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 is passive immunity?
Previous transfusion; pregnant woman whose fetus had paternal antigens
Receiving preformed Antibodies
not Ab mediated
IgG and IgM bind to pathogens activating C1 convertase and leads to C2 and C4 and then C3 convertase activated

2. What cytokines to Th2 secrete?
IL 4 - 5 - 10 - 6
False! B cell class switching requires a second signal
opsonizes
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels

3. What is the pathogenesis of a hypersensitivity reaction?
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
Yes
IL 4
Cross link antigens which increases their phagocytability; activate complement for MAC attack; opsonization; neutralization

4. What is the defect in Leukocyte adhesion defect? What is the presentation? What are the labs?
IgM and IgG
Leukocyte adhesion defect; ataxia telangietasia; ataxia telangiectasia; chediak higashi syndrome; IgA def; Digeorge syndrome; Jobs; Chediak Higashi
Cytokine release syndrome due to initial release from initial binding (fever etc) and hypersensitivity reaction
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

5. what happens in a deficiency of C5- C8? why dont you get recurrent pyogenic infections like in C3 def?
Proteins; IgG - IgM - endotoxin (microbial surfaces in general - nonspecific ones also) - mannose binding Lectin; classic - alternative - MB pathway (resp)
Interferon gamma and IL 2
Septicemia with neisseria; because at least you have C3 to act like a neutrophilic chemotactic and an acute phase reactant
Antidote for digoxin intoxication

6. Name three things that IL 1 does as a cytokine. other than the liver - who secretes IL 1
Induces fever - chemokine secretion to recruit - activates adhesion molecules; macrophages
Anti viral and anti tumor
Recomb cytokine of GCSF (granulocyte macrophage colony stimulating factor; for recovery of bone marrow
Alternative splicing of mRNA

7. where do NK cells develop?
Not thymus - BM
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
mesenchymal
Bind FcG for antibody dependent cellular cytotoxicity

8. What bugs can actually infect the lymph node itself?
Mycobacterium Tuberculosis - Mycobacterium Avium Intracellulare; Toxoplasmosis Gondii
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies
Antiviral by inducing ribonuclease which degrades only viral mRNA (prevents protein synthesis) and activates NK cells to kill virus infected cells
Chronic granulomatous disease

9. How does complement link innate and adaptive?
Type III hypersensitivity where an internal antigen antibody complexes activate classical complement pathway resulting in C3a neutrophilic chemotaxis and neutrophilic lysosomal death. SLE
Cross link antigens which increases their phagocytability; activate complement for MAC attack; opsonization; neutralization
Adaptive uses classic pathway to kill; innate uses alternative pathway to kill
Internal iliac

10. What is the main cytokine released by T cells? What does it do
IgM and IgG
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells
IL 3; supports growth and differentiation of bone marrow stem cells
Previous transfusion; pregnant woman whose fetus had paternal antigens

11. what else does interferon gamma do other than inducing ribonuclease production - activating NK cells - inducing increased MHC expression?
Activate macrophages
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
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!
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

12. What lymph node drains the upper limb?
T cell activation; no with CD 4 or CD 8
encapsulated
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
Axillary

13. What do macrophages secrete that activate Th1 cells to secrete interferon gamma?
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
TNF alpha and IL1
IgA
Antigliadin - antiendomysial (both are IgAs - anti tissue transgluataminase igA)

14. What are the three types of lymphocytes?
carboxy terminal
Anti topoisomerase
B - T - and NK cells
Immunosuppression after kidney transplantation

15. hat is the presentation of Jobs syndrome or Hyper IgE?
Anti nuclear Antibodies (ANA); Anti dsDNA - anti Smith
Coarse Faces - cold (noninflamed d/t inability to attract neutrophils) staph abscesses - retained primary teeth - high igE - dermatologic problems (eczema)
If there is class switching and plasma cell production (that is when memory cells are produced)
All MHC 1/CD8

16. Which HLA's are included in MHC I? MHC II?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

17. The alternative pathway is the only constutively...
active complement pathway
IL 15; IL 12 - interferon Beta and interferon alpha
When you select for which MHC it will have; take out the lymphs that self react
Hyperacute; presence of preformed antibodies in the recipient ( to blood groups or HLA )

18. What are the autoantibodies for graves?
Anti TSh receptor
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
isotype
Patient has had previous exposure to blood products which result in presence of preformed anti HLA cytotoxic Abs

19. How is the thymus organized? what happens in each section?
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
A - B - C; all the D's
IL 4 -5 -6 for B cell class switching - IL 10 to inhibit TH1
Anti glutamate carboxylase and anti insulin

20. which antibody activate mast cells - basophils - and eosinophils?
IgM
IgE
When you select for which MHC it will have; take out the lymphs that self react
Recom IL 11; thrombocytopenia

21. IgE has the ___________ in the serum
lowest concentration
Th1; interferon gamma; IL 2 for cytotoxic T cell activation
Antimicrosomal and antithyroglobulin
Vasculitis of graft vessels with dense interstitial lymphocytic infiltrate; yes! with immunosuppressants

22. What are the two signals required for B cell class switching? Which is the second signal?
CD40 (on b cell) CD40 ligand on Th2 cell; and interleukins (4 -5 -6) from Th2 cell; CD40 is actually the second signal
IL 4 -5 -6 for B cell class switching - IL 10 to inhibit TH1
IL 4
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

23. What lymph node drains the sigmoid colon?
Inferior mesenteric
C - ANCA (antiproteinase); in neutrophil; c= cytoplasmic
IgE
IL 3; supports growth and differentiation of bone marrow stem cells

24. What is the pathology seen in chronic transplant rejection?
Fc
Induce differentiation of T cells into Th1 helper cells and activates NK cells also; B cells
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection
Fibrosis of blood vessels and graft tissue from ischemia; obliterative vascular fibrosis with intimal thickening

25. What is the thymus ? Where is it located? is it encapsulated? How many lobes does it have?
Superficial inguinal
Defect in CD40L results in inability to class switch; a lot of IgM and no IgG - A - E
The place of T cell diff and maturation; ant mediastinum above heart; yes; 2
TCR - CD4/8 - CD28 (binds B7) - CD3 (for intracellular transduction) - CD40L

26. Type IV hypersensitivity is i...
Its involved in inflammation and results in anaphylaxis and neutrophil chemotaxis.
DM type I
not Ab mediated
Secretory component

27. What cytokines do macrophages release? who else can secrete IL 6? IL 12?
Celiac
Anti Ach receptor
IgE; by activating eosinophils
IL 1 - IL 6 - IL 12 - TNF alpha; IL 6- Th2 cells; IL 12- B cells

28. What are the mediators that mast cells release?
Histamine (causes vasodilation) - leukotrienes (causes bronchoconstriction) - chemotaxins for eos - and heparin (increased blood flow needs to be anticoagulated!)
Complement activation (active in both)
Chronic granulomatous disease
Patient has had previous exposure to blood products which result in presence of preformed anti HLA cytotoxic Abs

29. What is Aldesleukin? What is it used for
A recomb cytokine of IL 2; RCC and metastatic melanoma
Ig - CD19 - CD20 - CD21 - CD40 - MHC II - B7
CRP - C3b - IgM
Hereditary angioedema; PNH

30. which antibody is involved in the primary response or immediate response to an antigen?
Daclizumab; prevent ACUTE rejection of renal transplant
IgM
pathogenesis
Hereditary angioedema; PNH

31. Which is the main antibody in the delayed or secondary response to an antigen?
IgG
Local infection/inflammation; infection of the ln itself; metastasis
Celiac
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection

32. Which disease is associated with B8?
HBV - HBC - Kaposis - leukemias - malignant melanoma - hairy cell leukemia and condyluma accuminata
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Graves
Bind FcG for antibody dependent cellular cytotoxicity

33. What is the most common example of passive immunity?
Cytokine release syndrome due to initial release from initial binding (fever etc) and hypersensitivity reaction
IgAs in mothers breast milk!
Periarteriolar lymphatic sheath in the white pulp that surround that dead end of the capillaries in the red pulp - contain T cells
IL 3; supports growth and differentiation of bone marrow stem cells

34. What is the main function of IL 12? other than macrophages who else can release IL 12?
Anti alpha subunit 3 of collagen on type IV bm
isotype
Kill them because they have CD16 on them that recognize the FcG portion
Induce differentiation of T cells into Th1 helper cells and activates NK cells also; B cells

35. What are the T cell functions?
Anemias (esp due to renal failure)
...
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection
Axillary

36. What does interferon gamma do to be antiviral?
Increases expression of MHC I and MHC II and also activates NK cells
Secretory component
Isotype switching (activated by Th2 cell signals and cytokines) - somatic hypermutation
Nuclear remnants that are usually taken out of RBC before complete maturation by Macrophages

37. What is the clinical use of Muromonab?
Trypanosomes with programmed rearrangement (results in recurring fever -- sleeping sickness!)
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Immunosuppression after kidney transplantation
Celiac

38. what will NK cells do to cells covered in IgG Ab? why?
Hours later (instead of minutes); instead of release of preformed mediators - mast cells synthesize PGs and LTs that mediate the late phase reaction (edema - inflammation - decreased airflow)
Increases expression of MHC I and MHC II and also activates NK cells
Kill them because they have CD16 on them that recognize the FcG portion
Induces fever - chemokine secretion to recruit - activates adhesion molecules; macrophages

39. Often bacteria are associated with being killed by humoral immunity. Name some bugs that require cell mediated immunity because they evade humoral response
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
Legionella - N. gonorrhea - L. monocytogenes - viruses - protozoa (leismaniasis)
pathogenesis
Anemias (esp due to renal failure)

40. What are the autoantibodies for myasthenia gravis?
Anti Ach receptor
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)
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
Mediates septic shock; activates the endothelium for adhesion and dilation and leukocyte recruitment results in vascular leak

41. DTH (delayed type hypersensitivity) is the ________ of a PPD reaction
...
pathogenesis
Immunosuppression after kidney transplantation in combination with cyclosporine and corticosteroids
Antiviral by inducing ribonuclease which degrades only viral mRNA (prevents protein synthesis) and activates NK cells to kill virus infected cells

42. Which disease is associated withB B27?
Scratch test - histamine mediated wheal; radioimmunosorbent assay (detects specific IgEs in serum)
T cell activation; no with CD 4 or CD 8
TLR ad nuclear receptors
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies

43. How does the alternative pathway lead to MAC activation?
T cells react to the angtigen and activate leukocyted (macrophage acitivation)
Carbohydrate
Its main effect is a defect in Ab opsonization for killing
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

44. What is the mechanism for sirolimus? what else it known as?
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
Superficial inguinal
Basophils! THey want IG E class switch!
Binds to Mtor which (like tacrolimus and cyclosporine just in a different pathway) inhibits IL 2 production and thus t cell proliferation in response to IL 2 producton

45. Which diseases are associated with DR5?
Brain - eyes - placenta/fetus - testicles; because they can have an antigen in there and not get attacked by immune system because dont have contact with immune system via blood and lymph; if an infection occurs such that trauma results in exposure t
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)
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
Pernicious Anemia and Hashimotos

46. Which diseases are associated with DR4?
Immune complex - Arthus reaction and Serum sickness; they are all a result of antibody- antigen complex deposition resulting in complement activation
IL 4 -5 -6 for B cell class switching - IL 10 to inhibit TH1
DM type I and RA
IgM and IgA

47. What is the most common selective Ig deficiency? What is the presentation?
Delayed type hypersensitivity
Interferon gamma and IL 2
IgA; sinus and lung infections from lack of secretory defense - milk allergies and diarrhea from giardiasis; Anaphylasix on exposure to blood products with igA
Scratch test - histamine mediated wheal; radioimmunosorbent assay (detects specific IgEs in serum)

48. What is the presentation of scid? treatment?
Anti viral and anti tumor
AR; defect in MT function results in decreased transport and phagocytosis; recurrent pyogenic infections by staphylococci and streptococci - partial albinism - and peripheral neuropathy
Recurrent infections to every type of antigen; bone marrow transplant (be weary of GVH disease!)
SP infections

49. What are the function of B cells?
An anaphylactic immediate reaction; atopy refers to the inherited propensity to develop asthmatic or allergic reactions
Make antibody - allergy type 1 (igE) - Cytotoxic and immunecomplex hypersensitivity type II and III (igG); hyperacute organ rejection is Ab mediated
Histamine (causes vasodilation) - leukotrienes (causes bronchoconstriction) - chemotaxins for eos - and heparin (increased blood flow needs to be anticoagulated!)
Acts as second signal on B cells to induce class switching to IgA; also stimulates eosinophils

50. What is recomb gamma interferon used for?
Wiskott Aldrich syndrome
Activates Macrophages and Th1 cells; suppresses Th2 cells; antiviral and antitumor
Chronic granulomatous disease
Proteins; IgG - IgM - endotoxin (microbial surfaces in general - nonspecific ones also) - mannose binding Lectin; classic - alternative - MB pathway (resp)

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