Immunology MCQ BY: Dr. Algassim
Immunology MCQ BY: Dr. Algassim
Immunology MCQ BY: Dr. Algassim
IMMUNOLOGY
MCQ
BY:
Dr.
Algassim
Q1:
Which
of
the
fallowing
cells
produces
Anti-‐bodies?
A:
macrophage.
B:
B-‐cells.
C:
T-‐cells
D:
plasma
cells
The
answer
is
D.
Explanation:
when
B-‐cell
receptor
(BCR)
ie:
IgD&IgM.
Come
in
contact
with
an
antigen.
B-‐cells
proliferate
and
differentiate
into
plasma
cells
with
the
help
of
Th2.
Q2:
Which
of
the
following
Antibodies
cross
the
placenta?
A:
IgA.
B:
IgE.
C:
IgG.
D:
IgD.
The
Answer
is
C.
Explanation:
you
should
know
that
IgA
is
bound
to
mucous
membranes,
IgE
on
mast
cells,
and
IgD
&
IgM
act
as
BCR.
IgGs
circulate
blood.
Remember
that
some
Auto
antibodies
are
IgGs.
Q3:
a
37
weaker
primagravida.
Delivers
a
2200
grams
baby.
The
delivery
was
uneventful.
Apgar
score
were
7
at
1
,and
9
at
5.
On
examination
you
notice
a
tachycardia,
hyperactivity
and
restlessness
warm
moist
skin
and
goiter.
Upon
further
inquiry
the
mother
tells
you
that
she
had
Garves’
disease
treated
with
radioactive
iodine
3
years
ago.
Now
she
is
on
levothyroxine
100
microgram
daily.
What
is
the
best
explanation
for
these
neonatal
findings?
A:
Congenital
multi-‐nodular
goiter.
B:
DiGeorge
syndrome
(22q11).
C:
Mother’s
Thyroid
Stimulating
Antibody
(TSI).
D:
Multiple
endocrine
neoplasia
type
B1.
The
answer
is:
C
Explanation:
Don’t
let
the
long
question
fool
you
and
think
of
the
basics.
If
you
recall
the
explanation
of
Q2
above
you
will
find
the
answer,
which
is
obvious.
Although
the
mother
went
through
radioiodine
therapy
that
resulted
in
HYPOthyriodism,
her
immune
system
still
produces
TSI.
TSI
can
cross
the
placenta
giving
the
picture
of
neonatal
graves
disease.
Neonatal
graves’
usually
has
a
benign
course
lasting
3-‐6
months
(which
is
the
life
of
maternal
antibodies)
and
observation
is
sufficient.
Q4:
a
24
months
old
boy
with
recurrent
superficial
infections,
and
lymphadenopathy.
Presented
with
fever,
left
leg
pain,
swelling,
erythema
and
inguinal
lymphadenopathy.
You
diagnosis
was
cellulitis.
After
admission
and
IV
antibiotics
an
inguinal
lymph
node
biopsy
was
taken
for
acid-‐fast
stain
and
culture.
Pathology
reports
a
non-‐caseating
granuloma
and
culture
growing
Serratia
Spp.
What
is
the
diagnosis?
A:
Chronic
granulomatous
disease.
B:
ataxia
telangiectasia.
C:
SCID.
D:
Wiscott-‐Aldrich
syndrome.
The
Answer
is
A.
Explanation:
The
pathology
report
hinted
the
answer.
In
chronic
granulomatous
disease
(CGD)
the
phagocytic
cells
fail
to
produce
O2
free
radical
to
kill
bacteria
due
to
congenital
deficiency
in
NADPH
oxidase.
The
result
is
chronic
granuloma,
hence
the
name.
Serratia
Spp
are
common
organisms.
Other
catalase
positive
organisms
can
be
found
as
will.
Q5:
All
the
fallowing
is
required
in
B-‐cell
class
switch,
except?
A:
Peptide
Antigen.
B:Th1
Cytokines
profile.
C:CD40-‐CD40L
D:
MHC
ll-‐TCR
E:
IL4-‐IL5
The
Answers
is
B.
Explanation:
when
antigen
presented
to
Th2
Through
MHCll
on
the
B-‐cell.
Other
interactions
happen
at
the
same
time
sometimes
called
immunologic
synapse.
Some
of
these
interactions
are
mentioned
above.
You
have
to
remember
that
for
every
T-‐dependent
B
cell
activation
a
peptide
must
be
on
the
top
of
MHC
ll
molecule.
Q6:
in
all
the
fallowing
vaccines
which
one
doesn’t
produce
long-‐
standing
memory
cells?
A:
Pneumococcal
polysaccharide
vaccine
(PPSV)
B:
Haemophilus
influenzae
type
B
vaccine
(Hib)
C:
heptavalent
pneumococcal
conjugate
vaccine
(PCV
7)
D:
measles
mumps
and
rubella
vaccine
(MMR)
The
Answer
is:
A
Explanation:
when
examining
the
above
choices
you
must
notice
that
all
have
peptide
part
that
can
be
presented
to
Th
cells
except
PPSV
which
is
all
polysaccharides.
Remember
that
MHCl
&
ll
only
present
peptides
to
TCR.
The
end
result
of
PPSV
is
T-‐
independent
B
cell
activation
with
no
memory
cells.
Acronyms:
TCR:
T
cell
receptor
BCR:
B
cell
receptor
MHC:
major
histio-‐compatibility
complex.
Th1,2=
T
Cell
helper
1,2
SCID:
sever
combined
immunodeficiency