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. Which diseases are associated with DR4?
Anti Ach receptor
DM type I and RA
Anti IF
Alternative splicing of mRNA

2. What is the thymus ? Where is it located? is it encapsulated? How many lobes does it have?
Macrophages - Dendritic cells - B cells
The place of T cell diff and maturation; ant mediastinum above heart; yes; 2
IL 4 - 5 - 10 - 6
Septicemia with neisseria; because at least you have C3 to act like a neutrophilic chemotactic and an acute phase reactant

3. What are the main Cell surface proteins on T cells?
Previous transfusion; pregnant woman whose fetus had paternal antigens
TCR - CD4/8 - CD28 (binds B7) - CD3 (for intracellular transduction) - CD40L
Fab portion
Glycoproteins; HLA

4. What does interferon gamma do to be antiviral?
pathogenesis
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
Anti viral and anti tumor
Increases expression of MHC I and MHC II and also activates NK cells

5. What is muromonab - CD3 (OKT3)
Antidesmoglein
From self; from identical twin or clone; from nonidentical individual of same species; from different species; fetus; pig valve
Monoclonal Ab to CD3- blocks cellular transduction and signaling of T cells
...

6. Which antibodies can be multimeric?
Interferon gamma; Th1
IgM and IgA
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies
opsonizes

7. explain the process from beginning (ie phagocytosis of the peptide) to end of how Abs are formed in Goodpasteurs.
For some reason a mature naive B lymphocyte got away from tolerance and the result was a production an Ab on its surface with an Fab region that recognized the alpha 3 collagen subunit on the BM as non self. It then gets activated by a Th2 cell (enti
Hyperacute; presence of preformed antibodies in the recipient ( to blood groups or HLA )
Histamine (causes vasodilation) - leukotrienes (causes bronchoconstriction) - chemotaxins for eos - and heparin (increased blood flow needs to be anticoagulated!)
C3b; coating of a pathogen with molecules that promotes phagocytosis; IgG and CRP

8. What are the two signals required for Th1 cells? what happens after then activated?
Defect in B cell maturation; idiopathic - presents at older age and normal number of B cells and hyperplastic germinal centers because B cells can be activated but can not produce Abs
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
MHC II/CD4 and B7 (on APC) and CD28 (on Th cell); releases cytokines to kill those extracellular buggers!

9. What are the symptoms of serum sickness?
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
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
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
Surrounds the red pulp and begins with PALS and then turns into follicles with B cells/follicles

10. What is the presentation of scid? treatment?
Paracortex
Recurrent infections to every type of antigen; bone marrow transplant (be weary of GVH disease!)
Th1; interferon gamma; IL 2 for cytotoxic T cell activation
Activate macrophages

11. How fast does it occur?
IgA
The patient could become cyanotic in the OR!
Antigliadin - antiendomysial (both are IgAs - anti tissue transgluataminase igA)
Anti IF

12. What do multimeric antibodies require for assembly?
Anti mitochondrial
A j chain
IL 1 and IL 6
Anti SS- A (anti RO) and Anti SS- B

13. What is the monoclonal antibody to IL2 on activated T cells? What is it used for?
Daclizumab; prevent ACUTE rejection of renal transplant
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
IgAs in mothers breast milk!
Hemochromatosis

14. What is recomb beta interferon used for?
A - B - C; all the D's
IgE; by activating eosinophils
Both decrease cd8 tcell prolif but one through mtor and the other through calcineurin (resp)
MS

15. Which disease is associated with DR3?
Proteins; IgG - IgM - endotoxin (microbial surfaces in general - nonspecific ones also) - mannose binding Lectin; classic - alternative - MB pathway (resp)
DM type I
Severe recurrent pyogenic sinus and resp tract And increased susceptibility to type III hypersensitivity like SLE
Cyclosporine - OKT3

16. What lymph node drains the anal canal (below the pectinate line)?
Kill them because they have CD16 on them that recognize the FcG portion
IgM and IgA
Superficial inguinal
The igA found in breast milk

17. What is wiskott aldrich syndrome? What is its mode of inheritance? What is the pathogenesis of disease? What is its triad of presentation? what labs does it present with?
Humoral
isotype
MHC I; from RER with help of the B2 microglobulin
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

18. What lymph node drains the scrotum?
Superficial inguinal
Defect in CD40L results in inability to class switch; a lot of IgM and no IgG - A - E
C3b; coating of a pathogen with molecules that promotes phagocytosis; IgG and CRP
Severe pyogenic infections early in life

19. What is the receptor for EBV? On what cells is that located?
A - B - C; all the D's
CD21 on B cells (although there is T cell lymphocytosis in EBV)
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
not Ab mediated

20. what cell surface proteins are on all APCs?
MHC II - B7
NK cells
MS
Hereditary angioedema; PNH

21. IgM can fix complement but...
IgG
Its a serine protease that activates apoptosis; NK and CD8
cannot cross placenta
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 :(

22. Which diseases are associated with DR2?
Induce differentiation of T cells into Th1 helper cells and activates NK cells also; B cells
MS - hay fever - SLE - goodpastures
Defect in CD40L results in inability to class switch; a lot of IgM and no IgG - A - E
Sinusitis - otitis media - pneumonia

23. What is hereditary angioedema? What are the C3 levels?
mesenchymal
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
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
Intracellular pathogens (acute and chronic viruses and virally induced cancers)

24. What lymph node drains the rectum (above the pectinate line)?
Internal iliac
When you select for which MHC it will have; take out the lymphs that self react
Suppresses immune response (also specifically Th1 cells) and activates Th2; regulatory T cells
2 heavy chains and two light chains

25. What is the toxicity of azathioprine?
Humoral
Cyclosporine - OKT3
...
A j chain

26. which of the transplant rejections is antibody mediated? why does it occur?
cannot cross placenta
Lack of NADPH oxidase results in a lack of respiratory burst in neutrophils; susceptibility to catalase positive organisms (S. aureus - E. Coli - Aspergillus)
Hyperacute; presence of preformed antibodies in the recipient ( to blood groups or HLA )
Glycoproteins; HLA

27. What are the autoantibodies for primary biliary cirrhosis?
Anti mitochondrial
Defect in B cell maturation; idiopathic - presents at older age and normal number of B cells and hyperplastic germinal centers because B cells can be activated but can not produce Abs
No because no peptide fragment!
acute phase reactants

28. Which disease is associated with B8?
Th1; interferon gamma; IL 2 for cytotoxic T cell activation
C5a
Anti smooth muscle
Graves

29. describe the pathogenesis of delayed type IV hypersensitivity
IL 4
T cells react to the angtigen and activate leukocyted (macrophage acitivation)
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Superior mesenteric

30. What is the presentation of Brutons agammaglobulinemia?
An alpha and beta chain; only on APCs; TCR and CD4; extracellular (phagocytosed by APCs)
In IgE AIHA- it results in MAC attack (remember IgE is not an opsonin!) - in IgG AIHA C3b (and IgG) opsonization results in phagocytosis by fixed macrophages in the spleen
pentamer
Recurrent sinopulmonary bacterial infections after 6 months (d/t mothers igGs transplacental) due to opsonization defect

31. What lymph node drains the sigmoid colon?
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
Anti Ach receptor
delayed!
Inferior mesenteric

32. What is the marginal zone of the spleen? what happens there?
Antihistone
Found in the red pulp; contains the cords of billroth or the splenic parenchyma that have APCs/Macrophages that closely interact with the basement membrane of the vasculature and where RBCs squeeze through into the parenchyma and interact with Macrop
Negative nitroblue tetrazolium reduction test
Cytokine release syndrome due to initial release from initial binding (fever etc) and hypersensitivity reaction

33. T/F B cells do not require a second signal
Para aortic
False! B cell class switching requires a second signal
RNA segment reassortment
Kill them because they have CD16 on them that recognize the FcG portion

34. What are the autoantibodies for autoimmune hepatitis?
Anti smooth muscle
IgE; by activating eosinophils
Lack of MHC class I constant region which it binds or a nonspecific activation signal (TLR)
Mycobacterium Tuberculosis - Mycobacterium Avium Intracellulare; Toxoplasmosis Gondii

35. What is colostrum?
Ig - CD19 - CD20 - CD21 - CD40 - MHC II - B7
The igA found in breast milk
An alpha and beta chain; only on APCs; TCR and CD4; extracellular (phagocytosed by APCs)
Anemias (esp due to renal failure)

36. Complements are...
TGF beta and IL 10
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)
acute phase reactants
S. aureus - E. Coli - aspergillus

37. when can graft versus host disease? What is the result?
1) susceptibility to encapsulated organisms 2) Howell Jolly Bodies 3) Target cells 4) Thrombocytosis
In any situation where immunologically competent cells are transplanted into immunologically crippled recipient; graft rejects all the cells due to foreign proteins resulting in severe organ dysfunction
Yes
Increases expression of MHC I and MHC II and also activates NK cells

38. What are the main symptoms of T cell immunodeficiencies?
Intracellular pathogens (acute and chronic viruses and virally induced cancers)
Chronic granulomatous disease
Local infection/inflammation; infection of the ln itself; metastasis
Maculopapular rash (palm - soles - back - neck) - jaundice with bile duct necrosis - hepatosplenomegaly - diarrhea; bone marrow and liver transplants (rich with lymphocytes); SCID patient receiving whole blood transfusion

39. What portion of the lymph node is not well developed in DiGeorge Syndrome?
Paracortex
IL 4 - 5 - 10 - 6
Suppresses immune response (also specifically Th1 cells) and activates Th2; regulatory T cells
Not thymus - BM

40. What lymph node drains the testes?
Para aortic
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
IgG
Cells that stil have weird parts of their membrane that macrophages usually bite off

41. The alternative pathway is the only constutively...
Type III hypersensitivity where an internal antigen antibody complexes activate classical complement pathway resulting in C3a neutrophilic chemotaxis and neutrophilic lysosomal death. SLE
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
Edema and necrosis in that region
active complement pathway

42. Describe the capsular structure of a lymph node; What are the functions of the LN?
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
A B and T cell disorder; defect in DNA repair enzymes; ataxia - telangactasia and IgA def; igA def. and increased AFP
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
Anti Ach receptor

43. what results in symptoms of shock in an acute hemolytic transfusion reaction?
Since it is a comp dependent type II hypersensitivity reaction; C3a brings anaphylotoxins that bring in mediators of shock
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
type four
Secretory component

44. 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

45. are Th cells involved in trapping of antigens of endotoxin/LPS?
No because no peptide fragment!
Th2; Th1
pentamer
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

46. Which disease is associated withB B27?
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies
B - T - and NK cells
NK cells
Kill them because they have CD16 on them that recognize the FcG portion

47. In general What are T cells good for?
Anti viral and anti tumor
Activate B cells - activate Macrophages - kill viruses directly - delayed cell mediated hypersensitivity - acute and chronic rejection
Severe recurrent pyogenic sinus and resp tract And increased susceptibility to type III hypersensitivity like SLE
Rheumatic arthritis

48. The ______ in the BM are DN - the DP are in the cortex of thymus
IL 4 -5 -6 for B cell class switching - IL 10 to inhibit TH1
T cell precursor
Immunosuppression after kidney transplantation in combination with cyclosporine and corticosteroids
Hereditary angioedema; PNH

49. What are MHC Class molecules (ie what macromolecule are they made out of)? what gene are responsible for MHC?
Glycoproteins; HLA
Cell mediated due to T cell cytotoxicity reacting to foreign MHCs; few weeks after
Anticentromere; anti Scl -70 (anti DNA topoisomerase I)
Its a serine protease that activates apoptosis; NK and CD8

50. What is epo used for?
Anemias (esp due to renal failure)
Intracellular pathogens (acute and chronic viruses and virally induced cancers)
An alpha chain and a B2 microglobulin; on all nucleated cells; TCR and CD8; intracellular antigens
Fc

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