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. Describe complement dependent Type II hypersensitivity. Give an example.
...
not Ab mediated
IgM or IgG antibodies coat the antigen and result in activation of MAC complex via the classical pathway OR fixed macrophages in the spleen phagoctyose the opsonized (C3b or igG) antigens - ex penicillin reaction; IgM AIHA - anti B IgMs in a group A
Anti alpha subunit 3 of collagen on type IV bm

2. Which type of selection of thymic development provides central tolerance?
secondary
Negative selection
Superficial inguinal
CGD; Jobs syndrome (defect in Neutrophil chemotactic response)

3. For which toxins are preformed antibodies (passive) given?
Tetanus - Botulinum - HBV - Rabies
Lack of response from lymphocytes when activated; because they are self reactive - this is a form of tolerance
Hemochromatosis
T cell dysfunction

4. The pathogenesis of contact dermatitis is ________ hypersensitivity
Nuclear remnants that are usually taken out of RBC before complete maturation by Macrophages
Superficial inguinal
IgAs in mothers breast milk!
type four

5. What part of the complement system also acts as an opsonin? What is opsonization? can you Name two other opsonins?
A chemotactic factor for neutrophils
Anti viral and anti tumor
active complement pathway
C3b; coating of a pathogen with molecules that promotes phagocytosis; IgG and CRP

6. What do multimeric antibodies require for assembly?
dimer
T cell activation; no with CD 4 or CD 8
CGD; Jobs syndrome (defect in Neutrophil chemotactic response)
A j chain

7. What cytokines are released by Th1 cells?
HBV - HBC - Kaposis - leukemias - malignant melanoma - hairy cell leukemia and condyluma accuminata
First a B cell gets sensitized to an allergen - after sensitization - it gets induce by Th2 secreting IL4 to class switch from IgM to IgE - next time blood stream is exposed to allergen these antigens cross like IgEs on mast cells and result in chemi
Interferon gamma and IL 2
Receiving preformed Antibodies

8. What do mature naive B lymphocytes express?
Internal iliac
Anti IF
IgM and IgD
Pernicious Anemia and Hashimotos

9. What is the pathogenesis of chronic transplant rejection? When does it occur? is it reversible?
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells
acute phase reactants
Anticentromere; anti Scl -70 (anti DNA topoisomerase I)
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 :(

10. What lymph node drains the scrotum?
False! B cell class switching requires a second signal
Axillary
Superficial inguinal
Monoclonal Ab to CD3- blocks cellular transduction and signaling of T cells

11. what secretes IL 4?
Basophils! THey want IG E class switch!
From self; from identical twin or clone; from nonidentical individual of same species; from different species; fetus; pig valve
Vasculitis of graft vessels with dense interstitial lymphocytic infiltrate; yes! with immunosuppressants
Macrophages - Dendritic cells - B cells

12. Which disease is associated with DR3?
Complement activation (active in both)
DM type I
opsonizes
IgM or IgG antibodies coat the antigen and result in activation of MAC complex via the classical pathway OR fixed macrophages in the spleen phagoctyose the opsonized (C3b or igG) antigens - ex penicillin reaction; IgM AIHA - anti B IgMs in a group A

13. What are the autoantibodies for pernicious anemia?
Anti smooth muscle
Anti IF
N. meningitidis - H. influenzae - S. pneumonia - Salmonella d/t lack of C3b opsonization for MAC d/t lack of complement activation d/t lack of IgM; MAC is needed by encapsulated avoid by humoral and cell mediated through their capsule
Fibrosis of blood vessels and graft tissue from ischemia; obliterative vascular fibrosis with intimal thickening

14. What are howell jolly bodies?
Nuclear remnants that are usually taken out of RBC before complete maturation by Macrophages
Adaptive uses classic pathway to kill; innate uses alternative pathway to kill
Type IV
If there is class switching and plasma cell production (that is when memory cells are produced)

15. How fast does it occur?
The patient could become cyanotic in the OR!
Graves
...
False! B cell class switching requires a second signal

16. Which disease is associated with DR7?
Th1; interferon gamma; IL 2 for cytotoxic T cell activation
Steroid responsive nephrotic syndrome
An acidified endosome with the antigen fuses with the MHC which causes the release of the invariant chain Which is sitting in spot of antigen and stabilizing the MHC II
Pernicious Anemia and Hashimotos

17. What does IL 10 do? who is secreted by?
Local infection/inflammation; infection of the ln itself; metastasis
TCR - CD4/8 - CD28 (binds B7) - CD3 (for intracellular transduction) - CD40L
Suppresses immune response (also specifically Th1 cells) and activates Th2; regulatory T cells
Lack of response from lymphocytes when activated; because they are self reactive - this is a form of tolerance

18. What are complements in the complement system? What activates them? there seems to be different ones - What are these pathways called?
Proteins; IgG - IgM - endotoxin (microbial surfaces in general - nonspecific ones also) - mannose binding Lectin; classic - alternative - MB pathway (resp)
Lack of MHC class I constant region which it binds or a nonspecific activation signal (TLR)
Hereditary angioedema; PNH
Fc

19. T/F B cells do not require a second signal
Stimulate the liver to release acute phase reactants
Edema and necrosis in that region
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
False! B cell class switching requires a second signal

20. What are the autoantibodies for myasthenia gravis?
Anti Ach receptor
A j chain
Pernicious Anemia and Hashimotos
Legionella - N. gonorrhea - L. monocytogenes - viruses - protozoa (leismaniasis)

21. What is the main function of interferons?
A j chain
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection
Immunosuppression after kidney transplantation in combination with cyclosporine and corticosteroids
Antiviral for uninfected cells (for future protection) and kills virally infected cells (NK activation)

22. What cytokines do macrophages release? who else can secrete IL 6? IL 12?
DM type I
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells
Cytokine IL 10 secreted by Th2
1) VJ light chain random creation 2) VDJ (heavy chain) random creation 3) random combination of light with heavy 4) somatic hypermutation (high frequency mutating that occurs on activation) 5) terminal deoxynucleotidyl transferase (TDT) random additi

23. in which immunodef order do you see a lot of pus? no pus?
Axillary
Th cells fail to produce interferon gamma; a lot of IgE
Activates Th1 helper cells; Macrophages
CGD; Jobs syndrome (defect in Neutrophil chemotactic response)

24. What does CD16 on NK cells do?
Induce differentiation of T cells into Th1 helper cells and activates NK cells also; B cells
Scratch test - histamine mediated wheal; radioimmunosorbent assay (detects specific IgEs in serum)
Anti Ach receptor
Bind FcG for antibody dependent cellular cytotoxicity

25. Name two endogenous pyrogens
DM type I
Inferior mesenteric
IL 1 and IL 6
Chronic granulomatous disease

26. What is the pathology seen in chronic transplant rejection?
Fibrosis of blood vessels and graft tissue from ischemia; obliterative vascular fibrosis with intimal thickening
Carbohydrate
Antibody mediated cytotoxicity; either complement dependent or complement independent
neutrophilia!

27. What is recomb gamma interferon used for?
Cells that stil have weird parts of their membrane that macrophages usually bite off
Anti glutamate carboxylase and anti insulin
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells
Chronic granulomatous disease

28. where are complements produced?
A - B - C; all the D's
Liver! (they are proteins circulating in the blood)
IgA; sinus and lung infections from lack of secretory defense - milk allergies and diarrhea from giardiasis; Anaphylasix on exposure to blood products with igA
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

29. What are the autoantibodies for type I diabetes mellitus?
Patient has had previous exposure to blood products which result in presence of preformed anti HLA cytotoxic Abs
Negative!
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
Anti glutamate carboxylase and anti insulin

30. where do NK cells develop?
IL 3; supports growth and differentiation of bone marrow stem cells
The patient could become cyanotic in the OR!
Not thymus - BM
Anti glutamate carboxylase and anti insulin

31. What links the adaptive and innate immunity?
Complement activation (active in both)
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
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
IgG

32. What is the most common selective Ig deficiency? What is the presentation?
TGF beta and IL 10
Hyperacute; presence of preformed antibodies in the recipient ( to blood groups or HLA )
IgA; sinus and lung infections from lack of secretory defense - milk allergies and diarrhea from giardiasis; Anaphylasix on exposure to blood products with igA
Alternative splicing of mRNA

33. What is the cause of thymic aplasia? What is its presentation? What are the labs?
Antidesmoglein
Stimulate the liver to release acute phase reactants
Digeorge syndrome - 22q11 deletion resulting in failure to develop 3rd and 4th pharyngeal pouches; cardiac and great vessel congenital defects - tetany from hypocalcemia - recurrent viral/fungal infections from T cell deficiency; hypoPTH - hypoCa - a
Activates Th1 helper cells; Macrophages

34. What is the pathogenesis of chronic granulomatous disease; What is the presentation? What is the labs?
Lack of NADPH oxidase results in a lack of respiratory burst in neutrophils; susceptibility to catalase positive organisms (S. aureus - E. Coli - Aspergillus)
active complement pathway
acute phase reactants
Active; passive - fast but short half life (3 weeks!)

35. What two ways do you test for a type 1 hypersensitivity reaction? what will you see?
IgA
Scratch test - histamine mediated wheal; radioimmunosorbent assay (detects specific IgEs in serum)
Fibrosis of blood vessels and graft tissue from ischemia; obliterative vascular fibrosis with intimal thickening
IL 4 - 5 - 10 - 6

36. which of the transplant rejections is antibody mediated? why does it occur?
Recom IL 11; thrombocytopenia
DM type I
Hyperacute; presence of preformed antibodies in the recipient ( to blood groups or HLA )
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

37. What are the two signals required for T cells? what happens after?
IgG and IgM bind to pathogens activating C1 convertase and leads to C2 and C4 and then C3 convertase activated
IgM or IgG antibodies coat the antigen and result in activation of MAC complex via the classical pathway OR fixed macrophages in the spleen phagoctyose the opsonized (C3b or igG) antigens - ex penicillin reaction; IgM AIHA - anti B IgMs in a group A
Fab portion
MHC I/CD8 and IL2/IL 2 Receptor (IL 2 is from Th1!); cytoxicity!

38. what happens in a deficiency of C1 esterase inhibitor? DAF?
MHC I; from RER with help of the B2 microglobulin
Th1; interferon gamma; IL 2 for cytotoxic T cell activation
Hereditary angioedema; PNH
MHC class molecules bind to KIRS or CD94 to prevent killing

39. Which disease is associated with B8?
Graves
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection
Th cells fail to produce interferon gamma; a lot of IgE
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels

40. What cytokines to Th2 secrete?
Type III hypersensitivity where an internal antigen antibody complexes activate classical complement pathway resulting in C3a neutrophilic chemotaxis and neutrophilic lysosomal death. SLE
Activates Th1 helper cells; Macrophages
IL 4 - 5 - 10 - 6
1) susceptibility to encapsulated organisms 2) Howell Jolly Bodies 3) Target cells 4) Thrombocytosis

41. What is the monoclonal antibody to IL2 on activated T cells? What is it used for?
Antigliadin - antiendomysial (both are IgAs - anti tissue transgluataminase igA)
IgM and IgD
Edema and necrosis in that region
Daclizumab; prevent ACUTE rejection of renal transplant

42. What lymph node drains the rectum (above the pectinate line)?
Defect in BTK a tyrosine kinase gene; failed maturation of B cells; X linked recessive
IgAs in mothers breast milk!
The place of T cell diff and maturation; ant mediastinum above heart; yes; 2
Internal iliac

43. What are the main Cell surface proteins on T cells?
1) susceptibility to encapsulated organisms 2) Howell Jolly Bodies 3) Target cells 4) Thrombocytosis
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection
Activate macrophages
TCR - CD4/8 - CD28 (binds B7) - CD3 (for intracellular transduction) - CD40L

44. The lymphocytes are ________ origin
mesenchymal
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)
Anti alpha subunit 3 of collagen on type IV bm
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear

45. What is the end result of complement activation? what bugs are this important for? through what pathway and why?
IgM
MAC (membrane attack complex) Which is activated by C5b - C9 and results in lysis and cytoxicity by creating pores in the target membrane; encapsulated organisms (S. pnuemonia - H.influenzae - B perfussis for example) and other organisms with non pep
opsonizes
Basophils! THey want IG E class switch!

46. What is hereditary angioedema? What are the C3 levels?
Acts as second signal on B cells to induce class switching to IgE and IgG
Previous transfusion; pregnant woman whose fetus had paternal antigens
opsonizes
Aut. Dominant; C1 esterase inhibitor deficiency resulting in continued C1 which results in increased C2 and C4 cleavage products which have anaphyltoxic activity and result in swelling of face and oropharynx

47. Which Thelper cell activated Macrophages? by secreting what? what else does Th1 secrete? For what?
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
Histamine; post capillary venules - vasodilation
Th1; interferon gamma; IL 2 for cytotoxic T cell activation
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)

48. IgM can fix complement but...
Antiviral for uninfected cells (for future protection) and kills virally infected cells (NK activation)
cannot cross placenta
Bind FcG for antibody dependent cellular cytotoxicity
lowest concentration

49. what bacteria are a splenectomy patient most susceptible to? why?
N. meningitidis - H. influenzae - S. pneumonia - Salmonella d/t lack of C3b opsonization for MAC d/t lack of complement activation d/t lack of IgM; MAC is needed by encapsulated avoid by humoral and cell mediated through their capsule
DM type I
IgM and IgG
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)

50. How does igA cross the epithelium?
secondary
Soluble C3 spontaneously hydrolyzes spontaneously to C3b and opsonizes microbial and host cell surfaces and accumulates on surfaces; C3b activates C5 convertase which leads to MAC activation
neutrophilia!
By transcytosis

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