clinical immunology final mcqs (1).pdf

Variant 1 1.Is venous blood used for immunophenotyping of cells? (1 Point) Yes No 2.Immunodeficiency conditions and diseases are associated with a defect in innate or acquired immunity: (1 Point) Yes No 3.Severe combined immunodeficiency includes a group of serious immune disorders caused by diff...

Variant 1 1.Is venous blood used for immunophenotyping of cells? (1 Point) Yes No 2.Immunodeficiency conditions and diseases are associated with a defect in innate or acquired immunity: (1 Point) Yes No 3.Severe combined immunodeficiency includes a group of serious immune disorders caused by different immunopathogenic mechanisms: (1 Point) Yes No 4.Is it necessary to determine the blood group compatibility between donor and recipient before kidney transplantation? (1 Point) Yes No 5.Recurrent miscarriages have NO association with defects in coagulation factors or circulating anticoagulants (lupus-like anticoagulants): (1 Point) Yes No 6.Antibodies in women with reproductive disorders are tested from serum? (1 Point) Yes No 7.The modern classification of tumor antigens is based on their molecular structure and origin: (1 Point) Yes No 8.Alpha-fetoprotein immunoassay is used in the diagnosis of breast cancer: (1 Point) Yes No 9.IgM is a pentameric immunoglobulin composed of five monomer units plus one J-chain. (1 Point) Yes No 10.Flow cytometry can be used for the immunological detection of bone marrow metastases from hematopoietic and non-hematopoietic malignancies: (1 Point) Yes No 11.Natural killer cells (NK cells): (2 Points) express their own TCR genes rearrange their immunoglobulin genes originate from the bone marrow have IgG molecules on their cell surface 12.Which of the immunodeficiencies are most common? (2 Points) primary immune deficiencies (PID) secondary immune deficiencies (SID) both groups have the same frequency there is no correct answer 13.Which of the selected primary immune deficiency (PID) is NOT associated with impaired phagocytic function? (2 Points) chronic granulomatous disease (CHD) Chediak Higashi syndrome Bruton's disease there is no correct answer 14.The accelerated graft rejection reaction occurs: (2 Points) intraoperatively or immediately after the operation 24 to 72 hours after transplantation up to 3 months after transplantation 3 months after transplantation 15.Which of the following is a diagnostic marker for colon tumors: (2 Points) alpha-fetoprotein carcinoembryonic antigen (CEA) presence of Reed-Sternberg cells EBV-associated antigens 16.Non-Hodgkin's lymphomas: (2 Points) Demonstrate positivity in staining with cytokeratin antibodies They are usually T-cell and rarely B-cell phenotype They can be differentiated from carcinomas using antibodies to CD45 (total leukocyte antigen) Are reactive B-cell hyperplasia 17.Antigens, which are usually expressed only in embryonic cells, but are sometimes found in tumors, are known as: (2 Points) Oncofetal antigens HTLV-1 Maternal Neonatal 18.In which of the following cases circulating antibodies can be formed: (2 Points) after blood transfusion pregnancy previous transplantations all answers are correct 19.Hereditary angioedema (HAE) is an autosomal dominant immunodeficiency disease associated with a quantitative decrease or decreased function of: (2 Points) phagocytic cells serum immunoglobulins C1 esterase inhibitor all answers are correct 20.HLA-G antigens are normally expressed in: (2 Points) sterility in pregnancy from the trophoblastic cells infectious diseases ankylosing spondylitis 21.Normal pregnancy is characterized by: (2 Points) reduced production of antibodies in the mother's body balance between Th1 and Th2 cytokine production Rh- and ABO- blood group incompatibility presence of antiphospholipid antibodies in the mother's serum 22.Electrophoresis is: (2 Points) double immunodiffusion in gel separation of molecules in an electric field complement fixation reaction agglutination reaction 23.What are the immunological methods for determining the levels of serum immunoglobulins? (2 Points) complement fixation reaction nephelometry and turbidimetry indirect IFA PCR 24.By what mechanism do type III allergic reactions develop: (2 Points) anaphylaxis complement-mediated cytolysis immune complexes infectious immunity 25.Contact dermatitis is an example of: (2 Points) anaphylactic reaction cytotoxic hypersensitivity slow type of hypersensitivity hypersensitivity involving antigen-antibody complexes 26.Lymphocytic infiltration of the thyroid gland is characteristic of: (2 Points) tuberculosis pneumonia hemolytic anemias Hashimoto's thyroiditis 27.NK - cells and cytotoxic T - lymphocytes have a major protective role in immunity against: (2 Points) viruses toxigenic bacteria extracellular bacteria all of the above 28.In chronic granulomatous disease as a result of enzymatic defects is reduced bactericidal granulocytes, due to which patients have frequent infections from: (2 Points) catalase - positive microorganisms catalase - negative microorganisms oxidase - positive microorganisms oxidase - negative microorganisms 29.Tuberculosis infection is characterized by the development of? (2 Points) type I hypersensitivity type II hypersensitivity type III hypersensitivity type IV hypersensitivity 30.Which autoantibodies are found in gluten enteropathy? (2 Points) autoantibodies against parietal cells of the stomach and intrinsic factor anti-gliadin antibodies anticardiolipin antibodies antimitochondrial antibodies 31.What medications are used to treat anaphylactic shock: (2 Points) diuretics and expectorants beta-blockers and folic acid adrenaline and corticosteroids vitamin D and fluoroquinolones 32.Which of the following causes lead to the development of secondary immune deficiencies (SID)? (2 Points) genetic biochemical and metabolic burns all answers are correct 33.Indicate the incorrect answer: Autoimmune diseases due to antibodies can occur as a result of: (2 Points) formation of antigen-antibody complexes antibodies blocking a cellular receptor antibody-induced, complement-mediated lysis cell-mediated reaction 34.The mechanism of protection against HBV (hepatitis B virus) is: (2 Points) intestinal mucosal antibodies (coproantibodies) antibodies against hemagglutinin and neuraminidase protective antibodies against surface protein G interferon α 35.The name of the resident macrophages in pancreatic islets is: (2 Points) osteophages Langerhans cells Kupffer cells microglial cells 36.The opsonization is a process of: (4 Points) ingestion and destruction of an antigen by the phagocyte coating the antigen with antibodies in order to relieve phagocytosis coating the antigen with complement to relieve phagocytosis preparation of monoclonal antibodies attachment of phagocytes to bacteria release of toxins to kill phagocytes 37.The most common clinical manifestations of C3 deficiency are: (4 Points) development of tumors increased susceptibility to viral infections partial albinism increased susceptibility to fungal infections increased susceptibility to bacterial infections may be accompanied by chronic glomerulonephritis 38.Which of the following substrates are most commonly used to determine antinuclear antibodies (ANA) with indirect immunofluorescence: (4 Points) cryostat section of rat liver cryostat section of rat kidney cryostat section of rat stomach HEp2 cell line HeLa cell line human retinal epithelial cell line 39.Select the most common immunological causes of infertility: (4 Points) antisperm antibodies in the mother Rh-incompatibility cryptorchidism autoimmune aspermatogenesis erectile dysfunction C1-inhibitor deficiency 40.Prostate-specific antigen: (4 Points) It is usually measured by ELISA and it is never elevated in smokers It is usually measured by ELISA and may be elevated in smokers It is measured by RIA and it is never elevated in prostatitis It may be elevated in prostatitis It is measured by RIA and is elevated in gastric cancer It is measured by RIA and ELISA and is elevated in liver cancer 41.In cellular effector mechanisms of antitumor immunity: (4 Points) CD4 + T-helpers interact with APC via at least two signals Activation of T-helpers does not require costimulatory signals Activated CD4 + T cells secrete cytokines to signal and activate other immune components Macrophages are not involved CD4 + T cells interact with APC via their MCH class I receptors CD4 + T cells produce granzymes to activate T-cytotoxic cells 42.Which of the following statements about severe combined immune deficiency (SCID) is true: (4 Points) patients with severe combined immune deficiency (SCID) often suffer from viral infections patients with severe combined immune deficiency (SCID) often suffer from bacterial infections no answer is correct all answers are correct patients with severe combined immune deficiency (SCID) rarely suffer from fungal infections patients with severe combined immune deficiency (SCID) rarely suffer from viral infections 43.An eight-month-old infant suffers from frequent Gram-positive bacterial infections. The most likely reason for this is: (4 Points) the mother has not given sufficient immunity during pregnancy the child suffers from hemolytic disease of the newborn the child has a defect in the alternative path of the complement system chronic granulomatous disease (CGD) the child is allergic to breast milk defect in phagocytosis 44.Which of the following statements are true? (4 Points) the acquired immunity is evolutionarily older than the innate immunity innate immunity is non-specific the adaptive immunity turns on immediately innate immunity does not involve the production of antibodies the first contact in innate immunity leads to a specific memory the second contact in adaptive immunity results in the activation of mechanisms with the same force 45.Multiple myeloma (MM): (4 Points) is neoplastic proliferation of a single clone of plasma cells producing M-protein is a neoplastic proliferation of polyclonal plasma cells producing M-proteins M-proteins are usually examined by immunoelectrophoresis M-proteins consist mainly of IgM Plasma cells in MM do not usually damage bones The M-gradient determined by electrophoresis is usually in the region of α1-globulins 46.Which of the following are labeled antigen-antibody reactions? (4 Points) latex agglutination ELISA CFR IFA ASO test precipitation 47.Which of the selected primary immune deficiencies (PID) are associated with phagocytic dysfunction? (4 Points) chronic granulomatous disease (CGD) Chediak-Higashi syndrome Bruton's disease there is no correct answer chronic mucocutaneous candidiasis all answers are correct 48.In rheumatoid arthritis, the following autoantibodies are most commonly found: (4 Points) antithyroglobulin rheumatoid factor (RF) antineutrophil cytoplasmic antibodies (ANCA) anti-smooth muscle antibodies (ASMA) antimitochondrial antibodies (AMA) anti–cyclic citrullinated peptide antibodies (anti-CCP) 49.The principles of treatment of type I allergic reactions include all of the following, EXCEPT: (4 Points) bone marrow transplantation antihistamines decongestants glucocorticoids hyposensitization antioxidants 50.Which of the diseases affect the gastrointestinal tract? (4 Points) rheumatoid arthritis SLE pernicious anemia celiac disease Hashimoto's thyroiditis myasthenia gravis 51.Clinical case 1 A.P., 31, has had three consecutive miscarriages in the 8th gestational week. Gynecological examination, hysterosalpingography, laparoscopy, endometrial biopsy, and microbiological examination of vaginal and cervical secretions show no abnormalities. In the anamnesis, the patient did not report any complaints or family history of systemic autoimmune disease. The appointed immunological testings established: 1. Panel "Antiphospholipid antibodies" – anti-cardiolipin IgM, anti-phosphatidylserine, and anti-phosphate diethanolamine IgG - positive. 2. Panel "Antinuclear antibodies" (common ANA, anti-DNA, anti-Sm, anti-RNP, anti-SS-A, anti-SS-B, anti-histone) - within the reference range. 3. Panel "Antithyroid antibodies" (anti-thyroglobulin, antithyroid peroxidase) - within the reference range. 4. Lupus anticoagulant - 1.6 at a reference value of 0.8-1.2. 5. Reproductive immunophenotype: percentage of T- and B-lymphocyte populations and subpopulations - within reference limits; CD16 + CD 56+ NK cells - 17%, with an upper reference limit of 11%. 6. Gene mutations associated with thrombophilia - not detected. After consultation with an immunologist, a diagnosis was established and treatment was prescribed. One year later, at 38 gestational weeks, A.P. gives birth to a healthy boy. What is the most likely diagnosis for the patient? (2 Points) antiphospholipid syndrome systemic lupus erythematosus rheumatoid arthritis Hashimoto's thyroiditis 52.Question-related to clinical case 1: What are the supporting points for the diagnosis? (2 Points) absence of gene mutations associated with thrombophilia reference values of ANA recurrent miscarriages, high levels of lupus anticoagulant and antiphospholipid antibodies in the absence of clinical manifestations of systemic autoimmune disease reference values of anti-thyroid antibodies 53.Question-related to clinical case 1: What therapy would you prescribe? (2 Points) combined therapy with heparin, aspirin and intravenous immunoglobulin levothyroxine antibiotics sulfonamides 54.Clinical case 2 A six-month-old girl was admitted to hospital with severe bronchopneumonia. The baby is a normal pregnancy and was born in a term weighing 2.5kg. He is the third child of healthy sibling parents (first cousins) and has two healthy older siblings. Examination reveals abandonment in physical development (height and weight). The girl was intoxicated, with a temperature of 38.6 ° C, tachycardia and with symptoms of respiratory distress. Lung radiography shows bilateral diffuse infiltrates. Whole blood count and DCC in the reference values. Venous antibacterial therapy was administered and after seven days the child was discharged in good general condition, but 10 days later he was admitted again with fever and X-ray evidence of pneumonia. What additional laboratory tests would you perform: (2 Points) study of the absolute number and percentage of lymphocyte populations and subpopulations in peripheral blood by immunophenotyping lung radiography differential blood count examination of iron 55.Question-related to clinical case 2: The flowcytometric test reveals the following: - Absolute lymphocyte count 2.8 x10/9 / l - below the lower reference limit for this age - CD19 + B- lymphocytes 0.6 x10/9/l - below the lower reference limit for this age - CD3+ T lymphocytes 1.0x10/9/l - below the lower age limit for this age - CD3 + CD4 + T-lymphocytes 0.3x10/9/l - below the lower reference limit for this age - CD3 + CD8 + T-lymphocytes 0.2 x10/9/ l - below the reference age limit - CD3-CD16 + NK cells 0.1x10/9/ l - below the lower reference limit for this age Based on the immunological results, it is likely that it is: (2 Points) deficiency of the phagocytic system deficiency of leukocyte adhesion humoral deficiency severe combined immunodeficiency (SCID) 56.Question-related to clinical case 2: What treatment would you suggest: (2 Points) bone marrow transplantation a combination of 2 or more antibiotics stem cell transplantation from a compatible donor immunoglobulin treatment Variant 2 1.The name of the macrophages in the liver is: (2 points) a / osteophages b / Langerhans cells c / Kupffer cells d / microglial cells 2. Which cells can phagocytose ? (4 points) a / neutrophils b / platelets c / T-cytotoxic cells d / macrophages d / lymphoblasts e / plasma cells 3.Which of the following factors does NOT belong to innate immunity: (4 points) a) phagocytosis b / T-lymphocytes c / complement , lysozyme d / antibodies e / skin, mucus , normal microflora e / lysozyme 4. The defenses are: (2 points) a / growth factors b) antimicrobial peptides in neutrophil granules c / cytokines - mediators of the immune response d / interferons 5. NK - cells and cytotoxic T - lymphocytes have a major protective role in immunity against: (2 points) a / viruses b / toxigenic bacteria c / extracellular bacteria d / all specified 6. In humans, the primary lymphatic organs include: (2 points) a / lymph nodes b / bone marrow c / spleen and kidney d / stomach and lungs 7. Which molecules are expressed by mature B-lymphocytes on their surface? (2 points) a / IgM and IgD b / IgM and IgA c / IgD and IgE d / IgG and IgD 8. One B-cell can synthesize different antibodies. (1 point) a / YES b / NO 9. IgA is the predominant immunoglobulin in secretions: (1 point) a / YES b / NO 10. Intracellular bacteria are eliminated from the immune system mainly by humoral immune mechanisms: (1 point) a / YES b / NO 11. Electrophoresis is: (2 points) a) double immunodiffusion in gel b / separation of molecules in an electric field c / complement fixation reaction d / agglutination reaction 12. What are the immunological methods for determining the levels of serum immunoglobulins ? (4 points) a / complement fixation reaction b / nephelometry and turbidimetry c / indirect IFA d / blast transformation test (καμια απο τις υπολοιπες, επρεπε να εχει radial immunodiffusion) 13. The mechanism of protection against influenza virus is: (2 points) a / interferon α; b) antibodies against hemagglutinin and neuraminidase c) protective antibodies against surface protein G; d / intestinal mucosal antibodies (coproantibodies) 14. Which of the following statements is true?(4 points) a) Acquired immunity is evolutionarily older than innate immunity b / innate immunity is non-specific c / adaptive immunity is activated immediately d) innate immunity does not involve the production of antibodies e / the first contact in innate immunity leads to specific memory f / the second contact in adaptive immunity leads to activation of the mechanisms with the same force 15. Hereditary angioedema (NAE) is an autosomal dominant immunodeficiency disease associated with a quantitative decrease or decreased function of: (2 points) a) phagocytic cells b / serum immunoglobulins c / C1 esterase inhibitor d / all answers are correct 16.Which of the following causes does NOT lead to the development of primary immune deficiencies (PID)? (2 points) a / genetic b / arrest in embryogenesis c / biochemical and metabolic d / burns 17. Adenosine deaminase deficiency (ADA) is a form of: (2 points) a / primary immune deficiency (PID) b / secondary immune deficiency (TYPE) c / complement deficiency d / all answers are correct 18. Waldenström's macroglobulinemia reveals secretion of: (2 points) a) polyclonal IgG b / monoclonal IgG c / polyclonal IgM d / monoclonal IgM 19. Omenn's syndrome is: (2 points) a / secondary immune deficiency (TYPE) b / deficiency of phagocytic function c / severe combined immune deficiency (CKD) d / all answers are correct 20.Which of the following statements about severe combined immune deficiency (CKD) are true: (4 points) a / patients with severe combined immune deficiency (CKD) often suffer from viral infections b / patients with severe combined immune deficiency (CKD) often suffer from bacterial infections c / no answer is correct d / all answers are correct e / patients with TKID rarely suffer from fungal infections f / patients with TKID rarely suffer from viral infections 21.Which of the selected primary immunodeficiency (PID) are associated with impaired phagocytic function? (4 points) a / chronic granulomatous disease (CHD) b / Chediak Higashi syndrome c / Bruton's disease d / there is no correct answer e / chronic mucocutaneous candidiasis f / all answers are correct 22. The basis for the diagnosis of severe combined immune deficiency (CKD) is in: (4 points) a / manifestation of the symptoms of immune deficiency in old age b / normal mental and physical development c / data for B, T and NK cell deficiency from flow cytometric examination d / manifestation of the symptoms of immune deficiency at an early age e / there is no correct answer f / all answers are correct 23. Tuberculin allergy is an example of: (2 points) a) anaphylactic reaction b / cytotoxic hypersensitivity c / delayed type of allergy d/a+b 24. Which class of immunoglobulins is detected in elevated levels in patients with allergic diseases, developing by the mechanism of the allergic reaction of type I: (2 points) a / IgM b / IgG c / IgE d / IgA 25. In the treatment of hay fever are mainly used: (2 points) a / antipyretics b / beta-blockers c / antihistamines g / sulfonamides 26. Under the action of cyclooxygenase from arachidonic acid are obtained: (2 points) a / immunoglobulins b / prostaglandins c / interleukins d / bradykinin 27. For the development of an allergic reaction it is necessary: (2 points) a / high blood sugar levels b / preliminary sensitization c / peripheral vasospasm d / immune deficiency 28. Autoantibodies are normally present in the repertoire of the immune system: (1 point) a / YES b / NO 29. Antinuclear antibodies (AHA) are positive in most patients with systemic lupus erythematosus (SLE): (1 point) a / YES b / NO 30.Which of the following indicators is of the greatest clinical importance in the study of immune status in patients with SLE: (2 points) a / NBT test b) anti-DNA antibodies c / CD4 / CD8 index d / Bence-Jones protein 31. Rheumatoid arthritis develops by the mechanism of: (2 points) a) anaphylactic allergic reactions b / cytolytic allergic reactions c / immunocomplex allergic reactions d / cell-mediated allergic reactions 32. The rheumatoid factor in the serum of patients with rheumatoid arthritis is most often: (2 points) a / IgM reacting with the Fc fragment of endogenous IgG b) IgM reacting with the IgG Fab fragment c / IgE , reacting with allergens d) antibody against DNA 33. Autoantibodies against microsomes of thyroid cells can be found at: (2 points) a / kidney cancer b / Hashimoto's thyroiditis c / pancreatitis d / carcinoma of the pancreas 34. To prove autoimmune diseases of the thyroid gland are examined: (4 points) a) antinuclear antibodies b) antithyroglobulin antibodies c / antineutrophilcytoplasmic antibodies d) antimicrosomal antibodies e / antibodies against the islet cells of the pancreas f / antibody against DNA 35. Systemic lupus erythematosus: (4 points) a) is caused by mutations in double-stranded DNA b / manifests itself with many symptoms and affects many organs c / is an example of a T cell-mediated disease d / is the result of the formation of immune complexes e / is an immunodeficiency disease f / is organ-specific disease 36. The following autoantibodies are most commonly detected in SLE: (4 points) a / general ANA b / antineutrophilcytoplasmic antibodies (ANCA) c / antimitochondrial antibodies (AMA) d / anti-ds DNA e / rheumatoid factor (RF) f / anti-smooth muscle antibodies (AGMA) 37. The modern classification of tumor antigens is based on their molecular structure and origin: (1 point) a / YES b / NO 38. Immunological Study of alpha-fetoprotein are used in breast cancer: (1 point) a / YES b / NO 39. The Bence-Jones protein is: (2 points) a) transferrin fragments b / polyclonal free light chains c / monoclonal free light chains d / beta 2-microglobulin 40. Prostate-specific antigen: (4 points) a / is usually measured by ELISA and is never elevated in smokers b / is usually measured by ELISA and may be elevated in smokers c / is measured by RIA and is never elevated in prostatitis d / may be elevated in prostatitis e) is measured by RIA and is elevated in gastric cancer e / is measured by RIA and ELISA and is elevated in liver cancer 41. Autoantibodies in women with reproductive disorders are tested by serum: (1 point) a / YES b / NO 42.HLA-G antigens are normally expressed in: (2 points) a / sterility b / pregnancy from the trophoblast c / infectious diseases d / ankylosing spondylitis 43. The normal course of pregnancy is characterized by: (4 points) a) increased synthesis of serum immunoglobulins b / dominance of Th1 immune response c / dominance of Th2 immune response d) suppression of T-cell activation e) increased levels of C-reactive protein f) presence of anti-phospholipid antibodies 44. The developed clinical picture of HIV infection is characterized by the following neoplasms: (4 points) a / lymphoma of Burkitt ; b / Hodgkin 's lymphoma ; c / nasopharyngeal carcinoma; d / carcinoma of the endometrium ; e / carcinoma of the cervix; e / Kaposi 's sarcoma 45. Intravenous IgG can be used for immunomodulation in patients with congenital immunodeficiency diseases. (1 point) a / YES b / NO 46. Type II allergic reactions are realized with the help of: (4 points) a) class A immunoglobulins b / class D immunoglobulins c / class G immunoglobulins or class M immunoglobulins d / complement e / mast cells f / basophils 47. Which of the following combinations constitute a specific targeted immunotherapy? (4 points) a) immunotoxins and immunocytokines b / rhodioimmunoconjugates and antibiotics c / checkpoint inhibitors and "naked" MoAt (monoclonal antibodies) d) antimetabolites and allylating agents e / cytokines and GM-CSF f) tyrosine kinase inhibitors and cytostatics 48. Autoantibodies to cytoplasmic neutrophil antigens (ANCA) are NOT detected in Wegener 's granulomatosis: (1 point) a / YES b / NO 49.Which of the following mechanisms are involved in the development of autoimmune diseases? (2 points) a / modification of own antigen and its recognition as foreign to the immune system b / deficiency of suppressor T-cells c / antigenic mimicry due to infection by microorganisms with cross-reactive antigens d / all answers are correct 50. The HIV receptor is on: (2 points) a / CD3 molecule b / CD4 molecule c / CD8 molecule d / CD19 molecule 51. Clinical case 1: While working in the yard of his house, a 45-year-old man was bitten twice by a bee. A few minutes later he developed a generalized rash and fainted. In the emergency department, where he was taken, he was diagnosed with low blood pressure, a barely perceptible pulse and swelling of the larynx, which necessitated emergency intubation. 1. What is the most likely diagnosis? (2 points) a / anaphylactic shock b / cytotoxic hypersensitivity c / endotoxic shock d / stroke 52. Question to clinical case 1: What specialized immunological tests will you order after controlling the patient's serious condition? (2 points) a / measurement of blood sugar b / complete blood count c / tested for general and specific IgM and IgG d / study of general and specific IgE 53.Question to clinical case 1: Indicate other diseases developing by the same pathogenetic mechanism: (2 points) a / arterial hypertension b / myocardial infarction c / insulin-dependent type I diabetes d / allergic rhinitis 54.Clinical case 2: A 45-year-old man goes to his personal doctor with the following complaints - dry cough, fatigue, tiredness , weight loss, bloody sputum. The medical examination established - fever 38, 5 ° С, pathological noise finding in the lungs, weight reduction by 20 kg. Laboratory tests show - lymphocytosis , increased CRP, accelerated ESR. A Mantoux test was performed - positive. What is the suspected diagnosis? (2 points) a / tuberculosis b / AIDS c / pneumoconiosis d / interstitial pneumonia 55. Question to clinical case 2: What tests do you recommend to be performed to confirm it? (2 points) a / IFA b / T spot - TB c / ELISA d / RIA 56. Question to clinical case 2: What drugs will be treated? (2 points) a / Tetracycline ; b / Ciprofloxacin ; c / Isoniazid ; d / Itraconazole Variant 3 1. The material for autoantibody testing is whole venous blood: (1 Point) YES NO 2.Contact dermatitis is an example of a type II allergic reaction: (1 Point) YES NO 3.Immunotherapy of tumors with the BCG vaccine is non-specific: (1 Point) YES NO 4.The cellular immune response is mediated by B cells: (1 Point) YES NO 5.In Bruton's agammaglobulinemia, infants usually suffer from severe viral infections: (1 Point) YES NO 6.In the primary immune response against bacteria and viruses, specific IgG antibodies appear in the patient's serum: (1 Point) YES NO 7.AIDS is a secondary immunodeficiency characterized by frequent infections by opportunistic microorganisms: (1 Point) YES NO 8.After blood transfusions, pregnancy or previous transplants, circulating antibodies may form: (1 Point) YES NO 9.IgA antibodies can attach to the surface of mast cells through their Fc fragment: (1 Point) YES NO 10.Heterologous antigens are found in closely related species. (1 Point) YES NO 11.Which autoantibodies are found in myasthenia gravis? (2 Points) a / autoantibodies against gastric parietal cells and intrinsic factor b) anticardiolipin antibodies c) antibodies against acetylcholine receptors d) antimitochondrial antibodies 12.In patients with insulin-dependent diabetes mellitus, antibodies to: (2 Points) a / nuclear antigens b / thyroid microsomes c / islet cells of the pancreas d / IgG molecules 13.The following autoantibodies are commonly found in autoimmune hepatitis: (2 Points) a) anti-LKM-1X Bs b / anti-thyroglobulin c / anti-smooth muscle d / anti-insulin 14.Autoantibodies to double-stranded DNA are found mainly in patients with: (2 Points) a / Hashimoto's lymphocytic thyroiditis b / sepsis c / SLEH HQ d / pernicious anemia 15.Which autoantibodies are found in pernicious anemia? (2 Points) a) autoantibodies against gastric parietal cells and intrinsic factor b) anti-gliadin antibodies c / antibodies against acetylcholine receptors d) antimitochondrial antibodies 16.Type I allergic reactions are: (2 Points) a / immunocomplex b / cytolytic c / IgE mediated (anaphylactic, atopic) d / delayed allergy 17.In degranulation of mast cells are released: (2 Points) a / complement fractions b / histamine and arachidonic acid c / adrenaline and noradrenaline d / acute phase proteins 18.An example of a rapid reagin-type allergic reaction is: (2 Points) a / contact dermatitis b / serum sickness c / hemolytic disease of the newborn d / anaphylactic shock 19.To the group of specific therapeutic serums are all listed below, EXCEPT: (2 Points) a / heterologous b / homologous human c / antibacterial d / alive 20.All vaccinations and revaccinations in our country against the diseases described below are mandatory, with the EXCEPTION of: (2 Points) a / tuberculosis b / cholera c / diphtheria d / tetanus 21.The CD3 + molecule is a marker for: (2 Points) a) immunocompetent T cells b / macrophages c / NK cells d / mature B-lymphocytes 22.IFN-α is secreted by: (2 Points) a / B lymphocytes b / leukocytes c / T-lymphocytes d / macrophages 23.The name of the resident macrophages in the liver is: (2 Points) a / osteoclasts b / Langerhans cells c / Kupffer cells d / microglia 24.The humoral immune response: (2 Points) a) results in the production of antibodies by plasma cells X b / includes only T cells c / is part of the natural (innate) immunity d / there is no correct answer 25.Which of the selected primary immune deficiencies (PID) is NOT associated with phagocytic dysfunction? (2 Points) a / chronic granulomatous disease (CHD) b / Chediak Higashi syndrome c / chronic cutaneous candidiasis d / there is no correct answer 26.The over-acute graft rejection reaction develops: (2 Points) a / intraoperatively or immediately after surgery (over-acute or hyperacute) b / 24-72 hours after transplantation (accelerated) c / up to 3 months after transplantation (acute) d / 3 months after transplantation (chronic) 27.Tissue and organ transplantation between monozygotic twins is called: (2 Points) a / xenogeneic b / allogeneic c / autogenous d / syngeneic 28.Indicate which of the following mechanisms can be used to lyse tumor cells: (2 Points) a / by virus neutralization b / NK cells c / through cells in ADCC d / by precipitation 29.Bence-Jones protein is: (2 Points) A / free heavy chains B / free light γ or λ chains C / IgM class antibodies against normal antibodies (IgG) D / Fc fragment of IgG 30.Serum values of most tumor markers are affected mainly in: (2 Points) A / athletes B / drug addicts C / patients with diabetes mellitus D / smokers and pregnant women 31.TNFα: (2 Points) A / activates complement in the classical way B / activates complement in the alternative way C / causes necrosis of solid VH tumors D / activates eosinophils 32.The technology of obtaining toxoids (antitoxins) is: (2 Points) A / treatment of the exotoxin for 28-40 days B / treatment of the exotoxin with 0.3-0.5% formalin C / treatment of the exotoxin at 38-40 ° C D / answers a + b + c 33.Which drugs are used to treat anaphylactic shock: (2 Points) A / adrenaline and corticosteroids B / beta-blockers and folic acid C / diuretics and expectorants D / vitamin D and fluoroquinolones 34.Where do B-lymphocytes acquire their immune competence? (2 Points) A / bone marrow B / thymus C / liver D / spleen 35.Indicate which of the following methods of tissue compatibility testing is molecular: (2 Points) A / NBT B / polymerase chain reaction safe C / lymphocytotoxic test D / mixed lymphocyte culture test 36.In which autoimmune diseases are metabolic disorders observed? (4 Points) A / Hashimoto’s thyroiditis B / SLE C / rheumatoid arthritis D / insulin-dependent diabetes mellitus E / myasthenia gravis E / scleroderma 37.Inflammatory infiltrates are observed in the following autoimmune diseases: (4 Points) A / Hashimoto’s thyroiditis B / autoimmune hemolytic anemia C / insulin-dependent diabetes mellitus D / myasthenia gravis E / primary biliary cirrhosis F / Wegener’s granulomatosis 38.The following autoantibodies are most commonly found in autoimmune hepatitis: (4 Points) A / anti-LKM-1X B / antineutrophilcytoplasmic antibodies (ANCA) C / anti-SSR D / anti-smooth muscle antibodies (AGMA) e) anticardiolipin antibodies f) antithyroglobulin antibodies 39.Anaphylactic reactions: (4 Points) A / develop in a very short time – 30 min B / mediated by lymphocytes C / are the result of the release of large amounts of urea d) are mediated by IgE e / develop over days and weeks f / IgA-mediated 40.Examples of type III allergic reactions are: (4 Points) A / endotoxic shock B / anaphylaxis C / the phenomenon of Arthus D / Raynaud’s phenomenon E / Sjögren’s syndrome F / poststreptococcal glomerulonephritis 41.What are the WRONG statements about the complement system? (4 Points) A / is a complex of cells B / opsonizes C / lyses cells, bacteria d) the components are usually in active form in serum e / three are the activation pathways f) the classical activation pathway is due to antigen-antibody complexes 42.Hereditary angioedema (NAE) is found in: (4 Points) a) Increased absolute number of eosinophils B / increased serum IgE concentration C / increased concentration of C1 esterase inhibitor d) qualitative deficiency of C1 esterase inhibitor e) quantitative deficiency of C1 esterase inhibitor f / no correct answer 43.Which of the following conditions is NOT associated with Epstein-Barr virus (EBV)? (4 Points) A / melanoma B / nasopharyngeal carcinoma C / Hodgkin’s lymphoma D / Burkitt’s lymphoma E / multiple myeloma F / diffuse B-cell lymphoma 44.In which autoimmune diseases is splenectomy performed? (4 Points) A / hemolytic anemias B / dermatomyositis C / SLE D / rheumatoid arthritis E / idiopathic thrombocytopenic purpura F / Hashimoto’s thyroiditis 45.The oncofetinal tumor-associated antigen AFP (alpha-feto-protein) is positive and increases in the serum of patients with: (4 Points) A/ Testicular carcinoma B / breast cancer C / lung cancer D / renal cell carcinoma E / thyroid carcinoma F / liver carcinoma 46.Which of the selected primary immune deficiencies (PID) are associated with phagocytic dysfunction? (4 Points) A / Bruton’s disease B / Chediak Higashi syndrome C / chronic mucocutaneous candidiasis D / chronic granulomatous disease (CHD) E / there is no correct answer F / all answers are correct 47.Morphological changes in the kidneys are observed in the following autoimmune diseases: (4 Points) A / SLE B / Hashimoto’s thyroiditis C / dermatomyositis G / glomerulonephritis E / myasthenia gravis F / pernicious anemia 48.Characteristic of primary biliary cirrhosis is the presence of: (4 Points) a) Hypergammaglobulinemia (IgM) B / antineutrophilcytoplasmic antibodies (ANCA) C / antimitochondrial antibodies (AMA) D / Bence-Jones protein E / anti-SSR F / HLA-B27 49.The biology of cancer cells is characterized by: (4 Points) A / cancer cells divide extremely fast B / cancer cells proliferate normally C / cancer cells never metastasize D / cannot be “caught” by the immune system E / never induce an immune response F / the cancer gives local and distant metastases 50.In rheumatoid arthritis, the following autoantibodies are most commonly found: (4 Points) A / anti-SSR B / anti-smooth muscle antibodies (AGMA) C / antineutrophilcytoplasmic antibodies (ANCA) D / rheumatoid factor (RF) E / antimitochondrial antibodies (AMA) F / antithyroglobulin 51. Clinical case 1: A 45-year-old man goes to his personal doctor with the following complaints – dry cough, fatigue, tiredness, weight loss, bloody sputum. The medical examination established – fever 38.5 ° С, pathological noise finding in the lungs, weight reduction by 20 kg. Laboratory tests show – lymphocytosis, increased CRP, accelerated ESR. A Mantoux test was performed – positive.What is the suspected diagnosis? (2 Points) a) tuberculosis b) AIDS c) pneumoconiosis d) interstitial pneumonia 52. Question to clinical case 5: What test do you recommend for confirmation? (2 Points) a) IFA b) T-SPOT.TB test c) ELISA d) RIA 53. Question to clinical case 1: What clinical material is taken to perform the above test? (2 Points) A / sputum B / cerebrospinal fluid In / urine D / peripheral blood 54. Clinical case 2: Mario was born by caesarean section weighing 3.1 kg. He is the sixth child of parents without blood relationship. At the age of 4 weeks, he developed an axillary abscess that healed spontaneously, followed by a staphylococcal abscess on the chest wall, which required a surgical incision and a course of oxacillin therapy. From the research: there is a total number of white blood cells 45x109 / l. By the end of the first year, he developed two staphylococcal abscesses, treated surgically and with systemic antibiotics. By the age of 2, he had been admitted to hospital five times with staphylococcal abscesses. Three of his older brothers died of infections between the ages of 7 months and 3 years, but his parents and two sisters are healthy. On examination, he is pale and has a high temperature. Abandons with weight and height for his age. There is axillary and inguinal lymphadenopathy and hepatosplenomegaly. Laboratory tests showed mild anemia (Hb 104 g / l) with marked polymorphonuclear leukocytosis. A polyclonal increase in all classes of immunoglobulin, especially IgG and IgA, was found. NBT test – stimulated – below normal, unstimulated – in normal values. Based on the immunological results, what disease is most likely to be involved? (2 Points) A / chronic granulomatous disease (CHD) B / deficiency of leukocyte adhesion C / humoral deficit D / severe combined immunodeficiency 55. Question to clinical case 2: Now 7 years old, Mario continues to have recurrent abscesses, despite long-term co-trimoxazole therapy. Treatment of acute infections lasts at least 8 weeks. He did not have a life-threatening infection requiring IFN-γ therapy, but he did have a prophylactic antifungal agent. What would be the best treatment option for him? (2 Points) A / bone marrow transplantation B / combination of 2 or more antibiotics C / stem cell transplantation from a compatible donor D / treatment with immunoglobulin 56. Question to clinical case 2:What can cause the disease? (2 Points) a) lack of the enzyme NADPH oxidase b) defective glucose-6-phosphate dehydrogenase c / disorders in gluten metabolism d) adenylate alkinase deficiency Variant 4 1. Which cells can phagocytose? (4 points) a / neutrophils b / platelets c / T-cytotoxic cells d / macrophages d / lymphoblasts e / plasma cells 2. Classical MHC class II antigens (HLA-DR, DQ) have a more limited distribution than MHC class I antigens: (1 point) a / YES b / NO 3. The main role in protection against viruses is played by cellular immunity: (1 point) a / YES b / NO 4. NK - cells and cytotoxic T - lymphocytes have a major protective role in immunity against: (2 points) a / viruses b / toxigenic bacteria c / extracellular bacteria d / all specified 5. The Respiratory explosion/ burst is related to: (2 points) a / humoral immunity b / cellular immunity c / phagocytosis d / NK cells 6. Which of the following indicators is most important for the immune status of patients with chronic granulomatous disease? (2 points) a / NBT test b / anti DNA antibodies c / CD4 / CD8 index d / Bence-Jones protein 7. What is the fastest and most accurate method for detecting serum immunoglobulin levels? (2 points) a / immunoelectrophoresis b / nephelometry c / IFA d / RSK 8. Chronic recurrent infections are common in immunodeficiency conditions: (1 point) a / YES b / NO 9. Hereditary angioedema (NAE) is a primary immune deficiency (PID) due to a defect in the phagocytic system and is treated with corticosteroids and antihistamines: (1 point) a / YES b / NO 10.Which of the following causes does NOT lead to the development of primary immune deficiencies (PID)? (2 points) a / genetic b / arrest in embryogenesis c / there is no correct answer d / burns 11. Adenosine deaminase deficiency (ADA) is a form of: (2 points) a / primary immune deficiency (PID) b / secondary immune deficiency (TYPE) c / complement deficiency d / all answers are correct 12. Waldenström’s macroglobulinemia reveals secretion of: (2 points) a) polyclonal IgG b / monoclonal IgG c / polyclonal IgM d / monoclonal IgM 13. Omenn’s syndrome is: (2 points) a / secondary immune deficiency (TYPE) b / deficiency of phagocytic function c / severe combined immune deficiency (CKD) d / all answers are correct 14.Which of the following statements about severe combined immune deficiency (CKD) are true: (4 points) a / patients with severe combined immune deficiency (CKD) often suffer from viral infections b / patients with severe combined immune deficiency (CKD) often suffer from bacterial infections c / no answer is correct d / all answers are correct e / patients with TKID rarely suffer from fungal infections f / patients with TKID rarely suffer from viral infections 15.Which of the selected primary immune deficiencies (PID) are associated with phagocytic dysfunction? (4 points) a / chronic granulomatous disease (CHD) b / Chediak Higashi syndrome c / Bruton’s disease d / there is no correct answer d / chronic mucocutaneous candidiasis f / all answers are correct 16. The basis for the diagnosis of severe combined immune deficiency (CKD) is in: (4 points) a / manifestation of the symptoms of immune deficiency in old age b / normal mental and physical development c / data for B, Ti and NK cell deficiency from flow cytometric examination d / manifestation of the symptoms of immune deficiency at an early age e / there is no correct answer f / all answers are correct 17. The determination of allergen specific IgE is necessary to prove the allergic reaction of type I: (1 point) a / YES b / NO 18. Which molecules are formed under the action of cyclooxygenase from arachidonic acid? (2 points) a / immunoglobulins b / prostaglandins c / interleukins d / bradykinin 19. For testing antibodies in allergic conditions are used: (4 points) a) immunofluorescence test b / ELISA c / complement fixation reaction d / neutralization d / immunoblot f / all answers are correct 20. For the development of an allergic reaction it is necessary: (2 points) a / high blood sugar levels b / preliminary sensitization c / peripheral vasospasm d / immune deficiency 21. What medications are used in the treatment of anaphylactic shock: (2 points) a / diuretics and expectorants b / beta-blockers and folic acid c / adrenaline and corticosteroids d / vitamin D and fluoroquinolones 22. Type II allergic reactions are realized with the help of: (4 points) a) class A immunoglobulins b / class D immunoglobulins c / class G immunoglobulins d / complement e / mast cells e / basophils 23. Atopic diseases develop: (4 points) a / with the participation of the complement b / in case of hereditary predisposition c / under the action of immune complexes d / with the participation of IgE e / with the participation of acute phase proteins f / in hypoglycaemia 24. Autoantibodies are normally present in the repertoire of the immune system: (1 point) a / YES b / NO 25. Rheumatoid arthritis develops by the mechanism of: (2 points) a) anaphylactic allergic reactions b / cytolytic allergic reactions c / immunocomplex allergic reactions d / cell-mediated allergic reactions 26. The rheumatoid factor in the serum of patients with rheumatoid arthritis is most often: (2 points) a / IgM reacting with the Fc fragment of endogenous IgG b) IgM reacting with the IgG Fab fragment c / IgE, reacting with allergens d) antibody against DNA 27. Autoantibodies against thyroid cell microsomes can be detected in: (2 points) a / kidney cancer b / Hashimotos thyroiditis c / pancreatitis d / carcinoma of the pancreas 28. In SLE, what is the most common fluorescence in ANA study with IIFA: (2 points) a / homogeneous / diffuse b / spotted c / nucleolar d / centromeric 29. To prove autoimmune diseases of the thyroid gland are examined: (4 points) a) antinuclear antibodies b) antithyroglobulin antibodies c / antineutrophilcytoplasmic antibodies d) antimicrosomal antibodies e / antibodies against the islet cells of the pancreas f / antibody against DNA 30. Systemic lupus erythematosus:(4 points) a) is caused by mutations in double-stranded DNA b / manifests itself with many symptoms and affects many organs c / is an example of a T cell-mediated disease d / is the result of the formation of immune complexes e / is an immunodeficiency disease f / is organ-specific disease 31. For immunophenotyping of cells is used: (2 points) a / serum b / venous blood with EDTA c / peripheral blood from the finger d / there is no correct answer 32. What are monoclonal antibodies?(2 points) a) a pure population of immunoglobulins with the same structure and antigenic determinants b) albumins that are encoded by an antigenic group c / mixed Ig population with the same structure but different antigenic determinants d) substances that cause the expression of Ig from another class of B-cells 33. For initial screening of HIV infection the ELISA method is used, and as a confirmatory test is used: (2 points) a / RIA b / IFA c / NBT test d / Immunoblot 34. AIDS is a secondary immune deficiency (TYPE) that develops after: (2 points) a / bacterial infection b / viral infection c / fungal infection d / all answers are correct 35. The following clinical neoplasms are characteristic of the developed clinical picture of HIV infection: (4 points) a / Burkitt’s lymphoma; b / Hodgkin’s lymphoma; c / nasopharyngeal carcinoma; d / carcinoma of the endometrium; e / carcinoma of the cervix; e / Kaposi’s sarcoma 36. The serum level of CEA (carcinoembryonic antigen) is usually examined by flow cytometry: (1 point) a / YES b / NO 37. The Bence-Jones protein is: (2 points) a) transferrin fragments b / polyclonal free light chains c / monoclonal free light chains d / beta 2-microglobulin 38. Prostate-specific antigen: (4 points) a / is usually measured by ELISA and is never elevated in smokers b / is usually measured by ELISA and may be elevated in smokers c / is measured by RIA and is never elevated in prostatitis d / may be elevated in prostatitis e) is measured by RIA and is elevated in gastric cancer f / is measured by RIA and ELISA and is elevated in liver cancer 39. Opsonization is a process of: (4 points) a) uptake and destruction of antigen by the phagocyte b) coating the antigen with antibodies in order to alleviate phagocytosis c / coating the antigen with complement to relieve phagocytosis d) preparation of monoclonal antibodies e / attachment of phagocytes to bacteria f / release of toxins to kill phagocytes 40. Specific immunoprophylaxis is the introduction into the body of bioproducts (vaccines, serums, specific immunoglobulins) in order to prevent and induce a specific immune response against one or more infectious diseases: (1 point) a / YES b / NO 41. Characteristic of type IV allergic reactions is: (4 points) a / develop rapidly within 20-30 minutes b / mediated by antibodies c / are mediated by complement d / develop slowly, usually within 48-72 hours e / mediated by albumin f / mediated by CD4 + T cells 42. Recurrent abortions have NOT to do with defects in coagulation factors or circulating anticoagulants (lupus-like anticoagulants): (1 point) a / YES b / NO 43. Transplant rejection may be a manifestation of: (2 points) a) cell-mediated immunity b / type III hypersensitivity (immune complexes) c / complement-dependent cytotoxicity d / all answers are correct 44. The study of cellular immunity in women with reproductive problems includes: (2 points) a / T-lymphocytes (CD3 +, CD4 +, CD8 +) b / B-lymphocytes (CD19 +) c / NK cells (CD3 +, CD56 +, C16 +) d / there is no correct answer (στο βιβλιο λεει οτι ολα ειναι σωστα) 45. The normal course of pregnancy is characterized by: (4 points) a) increased synthesis of serum immunoglobulins b) predominance of Th1 immune response c / predominance of Th2 immune response d) suppression of T-cell activation e) increased levels of C-reactive protein f) presence of anti-phospholipid antibodies 46. IgA antibodies are found in the blood as monomers, and in mucous secretions as dimers: (1 point) a / YES b / NO 47. Which virus is oncogenic? (2 points) a / Herpes zoster b / HIV-2 c / Epstein-Barr virus d / Coxackie virus 48.IFN-α is secreted by: (2 points) a / B lymphocytes b / leukocytes c / T-lymphocytes d / macrophages 49.Which of the listed immune reactions are marked? (4 points) a / latex agglutination b / ELISA c / RSK d / AST e / IFA f / precipitation 50. For the laboratory diagnosis of which cancer is CA-125 used? (2 points) a / breast cancer b / colorectal cancer c / carcinoma of the stomach d / ovarian cancer 51. Clinical case 1 A 6-year-old child was hospitalized in the Pediatric Clinic with the following complaints: swelling of the distal parts of the upper and lower limbs and around the eyes, arterial hypertension, hematuria. Blood was taken for an antistreptolysin titer (AST) test, as a four-week medical examination revealed a fever of 39 ° C, a cough and a sore throat. Throat secretion was taken for microbiological examination. AST levels were elevated: 800 IU / ml and an antibiotic was prescribed for 10 days. As a result of treatment, AST titers decreased and the microbiological test was negative. What type of antigen- antibody reaction is AST? (2 points) a) hemagglutination b) complement fixation reaction c) agglutination d) neutralization 52.Question to clinical case 1: What could be the cause of elevated AST levels? (2 points) a) infection with Streptococcus agalactiae (b) an infection caused by Streptococcus pneumoniae (c) infection with Streptococcus pyogenes (d) infection with Haemophilus influenzae 53. Question to clinical case 1: What is the most appropriate antibiotic for treatment? (2 points) a) Amikacin b) Penicillin c) Ciprofloxacin d) Chloramphenicol 54.Clinical case 2 A 63-year-old patient goes to the GP, with complaints of temperature 38 degrees, erythema on the face, swelling and pain in the metacarpophalangeal joints bilaterally, limited movement in the shoulder joints and wrists. He ordered paraclinical tests, which revealed: increased ESR, normal SRS, decreased hemoglobin and protein in the urine, and diagnosed with: Obs. SLE. Refers her to a clinical immunologist. Which of the immunological samples will need to be tested to confirm the diagnosis of SLE: (2 points) a / general ANA, ds DNA, anti-CCP b / tumor markers c / C1-esterase inhibitor, histamine d/a+b 55.Question to clinical case 2: Apart from this test, what other immunological tests would you recommend? (2 points) a / Bence-Jones protein b / C1-esterase inhibitor c/a+b d / C3 and C4 fractions of complement 56. Question to clinical case 2: What treatment is recommended in this case? (2 points) a / antihistamines b) C1 esterase inhibitor replacement therapy c / corticosteroids or biological therapy (monoclonal antibodies) d / stem cell transplantation Variant 5 1. The functions of the immune system do NOT include distinguishing one's own from foreign antigens: (1 βαθμοί) YES NO 2.IgE antibodies are monomers: (1 βαθμοί) YES NO 3. Adjuvant is a substance that is inserted into a vaccine to lower the immune response: (1 βαθμοί) YES NO 4. Adaptive immunity is an older form of protection with a low degree of effectiveness: (1 βαθμοί) YES NO 5. In immunodeficiency diseases, immunization with live vaccines is contraindicated: (1 βαθμοί) YES NO 6. In patients with AIDS it is necessary to determine the abs. number and percentage of CD4 + T cells: (1 βαθμοί) YES NO 7. Immunodeficiency conditions and diseases are associated with a defect of natural resistance or acquired immunity: (1 βαθμοί) YES NO 8. The graft is a graft from one place to another in the same individual:(1 βαθμοί) YES NO (μαλλον, μονο το autograft ειναι YES from one place to another in the same individual) 9. Hemolytic disease of the newborn is an example of a type I allergic reaction: (1 βαθμοί) YES NO 10. Mechnikov detects phagocytosis: (1 βαθμοί) YES NO 11. Which autoantibodies are detected in Antiphospholipid syndrome? (2 βαθμοί) a) autoantibodies against parietal cells of the stomach and intrinsic factor b) anticardiolipin antibodies c / antimitochondrial antibodies d) antibodies against acetylcholine receptors 12. Antimitochondrial antibodies most often: (2 βαθμοί) a / are found in patients with primary biliary cirrhosis b / are found in patients with rheumatoid arthritis c / do not harm the body d / are found in Hashimoto's thyroiditis 13. Which of the autoimmune diseases is organ-specific? (2 βαθμοί) a / Hashimoto's thyroiditis b / SLE c / rheumatoid arthritis d / scleroderma 14. In SLE, which is the most common fluorescence in ANA testing with IIFA: (2 βαθμοί) a / homogeneous / diffuse / b / spotted c / nucleolar d / centromeric 15. Anti-LKM, ANA and anti-smooth muscle antibodies are important immunological markers in the diagnosis of: (2 βαθμοί) a) rheumatoid arthritis b / autoimmune hepatitis c / anaphylactic shock d / multiple myeloma 16. By what mechanism are type IV allergic reactions carried out: (2 βαθμοί) a / immune complexes b / anaphylaxis c / complement-mediated cytolysis d / infectious immunity 17. Anaphylactic reactions: (2 βαθμοί) a / develop in a very short time - 30 minutes b / develop within a few days c / are the result of the release of interferons d) are mediated by IgM 18. For testing antibodies in allergic conditions are used: (2 βαθμοί) a) immunofluorescence test b / ELISA and / or immunoblot c / complement fixation reaction d / neutralization 19. According to the method of preparation, vaccines can be: (2 βαθμοί) a / killed or alive b / recombinant vector c / subunit (subunit) d / all answers are correct 20. Immunoprophylaxis: (2 βαθμοί) a / aims to cause infection b / uses a specific serum c / uses a vaccine as an immunizing agent d / is administered after exposure to an infectious agent 21. The immune competence of T-lymphocytes is acquired in: (2 βαθμοί) a / the thyroid b / bone marrow c / thymus d / MALT 22. What is the name of the immunological method for measuring the intensity of light passing through a solution or suspension? (2 βαθμοί) a / nephelometry b / turbidimetry c / immunodiffusion d / AST 23. Where do B-lymphocytes acquire their immune competence? (2 βαθμοί) a / liver b / thymus c / bone marrow d / spleen 24. AST is a reaction: (2 βαθμοί) a haemagglutination b / ELISA c / neutralization d / precipitation 25. Which of the listed immunological tests is highly specialized? (2 βαθμοί) a / leukocyte count b / flow cytometric determination of lymphocyte populations and subpopulations c / DCC d) quantification of immunoglobulins 26. The chronic graft rejection reaction occurs: (2 βαθμοί) a / intraoperatively or immediately after the operation b / 24-72 hours after transplantation c / up to 3 months after transplantation d / 3 months after transplantation 27.Indicate which of the following methods for tissue compatibility testing is molecular: (2 βαθμοί) a) lymphocytotoxic test b / NBT c / polymerase chain reaction d / mixed lymphocyte culture test 28. The most common biological carcinogens are: (2 βαθμοί) a / mycoplasmas b / chlamydia c / RNA viruses d / DNA viruses 29. Determining the levels of CEA in the serum of patients with colorectal cancer is of paramount importance for: (2 βαθμοί) a / the diagnosis of the disease b / control of treatment and prognosis c / the differential diagnosis d / the medical examination of the patient 30. CA 19-9 is the most specific marker in tumors of: (2 βαθμοί) a / kidneys b / digestive system c / CNS d / respiratory system 31. In serum prostate cancer, the level of: (2 βαθμοί) a / PSA (prostate specific antigen) b / calcitonin c / progesterone d) antibodies against C. trachomatis 32. CD4 + molecules are located on the surface of: (2 βαθμοί) a / erythrocytes b / T-helpers c) cytotoxic T-lymphocytes d / plasma cells 33. Which of the immunodeficiencies are the result of genetically determined defects? (2 βαθμοί) a / primary immune deficiencies (PID) b / secondary immune deficiencies (TYPE) c / both answers are correct d / there is no correct answer 34. During degranulation of mast cells are released: (2 βαθμοί) a / complement fractions b) histamine and arachidonic acid c / adrenaline and noradrenaline d / acute phase proteins 35.IFN-α is secreted by: (2 βαθμοί) a / B lymphocytes b / leukocytes c / T-lymphocytes d / macrophages 36.Which of the following substrates are most commonly used to determine ANA with indirect immunofluorescence: (4 βαθμοί) a) cryostat section of rat liver b / cryostat section of rat kidney c / cryostat section of rat stomach d / HEp2 cell line e / NeLa cell line f / human retinal epithelial cell line 37. Morphological changes in the kidneys are observed in the following autoimmune diseases: (4 βαθμοί) a / Hashimoto's thyroiditis b / SLE c / dermatomyositis d / glomerulonephritis e / myasthenia gravis f / pernicious anemia 38.Which of the diseases affect the gastrointestinal tract? (4 βαθμοί) a) rheumatoid arthritis b / SLE c / pernicious anemia d / celiac disease e / Hashimoto's thyroiditis e / myasthenia gravis 39. Examples of type III allergic reactions are: (4 βαθμοί) a / staphylococcal toxic shock syndrome b / anaphylaxis c / serum sickness d / rheumatoid arthritis e / blood group incompatibility e / brucellosis 40.Detection of specific IgE aids the diagnosis of: (4 βαθμοί) a / systemic lupus b / hay fever c / serum sickness d / bronchial asthma e / hemolytic disease of the newborn f / Hashimoto's thyroiditis 41. Characteristic of primary biliary cirrhosis is the presence of: (4 βαθμοί) a / HLA-B27 b / antineutrophilcytoplasmic antibodies (ANCA) c / antimitochondrial antibodies (AMA) d / Bense-Jones protein e / anti-SSR f / hypergammaglobulinemia (IgM) 42.Which of the following methods are suitable for measuring serum immunoglobulin concentrations? (4 βαθμοί) a / nephelometry b / ELEC test c / Gruber type reaction d / turbidimetry e / neutralization f / Vidal type agglutination 43.Which of the following statements about severe combined immune deficiency (CKD) are true: (4 βαθμοί) a / patients with severe combined immune deficiency (CKD) rarely suffer from viral infections b / patients with severe combined immune deficiency (CKD) rarely suffer from bacterial infections c / patients with severe combined immune deficiency (TKID) often suffer from viral infections d / patients with severe combined immune deficiency (CKD) often suffer from fungal infections e / all answers are correct is / no answer is correct 44. The biology of cancer cells is characterized by: (4 βαθμοί) a) cancer cells proliferate normally b / cancer cells divide extremely fast c / cancer cells never metastasize d / the cancer gives local and distant metastases e / never induce an immune response f / cannot be "caught" by the immune system 45. The following are used for ANA testing: (4 βαθμοί) a) direct immunofluorescence test b / indirect immunofluorescence test c / ELISA and / or immunoblot d / complement fixation reaction e / neutralization reaction f / agglutination reaction 46. Morphological changes on the skin are observed in the following autoimmune diseases: (4 βαθμοί) a / SLE b / Hashimoto's thyroiditis c / insulin-dependent diabetes mellitus d / systemic scleroderma e / pernicious anemia f / celiac disease 47. The presentation of the antigen together with the molecules of class MHC-II is carried out by: (4 βαθμοί) a / macrophages b / dendritic cells c / NK cells d / immunoglobulins e / platelets f / eosinophils (and B-lymphocytes) 48. Inflammatory infiltrates are observed in the following autoimmune diseases: (4 βαθμοί) a / autoimmune hemolytic anemia b / Hashimoto's thyroiditis c / insulin-dependent diabetes mellitus d / Wegener's granulomatosis e / primary biliary cirrhosis e / myasthenia gravis 49. What are the WRONG statements about the complement system? (4 βαθμοί) a / lyses cells, bacteria b / opsonizes c / is a complex of cells d) the components are usually in active form in the serum e / three are the activation pathways e) the classical activation pathway is due to antigen-antibody complexes 50.Which of the selected conditions are NOT associated with Epstein-Barr virus (EBV)? (4 βαθμοί) a / Burkitt's lymphoma b / nasopharyngeal carcinoma c / Hodgkin's lymphoma g / melanoma d / multiple myeloma e / diffuse B-cell lymphoma 51.Clinical case 1: A newborn is born at term after a normal pregnancy with severe jaundice, lethargic and apathetic. The tests revealed a reduced number of erythrocytes, elevated levels of indirect bilirubin in the blood and blood group 0, Rh (+) positive. Mother reported that a daughter of 2d., Which is also with blood group 0, Rh (+) positive, without had similar problems after her birth. From research done on the mother revealed no abnormalities, her blood group is B, Rh (-) negative. What is the most likely diagnosis in a baby? (2 βαθμοί) a / severe birth trauma b / hemolytic disease of the newborn c / endotoxic shock d / neonatal meningitis 52. Question to clinical case 1: Hemolytic disease of the newborn is carried out by the mechanism of: (2 βαθμοί) a / type I (anaphylactic) hypersensitivity reactions b / type II (cytotoxic) hypersensitivity reactions c / type III (immuno-complex) hypersensitivity reactions d / type IV (cell-mediated) hypersensitivity reactions 53. Question to clinical case 1: Can such a condition be prevented? (2 βαθμοί) a / yes, by injecting the mother's anti-D immunoglobulin after the first birth b / yes, by examination of the amniotic fluid c / no, no prevention d / yes, by infusing interferon to the mother during pregnancy 54.Clinical case 2: A 23-year-old young man was sent by a dermatologist to an immunology laboratory to test for cellular immunity. The reason for this is persistent oral candidiasis. The results show greatly reduced CD4 + T lymphocytes and a reduced CD4 / CD8 index in the peripheral blood. What is the most likely cause of this condition? (2 βαθμοί) a) Bruton's disease b) HIV infection c) IgA deficiency d) complement deficiency 55.Question to clinical case 2: What other test should be done with this diagnosis? (2 βαθμοί) a) Gruber agglutination b) RSC (complement binding reaction) c) ELISA for specific antibodies d) Widal agglutination test 56.Question to clinical case 2: To which specialist will you refer the patient? (2 βαθμοί) a) back to the dermatologist b) to a rheumatologist c) to a hematologist d) to a specialist in infectious diseases Variant 6 1.Rheumatoid factor in the serum of patients with rheumatoid arthritis is most often: (2 βαθμοί) a / IgM reacting with the Fc fragment of endogenous IgG b / IgM reacting with the IgG Fab fragment c / IgE, reacting with allergens d/ antibody against DNA 2.Job's syndrome: (2 βαθμοί) a / is a deficiency of phagocytic function b / is characterized by a low concentration of IgE c / is characterized by a defect in the aortic arch d / all answers are correct 3.Which autoantibodies are found in pernicious anemia (2 βαθμοί) a / anti-mitochondrial antibodies b) anti-gliadin antibodies c / antibodies against acetylcholine receptors d / autoantibodies against gastric parietal cells and intrinsic factor 4.Cellular immune response is mediated by B cells: (1 βαθμός) a / yes b / no 5.NK cells and cytotoxic T - lymphocytes have a major protective role in immunity against: (2 βαθμοί) a / viruses b / toxigenic bacteria c / extracellular bacteria d / all answers are correct 6.The recognition of the graft as a foreign tissue is carried out mainly by: (2 βαθμοί) a / osteoclasts b / lymphokines c / B-lymphocytes d / Antigen presenting cells (APC) and T-cytotoxic lymphocytes 7.Which cells are phagocytic? (4 βαθμοί) a / neutrophils b / platelets c / T-cytotoxic cells d / macrophages e / lymphoblasts f / plasma cells 8.The primary immune organs in humans include: (4 βαθμοί) a / lymph nodes b / thymus c / bone marrow d / spleen and kidney e / stomach and lungs f / parathyroid gland and thymus 9.Indicate by which of the following mechanisms antibodies mediate lysis of tumor cells: (2 βαθμοί) a / virus neutralization b / Antibody-dependent cellular cytotoxicity (ADCC) c / NK cells d / precipitation 10.Circulating antibodies may develop after blood transfusions, pregnancy, or previous transplants:(1 βαθμός) a / yes b / no 11.Which of the following markers is most important for the immune status of an HIV- positive patient? (2 βαθμοί) a / NBT test b / CD4 + T cells c / C3 and C4 complement d / Anti - DNA antibodies 12.A nasopharyngeal swab is the appropriate sample for PCR diagnosis of COVID-19 (1 βαθμός) a) yes b) no 13.Which of the following statements are true? (4 βαθμοί) a / acquired immunity is evolutionarily older than innate immunity b / innate immunity is non-specific c / adaptive immunity is activated immediately d/ innate immunity does not involve antibody production e / the first contact in innate immunity leads to specific memory f / the second contact in adaptive immunity leads to activation of the mechanisms with the same strength 14.The following neoplasms are characteristic for advanced HIV infection: (4 βαθμοί) a / Burkitt's lymphoma b / Hodgkin's lymphoma c / nasopharyngeal carcinoma d / carcinoma of the endometrium e / carcinoma of the cervix uteri f / Kaposi's sarcoma 15.Epstein-Barr virus (EBV) has a transforming activity on B lymphocytes (1 βαθμός) a) yes b) no 16.The main mechanism of protection against the Influenza virus as a causative agent of flu is: (2 βαθμοί) a / interferon α production b / production of antibodies against hemagglutinin and neuraminidase c / protective antibodies against surface protein G d / intestinal mucosal antibodies (coproantibodies) 17.Any of the following statements concerning the prevention of SARS-CoV-2 is true, EXCEPT: (2 βαθμοί) a / There are mRNA - based vaccines available b / There are inactivated vaccines available c / There are toxoid vaccines available d / There are viral vector vaccines available 18.Which of the following conditions is not associated with the Epstein-Barr virus (EBV)? (4 βαθμοί) a / Burkitt's lymphoma b / nasopharyngeal carcinoma c / Hodgkin's lymphoma d / melanoma e / diffuse B-cell lymphoma f / multiple myeloma 19.Autoantibodies against thyroid cell microsomes can be detected in (2 βαθμοί) a / kidney cancer b / Hashimoto's thyroiditis c / pancreatitis d / carcinoma of the testes 20.The following markers are typical characteristics of primary biliary cirrhosis: (4 βαθμοί) a / HLA-B27 b / antineutrophilcytoplasmic antibodies (ANCA) c / NBT test d / anti-CCP e / antimitochondrial antibodies (AMA) f / hypergammaglobulinemia IgM 21.Secondary immune deficiencies are caused by various factors: (1 βαθμός) a / yes b / no 22.The current classification of tumor antigens is based on their molecular structure and origin: (1 βαθμός) a / yes b / no 23.All the listed factors are carcinogenic, but the most common is: (2 βαθμοί) a / gamma rays b / chemical carcinogens c / RNA viruses d / DNA viruses 24.What are the wrong statements about complement system? (4 βαθμοί) a / it lyses cells, bacteria b / it opsonizes c / the classical activation pathway is due to antigen-antibody complexes d / complement fractions are usually in active form in serum e / there are 3 pathways for complement activation f / it is a complex of cells 25.Tissue and organ transplantation between monozygotic twins is called: (2 βαθμοί) a / xenogeneic b / allogeneic c / syngeneic d / autogenous 26.Indicate which of the following conditions and indicators are associated with recurrent abortions: (4 βαθμοί) a / scarlet fever b / Guillain-Barré syndrome c / viral hepatitis A d / antiphospholipid syndrome e / autoimmune aspermogenesis f / increased number of NK cells 27.Serum is the most appropriate specimen for testing autoantibodies in women with reproductive disorders: (1 βαθμός) a / yes b / no 28.Which of the following diseases affect the gastrointestinal tract? (4 βαθμοί) a / rheumatoid arthritis b / SLE c / pernicious anemia d / celiac disease e / Hashimoto's thyroiditis f / myasthenia gravis 29.Which of the following statements concerning severe combined immune deficiency (SCID) are correct? (4 βαθμοί) a / patients with severe combined immune deficiency (SCID) often suffer from viral infections b / patients with severe combined immune deficiency (SCID) often suffer from bacterial infections c / patients with SCID rarely suffer from fungal infections d / patients with SCID rarely suffer from viral infections e / all answers are correct f / there is no correct answer 30.Which of the following methods is not used to detect rheumatoid factor in serum? (2 βαθμοί) a / nephelometry b / indirect immunofluorescence c / ELISA d / immunoturbidimetry 31. All vaccinations and re-vaccinations in the European Union against the diseases described below are mandatory, with EXCEPTION of: (2 βαθμοί) a / tuberculosis b / tetanus c / diphtheria d / cholera 32.In SLE, the following autoantibodies are most commonly detected: (4 βαθμοί) a / total ANA ( anti-nuclear antibodies) b / antineutrophilcytoplasmic antibodies (ANCA) c / antimitochondrial antibodies (AMA) d / anti-ds DNA antibodies e / rheumatoid factor (RF) f / anti-smooth muscle antibodies (ASMA) 33.Intravenous IgG can be used for immunomodulation in patients with congenital immunodeficiency diseases (1 βαθμός) a / yes b / no 34.Atopic diseases develop (2 βαθμοί) a / with participation of complement b / with participation of suppressor T cells c / under the action of immune complexes d / with participation of IgE 35.Which molecules are associated with mature B-lymphocytes? (2 βαθμοί) a / IgM and IgD b / IgM and IgA c / IgD and IgE d / IgG and IgD 36.Prostate-specific antigen (PSA) (4 βαθμοί) a / is usually measured by ELISA and is never elevated in smokers b / is usually measured by ELISA and may be elevated in smokers c / is measured by RIA and is never elevated in prostatitis d / may be elevated in prostatitis and prostate cancer e) is measured by RIA and is elevated in gastric cancer f / is measured by RIA and ELISA and is elevated in liver cancer 37.Alpha-fetoprotein (AFP) detection is used as the most important marker in breast cancer: (1 βαθμός) a) yes b) no 38.IFN-gamma is a cytokine, mediating: (2 βαθμοί) a / cellular – immune response b / humoral – immune response c / recognition of the antigen by CD8+ T-cells d / all answers are correct 39.Which of the following combinations constitute specific targeted immunotherapy in tumors? (4 βαθμοί) a / immunotoxins and cytokines b / antibiotics and antivirals c / checkpoint inhibitors and monoclonal antibodies d / antimetabolites and alkylating agents e / tyrosine kinase inhibitors and cytostatics f / all answers are correct 40.Hereditary angioedema (HAE) is an autosomal dominant immunodeficiency disease associated with a quantitative or functional decrease of: (2 βαθμοί) a / phagocytic cells b / serum immunoglobulins c / C1 esterase inhibitor d / all answers are correct 41.Autoantibodies to double-stranded DNA are detected mainly in patients with: (2 βαθμοί) a / Hashimoto's lymphocytic thyroiditis b / SLE c / sepsis d / pernicious anemia 42.HLA-G antigens are normally expressed in: (2 βαθμοί) a / sterility b / trophoblast during pregnancy c / infectious diseases d / ankylosing spondylitis 43.Which of the following autoantibodies are most commonly found in patients with rheumatoid arthritis: (4 βαθμοί) a / antithyroglobulin b / rheumatoid factor (RF) c / antineutrophilcytoplasmic antibodies (ANCA) d / anti-smooth muscle antibodies (AGMA) e / antimitochondrial antibodies (AMA) f / anti-CCP 44.Which of the selected primary immune deficiencies (PID) is NOT associated with phagocytic defect? (2 βαθμοί) a / chronic granulomatous disease (CGD) b / hereditary angioedema c / Di – George‘s syndrome d / there is no correct answer 45.The hyperacute graft rejection reaction develops: (2 βαθμοί) a / up to 3 months after transplantation b / 24-72 hours after transplantation c / intraoperatively or immediately after the operation d / 3 months after transplantation 46.Antinuclear antibodies (ANA) are positive in most patients with systemic lupus erythematosus (SLE): (1 βαθμός) a / yes b / no 47.Defensins are: (2 βαθμοί) a / growth factors b/ antimicrobial peptides in neutrophil granules c / cytokines - mediators of the immune response d / interferons 48.The following autoantibodies are commonly found in autoimmune hepatitis: (2 βαθμοί) a / anti-insulin b / anti-thyroglobulin c / anti-thyroid microsome d / anti-LKM-1 49.Tissue compatibility between donor and recipient is determined by examination of all listed antigens EXCEPT: (4 βαθμοί) a / class I molecules of МHC b / class II molecules of MHC c / class III molecules of MHC d / ABO blood groups e / antibodies against lymphocytes from the donor f / carcinoembryonic antigen 50.Which of the following mechanisms are involved in the development of autoimmune diseases? (2 βαθμοί) a / modification of self antigen and its recognition as foreign by the immune system b / deficiency of suppressor T-cells c / antigenic mimicry due to infection by microorganisms with cross-reactive antigens d / all answers are correct 51.Clinical case 1: A 36-year-old man with a 20-year history of insulin-dependent diabetes goes for a routine check-up to his GP. Renal dysfunction has been identified by diabetic nephropathy with elevated blood urea and creatinine levels, which have increased significantly in the last few years. The doctor suggests that the patient should get a kidney transplant procedure and that a suitable donor must be sought. The patient's sister agrees to donate her kidney for transplantation. Immunological tests for tissue compatibility and blood tests of the patient and his sister showed coincidence in HLA-A, HLA-B, and HLA-D loci, both of which are of blood group 0. The patient begins treatment with cyclosporine A and a series of blood transfusions before surgery. The planned transplant is successful for both the donor and the recipient. The patient remains in the hospital for several weeks to be monitored for a rejection reaction. What type of transplantation is performed in this patient? (2 βαθμοί) a) autograft b) isograft c) allograft d) xenograft 52.Question to clinical case 1: What complications are possible after organ transplantation? (2 βαθμοί) a) susceptibility to infections and neoplasms b) hyperhidrosis c) aphonia d) hypothermia 53.Question to clinical case 1: Which of the following drugs is a specific immunosuppressor used in the immune modulation of transplanted patients? (2 βαθμοί) a) Lactacystin (LAC) b) Azathioprine (Imuran) c) Cyclophosphamid d) There is no correct answer 54.Clinical case 2: A 28-year-old woman entered the Rheumatology Clinic for the first time with complaints of pain and swelling in the small joints of the fingers, hands and feet, wrists, elbows, and knees. She also reported nocturnal joint pain and warming of the joints. There was morning stiffness for more than an hour, and the complaints date back two months. The attending physician refers to the diagnosis of rheumatoid arthritis. Which immunological indicator is used to confirm the diagnosis: (2 βαθμοί) a / anti-smooth muscle antibodies (ASMA) b / rheumatoid factor c / HLA-B27 d / NBT test 55.Question to clinical case 2: Which of the following immunological methods is used to diagnose rheumatoid arthritis: (2 βαθμοί) a / turbidimetry b / CD4+ / CD8+ index c / indirect immunofluorescence d / PCR 56.Question to clinical case 2: Which drug would you suggest for the treatment of rheumatoid arthritis: (2 βαθμοί) a / Levofloxacin b / Methotrexate c / Ethambutol d / Salofalk 57.Clinical case 3: A 22-year-old woman has recently given birth to her first child. She was tested with ELISA during the first trimester of pregnancy and was found to be HIV positive. A second, confirmatory test was also positive and she started HAART. Which one of the listed tests below should be performed to confirm HIV infection? (2 βαθμοί) a/ Turbidimetry b/ Western blotting c/ IFA d/ Immunophenotyping 58.Question to clinical case 3: When you should consider initiation of antiretroviral therapy in adults with AIDS? (2 βαθμοί) a /CD4+ T-cell count below 1,000 per cubic milliliter b /CD4+ T-cell count below 500 per cubic milliliter c /Immediately after HIV positive confirmatory test independently from the CD4 T-cell count d /CD4+ T-cell count below 200 per cubic milliliter 59.Question to clinical case 3: The baby boy is brought into the clinic for a check-up. He appears to be healthy but his HIV-positive mother is concerned about his HIV status. Which test is recommended for babies born from HIV-positive mothers? (2 βαθμοί) a/ Flowcytometry b/ T-spot c/ PCR d/ Immunofluorescent assay (IFA) 60.Clinical case 4: A 58-year-old woman was hospitalized with complaints of shortness of breath, chest tightness, dry cough, fever, and lethargy. The medical examination and the relevant tests confirmed that the patient has COVID-19. Which of the following tests is recommended for the detection of specific immunoglobulins against SARS-CoV-2? (2 βαθμοί) a / Radioimmunoassay (RIA); b / Real-time PCR (RT-PCR); c / Immunofluorescence assay (IFA); d / Immunochromatographic test 61.Question to clinical case 4: Which class of immunoglobulins is a specific marker for a history of COVID-19 infection? (2 βαθμοί) a / IgE total; b / IgM – SARS-CoV-2; c / IgD; d / IgG – SARS-CoV-2 62.Question to clinical case 4: On which day after COVID-19 infection patients develop IgG antibodies? (2 βαθμοί) a / 38th day; b / 19th day; c / 8th day; d / 11th day Variant 7 1. "Sm" and "RNP" are part of the group of extractable nuclear antigens that induce the formation of ANA: (1 βαθμός) a/ YES b/ NO 2. Fast-type hypersensitivity reactions usually occur after 15-30 minutes: (1 βαθμός) a/ YES b/ NO 3. Active, long-term immunization against poliovirus can be performed by parenteral injection of an inactivated vaccine. (1 βαθμός) a/ YES b/ NO 4. The spleen is a peripheral (secondary) lymphoid organ: (1 βαθμός) a/ YES b/ NO 5. Secondary immune deficiencies are caused by various factors: (1 βαθμός) a/ YES b/ NO 6. Phagocytosis is a process involving NK cells and cytotoxic T lymphocytes: (1 βαθμός) a/ YES b/ NO 7. In AIDS patients, the immune deficiency is due to a primary infection of the virus in B cells: (1 βαθμός) (correct if says T cells) a/ YES b/ NO 8. Antiphospholipid syndrome is associated with the presence of anticardiolipin antibodies, fetal loss, arterial or venous thrombosis: (1 βαθμός) a/ YES b/ NO 9. Serum sickness is an example of type III allergic reaction: (1 βαθμός) a/ YES b/ NO 10. IgA deficiency is the most common disorder of the group of selective immunoglobulin deficiencies: (1 βαθμός) a/ YES b/ NO 11. Autoimmune hemolytic anemias most often occur in the type of: (2 βαθμοί) a / anaphylactic hypersensitivity reactions b / cytotoxic hypersensitivity reactions c / immune complex hypersensitivity reactions d) cell-mediated hypersensitivity reactions 12. Which of the following methods is NOT used to detect rheumatoid factor in serum? (2 βαθμοί) a / nephelometry b / indirect immunofluorescence c / ELISA d / immunoturbidimetry 13. Which antibodies are detected in primary biliary cirrhosis? (2 βαθμοί) a/ anti-gliadin antibodies b/ anti-cardiolipin antibodies c/ antibodies against acetylcholine receptors d/ anti-mitochondrial antibodies 14. Autoantibodies to cytoplasmic neutrophil antigens (ANCA) are found mainly in: (2 βαθμοί) a / Goodpasture syndrome b / amyloidosis c / Wegener's granulomatosis d / there is no correct answer 15. Which of the autoimmune diseases is organ-non-specific: (2 βαθμοί) a / Hashimoto's thyroiditis b / rheumatoid arthritis c / Graves’ disease d / myasthenia gravis 16. Type II allergic reactions are realized by the mechanism of: (2 βαθμοί) a / anaphylaxis b / complement-mediated cytolysis c / immune complexes d / infectious immunity 17. Atopic diseases develop: (2 βαθμοί) a / with the participation of the complement b / with the participation of suppressor T cells c / under the action of immune complexes d / with the participation of IgE 18. What medications are used to treat anaphylactic shock? (2 βαθμοί) a / diuretics and expectorants b / beta-blockers and folic acid c / adrenaline and corticosteroids d / vitamin D and fluoroquinolones 19. Live vaccines have the following characteristics, EXCEPT: (2 βαθμοί) a / they are the product of living microorganisms (bacteria or viruses) b / artificially weakened (attenuated) pathogenicity c / preserved immunogenicity d / are obtained by culturing pathogenic microorganisms with subsequent inactivation under the influence of heat or chemical substances 20. The technology of obtaining toxoids (antitoxins) is: (2 βαθμοί) a / treatment of the exotoxin with 0.3-0.5% formalin b / answers a + c + d c / treatment of the exotoxin at 38-40 °C d / treatment of the exotoxin for 28-40 days 21. CD4+ molecules are located on the surface of: (2 βαθμοί) a / erythrocytes b / plasma cells c/ cytotoxic T lymphocytes d / T-helper cells 22. After the antigenic stimulus, the mature B-lymphocytes are transformed into: (2 βαθμοί) a / plasma cells b / T-helpers c / cytotoxic T lymphocytes d / NK cells 23. How many ways are known to activate the complement system? (2 βαθμοί) a / one b / two c / three d / four 24. Which of the following markers is most important for the immune status of an HIV-positive patient? (2 βαθμοί) a / NBT test b / CD4 + T cells c / Bence-Jones protein d / anti DNA antibodies 25. Which of the immune deficiencies IS the result of genetically determined defects? (2 βαθμοί) a / secondary immune deficiencies (SID) b / primary immune deficiencies (PID) c / both answers are correct d / there is no correct answer 26. The acute graft rejection reaction develops: (2 βαθμοί) a / 2 to 3 months after transplantation b / 24-72 hours after transplantation c / intraoperatively or immediately after the operation d / 3 months after transplantation 27. The recognition of the graft as a foreign tissue is carried out mainly by: (2 βαθμοί) a / osteoclasts b / lymphokines c / B-lymphocytes d / APC and T-cytotoxic lymphocytes 28. All the listed factors are carcinogenic, but the most common of them are: (2 βαθμοί) a / gamma rays b / chemical carcinogens c / RNA viruses d / DNA viruses 29. Bence-Jones protein is mainly found in: (2 βαθμοί) a / joint fluid b / cerebrospinal fluid c / urine and serum d / tumor biopsy 30. CA 15-3 is a marker of the first choice in the immunodiagnostics of: (2 βαθμοί) a / hepatoma b / glioblastoma c / malignant melanoma d / breast cancer 31. Which of the following characteristics does not apply to Burkitt's lymphoma: (2 βαθμοί) a / B-cell neoplasm b / from the group of non-Hodgkin's lymphomas c / has a connection with EBV d / T-cell neoplasm 32. The chronic graft rejection reaction occurs: (2 βαθμοί) a / 3 months after transplantation b / 24-72 hours after transplantation c / up to 3 months after transplantation d / intraoperatively or immediately after the operation 33. What is the name of the immunological method for measuring the intensity of light passing through a solution or suspension? (2 βαθμοί) a / nephelometry b / immunodiffusion c / turbidimetry d / immunofluorescence 34. Tissue and organ transplantation between monozygotic twins is called: (2 βαθμοί) a / xenogenic b / allogenic c / syngenic d / autogenous 35. To the group of specific therapeutic serums are all listed below, EXCEPT: (2 βαθμοί) a / heterologous b / alive c / antibacterial d / homologous human 36. The following are used for ANA testing: (4 βαθμοί) a / the direct immunofluorescence test b / the indirect immunofluorescence test c / ELISA and / or immunoblot d / complement fixation reaction e / neutralization reaction f / agglutination reaction 37. In which autoimmune diseases we may recommend splenectomy? (4 βαθμοί) a / SLE b / dermatomyositis c / hemolytic anemias d / rheumatoid arthritis e / idiopathic thrombocytopenic purpura f / Hashimoto's thyroiditis 38. Morphological changes in the skin are observed in the following autoimmune diseases: (4 βαθμοί) a / SLE b / Hashimoto's thyroiditis c / insulin-dependent diabetes mellitus d / systemic scleroderma e / pernicious anemia f / celiac disease 39. Examples of type I allergic reactions are: (4 βαθμοί) a / atopic colitis b / bronchial asthma c / glaucoma d / otogenic meningitis e / colon polyposis f / Reiter's syndrome 40. The following characteristic are typical for the development of type IV allergic reactions: (4 βαθμοί) a / they develop rapidly within 20-30 minutes b / they are mediated by antibodies c / they are mediated by complement d / they develop slowly, usually within 48-72 hours e / they are mediated by albumin f / they are mediated by CD4 + T cells 41. Antigen presentation together with the molecules of class MHC-II is carried out by: (4 βαθμοί) a / macrophages b / dendritic cells c / NK cells d / immunoglobulins e / platelets f / eosinophils 42. Which of the selected primary immune deficiencies (PID) are associated with phagocytic dysfunction? (4 βαθμοί) a / chronic granulomatous disease (CHD) b / Chediak Higashi syndrome c / Bruton's disease d / chronic mucocutaneous candidiasis e / there is no correct answer f / all answers are correct 43. Oncofetal tumor-associated antigen AFP (alpha-fetoprotein) is positive and increases in the serum of patients mainly with: (4 βαθμοί) a / testicular carcinoma b / breast cancer c / lung cancer d / liver cancer e / thyroid carcinoma f / renal cell carcinoma 44. Which autoimmune diseases are supported by metabolic disorders? (4 βαθμοί) a / Hashimoto's thyroiditis b / SLE c / insulin-dependent diabetes mellitus d / rheumatoid arthritis e / myasthenia gravis f / scleroderma 45. In autoimmune hepatitis, the following autoantibodies are most commonly detected: (4 βαθμοί) a / anti-CCP b / anti-neutrophil cytoplasmic antibodies (ANCA) c / anti-LKM-1 d / anti-smooth muscle antibodies (AGMA) e / anti-cardiolipin antibodies f/ anti-thyroglobulin antibodies 46. Hereditary angioedema (HEA) is characterized by: (4 βαθμοί) a / quantitative deficiency of a C1 esterase inhibitor b / increased serum IgE concentration c / increased concentration of C1 esterase inhibitor d / qualitative deficiency of C1 esterase inhibitor e / increased absolute number of eosinophils f/ there is no correct answer 47. Which of the following substrates are most commonly used to determine ANA with indirect immunofluorescence: (4 βαθμοί) a / cryostat section of rat liver b / cryostat section of rat kidney c / cryostat section of rat stomach d / HEp2 cell line e / HeLa cell line f / human retinal epithelial cell line 48. Which of the diseases affect the gastrointestinal tract? (4 βαθμοί) a/ rheumatoid arthritis b / SLE c / pernicious anemia d / celiac disease e / Hashimoto's thyroiditis f / myasthenia gravis 49. Which of the following statements about severe combined immune deficiency (SCID) is true: (4 βαθμοί) a / patients with severe combined immune deficiency (SCID) rarely suffer from viral infections b / patients with severe combined immune deficiency (SCID) rarely suffer from bacterial infections c / patients with severe combined immune deficiency (SCID) often suffer from fungal infections d/ patients with severe combined immune deficiency (SCID) often suffer from viral infections e/ no answer is correct f / all answers are correct 50. Examples of type III allergic reactions are: (4 βαθμοί) a / staphylococcal toxic shock syndrome b / anaphylaxis c / serum sickness d / rheumatoid arthritis e / blood group incompatibility f / brucellosis 51. Clinical case 1 A 36-year-old man with a 20-year history of insulin-dependent diabetes goes for a routine check-up with his GP. Renal dysfunction has been identified by diabetic nephropathy with elevated blood urea and creatinine levels, which have increased significantly in the last few years. The doctor suggests that the patient should be involved in a kidney transplant procedure and that a suitable donor must be sought. The patient's sister agrees to donate her kidney for transplantation. Immunological tests for tissue compatibility and blood tests of the patient and his sister showed coincidence in HLA-A, HLA-B and HLA-D loci, both of which are of blood group 0. The patient begins treatment with cyclosporine A and a series of blood transfusions before surgery. The planned transplant is successful for both the donor and the recipient. The patient remains in the hospital for several weeks to monitor and monitor for a rejection reaction. 1. What are the side effects of cyclosporine A? (2 βαθμοί) a) anisocoria b) ptosis of the eyelids c) nephro- and hepatotoxicity d) hypotension 52. Question-related to clinical case 1: What complications are possible after organ transplantation? (2 βαθμοί) a) susceptibility to infections and neoplasms b) hyperhidrosis c) aphonia d) hypothermia 53. Question-related to clinical case 1: Which kidney transplants have a higher survival rate: (2 βαθμοί) a) from living antigen-related donors b) from cadaveric donors c) there is no difference in survival levels d) graft donors are not used 54. Clinical case 2 A 28-year-old woman entered the Rheumatology Clinic for the first time with complaints of pain and swelling in the small joints of the fingers, hands and feet, wrists, elbows and knees. She also reported nocturnal joint pain and warming of the joints. There was morning stiffness for more than an hour, and the complaints date back two months. The attending physician refers to the diagnosis of rheumatoid arthritis. Proof of which immunological indicator is used to confirm the diagnosis: (2 βαθμοί) a / anti-smooth muscle antibodies (ASMA) b / rheumatoid factor c / HLA-B27 d / NBT test 55. Question-related to clinical case 2: Which of the following immunological methods is used to diagnose rheumatoid arthritis: (2 βαθμοί) a / turbidimetry b / CD4 / CD8 index c / indirect immunofluorescence d / PCR 56. Question-related to clinical case 2: Which drug would you suggest for the treatment of rheumatoid arthritis: (2 βαθμοί) a / Levofloxacin b / Methotrexate c / Ethambutol d/ Salofalk Entry tests: 2. IgA low serum levels are detected in: (2 points) a/ selective IgA deficiency b/ allergic reaction c/ chronic granulomatous disease d/ thyrotoxicosis 9. Which of the following viruses possess well expressed oncogenic potential? (4 points) a/ Influenza virus b/ Ebola virus c/ EBV d/ Polioviruses e/ HPV 11. Glomerulonephritis and vascular diseases (small vessel disease) due to antibodies are typical for: ( 2 points) a/ the Arthus phenomenon b/ hereditary angioedema c/ SLE d/ anaemia haemolytica 12. Immuno-scintigraphy uses monoclonal antibodies against tumor antigens, conjugated with: (2points) a/ FITC b/ rodamine c/ Iodine131, Technetium99 d/ enzyme 9. What tests are for evaluation of the phagocytic activity? (4 points) a. Flow cytometry of detection of oxidative burst d. NBT test c. immunoglobulins serum levels d. CD4/CD8 index 10. What do we use for immunophenotyping of the cells? Venous Blood serum 1. Which of the following factors belong to the innate immunity: (6 points) a. Phagocytes b. antibodies c. Complement, Lysozyme, a and b interferons d. T-lymphocytes e. Skin, mucus, normal microflora f. B-lympocytes 6. What of the following disorders with immune deficit is connected exclusively with impairment of humeral immune response? (2 points) Agammaglobulinemia of Bruton di- George syndrome chronic candidosis of skin and mucus angiedema hereditaria 5. INF –Y is produced by: (2 points) fibroblasts T- lymphocytes B- lymphocytes Leukocytes MCQ BOOK Natural resistance 1. Natural resistance (EP) is a non-specific, innate form of protection: A) yes b) no 2. The skin and mucous membranes have antimicrobial action: A) true b) incorrect 3. The complement system is a cellular component of innate immunity: a) yes B) no 4. NK cells (natural killers) perform intracellular killing of microorganisms and tumor cells: a) true B) incorrect 5. Opsonization facilitates the phagocytosis of bacteria: A) yes b) no 6. The functions of complement are related to: (2 points) a) antibody-dependent cellular cytotoxicity (ADCC) B) lysis of cells, including bacterial (c) participation in antigen processing and presentation D) opsonization by the C3b particle e) all answers are correct 7. Where is the presence of lysozyme detected? (4 points) a) in sweat glands B) in tears and saliva c) in the skin D) in the serum and in the mucous secretions of the mucous membranes e) there is no correct answer 8. Which of the following molecules are acute phase proteins: (2 points) A) C-reactive protein (CRP) b) interferon-a c) lactoferrin d) endotoxin e) exotoxin 9. Which of the following cytokines are produced by mononuclear phagocytes: (2 points) a) IL2 and IL4 b) IFN-gamma and IFN-beta B) TNF-alpha, IL1 and IL6 d) all answers are correct e) there is no correct answer 10. NK cells (natural killers) perform the following functions: (2 points) a) activation of complement B) ADCC c) synthesis of antibodies D) lysis of virus-infected cells e) all answers are correct 11. Receptors for the Fc fragment of immunoglobulins have the following cells: (4 points) a) T-lymphocytes B) neutrophils C) macrophages d) dendritic cells e) all listed 12. In the mucous secretions he most often finds: (2 points) a) IgG B) IgA c) IgE d) IgM e) IgD 13. The activation of the complement by the alternative route is carried out by: (4 points) A) bacterial lipopolysaccharides and autoantibodies (eg C3-nephritic factor) b) C-reactive protein (CRP) and other acute phase proteins c) antigen-antibody complexes G peptidoglycan e) all listed 14. Toll-like receptors (TLRs) are characterized by: (4 points) a) are located on the surface of T and B lymphocytes B) are found on the surface of macrophages and dendritic cells (c) are detected by binding to antibodies D) bind to PAMP (pathogen-associated molecular patterns)structures of bacteria and viruses e) activate complete 15. Typical of innate immunity is that: (2 points) (a) is an adaptive form of protection B) is inherited and has a non-specific effect c) has a memory d) all answers are correct e) there is no correct answer Acquired immunity 2. The bone marrow is a central immune organ. A) true b) incorrect 3. The thymus is a peripheral immune organ a) yes B) no 5. Th1 cells produce IFN-beta, IL4 and TNFα a) true B) incorrect 8. CD8 T cells destroy their targets: (4 points) A) after recognition of antigens associated with MHC class I molecules b) after recognition of antigens associated with MHC class II molecules c) by activating the alternative complement pathway d) all answers are correct e) no faithful f) due to releasing of interferons 12. The articulated region of the IgG heavy chain is located: (2 points) A) between CH1 CH2 b) between CH2 and CH3 c) between CH3 and CH4 d) between VH and CH1 e) there is no correct answer 13. The class of an immunoglobulin molecule is determined by: (2 points) a) L-chains b) disulfide bonds C) H-chains (d) the variable areas e) there is no correct answer 14. The first immunoglobulin that is synthesized by the fetus is: (2 points) a) IgA b) IgE c) IgG D) IgM e) IgD 15. CD4 cells can: (4 points) A) support B cells for antibody production b) process and present the antigen C) enhance the functions of T cells d) release IL1 e) all answers are correct Infections and immunity 1. Cellular immunity plays a key role in protection against viruses A) true b) wrong 4. Lysozyme in mucous secretions effectively eliminates Gram-positive bacteria. A) true b) wrong 5. At the primary immune response against bacteria and viruses, specific IgG antibodies appear in the patient's serum: a) true B) wrong 6. Liver cell damage in hepatitis B infection is due to: (2 points) a) toxins b) direct lysis by the virus C) immunopathic effect of cytotoxic T-lymphocytes d) all answers are correct e) none 7. The high antigenic variability of which of the following viruses makes it very difficult for the immune system to recognize them: (6 points) a) hepatitis A virus B) influenza viruses (c) varicella virus D) hepatitis C virus E) HIV-1/2 8. It is typical for active tuberculosis infection to be accompanied by: (2 points) a) an effective humoral immune response b) immunocomplex disease C) infectious type of allergy (IV type) d) endotoxic shock e) there is no correct answer 9. Which of the following bacteria develop intracellularly, which prevents the access of