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Msb 103:Blood And Immune Mechanism Question Paper
Msb 103:Blood And Immune Mechanism
Course:Bachelor Of Medicine And Bachelor Of Surgery
Institution: Moi University question papers
Exam Year:2006
M O I U N I V E R S I T Y
SCHOOL OF MEDICINE
END OF TERM III EXAMINATION (ETE III) 2005/2006
COURSE: MSB 103 : BLOOD & IMMUNE MECHANISM
PROGRAMME: M.B.Ch.B. YEAR OF STUDY: 1(ONE)
DATE: 25TH SEPTEMBER, 2006 TIME: 9.00 A.M. - 12.00 NOON
GENERAL INSTRUCTIONS:-
(i) Write your University Registration Number on every piece of paper you use.
(ii) Do not write your names on any piece of paper you use.
(iii) This paper consists of four (4) sections, headed: Section A - Human Anatomy, Section B - Medical Biochemistry, Section C - Medical Physiology, Section D - Immunology. All to be answered in a total time of three (3) hours.
iv) Each section constitutes a CAT relating to the discipline named.
v) Answer all the questions in all the four (4) sections.
vi) Questions in each section must be answered in separate answer booklets or answer sheets so that they can be handed in separately at the end of the examination.
(iv) Read carefully the additional instructions preceeding each section.
SECTION A: HUMAN ANATOMY (50 Minutes)
MULTIPLE CHOICE QUESTIONS
TYPE III (20 minutes)
INSTRUCTIONS:-
(I) THERE IS ONLY ONE WRONG STATEMENT IN EACH QUESTION. FIND IT AND MAR X IN THE SHEET PROVIDED.
(II) A CORRECT RESPONSE EARNS YOU ONE MARK.
1. Concerning the humerus
(a) The ulnar nerve passes in front of the medial epicondyle
(b) The radial nerve lies on its back
(c) The axillary nerve curves around its surgical neck
(d) The brachial artery is first medial then anterior to it
(e) The coracobrachialis muscle is attached to the middle of its medial border
2. The radius bone give insertion to the following
(a) The biceps brachii
(b) The brachioradialis
(c) The supinator
(d) The pronator quadratus
(e) The anconeus
3. The branches of the axillary artery include
(a) The superior thoracic
(b) The thoraco-acromial
(c) The anterior circumflex
(d) The posterior circumflex
(e) The profunda brachii
4. The branches of the medial cord of the brachial plexus are
(a) Medial cutaneous nerve of the arm
(b) Medial cutaneous nerve of the forearm
(c) The medial pectoral nerve
(d) The axillary nerve
(e) The ulnar nerve
5. The posterior relations of the brachial artery include
(a) The long head of triceps
(b) The radial nerve
(c) The axillary nerve
(d) The medial head of triceps
(e) The brachialis muscle
6. The muscles supplied by the median nerve in the forearm are
(a) The pronator teres
(b) The flexor carpi ulnaris
(c) The flexor carpi radialis
(d) The palmaris longus
(e) The flexor digitorum superficials
7. The muscles included in the abduction of the arm are
(a) Supraspinatus
(b) Infraspinatus
(c) Deltoid
(d) Serratus anterior
(e) Trapezius
8. The muscles supplied by the ulnar nerve in the hand include
(a) The flexor digiti minimi
(b) The abductor digiti minimi
(c) The opponens pollicis
(d) The opponens digiti minimi
(e) The adductor pollicis
9. The structures passing superficial to the flexor retinaculum are
(a) Ulnar nerve
(b) Ulnar artery
(c) Radial nerve
(d) Tendon of palmaris longus
(e) Palmar cutaneous branch of median nerve
10. The dorsal digital expansion of the index finger receives the tendons of
(a) The extensor digitorum
(b) One lumbrical
(c) Two dorsal interossei
(d) One palmar interosseous
(e) The extensor indicis
11. The relations of the third part of the axillary artery are
(a) The median nerve is lateral
(b) The ulnar nerve is medial
(c) The musculocutaneous nerve is posterior
(d) The axillary vein is medial
(e) The radial nerve is posterior
12. The arteries which share in the anastomoses around the elbow are
(a) The superior ulnar collateral
(b) The inferior ulnar collateral
(c) The superficial palmar branch of the radial artery
(d) The anterior ulnar recurrent
(e) The posterior ulnar recurrent
13. Injury of the ulnar nerve above the elbow leads to
(a) Loss of sensations on the medial third of the palm
(b) Loss of adduction of the fingers
(c) Loss of pronation
(d) Loss of sensation from the medial one and half fingers
(e) Loss of the sensations on the medial third of the back of the hand
14. The median nerve
(a) Passes between the two heads of the pronator teres
(b) Descends on the under surface of the flexor digitorum superficialis
(c) Lies on the anterior surface of the flexor digitorum profundus
(d) Before the wrist it lies medial to the tendon of the flexor digitorum superficialis
(e) It passes deep to the flexor retinaculum
15. The radial nerve
(a) Is a branch of the posterior cord
(b) Lies deep to the third part of the axillary artery
(c) Leaves the axilla by passing between the long and lateral heads of the triceps to the spiral groove
(d) Is accompanied by the profunda brachii vessels
(e) It gives branches to the triceps muscle
16. The axillary nerve
(a) Is a branch of the posterior cords
(b) Its root value is C5, C6
(c) It lies on the anterior surface of the subscapularis muscle
(d) It supplies the teres major muscle
(e) It supplies the teres minor muscle
17. The deltoid muscle
(a) Arises, partially from the clavicle
(b) Inserted to the humerus
(c) Is supplied by the axillary nerve
(d) Its anterior fibers laterally rotate the arm
(e) Its middle fibers are powerful abductors of the arm
18. The flexor digitorum profundus muscle
(a) Arises from the ulna and the humerus
(b) Is supplied by the ulnar and median nerves
(c) Is contained with the flexor digitorum superficialis into oen common synovial sheath
(d) Its tendon has to pass between the two slips of the flexor digitorum superficialis tendon
(e) Is inserted to the bases of the distal phalanges of the medial four fingers
19. The radial artery
(a) Is a branch of the brachial artery
(b) Pulse can be felt by pressing it against the lower end of radius
(c) It passes to the back deep to the tendon of the abductor pollicis longus and extensor pollicis brevis
(d) It reaches the palm by passing between the two heads of the adductor pollicis muscle
(e) It shares in the formation of the deep palmar arch
20. The pronator teres muscle
(a) Arises by two heads from the humerus and the ulna
(b) Is inserted in the radius
(c) Is supplied by the median nerve
(d) It flexes the elbow joint
(e) The radial artery passes deep to its two heads
SUBSECTION A ii – SHORT ANSWER QUESTION (SAQ) (5 minutes)
INSTRUCTIONS:
(I) THERE IS ONE (1) QUESTION IN THIS SUBSECTION
(II) ANSWER THE QUESTION
SAQ 1. Describe development of an erythrocyte
SUBSECTION A(iii): DIAGRAMS (25 minutes)
INSTRUCTIONS:
(I) USE THE ANSWER SHEET PROVIDED
Q 1. Name the diagrams (1-5), write histological components (a-e)
SECTION B: MEDICAL BIOCHEMISTRY (35minutes)
SUB-SECTION BI: MULTIPLE CHOICE QUESTIONS (MCQs)
TYPE III
INSTRUCTIONS:-
(I) EACH OF THE QUESTIONS IN THIS SUBSECTION CONSISTS OF A STATEMENT/QUESTION WHOSE MOST APPROPRIATE COMPLETION/ANSWER IS PROVIDED AMONG THE FIVE OPTIONS NUMBERED (a) - (e).
(II) FOR EACH QUESTION SELECT THE MOST APPROPRIATE OPTION AND INDICATE BY PRINTING AN X IN THE APPROPRIATE BOX IN THE ANSWER SHEETS PROVIDED. IF YOU DO NOT KNOW THE ANSWER, PRINT X IN THE BOX IN THE `DK'' COLUMN
(III) A CORRECT RESPONSE EARNS YOU ONE MARK.
1. Cholesterol is a precursor for the formation of the following bile acids except
(a) Chenodeoxycholic acid
(b) Deoxycholic acid
(c) Lithocholic acid
(d) Cholic acid
(e) Glycocholic acid*
2. All of the following are metabolic products of bilirubin metabolism with the exception of
(a) UDP
(b) Glucuronate
(c) NADP+
(d) NAD+ *
(e) Urobilinogen
3. Which of the following proteoglycans has no sulfate in its structure?
(a) Hyaluronate *
(b) Keratan
(c) Dermatan
(d) Heparan
(e) Heparin
4. Which of the following is a major site of heme catabolism?
(a) The liver *
(b) Erythrocytes
(c) Kidneys
(d) Bone-marrow
(e) Cytochromes
5. Which of the following is the principal amino acid of the collagen?
(a) Glycine *
(b) Proline
(c) Lysine
(d) Hydroxyproline
(e) Hydroxylysine
6. Which of the following plasma lipoproteins are formed in the intestine?
(a) Chylomicrons *
(b) HDL
(c) VLDL
(d) IDL
(e) LDL
7. All of the following are involved in the synthesis of heme except
(a) NAD+ *
(b) Succinyl CoA
(c) ALA synthase
(d) Fe++
(e) C02
8. Which of the following is not a hydrolytic product of mucopolysaccharide?
(a) Glucuronic acid
(b) Myristic acid *
(c) Glucosamine
(d) Acetic acid
(e) Sulfuric acid
9. Elimination of methyle carbon as carbon monoxide from heme yields
(a) Stercobilin
(b) Urobilin
(c) Biliverdin *
(d) Verdohemoglobin
(e) Bilirubin
10. Plasma glycoproteins are complex mixtures of proteins and carbohydrates linked together via
(a) Threonine side chain
(b) Asparagine side chain *
(c) Serine side chain
(d) Glycine side chain
(e) Lysine side chain
11. Lipid-based energy are transported by all of the following plasma lipoproteins except
(a) Chylomicrons
(b) VLDL
(c) IDL
(d) LDL
(e) HDL
12. Which of the following enzymes controls the rate limiting step of heme synthesis in the majority of tissues?
(a) ALA synthetase *
(b) ALA dehyrogenase
(c) Uroporphyrinogen synthetase
(d) Coproporphyrin oxidase
(e) Uroporphyrin decarboxylase
13. Glycosaminoglycans have the following functions except as
(a) Components of plasma membrane
(b) Endoskeletal structures of bones
(c) Storage forms of polysaccharides *
(d) Lubricants of extracellular matrix
(e) Anticoagulants
14. The loss of iron and methylene carbon from heme results in
(a) Urobilinogen
(b) Bilirubin
(c) Biliverdin *
(d) Stercobilinogen
(e) Bilirubin glucuronide
15. One of the main functions of myoglobin in humans is the transportation of
(a) C02 in peripheral tissues
(b) Protons in peripheral tissues
(c) Oxygen in peripheral tissues
(d) Oxygen to all parts of the body
(e) Oxygen within muscle *
*16. The role of HDL in the body is
(a) To remove cholesterol from the liver
(b) To remove cholesterol from plasma
(c) To remove bile acids from the liver
(d) To synthesize plasma membrane
(e) To remove cholesterol from adipose tissue
*17. The functional form of Hb is
(a) Oxyhemoglobin *
(b) Methemoglobin
(c) Verdohemoglobin
(d) Carboxyhemoglobin
(e) Ferrohemoglobin
18. Which of the following glycosaminoglycans is found in both animal and bacterials cells?
(a) Heparin
(b) Hyaluronic acid
(c) Dermatan
(d) Heparan
(e)
19. The metabolic product of bilirubin that may be detected in feces is called
(a) Urobilin
(b) Urobilinogen
(c) Stercobilin
(d) Stercolith
(e) Sterbilin
20. Keratins are highly insoluble proteins which are notable for all of the following except
(a) High content of lysine in hair
(b) Great insolubility
(c) High content of cystine in hair
(d) Great resistance to attack by enzymes
(e) High content of cystine in finger nails
21. A major apoprotein found in LDL is
(a) Apoprotein A
(b) Apoprotein B
(c) Apoprotein C
(d) Apoprotein D
(e) Apoprotein E
22. Heme is an iron-containing pophyrin made up of all of the following except
(a) Four pyrrale rings
(b) Four nitrogen atoms
(c) Four oxygen-binding sites
(d) Four methylene bridges
(e) Four methyl groups
23. Under normal conditions chondroitin sulfate would not be expected to be present in
(a) Synovial fluid
(b) Aorta
(c) Cartilages
(d) Ligaments
(e) Tendon
24. Condensation of two molecules of ALA result in the formation of porphobilinogen and
(a) C02 - ALA
(b) 2H20 - Porphobilinogen
(c) 3NH2 – hydroxyl methylbilane
(d) CoA.SH – a- amino-b- ketoadipate
(e) NADH
25. Mucin glycoproteins are normally found in all of the following except
(a) Saliva
(b) Blood serum
(c) Gastrointestinal tract
(d) Female genital tract
(e) Nosal mucous
26. Which of the following plasma lipoproteins are formed in peripheral tissues?
(a) Chylomicrons - intestines
(b) VLDL
(c) IDL
(d) LDL - hepatocytes
(e) HDL
27. The vinyl groups of heme molecule are located in
(a) Ring 1 and ring 2
(b) Ring 1 and ring 3
(c) Ring 2 and ring 3
(d) Ring 3 and ring 4
(e) Ring 1 and ring 4
28. Which of the following would not be expected to be one of the components of the keratan?
(a) Fucose
(b) N-acetylgalactosamine
(c) Uronic acid
(d) Sialic acid
(e) Mannose
29. Deacarboxylation of all acetate groups in uroporphyrin yields
(a) Tetraporphyrin
(b) Coproporphyrin
(c) Protopophyrin
(d) Pophopophyrin
(e) Heme
30. Which of the following sugars is not likely to be found in glycoproteins?
(a) Fructose
(b) Glucose
(c) Fucose
(d) Mannose
(e) Galactose
31. Which of the following is not a function of plasma lipoproteins?
(a) Transportation of lipids
(b) Excretion of cholesterol
(c) Synthesis of fatty acids
(d) Formation of bile acids
(e) Formation of plasma membrane
32. Carbon monoxide is formed from methylene carbon of heme eliminated from rings
(a) One and three
(b) Two and three
(c) One and two
(d) Three and four
(e) One and four
33. Which one of the following is a lipid-clearing agent?
(a) Heparin
(b) Heparan
(c) Keratan
(d) Chondroitin
(e) Dermatan
34. In the final stage of heme synthesis, ferrochelatase inserts iron into
(a) Protoporphyrin IV
(b) Protoporphyrin VII
(c) Protoporphyrin XII
(d) Protoporphyrin IX
(e) Protoporphyrin XI
35. Fetal hemoglobin consists of
(a) 574 amino acids
(b) 287 amino acids
(c) 141 amino acids
(d) 146 amino acids
(e) 582 amino acids
SECTION C: MEDICAL PHYSIOLOGY(50 Minutes)
SUBSECTION C(i) : MULTIPLE CHOICE QUESTIONS (MCQ) (30 minutes)
TYPE 2
INSTRUCTIONS
(i) EACH OF THE QUESTIONS IN THIS SECTION HAS A STEM STATEMENT FOLLOWED BY FIVE COMPLETIONS NUMBERED (a) TO (e). A GIVEN COMPLETION, WHEN ADDED TO THE STEM STATEMENT MAY PRODUCE A COMPLETE STATEMENT THAT IS TRUE (T) OR FALSE (F).
(ii) INDICATE AGAINST THE APPROPRIATE NUMBERS IN THE ANSWER SHEETS PROVIDED WHETHER THE COMPLETE STATEMENTS IS TRUE (T) OR FALSE (F) BY PRINTING AN X IN THE BOX IN THE COLUMN HEADED T FOR TRUE OR F FOR FALSE.
(iii) IF YOU DO NOT KNOW WHETHER THE COMPLETE STATEMENT IS TRUE OR FALSE, PRINT THE X IN THE COLUMN HEADED D (FOR DO NOT KNOW).
(iv) A CORRECT RESPONSE EARNS YOU PLUS ONE MARK. AN INCORRECT RESPONSE EARNS MINUS ONE - HALF OF A MARK. AN X IN THE D COLUMN EARNS YOU ZERO MARK. ANY UNANSWERED OPTION COUNTS AS INCORRECT.
1. Basophils
(a) Are involved in hypersensitivity reactions
(b) Make up about 20% of total white blood cells
(c) Kill invading organisms by phagocytosis
(d) Are abundant beneath epithelial surfaces
(e) Are involved in lymphocyte activation
2. Innate immunity
(a) Is specific to invading organisms
(b) Is involved in rejection of foreign tissue
(c) Is deficient in young children
(d) Is mediated by lymphocytes
(e) Involves complement activation
3. Erythropoiesis
(a) Does not occur in absence of erythropoietin
(b) Is enhanced on ascending a mountain
(c) In the fetus occurs in the liver
(d) Is enhanced by infections
(e) Occurs daily
4. Plasma proteins
(a) Are all made in the liver
(b) Concentration is about 10g/dl
(c) Contribute to the oncotic, pressure of 50mmHg in capillaries
(d) Participate in acid-base balance
(e) Transport oxygen in circulation
5. Regarding blood
(a) Volume is about 8L in a 70kg adult male
(b) Cells originate principally in the femur of adults
(c) Plasma is about 5% of total body weight
(d) Has a pH of 7.4
(e) Serum clots on standing in a test tube
6. Hemoglobin
(a) Affinity for oxygen varies with carbon dioxide present in the blood
(b) May bind hydrogen iron
(c) Determines the blood group of an individual
(d) A, has a higher affinity for oxygen than hemoglobin F
(e) Breakdown is the main source of bilirubin found in blood
7. With respect to the hemostatic mechanisms of the body
(a) After about 6 minutes, the hemostatic plug consists almost entirely of fibrin
(b) All the coagulation factors in plasma are in active form except thrombin
(c) The action of active factor thirteen (XIII) leads to formation of hydrogen bonds between fibrin monomers
(d) Bleeding time is a reflection of how long it takes to activate the coagulation mechanism
(e) Platelets promote blood clotting
8. Anticoagulants in intact blood vessels
(a) Inhibit platelet phospholipid synthesis
(b) Reduce plasma Ca2+ concentration
(c) Reduces circulating thrombin levels
(d) Inhibit synthesis of glutamic acid
(e) Inactivate plasminogen
9. In a normal male human being, mature red blood cells
(a) Have an average diameter of 72 micrometers
(b) Contain no mitochondria
(c) Have a relatively large surface area to volume ratio
(d) Remain in circulation for an average of 100 days
(e) Determine the blood group of an individual
10. Platelets
(a) Production is regulated by erythropoietin
(b) Membrane have collagen receptors
(c) Phospolipids initiate blood clotting
(d) Regulates circulatory levels of factor VIII
(e) Count is about 500,000/?I in normal adult females
11. Thrombin
(a) Is secreted from the liver
(b) Promotes blood clotting in vivo
(c) Inhibits platelets
(d) Is absent in the brain
(e) Activates fibrin
12. As concerns the ABO system blood group antigens
(a) “O” blood group has anti A and anti B agglutinins
(b) Are controlled by sex linked recessive genes
(c) Are only found on red blood cell membranes
(d) Are glycolipids
(e) They develop in the fetus
13. Rhesus factors
(a) Rhesus-ve individuals have agglutinogen D
(b) Is present at birth
(c) Agglutinins are absent in Rh+ individuals
(d) Are inherited as mendelian allelomorphs
(e) Are only found in blood
14. Stabilization of fibrin clot requires
(a) Platelet phospholipids
(b) Plasmin
(c) Ca2+
(d) Factor XIIIa
(e) Thrombin
15. The role of calcium ions in hemostasis is the conversion of
(a) Inactive factor X to its active form
(b) Prothormbin to thrombin
(c) Fibrinogen to fibrin
(d) Tissue thromboplastin to its active form
(e) Inactive platelets to activated platelets
SUBSECTION C(ii) : SHORT ANSWER QUESTIONS (SAQs) (20 minutes)
INSTRUCTIONS:
(I) THERE ARE TWO (2) QUESTIONS IN THIS SECTION
(II) ANSWER ALL THE TWO (2) QUESTIONS
(III) START EACH QUESTION ON A FRESH PIECE OF PAPER OF THE BOOKLET
SAQ 1. Explain the significance of hematological parameters
(10 minutes)
SAQ 2. Write short notes on blood transfusion
(10 minutes)
SECTION D: IMMUNOLOGY
(60 Minutes)
INSTRUCTIONS:-
(i) THIS PAPER IS MADE UP OF TWO (2) SUBSECTIONS: I AND II. SUBSECTION I CONSISTS OF THIRTY (30) MULTIPLE CHOICE QUESTIONS (MCQs) TO BE ANSWERED IN FORTY (40) MINUTES. SUBSECTION II CONSISTS OF TWO (2) SHORT ANSWER QUESTION (SAQs) TO BE ANSWERED IN THIRTY (30) MINUTES.
(ii) FOR THE MCQs, EACH QUESTION CONSISTS OF A STATEMENT/STEM WHOSE MOST CORRECT RESPONSE IS PROVIDED AMONG THE FIVE OPTIONS NUMBERED A TO E.
(iii) FOR EACH MCQ, SELECT ONLY ONE APPROPRIATE OPTION AND INDICATE BY CIRCLING IT.
EXAMPLE:
Major features of innate immunity include
(a) recognition
(b) specificity
(c) memory
d first line of defense
(e) adaptability
The most appropriate response is d
(iv) ATTEMPT ALL QUESTIONS IN THE TWO SUBSECTIONS.
SUBSECTION DI: MULTIPLE CHOICE QUESTIONS (MCQs) (30 minutes)
1. In the activation of CD4 T cells antigen signal is delivered through
(a) HLA-DP Dr & DQ molecules
(b) CD3 CD4/CD8-TCR-MHC peptide complex *
(c) CD3-TCR-CD28-peptide complex
(d) CD28-CD80/86-peptide complex
(e) HLA-DP-TCR-peptide complex
2. Class III MHC region does not code for
(a) Tumor necrosis factor (TNF)
(b) C2, BF, C4b & C4a
(c) 21-Hydroxylase enzymes
(d) T cell antigenic receptor (TCR) *
(e) Heat shock proteins
3. Properdin has the effect of amplifying complement activation by
(a) Facilitating the binding of Factor B to C3b
(b) Facilitating the binding of Factor D to C3b
(c) Stabilization of the C3bBb complex *
(d) Promoting the binding of C1q to antibody
(e) Facilitating binding of membrane attach complex to the target
4. Plasma cells
(a) Are derived from myeloid cells
(b) Are same as monocytes
(c) Develop from B cell lineage *
(d) Do not secrete immunoglobulins
(e) Develop from thymocytes
5. Cell-mediated immunity
(a) Can be transferred passively using immune sera
(b) Is mediated by B & T cells
(c) Is mediated by T cells, macrophages & interleukins *
(d) Is the same as innate immunity
(e) Is mediated by antibodies & interleukins
6. Immune adherence of microorganisms on phagocytes is enhanced by
(a) C3b & C4b components *
(b) Antibody against C3bBp
(c) FC receptors for IgE on Basophils
(d) C567 factor & proprodin
(e) C1 esterase inhibitor
7. All immunoglobulin G (IgG) sub-classes
(a) Are produced mainly in the primary immune response
(b) Are actively transmitted across the placenta equally
(c) Activate the classical complement pathway in the order * IgG3>IgG1>IgG2>IgG4
(d) Are poor antitoxin factors
(e) Posses high agglutination activity
8. Biological functions of immunoglobulins are mediated by
(a) Hinge region
(b) Fragment Fab
(c) Light chains
(d) Fragment Fc
(e) Antigen combining site *
9. IgE characteristic features include the following except
(a) Detection in serum indicates recent injection
(b) Concentration in normal serum is very high *
(c) Production is strongly T cell regulated
(d) Half-life is very short
(e) Molecular weight is 186kDa
10. IgM+ B cell switching to IgG is mediated by
(a) IL-3
(b) IL-4 *
(c) IL-6
(d) IL-7
(e) IL8
11. Anti-idiotypic antibodies are generated against
(a) Antigenic determinant in the C region of heavy & light chains of immunoglobulins
(b) The hinge region disulphide bonds
(c) The Fc gragment of IgA molecules
(d) Foreign heavy chains of immunoglobulins
(e) Hypervariable determinants in the V region of heavy & light chains of immunoglobulins *
12. Complement levels in serum is determined by all except
(a) Immunoelectrophoresis
(b) CFT
(c) Single radial immunodiffusion (mancini)
(d) Latex agglutination text
(e) ELISA
13. J-chain is present in
(a) IgE aggregates
(b) IgG monomeric
(c) Both IgM & IgA
(d) IgD & IgE polymers
(e) Secretory components
14. IL-2R synthesis & IL-2 secretion does not involve
(a) T cell membrane peptide/MHC/TCR/CD3 signal tranduction
(b) Activation of protein tyrosine kinase
(c) Increase of intracellular Ca++
(d) Plasma membrane inositol phosphate lipid hydrolysis
(e) Decreased intracellular Ca++ & inhibition of phosphate
15. Cytotoxic T cells (CTL) mediate killing of target through
(a) Recognition of foreign antigens in association with MHC class II molecules
(b) Inhibition of apoptosis
(c) Reversible of perforin polymerization
(d) Activation of apoptosis by serine proteases (granzymes)
(e) ?-IFN enhancement of MHC calss II molecules
16. Cytokines are
(a) High molecules weight glycoproteins
(b) Pleiotropic
(c) Not redundant
(d) Not multifunctional
(e) Produced by only mitogen activated leukocytes
17. One of the following cytokines enhances proliferation of T cells
(a) IL-2
(b) IL-1
(c) IFN-?
(d) IFN-?
(e) IL-4
18. C1q inhibitor destroys
(a) Alternative pathway C3 convertase
(b) Factor B
(c) Cobra venam factor
(d) Membrane attack complex
(e) Activated C1? ?CIS
19. C3b & C4b receptors are not found in the following cells
(a) Monocytes
(b) Macrophages
(c) Neutrophils
(d) Erythrocytes
(e) CD8+ T lymphocytes
20. Major antibody of primary immune response is
(a) IgA
(b) IgG
(c) IgM
(d) IgD
(e) IgE
21. A substance that eroke either a humoral or cell-mediatal immune response is termed as
(a) Immunogen
(b) Hapten
(c) Antigen
(d) Epitope
(e) Adjuvent
22. Cells that express both surface IgM & IgD include
(a) Plasma cells
(b) Immature B cells
(c) Mature B cells
(d) Pre B cells
(e) T helper cells
23. Differences between IgG subclasses reside in
(a) Agglutination activity
(b) Light chain type
(c) Relative concentraton in serum
(d) Susceptibility to pepsin digestions
(e) Anti-toxin & opsonic capabilities
24. The class specific antigenic determinants of immunoglobulins are associated with
(a) Framework residues of variable regions of both heavy & light chains
(b) Constant regions of the light chains
(c) Constant regions of the heavy chains
(d) Variable regions of the light chains
(e) Variable regions of the heavy chains
25. In the adult human, B cells development takes place in
(a) Spleen
(b) Liver
(c) Bone marrow
(d) Thymus cortex
(e) Thymus medulla
26. Thymus dependent antigens
(a) Stimulate B cells directly without help from T cells
(b) Stimulate T cells directly without help from B cells
(c) Require help from antigen specific T cells in order to stimulate B cells
(d) Include B cells mitogens
(e) Stimulate B cells directly with help from accessing cells
27. Papain cleaves IgG into
(a) F (ab’) 2 and Fc portion
(b) Two heavy (H) & 2 light (L) chains
(c) 2 Fab & Fc fragments
(d) Several Fc fragments
(e) Three or four paratopes
28. B cells that do not encounter stimulating antigen will die by
(a) Necrosis
(b) Apoptosis
(c) Increased TCR - ?/? T cells
(d) Low affinity of TCR for MHC molecules
(e) High affinity of surface immunoglobulin for TCR
29. Anaphylatotins of complement system are
(a) C3a & C4b
(b) C1q, C1? & CIS
(c) C3a & C4b
(d) C3a & C5a
(e) Factor B & D
30. T-independent antigens signal in B cell activation is delivered through
(a) IL-1 production
(b) TCR/MHC/CD4 complex
(c) TCR/CD3/CD8 complex
(d) TCR/CD3/MHC peptide complex
(e) CR2-CD19-TAPA-1-Leu 13
SUB-SECTION DII - SHORT ANSWER QUESTIONS (SAQs) (30 minutes)
INSTRUCTIONS:
I) THERE ARE TWO (2) QUESTIONS IN THIS SECTION
II) ANSWER THE TWO (2) QUESTIONS
III) START EACH QUESTION ON A FRESH PAGE OF THE BOOKLET OR PAPER.
SAQ 1. Describe activation of the classical complement pathway
(10 marks)
SAQ 2. Explain the structure and function of the following antibodies
(a) IgG (10 marks)
(b) sIgA (10 marks)
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