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 the classic complement pathway.
CRP - C3b - IgM
IL 4 - 5 - 10 - 6
IgG
IgG and IgM bind to pathogens activating C1 convertase and leads to C2 and C4 and then C3 convertase activated

2. What are C1 - C2 - C3 - C4 important for?
...
secondary
Trypanosomes with programmed rearrangement (results in recurring fever -- sleeping sickness!)
Viral neutralization of igM and IgG!

3. What is an example of a parasite showing antigenic variation?
Trypanosomes with programmed rearrangement (results in recurring fever -- sleeping sickness!)
...
TLR ad nuclear receptors
Kill them because they have CD16 on them that recognize the FcG portion

4. ________ regulate the cell mediated response.
Humoral
delayed!
HBV - HBC - Kaposis - leukemias - malignant melanoma - hairy cell leukemia and condyluma accuminata
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

5. What are the autoantibodies for other vasculitides?
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
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
Immune complex - Arthus reaction and Serum sickness; they are all a result of antibody- antigen complex deposition resulting in complement activation
type four

6. what happens in a deficiency of C1 esterase inhibitor? DAF?
Axillary
delayed!
Remove encapsulated bacateria
Hereditary angioedema; PNH

7. The MALT/GALT are not...
encapsulated
Chronic granulomatous disease
Th cells fail to produce interferon gamma; a lot of IgE
An alpha chain and a B2 microglobulin; on all nucleated cells; TCR and CD8; intracellular antigens

8. What are the function of B cells?
Superior mesenteric
Make antibody - allergy type 1 (igE) - Cytotoxic and immunecomplex hypersensitivity type II and III (igG); hyperacute organ rejection is Ab mediated
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
Recomb cytokine of GCSF (granulocyte macrophage colony stimulating factor; for recovery of bone marrow

9. Which TCR MHC system is important for viral immunity? neoplastic? donor graft cells?
Alternative splicing of mRNA
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
T cells react to the angtigen and activate leukocyted (macrophage acitivation)
All MHC 1/CD8

10. T/F B cells do not require a second signal
Type III hypersensitivity where an internal antigen antibody complexes activate classical complement pathway resulting in C3a neutrophilic chemotaxis and neutrophilic lysosomal death. SLE
Anti SS- A (anti RO) and Anti SS- B
IgG
False! B cell class switching requires a second signal

11. What is the receptor for EBV? On what cells is that located?
Superficial inguinal
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
CD21 on B cells (although there is T cell lymphocytosis in EBV)
IgA; sinus and lung infections from lack of secretory defense - milk allergies and diarrhea from giardiasis; Anaphylasix on exposure to blood products with igA

12. what bacteria are a splenectomy patient most susceptible to? why?
If there is class switching and plasma cell production (that is when memory cells are produced)
RNA segment reassortment
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
Interferon gamma and IL 2

13. Which disease is associated with DR3?
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
DM type I
MS
...

14. Which is the most abundant antibody in blood?
Since it is a comp dependent type II hypersensitivity reaction; C3a brings anaphylotoxins that bring in mediators of shock
Monoclonal Ab to CD3- blocks cellular transduction and signaling of T cells
IgG
T cell activation; no with CD 4 or CD 8

15. The Fc region is found on the...
Delayed type hypersensitivity
carboxy terminal
IL 3; supports growth and differentiation of bone marrow stem cells
IgAs in mothers breast milk!

16. What are the autoantibodies for Celiac disease?
IgE
Anti Ach receptor
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Antigliadin - antiendomysial (both are IgAs - anti tissue transgluataminase igA)

17. What is the most common example of passive immunity?
Anti viral and anti tumor
IL 3; supports growth and differentiation of bone marrow stem cells
Barrel hoop basement membrane fenestrations
IgAs in mothers breast milk!

18. What lymph node drains the testes?
Para aortic
secondary
An alpha chain and a B2 microglobulin; on all nucleated cells; TCR and CD8; intracellular antigens
IgE

19. What is the main function of IL 8?
carboxy terminal
Local infection/inflammation; infection of the ln itself; metastasis
2 heavy chains and two light chains
A chemotactic factor for neutrophils

20. What happens in a deficiency of C3?
No because no peptide fragment!
Severe recurrent pyogenic sinus and resp tract And increased susceptibility to type III hypersensitivity like SLE
Pernicious Anemia and Hashimotos
IgE

21. If the alternative pathway is constitively active - how come normal cells don't get attacked with MAC?
Th2; Th1
DAF and C1 esterase inhibitor on cells prevent complement activation on their surfaces (microbial surfaces lack this)
Sinusitis - otitis media - pneumonia
delayed!

22. in which immunodef order do you see a lot of pus? no pus?
Lack of NADPH oxidase results in a lack of respiratory burst in neutrophils; susceptibility to catalase positive organisms (S. aureus - E. Coli - Aspergillus)
isotype
CGD; Jobs syndrome (defect in Neutrophil chemotactic response)
Complement activation (active in both)

23. What is the main cytokine that activates eosinophils?
Normal pro B (CD 19 +) - no mature B cells results in decreased total B cell level - and decreased amount of immunoglobulins in each class
Cyclosporine and tacrolimus; sirolimus (as well as hyperlipidemia)
IL 5
Alternative splicing of mRNA

24. __________ are a part of the innate system.
Opsonize bacteria (for enhanced phagocytosis) - neutralize viruses (igG) - activate complement (igM and igG) - sensitize mast cells (igE)
Monoclonal Ab to CD3- blocks cellular transduction and signaling of T cells
NK cells
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

25. What is Aldesleukin? What is it used for
A recomb cytokine of IL 2; RCC and metastatic melanoma
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
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
False! B cell class switching requires a second signal

26. So antibodies are the effectors for the humoral response. List some of their functions.
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Cross link antigens which increases their phagocytability; activate complement for MAC attack; opsonization; neutralization
IL 4 - 5 - 10 - 6
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

27. What are the cell surface proteins for Macrophages? which two are for opsonins?
Remove encapsulated bacateria
Mycobacterium Tuberculosis - Mycobacterium Avium Intracellulare; Toxoplasmosis Gondii
MHC II - B7 - CD40 and CD14; CD40 and D14 for FcG and C3b resp
Adaptive uses classic pathway to kill; innate uses alternative pathway to kill

28. What is the monoclonal antibody to IL2 on activated T cells? What is it used for?
Liver! (they are proteins circulating in the blood)
S. aureus - E. Coli - aspergillus
Lymphocytes
Daclizumab; prevent ACUTE rejection of renal transplant

29. What lymph node drains the breast?
Axillary
Induce differentiation of T cells into Th1 helper cells and activates NK cells also; B cells
S. aureus - E. Coli - aspergillus
Daclizumab; prevent ACUTE rejection of renal transplant

30. Which diseases are associated with DR4?
except hyperacute
DAF and C1 esterase inhibitor on cells prevent complement activation on their surfaces (microbial surfaces lack this)
Defect in BTK a tyrosine kinase gene; failed maturation of B cells; X linked recessive
DM type I and RA

31. The lymphocytes are ________ origin
SP infections
Vasculitis of graft vessels with dense interstitial lymphocytic infiltrate; yes! with immunosuppressants
Antigliadin - antiendomysial (both are IgAs - anti tissue transgluataminase igA)
mesenchymal

32. Name 5 ways Antibody diversity is generated?
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
The patient could become cyanotic in the OR!
IL 4 - 5 - 10 - 6
IL 5

33. What is serum sickness? give an example.
Adenosine deaminase deficiency (AR) - defective IL 2 receptor (X linked) - and failure to synthesize MHC II; both humoral and cell mediated deficiency
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
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
From self; from identical twin or clone; from nonidentical individual of same species; from different species; fetus; pig valve

34. Which MHC presents intracellular peptides? how so?
In the germinal center of secondary follicles (In the paler center)
Acts as second signal on B cells to induce class switching to IgA; also stimulates eosinophils
MHC I; from RER with help of the B2 microglobulin
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

35. What is the most common selective Ig deficiency? What is the presentation?
T cell dysfunction
IgA; sinus and lung infections from lack of secretory defense - milk allergies and diarrhea from giardiasis; Anaphylasix on exposure to blood products with igA
All MHC 1/CD8
IL 5

36. Leukocyte adhesion defect presents with...
T cell dysfunction
neutrophilia!
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
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

37. What lymph node drains the scrotum?
Superficial inguinal
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
Nuclear remnants that are usually taken out of RBC before complete maturation by Macrophages
Cytokine IL 10 secreted by Th2

38. which B and T cell disorder presents with specifically low IgM?
Wiskott Aldrich syndrome
P - ANCA (antimyeloperoxidase); in neutrophil; p= perinuclear
AR; defect in MT function results in decreased transport and phagocytosis; recurrent pyogenic infections by staphylococci and streptococci - partial albinism - and peripheral neuropathy
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

39. What is the end result of complement activation? what bugs are this important for? through what pathway and why?
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
Anti alpha subunit 3 of collagen on type IV bm
Antihistone
Anti smooth muscle

40. IgE has the ___________ in the serum
Fever - urticaria - arthralgias - proteinuria - lymphadenopathy
An alpha and beta chain; only on APCs; TCR and CD4; extracellular (phagocytosed by APCs)
Mediates septic shock; activates the endothelium for adhesion and dilation and leukocyte recruitment results in vascular leak
lowest concentration

41. If an antigen lacks a peptide component How does the adaptive immunity attack it? What type of response is this called. give an example of bugs that do this. what implications does this have on splenectomy?
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 :(
Antidesmoglein
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
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies

42. What are the four steps in phagocytosis? What are the four disease that correspond to each step?
Glycoproteins; HLA
heavy chains
Opsonization (Brutons agammaglobulinemia) - adhesion (Leukocyte adhesion defect) - phagocytosis (chediak higashi syndrome) - respiratory burst (chronic granulomatous disease)
Secretory component

43. Give an example of someone who could get hyperacute transplant rejection.
mesenchymal
All MHC 1/CD8
Lack of NADPH oxidase results in a lack of respiratory burst in neutrophils; susceptibility to catalase positive organisms (S. aureus - E. Coli - Aspergillus)
Previous transfusion; pregnant woman whose fetus had paternal antigens

44. What lymph node drains the sigmoid colon?
Inferior mesenteric
Decreased Th1 response; disseminated mycobacterial infections; decreased interferon gamma
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
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

45. What is recomb beta interferon used for?
1) susceptibility to encapsulated organisms 2) Howell Jolly Bodies 3) Target cells 4) Thrombocytosis
In the germinal center of secondary follicles (In the paler center)
Anti SS- A (anti RO) and Anti SS- B
MS

46. where do NK cells develop?
Anti viral and anti tumor
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
Complement activation (active in both)
Not thymus - BM

47. What is the pathogenesis of a candida skin test?
Anti nuclear Antibodies (ANA); Anti dsDNA - anti Smith
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies
Activates cytotoxic CD 8 T cells as second signal
Delayed type hypersensitivity

48. What is the pathology in hyperacute transplant rejection?
Ischemia and necrosis of graft due to occlusion of vessels and fibrinoid necrosis and thrombosis within the vessels
Previous transfusion; pregnant woman whose fetus had paternal antigens
SP infections
Psoriasis - Ankylosis Spondylitis - IBD - Reiters; all seronegative spondylopathies

49. What is the marginal zone of the spleen? what happens there?
pathogenesis
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
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
2 heavy chains and two light chains

50. What lymph node drains the anal canal (below the pectinate line)?
MHC class molecules bind to KIRS or CD94 to prevent killing
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
Superficial inguinal
CD40 (on b cell) CD40 ligand on Th2 cell; and interleukins (4 -5 -6) from Th2 cell; CD40 is actually the second signal

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