Identify the letter of the choice that best completes the

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					Identify the letter of the choice that best completes the statement or answers the
B                                        1.       Which of these characteristically does
                                                  not cross placental barrier in
                                                   a.    IgG1     c.     IgG3
                                                   b.    IgG2     d.     IgG4

B - ? –same question as #1             2.        Which of these characteristically does
                                                 not cross placental barrier in
                                                  a.    IgG1     c.     IgG3
                                                  b.    IgG2     d.     IgG4

A – there are 4; one is nondistinct;   3.        IgA protease is produced by several
other 3 are for IgA1                             bacterial pathogens against:
                                                  a.   IgA1     c.  Both
                                                  b.   IgA2     d.  Neither

A                                      4.        Which of the following possess a J-
                                                 chain ?
                                                  a.   IgM     c.   Both
                                                  b.   IgD     d.   Neither

E – rest are all parts of              5.        Which of the following is not
immunoglobulins, which plasma                    produced by plasma cells ?
cells create                                      a. Mu          d. J -chains
                                                  b. Kappa       e. Secretory
                                                     chains          piece
                                                  c. Lambda

A – IgM does not pass through          6.        The immunoglobulin in the serum of
placenta                                         this infant is all of maternal origin.
                                                  a. Th IgM        d. The
                                                       is of           immunoglobulin
                                                       fetal           in the serum is
                                                       origin          all of fetal
                                                  b. The IgM e. The
                                                       is both         immunoglobulin
                                                       of fetal        in the serum of
                                  and                this infant is all
                                  maternal           of maternal
                                  origin.            origin.
                               c. The IgG
                                  is of

B                       7.    Which is the region of complement
                               a. Light     d. Hypervariable
                                    chain       region

                               b. Heavy        e. Fab portion

                               c. Kappa

                              research gives the following answers – not
a.   IgA   d.   IgG           matching!
b.   IgD   e.   IgM
c.   IgE   f.   S-IgA

E                       8.    Fixes Complement best of all
D                       9.    Half-life in human blood of
                              approximately 21 days
D                       10.   Immunoglobulin class most
                              frequently acting as rheumatoid
                              factor in rheumatoid arthritis.
D                       11.   Multiple myeloma is most frequently
                              associated with which
                              immunoglobulin class?
A                       12.   Selective immunoglobulin deficiency
                              most frequently involves which
A                       13.   Heavy chain (Franklin's) disease
                              usually involves the heavy chains of
                                         which antibody class?

a. IgG        d. A and C
b. IgM        e. A,B and C
c. Complement f. A and B

E                                  14.   Type II hypersensitivity reactions
                                         may involve which of the above?

a. IgG        d. A,B
                 and C
b. IgM        e. A and
                 C only
c. Complement f. A and
                 B only

E - ? – same as #14                15.   Type II hypersensitivity reactions
                                         may involve which of the above?

a.    IgA     d.   LgG
b.    IgD     e.   LgM
c.    IgE     f.   S-lgA

D – IgG would be the only one to   16.   The cord blood of a newborn is
cross placenta                           analyzed shortly after birth because
                                         of a suspected in utero infection. An
                                         elevation of which Ab class best
                                         confirms this suspicion
                                         st mutans is oral – dental decay
a. Hemophilus d. St. mutans
b. St.        e. Neisseria
   pneumoniae    gonorrhoeae
c. St.

D                                  17.   IgA protease is produce by all of the
                                         following EXCEPT

a. Anaphylatoxin c. Inmune
   activity         adherence
b. Chemotaxis

B                                       18.   C3b
A                                       19.   C3a
C                                       20.   C4b

a.   IL-1     c.     Both
b.   IL-2     d.     Neither

B                                       21.   Produced by T cells.
A                                       22.   Produced by Macrophages
D                                       23.   Produced by Mast cells.

a.   C2a     d.     C5a
b.   C3a     e.     C3bBb3b
c.   C4a     f.     C3bPBb

D                                       24.   Most potent anaphylatoxin of the
                                              Complement systems:

a. NK cell          d. Eosinophil
b. T-cell           e. Platelet
c. Basophil         f. Mast: cell

E                                       25.   Peripheral blood elements of humans
                                              which contain both histamine and

a. Cytotoxic T-      f.   B -cells
   cells (Tcyt)
b. NK cells          g. choices A,C,
                        and E only
c. T killer cells    h. A,B & C only
d. Helper T          i. All of these
   cells                except choice
e. Macrophages       j. Choices A
                        through F

D                                       26.   The disorder known as Insulin-
                                              dependent diabetes (or Type I
                                                diabetes) develops as a result of
                                                action associated with which of the

 a. 10,800 >_      c. 10,500                                                           Dif
    12___>            >                                                                fer
    N65, E4,          13                                                               en
    B1, L25,          >                                                                t
    M5                N69,                                                             ins
        38            E3, B0,                                                          tru
                      L26,                                                             cti
                      M2                                                               on
                          37                                                           Be
 b. 4,500 >        d. 7,500                                                            lo
    15                >                                                                w
    >    N52,         16
    E3, B0,           >                                                                [A
    L40, M5           N63,                                                             ] if
            45        E3, B0,                                                          a,
                      L30,                                                             b
                      M4                                                               &
                          47                                                           e
ABCD - can’t find out what these       27.      Which of the following sets of         rre
values represent                                hematologic values obtained from       ct
                                                female patients is abnormal?
] if only d is correct
 [B]     if a & c are correct    [E] if all are correct
     [C] if b & d are correct
E 1. Which of the following is/are not classified as Type II Hypersensitivity
         a. serum sickness               c. Systemic anaphylaxis
         b. Rheumatoid arthritis         d. Erythroblastosis fetalis

C 2.   Factor H, a tetramer found in normal serum, has which of the following activities?
        a. It prevents Factor d.     It stabilizes and protects C3
               B from binding                       convertase.
               to C3b
        b. It removes Factor e.      All of the above.
               Bb from C3
              convertase of
              the Alternate
    c.    It enhances                  b-yes
              Factor I                 c-yes
              binding to C3b           d-yes
              and thus
              increases the
              inactivation of
              C3b by

D   3.    Which of the following cells in human peripheral blood possess lysozyme?
          a.       Eosinophil                 c.      Basophil
          b.       Monocyte                   d.      Neutrophil

C   4.    For which of these conditions would you consider urgent antipyretic therapy (e.g.
              acetaminophen) for a previously healthy adult 25 YOA male in good nutritional
           a.                  37.5 ¡C-normal             c.    38¡C - normal
           b.                  100.4 ¡F - high            d.    40¡C - high

E   5.    The term, ""fever of unknown origin" when applied to a child implies:
           a. Thorough evaluation by a            d. Lack of a
              physician with a physical exam,         diagnosis after
              history and appropriate lab tests       one week of
              including culture of blood, urine,      hospitalization.
              CBC, etc.
           b. A body temperature of 38.5 or       e. All of the
              more.                                   above.
           c. The febrile state lasting for a
              duration of at least 2 weeks

E    6.                         In which of the following hypersensitivity states is
                                complement NOT involved?
                                 a.  serum            c.   Goodpasture's
                                     sickness              syndrome
                                 b.  Allergic         d.   Tuberculin
                                     rhinitis              sensitivity

A    7.                         Routine initial work-up of a patient with FUO would
                  least likely include which of the following:
                   a.    Blood              d.    Exploratory
                         cultures                 surgery
                   b.    Liver biopsy       e.    All of the above

                   c.   Liver function

B      8.         Which of the following does not serve as a moderator
                  for activities of mediator factors involved in immediate
                  allergic reactions?
                   a.    Na chromglycate      d.    Eysozyme
                   b.    Epinephrine          e.    Corticosteroid
                   c.    Ephedrine

B          9.    Which of the following test procedures is used to
                 quantitate the allergen-specific IgE in a patient?
                  a. Prausnitz-Kustner passive       d. RIST
                     cutaneous anaphylaxis test
                  b. Serum electrophoresis           e. Patch
                  c. RAST

A          10.   Of the following causes of FUO, which is the most
                 common in US hospitals?
                  a. Connective tissue       d. Neoplastic
                      disease                   disease
                  b. Undiagnosed disease e. All of the
                  c. Infection

D          11.   The Pel-Epstein fever type of febrile state is most
                 suggestive of which of these disease      conditions?
                  a. Pulmonary embolus        d. Hodgkin's
                  b. Infectious               e. Sarcoidosis
                  c. Systemic lupus

a.          IgA           d.      IgC
b.          IgD           e.      IgM
c.          IgE           f.      S-IgA

C                 12.                 The immunoglobulin class which is chiefly
                                      involved as a blocking Ab for Type I
                                      hypersensitivity reaction is:

a.   IgA         d.   IgG
b.   IgD         e.   IgM
c.   IgE         f.   None of these

F          13.            Immunoglobulin chiefly associated with   reactions with
                          cellular antigen.
C          14.            Immunoglobulin chiefly associated with   Type I
F          15.            Immunoglobulin chiefly associated with   Type IV
F          16.            Immunoglobulin chiefly associated with   adverse reactions
                          to the fetus in hemolytic   disease of   the newborn.

a. Factor H           e. Decay
                         Factor (DAF)
b. Factor I           f. C5 convertase
                         of CCP
c. C3                 g. None of these
   of the ACP
d. C3
   of OCP

D          17.                 C4b2b
F          18.                 c4b2b3b
G          19.                 C3bBb3b
A          20.                 C3Bb
C          21.                 C3bBb
B                                            22.               An endopeptidase which cleaves C3b.
E                                            23.               Inhibits activity of C3 convertase
a. Active naturally-acquired            d. Passive artificially acquired
   immunity                                immunity
b. Passive naturally acquired           e. Passive adaptively acquired
   immunity                                immunity
c. Active artificially acquired

B     24.           Colostrum ingestion
C     25.           Tetanus toxoid administration
C     26.           MMR childhood immunization
C     27.           DPT & OPV childhood immunization
A     28.           Chicken pox infection
A     29.           Infection with Salmonella organisms
E     30.           Transplacental crossover of maternal ABS

a. Stabilizes or   c.   Both
   protects C3
b. Stabilizes or   d. Neither
   protects C5

A           31.                   Properdin
A           32.                   Factor H
A           33.                   Factor I

a.   Killed virus                        f.   Antitoxin
b.   Killed bacteria                     g.   Toxoid
c.   Live attenuated virus               h.   Immune serum globulin
d.   Live attenuated bacteria            i.   Antivenom
e.   Toxin                               j.   None of these

F                           34.           Diphtheria childhood immunizations
C                           35.           Polio childhood immunizations
F                           36.           Tetanus childhood immunizations
D                           37.           Pertussis childhood immunizations
C                           38.           Measles, mumps, rubella childhood vaccine
C                           39.           Prophylactic therapy for Hepatitis A case contacts

a. CH2 region of molecule           d. VH and VL regions of the molecule
b. CH3 region of molecule           e. None of these
c. CH4 region of the molecule
 can’t find a decent biochem reference for this
ABCDE         40.          The Clq binding site of IgG
ABCDE         41.          The Clq binding site of IgM
ABCDE         42.          The Clq binding site of IgD
ABCDE         43.          The Clq binding site of IgE
ABCDE         44.          The Clq binding site of IgE
ABCDE         45.          The Clq binding site of IgE
ABCDE         46.          J chain binding site of IgG
ABCDE         47.          Neutrophil binding site if IgM
ABCDE         48.          Antigenic combining site of IgG

   Allergy capable of transient
a. passive transfer from one person c. Both
   to another by serum.
   Allergy capable of passive transfer
b.                                     d. Neither
   by means of cells only.

D                          49.           Systemic anaphylaxis
A                          50.           Tuberculin sensitivity
D                          51.           Food Allergy
D                          52.           Contact dermatitis
B                          53.           Poison Ivy

a. chemotactic         c. Both
b.                     d. Neither

C           54.            C3a
B           55.            C4a
C           56.            C5a
D           57.            C5b67

   Myeloperoxidase               Chronic granulomatous
a.                            c.
   deficiency                    disease
b. Chediak-Higashi disease    d. Systemic lupus erythematosis

B    58.   Disease characterized by severe recurrent and lingering bacterial
           infections beginning in infancy, or early childhood. Causative agents
           are most often members of the Enterobacteriaceae (e.g. Serratia,
          Escherichia, Klebsiella, etc or S. aureus. The patient's neutrophils are
          adequate for chemotaxis and pathogen ingestion.
C   59.   The patients frequently exhibit a state of neutropenia coupled with
          recurrent severe attacks of bacterial sinusitis and pneumonia and/or
          deep tissue abscesses accented by mild bleeding episodes. Presence of
          normal microbe ingestion, abnormally large lysosomes, deficient
          chemotaxis and diminished degranulation of the neutrophils
          characterize neutrophils after phagocytosis.
A   60.   Inherited condition most frequently recognized by patients increased
          susceptibility to Candida albicans infections. Neutrophil chemotaxis,
          phagocytosis and degranulation activity is normal. Microbe killing is
          defective. Diagnosis is made in part by testing levels of specific
          enzyme-associated activity in blood cells on the blood film.

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