genes encode?
 A Complement component C3
 B Tumor necrosis factor
 C IL-2
 D β2-microglobulin
 E HLA-DQ
The correct answer is B. Both TNF (TNFα) and lymphotoxin (TNFβ) are encoded
within the MHC class III region. Complement components C2, C4, and factor B
are encoded within this region. IL-2 is not encoded within any part of the MHC.
β2-microglobulin forms part of the structure of the MHC class I molecule, but is
encoded outside of the MHC. HLA-DQ is one of the MHC class II molecules in
humans.
Superantigens:
 A Do not cause pathology.
 B Are not mitogenic for T-cells.
 C Bind to MHC class III.
 D Bind to all members of a given V beta T-cell receptor family.
 E Have to be processed before recognition by the T-celL
The correct answer is D. They recognize the common structures in a given V beta
T-cell receptor family and bind to all of them, cross-linking the T-cell to the MHC
class II on an antigen-presenting cell. This is a powerful stimulus.
Western blots are primarily used to detect:

 A Protein.
 B Carbohydrate.
 C Lipid.
 D RNA.
 E DNA
The correct answer is A. Following separation by techniques such as SDS-PAGE
or isoelectric focusing, proteins can be blotted by transverse electrophoresis onto
polyvinylidene difluoride (PVDF) or nitrocellulose membranes and then identified
by staining with appropriately labeled antibodies
The circulation of a 2-month-old breast-fed baby will contain maternal:
 A IgA
 B IgD
 C IgE
 D IgG
 E IgM
The correct answer is D. Maternal IgG is transferred across the placenta from the
mother to the fetus by a mechanism involving the specific Fcγ receptor FcRn. IgG is
the only immunoglobulin class to cross the placenta. Immunoglobulins in the milk
(mostly secretory IgA) will provide enteric protection for the baby but are not
absorbed. Thus, the maternal immunoglobulin in the circulation of a 2-month-old-baby
will mostly be placentally transferred IgG which will provide “cover” for the first few
months of life. There are large amounts of IgA in breast milk, and it is presumed that
IgA-producing cells, responding to gut antigens, migrate and colonize breast tissue.
However, this secretory IgA is not absorbed by the baby but remains in the intestine to
protect the mucosal surfaces. Although largely a cell surface-associated
immunoglobulin present on naive B-cells, IgD is found in the maternal circulation,
albeit in rather small quantities (approximately 30 μg/mL). However, there is no
mechanism whereby the maternal IgD can be passed in reasonable amounts to either
the fetus or to the newborn. IgE is present in the maternal circulation in vanishingly
small amounts (approximately 0.05 μg/mL) and is not passed to the fetus or newborn.
IgM is neither transferred across the placenta nor present to any great extent in
Which of the following is a coreceptor for HIV?

 A RANTES
 B CD8
 C CD54
 D CR5
 E CXCR4
The correct answer is E. CXCR4 is a chemokine receptor that HIV utilizes as a
coreceptor for entry into naive CD4+ T-cells and mature dendritic cells. Another
chemokine receptor, CCR5, is used particularly for entry of HIV into immature
dendritic cells, macrophages, and activated effector or memory CD4+ T-cells.
RANTES is a CC chemokine that attracts immature dendritic cells. CD4, but not
CD8, is a receptor for HIV. CD54 is ICAM-1, an adhesion molecule that also
functions as a receptor for rhinovirus and for Plasmodium falciparum infected
erythrocytes, but not for HIV. CR5 is a complement receptor present on
neutrophils and platelets that binds C3d and C3dg, but not HIV.
Graft vs host disease often accompanies transplantation of:
 A Cartilage
 B Kidney
 C Bone marrow
 D Heart
 E Pancreas
The correct answer is C. Bone marrow usually has appreciable numbers of
immunocompetent T-cells capable of recognizing the transplantation
antigens of the host and reacting against them causing graft vs host disease.
Cartilage has no immunocompetent T-cells. Kidney, heart, and pancreas
have few if any immunocompetent T-cells.
Hyperacute graft rejection is caused by:
 A Preformed antibody
 B CD4 lymphocytes
 C CD8 lymphocytes
 D Platelets
 E Circulating immune complexes
The correct answer is A. Rejection occurs within minutes and is
usually caused by blood group incompatibility not
presensitization to class I MHC through blood transfusion. CD4
and CD8 lymphocytes contribute to acute rejection of solid grafts.
Platelet thrombin may be involved in acute late rejection of
human renal allografts following deposition of antibody on the
glomerular vessel wall. Complexes may be involved in the
insidious and late rejection associated with subendothelial
deposits of immunoglobulin and C3 on glomerular basement
membranes of kidney grafts.
Which of the following allogeneic grafts does NOT require immunosuppression?
 A Kidney
 B Heart
 C Liver
 D Bone marrow
 E Cornea
The correct answer is E. Cornea are avascular and do not sensitize the recipient.
Allogeneic kidney, heart, liver, and bone marrow grafts will be rejected unless
transplanted under the cover of immunosuppression.
What is HLA-DR2 a risk factor for?
 A Multiple sclerosis
 B Type I diabetes
 C Ankylosing spondylitis
 D Rheumatoid arthritis
 E Myasthenia gravis
The correct answer is A. Individuals with HLA-DR2 are more at risk of
developing multiple sclerosis (MS) than those with other HLA-DR specificities.
Thus, a higher frequency of HLA-DR2 is found in MS patients than the normal
population. HLA-DQ2 and HLA-DQ8 are risk factors for type I diabetes. HLA-
B27 is a powerful risk factor for ankylosing spondylitis, and for a number of other
autoimmune disorders including anterior uveitis and for amyloidosis in
rheumatoid arthritis. HLA-DR4 is a risk factor for rheumatoid arthritis. HLA-B8
is a risk factor for myasthenia gravis.
Which type of immunoglobulin is present in tears?
 A) IgA
 B) IgD
 C) IgE
 D) IgG
The correct answer is D
Which of the following is an example of tumor antigen associated with liver
cancer?
 A EBV
 B PSA
 C Muc-1
 D HER2
 E Alpha-fetoprotein
The correct answer is E. Alpha-fetoprotein is a tissue specific antigen associated
with liver cancer. EBV is a virus, not an antigen. Epstein–Barr viral antigens are
associated with Burkitt's lymphoma, post-transplant lymphoma, and
nasopharyngeal carcinoma, but not with liver cancer. Prostate-specific antigen, as
its name suggests, is a tissue-specific antigen associated with prostate cancer.
Muc-1 is an antigen that is overexpressed in colorectal, pancreatic, ovarian, and
lung cancers. HER2 is an antigen that is overexpressed in breast and lung cancers.