Medical Microbiology & Immunology

Guri Tzivion, PhD

tzivion@windsor.edu
Extension 506
BCHM 306: January 2015
Windsor University School of Medicine
 MD3 Immunology

Review for final exam

The exam will cover:
Innate Immunity: 2-3 questions

Adaptive immunity & antibodies: 2-4 questions

MHC & Transplantation: 2-3 questions

Hypersensitivity & Allergy: 2-3 questions

Immunological Methods & Blood Typing: 1-2 questions

The Complement System: 2-3 questions

Tolerance and Autoimmune Disorders: 2-3 questions

Cancer Immunity and immunodeficiency: 2-3 questions

 Sample Questions
1) The class of immunoglobulin present in highest
concentration in the blood of a human newborn is

A. IgG.
B. IgM.
C. IgA.
D. IgD.
E. IgE.
 Sample Questions
1) The class of immunoglobulin present in highest
concentration in the blood of a human newborn is

A. IgG.
B. IgM.
C. IgA.
D. IgD.
E. IgE.
 Sample Questions
2) Antigen-presenting cells that activate helper T cells
must express which one of the following on their
surfaces?

A. IgE
B. Gamma interferon
C. Class I MHC antigens
D. Class II MHC antigens
E. T-cell Receptor
 Sample Questions
2) Antigen-presenting cells that activate helper T cells
must express which one of the following on their
surfaces?

A. IgE
B. Gamma interferon
C. Class I MHC antigens
D. Class II MHC antigens
E. T-cell Receptor
 Sample Questions
3. A patient skin-tested with purified protein derivative
(PPD) to determine previous exposure to
Mycobacterium tuberculosis develops induration at the
skin test site 48 hours later. Histologically, the reaction
site would MOST probably show

A. Eosinophils.
B. Neutrophils.
C. Helper T cells and macrophages.
D. B cells.
E. Antibody-antigen precipitates.
 Sample Questions
3. A patient skin-tested with purified protein derivative
(PPD) to determine previous exposure to
Mycobacterium tuberculosis develops induration at the
skin test site 48 hours later. Histologically, the reaction
site would MOST probably show

A. Eosinophils.
B. Neutrophils.
C. Helper T cells and macrophages.
D. B cells.
E. Antibody-antigen precipitates.
 Sample Questions
4. Hemolytic disease of the newborn caused by Rh blood
group incompatibility requires maternal antibody to
enter the fetal bloodstream. Therefore, the mediator of
this disease is

A. IgE antibody.
B. IgG antibody.
C. IgM antibody.
D. IgA antibody.
E. IgD antibody.
 Sample Questions
4. Hemolytic disease of the newborn caused by Rh blood
group incompatibility requires maternal antibody to
enter the fetal bloodstream. Therefore, the mediator of
this disease is

A. IgE antibody.
B. IgG antibody.
C. IgM antibody.
D. IgA antibody.
E. IgD antibody.
 Sample Questions
5. Your patient became ill 10 days ago with a viral disease.
Laboratory examination reveals that the patient's
antibodies against this virus have a high ratio of IgM
to IgG. What is your conclusion?

A. It is unlikely that the patient has encountered this organism

previously.
B. The patient is predisposed to IgE-mediated hypersensitivity
reactions.
C. The information given is irrelevant to previous antigen
exposure.
D. It is likely that the patient has an autoimmune disease.
E. It is likely that the patient was exposed previously to the virus.
 Sample Questions
5. Your patient became ill 10 days ago with a viral disease.
Laboratory examination reveals that the patient's
antibodies against this virus have a high ratio of IgM
to IgG. What is your conclusion?

A. It is unlikely that the patient has encountered this organism

previously.
B. The patient is predisposed to IgE-mediated hypersensitivity
reactions.
C. The information given is irrelevant to previous antigen
exposure.
D. It is likely that the patient has an autoimmune disease.
E. It is likely that the patient was exposed previously to the virus.
 Sample Questions
6. The role of the macrophage during an antibody
response is to:

A. Make antibody.

B. Lyse virus-infected target cells.

C. Activate cytotoxic T cells.

D. Process antigen and present it.

 Sample Questions
6. The role of the macrophage during an antibody
response is to:

A. Make antibody.

B. Lyse virus-infected target cells.

C. Activate cytotoxic T cells.

D. Process antigen and present it.

 Sample Questions
7. Each of the following statements concerning the variable
regions of heavy chains and the variable regions of light
chains in a given antibody molecule is correct EXCEPT:

A. They have the same amino acid sequence.

B. They define the specificity for antigen.
C. They are encoded on different chromosomes.
D. They contain the hypervariable regions.
E. They are produced by B cells after exon rearrangement.
 Sample Questions
7. Each of the following statements concerning the variable
regions of heavy chains and the variable regions of light
chains in a given antibody molecule is correct EXCEPT:

A. They have the same amino acid sequence.

B. They define the specificity for antigen.
C. They are encoded on different chromosomes.
D. They contain the hypervariable regions.
E. They are produced by B cells after exon rearrangement.
 Sample Questions
8. Type IV hypersentivity is often referred to as:

A. Immediate.
B. Delayed.
C. Anaphylactic.
D. Anergic.
E. Allotypic.
 Sample Questions
8. Type IV hypersentivity is often referred to as:

A. Immediate.
B. Delayed.
C. Anaphylactic.
D. Anergic.
E. Allotypic.
 Sample Questions
9. A graft between members of the same species is termed
an:

A. Autograft.
B. Isograft.
C. Xenograft.
D. Allograft.
E. None of the above.
 Sample Questions
9. A graft between members of the same species is termed
an:

A. Autograft.
B. Isograft.
C. Xenograft.
D. Allograft.
E. None of the above.
 Sample Questions
10. In type 1 diabetes (insulin-dependent diabetes
mellitus), the target of the autoimmune attack is:

A. All of the cells in the islets of Langerhans.

B. The b-cells in the islets of Langerhans.
C. The somatostatin-producing cells in the islets of
Langerhans.
D. The glucagon-producing cells in the islets of
Langerhans.
E. Cells throughout the body which have an insulin
receptor.
 Sample Questions
10. In type 1 diabetes (insulin-dependent diabetes
mellitus), the target of the autoimmune attack is:

A. All of the cells in the islets of Langerhans.

B. The b-cells in the islets of Langerhans.
C. The somatostatin-producing cells in the islets of
Langerhans.
D. The glucagon-producing cells in the islets of
Langerhans.
E. Cells throughout the body which have an insulin
receptor.
 NBME Microbiology Exam Topics
Microbiology Module (125 items)
General Principles:
Biochemistry, Molecular Biology, Genetics Tissue Response to
Disease Pharmacodynamic/Pharmacokinetic Processes
Microbial Biology and Infection, Microbial classification and
its basis, Bacteria and bacterial diseases, Viruses and viral
diseases Fungi and fungal infections, Parasites and parasitic
diseases Principles of sterilization and pure culture technique
Immune Responses
Organ Systems:
Hematopoietic & lymphoreticular, Central & peripheral nervous
Skin & related connective tissue, Musculoskeletal, Respiratory
Cardiovascular, Gastrointestinal, Renal/urinary, Reproductive
Immunology Module (25 items):
Immunologic Processes, Immunologic Diseases
 NBME Sample Question
11. During an experiment, an investigator gently abrades the
skin from the flank of a mouse, creating a 1 2-cm skin
window. A glass cover slip is then placed over the area so
that cells attracted to the site attach to the cover slip for
assessment. Two hours later, an extravasation of cells from
the vasculature is noted on the cover slip. Which of the
following complement components is the direct cause of the
enhanced vascular permeability and chemoattraction in the
abraded skin area in this experiment?
(A) C1q
(B) C4b
(C) C5a
(D) C7
(E) C9
 NBME Sample Question
11. During an experiment, an investigator gently abrades the
skin from the flank of a mouse, creating a 1 2-cm skin
window. A glass cover slip is then placed over the area so
that cells attracted to the site attach to the cover slip for
assessment. Two hours later, an extravasation of cells from
the vasculature is noted on the cover slip. Which of the
following complement components is the direct cause of the
enhanced vascular permeability and chemoattraction in the
abraded skin area in this experiment?
(A) C1q
(B) C4b
(C) C5a
(D) C7
(E) C9
 NBME Sample Question
12. An investigator injects an experimental animal with a
newly discovered bacterial strain to evaluate T-lymphocyte
activation. It is found that bacterial engulfment by
macrophages results in the presentation of bacterial-
derived peptide ligands to CD4+ T lymphocytes. Which of
the following cell-surface molecules on the macrophage is
most directly involved in the presentation of the processed
peptides?

(A) CD28
(B) Class II MHC
(C) Fc receptor
(D) Interleukin-2(IL-2)receptor
(E) Membrane immunoglobulin
 NBME Sample Question
12. An investigator injects an experimental animal with a
newly discovered bacterial strain to evaluate T-lymphocyte
activation. It is found that bacterial engulfment by
macrophages results in the presentation of bacterial-
derived peptide ligands to CD4+ T lymphocytes. Which of
the following cell-surface molecules on the macrophage is
most directly involved in the presentation of the processed
peptides?

(A) CD28
(B) Class II MHC
(C) Fc receptor
(D) Interleukin-2(IL-2)receptor
(E) Membrane immunoglobulin