SLIDESMANIA.

COM

SLIDESMANIA.COM
Talking points:

● Safety and specimen preparation

Immunology & Serology ● Antigen and antibody structures and functions
● Natural immunity and lymphoid System
ASSESSMENT (SEPTEMBER 09,2021) ● MHC (Major histocompatibility complex)
● Cytokines and complement system

● Precipitation reactions, agglutination and Labelled Immunoassays

SLIDESMANIA.COM

SLIDESMANIA.COM

General terms
Immunology → the study of a ________________ when foreign

Safety and specimen

substances are introduced into the body.

Serology→ the study of a noncellular portion of the blood

Preparation
known as ___________.

_______________→ a foreign substance that induces an immune

response; generally of ________molecular weight and consists
of __________ or _________________.

________________________→ serum factors in the blood

formed in response to foreign substance
exposure.
SLIDESMANIA.COM

SLIDESMANIA.COM

Standard Precautions
Question #1
The CDC recommends that "standard precautions" be exercised by all health care All human blood and other body fluids
>>>term established by CDC
workers to prevent transmission of hepatitis B virus, HIV and other bloodborne must be treated as potentially
pathogens. What do these precautions include?
referring to broadened focus on
__________________.
prevention, application of the
a.Wearing protective clothing when testing blood specimens from patients in specific principles to all patients regardless *Human immunodeficiency virus (HIV),
areas of the_____or presumed infection hepatitis B virus (HBV), and other blood-
b.Using special precautionary methods when testing blood specimens with a biohazard borne microorganisms can be transmitted
________.
label thru blood and other body fluids and it can
c.Handling every patient blood specimen as if it were infectious cause disease in human beings.
d.Carefully recapping needles before discarding
SLIDESMANIA.COM

SLIDESMANIA.COM
Additional Informations
_______________________________
__________→ is the most important source of
HIV, HBV, and other bloodborne pathogens in >>>Diluted household bleach
>>>set of rules about the concept of personal protective the occupational setting prepared daily inactivates HBV in
equipment,proper disposal of needles, handwashing,etc. ____minutes and HIV in
__________→ may be stable in dried blood and
blood products at _____0C for up to 7 days ____ minutes

_______→retains infectivity for more >>>Contaminated materials must be

than______ days in dried specimens at room
disposed properly in
temperature and for more than 1 week in an
aqueous environment at room temperature “_____________ “containers.
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 2

Antigen and antibody Any substance, protein or non-protein that when

introduced into an animal caused production of an
structures and functions antibody is called______.
a.Hapten
b.Determinant
c.Molecular Weight
d.Antigen
SLIDESMANIA.COM

SLIDESMANIA.COM

*______________→ a foreign substance that induces an immune

response; generally of high molecular weight and consist
of proteins or polysaccharides.
*_________→alone cannot stimulate antibody formation. It can
Question # 3
react with antibody, but it is monovalent, so no complexes form.
>>>When complexed to a carrier, the hapten can stimulate antibody formation. If Reactive sites on an antigen are known as_______.
hapten is complexed to a carrier at multiple sites, then agglutination can take
a.determinants
place.
*Molecular mass (m) →is the mass of a given molecule. b.valence
c.haptens
*_______________________→ is the key portion(molecular shapes or
configurations) of the immunogen that are recognized by B or T cells.
d.immunoglobulins
Valence>>>the property of an element that determines the number of other
atoms with which an atom of the element can combine.
SLIDESMANIA.COM

SLIDESMANIA.COM
NATURE OF EPITOPES
Question # 4
Although an immunogen must have a molecular weight of at
The portion of an antigen that binds to an antibody or T least ______, only a small part of the immunogen is actually
cell receptor is called _______. recognized in the immune response. This key portion of the
a.Allergin immunogen is known as the determinant site or epitope.
b.Avidin
___________→ are molecular shapes or configurations that are
c.Epitope
recognized by B or T cells.
d.Valence
SLIDESMANIA.COM

SLIDESMANIA.COM

Additional Informations Question # 5

*___________→any substance capable of inducing an Which of the following would be the best immunogen?
allergy a.protien with a molecular weight of 200,000
*Avidin →biotin-binding protein that is believed to b.nylon
function as an antibiotic in the eggs of c.polysaccharide with a molecular weight of 250,000
birds,reptiles and amphibians d.proteins with a molecular weight of 175,000
*Valence→the combining power of an element
SLIDESMANIA.COM

SLIDESMANIA.COM

ANTIGEN CHARACTERISTICS
Question # 6
Traits of Immunogens
Lipids are non immunogenic unless they are bound to In general, the ability of an immunogen to stimulate a host
protein. Polysaccharides are the most immunogenic response depends on the following characteristics:
biological molecule.
a.first statement is true, second statement is false 1.__________________________________
2.__________ composition and __________ complexity
b.first statement is false, second statement is true
3.Foreignness
c.both statements are true 4.Ability to be processed and presented with MHC molecules
d.both statements are false
SLIDESMANIA.COM

SLIDESMANIA.COM
ANTIGEN CHARACTERISTICS Question # 7
Traits of Immunogens _____________ The Fab portion of an antibody:
(2) Chemical composition and Molecular Carbohydrates a.binds Fc receptor.
complexity Nucleic Acids
nonimmunogenic/weakly immunogenic
Lipids b. consists of two light chains only
ü Proteins and polysaccharides are best c.consists of two heavy chains only
immunogens d. contains the hypervariable region
ü _________ are the most powerful
immunogens because they are made up
of a variety of units (amino acids).
SLIDESMANIA.COM

SLIDESMANIA.COM

Structure of an Antibody
Question # 8
*______________ → is a region on an antibody that binds to
antigens.It is composed of one________ and one _______domain
The crystallizable fragment of an immunoglobulin is which
of each of the heavy and the light chain. These domains shape the
paratope — the antigen-binding site — at the amino terminal end of terminal of the protein?
the monomer. a.C terminal
b.N terminal
*___________→ is the tail region of an antibody that interacts with c.Either C terminal or N terminal
cell surface receptors called ___________and some proteins of the d.None of these
complement system. This property allows antibodies to activate the
immune system.
SLIDESMANIA.COM

SLIDESMANIA.COM

The antigen binding site of an immunoglobulin is the

___________ or the amino terminal end of the heavy and Question # 9
light chains; whereas the crystallizable fragment is the
Where is the complement binding site on the IgG
carboxyl end of the protein chains.
molecule?
a.CH2 domain
b.CH 1 domain
c.CH 3 domain
d.Hinge region
v The segment of H chain located between the
CH1 and CH2 regions is known as the hinge
region
SLIDESMANIA.COM

SLIDESMANIA.COM
Question # 10 Antibody variations
The isotype of an immunoglobulin antibody: § __________—the _______ that is unique to each
a.is defined by the heavy chain. immunoglobulin class.
b. is defined as different alleles of the same antibody § ___________—___________ in the _______
type (e.g. IgG). regions.
c. are genetic variations in the constant regions. >>>Allotypes occur in the four ______subclasses.
d. is the variation within the variable region. § ________—variations in ________ regions that give
individual antibody molecules specificity
SLIDESMANIA.COM

SLIDESMANIA.COM

*_____________→ antibody involved in allergic reactions, causes the release of

Question # 11 histamine when it combines with antigen in tissue, and is capable of producing
sensitivity to the antigen when introduced into the skin of a normal individual.
Identical antibodies produced from a single clone of
*_________________→antibodies that recognize antigens on red blood cells
plasma cells describes ______. (RBCs) at temperatures below normal core body temperature.
a.Reagin
*_________________→antibodies produced against poorly defined antigens and
b.Cold agglutinin that they are generally “weak” antibodies with multi-specific activities
c.heterophile antibodies
d.Monoclonal antibodies
SLIDESMANIA.COM

SLIDESMANIA.COM

*T-cell lymphoproliferative disorder (ITLPD)→non-aggressive,

Question # 12 clonal, mature T-cell disorder

Multiple myeloma is a_________.

___________________ →results from a combined B- and T-cell
a.T-cell lymphoproliferative disorder (ITLPD). defect and is characterized by recurrent infection, eczema, and
b.cancer of plasma cells characterized by increased antibody concentration. thrombocytopenia
c.results from a combined B- and T-cell defect and is characterized by recurrent
infection, eczema,and thrombocytopenia. ____________________→characterized by uncoordinated muscle
d.characterized by uncoordinated muscle movements and dilation of small vessels; seen
movements and dilation of small vessels; seen in sclera of eye
in sclera of eye.
SLIDESMANIA.COM

SLIDESMANIA.COM
Precipitation
Question # 13 § First noted in 1897 by _________
§ involves combining _________antigen with __________ antibody to produce
The area of precipitation curve wherein there is antigen ___________ immune complexes that are visible
excess such that no precipitate is produced, this zone is
Ø Precipitation Curve
known as______. • _______________________- number of multivalent sites of antigen and
a.Equivalence zone antibody are approximately equal; each antibody binds to more than 1 antigen
forming a stable network or lattice
b.None of these • __________ >>> __________ excess
c.Postzone • ___________>>>Antigen (Ag) excess
d.Prozone
SLIDESMANIA.COM

SLIDESMANIA.COM

*Equivalence zone →is where both the optimal antigen-

Question # 14 antibody interaction and maximal precipitation occur.
The detection of precipitation reactions depends on the presence of maximal
proportions of antigen and antibody. A patient's sample contains a large amount of *Prozone reaction→ refers to the absence of antibody-
antibody, but the reaction in a test system containing antigen is negative. What antigen precipitation in the presence of
has happened?
a.Performance error
_______________.
b.Low specificity
c.A shift in the zone of equivalence
d.Prozone phenomenon
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 15 Precipitation Curve

Prozone reaction in serologic testing is corrected by • Zone of Equivalence- number of
multivalent sites of antigen and
________. antibody are approximately equal; each
a.heat inactivating the serum at 56 degrees Celsius antibody binds to more than 1 antigen
forming a stable network or lattice Troubleshooting:
b.subjecting the serum to ultracentrifugation • Prozone >>> Antibody(Ab) excess
c.diluting the serum • ___________>>>Antigen (Ag) excess ü Prozone>>>_________________
ü Postzone>>>_________________
d. first keeping the serum at 4 degrees Celsius
SLIDESMANIA.COM

SLIDESMANIA.COM
The antigen-antibody reaction is a _______chemical
Question # 16 reaction.

Which of the following describes an antigen- antibody Antigen + antibody ⇄ antigen-antibody complex
reaction?
a.The reaction is reversible Note: The forces connecting the antigen-antibody are not
b.The reaction is the same as a chemical reaction sturdy valence bonds, but weaker bonds that are fittingly
c. A lattice is formed at postzone named “weak interactions.”
d.A lattice is formed at prozone
SLIDESMANIA.COM

SLIDESMANIA.COM

*___________→the _________ strength of binding

between an antibody and an antigen
Question # 17
The binding strength of a multivalent antibody to its *__________→ Semiquantitative technique used to assay
monovalent antigen is referred to as its ___. the concentration of an antibody
a.Avidity
b.Titer *___________→ Represents how much of a given
c.Affinity substance is measured
d.Sensitivity
e.Specificity *___________→Represents what is being measured.
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 18 Question # 19
When papain is added to treat monomeric What enzyme splits the immunoglobulin into 2 Fab
antibodies,_______fragments are produced. fragments and 1 Fc fragment?
a.1 a.Pepsin
b.2 b.Papain
c.3 c.neither pepsin nor papain
d.4 d.both pepsin and papain
SLIDESMANIA.COM

SLIDESMANIA.COM
The basic structure of an immunoglobulin
is a tetrapeptide, consisting of two H and two L
chains linked by disulfifide bonds. Intrachain
disulfide bonds create flooded regions or domains. Question # 20
The amino-terminal end of each chain is a variable
region, while the carboxy-terminal end is one or
more constant regions. Which of the following immunoglobulin(s) can cross the
placenta?
__________→ digestion yields two F(ab)
fragments and an FC portion a.IgG
____________→ digestion yields a F(ab)2
b.IgM
fragment, with all the antibody activity, and FC1 c.IgA
fragment.
d.IgE
SLIDESMANIA.COM

SLIDESMANIA.COM

Properties of Immunoglobulin
IgG IgA IgM IgD IgE
Molecular weight 150,000 160,000– 180,000 190,000
Sedimentation 7S 7S 19 S 7S 8S
coeffificient Question # 21
Percent of total 70–75 10–15 10 <1 0.002
immunoglobulin
Which of the following IgG subclass can cross the
Serum 70–350 1–3 0.005
concentration
placenta?
(mg/dL) 1.IgG3 2.IgG 1 3.IgG 2
Serum half-life 23 5 6 1–3 2–3
(days) a.All except 1 and 2
Carbohydrate 2–3 7–11 12 9–14 12 b.All except 3
content (weight
percent) c.All except 1 and 3
Complement No No No
fixation
d.All except 3 and 4
Crosses placenta No No No No
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 22
IgG antibody is present in highest concentration in serum
Which of the following immunoglobulin cross-links mast
and is the only antibody type that can cross the placenta
cells to release histamine?
efficiently, except for its ______________.
a.IgG
b.IgM
c.IgA
d.IgE
SLIDESMANIA.COM

SLIDESMANIA.COM
5 Types of antibodies
*_______ monomer → Antibody for allergy and antiparasitic activity
Question # 23
*_______ pentamer→ The main antibody for primary responses, best at
fixing complement; the monomer form of IgM serves as the B cell receptor. Failure of the immune system to respond against an
epitope in an aggressive way is termed____.
*______ monomer→Main blood antibody for secondary responses,
neutralizes toxins, opsonization a.autoimmunity
b.positive selection
*_______ dimer→Secreted into mucus, tears, saliva, colostrum
c.negative selection
*_______ monomer→B cell receptor d.tolerance
SLIDESMANIA.COM

SLIDESMANIA.COM

*____________→misdirected immune response that occurs when

the immune system goes wrong and attacks the body itself.

*____________→ involves targeting the desired cell population with Natural immunity
and lymphoid System
an antibody specific to a cell surface marker (CD4, CD8, etc.). The
targeted cells are then retained for downstream analysis.

*______________→is when several cell types are removed, leaving

the cell type of interest untouched.
SLIDESMANIA.COM

SLIDESMANIA.COM

General terms
Natural Vs. Acquired
______________→ state of being resistant to infection
NATURAL ACQUIRED
Natural Immunity
§ Also known as _____________ § Is innate (not acquired)/natural. § Is ________ present @ birth

§ Resist infection by normally present body functions § Is __________ against pathogens. § Is ________ against pathogens.

Acquired Immunity § Has ______ immunological memory. § Has immunological memory.

§ Also known as_______________
§ Developed as a result of exposure to foreign substances or agents § Can recognize antigens as a whole. § Each Ag has a specific response.

§ Occurs very quickly (within minutes). § Takes _____________ to reach its full
fxn capacity.
SLIDESMANIA.COM

SLIDESMANIA.COM
Question # 24 Question # 25
Innate immunity includes ________. Which of the following is a non phagocytic cytotoxic cell able to
a.anamnestic response rapidly kill cells without having been previously exposed to that cell?

b. antibody production
a.cytotoxic T cell
C. cytotoxic T cell activity b.helper T cells
d.phagocytosis by polymorphonuclear cells c.natural killer cells
d.suppresor T cell
SLIDESMANIA.COM

SLIDESMANIA.COM

Additional Informations
Cells of the Natural immune system
Question # 26
Natural killer (NK) cell and other NK cell killing of infected cells; diverse
innate lymphoid cells (ILCs) functions of ILCs The first leukocyte to migrate to the area of
Monocyte and macrophage Phagocytosis
damaged/infected tissues during inflammatory response is
Activation of T cells
Follicular dendritic cell Activation of B cells
______.
Production of inflammatory mediators a.Monocyte
Neutrophil Phagocytosis b.Eosinophil
Natural killer cells/NK cells→ Transitional cell bridging the innate and the acquired response to
pathogens.NK cells mediate cytolytic reactions and kill target cells
c.Neutrophil
__________________________________
d.Macrophage
e.B-cell
SLIDESMANIA.COM

SLIDESMANIA.COM

Inflammation
Ø Overall reaction of the body to injury or invasion by microorganisms
Ø Cardinal signs: Question # 27
v ____________>>>Redness
v ____________>>>heat
v ____________>>>pain
What is the name of the process by which phagocytic cells
v ____________>>>Swelling/edema are attracted to a substance such as a bacterial рeptide?
v ____________>>>Loss of function a.Diapedesis
Ø Stages:
a) Vascular response>>>Vasodilation (histamine) b.Degranulation
b) Cellular response: c.Chemotaxis
§ Neutrophils>>>________ mins (acute)
§ Monocytes>>>_________ hrs (chronic)
d.Phagocytosis
a) Resolution and repair>>>mediated by fibroblast
SLIDESMANIA.COM

SLIDESMANIA.COM
*____________ →is the movement of cells in a certain direction under the
stimulation of chemical substances while *___________→the passage of blood cells through the intact walls of
*____________ →is the coating of antibody and/or complement. Both of these the capillaries, typically accompanying inflammation
two processes help facilitate phagocytosis.

*_____________→the immediate response of tissue mast cells to

wounding, releasing preformed mediators into the local connective
Steps in Phagocytosis ____________ (C5a,LTB4,IL-4,N-formyl methionine)
Diapedesis tissue which results in the recruitment of cellular and soluble effectors
Adherence
Engulfment/ Opsonins (C3b, IgG)
Phagosome formation *__________→a specific form of endocytosis by which cells
Fusion/ Degranulation internalize solid matter, including microbial pathogens
_____________ (Respiratory burst)
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 28 Question # 29
___________is the movement of cells in a certain direction under Which immunoglobulin appears first in the primary immune
the stimulation of chemical substances while __________is the response?
coating of antibody and/or complement. Both of these two processes
a.IgG
help facilitate__________.
a.Engulfment - opsonization - phagocytosis
b.IgM
b.Opsonization - chemotaxis - engulfment c.IgA
c.Chemotaxis - degranulation - phagocytosis d.IgE
d.Phagocytosis - chemotaxis - opsonization
e.Chemotaxis - opsonization - phagocytosis
SLIDESMANIA.COM

SLIDESMANIA.COM

Primary Immune Response

Question # 30 Ø When antigen exposure occurs for the first time (__________), our body gives
the primary immune response. There is a latent period, wherein immediately
after the priming dose, no antibodies are detected in the serum. This is followed
The complement fixation (CF) test is especially sensitive to antibody
by a log phase in which active biosynthesis of antibodies takes place.
of the IgM class. Therefore, CF testing for antibodies should
a.be useful in detecting antibody transferred transplacentally to the Ø During the plateau, or steady-state, the serum concentration of antibodies
fetus. remains constant. Finally, a decline phase is observed, during which
b.be useful in detecting long-lasting antibodies. catabolism is greater than synthesis. Thus, the primary response is slow,
sluggish and short-living. It has a long lag phase of 5 to 7 days. Low titers of
c.correlate well with the results of delayed-type hypersensitivity
antibodies (_________) are persistent for short duration. The primary response
reactions. may take 14 days to resolve and generates memory cells.
d.yield a positive result early in infectious diseases.
SLIDESMANIA.COM

SLIDESMANIA.COM
Question # 31 Question # 32
Which of the following cells are the main mediators of humoral Cell mediated immunity is primarily dependent on
immunity? _______.
a.Regulatory T cells
а. В сеlls
b. B cells
c. Natural killer cells
b.T helper cells
d.Cytotoxic T cells c. Plasma cells
e.Helper T cells d. Dendritic cells
SLIDESMANIA.COM

SLIDESMANIA.COM

Acquired immunity/Adaptive immune system Additional Informations

§ Two types of immunity: § There are two kinds of immune responses and resulting immunity:
§ 1.humoral immunity
§ 2.cell-mediated immunity
1.Humoral or circulating antibody system (mainly dependent
§ __________ immunity →is based on serum antibodies that are produced by on _______)
plasma cells and bind to antigens in order to assist with their elimination.
2.Cell-mediated immunity (mainly dependent on ________)
§ __________ immunity → is based on the action of cytotoxic cells that activate
other immune cells and help eliminate pathogens and infected host cells.
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 33 Question # 34
What type of B cells are formed after antigen stimulation? Which of the following is a characteristic of B cells?
a.Plasma cells and memory cells a.phagocytic
b.Mature B cells b.participate in antibody-dependent cellular cytotoxicity
c.Antigen-Dependent cells (ADCC) reactions
d. Receptor-activated B cells c.contain surface immunoglobulins
d.Secrete the C5 component of complement
SLIDESMANIA.COM

SLIDESMANIA.COM
B cells
Question # 35 v Igs present on the B-cell surface behaves as specific receptors for antigens. When
an antigen enters our body, it reacts with the B-cells of appropriate specificity. This
Which of the following is NOT a characteristic of B cells? interaction stimulates B-cells to undergo blastoid transformation, converting them into
plasmablasts (clone formation) and finally into plasma cells, which produce and
a.Characterized by surface immunoglobulins secrete antibodies.
b.Differentiate into memory cells
Functions:
c.Differentiate into plasma cells ü To make antibodies against antigens
ü To perform the role of antigen-presenting cells (APCs)
d.Exhibit the CD4 antigen ü To develop into memory B cells after activation by antigen interaction
T cell
SLIDESMANIA.COM

SLIDESMANIA.COM

Additional Informations
Question # 36
Cells of the adaptive immune response
Which of the following immune cells is most effective at destroying Helps activate macrophages,
host cells that are infected with viruses? cytotoxic T cells, and B cells
Suppresses other cells of the
a.Cytotoxic T cells immune response
b.Natural killer cells Kills infected cells
c.Macrophages Produce antibodies
d.Plasma cells ______________________ →are effector cells that destroy virus-infected cells, tumor cells, and
e.B cells tissue grafts.
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 37 Secondary immune response

Which immunoglobulin appears in highest titer in the Ø A secondary immune response is observed when the same antigen enters the
body for a second time (i.e., ________). It can occur after weeks, months or even
secondary response? years. Following a booster dose, there is a markedly enhanced response
a.IgG characterized by an accelerated appearance of immunocompetent cells and
antibodies.
b.IgM
c.IgA Ø It has a very short and negligible latent phase of 2 to 3 days and ______levels of
d.IgE antibodies (______) lasting for a long period. Thus, the secondary response is
prompt, powerful and with a prolonged anamnestic or recall response.
SLIDESMANIA.COM

SLIDESMANIA.COM
Question # 38 Secondary immune response
How does the secondary humoral immune response differ from the primary In the secondary immune response, a certain type of cell called a
immune response? ‘______________’ becomes activated. This occurs upon the second or
a.the lag phase (the time between exposure to immunogen and production of subsequent exposure of the host to a particular antigen. Unlike the primary
antibody) is longer in the secondary immune response response, the secondary immune response is relatively faster and more effective
b.IgM is the predominant antibody class produced in the secondary immune in suppressing infections because of its _______antibody binding affinities. This
response is how __________ work. Since vaccines induce the initial primary immune
c.The antibody levels produced are higher in the secondary immune response response, the body responds more quickly and effectively upon re-exposure to the
d. Cytotoxic T lymphocytes play an important role in the secondary response same antigen (secondary response) from which the vaccine was made
SLIDESMANIA.COM

SLIDESMANIA.COM

__________ immunodeficiencies
>>>are a group of disorders caused by defects in the
Question # 39 immune system development and function.
The most common type of primary immunodeficiency o Epidemiology
o Complement deficiencies comprise 1-10 % of the total immunodeficiencies.
results from a primary defect in which type of the immune
cell? Type PID Cases

a.B cells B-cell/antibody ________

b.Combined T and B cells Combined T-cell and B- 20 %

cell
c.Antigen presenting cell Phagocytes 20 %
d. T cell T-cell 10%

e.Phagocytic cell
SLIDESMANIA.COM

SLIDESMANIA.COM

___________
Question # 40 v _____________ present on the B-cell surface behaves as specific __________ for
antigens. When an antigen enters our body, it reacts with the B-cells of appropriate
The B cell surface receptor for antigen is _____. specificity. This interaction stimulates B-cells to undergo __________transformation,
converting them into plasmablasts (clone formation) and finally into __________, which
a.Immunoglobulin produce and secrete ____________.
b.Interleukin 1
Functions:
c.Interleukin 2 ü To _______ antibodies against antigens
ü To perform the ______ of antigen-presenting cells (APCs)
d.MHC I antigen ü To develop into _________ B cells after activation by antigen interaction
SLIDESMANIA.COM

SLIDESMANIA.COM
Additional Informations Additional Informations
Interleukins and effects
Activates neutrophils _______
Differentiation and maturation of T and B cells _______ *_______________→Soluble mediators that serves as the language for cell
T cell activation factor _______ communication. Either immune / non-immune.
Activates NK cells IL-12
Activates B cells IL-4 and 6
Activates eosinophils _________
Inhibition of cytokine synthesis IL-10
Stimulates hematopoeitic cells IL-3
Regulates hematopoiesis _________
Proliferation of T cells, thymocytes, mast cells IL-9
Activates Tc cell ; LAK cells IL-2 (Lyphokine activated killer cells)
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 41 Antigen presenting cell (APC)

Cells that can act as antigen-presenting cells for >>>An immune cell that detects, engulfs, and informs the adaptive immune response about an
infection.
exogenous antigens include _____.
a.all nucleated cells >>>Cells that function as antigen presenting cells include _________ cells, __________ and
________ cells. Dendritic cells are the most effective of all the antigen presenting cells in the
b.endothelial cells initial immune response because they constitutively express those cell surface molecules
required for antigen presentation.
c.B lymphocytes
d.T lymphocytes
SLIDESMANIA.COM

SLIDESMANIA.COM

Antigen presenting cell (APC)

Question # 42
Examples of APCs:
1.Dendritic cells
Which of the following is the most effective antigen 2.Macrophages
presenting cell (APC) in the body? 3.B cells

a.microglial cells *Most common APC type:

§ ______________ → most effective of all the antigen presenting cells in the
b.mesangial cells initial immune response because they constitutively express those cell surface
c.dendritic cells molecules required for antigen presentation.
§ Macrophages
d.Kupffer cells
SLIDESMANIA.COM

SLIDESMANIA.COM
Macrophages

Question # 43 Macrophages→ specialized cells involved in the detection, ___________and destruction

of bacteria

Which of the following frequently functions as an antigen presenting Ø When macrophages are activated in immune responses, this increases their size, their
lysosomal enzyme content, their active metabolism, and phagocytic ability.
cell?
a.plasma cells
Type of macrophage Location
b.Macrophage _________ macrophage Lung alveoli
C.Natural killer cell Liver
d.T cell CNS
__________ macrophages Spleen
Kidney
SLIDESMANIA.COM

SLIDESMANIA.COM

Mitogens
Question # 44 ____________→ substances that trigger mitosis and
lymphocyte blastogenesis
Which of the following mitogens can activate B Mitogens
lymphocytes ? Mitogens Cells Activated
a.Phytohemagglutinins ____________ mitogens Both T and B
b.Concanavaline A lymphocytes
c.Lipopolysaccharide Lipopolysaccharide ___________
Phytohemagglutinins and __________
d.Phytohemagglutinins and Concanavaline A
concanavaline A
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 45 _______ recognition

Interaction between B and T helper cells involves_____. The protein ________ is processed within the _____cell and
a.MHC II molecule on B cell binding to MHC I molecule on the T cell presented with MHC II. The presented antigen is then recognized by
b.MHC II molecule on B cell binding to the CD3 on the T cell helper T (Th) cells specific to the same antigen. The ____cell
c.Foreign antigen on B cell binding to T cell receptor receptor (__CR) of the Th cell recognizes the antigen, and its CD4
d.CD3 molecule on B cell binding to T cell receptor molecule interacts with the MHC II on the B cell. This coordination
between B cells and Th cells is called _______recognition.
SLIDESMANIA.COM

SLIDESMANIA.COM
Common CD marker
Question # 46 T suppressor/cytotoxic CD ___

A human cell with CD8 on its surface is most likely a B cells CD ____
_____. NK cells CD ___
а. В сеll T-helper CD ___
b.Monocyte Thymocytes CD 1
c.T helper cell E rosette receptor CD 2
d.Cytotoxic T cell TCR CD ____
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 47 Lymphoid organs

Which two organs are considered the primary lymphoid organs Primary Lymphoid organs
in which immunocompetent cells originate and mature? ü Thymus
a.Thyroid and Peyer's patcher ü Bone marrow
b.Spleen and mucosal-associated lymphoid tissue (MALT)
c.Thymus and bone marrow ü Primary lymphoid organs include the ________, bursa of
d.Lymph nodes and thoracic duct fabricius, __________ and intestinal epithelium, wherein there is
antigen-independent proliferation and differentiation of
lymphocytes.
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 48 Lymphoid organs

Which of the following is a secondary lymphoid organ? Secondary lymphoid organs include _____ nodes, _________, and mucosa-
a.Spleen associated lymphoid tissue, wherein antigenic stimuli initiate immune responses in
lymphocytes. These are tactically positioned so that foreign antigens that enter through
b.Thymus
the bloodstream, peripheral tissues, and mucosal sites are skillfully trapped.
c.Bone marrow
d.Bursa of fabricius The structure of the secondary lymphoid tissues is such that it helps in the initiation of
adaptive responses. This is because of better interactions between dendritic cells that
bear the antigen, the B-cells and T-cells.
SLIDESMANIA.COM

SLIDESMANIA.COM
Lymphoid organs Question # 49
Secondary lymphoid organs T cells travel from the bone marrow to the thymus for maturation. What is the
correct order of the maturation sequence for T cells in the thymus?
§ Includes: ______nodes, ______, and mucosa-associated
a.Bone marrow to the cortex; after thymic education, released back to peripheral
lymphoid tissue circulation
§ Effective in trapping and concentrating foreign substances b.Maturation and selection occur in the cortex; migration to the medulla; release of
mature T cells to secondary lymphoid organs
§ Main sites of antibody production
c.Storage in either the cortex or medulla; release of T cells into the peripheral
§ Area where trapped antigen are engulfed by macrophages circulation
d. Activation and selection occur in the medulla; mature T cells are stored in the
cortex until activated by antigen
SLIDESMANIA.COM

SLIDESMANIA.COM

Thymus
Thymus Ø It is made of lobules, which are differentiated into an outer cortex and inner
medulla. The immature lymphocytes from the yolk sac, fetal liver and bone marrow
Ø Is a lymphoepithelial bilobed structure located behind the upper part of the travel to the________. Within the cortex of the thymus, they undergo changes such
sternum. It acquires a characteristic lymphoid appearance by the 3rd month of as maturation and attainment of specific surface characteristics. Furthermore,
gestation and increases in size during fetal development. It reaches maximum they move into the medulla of the thymus where lymphocytes complete their
size at birth, gradually decreases in size with age and finally atrophies. maturation process and exit into the blood.

Ø ___________ T-cells are further seeded into secondary lymphoid organs. It is a

major site for lymphocyte proliferation and production of T-lymphocytes,
wherein lymphocytes acquire new surface antigens.
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 50 Severe combined immunodeficiency (SCID)

Severe combined immunodeficiency (SCID) is an: o Genetic inheritance: ___ linked &_________
a.immunodeficiency with decreased B cells and neutrophils.
o Occurs in early stage of life (3 months)
b.immunodeficiency with lymphocytopenia and Eosinophilia.
c.immunodeficiency with decreased or dysfunctional T and B cells. o Pneumocystic pneumonia is the most common
d. immunodeficiency with decreased lymphocytes and decreased finding
complement concentration.
SLIDESMANIA.COM

SLIDESMANIA.COM
Question # 51 Question # 52
Loss of self tolerance results in_______. Non-responsiveness to potent antigentic stimulation
a.autoimmune disease arising from T cell dysfunction is called?
b.graft-versus-host disease a.allergy
c.immunodeficiency b.delayed hypersensitivity
d.tumors c.anergy
d.immune tolerance
SLIDESMANIA.COM

SLIDESMANIA.COM

Additional Informations
*Immune _____________→Specific immunologic unresponsiveness
>>>An immune response to a certain antigen does not occur, although

MHC (Major
the immune system is functioning normally.A defect in this mechanism leads to
autoimmunity
*Anergy→ non-responsiveness to potent antigentic stimulation arising from T cell
dysfunction
Histocompatibility Complex)
*Allergy → the body's reaction to a normally harmless substance such as pollen, molds,
animal dander, latex, certain foods and insect stings.

*____________ hypersensitivity →is a common immune response that occurs through

direct action of sensitized T cells when stimulated by contact with antigen(usually require
12–24 hours at a minimum for signs of inflammation to occur locally)
SLIDESMANIA.COM

SLIDESMANIA.COM

MAJOR HISTOCOMPATIBILITY COMPLEX

Question # 53
>>>Found on the _____________________
Short arm of chromosome 6 is where: >>>MHC gene products are responsible for ___________
a.ABO genes are found >>> Role in intercellular recognition and discrimination of
b.MHC genes are found ______________
c.Rh genes are found >>> Also plays a role in susceptibility to diseases and
d.H genes are found autoimmunity
SLIDESMANIA.COM

SLIDESMANIA.COM
_______ are products of genes responsible for coding the Major
Histocompatibility Complexes located in the short arm of
Question # 54 chromosome 6. ABO genes are located in long arm of chromosome
9; Rh in short arm of chromosome 1; and H genes are located
The HLA antigens are encoded by the genes of _______. in the long arm of chromosome 19.
a.Major Histocompatibility Complex Short arm of chromosome 6
b.Lr (immune response) system
c.Hh blood group system Long arm of chromosome 9
d. Lymphokine system Short arm of chromosome 1
Long arm of chromosome 19
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 55 MHC Class I Class II

Distribution All nucleated Ag presenting cells
cells
Which MHC class of antigens is necessary for antigen Gene products HLA-A,B,C HLA-DQ, DP, DR
recognition by CD4-posițive T cells? Peptides Endogenous Exogenous
a.Class I T cell

b.Class II
c.Class III
d.No MHC molecule is necessary for antigen
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 56

Cytokines and A thermolabile protein present in normal serum is known

as _______.
complement system a.Amboceptor
b.Antibody
c.Buffer
d.Complement
SLIDESMANIA.COM

SLIDESMANIA.COM
Complement
Question # 57 § The term was coined by _________
§ ____________ won the Nobel Prize for elucidating the nature of Complement
§ Synthesized in the ________,except for:
All of the following are immunological functions of 1.C1
complement ,EXCEPT: 2.Factor D
Major functions:
a.Induction of an antiviral state ü _____________
b.Opsonization ü Inflammatory response
ü Chemotaxis
c.Chemotaxis § The complement system is part of the nonspecific immune response, but because it
d.Anaphylatoxin formation can also be activated by components of the specific immune response, the complement
system serves as a connection between both systems.
§ _____________ (inactivated by heating serum at ______ 0C for 30 mins)
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 58 Question # 59
In the classical pathway of complement : Calcium ions are necessary in the activation of
a.C3 is activated by binding C-reactive protein. complement in that these:
b.the sequence of activation is C1, C2, C3 then C4. a.activate C4b2a complex.
c.C1q is activated by the presence of a single Fab region. b.stabilize Clq, Clr, Cls a unit.
d. activation by antibody requires one IgM or two IgG. c.cleave Cls to become enzymatically active.
d.allow interaction between C3 and Factor B.
SLIDESMANIA.COM

SLIDESMANIA.COM

Classical Pathway
Ø Triggered by ____________
Ø Activators: Question # 60
ü ______>>>best in complement fixation(pentameric)
ü ________>>>atleast 2 molecules of IgG
ü CRP Which of the following immunoglobulins can activate the
alternative pathway of the complement system?
Ø Units
a.IgA
§ Recognition unit: C1
§ Consists of a complex of 3 subunits: b.IgE
1.C1q c.IgM
2.C1r
3.C1s d. IgD
§ Stabilized by __________
SLIDESMANIA.COM

SLIDESMANIA.COM
Alternative Pathway/Properdin Pathway
Question # 61
Triggering factors:
The alternative complement pathway:
§ ________/endotoxin (gram (-) organism)
a.can be activated by bacterial capsule polysaccharide
§ Fungal cell wall
b.uses C5b as a C3 convertase
§ Cobra venom factor
c.bypasses steps C3 through C5
§ Aggregated _______
d.is inactivated by properdin
Note: ________→ stabilizes the C3 convertase of the
alternative pathway
SLIDESMANIA.COM

SLIDESMANIA.COM

Question # 62. Question # 63

Which of the following is not part of the membrane attack The membrane attack complex is comprised of which of
complex? the ff. complement components?
a.С4 а. С4ЬС2а
b.C5 b.C5b6789
c.С7 c.C3bBb
d.C9 d.C3bBb3b
e.C4b2aC3b
SLIDESMANIA.COM

SLIDESMANIA.COM

Membrane Attack Complex (MAC) Question # 64

v ___________ Which complement protein is present in the greatest
Induces the formation of hollow cylinders (tubules) in concentration in human serum ?
the lipid bilayer of the cell membrane allowing exit of a.C1
electrolytes & water out of the cell b.C2
c.C3
d.C4
e.C5
SLIDESMANIA.COM

SLIDESMANIA.COM
Proteins of the Complement System
Classical Pathway
Serum Protein Concentration(ug/mL Function Question # 65
)
C1q 150 Binds to Fc region of IgM and IgG
A person has an inherited disorder that prevents expression of the complement
50 Activates Cls
component C3. What would be the expected effect of this defect?
50 Cleaves C4 and C2
a.Inability to activate complement by either the classical or the alternate pathway
C4 300-600 Part of C3 convertase (C4b)
b.Inability to activate complement by the alternate pathway
C2 25 Binds to C4b-forms C3 convertase
c. Inability to activate complement by the classical pathway
Key intermediate in all pathways
d. Increased susceptibility to viral infections but not to gram-positive bacterial
80 Initiates membrane attrck complex
infections
C6 45 Binds to C5b in MAC
C7 90 Binds to C5bC6 in MAC
55 Starts pore formation on membrane
60 Polymerizes to cause cell lysis
SLIDESMANIA.COM

SLIDESMANIA.COM

COMPLEMENT COMPONENTS AND DISEASE ASSOCIATIONS

Complement component Disease associated with its deficiency

Question # 66
C2 and C4 Immune complex disorders (LE-like
syndromes)
C3 Severe, recurrent, life threatening pyogenic
infections with encapsulated bacteria
C5,6,7,8 Recurrent infections with Neisseria species The enzyme that cleaves Factor B to Bb ( and Ba )
GPI linkages (DAF, CD59 or MIRL)
*GPI→ Glycosylphosphatidylinositol
Paroxysmal Nocturnal Hemoglobinuria
(PNH)
is_____ ?
DAF/CD55→decay-accelerating factor
*MIRL/CD 59→membrane inhibitor of reactive lysis
a.Factor B
C1 INH Hereditary Angioneurotic Edema (HANE) b.Factor I
Take note: >>>Deficiency of _________→ is by far the _______ complement deficiency since
it affects both the classical and alternative pathway.
c.Factor D
>>>______deficiency → is the most common _________deficiency. d.C1
SLIDESMANIA.COM

SLIDESMANIA.COM

Proteins of the Complement System

Alternative Pathway
Serum Protein Function Precipitation reactions,
Factor ______ Binds to C3b to form C3 Agglutination and Labelled
convertase
Cleaves factor ___ Immunoassays
Properdin Stabilizes C3bBb-C3
convertase
SLIDESMANIA.COM

SLIDESMANIA.COM
Precipitation
Question # 67 § First noted in 1897 by Kraus
§ involves combining ________ antigen with __________ antibody to produce
When soluble antigens and antibodies are made to react, i________ immune complexes that are visible
the principle is ______.
Ø Precipitation Curve
a.Passive agglutination • _______________- number of multivalent sites of antigen and antibody are
b.Direct agglutination approximately equal; each antibody binds to more than 1 antigen forming a
stable network or lattice
c.Indirect agglutination • Prozone >>>excess _______
d.Reverse passive agglutination • ___________>>>excess Ag
e.Precipitation
SLIDESMANIA.COM

SLIDESMANIA.COM

Agglutination
Direct Agglutination Indirect agglutination/Passive agglutination
In direct agglutination insoluble
particulate antigens are combined with
In passive particle (indirect) agglutination, soluble antigens
are coupled to large particles such as erythrocytes or latex
Question # 68
soluble antibodies to form antigen- spheres. When specific antibodies are added to coated
antibody complexes.This results to the erythrocytes or latex spheres, antibody bridges are formed Reverse passive agglutination is a type of agglutination reaction in which _______ is affixed
formation of clumps or agglutinations. between the particles, and agglutination occurs.
in the particle carrier to detect antigens .An example of this is_______.
1.antibodies
ü detection of ___________ ü detection of an _________
ü Examples: ü ____________ (attached to a carrier) 2.antigens
ü Bacterial agglutination tests ü Carriers: 3.CRP latex agglutination test
ü For sero-typing and sero- 1. Cells 4. ASO latex agglutination test
grouping(e.g.,Vibrio 2. Bacteria
Cholerae,Salmonella spp.) 3. Latex
a.1-2-3
4. Charcoal b.1-2-4
5. Bentonite c.2-1-3
d.2-1-4
SLIDESMANIA.COM

SLIDESMANIA.COM

Reverse passive agglutination Question #69

Reverse passive agglutination is a type of agglutination reaction in which antibodies is
All of the following causes false positive agglutination
affixed in the particle carrier to detect antigens .An example of this is CRP latex
agglutination test . EXCEPT:
CRP>>>Antibodies are coated with latex
a.Post zone phenomenon
b.Heterophile antibodies
c.Use of saline stored in glass
d.Delay in reading slide test
SLIDESMANIA.COM

SLIDESMANIA.COM
FALSE REACTIONS IN AGGLUTINATION TESTING
FALSE POSITIVE REACTION FALSE NEGATIVE REACTION
________centrifugation ________centrifugation
Contaminated glasswares, slides or Inactive reagents (due to improper
reagents storage) Question # 70
Autoagglutination Inadequate washing (unbound
immunoglobulins that are not Which of the following is/are clinical manifestations of Type
removed can neutralize AHG
reagent) I hypersensitivity?
Saline stored in glass bottles Delays in testing procedure (In a.Asthma
(leaching of colloidal silica) antiglobulin testing, antibody is
eluted from the RBCS) b.Contact dermatitis
Presence of ___________, _______ and c. Pneumonitis
heterophile antibodies and RF _________phenomenon
Delay in reading slide test Failure to add antiglobulin reagent d. Asthma and Pneumonitis
SLIDESMANIA.COM

SLIDESMANIA.COM

_________ Type II ___________ Туре IV

Release of __________ due to _________ of Release of
mediators of antibody and antigen- antibody cytokines

“Cast thy burden upon the LORD, and

inflammation from complement bound complexes (mediated by
____ cells and to membrane ______cells)
_________
he shall sustain thee:he shall never
1.Anaphylaxis
2.Hay fever
1.Transfusion
reactions
1.Serum sickness
2.Arthus reaction
1.______________
2.Tuberculin test
suffer the righteous to be moved.”
3._________
4.Asthma
2.Autoimmune
hemolytic anemia
3.Lupus
erythematosus
3.Pneumonitis
4.______________ Psalms 55:22
3.HDN 5.Poison ivy
SLIDESMANIA.COM

Thank you!