IMMUNOLOGY STUDY QUESTION PACKET #1: 1-2013

ANSWERS are at the END.

1.

Which of the following is NOT a required step in either B or T lymphocyte maturation?

A)
B)
C)
D)
E)

2.

Which one of the following statements is an accurate description of the ways in which MHC molecules
are involved in thymic selection processes that shape the T cell repertoire?
A)
B)
C)
D)
E)

3.

Class I MHC molecules are involved in positive selection only, and Class II molecules are
involved in negative selection only
Class I and class II MHC molecules are required for positive selection of self-MHC restricted T
cells and negative selection of strongly autoreactive T cells
Class I and class II MHC molecules are required for negative selection of self-MHC restricted T
cells and positive selection of strongly autoreactive T cells
Class I and class II MHC molecules are required for positive selection of self-MHC restricted T
cells but not negative selection of strongly autoreactive T cells
MHC molecules are not required for either positive or negative selection of T cells, and are only
required for activation of mature T cells outside the thymus

A 3 yo boy with documented hypogammaglobulinemia and recurrent otits media since he was 2 mos of
age is now hospitalized with Haemophilus meningitis. On admission, he has no serum antibodies for
tetanus toxoid, diphtheria toxoid, or conjugated H. influenza (all T-dependent antigens), despite previous
immunizations. He has normal numbers of T cells and normal proliferative responses to T cell
mitogens. Genetic studies performed during hospitalization show different mutations in the paternal and
maternal alleles of the surrogate light chain gene that is expressed during B cell development. All of
the following abnormalities in B cell development in this child are likely consequences EXCEPT:
A)
B)
C)
D)
E)

4.

Proliferative expansion of precursor cells

Cell surface expression of complete antigen receptor complexes
Negative selection of self-reactive lymphocytes
Activation of lymphoid precursor cells by foreign antigen
Receptor expression prior to encountering antigen

Absence of mature B cells

Absence of Ig receptor complex expression in immature B cells
Absence of Ig heavy chain gene recombination within B cell precursors
Absence of normal Ig light chain on the cell surface of pre-B cells
Absence of serum antibodies to T independent antigens.

5 yo Sean with recurrent infections was discovered by his sister, a physician, to have a genetic defect,
different from the case above, but that still impairs B cells maturation. Which of the following
abnormalities is most likely to be found in this patient?
A)
B)
C)
D)
E)

Small thymus
Absence of follicles in lymph nodes and spleen
Enlarged tonsils
Diminished parafollicular (paracortex) zones in lymph nodes
Absence of cytotoxic T cell function

5.

A helper T cell response to a protein antigen requires the participation of antigen-presenting cells that
express which of the following types of molecules?
A)
B)
C)
D)
E)

6.

Andrea, a young adult is exposed to a virus that infects and replicates in mucosal epithelial cells of the
upper respiratory tract. One component of the protective immune response to this viral infection is
mediated by CD8+ cytotoxic T lymphocytes (CTLs), which recognize and kill virus-infected cells. The
CTLs are able to recognize and kill the infected cells because
A)
B)
C)
D)
E)

7.

In response to interferon-gamma secreted during the innate immune response to the virus, the
mucosal epithelial cells express class II MHC, with bound peptides, on their cell surfaces
Mucosal epithelial cells, like all nucleated cells, express class I MHC molecules and are able to
process cytoplasmic viral proteins and display complexes of class I MHC and bound viral
peptides on their cell surfaces
Antibodies specific for viral antigens bind to those antigens on infected cell surfaces and engage
Ig Fc receptors on the CTL, thereby targeting the CTL to the infected cells
Virus-infected mucosal epithelial cells migrate to draining lymphoid tissue, where they present
viral peptide antigens to effector CD8+ T cells
Viral infection of the mucosal epithelial cells stimulates them to express E-selectin, which
allows the CD8+ T cell to adhere to its viral-infected target.

Amy, a 22 yo girl develops malaise, headache, low grade fever, followed by pharyngitis and cervical
lymph node enlargement as a result of infectious mononucleosis cause by Epstein-Barr virus (EBV).
Her acute symptoms resolve within 2 weeks and the fatigue begins to improve. If CD8+ effector T cells
are obtained from her lymphoid tissue at that time and put into an in vitro culture of her un-infected
epithelial cells together with EBV, which of the following molecules would be LEAST required to be
present for those effector CD8+ cells to be able to bind to and kill EBV-infected cells?
A)
B)
C)
D)
E)

8.

Class II MHC and CD4

Class I MHC and CD4
Class II MHC and CD8
CD4 and costimulators
Class II MHC and costimulators

microglobulin
HLA-A, B, or C
CD28
perforin
TAP

Which enzyme contributes to the antigen receptor junctional diversity by adding random nucleotides at
the junctions between V, D, and J segments?
A)
B)
C)
D)
E)

AID (activation induced deaminase)

RAG (recombinase activating gene)
TdT (terminal deoxyribonucleotidyl transferase)
DNA polymerase
DNA-dependent protein kinase

9.

Anti-Tumor Necrosis Factor (TNF) antibodies are now used in the treatment of patients with rheumatoid
arthritis. A complication of this therapy, seen in a subset of patients, is infection with various
microorganisms, including bacteria and fungi. Which of the following is a function of TNF that is
important in the defense against infections and is likely to be impaired in the setting of TNF blockade?
A)
B)
C)
D)
E)

10.

A previously healthy 5-yr old boy is infected with a particular upper respiratory tract pathogen he has
never seen before. During the first few hours of infection, which one of the following events occur?
A)
B)
C)
D)
E)

11.

Active humoral immunity

Passive humoral immunity
Active cell-mediated immunity
Passive cell-mediated immunity
Innate immunity

Which of the following statements is consistent with the process of clonal selection?
A)
B)
C)
D)
E)

13.

The adaptive immune system responds rapidly to the pathogen and keeps the infection under
control.
The innate immune system responds rapidly to the infection and keeps it under control.
Passive immunity mediated by maternal antibodies limits the spread of infection.
B and T lymphocytes recognize the pathogen and stimulate the innate immune response.
The pathogen causes malignant transformation of mucosal epithelial cells, and the malignant
cells are recognized by the adaptive immune system.

A standard treatment of animal bite victims, when there is the possibility of rabies infection, is
administration of human immunoglobulin preparations containing anti-rabies virus antibodies. Which
type of immunity would be established by this treatment?
A)
B)
C)
D)
E)

12.

Induction of fever
Reduction of cardiac output
Enhanced procoagulant activity of endothelial cells
Enhanced glucose utilization by muscle cells
Promotion of inflammatory events

The specificity of a lymphocyte antigen receptor changes to accommodate the structure of an

antigen that binds to it.
Many different antigen receptors with different specificities are expressed on each lymphocyte
Lymphocytes do not express antigen receptors on their cell surfaces until after exposure to
antigen.
The diversity of the lymphocyte repertoire for antigens is very small before exposure to antigen,
but increases significantly after antigen exposure.
The diversity of the lymphocyte repertoire for antigens is very large before exposure to antigen,
with millions of different clones of lymphocytes produced, each having a different specificity.

Which of the following statements best describes the two-signal requirement for nave T lymphocyte
activation by foreign antigen?
A)
B)
C)
D)
E)

Lymphocytes must recognize two different antigens to become activated.

Lymphocytes must recognize the same antigen at two sequential times to become activated.
Lymphocytes must recognize antigen and respond to a second signal generated by contact with
activated antigen presenting cells.
Both nave B and nave T lymphocytes must simultaneously recognize antigen for either to be
activated.
When lymphocytes recognize antigen, the antigen receptors must activate two-signal
transduction pathways to become activated.

14.

Which of the following descriptions of class I MHC molecules is NOT true?

A)
B)
C)
D)
E)

15.

Which of the following statements about class II MHC molecules is NOT true?
A)
B)
C)
D)
E)

16.

C)
D)
E)

There are many allelic variants of MHC genes in outbred populations.

MHC polymorphism is generated in an individual by somatic recombination of gene segments
encoding different exons of MHC molecules which occurs during each primary response to
antigen.
MHC polymorphism is the major barrier to acceptance of allogeneic organ grafts.
Two allelic variants of an MHC molecule are most likely to differ in amino acid sequences
located near their peptide binding clefts.
Both class I and class II MHC genes are polymorphic.

Which of the following statements about peptide binding to MHC molecules is true?
A)
B)
C)
D)

18.

Class II MHC molecules bind peptides derived from extracellular proteins.

Class II molecules bind to CD4 molecules on T cells.
Class II molecules are expressed on a limited number of cell types, including dendritic cells.
HLA-DR and HLA-DQ are human class II MHC molecules with two chains that bind peptides.
Class II MHC molecules are not expressed on cells that express class I MHC molecules.

Which of the following statements about polymorphism of MHC genes is NOT true?
A)
B)

17.

The principal function of class I MHC molecules is to display peptides derived from cytosolic
proteins on the cell surface.
Class I MHC molecules bind to CD8 molecules on T cells.
Human class I MHC molecules include HLA-A, HLA-B, and HLA-C.
Class I MHC molecules are normally expressed only on dendritic cells and other professional
antigen-presenting cells.
A cell will express class I MHC molecules encoded by genes inherited from both parents.

MHC molecules preferentially bind peptides derived from foreign (e.g.microbial) proteins and
not peptides derived from self molecules.
MHC molecules and their allelic variants are highly specific for individual peptides.
An MHC molecule has only one peptide-binding site, which accommodates only a single
peptide at a time.
Peptide binding to class I MHC molecules involves non-covalent interactions, whereas peptide
binding to class II MHC molecules is covalent.

Which of the following statements about the antigen-presenting function of macrophages is NOT
correct?
A)
B)
C)
D)
E)

Macrophages are particularly important at presenting peptides derived from particulate or

opsonized antigens that are internalized by phagocytosis.
Macrophages become activated by the helper T cells to which they present microbial peptides,
and as a result of this activation they become efficient at killing the microbes.
Resting macrophages express low levels of class II MHC molecules, but higher class II MHC
expression is induced on activation by the T cells to which they present antigen.
Macrophages express highly variable, high affinity receptors similar to T cells, specific for
individual microbial antigens, and these receptors facilitate the internalization of the antigens
for processing and presentation.
Macrophages present antigen to T cells in lymphoid organs and many nonlymphoid organs.

19.

Which of the following statements about dendritic cells is true?

A)
B)
C)
D)
E)

Immature dendritic cells are ubiquitously present in skin and mucosal tissues.
Dendritic cell maturation occurs only after they have migrated into lymph nodes in response to
signals derived from activated T cells to which they bind.
Class II MHC and T cell costimulators are highly expressed on immature dendritic cells and are
down-regulated during their maturation.
Dendritic cells that enter lymph nodes through draining lymphatics migrate to the B cell-rich
follicles in response to chemokines.
The principal function of mature dendritic cells is antigen capture.

Answers are on the next page!

ANSWERS:
1D
2B
3C
4B
5E
6B
7C
8C
9E
10 B
11 B
12 E
13 C
14 D
15 E
16 B
17 C
18 D
19 - A