Test your basic knowledge |

USMLE Step 1 Immunology

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What are the autoantibodies for wegeners granulomatosis?
Mediates septic shock; activates the endothelium for adhesion and dilation and leukocyte recruitment results in vascular leak
C - ANCA (antiproteinase); in neutrophil; c= cytoplasmic
It is a localized type III hypersensitivity reaction to an external antigen; localized instead of systemic; ?; intradermal injection of the antigen results in antibody production and antigen antibody complexes deposit in the skin
Immunosuppression after kidney transplantation

2. How fast does it occur?
Into cortex and medulla; cortex is where immature T lymphocytes enter - at the corticomedullar junction is where positive and negative selection occur; and at the medulla is where the mature T lymphs - reticulin cells and hassalls corpuscles are (dea
All MHC 1/CD8
The patient could become cyanotic in the OR!
Liver! (they are proteins circulating in the blood)

3. give an example of a virus that uses antigenic variation. What does a major variation result in? minor?
Influenza; antigenic shift; antigenic drift
An anaphylactic immediate reaction; atopy refers to the inherited propensity to develop asthmatic or allergic reactions
Carbohydrate
Isotype switching (activated by Th2 cell signals and cytokines) - somatic hypermutation

4. What is the autoantibody for SLE that is nonspecific? Specific?
Proteins; IgG - IgM - endotoxin (microbial surfaces in general - nonspecific ones also) - mannose binding Lectin; classic - alternative - MB pathway (resp)
Anti nuclear Antibodies (ANA); Anti dsDNA - anti Smith
isotype
mesenchymal

5. What is the general structure of an Ab?
Popliteal
Active; passive - fast but short half life (3 weeks!)
A B and T cell disorder; defect in DNA repair enzymes; ataxia - telangactasia and IgA def; igA def. and increased AFP
2 heavy chains and two light chains

6. What are the sinusoids of the spleen? What is the difference between a spleen and a lymph node?
Negative!
The red pulp of the spleen its where the vasculature channels go through and interact with the parenchyma of the spleen (has macrophages) which empty in the sinuses; they are both encapsulated (with trabeculae) secondary lymphoid organs that trap ant
Th cells fail to produce interferon gamma; a lot of IgE
CD56

7. IgM can fix complement but...
cannot cross placenta
neutrophilia!
It is a localized type III hypersensitivity reaction to an external antigen; localized instead of systemic; ?; intradermal injection of the antigen results in antibody production and antigen antibody complexes deposit in the skin
Type III hypersensitivity where an exogenous antigen results in a systemic antigen antibody complex disease (takes around 5 days after exposure for the Abs to develop); immune complexes then fix in tissue and activate complement resulting in tissue d

8. What lymph node drains the thigh?
IgG
Liver! (they are proteins circulating in the blood)
Superficial inguinal
IL 15; IL 12 - interferon Beta and interferon alpha

9. Which helper T cells' development is induced by IL 4? IL 12?
Previous transfusion; pregnant woman whose fetus had paternal antigens
except hyperacute
Th2; Th1
Anti SS- A (anti RO) and Anti SS- B

10. What is the thymus ? Where is it located? is it encapsulated? How many lobes does it have?
The place of T cell diff and maturation; ant mediastinum above heart; yes; 2
IgG
not Ab mediated
MHC I/CD8 and IL2/IL 2 Receptor (IL 2 is from Th1!); cytoxicity!

11. What is the toxicity of azathioprine?
Anti smooth muscle
Defect in LFA 1 integrin (CD 18) protein on phagocytes (neutrophils!); recurrent bacterial infections - severe gingivitis - poor wound healing - absent pus formation - and delayed separation of the umbilicus; neutrophilia
Leukocyte adhesion defect; ataxia telangietasia; ataxia telangiectasia; chediak higashi syndrome; IgA def; Digeorge syndrome; Jobs; Chediak Higashi
...

12. What are the autoantibodies for autoimmune hepatitis?
All MHC 1/CD8
Internal iliac
Anti smooth muscle
Interferon gamma; Th1

13. What two ways do you test for a type 1 hypersensitivity reaction? what will you see?
An alpha and beta chain; only on APCs; TCR and CD4; extracellular (phagocytosed by APCs)
TGF beta and IL 10
Scratch test - histamine mediated wheal; radioimmunosorbent assay (detects specific IgEs in serum)
Antimicrobial also secreted by CD8 and NK cells that induces apoptsosis

14. What are the symptoms of serum sickness?
Antibody mediated cytotoxicity; either complement dependent or complement independent
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
DAF and C1 esterase inhibitor on cells prevent complement activation on their surfaces (microbial surfaces lack this)
Th2; Th1

15. What is the presentation of Brutons agammaglobulinemia?
Recurrent sinopulmonary bacterial infections after 6 months (d/t mothers igGs transplacental) due to opsonization defect
Remove encapsulated bacateria
Adaptive uses classic pathway to kill; innate uses alternative pathway to kill
Its a serine protease that activates apoptosis; NK and CD8

16. What type of cells do NK cells attack? with What tools? by necrosis or apoptosis?
CGD; Jobs syndrome (defect in Neutrophil chemotactic response)
Wiskott Aldrich syndrome
No! That is why they are different from T cells - they can recognize antigens in free solution; if a bug has a peptide fragment that a mature naive B cell recognizes it will bind to it and cause activation - it then gets activated into a plasma cell!
Tumor cells and virally infected cells; perforin pore to secrete granzymes through it; apoptosis

17. What are four results of a splenectomy?
IL 4 - 5 - 10 - 6
1) susceptibility to encapsulated organisms 2) Howell Jolly Bodies 3) Target cells 4) Thrombocytosis
Mycobacterium Tuberculosis - Mycobacterium Avium Intracellulare; Toxoplasmosis Gondii
By transcytosis

18. What are the main cell surface proteins on B cells?
DM type I
Ig - CD19 - CD20 - CD21 - CD40 - MHC II - B7
pathogenesis
They directly stimulate Macrophages by binding CD14; also the alternative complement pathway binds to these host surfaces and induces MAC complex; also TLRs exist for endotoxins; also IgM though not an opsonin can act as a pentamer and trap the antig

19. What cytokines do macrophages release? who else can secrete IL 6? IL 12?
B - T - and NK cells
Paracortex
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells
This means that MHC can not recognize it and thus will not be phagocytosed. The humoral response rescues - IgM is the primary response attack. Since there is no class switching (without MHC activation no CD40 L and interleukins to activate!) then the

20. What lymph node drains the upper limb?
Axillary
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Graves
Not thymus - BM

21. What is the mode of inheritance of Chediak Higashi syndrome? What is the disease d/t? What does it result in? What is the presentation?
The interstitial tissue of a lymph node is structured into the cortex on the outside Which is densely cellular which transitions into the paracortex Which is less dense and then the medulla Which is least dense. The cells that inhabit these tissues a
...
Vasculitis of graft vessels with dense interstitial lymphocytic infiltrate; yes! with immunosuppressants
AR; defect in MT function results in decreased transport and phagocytosis; recurrent pyogenic infections by staphylococci and streptococci - partial albinism - and peripheral neuropathy

22. How do you test for chronic granulomatous disease?
Negative nitroblue tetrazolium reduction test
AR; defect in MT function results in decreased transport and phagocytosis; recurrent pyogenic infections by staphylococci and streptococci - partial albinism - and peripheral neuropathy
Barrel hoop basement membrane fenestrations
Immunosuppression after kidney transplantation

23. What is the main cytokine that activates eosinophils?
IL 4
IL 5
Barrel hoop basement membrane fenestrations
Severe pyogenic infections early in life

24. Which TCR MHC system is important for viral immunity? neoplastic? donor graft cells?
All MHC 1/CD8
Antiviral for uninfected cells (for future protection) and kills virally infected cells (NK activation)
A B and T cell disorder; defect in DNA repair enzymes; ataxia - telangactasia and IgA def; igA def. and increased AFP
Make antibody - allergy type 1 (igE) - Cytotoxic and immunecomplex hypersensitivity type II and III (igG); hyperacute organ rejection is Ab mediated

25. What is the defect in hyper IgM syndrome? What are the lab results?
Adaptive uses classic pathway to kill; innate uses alternative pathway to kill
Intracellular pathogens (acute and chronic viruses and virally induced cancers)
Defect in CD40L results in inability to class switch; a lot of IgM and no IgG - A - E
False! B cell class switching requires a second signal

26. What are the main symptoms of B cell immunodeficiencies?
SP infections
Coarse Faces - cold (noninflamed d/t inability to attract neutrophils) staph abscesses - retained primary teeth - high igE - dermatologic problems (eczema)
Daclizumab; prevent ACUTE rejection of renal transplant
T cell and antibody mediated vascular damage due to MHC non self being recognized as self by self lymphocytes and resulting in attack of the foreign antigens it presents (all of them); months to years after; no :(

27. What is the main function of interferons?
High endothelial venules are post capillary cuboidal endothelial cells that contain specific adhesion molecules for lymphocytes with specific binders that allows for lymphocytes to drain out of the vasculature into the lymph node structure (this is h
Antiviral for uninfected cells (for future protection) and kills virally infected cells (NK activation)
Severe pyogenic infections early in life
opsonizes

28. What happens in a deficiency of C3?
IgM and IgG
Yes
Anti Jo -1
Severe recurrent pyogenic sinus and resp tract And increased susceptibility to type III hypersensitivity like SLE

29. The lymphocytes are ________ origin
Pernicious Anemia and Hashimotos
Capsule of lymph node is made up of type III collagen (made by reticulin fibers!) - extension of this collagen extends into the splenic tissue as trabeculae; nonspecific filtration of lymph by Macrophages - Antibody production (via activation) - stor
mesenchymal
No! That is why they are different from T cells - they can recognize antigens in free solution; if a bug has a peptide fragment that a mature naive B cell recognizes it will bind to it and cause activation - it then gets activated into a plasma cell!

30. What are the autoantibodies for goodpastures syndrome?
Anti alpha subunit 3 of collagen on type IV bm
Legionella - N. gonorrhea - L. monocytogenes - viruses - protozoa (leismaniasis)
A - B - C; all the D's
Anti Jo -1

31. What is filgrastim and sargramostim? and What is it used for?
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
Recomb cytokine of GCSF (granulocyte macrophage colony stimulating factor; for recovery of bone marrow
IL 5

32. Which are the only two antiinflammatory cytokines?
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells
TGF beta and IL 10
Anticentromere; anti Scl -70 (anti DNA topoisomerase I)
Anti SS- A (anti RO) and Anti SS- B

33. What happens in a secondary follicle?
A recomb cytokine of IL 2; RCC and metastatic melanoma
Isotype switching (activated by Th2 cell signals and cytokines) - somatic hypermutation
A B and T cell disorder; X linked recessive; progressive deletion of B and T cells; thrombocytopenic purpura - infections - eczema; high IgE and IgA but low IgM
Lymphocytes

34. which of the IL2 inhibitors produce nephrotoxicity? thrombocytopenia/leukopenia?
Cyclosporine and tacrolimus; sirolimus (as well as hyperlipidemia)
The igA found in breast milk
Negative selection
Suppresses immune response (also specifically Th1 cells) and activates Th2; regulatory T cells

35. Monomer in circulation - ___ when secreted
IL 5
isotype
dimer
Tetanus - Botulinum - HBV - Rabies

36. What are superantigens? give two examples.
The red pulp of the spleen its where the vasculature channels go through and interact with the parenchyma of the spleen (has macrophages) which empty in the sinuses; they are both encapsulated (with trabeculae) secondary lymphoid organs that trap ant
Lymphocytes
Not thymus - BM
CROSS LINK Beta region on TCR of CD4 cells to the MHC class II on APCs this results in uncoordinated release of Interferon gamma from CD4 Th1 cells and subsequent release of IL1 - IL6 and TNF alpha from Macrophages --> toxic shock syndrome; s. pyogen

37. Type Iv hypersensitivity is...
Can be acquired in 20s -30s; increased risk of autoimmune disease - lymphoma - Sp infections; normal number of B cells and no plasma cells and immunoglobulin
Tetanus - Botulinum - HBV - Rabies
Daclizumab; prevent ACUTE rejection of renal transplant
delayed!

38. What is the presentation of hyperIgM syndrome?
Defect in BTK a tyrosine kinase gene; failed maturation of B cells; X linked recessive
C - ANCA (antiproteinase); in neutrophil; c= cytoplasmic
Its involved in inflammation and results in anaphylaxis and neutrophil chemotaxis.
Severe pyogenic infections early in life

39. What is the white pulp of the spleen?
Lack of response from lymphocytes when activated; because they are self reactive - this is a form of tolerance
Local infection/inflammation; infection of the ln itself; metastasis
Fab portion
Surrounds the red pulp and begins with PALS and then turns into follicles with B cells/follicles

40. which interleukin receptor is required for NK development? activation?
IL 15; IL 12 - interferon Beta and interferon alpha
Activates cytotoxic CD 8 T cells as second signal
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
Anti Ach receptor

41. Often bacteria are associated with being killed by humoral immunity. Name some bugs that require cell mediated immunity because they evade humoral response
Intracellular pathogens (acute and chronic viruses and virally induced cancers)
Anemias (esp due to renal failure)
Popliteal
Legionella - N. gonorrhea - L. monocytogenes - viruses - protozoa (leismaniasis)

42. which B and T cell disorder presents with specifically low IgM?
CD56
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)
Wiskott Aldrich syndrome
Viral neutralization of igM and IgG!

43. What does Interferon alpha and beta do? how?
Antiviral by inducing ribonuclease which degrades only viral mRNA (prevents protein synthesis) and activates NK cells to kill virus infected cells
Cyclosporine and tacrolimus; sirolimus (as well as hyperlipidemia)
Fab portion
Surrounds the red pulp and begins with PALS and then turns into follicles with B cells/follicles

44. What is the most common example of passive immunity?
IgAs in mothers breast milk!
IL 4
Cross link antigens which increases their phagocytability; activate complement for MAC attack; opsonization; neutralization
Th1; interferon gamma; IL 2 for cytotoxic T cell activation

45. What is the presentation of common variable immunodef? and What are the labs?
Glycoproteins; HLA
mesenchymal
Immune complex - Arthus reaction and Serum sickness; they are all a result of antibody- antigen complex deposition resulting in complement activation
Can be acquired in 20s -30s; increased risk of autoimmune disease - lymphoma - Sp infections; normal number of B cells and no plasma cells and immunoglobulin

46. What is the clinical use of Muromonab?
Scratch test - histamine mediated wheal; radioimmunosorbent assay (detects specific IgEs in serum)
It is a localized type III hypersensitivity reaction to an external antigen; localized instead of systemic; ?; intradermal injection of the antigen results in antibody production and antigen antibody complexes deposit in the skin
Defect in BTK a tyrosine kinase gene; failed maturation of B cells; X linked recessive
Immunosuppression after kidney transplantation

47. Which is the main antibody in the delayed or secondary response to an antigen?
Pernicious Anemia and Hashimotos
CROSS LINK Beta region on TCR of CD4 cells to the MHC class II on APCs this results in uncoordinated release of Interferon gamma from CD4 Th1 cells and subsequent release of IL1 - IL6 and TNF alpha from Macrophages --> toxic shock syndrome; s. pyogen
IgG
Axillary

48. What are the autoantibodies for other vasculitides?
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
Give a vaccine with a peptide comp from it that the cell mediated immunity otherwise cant get to! like h.influenzae vaccine. then class switching and memory response can occur
Axillary
Increases expression of MHC I and MHC II and also activates NK cells

49. What is the antimetabolite precursor of 6 mercaptopurine? What is the result?
Cyclosporine and tacrolimus; sirolimus (as well as hyperlipidemia)
Activate macrophages
The interstitial tissue of a lymph node is structured into the cortex on the outside Which is densely cellular which transitions into the paracortex Which is less dense and then the medulla Which is least dense. The cells that inhabit these tissues a
...

50. What are the cell surface proteins on NK cells?
Antiviral for uninfected cells (for future protection) and kills virally infected cells (NK activation)
delayed!
MHC I - CD16 - CD56
Closed circuit where go directly to veins and open where squeeze out of capillary sinusoids and interact with either PALS or with macrophages in the cords of Billroth (for antigen immune function or for blood cleaning or for both) and squeeze back in

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Major Subjects
Tests & Exams AP CLEP DSST GRE SAT GMAT	Certifications CISSP go to https://www.isc2.org/ PMP ITIL RHCE MCTS More...	IT Skills Android Programming Data Modeling Objective C Programming Basic Python Programming Adobe Illustrator More...	Business Skills Advertising Techniques Business Accounting Basics Business Strategy Human Resource Management Marketing Basics More...
Soft Skills Body Language People Skills Public Speaking Persuasion Job Hunting And Resumes More...	Vocabulary GRE Vocab SAT Vocab TOEFL Essential Vocab Basic English Words For All Global Words You Should Know Business English More...	Languages AP German Vocab AP Latin Vocab SAT Subject Test: French Italian Survival Norwegian Survival More...	Engineering Audio Engineering Computer Science Engineering Aerospace Engineering Chemical Engineering Structural Engineering More...
Health Sciences Basic Nursing Skills Health Science Language Fundamentals Veterinary Technology Medical Language Cardiology Clinical Surgery More...	English Grammar Fundamentals Literary And Rhetorical Vocab Elements Of Style Vocab Introduction To English Major Complete Advanced Sentences Literature Homonyms More...	Math Algebra Formulas Basic Arithmetic: Measurements Metric Conversions Geometric Properties Important Math Facts Number Sense Vocab Business Math More...	Other Major Subjects Science Economics History Law Performing-arts Cooking Logic & Reasoning Trivia

Test your basic knowledge |

USMLE Step 1 Immunology

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Let me suggest you:

Browse all subjects

Browse all tests

Most popular tests

Major Subjects

Tests & Exams

Certifications

IT Skills

Business Skills

Soft Skills

Vocabulary

Languages

Engineering

Health Sciences

English

Math

Other Major Subjects

Browse all subjects

Browse all tests

Most popular tests