MCQs:

1 Regarding innate immunity, allof the following is true EXOCEPT:

a- It is present in all individuals since birth and at all times.
b- It is important at the beginning of infection.
- It cannot tellthe difference between pathogens.
d- It always eliminates infectious organisms successfully.
e- It involves mainly granulocytes.

2 Which of the following has an important role in parasitic infections?

a- Neutrophils
b- Mast cells
C- Eosinophils
d- Monocytes
e- Lymphocytes
3 Which of the following is a primary lymphoid organ:
a- Bone marrow
b- Lymph nodes
- Spleen
d- Tonsils
e- Peyer's patches
4 Naive lymphocytes are:
a- Immature lymphocytes
b- Present only in the bone marrow and thymus
G- Responsible for immunological memory
d- Mature lyrnphocytes that have been activated by specific antigens
e- Mature lyrnphocytes that have not yet met antigen
5 Which statement about clonal selection theory is Correct:
a- Every naive lymphocyte has many types of receptors.
b- A clone of cells can recognize different antigens.
C- Only lymphocytes which meet antigens they recognize are activated.
d- The T cell receptor has 2 antigen recognition sites.
e The Bcell receptor cannot recognize an antigen directly.
Comparing BCR and TCR, which statement is TRUE?
a- The B and T cell receptors become released into the surroundings.
b- In contrast to BCR, TCR has 2 antigen binding sites.
C- Both are cell surface molecules.
d- Both molecules cooperate in innate immune mechanisms.
e- They bind to antigens non-specifically.
MCQS:
1 All of the following is true regarding neutrophils EXCEPT:
a- They are phagocytic cells.
b- They constitute the majority of peripheral blood leucocytes.
G- They act mainly as part of the innate immune mechanism.
d- They are capable of killing abnormal cells by induction of apoptosis.
e- They are attracted to the site of infection by the action of chemotactic
factors.
2 Macrophages perform the following functions EXCEPT:
a- Antigen presentation
b- Phagocytosis
C- Secretion of cytokines
d- Production of antibodies
e- Direct cytotoxicity
3 Which statement is TRUE concerning acute phase proteins?
a. They disappear fron the circulation after onset of infection.
b. Endotoxins may stimulate their production.
C. They deprive pathogens from their essential nutrients.
d. They are produced by the primary lymphoid organs.
e. TypelIFN is an example of acute phase proteins.
4 Allthe following statements regarding phagocytosis are true EXCEPT:
a- Bacieria are engulfed in phagosomes.
b- Natural killer cells are the most important phagocytic cells.
C- Respiratory burst is lethal to microorganisms.
d- Antibodies may aid in recognition.
e- Complement components (C3b) enhance phagocytosis.
5 Enhanced phagocytosis is known as:
a- Agglutination
b- Opsonization
C- Neutralization
d- Antibody-dependent cellular cytotoxicity
e- Complement activation
MCQs:
1 All of the following statements about haptens are correct EXCEPT:
a. They are low molecular weight substances.
b. They are incapable of inducing an immune response alone.
C. They are non-specific potentiators of the immune response.
d. When coupled with a carrier molecule, they can act as antigens.
e. Penicillin is an example of a hapten.
2 Antigenicity is increased by all of the following EXCEPT:
a- Chemical complexity of antigen
b- Foreignness
C- Being protein in nature
d- Very high dose of antigen
e- Large size of antigen
MCQs:
1 One of the following is a co-stimulatory molecule:
a- CD40
b- CD40L
C- CD28
d- CD3
e- TCR

2 Regarding helper T cells, all of the following statements are true EXCEPT:
a. They activate macrophages.
b. They activate B cellis.
C. They lyse target cells.
d. They recognize antigen presented by class lI! MHCmolecules.
e. They have CD4 molecules on their cell surface.
3 Dendritic cells are involved in:
a- Transporting the epitope to the surface of a B cell
b- Suppressing the immune system
C- Destroying target cells
d- Presenting peptides to naive T cells
e- Producing antibody
4 Extracellular bacteria are presented:
a- With MHC Ito CD4 Th cells
b- With MHC Ito CD8 Tc cells
C- With MHC Ilto B cells
d- With MHC Il to CD4 Th cells
e- With MHC I| to CD8 cells
5 The second signal needed for the activation of naive T cells is delivered
when:
a- CD40 ligand binds to CD40 molecule
b- CD4 binds to MHCIl molecule
C- CD8 binds to MHCI molecule
d- CD3 binds to TCR
e- CD28 binds to B7 molecule

6
Which statement about superantigens is INCORRECT?
a- They bind directly to MHC Ilmolecule outside the peptide binding cleft.
b- They result in the release of huge amount of cytokines.
C- They result stimulation of the normal acquired immune response.
d- They bind to the variable portion of the Bchain of the TCR.
e- Unlike ordinary antigens, they are not processed in APCs.
7 Cytotoxic T cells exert their killing by:
a. Antibodies with specific recognition capabilities
b. Inserting the complement components into target cell menbrane
C. T cell antigen receptors and MHC protein
d. Inserting a pore-forming protein called perforin into target cell membrane
e. Activation ofmacrophages
MCQs:
1 Cytokines are characterized by all the following EXCEPT:
a- They may have a direct effect on the cells producing them.
b- They may have antagonistic effects.
G- Those affecting migration of lymphocytes are called chemokines.
d- Their action is antigen-specific.
e- They attach to specific cell surface receptors.
2 One of the following is a pro-inflammatory cytokine:
a- |L-4
b- IL-5
C- TGF-B
d- IL-3
e- TNF-a
3 Th1 cells are characterized by one of the following:
a- They produce IL-4.
b- They are activated by IL-4.
C- Their development is promoted by IL-4.
d- Their development is inhibited by IL-4.
e- Their functions are enhanced by IL-4.
4 Allof the following statements about Th2 cells are true EXCEPT:
a. They produce IL-3, 4, 5 and 6.
b. Their development is inhibited by IFN-y.
C. They promote cell-mediated immunity.
d. Their development is promoted by IL-4.
e. They produce TGF-B.
5 IL-2 is produced by:
a- Activated macrophage
b- NK cells
C- Activated Th1
d- Th2
e- B lymphocytes
6 Interferon gamma:
a- ls considered the halmark of Th2 cells
b- Promotes haematopoiesis
C- Is produced by activated macrophages
d- ls also called type I interferon
e- Increases expression of MHC molecules on different cells
7 One of the following cytokines promotes growth and differentiation of
eosinophils:
a- IL-2
b- IL-10
C- TNF-a
d- L-5
e- lL-1
MCQS:
1 For ful activation, naive B cells must receive the following signal(s):
a- Signal derived from antigen binding to BCR
b- Signal derived from activated cytotoxic T cells
G- Signal derived from activated helper T cells
d- a& b
e- a &C

2 Thymus independent (TI) antigens:

a- Can stimulate B cells thrOugh T cell help
b- Do not produce memory cells
C- Can stimulate immunoglobulin class switching
d- Can only induce the production of lgG
e- Are usually protein in nature
3= The portion of the antibody molecule that binds antigenic epitopes is:
a- Termed the determinant
b- Comp0sed of variable and constant regions of lg heavy and lg light chains
C- Composed of the variable regions of lg heavy and lg light chains
d- The Fc fragment
e- Two lg light chains
IgM:
a- Can cross the placenta
b- Has many J chains
C- Is the predominant antibody in the secondary inmune response
d- Indicates immunity when present in the newborn
e- Is the only immunoglobulin to thymus independent antigens
5 IgE:
a- Is usually present as a dimer
b- ls present in large anmounts in serum
C- Is present as B cell receptor on B cells
d- Can attach to receptors on mast cells
e- Can cross the placenta
6 Immunoglobulin class switching is mediated by a change in:
a- Constant domains of heavy chains
b- Constant domains of light chains
G- Variable domain of heavy chain
d- Variable domain of light chain
e- Constant domains of both heavy and light chains
7 Regarding the primary immune response:
a- There is a very short induction (lag) period.
b- Immunoglobulins produced are mainly of lgM class.
C- Memory cells are the main effector cells.
d- The induced antibody level is very high.
e- It is the first response of innate immunity.
MCQs:
1 In the complement system:
a- The alternative pathway involves the nine components (C1-c9).
b- The alternative pathway is activated by mannose-binding lectin.
c- The classical pathway is best activated by bacterial endotoxin.
d- The membrane attack complex is made of CSb-C9.
e- The early steps in complement activation are similar in the 3 pathways.
2 Allof the following are functions of activated complement EXCEPT:
a- Bacterial lysis
b- Opsonization
C- Interference with viral replication
d- Chemotaxis
e- Immune complex clearance
3 The complement component which attaches to the Fc portion of lgM is:
a- C3a
b- C3b
C- C5a
d- C5b
e- C1

Anaphylatoxins:
a- Have chemotactic effect on phagocytic cells
b- Atach to C3b receptors on phagocytic cells
C- Play an important role in immune complex clearance
d- Can induce cytolysis
e- Include properdin
MCQS:
1 In active immunity allthe following are true EXCEPT:
a- The onset of protection is delayed.
b- There is development of memory.
C- The duration of protection is short.
d- There is stimulation of BIT cel.
e- It is specific.
2 The main advantage of passive immunization over active immunization is
that:
a- It contains primarily lgM.
b- It can be administered orally.
C- It provides antibody more rapidly.
d- Antibody persists for a longer time.
e- Memory persists longer.
3 The following represents artificial active acquired immunity:
a- Antibodies produced after subclinical infection
b- Antibodies produced after vaccination
C- Antibodies passing from mother to child
d- Antibodies produced after clinically manifest infection
e- Administration of antitoxin

4 The following represents passive acquired immunity:

a- Antibodies produced after subclinical infection
b- Antibodies produced after vaccination
C- Antibodies produced after clinically manifest infection
d- Antibodies produced in response to toxoid
e- Antibodies passing from mother to foetus
5 Treatment with gamma globulin is considered:
a- Artificial active immunity
b- Artificial passive immunity
c- Natural active immunity
d- Natural passive immunity
e- Innate immunity
 MCQs:
1- Humorai immunity may combat extraceliular bacteria by any of the
following EXCEPT:
a- Agglutination
b- Neutralization of bacterial toxins
C- Opsonization
d- Complement activation
e- ADCC

2 The main immune response against intraceliular bacteria is:

a- Type linterferon
b- ADCC by NK cells
C- Macrophages activated by Thi cells
d- Cytotoxic killing by Tc cells
e- Neutralization by specific antibodies
3 Innate immunity to viruses inciudes:
a- Type I interferon
b- Cytotoxic T cells
c- Cytokines production by T helper cells
d- Neutralizing antibodies
e- Opsonizing antibodies
4 The main specific immune defence mechanism against established viral
infections is:
a. Complement activation by alternative pathway
b. Antibody-mediated immune response
C. Cytotoxic T cell-mediated immune response
d. Helper T cell-mediated immune response
e. Killing by NK cells
5 The most important cells involved in innate immunity to fungi are:
a. Eosinophils
b. Helper T lymphocytes
c. Neutrophils
d. Cytotoxic T lymphocyies
e. Macrophages
MCQs:
1 Tumour antigens:
a- Are always specific for a certain tumour
b- May be shed from the tumour surface and thus enhance tumour rejection
C- May be of viral origin
d- Are never found on normal cels
e- Are recognized by cytotoxic T cells when carried on MHC Il molecules
2 Cells of the innate immune system that have an important role in
destruction of tumour cells are:
a- B cells
b- T helper cells
C- T cytotoxic cells
d- Neutrophils
e NK cells

3 In the immune response to tumours:

a- T cells are the main cells responsible for anti-tumour immunity.
b- Tc cells recognize antigens associated with MHC Il molecules on tumour cells
C- Helper T cells secrete cytokines which activate mast cells.
d- Helper T cells produce histamine which is directly toxic to tumour cells.
e- B cells play an important role in presenting tumour antigens to mast cells
4 The following mechanisms may contribute to tumour evasion EXCEPT:
a- Lack of expression of MHCIlon tumour cells
b- Lack of antigens on tumour cells that can stimulate the immune response
C- Blocking the expression of co-stimulatory molecules
d- Localization of tumour in an inaccessible site
e- Shedding of tumour antigens that block antibodies and T cells
MCQs:

1 On exposure to allergen, sensitized mast cells:

a. Release prefomed mediators after 12 hours
b. Undergo degranulation because of cross-linking of lgD on their surfaces
C. Bind lgE to their Fc receptors
d. Release IL-2 for further lgE production
e. Release histamine and form other mediators

2 Desensitization performed for the treatment of atopy:

a- Increases IL-4 production
b- Causes shift of Th1 to Th2 response
C- Causes shift of Th2 to Th1 response
d- Blocks release of mediators from sensitized mast cell
e- Involves injecting patients with gradually decreasing doses of the allergen
 Adverse effects foliowing incompatible blood transfusion occur as a
result of:
a- Anaphylactic reactions
b- Cytolytic hypersensitivity reactions
C Immune complex hypersensitivity reactions
d- Ceil mediated hypersensitivity reactions
e- None of the above

4 Immune complex-mediated reactions include:

a- Post-streptococcal glomerulonephritis
b- Asthma
c- Anaphylaxis
d- Contact dermatitis
e- Allergic rhinitis
5 Serum sicknesS:
a- ls a systemic form of type ll hypersensitivity reactions
b- ls a local form of immune complex disease
C- Is mediated by lgM or lgG
d- May occur as a result of cellmediated immune reaction
e- May be treated by administration of interferon
6 The main celis involved in type IV hypersensitivity are:
a- Cytotoxic T cells
b- Th1 cells
C- Th2 cells
d- B cells
e- NK cells
MCQs:
1 The MHC is characterized by allthe following EXCEPT:
a- It codes for the human leukocyte antigens (HLA).
b- It determines the compatibility of donor and recipient tissues.
C- It may increase the susceptibility of individuals to autoimmune diseases.
d- It is CO-dominantly expressed from maternal and paternal chromosomes.
e- Its products are not involved in allograft rejection.
2 The following is true regarding acute rejection EXCEPT:
a- It is the most common type of rejection.
b- It is antibody-mediated.
C- It takes days or weeks to develop.
d- It is explained by HLA incompatibility.
e- It is one of the types of allograft rejection.
3 Bone marrow transplantation in immunocompromised patients presents
which major problem?
a- Possibility of graft-versus-host disease
b- High risk of T cell leukaemia
C- Inability to use a live donor
d- Delayed hypersensitivity
e- None of the above

4 In the lymphocytotoxicity test, the following are used EXCEPT:

a- Antibodies against different HLAs
b- Lymphocyte suspension under test
C- Vital dye
d- Radioactive thymidine
e- Complement

5 An approach under trial for the prevention of graft rejection is:

a- Antigen-specific induced tolerance
b- Antigen-specific immuno-stimulation
C- Immunosuppression
d- Better selection of the donors
e- Adjuvants
MCQS:
1- Elimination of immature self-reacting lymphocytes in the primary
lymphoid organs is called:
a- Acquired tolerance
b- Central tolerance
C- Peripheral tolerance
d- Clonal selection
e- Positive selection

2 The mechanisms of autotolerance involve:

a- immunosurveillance
b- Clonal deletion
C- Activation of self-reactive cytotoxic T cells
d- Activation of self-reactive B cells
e- A state of secondary immunodeficiency
3 Negative clonal selection (clonal deletion) is:
a. One of the mechanisms of peripheral tolerance
b. More probable to occur later in life
C. The elimination of immature self-reactive lymphocytes during their maturation
d. The elimination of immature non-self-reactive ymphocytes during their
maturation
e. The elimination of mature self-reactive lymphocytes
Which one of the following diseases is a non-organ specific autoimmune
disease?
a- Grave's disease
b- Myxoedema
C- Hashimoto's thyroiditis
d- Systemic lupus erythromatosis
e- Autoimmune haemolytic anaemia
5 Rheumatoid factor is:
a- DNA-anti-DNA immune complex
b- Autoantibody to lgM
C- Autoantibody to complement components
d- Autoantibody to lgG
e- Any factor predisposing to rheumatoid arthritis
6 The laboratory diagnosis of autoimmune diseases includes all the
following EXCEPT:
a- Decreased level of serum complement
b- Decreased level of serum immunoglobulins
C- Detection of immune complexes in serum
d- Detection of immune complexes in tissues
e- Detection of serum auto-antibodies
MCOs:
1 Leucocyte adhesion deficiency is an example of a defect in:
a- Migration
b- Engufment
- Intracllular killing
d- The number of leucocytes
e- Terminal complement components
2 C1 inhibitor deficiency results in:
a- Increased susceptibility to pyogenic infections
b- Increased susceptibility to infection with N. meningitides
G- Hereditary angioedema
d- Infections characterized by little pus formation
e- Chronic infections with granuloma formation
3 Deficiency of NK celis may manifest by:
a- Increased incidence of pyogenic infections
b- Increased incidence of hypersensitivity reactions
- Increased rejection of transplanted organs
d- Increased incidence of malignancies
e- Deceased incidence of viral ifections

X-linked agammaglobulinaemia is characterized by deficiency of:

a- lgG
b- lgM
C- lgA
d- All of the above
e- Allclasses of complement
5 An X-ray film revealed absence of the thymus in an infant. The most likeiy
diagnosis of this case is:
a- DiGeorge syndrome
b- Chronic granulomatous disease
C- Severe combined immunodeficiency
d- Leukocyte adhesion deficiency
e- X-linked agammaglobulinaemia
6 The functional capability of T celis can be assayed by:
a- Mixed lymphocyte reaction
b- Fluorescent antibody assay with CD8 antiserum
G- Fluorescent antibody assay with CD3 antiserum
d- In vitro response to mitogens
e- In vivoresponse to toxoids
 Answers

Chapter 1: 1d 2c 3a 4 e 5c 6c

Chapter 2: 1d 2d 3b 4b 5b

Chapter 3: 1c 2d

Chapter 4: 1c 2c 3d 4 d 5e 6c 7d

Chapter 5: 1d 2e 3 d 4c 5c 6e 7d

Chapter 6: 1e 2b 3c 4e 5d 6a 7b

Chapter 7: 1d 2c 3e 4 a

Chapter 8: 1c 2c 3b 4 e 5b

Chapter 9: 1e 2c 3a 4c 5c

Chapter 10: 1c 2e 3a 4 a

Chapter 11: 1e 2c 3b 4 a 5c 6b

Chapter 12: 1e 2 b 3a 4 d 5 a

Chapter 13: 1b 2b 3c 4 d 5d 6b

Chapter 14: 1a 2 c 3d 4 d 5 a 6 d