IMMUNOLOGY AND HOST DEFENSE

Teaching Learning Examination

Mid-Term, 1997

1. All of the following are accurate characterizations of exotoxins & endotoxins EXCEPT

Exotoxins Endotoxins
1 - Produced by both Gm+ & Gm- bacteria, Found only in Gm- bacteria
but mostly by Gm+ bacteria
2- Protein in nature Lipopolysaccharide complexes
3- Relatively heat stable Relatively heat labile
4- Highly immunogenic; antitoxin is generally Weakly immunogenic; antibodies are
protective generally not directed against Lipid A
as it is relatively inaccessible.
5- Excreted by the bacterial cell into the medium Integral part of the bacterial cell wall

2. Gram-positive bacteria

1- stain red with Gram's stain.

2- are not susceptible to penicillin, an antibiotic that inhibits synthesis of peptide cross-links of
pepticloglycaln.
3- have teichoic acids in their cell walls.
4- have inner and outer membranes separated by a peptidoglycan layer.
5- have sterols in their membranes.

3. Strategies or mechanisms employed by bacteria to thwart or escape host defenses include all of
the following EXCEPT

1- abrupt shift in structure of surface antigens.

2- expression of a capsule that inhibits or retards phagocytosis.
3- taking up residence inside a host cell.
4- synthesis of lysozyme.
5- synthesis of IgA protease.

4. All of the following bacterial attributes are related to the pathogenetic mechanisms listed
EXCEPT

BACTERIAL ATTRIBUTE PATHOGENETIC MECHANISM

1- Capsule Retards phagocytosis

2- Fimbriae Adherence to host cells
3- Spore Amplifies bacterial reproduction by generating
more progeny than does binary fission
4- Siderophores Scavenges iron from host tissues
5. Enveloped viruses are characterized by all of the following EXCEPT

1- they mature by budding through the outer membrane of the host cell.
2- they may contain glycoproteins in the envelope.
3- they contain virus-encoded proteins in the envelope.
4- they contain host lipid in their envelope.
5- they are generally more stable to temperature and organics than naked nucleocapsids.

6. Biochemical analysis of a virus reveals the genome to be composed of 8 unequally-sized pieces

of single-stranded RNA, each of which is complementary to viral mRNA in infected cells. All
of the following statements about this virus are correct EXCEPT

1- the virus can undergo high-frequency recombination via reassortment of its RNA segments
when occupying a host cell simultaneously infected with a related virus.
2- the virus would be characterized as a positive-stranded RNA virus.
3- The virus particle contains a virus-encoded RNA-dependent RNA polymerase (a
transcriptase) that can copy the genome into its complement.
4- Different proteins are encoded by the different segments of the viral genome.

7. Rat Protein X was used as an immunogen in several different mice. Which of the following
factors may influence the spectrum of antibody specificities in the resulting antisera?

1- The state of nativity of the protein antigen.

2- The genetic background of the mouse.
3- The state of aggregation and route of injection of the immunogen.
4- All of the above
5- 1 and 3 above.

8. For the three antigens given below, the correct rank-order (high to low) for immunogenicity
when injected into a mouse is

1- rat insulin > bovine serum albumin (BSA) > rat serum albumin (RSA)
2- BSA > RSA > rat insulin.
3- RSA > rat insulin > BSA.
4- BSA > rat insulin > RSA.
5- RSA > BSA > rat insulin.

9. Which of the following is(are) a T-dependent antigen(s)?

1- Tetanus toxoid
2- Pneumococcal polysaccharide conjugated to tetanus toxoid
3- Dipepticles of glycine conjugated to pneumococcal polysaccharide
4- All of the above
5- 1 and 2 above
6- 2 and 3 above
10. In most adults, the percentage of the IgG-1 subclass as a percentage of total serum Ig in mg/dL
is

1- ~5%
2- ~10%.
3- ~25%.
4- ~50%.
5- ~75%.

11. Idiotypic determinants of a myeloma protein with specificity for Phosphoryl Choline [PC]

1- may be blocked by the hapten PC

2- may be reactive with an anti-idiotypic antibody even in the presence of PC.
3- may be reaction sites for antibodies made in a different species
4- may be reaction sites for antibodies made in the same species.
5- all of the above.
6- 1 and 3 above.

12. Which of the following is(are) likely to opsonize Streptococcus pneumoniae bacterial cells?

1- Purified monoclonal IgM with specificity for the capsular polysaccharide

2- Purified monoclonal IgM with specificity for the capsular polysaccharicle - in the presence
of fresh serum.
3- Purified polyclonal IgG with specificity for the capsular polysaccharicle
4- F(ab')2 fragments derived from polyclonal IgG with specificity for the capsular
polysaccharicle - in the presence of fresh serum
5- 2 and 3 above
6- 1, 2, & 3 above

13. Changes in sequence of genomic DNA that encodes Ig chains in lymphocytes may occur in the
normal course of development and differentiation through all of the following mechanism,
EXCEPT

1- addition of N-segments.
2- heavy chain isotype switch recombination.
3- V-region gene segment rearrangements.
4- somatic hypermutation.
5- switch from transmembrane form of Ig to secreted form of Ig.
14. The rule of cis recombination (within the same chromosome) for Ig genes, rather than trans 3
recombination (between homologous chromosomes) is generally applicable to

1- the rearrangement of a D-segment to a J-segment of the Ig VH-region.

2- the rearrangement of a V-segment to a J-segment of the Ig VL-region.
3- switch recombination for Ig CHgenes.
4- all of the above.
5- 1 and 2 above.

15. A lymphocyte that expresses the Ig µ-chain in the cytoplasm but no Ig light chain in the
cytoplasm and no readily detectable IgM on the membrane is MOST LIKELY a(an)

1- B-cell progenitor (pro-B-cell).

2- pre-B-cell.
3- immature B-cell.
4- mature B-cell.
5- either 1 or 2 above.

16. Allelic exclusion applied to expression of Ig H-chain genes is primarily due to

1- inactivation of one of the X chromosomes in each cell.

2- deletion of Ig C-region genes on one of the relevant chromosomes in lymphocytes.
3- deletion of Ig V-region genes on one of the relevant chromosomes in lymphocytes.
4- feedback inhibition of any further VH region gene segment rearrangement after on
functional VDJ rearrangement has been achieved.
5- deletion of all DH segments except the one involved in the functional VDJ rearrangement
for the VH-gene.

17. Which of the following statements about somatic hypermutation in the immune system, in
terms of target DNA, is correct?

1- it is targeted to T cell receptor genes only.

2- it is targeted to both V and C genes.
3- it is targeted to Ig V-segments only, not D- or J-segments.
4- it is targeted to functionally rearranged Ig V-region genes.
5- it is targeted to functionally rearranged Ig VH genes only, not VL genes.

18. The variability in the 2nd hypervariable region of Ig heavy chains among different IgG
molecules is contributed by

1- N-segments.
2- different VH gene segments in the genome.
3- somatic hypermutation.
4- 1 and 3 above.
S_ 2 and 3 above.
19. In which of the following sets are the immunoassays correctly ordered according to their
potential sensitivity, going from the assay of greatest sensitivity (able to detect very low
concentrations of Ag) to the assay of least sensitivity (able to detect only high concentrations of
Ag)?

1- Competitive radioimmunoassay > hemagglutination inhibition > radial immunodiffusion

2- Hemagglutination inhibition > competitive-type radioimmunoassay > > radial
immunodiffusion
3- Rocket immunoelectrophoresis > competitive-type radioimmunoassay > > ELISA
4- Competitive-type radioimmunoassay > rocket immunoelectrophoresis > >
hemagglutination inhibition
5- Hemagglutination inhibition > rocket immunoelectrophoresis > ELISA

20. Antiserum obtained from a rabbit immunized with polyclonal human serum IgG was passed
through a solid phase immunosorbent column containing a human IgG4 subclass, kappa type
myeloma protein as the Ag. The "absorbed" antiserum (i.e., that which passed through the
column without binding) is likely to react with which of the following human Ig myeloma
proteins

1- IgM, lambda type protein

2- IgA2, kappa type protein
3- IgG1, kappa type protein
4- 1 and 3 above
5- 2 and 3 above

21. For the process of making mouse monoclonal antibodies by the hybridoma technology,
desirable characteristics for an immortal fusion partner for immune mouse spleen cells include
all of the following EXCEPT

1- a selectable marker such as a defective HGPRT enzyme.

2- a cell with many plasma cell characteristics, such as a well developed ER and Golgi
apparatus.
3- a cell from the same animal species as the immune spleen cells.
4- a cell that has lost capability to make its own Ig H-chains and L-chains.
5- a cell capable of undergoing random Ig H-chain switch recombination at a high frequency
in culture.

22. Which of the following immunoassays could BEST be adapted for detection of a viral protein
antigen in the plasma of a very recently infected patient?

1- Counter- immunoelectrophoresis
2- Enzyme Linked ImmunoSorbent Assay
3- Radial immunodiffusion
4- Active, direct hemagglutination assay
5- Jerne direct hemolytic plaque assay
23. The fact that IgA is the predominant class of Ig in human intestinal secretions is due, in part to
all of the following EXCEPT

1- the preponderance of IgA plasma cells in the lamina propria of the intestinal epithelium.
2- the synthesis of the polymeric Ig receptor by intestinal epithelial cells.
3- the high concentration of IgA in the serum.
4- the synthesis of J chain by intestinal IgA plasma cells.

24. All of the following may comprise part of the first line of defense EXCEPT

1- neutrophils
2- fatty acids on the skin
3- IgM
4- cilia of the upper respiratory tract
5- lysozyme

25. Complement-mediated lysis of bacteria is

1 - more effective with Gram-positive bacteria because they have only one membrane.
2- more effective with Gram-positive bacteria because complement components of the MAC
[Membrane Attack Complex] can readily access a sensitive membrane.
3- more effective with Gram -negative bacteria because they have only one membrane.
4- more effective with Gram-negative bacteria because complement components of the MAC
can readily access a sensitive membrane.
5- equally effective against Gram-positive and Gram-negative bacteria.

26. The activation of the alternative pathway of complement is stimulated by which of the
following?

1- C5 convertase
2- The membrane attack complex of the Classical pathway
3- B cells bound to antigen
4- Bacterial cell walls, especially polysaccharides
5- C3a

27. Which of the following primary deficiencies of the immune system is the underlying cause of
hereditary angioedema?

1- C1 Inhibitor deficiency.
2- C3 deficiency
3- Deficiency of a component of the Membrane Attack Complex
4- Selective IgA deficiency
5- Myeloperoxidase deficiency
28. In patients with NADPH oxidase deficiency, the neutrophils lack the capacity to produce

1- superoxide and hydrogen peroxide.

2- lysozyme.
3- nitric oxide.
4- NADPH.
5- 1 & 3 above.

29. Neutrophils and macrophages share all of the following characteristics EXCEPT

1- both cell types are generated from a common stem cell that has responded to GM-CSF
during an early phase of differentiation.
2- both cell types are capable of phagocytosis of C3b or IgG opsonized microbes
3- both cell types generate phagolysosomes.
4- both cell types generate reactive oxygen intermediates (e.g., superoxide, peroxide, HOCl)
and chloramines capable of killing phagocytosed bacteria.
5- both cell types degrade bacterial proteins, present them to T cells, and secrete T-cell
activating cytokines.

30. Which of the following sets of molecules is found frequently on the same mature resting T cell
surface?

1- CD3 and CD2 (sheep erythrocyte receptor)

2- CD4 and CD8
3- T-cell receptor and class II MHC
4- CD 19 and CD 20
5- αβ T-cell receptor and γδ T-cell receptor

31. Which of the following lymphocyte subpopulations is in the greatest proportion in the
peripheral blood of most normal humans?

1- B cells
2- CD4+ T cells
3- CD8+ T cells
4- Large granular lymphocytes
5- γδ T cells
Data for question 32

Shown is a set of Ouchterlony patterns developed with various rabbit antisera directed against
either human Ig molecules, Ig chains of Ig fragments. One of the two antigens in each pattern is
human serum IgG, or a Fab fragment derived from human serum IgG; the other is an "unknown"
(U) human Ig or Ig fragment.

serum
IgG U Fabγ U IgG U Fabγ U
O O O O O O O O

O O O O
anti-IgG anti-IgG anti-κ anti-λ
(H + L) (H + L)

32. Of the following choices, the "unknown" U is MOST LIKELY

1- monoclonal IgG.
2- polyclonal IgG.
3- monoclonal IgM.
4- F(ab')2γ.
5- Fcγ.

Answers
1. 3 12. 5 23. 3
2. 3 13. 5 24. 1
3. 4 14. 4 25. 4
4. 3 15. 2 26. 4
5. 5 16. 4 27. 1
6. 2 17. 4 28. 1
7. 4 18. 5 29. 5
8. 2 19. 1 30. 1
9. 5 20. 5 31. 2
10. 5 21. 5 32. 5
11. 5 22. 2