Immunology Practice Exam 2

Recommendation: Do this practice test like it’s for real, sit down for a good 30-45
min and go at it without looking at the answers. I feel that if you are comfortable with
these questions, Mondays exam shouldn’t be a problem. As usual, if you have
questions, comments, or if you’re scarred out of your mind, e-mail me. Good luck on
Monday.

1. What stage of B-cell development is characterized by a surrogate light chain at the

membrane surface?
A. Lymphoid stem cell
B. Pro B-cell
C. Pre B-Cell
D. Immature B-cell
E. Mature B-cell

2. What interaction is important for the early stages of B-cell development?

A. CD40L on T-cells binding to CD40 on B-cells
B. CD40L on B-cells binding to CD40 on T-cells
C. Kit on B-cells binding to SCF on bone marrow stromal cells
D. Kit on bone marrow stromal cells binding to SCF on B-cells
E. CD28 on T-cells binding to B7 on APC

3. CD79a and CD79b (Ig alpha and beta) are important for B-cells by being
involved in
A. Acting as a co-receptor
B. Acting as an antigen
C. Cell to cell recognition
D. Signal transduction
E. Allelic exclusion

4. When an immature B-cell interacts with a multivalent (or cell bound) self antigen,
what will most likely happen to the B-cell?
A. Undergo receptor editing
B. Become anergic
C. Become a mature cell
D. Become a T-cell
E. Undergo apoptosis

5. IgM and IgD are expressed simultaneously on mature B-cells due to

A. RNA splicing
B. Antigen recognition
C. B-cell receptor capping
D. Lipid Rafts
E. DNA splicing

6. How does a naïve B-cell become activated?

A. Using TCR to bind soluble antigen with Ig alpha and beta for signal transduction
B. Using BCR to bind antigen bound to MHC with Ig alpha and beta for signal
transduction
C. Using TCR to bind antigen bound to MHC with CD3 for signal transduction
D. Using BCR to bind soluble antigen with Ig alpha and beta for signal transduction
E. Using BCR to bind soluble antigen

7. To enhance B-cell activation, complement components are often required. These

complement components can bind to the antigen as well as certain co-receptors
found on B-cells. What the co-receptors I am talking about?
A. CD3
B. CD19, CD81, CD21
C. Ig alpha and beta
D. CD4 and CD8
E. CD2

8. Thymus-independent antigens are characterized by

A. Inducing memory
B. Allowing for affinity maturation
C. Not resulting of isotype switching
D. Being a protein as its chemical nature

9. TI-2 antigens are characterized by

A. Causing polyclonal activation of B-cells
B. Containing multivalent epitopes
C. LPS as an example
D. Being mitogens

10. What is the CD molecule found on B1 cells?

A. CD3
B. CD8
C. CD19
D. CD5
E. CD92

11. What is the ABSOLUTE requirement in order for T- and B-cells to interact/do the
tango?
A. B-cells need to isotype switch
B. T-cells need to have interacted with soluble antigen
C. Both T-and B-cells need to be activated
D. B-cells need to have interacted with antigen bound to MHC
E. T-cells need to undergo somatic hypermutation

12. What are the CD molecules necessary for B-and T-cells to tango?
A. CD45 and CD45L
B. CD80 and CD80L
C. CD40L found on B-cells and CD40 on T-cells
D. CD40L found on T-cells and CD40 on B-cells
E. CD3 found on T-cells and CD79a and b on B-cells

13. What is a possible result of the first tango conducted by a T- and B-cell?
A. Induction of memory for the B-cell
B. Class switching
C. Somatic recombination
D. RNA splicing resulting in both IgM and IgD expressed on the surface of B-cells
E. Affinity maturation

14. Which of the following describes the sequence of events which occur concerning
the tangos?
A. The first tango occurs, which could result in affinity maturation, followed by
interaction with follicular dendritic cells expressing class II MHC, then the second
tango occurs, which results in class switching and memory.
B. The body is initially set in motion across the floor through the flexing of the lower
joints (hip, knee, ankle) while the feet are delayed, then the feet move quickly to
catch the body, resulting in snatching or striking action that reflects the staccato
nature of this style's preferred music.
C. The first tango occurs, which could result in memory, followed by interaction
with follicular dendritic cells expressing class I MHC, then the second tango
which results in affinity maturation.
D. The first tango occurs, which could result in affinity maturation, followed by
interaction with follicular dendritic cells expressing class I MHC, then the second
tango occurs, which results in class switching and memory.
E. The first tango occurs, which could result in class switching and memory,
followed by interaction with follicular dendritic cells expressing class I MHC,
then the second tango which results in affinity maturation.

15. Which of the following describes the difference between naïve and memory B-
cells?
A. Naïve cells secrete IgG and memory cells secrete IgA
B. Memory cells have a significantly higher affinity for its antigen
C. Memory cells secrete IgG and naïve cells secrete IgA
D. IgM is the primary antibody secreted in memory cells
E. Naïve cells have a significantly higher affinity for its antigen

16. IL-2 is of great importance for the proliferation of T-cells. Cyclosporine is a

common drug used in transplant recipients which inhibits IL-2 production in
helper T-cells. In order for IL-2 to be produced, what signal is necessary?
A. TCR binging to MHC and peptide antigen
B. CD40L binding to CD40
C. CD28 on an antigen presenting cell binding to B7 on a T-cell
D. CD28 on a T-cell binding to B7 on an antigen presenting cell
E. IL-12 interacting with THO cells
 17. A technician working in a hematology lab was performing an ouchterlony and
observed a spur in the sample. What kind of identity does this indicate?
A. Identity
B. Nonidentity
C. Mixture of antigens
D. Partial identity

18. The same hematology technician wanted to test for the presence of anti-
erythrocyte antibodies in the serum of a patient. What test should he run?
A. Indirect Coombs test
B. Direct Coombs test
C. Latex agglutination
D. Western Blot
E. Southern Blot

19. A direct Coombs test was performed on a baby in its seventh month of gestation. The
mother has had trouble with two earlier pregnancies, and she has never received
RhoGAM. The physician is concerned about the possibility of erythroblastosis fatalis.
What ingredients would be necessary to perform this procedure?
A. Mother’s serum plus RhoGAM plus Coombs reagent
B. Mother’s serum plus Rh- RBCs plus Coombs reagent
C. RhoGAM plus Rh+ RBCs from the baby
D. Rh+ RBCs from the baby plus Coombs reagent
E. Rh+ RBCs plus mother’s serum plus Coombs reagent

Match the following immunoglobulins with their respective functions. Each one can be
used once, twice, three times, maybe four times, probably not five times, or never.
IgG IgM IgD IgE IgA

20. Crosses the placenta to interact with the bramble receptor_______

21. Cell surface found only on mature B-cells only_______
22. Highest avidity_______
23. Able to fix complement________and _________
24. Found in high amount in mucosal tissue________
25. First immunoglobulin to be released from an activated B-cell________
26. Involved in allergic reactions________
27. Highest affinity to receptors on mast cells and basophils_________

28. Which type of antibody determinant is involved in determining the antigen binding
site?
A. Idiotype
B. Isotype
C. Allotype
D. Phenotype
E. Genotype
29. Which of the following occurs when IgM and IgD are on the surface of B-cells?
A. Somatic hypermutation
B. Somatic recombination
C. Class switching
D. High ratio of secreted IgM
E. The B-cells are activated and pumping out antibodies

30. Which molecules are involved in isotype switching?

A. RAG-1/RAG-2
B. DNA polymerase
C. CDR3
D. RNA polymerase
E. Activation Induced cytidine Deaminase (AID)

31. Which of the following happens after a B-cell has encountered antigen?
A. P-nucleotide addition
B. Somatic recombination
C. Somatic hypermutation
D. Junctional flexibility
E. Allelic exclusion

32. What is patient D’s titer?

A. 1/256
B. 1/128
C. 128
D. 256
E. 1024

33. A lab technician wanted to detect anti-erythrocyte antibodies in serum of the mother.
What test would the technician use?
A. Direct Coombs test
B. Indirect Coombs test
C. Hemaglutination
D. ELISA
E. Western Blot

34. If I wanted to test for the presence of serum antibodies for measles in a patient’s
blood sample using an ELISA, which of the following is true?
A. The ‘filling’ would be the measles virus antigen
B. The first layer would be anti-human antibodies
C. The ‘filling’ would be antibodies taken from the patient’s serum against anti-human
antibody
D. The last layer would be antibodies taken from the patient’s serum against measles
virus antigen
E. The ‘filling’ would be antibodies taken from the patient’s serum against measles virus
antigen

35. Which of the following is true regarding the C’ fixation assay?

A. A positive result is when there is lysis of RBCs
B. A negative result is when there is lysis of RBCs
C. A positive result is when there are antibodies generated against serum proteins
D. A negative result is when there are antibodies generated against serum proteins

36. A 17 yo heroin user visits a family planning/STD clinic irregularly to receive birth
control pills. In April 2004, the standard HIV screen performed by this clinic reports back
that her test was positive. What does the primary test for HIV use?
A. Electrophoresis of HIV antigens in polyacrylamide gel
B. HIV antigen covalently coupled to RBC, patient serum, and anti-immunoglobulin
C. HIV antigen covalently coupled to RBC, patient serum, and C’
D. HIV antigen, patient serum, anti-immunoglobulin serum, and enzyme-substrate ligand
E. HIV antigen, patient serum, anti-immunoglobulin serum, and radioactive ligand

37. A direct Coombs test was performed on a baby in its seventh month of gestation. The
mother has had trouble with two earlier pregnancies, and she has never received
RhoGAM. The physician is concerned about the possibility of erythroblastosis fatalis.
What ingredients would be necessary to perform this procedure? REPEAT Q…FORGET
IT
A. Mother’s serum plus RhoGAM plus Coombs reagent
B. Mother’s serum plus Rh- RBCs plus Coombs reagent
C. RhoGAM plus Rh+ RBCs from the baby
D. Rh+ RBCs from the baby plus Coombs reagent
E. Rh+ RBCs plus mother’s serum plus Coombs reagent

38. MHC class I is characterized by

A. Having two different polypeptide chains, process and present intracellular antigens,
does not consist of Beta 2 microglobulin, and found exclusively on APCs
B. Having one polypeptide chain, process and present extracellular antigens, consists of
Beta 2 microglobulin, and found on almost all cells of the body
C. Having one polypeptide chain, process and present intracellular antigens, consists of
Beta 2 microglobulin, and found exclusively on APCs
D. Having two different polypeptide chains, process and present intracellular antigens,
does not consist of Beta 2 microglobulin, and found on almost all cells of the body
E. Having two different polypeptide chains, process and present extracellular antigens,
does not consist of Beta 2 microglobulin, and found exclusively on APCs
F. Having one polypeptide chain, process and present intracellular antigens, consists of
Beta 2 microglobulin, and found on almost all cells of the body

39. MHC class II is characterized by

A. Having two different polypeptide chains, process and present extracellular antigens,
does not consist of Beta 2 microglobulin, and found exclusively on APCs
B. Having two different polypeptide chains, process and present intracellular antigens,
does not consist of Beta 2 microglobulin, and found exclusively on APCs
C. Having one polypeptide chain, process and present extracellular antigens, consists of
Beta 2 microglobulin, and found on almost all cells of the body
D. Having one polypeptide chain, process and present intracellular antigens, consists of
Beta 2 microglobulin, and found exclusively on APCs
E. Having two different polypeptide chains, process and present intracellular antigens,
does not consist of Beta 2 microglobulin, and found on almost all cells of the body
F. Having one polypeptide chain, process and present extracellular antigens, consists of
Beta 2 microglobulin, and found on almost all cells of the body

40. CD4+ cells are an essential component of the immune response secreting a variety of
cytokines functioning to regulate the various immune cells. They are able to do this
because they
A. Recognize MHC class I and intracellular derived antigens
B. Recognize MHC class I and extracellular derived antigens
C. Recognize MHC class II and intracellular derived antigens
D. Recognize MHC class II and extracellular derived antigens

41. CD8+ cells are an important component of the immune response destroying
infected/altered self cells. They are able to do this because they
A. Recognize MHC class I and intracellular derived antigens
B. Recognize MHC class I and extracellular derived antigens
C. Recognize MHC class II and intracellular derived antigens
D. Recognize MHC class II and extracellular derived antigens
42. When APCs present antigen to T-cells, a co-stimulatory interaction is required. What
is this?
A. CD40L on the APC and CD40 on the T-cell
B. CD40L on the T-cell and CD40 on the APC
C. CD80/CD86 (B7-1/ B7-2) on the APC and CD28 on the T cell
D. CD80/CD86 (B7-1/ B7-2) on the T-cell and CD28 on the APC
E. I don’t know what co-stimulation means

43. What binds to an MHC molecule to prevent proteins from binding to it prematurely?
A. TAP1 and TAP2
B. HLA-DM
C. Tapasin
D. Invarient chain
E. IFN-gamma

44. What transports antigen from the cytoplasm to the ER?

A. TAP1 and TAP2
B. HLA-DM
C. Tapasin
D. Invarient chain
E. IFN-gamma

45. The great and powerful immunoproteosome

A. Is induced by IFN-gamma, involved in the exogenous pathway, and cleaves peptides
suitable for MHC class I
B. Is induced by IFN-gamma, involved in the exogenous pathway, and cleaves peptides
suitable for MHC class II
C. Is induced by IFN-gamma, involved in the endogenous pathway, and cleaves peptides
suitable for MHC class I
D. Is induced by IFN-alpha, involved in the exogenous pathway, and cleaves peptides
suitable for MHC class I
E. Is induced by IFN-gamma, involved in the endogenous pathway, and cleaves peptides
suitable for MHC class II

46. Which of the following is associated with the endogenous pathway?

A. MHC class I for antigen processing and presentation, TAP1 and TAP2,
immunoproteosome, HLA-DM, CLIP
B. MHC class I for antigen processing and presentation, invariant chain, CLIP,
immunoproteosome, calreticulin
C. MHC class II for antigen processing and presentation, TAP1 and TAP2,
immunoproteosome, tapasin
D. MHC class II for antigen processing and presentation, invariant chain, tapasin, CLIP
E. I am sick of reading your long and annoying answer choices
F. MHC class I for antigen processing and presentation, tapasin, TAP1 and TAP2,
immunoproteosome
G. MHC class II for antigen processing and presentation, CLIP, invariant chain, HLA-
DM

47. Which of the following is associated with the exogenous pathway?

A. MHC class I for antigen processing and presentation, TAP1 and TAP2,
immunoproteosome, HLA-DM
B. MHC class II for antigen processing and presentation, CLIP, invariant chain, HLA-
DM
C. MHC class I for antigen processing and presentation, invariant chain, CLIP,
calreticulin
D. MHC class II for antigen processing and presentation, TAP1 and TAP2,
immunoproteosome, tapasin
E. MHC class II for antigen processing and presentation, invariant chain, tapasin, CLIP
F. MHC class I for antigen processing and presentation, tapasin, TAP1 and TAP2,
immunoproteosome

48. CD1 is characterized by being

A. TAP dependent, HLA-DM dependent, presents peptides, requires endosome
acidification
B. TAP independent, HLA-DM independent, presents lipids, does not require endosome
acification
C. TAP dependent, HLA-DM independent, present lipids, requires endosome
acidification
D. TAP independent, HLA-dependent, present lipids, does not require endosome
acidification
E. TAP independent, HLA-DM independent, presents lipids, requires endosome
acidification

49. Positive selection

A. Happens in the medulla, is when T-cells bind self, and results in lineage commitment
B. Happens in the medulla, is when T-cells are sampled a protein, and results in
elimination
C. Happens in the cortex, is when T-cells bind self, and results in lineage commitment
D. Happens in the cortex, is when T-cells are sampled a protein, and the best survive
E. Happens in the bone marrow for T-cells…I hope you don’t pick this

50. During negative selection, a couple of my T-cells bind with low affinity to a self
molecule. What will be the result of these T-cells?
A. Undergo apoptosis
B. Transform into regulatory T-cells
C. Survive, seek and destroy

51. A few other T-cells bound with moderate affinity…result for these guys?
A. Undergo apoptosis expressing CD4 and CD8
B. Undergo apoptosis expressing CD4 or CD8
C. Express CD4, CD25, have Foxp3 as a transcription factor and serve a regulatory role
D. Survive, seek and destroy
E. Produce antibodies

Answers
1. C
2. C
3. D
4. E
5. A
6. D
7. B
8. C
9. B
10. D
11. C
12. D
13. E
14. D
15. B
16. D
17. D
18. A
19. D
20. IgG
21. IgD
22. IgM
23. IgM and IgG
24. IgA
25. IgM
26. IgE
27. IgE
28. A
29. B
30. E
31. C
32. C
33. B
34. E
35. B
36. D
37. D
38. F
39. A
40. D
41. A
42. C
43. D
44. A
45. C
46. F
47. B
48. E
49. C
50. C
51. C