1.
Innate defenses, Complement, Antigen and antibody structure and function
Toll-like receptors (TLR) are important activators of the innate immune system. Which of the following microbial substances activates TLR-4?
Correct Answer
B. Lipopolysaccaride
Explanation
TLR-4 is specifically activated by lipopolysaccharide (LPS), which is a component of the outer membrane of Gram-negative bacteria. LPS is recognized by TLR-4 and triggers an immune response, leading to the activation of innate defenses. Peptidoglycan is recognized by other TLRs, such as TLR-2, and activates a different pathway. Double stranded RNA is recognized by TLR-3, while single stranded RNA is recognized by TLR-7 and TLR-8. Bacterial flagella do not directly activate TLR-4.
2.
Patients with Leukocyte adhesion deficiency syndrome (LAD) are unable to produce the beta chain of the complement receptor 3 (CR3) heterodimer. Which of the following functions may be deficient in LAD patients?
Correct Answer
B. Opsonization of bacteria
Explanation
Patients with Leukocyte adhesion deficiency syndrome (LAD) are unable to produce the beta chain of the complement receptor 3 (CR3) heterodimer. Opsonization is the process of marking bacteria for phagocytosis by immune cells. Since LAD patients cannot produce the beta chain of CR3, which is involved in opsonization, their ability to opsonize bacteria may be deficient. This means that LAD patients may have difficulty in effectively marking bacteria for phagocytosis, leading to impaired immune response against bacterial infections.
3.
The activity of complement is dependent on the sequential activation of its components in a cascading fashion. Which of the complement activation pathways would be most severely affected by a defect in the synthesis of Factor D?
Correct Answer
A. The alternate pathway
Explanation
A defect in the synthesis of Factor D would most severely affect the alternate pathway of complement activation. Factor D is a crucial component in the alternate pathway, as it cleaves Factor B to generate the active fragment, which then combines with C3b to form the C3 convertase enzyme. Without Factor D, the alternate pathway cannot proceed, leading to a significant impairment in the activation of complement.
4.
A 70-year-old man is admitted to the hospital for recurrent lung infections with Streptococcus pneumonae. He has a history of chronic alcoholism and a 100 pack year smoking history. Extensive laboratory testing reveals that he cannot activate the alternate pathway of complement. A lung biopsy reveals numerous bacteria, but few leukocytes in the lung. Which of the following mediators is Most Likely deficient?
Correct Answer
C. C5a
Explanation
The patient's inability to activate the alternate pathway of complement suggests a deficiency in one of the mediators involved in this pathway. C5a is a potent chemotactic factor that attracts and activates neutrophils, which are responsible for phagocytosing bacteria. Therefore, a deficiency in C5a is the most likely explanation for the few leukocytes seen in the lung biopsy despite the presence of numerous bacteria.
5.
The complement cascade can be activated in a number of ways. Cobra venom factor (CVF) is one of these ways. Which pathway is activated by CVF?
Correct Answer
B. The alternative pathway
Explanation
The alternative pathway is activated by cobra venom factor (CVF). The alternative pathway is one of the three pathways of the complement cascade, along with the classical pathway and the lectin pathway. CVF specifically activates the alternative pathway, leading to the activation of complement proteins and the initiation of an immune response.
6.
A 23 year old female patient presents with a malar rash, joint pains and general malaise. Laboratory tests indicated the presence of anti-Sm and anti-ds DNA antibodies. If you were to measure the patients complement C2 and C4 levels, what might you expect?
Correct Answer
A. C4 and C2 would be lower than the normal range
Explanation
The presence of anti-Sm and anti-ds DNA antibodies, along with symptoms such as malar rash, joint pains, and general malaise, suggests a possible diagnosis of systemic lupus erythematosus (SLE). In SLE, there is often complement activation and consumption, leading to decreased levels of complement proteins such as C2 and C4. Therefore, it would be expected that C4 and C2 levels would be lower than the normal range in this patient.
7.
In complement activation, the mannan binding lectin (MBL) pathway is characterized by which of the following?
Correct Answer
B. MEL acts on Cl to produce C4b and C4a
8.
Which of the following immunoglobulin regions/domains determine the affinity, specificity and idiotype of the molecule?
Correct Answer
C. The light and heavy chain hypervariable domains
Explanation
The light and heavy chain hypervariable domains determine the affinity, specificity, and idiotype of the immunoglobulin molecule. These domains contain the most variable regions within the immunoglobulin molecule, allowing for a wide range of antigen recognition and binding. The hypervariable domains contribute to the diversity of immunoglobulin molecules and their ability to recognize and bind to specific antigens.
9.
V(D)) recombination events take place in the following cells
Correct Answer
E. CD4+ T cells, CD8+ T cells & B cells
Explanation
The correct answer is CD4+ T cells, CD8+ T cells & B cells. V(D)J recombination is a process that occurs during the development of lymphocytes, specifically T cells and B cells. This process involves the rearrangement of gene segments called V (variable), D (diversity), and J (joining) to generate a diverse repertoire of antigen receptors. CD4+ T cells, CD8+ T cells, and B cells are all types of lymphocytes that undergo V(D)J recombination. This process is essential for the immune system to recognize and respond to a wide range of pathogens.
10.
A single patient that produces IgG1 to differing epitopes will have which of the following?
Correct Answer
E. Same isotype, same allotype, different idiotype
Explanation
A single patient that produces IgG1 to differing epitopes will have the same isotype (IgG1), indicating that the antibodies belong to the same class of immunoglobulins. They will also have the same allotype, meaning that they share the same genetic variants of the constant region of the antibody. However, they will have different idiotype, which refers to the unique combination of variable regions that determine the specificity of the antibody.
11.
In 1972 Rodney Porter won the Nobel Prize for demonstrating the structure of antibodies, He digested IgG using papain to produce what?
Correct Answer
B. 2 Fab plus one Fc
Explanation
Rodney Porter won the Nobel Prize in 1972 for his work on the structure of antibodies. He used papain to digest IgG, which resulted in the production of 2 Fab fragments and one Fc fragment. The Fab fragments are responsible for binding to antigens, while the Fc fragment is involved in various immune functions. This digestion process allowed Porter to better understand the structure and function of antibodies.
12.
Antibodies of different classes, including IgM, IgG, IgA, and IgE, arise after varying kinds of antigenic stimulation. In which of the following situations would particular antibody responses be expected?
Correct Answer
C. IgM produced after exposure to a carbohydrate antigen will have relatively low affinity for its antigen
Explanation
When exposed to a carbohydrate antigen, the IgM antibodies produced will have relatively low affinity for the antigen. This is because carbohydrate antigens are typically T cell-independent antigens, meaning they do not require T cell help for their immune response. T cell-independent antigens stimulate B cells to produce IgM antibodies directly, without the need for affinity maturation. As a result, the IgM antibodies produced in response to carbohydrate antigens will have lower affinity compared to antibodies produced in response to protein antigens, which require T cell help and undergo affinity maturation to produce higher affinity antibodies such as IgG.
13.
IgM differs from igG in a number of ways, but which of the following differences between IgG and 1gM would you agree with?
Correct Answer
A. IgM is almost always low affinity for antigen, while IgG is usually high affinity for antigen.
Explanation
IgM is almost always low affinity for antigen, while IgG is usually high affinity for antigen. This means that IgM antibodies have a weaker binding to antigens compared to IgG antibodies. IgM is the first antibody produced during an immune response and is responsible for the initial defense against pathogens. It has a pentameric structure which allows it to bind to multiple antigens simultaneously. On the other hand, IgG antibodies are produced later in the immune response and have a higher affinity for antigens, providing a stronger and more specific immune response.