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Questions and Answers

The alternative complement pathway is activated by ..............

  • mannose binding lectin
  • ficolins
  • microbial surfaces (correct)
  • antigen-antibody complexes

    • A patient deficient of complement component C4 is most likely to develop ............

  • rheumatoid arthritis
  • systemic lupus erythematosus (correct)
  • Muckle wells syndrome
  • hereditary angioedema

    • Opsonisation is a process by which ...........

  • pathogens invade cells
  • pathogens evade the complement system
  • pathogens are coated making them more suceptible to phagocytosis (correct)
  • pathogens induce cytokine production

    • Hereditary Angiodema is associated with a deficiency in which complement inhibitor?

    <p>C1 inhibitor (B)</p> Signup and view all the answers

    Why is mannose binding lectin not activated by mannose antigens on host cells?

    <p>sialic acid hides mannose antigens on host cells (A)</p> Signup and view all the answers

    Innate immune memory is a result of .........

    <p>epigenetic modifications (C)</p> Signup and view all the answers

    In the alternative complement cascade which protein extends the half life of the C3 convertase?

    <p>Properdin (D)</p> Signup and view all the answers

    Which complement receptor aids in the clearance of immune complexes?

    <p>CR1 (A)</p> Signup and view all the answers

    Which immunoglobulin can most efficiently activate the classical complement pathway?

    <p>IgM (D)</p> Signup and view all the answers

    What is an antibacterial action of defensins?

    <p>Pore formation in the bacterial membrane (C)</p> Signup and view all the answers

    Which characteristic is NOT associated with the innate immune response?

    <p>requires gene rearrangement (A)</p> Signup and view all the answers

    Which complement pathways lead to the formation of the membrane attack complex?

    <p>the classical pathway, the alternative pathway and the lectin pathway (B)</p> Signup and view all the answers

    Why is free serum IgM unable to activate the complement component C1?

    <p>it has a planar conformation (A)</p> Signup and view all the answers

    C-reactive protein is a member of which family of proteins?

    <p>pentraxins (D)</p> Signup and view all the answers

    How many Fc domains must be bound by C1 to activate the complement cascade?

    <p>two (D)</p> Signup and view all the answers

    Lysozyme.............

    <p>cleaves peptidoglycan (B)</p> Signup and view all the answers

    Waldenstrom macroglobulinemia is linked to a mutation in which TLR adaptor protein?

    <p>MyD88 (D)</p> Signup and view all the answers

    What type of crystal activates the NLRP3 inflammasome in gout patients?

    <p>uric acid (C)</p> Signup and view all the answers

    Patients with a gain of function mutation of the cytosolic DNA sensor STING produce too much of which cytokine?

    <p>Interferon (type 1) (D)</p> Signup and view all the answers

    Pattern recognition receptors recognise PAMPs. What is PAMP an abreviation for?

    <p>pathogen associated molecular pattern (B)</p> Signup and view all the answers

    Which TLR dificency is associated with recurrent herpes simplex encephalitis?

    <p>TLR3 (D)</p> Signup and view all the answers

    Which complex of proteins assemble to form the NLRP3 inflammasome?

    <p>NLRP3, ASC and pro-caspase-1 (D)</p> Signup and view all the answers

    Which type of cell death leads to neutrophils releasing their chromatin trapping microorganisms?

    <p>NETosis (D)</p> Signup and view all the answers

    Which pattern recognition receptor has been associated with Crohn's disease?

    <p>NOD2 (B)</p> Signup and view all the answers

    The pattern recognition receptor TLR9 is activated by which ligand?

    <p>DNA (B)</p> Signup and view all the answers

    Which intracellular receptor is activated by peptidoglycan?

    <p>NOD2 (D)</p> Signup and view all the answers

    The acute phase response is associated with...........

    <p>an increased level of C-reactive protein (A)</p> Signup and view all the answers

    Muckle Wells syndrome is associated with overproduction of which cytokine?

    <p>Interleukin-1 (D)</p> Signup and view all the answers

    Name a pattern recognition receptor expressed at the cell surface.

    <p>TLR5 (C)</p> Signup and view all the answers

    Which toll-like receptor (TLR) adaptor protein is used by all TLRs except TLR3?

    <p>MyD88 (A)</p> Signup and view all the answers

    Which cytokine is processed to its mature form upon activation of the inflammasome?

    <p>IL-1b (B)</p> Signup and view all the answers

    Which of the following statements about acute stress and immune function is correct?

    <p>acute stress has beneficial effects on immune function (A)</p> Signup and view all the answers

    Which of the following statements about chronic stress and immune function is correct?

    <p>chronic stress has harmful effects on immune function (C)</p> Signup and view all the answers

    Which of the following statements about coping and stress is correct?

    <p>all of the above (D)</p> Signup and view all the answers

    Which of the following statements about social support and immune function is correct?

    <p>all of the above (A)</p> Signup and view all the answers

    Which of the following statements about negative affect and immune function is correct?

    <p>depression is linked to poorer immune function with a “dose-response” relationship (C)</p> Signup and view all the answers

    Which of the following statements about positive affect and immune function is NOT correct?

    <p>optimism and emotional expressiveness are not related to better immune function (A)</p> Signup and view all the answers

    What initiates the Classical pathway of the complement cascade?

    <p>C1 binding to an antigen-antibody complex or CRP bound to phosphocholine (C)</p> Signup and view all the answers

    Which of the following activates the Lectin pathway in the complement cascade?

    <p>Mannose binding lectin (B)</p> Signup and view all the answers

    What is the initiating event for the Alternative pathway of the complement cascade?

    <p>Spontaneous hydrolysis of C3 (A)</p> Signup and view all the answers

    In addition to the clearance of immune complexes, which outcome is associated with the activation of the complement cascade?

    <p>all of the above (D)</p> Signup and view all the answers

    Apart from defensins, which family of antimicrobial peptides is found in humans?

    <p>Histatins and Cathelicidins (A)</p> Signup and view all the answers

    Which acute phase protein is NOT measured as a clinical marker of inflammation?

    <p>Serum amyloid A (SAA) (D)</p> Signup and view all the answers

    Why do T cells need to work with antigen-presenting cells (APCs)?

    <p>T cells are unable to recognize native antigens directly (A)</p> Signup and view all the answers

    What are the two possible pathways for antigen processing

    <p>Exogenous pathway and endogenous pathway (C)</p> Signup and view all the answers

    What is the genetic process that creates diversity in the adaptive immune cell repertoire, and which enzymes are involved in this process?

    <p>VDJ recombination - Involves recombination activating gene 1 (RAG1) and recombination activating gene 2 (RAG2). Involves the splicing of a variable region, a diversity region and a joining region (B)</p> Signup and view all the answers

    What is meant by the term immune tolerance?

    <p>The immune system's ability to prevent immune responsiveness to self-antigens (C)</p> Signup and view all the answers

    What is an advantage of live-attenuated vaccines compared to killed vaccines?

    <p>all of the above (D)</p> Signup and view all the answers

    What is the role of serum protein properdin in the complement system?

    <p>Increases the half-life of the C3 convertase by protecting it from proteases (D)</p> Signup and view all the answers

    What initiates the Lectin pathway of the complement cascade?

    <p>MBL associated serine proteases (D)</p> Signup and view all the answers

    Which immunoglobulin can efficiently activate the lectin pathway in complement activation?

    <p>IgA (A)</p> Signup and view all the answers

    In the lectin pathway, what is the function of MBL-associated serine proteases?

    <p>Initiate activation of lectin pathway through MBL binding (A)</p> Signup and view all the answers

    What is the main function of serum protein properdin in the complement system?

    <p>Extends the half-life of the C3 convertase in the alternative pathway (D)</p> Signup and view all the answers

    What are the TWO isotypes of immunoglobulin expressed by naïve B cells?

    <p>IgM and IgD (B)</p> Signup and view all the answers

    Which process involves naïve B cells switching from IgM to IgD expression?

    <p>Isotype switching (C)</p> Signup and view all the answers

    What is the primary role of IgD in the immune system?

    <p>Serving as a B cell receptor for antigen recognition (A)</p> Signup and view all the answers

    Outline the TWO major steps that take place in the thymus that lead to central T cell tolerance.

    <p>Positive selection of T cells in the thymus of cells which can bind MHC Negative selection of T cells which can bind self antigen, or have high affinity for self MHC (A)</p> Signup and view all the answers

    What is NOT a mechanism by which peripheral T cell tolerance is achieved?

    <p>T cell apoptosis induced by repeated stimulation of the TCR in a inflammatory environment (D)</p> Signup and view all the answers

    Regarding vaccination, match the following

    <p>Pneumococcus = ub unit vaccine containing pneumococcal capsid antigen Mycobacteria tuberculosis = Live-attenuated strain of Mycobacteria bovis Shingles/chickenpox = Live-attenuated strain of varicella-zoster virus Hepatitis B = Hepatitis B surface antigen produced by recombinant expression</p> Signup and view all the answers

    What is NOT an example of autoimmune diseases where the pathogenesis is definitely directly mediated by a pathogenic antibody.

    <p>dsDNA antibody in SLE and PR3 antibody in vasculitis (B)</p> Signup and view all the answers

    What is NOT a proven strategy for preventing HIV infection.

    <p>Abstinence (D)</p> Signup and view all the answers

    What is NOT a acquired immunodeficiency syndrome (AIDS) defining illnesses

    <p>Hodgkin lymphoma and cancers of the mouth (D)</p> Signup and view all the answers

    Define the term primary immunodeficiency

    <p>Immunodeficiency that is due to an inborn defect, often genetic, rather than occurring as part of another disease process. (A)</p> Signup and view all the answers

    Which molecule is required for somatic recombination events between V(D)J segments that produce T and B cell receptors. Absence means no T and no B cells, no adaptive immunity

    <p>RAG1/2 (D)</p> Signup and view all the answers

    A child known to be nut-allergic suffers systemic anaphylaxis after inadvertent ingestion of peanuts and develops facial angioedema and low blood pressure. What is the order of the key immunological events that underlie this episode, beginning with exposure to the allergen at the outset of this event and ending with the onset of symptoms?

    <ol> <li>Peanut allergens bind to pre-formed anti-peanut IgE antibodies on the surface of mast cells (+/- basophils) 2Cross-linking of contiguous epitopes on adjacent IgE molecules activates the mast cell leading to degranulation. 3) with release of preformed mediators (histamine, tryptase and others) and production of leukotrienes 4)The pharmacological effects (increased capillary permeability, vasodilation) lead to the clinical features of anaphylaxis observed (A)</li> </ol> Signup and view all the answers

    Why is cross-matching a necessary precaution before transplanting a solid organ into a patient?

    <p>Because antibodies in the patient's circulation that react with donor antigens may cause hyperacute rejection which is a life-threatening complication. (D)</p> Signup and view all the answers

    Why is HLA-matching not a requirement for liver transplantation?

    <p>Liver transplantation is usually of highest urgency and there is little time to find a good HLA match. In addition, liver transplants appear to be well accepted despite HLA-mismatches, which may be explained by the fact that livers carry many ‘passenger’ leukocytes that will colonise the host and give rise to a chimeric Immune system, which helps to induce tolerance (A)</p> Signup and view all the answers

    A 23-year-old man is advised to take ibuprofen after a minor injury.

    To which class of drugs does ibuprofen belong?

    <p>Non-steroidal anti-inflammatory drugs or NSAIDS (D)</p> Signup and view all the answers

    What is NOT an example of the same class of drug as ibuprofen

    <p>morphine (C)</p> Signup and view all the answers

    What is NOT an important side-effect and/or toxicities of ibuprofen when used at standard doses?

    <p>Death (D)</p> Signup and view all the answers

    Name the two types of immunoglobulin that naïve B-cells express on their surface

    <p>IgD and IgM (D)</p> Signup and view all the answers

    Which of the following statements is the most accurate to define immunological tolerance?

    <p>Lack of reactivity to antigens (C)</p> Signup and view all the answers

    1. A patient presents to the Emergency Department with the appearances below. She has experienced this every 1-2 years for 30 years; she has been told that she’s reacting to something, but it’s not clear what. She has a long history of unexplained episodes of abdominal pain. Which treatment is most likely to improve her acute symptoms?

    <p>C1 inhibitor concentrate (A)</p> Signup and view all the answers

    1. A researcher sets up an experiment to determine whether people with long covid may have anti-interferon gamma antibodies in their blood. Briefly: blood samples from participants are spun and serum collected. 100 microlitres of serum is then added to the pre-coated ELISA test wells. Bound antibody is detected using a secondary detection antibody. The diagram below illustrates this experimental system. What does the arrow point to?

    <p>Interferon gamma antigen (B)</p> Signup and view all the answers

    1. As part of the natural course of HIV infection (untreated), what is the usual order of changes to CD4 and CD8 T-cells counts, and viral load in the blood during the early phase after infection (weeks to months)

    <p>Virus load rises quickly as CD4 T-cell counts drop. As CD8 T-cell counts rise, viral load goes down and CD4 T-cell counts recover (D)</p> Signup and view all the answers

    A 6 month old infant has been developing well and has no significant infection history to date. There is no family history of infection. He presents with skin infection, and a junior doctor requests analysis of his blood for circulating levels of the IgG, A and M. The junior doctor is concerned about the results and asks for senior advice. What is the most likely interpretation? IgG 1 g/ L (normal range 1.5 to 6.3 g/ L) (low) IgA <0.1 g/ L (normal range 0 to 0.8 g/ L) (within range) IgM 1 g/ L (normal range 0 to 1.45g/ L) (within range)

    <p>Transient hypogammaglobulinemia of infancy is the most likely explanation (C)</p> Signup and view all the answers

    Which of the following T cell subsets are important for triggering or maintaining inflammation in chronic inflammatory disease?

    <p>Th1 (T helper 1) (D)</p> Signup and view all the answers

    Exogenous antigens are broken down by what type of enzymes in the phagolysosome?

    <p>Peptidases (A)</p> Signup and view all the answers

    Rejection of a kidney transplant may occur at different times after transplantation. What is a feature of chronic rejection?

    <p>It may be the long-term result of a lack of oxygen during warm ischemic time (B)</p> Signup and view all the answers

    What is a likely feature of tumour cells within an advanced secondary tumour?

    <p>high expression of PD-L1 (C)</p> Signup and view all the answers

    Which toll-like receptor (TLR) is activated by DNA?

    <p>TLR9 (A)</p> Signup and view all the answers

    Regarding T cell central tolerance in the thymus, what is the function of ‘negative selection’?The selection of:

    <p>autoreactive thymocytes (D)</p> Signup and view all the answers

    What is a central role of Peyer’s patches?

    <p>They are a site of tolerance induction to commensal bacteria (C)</p> Signup and view all the answers

    Allergic diseases are found at increased frequency in higher-income countries. Which explanation is considered to provide the best explanation for this observation?

    <p>High levels of histamine in Western diets (D)</p> Signup and view all the answers

    According to Lazarus & Folman’s (1984) transactional model, when do people experience stress?

    <p>When they perceive that their abilities or resources are not sufficient to counter a harmful, threatening, or challenging stressor. (C)</p> Signup and view all the answers

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